Publications by authors named "Nikolaus Pfisterer"
Background And Aims: Acute variceal bleeding (AVB), a severe adverse event of portal hypertension, may cause death in patients with cirrhosis. We investigated whether outcomes after AVB have improved over time.
Methods: Data from 406 patients with cirrhosis with AVB (2000-2022) from 2 Viennese centers were analyzed for recurrent bleeding, 6-week mortality, and 1-year transplant-free survival.
Article Synopsis
- 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.
Article Synopsis
- - 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
Article Synopsis
- The study aimed to use existing laboratory records to identify and treat individuals with hepatitis C virus (HCV) viremia, assisting in broader global elimination efforts.
- Out of 22,682 individuals who tested for HCV-RNA, 6006 had detectable viremia; barriers like invalid contact information hindered follow-up, but efforts led to successful treatment initiation in some.
- This interim report from the ELIMINATE project highlights the potential of systematic screening and recall, identifying a significant number of people previously lost to care who began antiviral treatment.
Introduction: Liver cirrhosis accounts for considerable morbidity and mortality worldwide and late presentation limits therapeutic options. We aimed to assess characteristics of patients with liver cirrhosis at the time of first presentation and during their clinical course.
Methods: Patients with cirrhosis as evident by presence of varices at endoscopy, liver stiffness ≥15kPa at elastography, or ascites requiring paracentesis between Q1/2015-Q2/2020 were retrospectively included.
Background: Prophylactic endoscopic band ligation (EBL) is used to prevent variceal bleeding in patients with liver cirrhosis. The association of thrombocytopenia, high INR (international normalized ratio) and liver dysfunction with the risk of procedure-related bleeding (PRB) remains debated and recommendations are controversial.
Methods: We analyzed real-life data of cirrhotic patients undergoing elective EBL at two large Viennese centers between Q1/2000-Q1/2018.
Article Synopsis
- Ulcerative colitis (UC) is a chronic condition with increasing prevalence and uncertain causes, and advanced molecular profiling may reveal important insights into its mechanisms and remission features.
- The study involved analyzing tissue and plasma samples from UC patients using mass spectrometry to identify changes in proteins and metabolites during active disease and remission, compared to healthy individuals.
- Results showed that inflammation involved various immune cells and indicated ongoing microvascular damage and platelet abnormalities even during remission, suggesting persistent molecular markers associated with UC.
Carvedilol Achieves Higher Hemodynamic Response and Lower Rebleeding Rates Than Propranolol in Secondary Prophylaxis.
Clin Gastroenterol Hepatol
August 2023
Background & Aims: Carvedilol induces stronger decreases in hepatic venous pressure gradient (HVPG) than conventional nonselective β-blockers (ie, propranolol). Limited data exist on the efficacy of carvedilol in secondary prophylaxis of variceal bleeding.
Methods: Patients undergoing paired HVPG measurements for guiding secondary prophylaxis with either carvedilol or propranolol were included in this retrospective analysis.
Portal hypertension (PH), a common complication of liver cirrhosis, results in development of esophageal varices. When esophageal varices rupture, they cause significant upper gastrointestinal bleeding with mortality rates up to 20% despite state-of-the-art treatment. Thus, prophylactic measures are of utmost importance to improve outcomes of patients with PH.
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- Portal hypertension (PH) is a significant issue in liver cirrhosis, leading to serious complications like variceal bleeding, but physicians' knowledge of treatment guidelines is limited.
- Two surveys were conducted among Austrian gastroenterologists to assess their understanding of variceal management and the use of albumin, finding mixed adherence to recommendations.
- Results revealed a tendency for overtreatment, with 30% recommending unnecessary follow-up procedures, while most specialists were unclear on correct indications for early interventions and demonstrated inconsistencies in albumin dosage adherence for various conditions.
Background: The prognostic impact of liver steatosis in obese patients is well established. Limited data on the risk factors for and impact of hepatic steatosis in lean patients are available.
Aims: Assess risk factors for liver steatosis in lean patients and investigate its impact on survival.
Background: Severe hypokalemia with severe neurological impairment and electrocardiogram (ECG) abnormalities due to the misuse of triamterene/hydrochlorothiazide (HCTZ) in a bodybuilder has not yet been reported.
Case Report: A 22-year-old bodybuilder developed acute generalized muscle cramps, sensory disturbance of the distal lower and upper limbs, quadriparesis, and urinary retention. These abnormalities were attributed to severe hypokalemia of 1.
Small Esophageal Varices in Patients with Cirrhosis-Should We Treat Them?
Curr Hepatol Rep
November 2018
Purpose Of Review: The natural history and classification systems of small varices (≤ 5 mm in diameter) in cirrhotic patients with portal hypertension are summarized. Studies that assessed the course of and therapeutic intervention for small varices are discussed.
Recent Findings: Current non-invasive methods show suboptimal sensitivity to detect small varices in patients with cirrhosis.
Background: Current guidelines favour the use of bleeding stents over balloon tamponade (BT) for refractory variceal bleeding (VB) from oesophageal varices. However, data on the efficacy and safety of self-expandable metal SX-ELLA Danis stents (SEMS) are limited.
Methods: Cirrhotic patients receiving SEMS for VB at four tertiary care centres were included in this retrospective multicentre study.
Non-selective beta-blocker treatment does not impact on kidney function in cirrhotic patients with varices.
Scand J Gastroenterol
September 2017
Goals And Background: Non-selective beta-blockers (NSBBs) are used for bleeding prophylaxis in cirrhotic patients with gastroesophageal varices (GEVs). Recent data suggested that NSBB treatment might increase the risk of renal dysfunction in patients with refractory ascites due to an impaired response to acute haemodynamic stress.
Study: Retrospective longitudinal assessment of kidney function in a cohort of cirrhotic patients with GEVs with vs.
Background And Aim: The aim of this study was to assess the impact of proton pump inhibitor (PPI) intake on the development of spontaneous bacterial peritonitis (SBP) or other infections, as well as on mortality, in a thoroughly documented cohort of patients with cirrhosis and ascites.
Patients And Methods: We performed a retrospective analysis of follow-up data from 607 consecutive patients with cirrhosis undergoing their first paracentesis at a tertiary center. A binary logistic regression model investigating the association between PPI intake and SBP at the first paracentesis was calculated.
Background & Aims: Nonselective β blockers (NSBBs) reduce portal pressure and the risk for variceal hemorrhage in patients with cirrhosis. However, development of spontaneous bacterial peritonitis (SBP) in these patients could preclude treatment with NSBBs because of their effects on the circulatory reserve. We investigated the effects of NSBBs in patients with cirrhosis and ascites with and without SBP.
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