Publications by authors named "Christiana Graf"
Article Synopsis
- A study assessed a new ultrasound-based algorithm for determining when to remove pancreatic stents placed to prevent post-ERCP pancreatitis, aiming to minimize unnecessary X-ray imaging.
- Out of 88 patients, the ultrasound approach successfully reduced the need for X-rays by 74%, accurately visualizing stents in 81% of cases but with limited specificity.
- The authors recommend implementing the ultrasound algorithm with training for experienced personnel due to challenges with visualizing shorter stents.
Background: Acute liver failure (ALF) secondary to metastatic melanoma presents a rare and diagnostically challenging clinical scenario.
Case Report: We report the case of a 57-year-old male who succumbed to fulminant liver failure attributed to hepatic infiltration by malignant melanoma. Despite extensive diagnostic evaluation, the underlying cause of ALF remained elusive until postmortem examination revealed multifocal metastatic melanoma.
Background And Aims: Data on the prevalence and characteristics of so-called rare HCV genotypes (GTs) in larger cohorts is limited. This study investigates the frequency of rare GT and resistance-associated substitutions and the efficacy of retreatment in a European cohort.
Methods: A total of 129 patients with rare GT1-6 were included from the European resistance database.
Background: In 2016, the World Health Organization propagated the elimination of hepatitis C virus (HCV) by 2030 in order to address the public health threat posed by viral hepatitis. This article looks at the progress that has been made globally and in Germany since 2016.
Methods: A selective literature search was conducted, with particular focus on studies and reviews relating to the elimination of hepatitis C infection both globally and in Germany.
Background & Aims: Voxilaprevir/velpatasvir/sofosbuvir (VOX/VEL/SOF) is highly effective for re-treatment of direct-acting antiviral (DAA)-experienced patients with chronic HCV infection. In the present study, predictors of virologic treatment response were analyzed in an integrative analysis of three large real-world cohorts.
Methods: Consecutive patients re-treated with VOX/VEL/SOF after DAA failure were enrolled between 2016 and 2021 in Austria, Belgium, Germany, Italy, Spain and Switzerland.
Article Synopsis
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Article Synopsis
- - The study investigates the effectiveness of endoscopic bougienage for treating benign esophageal strictures, focusing on how the timing between dilation sessions influences patient outcomes.
- - A total of 238 patients were analyzed from two centers, revealing that those treated with more frequent dilation sessions achieved better clinical results, except for patients with strictures caused by radiation, who did better with less frequent sessions.
- - The findings suggest that a higher frequency of bougienage generally results in faster symptom relief and better dilation outcomes, while specific cases like radiogenic strictures may require different treatment intervals for optimal results.
Introduction: Standardization of diagnostic criteria of autoimmune hepatitis (AIH) and primary biliary cholangitis (PBC) variant syndrome (AIH-PBC VS) has not been achieved so far and evidence-based recommendations for monitoring and treatment of the disease are still lacking. Our study aimed to assess the prevalence, biochemical, and serological features, as well as the clinical course, of VS.
Methods: We performed a retrospective study including all patients with VS between 1999 and 2020 in four German centers.
Article Synopsis
- Falciparum malaria is a serious disease mainly affecting travelers in Germany, with unclear rates of co-infection and insufficient rationale for antibiotic therapy alongside malaria treatment.
- A study conducted on 264 malaria patients showed that 64% received antibiotics, but only 11% had significant bacterial co-infections, while severe malaria didn't correlate with higher co-infection rates.
- The findings suggest that bacterial co-infections in malaria cases are uncommon but highlight the need for personalized risk assessments rather than a blanket approach to antibiotic use.
Article Synopsis
- Recent studies show that ongoing HCV infections are mainly transmitted through drug use and sexual behaviors, particularly among men who have sex with men (MSM), but the details of transmission and infection progression remain unclear.
- After following 161 patients with recently acquired HCV infections over 10 years, it was found that most were male MSM, many of whom were also HIV-positive, and their main transmission risks were sexual behavior and drug use.
- The findings indicate low spontaneous clearance rates of the infection, significant phylogenetic clustering among MSM cases, and a rise in specific HCV genotypes over time, highlighting the need for targeted interventions in high-risk groups.
Background: Non-anastomotic biliary strictures (NAS) are a common cause of morbidity and mortality after liver transplantation.
Methods: All patients with NAS from 2008 to 2016 were retrospectively analyzed. The success rate and overall mortality of an ERCP-based stent program (EBSP) were the primary outcomes.
Article Synopsis
- A study investigated risk factors for wound infections in patients who underwent percutaneous endoscopic gastrostomy (PEG) insertions, tracking over 600 cases for three years.
- Of those studied, 25% developed wound infections, with higher risks associated with nicotine use, history of ischemic stroke, and head and neck cancer.
- The most common bacteria found in these infections were Enterobacterales, and the study concluded that antibiotic prophylaxis did not significantly reduce infection rates, indicating a need for better clinical practices.
Article Synopsis
- The study aimed to evaluate olfactory dysfunction (OD) in both SARS-CoV-2 positive and negative patients to see if it could help identify COVID-19 infections early.
- Results showed that OD was present in 65.6% of COVID-19 positive patients and was more common in males and those with certain health conditions, with a notable increase in cases linked to the Delta variant compared to Omicron.
- Despite these findings, the sensitivity (69%) and specificity (64%) of OD as a diagnostic tool for identifying COVID-19 were deemed insufficient for it to be used routinely in clinical settings.
Objectives: Since 2013, heater-cooler unit (HCU) associated Mycobacterium chimaera infections linked to a global outbreak have been described. These infections were characterised by high morbidity and mortality due to delayed diagnosis, as well as challenges in antimycobacterial and surgical therapy. This study aimed to investigate the clinical characteristics and outcome of published cases of HCU-associated M.
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- Tuberculosis (TB) is mainly caused by the M. tuberculosis complex, with pulmonary tuberculosis being the typical form, but extrapulmonary TB (EPTB) is increasingly observed in certain regions.
- A study at University Hospital Frankfurt from 2013 to 2018 analyzed TB cases, revealing that 81.7% of patients were born outside Germany, with certain WHO regions showing a higher occurrence of EPTB.
- Countries like India, Nepal, and Turkey were significantly linked to higher rates of EPTB, suggesting that geographical origin impacts diagnosis timing, immune system response, and potential virulence factors in the bacteria.
Background & Aims: Data on the long-term persistence of HCV resistance-associated substitutions (RASs) after treatment with direct-acting antivirals (DAAs) are limited. This study evaluated the persistence of NS3, NS5A, and NS5B RASs for up to 5 years after the end of treatment (EOT).
Methods: We included samples from 678 individuals with an HCV genotype (GT) 1 or 3 infection and virologic DAA treatment failure collected in the European Resistance Database.
Article Synopsis
- The study emphasizes the importance of accurately assessing risks in patients with Acute-on-Chronic Liver Failure (ACLF), as it is linked to high short-term mortality, particularly for liver transplant decisions.
- The research found that patients with pulmonary impairment face significantly higher mortality rates, with those experiencing pulmonary failure having an alarming 83.7% mortality within 28 days.
- Adjusting the CLIF-C ACLF score to account for the level of pulmonary impairment can improve the prediction of outcomes, suggesting that both pulmonary failure and mechanical ventilation are critical factors for evaluating the prognosis of ACLF patients.
Purpose: To assess and correlate pulmonary involvement and outcome of SARS-CoV-2 pneumonia with the degree of coronary plaque burden based on the CAC-DRS classification (Coronary Artery Calcium Data and Reporting System).
Methods: This retrospective study included 142 patients with confirmed SARS-CoV-2 pneumonia (58 ± 16 years; 57 women) who underwent non-contrast CT between January 2020 and August 2021 and were followed up for 129 ± 72 days. One experienced blinded radiologist analyzed CT series for the presence and extent of calcified plaque burden according to the visual and quantitative HU-based CAC-DRS Score.
Purpose: The study sought to assess the performance of D-dimer testing for the diagnosis of acute coronary syndrome (ACS) and prediction of outcomes in patients admitted for suspected myocardial infarction (MI).
Results: A total of 3,557 patients with suspected ACS presenting to a single center with a broad range of symptoms including atypical chest pain were retrospectively recruited between 02/2012-01/2019. Of the study cohort, 435 patients had unstable angina (UA), 420 non-ST-segment elevation myocardial infarction (NSTEMI), 22 ST-segment elevation myocardial infarction (STEMI), and 2,680 non-coronary chest pain.
Article Synopsis
- Mycobacterium genavense is a slow-growing bacterium primarily infecting immunocompromised individuals, particularly those with HIV, but also increasingly seen in non-HIV patients, resulting in difficult-to-treat infections.
- A meta-analysis of 223 cases from 1992 to 2021 revealed gastrointestinal-related symptoms, such as abdominal pain and splenomegaly, as prominent clinical manifestations, with over 90% of patients receiving antimycobacterial treatment.
- The study found high mortality rates associated with these infections, but indicated that regimens including macrolides might improve survival outcomes.
Article Synopsis
- - The study investigated hepatic sarcoidosis in a mainly Caucasian group of 62 patients, revealing that 4.2% of sarcoidosis patients have liver involvement, with many being asymptomatic and showing cholestatic liver enzyme patterns.
- - Out of the patients, 14.5% developed cirrhosis, with some experiencing complications like portal hypertension; treatments like glucocorticoids and ursodeoxycholic acid led to significant improvements in alkaline phosphatase levels.
- - Overall, the findings emphasize the need for early detection and monitoring of hepatic sarcoidosis due to the potential for serious complications, although none of the patients required liver transplantation or developed liver cancer during the study period.
Introduction: Disseminated infection due to non-tuberculous mycobacteria has been a major factor of mortality and comorbidity in HIV patients. Until 2018, U.S.
View Article and Find Full Text PDFChronic viral hepatitis is associated with substantial morbidity and mortality worldwide. The aim of our study was to assess the ability of point shear-wave elastography (pSWE) using acoustic radiation force impulse imaging for the prediction of the following liver-related events (LREs): new diagnosis of HCC, liver transplantation, or liver-related death (hepatic decompensation was not included as an LRE). pSWE was performed at study inclusion and compared with liver histology, transient elastography (TE), and serologic biomarkers (aspartate aminotransferase to platelet ratio index, Fibrosis-4, FibroTest).
View Article and Find Full Text PDFBackground & Aims: There are limited data on patients with chronic HCV infection in whom combination voxilaprevir (VOX), velpatasvir (VEL), sofosbuvir (SOF) retreatment fails. Thus, we aimed to assess treatment failure and rescue treatment options in these patients.
Methods: Samples from 40 patients with HCV genotypes (GT) 1-4 in whom VOX/VEL/SOF retreatment failed were collected within the European Resistance Study Group.