Publications by authors named "Graupera I"

Background: Clinically significant liver fibrosis is associated with future adverse events in patients with steatotic liver disease. We designed a software tool for detection of clinically significant liver fibrosis in primary care.

Methods: In this prospective cohort study, we developed and validated LiverPRO using six independent cohorts from Denmark, Germany, and England that included patients from primary and secondary care with steatotic liver disease related to alcohol or metabolic dysfunction.

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Background & Aims: Expression of P21, encoded by the gene, has been associated with fibrosis progression in steatotic liver disease (SLD); however, the underlying mechanisms remain unknown. In the present study, we investigated the function of CDKN1A in SLD.

Methods: expression levels were evaluated in different patient cohorts with SLD, fibrosis, and advanced chronic liver disease (ACLD).

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Background & Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of advanced chronic liver disease (ACLD). Portal hypertension drives hepatic decompensation and is best diagnosed by hepatic venous pressure gradient (HVPG) measurement. Here, we investigate the prognostic value of HVPG in MASLD-related compensated ACLD (MASLD-cACLD).

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Many countries have incorporated population screening programmes for cancer, such as colorectal and lung cancer, into their health-care systems. Cirrhosis is more prevalent than colorectal cancer and has a comparable age-standardized mortality rate to lung cancer. Despite this fact, there are no screening programmes in place for early detection of liver fibrosis, the precursor of cirrhosis.

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Background & Aims: The management of acute kidney injury (AKI) in cirrhosis is challenging. The EASL guidelines proposed an algorithm for the management of AKI, but this has never been validated. We aimed to prospectively evaluate this algorithm in clinical practice.

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Background And Aims: Early detection of liver fibrosis is believed to promote lifestyle changes. We evaluated self-reported changes in alcohol intake, diet, exercise, and weight after participating in a screening study for liver fibrosis.

Methods: We conducted a prospective screening study of individuals at risk of alcohol-related liver disease (ALD) or metabolic dysfunction-associated steatotic liver disease (MASLD).

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Background & Aims: Alcoholic foamy degeneration (AFD) is a condition with similar clinical presentation to alcohol-associated hepatitis (AH), but with a specific histologic pattern. Information regarding the prevalence and prognosis of AFD is scarce and there are no tools for a noninvasive diagnosis.

Methods: A cohort of patients admitted to the Hospital Clinic of Barcelona for clinical suspicion of AH who underwent liver biopsy was included.

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Background: Patients with decompensated cirrhosis experience high mortality rates. Current prognostic scores, including the model for end-stage liver disease (MELD), may underperform in settings other than in those they were initially developed. Novel biomarkers have been proposed to improve prognostication accuracy and even to predict development of complications.

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Background: Non-alcoholic fatty liver disease (NAFLD) is rapidly increasing alongside overweight and obesity, not only in adults but also in children and adolescents. It is unknown what impact the development of NAFLD in childhood may have in later life. The importance of early detection and treatment lies in its potential for progression to cirrhosis, liver cancer and liver-related death, as well as its associated extrahepatic comorbidities.

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Article Synopsis
  • The study explores how adipose tissue macrophages (ATMs) are linked to liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) and assesses the impact of altering ATMs in a mouse model of non-alcoholic steatohepatitis (NASH).
  • Researchers analyzed adipose tissue and liver biopsies from 42 NAFLD patients, finding a correlation between increased pro-inflammatory ATMs and higher stages of liver fibrosis.
  • Modulating ATMs through a specific treatment notably reduced inflammation and fibrosis progression in the experimental NASH model, suggesting a potential therapeutic approach for managing liver damage in NAFLD.
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  • Liver cirrhosis is a significant global health issue that often goes undiagnosed until severe complications arise, highlighting the need for tools to identify at-risk individuals earlier.
  • Researchers developed the LiverRisk score, utilizing demographic and lab data from a large international cohort to categorize individuals into different risk groups for future liver-related issues.
  • The LiverRisk score demonstrated superior predictive accuracy for liver stiffness and related outcomes compared to existing serum biomarkers, effectively aiding in the identification of those at heightened risk for liver disease complications.
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Progressive hepatic damage and fibrosis are major features of chronic liver diseases of different etiology, yet the underlying molecular mechanisms remain to be fully defined. N-RAS, a member of the RAS family of small guanine nucleotide-binding proteins also encompassing the highly homologous H-RAS and K-RAS isoforms, was previously reported to modulate cell death and renal fibrosis; however, its role in liver damage and fibrogenesis remains unknown. Here, we approached this question by using N-RAS deficient (N-RAS) mice and two experimental models of liver injury and fibrosis, namely carbon tetrachloride (CCl) intoxication and bile duct ligation (BDL).

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Background & Aims: There is a need for accurate biomarkers of fibrosis for population screening of alcohol-related and non-alcoholic fatty liver disease (ALD, NAFLD). We compared the performance of the enhanced liver fibrosis (ELF) test to the fibrosis-4 index (FIB-4) and NAFLD fibrosis score (NFS), using transient elastography as the reference standard.

Methods: We prospectively included participants from the general population, and people at risk of ALD or NAFLD.

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Mitochondrial reactive oxygen species (mROS) are central to physiology. While excess mROS production has been associated with several disease states, its precise sources, regulation, and mechanism of generation remain unknown, limiting translational efforts. Here we show that in obesity, hepatic ubiquinone (Q) synthesis is impaired, which raises the QH /Q ratio, driving excessive mROS production via reverse electron transport (RET) from site I in complex I.

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Article Synopsis
  • Transient elastography (TE) has been widely used for nearly 20 years to diagnose liver fibrosis and has now expanded to include population screening and assessment of liver complications.
  • A working group of doctors and nurses conducted an online survey to create updated guidelines, using a structured approach to ensure comprehensive evaluation.
  • The updated document, backed by the Catalan Society of Gastroenterology, emphasizes TE as a reliable method for evaluating liver health and managing cirrhosis complications.
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  • * Findings reveal that 28% of patients experienced acute decompensation, with ascites being the most common issue, alongside other complications like hepatic encephalopathy and variceal bleeding.
  • * The research identifies factors such as low albumin levels and the presence of ischemic heart disease that increase the risk of decompensation and highlights a notable incidence of cancers among these patients, with 18% developing hepatocellular carcinoma or extrahepatic cancers.
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Background & Aims: The COVID-19 pandemic has had a major negative impact on health systems and many chronic diseases globally. We aimed to evaluate the impact of the first year of the pandemic on the outcomes of people with NAFLD cirrhosis.

Methods: We conducted a before-after study in four University hospitals in Catalonia, Spain.

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Background: The development of liver cirrhosis is usually an asymptomatic process until late stages when complications occur. The potential reversibility of the disease is dependent on early diagnosis of liver fibrosis and timely targeted treatment. Recently, the use of non-invasive tools has been suggested for screening of liver fibrosis, especially in subjects with risk factors for chronic liver disease.

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Article Synopsis
  • Scientists are trying to understand how liver diseases get worse, leading to serious conditions like cirrhosis and liver failure.
  • They studied liver samples from different stages of disease and made special protein networks to find out what happens in the liver as the disease progresses.
  • They discovered that certain processes like inflammation and cell death become more active as liver disease worsens, especially when it reaches the severe stage called acute-on-chronic liver failure (ACLF).
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  • The study investigates kidney dysfunction patterns in patients with acute decompensation of cirrhosis, both with and without acute-on-chronic liver failure (ACLF), involving 639 patient admissions over a 3-month follow-up period.
  • A significant 92% of ACLF patients experienced acute kidney injury (AKI), contrasting with only 35% of non-ACLF patients, highlighting the severe impact of ACLF on kidney health.
  • Outcomes for patients with AKI in the ACLF group were notably poor, with only 54% recovering kidney function and a 3-month survival rate of 51%, compared to much better outcomes in non-ACLF patients; factors such as
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Background And Aims: Stigmatization is a well-documented problem of some diseases. Perceived stigma is common in alcohol-related liver disease and hepatitis C, but little information exists on stigma in patients with non-alcoholic fatty liver disease (NAFLD). Aim of the study was to investigate frequency and characteristics of perceived stigma among patients with NAFLD.

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