Publications by authors named "Hartl L"

Background And Aims: Around 750,000 patients per year will be cured of HCV infection until 2030. Those with compensated advanced chronic liver disease remain at risk for hepatic decompensation and de novo HCC. Algorithms have been developed to stratify risk early after cure; however, data on long-term outcomes and the prognostic utility of these risk stratification algorithms at later time points are lacking.

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Background Aims: Clinically-significant portal hypertension (CSPH) in liver cirrhosis patients can lead to refractory ascites. A transjugular-intrahepatic-portosystemic shunt (TIPS) treats CSPH but may cause overt hepatic encephalopathy (oHE). Our aim was to determine the optimal reduction of the portal pressure gradient (PPG) via TIPS to control ascites without raising oHE risk.

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  • The LiverRisk score is a proposed blood test aimed at estimating liver stiffness and identifying patients at risk for compensated advanced chronic liver disease (cACLD) and liver-related events without prior known liver issues.
  • In a study involving nearly 7,500 patients, the score's diagnostic performance was evaluated against established methods like FIB-4 and APRI, revealing that while it moderately correlates with liver stiffness measurements, it tends to underestimate them.
  • Although the LiverRisk score demonstrated decent accuracy for predicting cACLD and hepatic decompensation, its limitations include a low negative predictive value, indicating it might not effectively rule out disease in some patients.
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Fusarium head blight (FHB) is a devastating disease of wheat, causing yield losses, reduced grain quality, and mycotoxin contamination. Breeding can mitigate the severity of FHB epidemics, especially with genomics-assisted methods. The mechanisms underlying resistance to FHB in wheat have been extensively studied, including phenological traits and genome-wide markers associated with FHB severity.

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  • A study aimed to evaluate the prevalence and factors related to cholestasis in critically ill COVID-19 patients with acute respiratory distress syndrome (ARDS) revealed that 53% of the 225 patients developed cholestasis during their ICU stay.
  • The analysis identified that higher levels of certain liver enzymes, inflammation markers, and the use of specific treatments like extracorporeal membrane oxygenation and ketamine were linked to the development of cholestasis.
  • Cholestasis was found to be a negative prognostic indicator, as its presence and peak alkaline phosphatase levels were associated with poorer survival rates in the ICU and at six months post-treatment.
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  • The ELIMINATE project aimed to reconnect individuals in Eastern Austria with previously documented hepatitis C virus (HCV) infections to medical care, supporting global elimination goals set by the WHO.
  • Researchers reviewed lab records from 2008 to 2020, identifying 5,695 individuals, but faced challenges such as 34% having died and 13% lacking contact information.
  • Ultimately, they successfully contacted 617 individuals, leading to a 64.3% treatment initiation rate, and confirmed an HCV cure in 326 people, demonstrating the effectiveness of targeted outreach strategies in addressing HCV.
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Background And Aims: We aimed to characterise insulin-like growth factor-1 (IGF-1) signalling in patients with advanced chronic liver disease (ACLD).

Methods: Consecutive patients undergoing hepatic venous pressure gradient [HVPG] measurement were prospectively included. Clinical stages were defined as follows: probable ACLD (pACLD): liver stiffness ≥10 kPa and HVPG ≤5 mmHg, S0: mild PH (HVPG 6-9 mmHg), S1: clinically significant PH (CSPH), S2: CSPH with varices, S3: past variceal bleeding, S4: past/current non-bleeding hepatic decompensation and S5: further decompensation.

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Pancreatic ductal adenocarcinoma (PDAC) is a dismal disease with a low 5-year survival rate of only 13%. Despite intense research efforts, PDAC remains insufficiently understood. In part, this is attributed to opposing effects of key players being unraveled, including the stroma but also molecules that act in a context-dependent manner.

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  • The study investigates the role of histamine in advanced chronic liver disease (ACLD) and its potential as a prognostic marker.
  • It includes 251 patients with ACLD, finding that higher plasma histamine levels correlate with circulatory dysfunction, but levels do not significantly vary across different stages of liver disease.
  • Elevated histamine levels are independently associated with an increased risk of acute-on-chronic liver failure (ACLF) or liver-related death over a median follow-up of 29.2 months.
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  • Metabolic dysfunction-associated steatotic liver disease (MASLD) and steatohepatitis (MASH) are prevalent in obese individuals and may improve with metabolic/bariatric surgery (MBS).
  • A study of 93 patients showed significant reductions in liver stiffness and indicators of liver health three months after MBS, correlating with weight loss.
  • Improvements in liver conditions were evident as early as three months post-surgery, indicated by lower liver stiffness measurements and liver injury markers.
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  • - The study investigated zinc and selenium deficiency in 309 patients with advanced chronic liver disease (ACLD) and found that 73% were deficient in zinc and 63% in selenium, indicating a high prevalence of these deficiencies in this population.
  • - It was observed that patients with decompensated ACLD had significantly lower levels of both trace elements compared to those with compensated ACLD, and there were strong correlations between zinc/selenium levels and disease severity indicators like MELD and HVPG.
  • - Low levels of zinc and selenium were independently associated with worsening liver-related events, including hepatic decompensation and liver-related death, suggesting that future research should explore the benefits of zinc/selenium supplementation for these patients.
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Pre-harvest sprouting (PHS) resistance is a complex trait, and many genes influencing the germination process of winter wheat have already been described. In the light of interannual climate variation, breeding for PHS resistance will remain mandatory for wheat breeders. Several tests and traits are used to assess PHS resistance, i.

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  • - Previous studies hinted that medications like statins, metformin, and RAS inhibitors might help with portal hypertension in cirrhotic patients, but their actual impact on serious complications like variceal bleeding needed more research.
  • - The study involved 920 cirrhotic patients who underwent endoscopic band ligation for variceal bleeding prevention; it analyzed the effects of the mentioned medications on bleeding rates and survival.
  • - The findings showed that the use of statins, metformin, and RAS inhibitors did not significantly lower the rates of initial or recurrent variceal bleeding, nor did they affect mortality rates, suggesting that these medications might not be effective for this specific issue, but they should still be used if clinically indicated for other
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Background: Obesity impacts the diagnostic accuracy of shear wave elastography (SWE). A deep abdominal ultrasound transducer (DAX) capable of point (pSWE) and two-dimensional (2D)-SWE has recently been introduced to address this issue.

Methods: We performed a prospective study in a cohort of mostly patients with obesity undergoing liver biopsy with a high prevalence of metabolic dysfunction-associate steatotic liver disease (MASLD).

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Background & Aims: Baveno VII has defined a clinically significant (i.e., prognostically meaningful) decrease in liver stiffness measurement (LSM) in cACLD as a decrease of ≥20% associated with a final LSM <20 kPa or any decrease to <10 kPa.

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Background & Aims: Non-invasive tests (NITs) for clinically significant portal hypertension (CSPH) require validation in patients with hepatitis D virus (HDV)-related compensated advanced chronic liver disease (cACLD). Therefore, we aimed to validate existing NIT algorithms for CSPH in this context.

Methods: Patients with HDV-cACLD (LSM ≥10 kPa or histological METAVIR F3/F4 fibrosis) who underwent paired HVPG and NIT assessment at Medical University of Vienna or Hannover Medical School between 2013 and 2023 were retrospectively included.

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  • The study aimed to create a blood-based algorithm using FIB-4 and VITRO to identify compensated advanced chronic liver disease (cACLD) and clinically significant portal hypertension (CSPH) in patients, especially in settings without access to liver stiffness measurements.
  • A total of 6,143 patients were analyzed; results showed that both LSM and FIB-4 were effective in predicting hepatic decompensation, with a notable risk difference based on FIB-4 levels (≥ 1.75 significantly increasing risk).
  • In a separate cohort, VITRO demonstrated strong diagnostic performance for CSPH, comparable to other established methods, suggesting a reliable means to identify patients at risk for liver-related complications.
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Background & Aims: Non-invasive tests to assess the probability of clinically significant portal hypertension (CSPH) - including the ANTICIPATE±NASH models based on liver stiffness measurement and platelet count±BMI, and the von Willebrand factor antigen to platelet count ratio (VITRO) - have fundamentally changed the management of compensated advanced chronic liver disease (cACLD). However, their prognostic utility has not been compared head-to-head to the gold standard for prognostication in cACLD, i.e.

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Background And Aims: Patients with cirrhosis show alterations in primary hemostasis, yet prognostic implications of changes in platelet activation remain controversial, and assay validity is often limited by thrombocytopenia. We aimed to study the prognostic role of platelet activation in cirrhosis, focusing on bleeding/thromboembolic events, decompensation, and mortality.

Approach And Results: We prospectively included 107 patients with cirrhosis undergoing a same-day hepatic venous pressure gradient (HVPG) and platelet activation measurement.

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Background & Aims: Advanced chronic liver disease (ACLD) may affect thyroid hormone homeostasis. We aimed to analyze the pituitary-thyroid axis in ACLD and the prognostic value of free triiodothyronine (fT3).

Methods: Patients with ACLD (liver stiffness measurement [LSM] ≥10 kPa) undergoing hepatic venous pressure gradient (HVPG) measurement between June 2009 and September 2022 and available fT3 levels were included.

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