Preventing the progression of cirrhosis to decompensation and death.

Two main stages are differentiated in patients with advanced chronic liver disease (ACLD), one compensated (cACLD) with an excellent prognosis, and the other decompensated (dACLD), defined by the appearance of complications (ascites, variceal bleeding and hepatic encephalopathy) and associated with high mortality. Preventing the progression to dACLD might dramatically improve prognosis and reduce the burden of care associated with ACLD. Portal hypertension is a major driver of the transition from cACLD to dACLD, and a portal pressure of ≥10 mmHg defines clinically significant portal hypertension (CSPH) as the threshold from which decompensating events may occur.

Progressive systemic inflammation precedes decompensation in compensated cirrhosis.

Background & Aims: Systemic inflammation is a driver of decompensation in cirrhosis with unclear relevance in the compensated stage. We evaluated inflammation and bacterial translocation markers in compensated cirrhosis and their dynamics in relation to the first decompensation.

Methods: This study is nested within the PREDESCI trial, which investigated non-selective beta-blockers for preventing decompensation in compensated cirrhosis and clinically significant portal hypertension (CSPH: hepatic venous pressure gradient ≥10 mmHg).

Facilitators and barriers to implementing mental health apps among interdisciplinary staff in the Veterans Health Administration.

The U.S. Department of Veterans Affairs (VA) developed evidence-informed mental health mobile applications (MH apps) to supplement treatment and serve as self-care resources for veterans.

Clinical significance of a new diagnosis of atrial fibrillation in patients with vascular disease.

Background: The Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) trial enrolled patients with vascular disease, but excluded patients requiring oral anticoagulation.

Objective: To explore the clinical significance of a new diagnosis of atrial fibrillation (AF) during follow-up.

Methods: New AF was identified from hospitalization, study drug discontinuation and adverse event reports.