Guadalupe Garcia-Tsao

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..The role of probiotics is examined in the following areas: a) prevention of infection, b) the hyperdynamic circulatory state of cirrhosis, c) hepatic encephalopathy, d) liver function, and e) nonalcoholic fatty liver disease...

..Liver involvement in patients with this disease has not been fully characterized...

..Report on significant advances in the pathophysiology, diagnosis, and management of the complications of portal hypertension that have occurred in the last year...

..A rational management of cirrhosis will result in improvements in quality of life, treatment adherence, and, ultimately, in outcomes...

..Papers were considered if they were published in English and if they included specific cases that were sufficiently described...

..Significant advances in the pathophysiology, diagnosis and management of the complications of portal hypertension that have occurred in the last year are reported...

..Vasoconstrictors are useful bridging therapies in HRS. Ultimately, liver transplantation is indicated in otherwise reasonable candidates in whom AKI does not resolve with specific therapy...

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..Preliminary data suggest that cryotherapy may be a reasonable option for diffuse GAVE lesions. Neither beta-blockers nor TIPS reduces the bleeding risk in patients with GAVE and thus should not be used in this setting...

..This chapter presents evidence regarding gut flora and its modification in the pathogenesis and management of these complications of cirrhosis...

..Patients who recover from an episode of SBP should be given long term prophylaxis with norfloxacin and should be assessed for liver transplantation...

..Predictors of the development of hepatocellular carcinoma (HCC), including hepatic venous pressure gradient (HVPG) were analyzed...

..The aim of this study was to explore the association of serum fibrosis marker levels with the risk of clinical and histological disease progression in a large cohort of patients with chronic hepatitis C (CHC)...

..For patients not undergoing transplantation, HRS reversal with terlipressin and/or albumin improves survival...

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..In this study, we sought to investigate the factors that influence patients' decisions as they consider treatment for hepatitis C infection...

..The objective of this study was to ascertain patient preferences for treatment of hepatitis C virus (HCV)...

..Beyond pathophysiological implications, this also has methodological implications that are discussed in this article...

..ClinicalTrials.gov number, NCT00006398.)..

..Our aim was to assess the relationship of iron and HFE genetic variations to progression and outcomes in the HALT-C Trial and whether PegIFN therapy influenced iron variables...

..The aim of this study was to evaluate the effect of sildenafil on systemic and portal hemodynamics in an open-label pilot study...

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..In the United States, neither previous nor occult HBV infection is an important factor in HCC development among patients with advanced chronic hepatitis C...

..The aim of this study was to evaluate the efficacy and safety of terlipressin, a systemic arterial vasoconstrictor, for cirrhosis type 1 HRS...

..Physicians should discuss both EVL and beta-blockers with patients requiring primary prophylaxis for variceal hemorrhage. Future guidelines should incorporate individual patient preferences...

..This article describes a practical approach to the management of cirrhotic patients who have gastroesophageal varices...

..However, the specific use of each of these therapies depends on the setting (primary or secondary prophylaxis, treatment of AVH) and on patient characteristics. The indications for each are summarized in Table 4...

..To improve stratification of patient care, we performed a systematic review to identify the most robust predictors of mortality in cirrhotic patients with SBP...

..This article reviews the pathophysiologic bases of the different pharmacologic treatments for portal hypertension in patients with cirrhosis and places them in the context of the natural history of varices and variceal hemorrhage...

..Although there are many studies of the predictors of death in hepatocellular carcinoma (HCC), most combine patients with and without cirrhosis and many combine those with compensated and decompensated cirrhosis...

..Patients who fail aggressive medical therapy and those with acute biliary/hepatic necrosis should be considered for liver transplantation...

..Multiphasic CT is useful in diagnosing liver involvement due to HHT; however, no strong correlation was seen between CT findings and the clinical subtype of HHT liver disease...

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..Many reports in the "C" recommendations were significant but fell short of receiving stronger ratings because of the size of reported patient studies, and also the factors that limited categories to the "B" rating...

..Vasoconstrictors could be used instead of albumin and, with longer use, prevent PCD and delay ascites recurrence...

..Prevention of recurrent variceal hemorrhage consists of the combination of β-blockers and endoscopic band ligation...

..To conduct a qualitative study to elicit patients' descriptions of their own experiences with treatment for hepatitis C (HCV)...

..69, P <.01). In conclusion, in cirrhotic animals BT appears to lead to endotoxemia, stimulation of GTPCH-I, increased BH(4) synthesis, and further enhancement of vascular NO production that leads to aggravation of vasodilatation...

..We performed a prospective, case-control study to investigate the effects of analgesics on acute hepatic decompensation...

..Exposure to systemic antibiotics is a risk factor for AR-BI; however, little is known about the effects of the increasingly used oral nonabsorbed antibiotics...

..Serum fibrosis marker levels during the lead-in treatment phase of patients enrolled in the Hepatitis C Antiviral Long-term Treatment against Cirrhosis (HALT-C) trial were determined...

..Future research in the field of BT in cirrhosis will allow the development of new therapeutic targets in the prevention of infections and other complications of cirrhosis...

..However, its effect on survival and healthcare costs is still uncertain...

..We review the pathogenesis and management of these complications, the role of adrenal insufficiency, and the utility of intensive care prognostic models...

..Patients with mild portal hypertension whose PLT remains greater than 100,000 have significantly less risk of GEV. Although HVPG correlates somewhat with PLT, changes in PLT cannot be used as a surrogate for HVPG changes...

..Possible mechanisms underlying this health discrepancy are not clear, but increased awareness of PBC as a cause of chronic cholestatic liver disease is critical in evaluating non-Caucasian patients in the United States...

..While the histologic diagnosis of AML in a surgical resection specimen is often straightforward, the radiographic, cytologic and intra-operative interpretation of a case with multiple lesions presents a considerable challenge...

..CONCLUSION: The ELF algorithm is a highly accurate noninvasive measure of PBC disease severity that provides useful long-term prognostic information...

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..In conclusion, methotrexate when added to UDCA for a median period of 7.6 years had no effect on the course of PBC treated with UDCA alone...

..Renewal of the award will allow Dr. Garcia-Tsao to maintain both POR and her mentoring endeavors to their fullest extent so she can continue to make significant contributions in the field of chronic liver disease and its complications. ..