Publications by authors named "Semmler G"
Objective: We aimed to collect data on gastroenterology and hepatology training from the viewpoint of trainees and trainers.
Methods: A national online survey was distributed among trainees and specialists at certified training institutions between February and May 2024.
Results: Overall, 226 respondents - 98 trainees, 78 trainers, 50 program directors, and department heads responded, with a national coverage of 70% of trainees and 85% of specialty-department heads.
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.
View Article and Find Full Text PDFBackground And Aims: Porto-sinusoidal vascular disorder (PSVD) is a rare vascular liver disorder characterised by specific histological findings in the absence of cirrhosis, which is poorly understood in terms of pathophysiology. While elevated hepatic copper content serves as diagnostic hallmark in Wilson disease (WD), hepatic copper content has not yet been investigated in PSVD.
Methods: Patients with a verified diagnosis of PSVD at the Medical University of Vienna and available hepatic copper content at the time of diagnosis of PSVD were retrospectively included.
Background: Portal hypertension (PH) resulting from static and dynamic intrahepatic changes drives liver-related complications even after removing the underlying aetiological factor.
Objective: We investigated the impact of inflammation on the dynamic component of PH during disease regression in animal models of toxin-induced cirrhosis and patients with alcohol-related cirrhosis.
Methods: In mice, cirrhosis was induced via toxin application for 12 weeks followed by toxin-withdrawal allowing for one or 2 weeks of regression.
Article Synopsis
- The study focused on identifying unique metabolomic signatures in patients with porto-sinusoidal vascular disorder (PSVD) and cirrhosis to improve diagnosis.
- Serum samples from healthy volunteers and patients with PSVD or cirrhosis were analyzed using advanced techniques like liquid chromatography-mass spectrometry, identifying significant metabolic changes linked to PSVD.
- Machine learning models were developed to distinguish PSVD from cirrhosis and healthy controls; key metabolites like taurocholic acid showed strong potential for non-invasive diagnostic use.
Colorectal neoplasia and diverticulosis are common findings on colonoscopies. While adenomas are precursors to colorectal cancer, diverticulosis is usually asymptomatic but can lead to diverticulitis. Despite their prevalence and coexistence, the relationship between these conditions remains unclear.
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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.
Background: Patients with advanced chronic liver disease (ACLD) are at high risk of developing hepatocellular carcinoma (HCC). Therefore, biannual surveillance is recommended. This large-scale multicenter study aimed to stratify the risk of HCC development in ACLD.
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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.
Article Synopsis
- Cirrhosis creates a proinflammatory environment, and the study aims to analyze specific inflammation patterns across various causes of compensated cirrhosis in both animal models and human patients.
- In rat models, inflammation differed based on the cirrhosis cause, with choline-deficient high-fat diet rats showing the highest proinflammatory gene expression, while in humans, different liver diseases exhibited varying levels of inflammatory markers.
- Despite common upregulation of proinflammatory pathways in all types of liver disease, the impact on fibrosis and portal hypertension varied based on the specific etiology of the disease.
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.
Background: The aim of this retrospective observational study was to examine the relationship between SCORE2 and the occurrence of colonic diverticula in a screening population without cardiovascular or gastrointestinal symptoms. SCORE2, recognized and supported by the European Society of Cardiology for cardiovascular risk assessment, served as the primary metric for the analysis in this investigation.
Methods: We studied 3935 asymptomatic individuals undergoing screening colonoscopy.
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
- 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.
Background: Optimal anticoagulation management in patients with myeloproliferative neoplasms (MPN) experiencing splanchnic vein thrombosis (SpVT) requires balancing risks of bleeding and recurrent thrombosis.
Objectives: We conducted a systematic review and meta-analysis to assess the incidence of bleeding and thrombosis recurrence in patients with MPN-SpVT.
Methods: We included retrospective or prospective studies in English with ≥10 adult patients with MPN-SpVT.
Article Synopsis
- 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.
Article Synopsis
- - 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.
Background & Aims: Regression of cirrhosis has been observed in patients with viral and non-viral etiologies of liver disease in whom the underlying cause of liver injury was effectively suppressed. However, the understanding of the factors contributing to reversibility of fibrosis and cirrhosis is limited. Our aims were to assess clinical factors, perform genotyping of known variants, and comprehensive metabolic phenotyping to characterize the regression of fibrosis in patients with compensated advanced chronic liver disease (cACLD).
View Article and Find Full Text PDFBackground & 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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- * The study found that CytoSorb treatment significantly reduced levels of bilirubin, procalcitonin, and interleukin-6, which are key biomarkers in ACLF, with ICU survivors showing better relative improvements.
- * No severe complications were linked to CytoSorb, suggesting its safety; however, further prospective research is needed to fully understand its impact on the clinical outcomes of ACLF patients with high cytok
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).