Publications by authors named "Morillas R"
Article Synopsis
- - The study aimed to understand the natural history and prognostic factors of porto-sinusoidal vascular disorder (PSVD) by analyzing a large cohort of 587 patients across 27 centers, finding that the majority were asymptomatic at diagnosis, but many experienced complications related to portal hypertension.
- - Over a median follow-up of 68 months, 8.5% of patients underwent liver transplantation, while 19% died, highlighting significant risks like portal hypertension-related bleeding and ascites, as well as the impact of age and liver function on prognosis.
- - The findings indicate that the severity of underlying conditions and liver/renal function significantly influence survival chances, leading to the development of a nomogram for more accurate prognosis prediction in
Article Synopsis
- Chronic hepatitis D (CHD) affects about 5% of hepatitis B patients in Spain, with a significant portion having pre-existing conditions like cirrhosis and coinfections.
- A study involving 329 patients revealed that 62% tested positive for HDV-RNA and that persistence of this viremia is linked to faster liver disease progression, with one-third already having cirrhosis at diagnosis.
- Key challenges in managing these patients include delays in accessing new antiviral treatments and difficulties in accurately assessing HDV-RNA levels locally.
Article Synopsis
- The study focused on creating a scoring system called the OCA response score (ORS) to predict how individuals with primary biliary cholangitis (PBC) will respond to the treatment using obeticholic acid (OCA).
- Data were collected from two large cohorts in Italy to derive and validate the score, which includes various clinical factors both before and after six months of treatment.
- The scoring system demonstrated good predictive ability for treatment response, which could help healthcare providers customize therapies for patients with PBC more effectively.
Background: Sofosbuvir, velpatasvir and voxilaprevir (SOF/VEL/VOX) is the recommended rescue therapy for patients with chronic hepatitis C infection who fail direct-acting antivirals (DAAs). Data are limited on the effectiveness of this treatment after the current first-line therapies. Our aim was to analyse the effectiveness and safety of SOF/VEL/VOX among patients failing sofosbuvir/velpatasvir (SOF/VEL) or glecaprevir/pibrentasvir (GLE/PIB).
View Article and Find Full Text PDFBackground: Suboptimal response to ursodeoxycholic acid occurs in 40% of primary biliary cholangitis (PBC) patients, affecting survival. Achieving a deep response (normalisation of alkaline phosphatase [ALP] and bilirubin ≤0.6 upper limit of normal) improves survival.
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- The study focused on patients with MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and aimed to analyze the effects of different biochemical patterns (hepatocellular, mixed, and cholestatic) on liver damage, diagnostic accuracy, and prognosis.* -
- Results showed that the hepatocellular pattern had higher rates of liver inflammation, while the cholestatic pattern was more associated with cirrhosis; moreover, non-invasive tests were less accurate for detecting fibrosis in the hepatocellular pattern.* -
- The study highlighted that biochemical patterns largely remained consistent over time, with the cholestatic pattern linked to higher mortality risk, particularly in patients with age, diabetes, and cirrhosis.*
Background And Aims: The landscape in primary biliary cholangitis (PBC) has changed with the advent of second-line treatments. However, the use of obeticholic acid (OCA) and fibrates in PBC-related cirrhosis is challenging. We assessed the impact of receiving a second-line therapy as a risk factor for decompensated cirrhosis in a real-world population with cirrhosis and PBC, and identify the predictive factors for decompensated cirrhosis in these patients.
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- This study compared the outcomes of two surgical techniques, endoscopic endonasal approach (EEA) and supraorbital keyhole procedure (SO), for treating meningiomas located at the planum sphenoidale and tuberculum sellae in 20 patients.
- The research found that while both methods had similar rates of tumor removal and visual outcomes, the EEA group experienced longer hospital stays and a higher incidence of CSF leaks compared to the SO group.
- Overall, both techniques resulted in comparable quality of life outcomes, though the SO group had a slightly higher recurrence rate and shorter follow-up period.
Background And Aims: The prognostic weight of further decompensation in cirrhosis is still unclear. We investigated the incidence of further decompensation and its effect on mortality in patients with cirrhosis.
Approach And Results: Multicenter cohort study.
Background: Calprotectin is a calcium-binding-S100-protein synthetized mainly in neutrophils which has been demonstrated to be an accurate biomarker of the presence of these cells. Gut barrier dysfunction in patients with advanced chronic liver disease (ACLD), in addition to the lack of noninvasive tools for diagnosis and prognosis of cirrhosis decompensations, has raised interest in this biomarker.
Aims: Our aim is to summarize the current evidence regarding the role of calprotectin in terms of its diagnostic and prognostic utility in ACLD.
Article Synopsis
- 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.
Background And Aims: Patients with compensated cirrhosis with clinically significant portal hypertension (CSPH: HVPG > 10 mm Hg) have a high risk of decompensation. HVPG is, however, an invasive procedure not available in all centers. The present study aims to assess whether metabolomics can improve the capacity of clinical models in predicting clinical outcomes in these compensated patients.
View Article and Find Full Text PDFBackground And Aims: HIV-positive patients on tenofovir hydroxyl fumarate (TDF)/emtricitabine have a lower risk of COVID-19 and hospitalization than those given other treatments. Our aim was to analyze the severity of COVID-19 in patients with chronic hepatitis B (CHB) on TDF or entecavir (ETV).
Methods: Spanish hospital databases (n = 28) including information regarding adult CHB patients on TDF or ETV for the period February 1st to November 30th 2020 were searched for COVID-19, defined as a positive SARS-CoV-2 polymerase chain reaction, and for severe COVID-19.
Objective: To investigate longitudinal changes in the liver stiffness measurement (LSM) in the general adult population without known liver disease and to describe its association with metabolic risk factors, with a special focus on subjects with non-alcoholic fatty liver disease (NAFLD) and dysglycemia.
Material And Methods: A longitudinal adult population-based cohort study was conducted in Catalonia. LSM was measured by transient elastography (TE) at baseline and follow-up (median: 4.
Background And Aims: In patients with non-severe acute or chronic autoimmune hepatitis (AIH) without cirrhosis, clinical practice guidelines recommend indistinct use of prednisone or budesonide. However, budesonide is infrequently used in clinical practice. We aimed to describe its use and compare its efficacy and safety with prednisone as first-line options.
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- Porto-sinusoidal vascular liver disorder (PSVD) is a rare condition that can lead to liver transplantation (LT), even when liver function is usually preserved, but there is limited data on LT outcomes for PSVD patients.!* -
- A study of 79 patients showed that common reasons for LT were refractory ascites and hepatic encephalopathy, with a post-LT survival rate of approximately 82% at one year and decreasing over five years; factors like severe associated conditions and high bilirubin or creatinine levels were linked to poorer survival outcomes.!* -
- While LT for PSVD can yield good results, ongoing severe conditions at the time of transplantation and certain lab values are critical for assessing patient prognosis,
Dysglycemia in young women attenuates the protective effect against fatty liver disease.
Front Endocrinol (Lausanne)
December 2022
Introduction: Sexual dimorphism has been reported in non-alcoholic fatty liver disease (NAFLD), similar to the sex differences evident with cardiovascular disease. Type 2 diabetes mellitus (T2D) significantly increases the risk and severity of NAFLD, but there is scarce information on whether T2D or altered glucose metabolism can modify the prevalence of NAFLD in men and women of reproductive age.
Purpose: To investigate the relationship between age, sex and NAFLD in subjects with and without dysglycemia.
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.
Background: Bacterial infections remain one of the main complications in cirrhosis and worsen patients' prognosis and quality of life. An increase in multidrug resistant microorganism (MDRM) infections among patients with cirrhosis, together with infection-related mortality rates, have been reported in recent years. Therefore, adaptation of the initial empiric antibiotic approach to different factors, particularly the local epidemiology of MDRM infections, has been recommended.
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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.
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.
View Article and Find Full Text PDFBackground & Aims: Treatment with non-selective beta-blockers (NSBBs) reduces the risk of ascites, which is the most common decompensating event in cirrhosis. This study aimed to assess the ability of a serum microRNA (miRNA) signature to predict ascites formation and the hemodynamic response to NSBBs in compensated cirrhosis.
Methods: Serum levels of miR-452-5p, miR-429, miR-885-5p, miR-181b-5p, and miR-122-5p were analyzed in patients with compensated cirrhosis (N = 105).
Article Synopsis
- Cirrhosis is a serious liver disease that develops over many years due to inflammation and can be caused by things like fatty liver problems and heavy drinking.
- New tests can help doctors find liver damage without needing to perform surgery, which is great for people at risk.
- Many people who don’t even know they have liver problems might already have serious liver damage, so more research is needed to decide if these tests should be used more widely to catch problems early.