Hemorragia digestiva alta : prevención y tratamiento /

En el presente manuscrito se presentan dos trabajos de investigación que abordan diferentes aspectos del área de la hemorragia digestiva alta. Por un lado, el trabajo nº 1, cuyo título en inglés es Transfusion strategies for acute upper gastrointestinal bleeding se centra en el área de conocimiento del manejo terapéutico de la hemorragia aguda. Por otro lado, el trabajo nº 2, titulado Acute hemodynamic response to beta-blockers and prediction of long-term outcome in primary prophylaxis of variceal bleeding , abarca otro aspecto de la hemorragia digestiva, concretamente la profilaxis de la hemorragia en una población de riesgo. Ambos trabajos han sido publicados en revistas científicas indexadas del primer decil de la especialidad (New England Journal of Medicine y Gastroenterology, respectivamente) Los artículos a los que se hace referencia pueden ser consultados en los Anexos 1 y 2, respectivamente.In this manuscript two research papers are presented. They address different aspects of the knowledge area of upper gastrointestinal hemorrhage. The paper number one, whose title in English is Transfusion strategies for acute upper gastrointestinal bleeding focuses on the area of knowledge of the therapeutic management of acute hemorrhage. On the other hand, the paper number 2, entitled Acute hemodynamic response to beta-blockers and prediction of long-term outcome in primary prophylaxis of variceal bleeding, covers another aspect of gastrointestinal bleeding, the prophylaxis of bleeding in a population at risk . Both works have been published in scientific journals indexed in the first decile of the specialty (New England Journal of Medicine and Gastroenterology, respectively) The articles referred may be consulted in the Annexes 1 and 2, respectively

Hemorragia digestiva alta: prevención y tratamiento

En el presente manuscrito se presentan dos trabajos de investigación que abordan diferentes aspectos del área de la hemorragia digestiva alta. Por un lado, el trabajo nº 1, cuyo título en inglés es Transfusion strategies for acute upper gastrointestinal bleeding se centra en el área de conocimiento del manejo terapéutico de la hemorragia aguda. Por otro lado, el trabajo nº 2, titulado Acute hemodynamic response to beta-blockers and prediction of long-term outcome in primary prophylaxis of variceal bleeding , abarca otro aspecto de la hemorragia digestiva, concretamente la profilaxis de la hemorragia en una población de riesgo. Ambos trabajos han sido publicados en revistas científicas indexadas del primer decil de la especialidad (New England Journal of Medicine y Gastroenterology, respectivamente) Los artículos a los que se hace referencia pueden ser consultados en los Anexos 1 y 2, respectivamente.In this manuscript two research papers are presented. They address different aspects of the knowledge area of upper gastrointestinal hemorrhage. The paper number one, whose title in English is Transfusion strategies for acute upper gastrointestinal bleeding focuses on the area of knowledge of the therapeutic management of acute hemorrhage. On the other hand, the paper number 2, entitled Acute hemodynamic response to beta-blockers and prediction of long-term outcome in primary prophylaxis of variceal bleeding, covers another aspect of gastrointestinal bleeding, the prophylaxis of bleeding in a population at risk . Both works have been published in scientific journals indexed in the first decile of the specialty (New England Journal of Medicine and Gastroenterology, respectively) The articles referred may be consulted in the Annexes 1 and 2, respectively

Hemorragia digestiva alta: prevención y tratamiento

En el presente manuscrito se presentan dos trabajos de investigación que abordan diferentes aspectos del área de la hemorragia digestiva alta. Por un lado, el trabajo nº 1, cuyo título en inglés es Transfusion strategies for acute upper gastrointestinal bleeding se centra en el área de conocimiento del manejo terapéutico de la hemorragia aguda. Por otro lado, el trabajo nº 2, titulado Acute hemodynamic response to beta-blockers and prediction of long-term outcome in primary prophylaxis of variceal bleeding , abarca otro aspecto de la hemorragia digestiva, concretamente la profilaxis de la hemorragia en una población de riesgo. Ambos trabajos han sido publicados en revistas científicas indexadas del primer decil de la especialidad (New England Journal of Medicine y Gastroenterology, respectivamente) Los artículos a los que se hace referencia pueden ser consultados en los Anexos 1 y 2, respectivamente.In this manuscript two research papers are presented. They address different aspects of the knowledge area of upper gastrointestinal hemorrhage. The paper number one, whose title in English is Transfusion strategies for acute upper gastrointestinal bleeding focuses on the area of knowledge of the therapeutic management of acute hemorrhage. On the other hand, the paper number 2, entitled Acute hemodynamic response to beta-blockers and prediction of long-term outcome in primary prophylaxis of variceal bleeding, covers another aspect of gastrointestinal bleeding, the prophylaxis of bleeding in a population at risk . Both works have been published in scientific journals indexed in the first decile of the specialty (New England Journal of Medicine and Gastroenterology, respectively) The articles referred may be consulted in the Annexes 1 and 2, respectively

Hemorragia digestiva alta: prevención y tratamiento

En el presente manuscrito se presentan dos trabajos de investigación que abordan diferentes aspectos del área de la hemorragia digestiva alta. Por un lado, el trabajo nº 1, cuyo título en inglés es Transfusion strategies for acute upper gastrointestinal bleeding se centra en el área de conocimiento del manejo terapéutico de la hemorragia aguda. Por otro lado, el trabajo nº 2, titulado Acute hemodynamic response to beta-blockers and prediction of long-term outcome in primary prophylaxis of variceal bleeding , abarca otro aspecto de la hemorragia digestiva, concretamente la profilaxis de la hemorragia en una población de riesgo. Ambos trabajos han sido publicados en revistas científicas indexadas del primer decil de la especialidad (New England Journal of Medicine y Gastroenterology, respectivamente) Los artículos a los que se hace referencia pueden ser consultados en los Anexos 1 y 2, respectivamente.In this manuscript two research papers are presented. They address different aspects of the knowledge area of upper gastrointestinal hemorrhage. The paper number one, whose title in English is Transfusion strategies for acute upper gastrointestinal bleeding focuses on the area of knowledge of the therapeutic management of acute hemorrhage. On the other hand, the paper number 2, entitled Acute hemodynamic response to beta-blockers and prediction of long-term outcome in primary prophylaxis of variceal bleeding, covers another aspect of gastrointestinal bleeding, the prophylaxis of bleeding in a population at risk . Both works have been published in scientific journals indexed in the first decile of the specialty (New England Journal of Medicine and Gastroenterology, respectively) The articles referred may be consulted in the Annexes 1 and 2, respectively

Further decompensation in cirrhosis: Results of a large multicenter cohort study supporting Baveno VII statements

Background: 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.Methods: Multicenter cohort study. The cumulative incidence of further decompensation (development of a second event or complication of a decompensating event) was assessed using competing risks analysis in 2028 patients. A four-state model was built: first decompensation, further decompensation, liver transplant, death. A cause-specific Cox model was used to assess the adjusted effect of further decompensation on mortality. Sensitivity analyses were performed for patients included before or after 1999. Results: In a mean follow-up of 43 months, 1192 patients developed further decompensation and 649 died. Corresponding 5-year cumulative incidences were 52% and 35%, respectively. The cumulative incidences of death and liver transplant after further decompensation were 55% and 9.7%, respectively. The most common further decompensating event was ascites/complications of ascites. Five-year probabilities of state occupation were: 24% alive with first decompensation, 21% alive with further decompensation, 7% alive with liver transplant, 16% dead after first decompensation without further decompensation, 31% dead after further decompensation, and <1% dead after liver transplant. The hazard ratio for death after further decompensation adjusted for known prognostic indicators, was 1.46 (95% CI 1.23-1-711) (p<0.001). The significant impact of further decompensation on survival was confirmed in patients included before or after 1999. Conclusion: In cirrhosis, further decompensation occurs in approximately 60% of patients, significantly increases mortality, and should be considered a more advanced stage of decompensated cirrhosis