J.A. Carrión

Pompeu Fabra University

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Papers

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i-10 index

Research Trends

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Document Type

Co-Authors

Xavier Forns

Universitat de Barcelona

Sabela Lens

Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas

Montserrat García–Retortillo

Hospital Del Mar

Teresa Broquetas

Hospital Del Mar

Marc Puigvehí

Hospital Del Mar

Rosa M. Morillas

Hospital Universitari Germans Trias i Pujol

Zoe Mariñó

Universitat de Barcelona

Núria Cañete

Hospital Del Mar

S. Coll

Hospital Del Mar

Miquel Navasa

Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas

Cooperative Institutions

Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas

265

Instituto de Salud Carlos III

212

Universitat de Barcelona

196

Universitat Autònoma de Barcelona

179

Centro de Investigación Biomédica en Red

174

Hospital Clínic de Barcelona

163

Consorci Institut D'Investigacions Biomediques August Pi I Sunyer

159

Hospital Del Mar

108

National Institutes of Health

Hospital del Mar Research Institute

Author Statistics

Papers

Citation

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PFO‐ACCESS: Augmenting Communications for Medical Care or Closure in the Evaluation of Patients With Stroke With Cardiac Shunts

Stroke Vascular and Interventional Neurology (2025)

Yasaman Pirahanchi Benjamin Shifflett Ehtisham Mahmud S. Brennan Dawn Meyer

BACKGROUND Patent foramen ovale (PFO) contributes to a quarter of embolic strokes of undetermined source. Although the benefit of PFO closure in selected patients has been demonstrated, our system workflow still resulted in a low rate of PFO evaluation for closure. The aim of the PFO‐ACCESS (Augmenting Communications for Medical Care or Closure in the Evaluation of Stroke Patients With Cardiac Shunts) program (which included implementation of the Viz.ai PFO‐specific communications module) was to determine if there was any change in PFO management due to improved communication between stroke and interventional cardiology teams. METHODS In this quality improvement project, we compared pre‐PFO ACCESS (December 2022–November 2023) to post‐PFO ACCESS periods (November 2023–June 2024) regarding PFO evaluations. The Viz.ai PFO module was implemented for the stroke and interventional cardiology teams without other workflow changes. Key performance indicators included referral frequency, PFO closure rates, and referral time intervals. Statistical comparisons utilized Mann–Whitney U , chi‐square, Fisher's exact, and exact Poisson test where appropriate. RESULTS The postimplementation period noted a 492% PFO referral increase (11 versus 38,65 [annualized]; P <0.0001). PFO closure number totals showed a 186% nonsignificant increase pre versus post (6 versus 10,17 [annualized]; P = 0.99), with PFO closure of percentage of total referred cases showing a large but nonsignificant decrease (54.55%, 26.32%; P = 0.14). Time comparisons showed a marked but nonsignificant decrease in median “referral sent to referral viewed” (10:37 hours, 1:08 hours; P = 0.73), “referral sent to referral accepted” (10:37 hours, 1:03 hours; P = 0.67) time interval, and “referral sent to closure” time interval (102 days, 97 days; P = 0.55). CONCLUSION The PFO‐ACCESS program with Viz.ai PFO module use resulted in a 492% increase in PFO referrals due to enhanced communication and efficiency in managing PFO‐related stroke cases. Though the increased number of referrals and closures were observed, the PFO closure percentage of total referred cases showed a marked but nonsignificant decrease indicating selective case management. The higher number of PFO closures shows that more patients are indeed appropriate for PFO closure consideration. Future efforts should focus on expanding outpatient use and increasing provider education to optimize PFO management.

Closure (psychology)

Stroke

10.1161/svin.124.001707

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Citations (0)

Elastography is unable to exclude cirrhosis after sustained virological response in HCV‐infected patients with advanced chronic liver disease

Liver International (2021)

Teresa Broquetas Paula Herruzo‐Pino Zoe Mariñó Dolores Naranjo Mercedes Vergara

Liver fibrosis and transient elastography (TE) correlation in hepatitis C virus (HCV)-infected patients with compensated advanced chronic liver disease (cACLD) after the sustained virological response (SVR) is unknown.To evaluate TE accuracy at identifying cirrhosis 3 years after HCV-eradication.Prospective, multi-centric study including HCV-cACLD patients before direct-acting antivirals (DAA). Diagnostic accuracy of TE (area under ROC, AUROC) to identify cirrhosis 3 years after SVR was evaluated.Among 746 HCV-infected patients (95.4% with TE ≥10 kPa), 76 (10.2%) underwent a liver biopsy 3 years after SVR. Before treatment, 46 (63%) showed a TE>15 kPa. The TE before DAA was the best variable for predicting cirrhosis (METAVIR, F4) after SVR (AUROC = 0.79). Liver function parameters, serological non-invasive tests (APRI and FIB-4), and TE values improved after SVR. However, liver biopsy 3 years after HCV elimination (median time = 38.4 months) showed cirrhosis in 41 (53.9%). Multivariate analysis (OR (95% CI), P) showed that HCV-genotype 3 (20.81 (2.12-201.47), .009), and TE before treatment (1.21 (1.09-1.34), <.001) were the only variables associated with cirrhosis after SVR. However, the accuracy of TE after SVR was poor (AUROC = 0.75) and 6 (27.3%) out of 22 patients with a TE <8 kPa had cirrhosis. Similar results were found with APRI and FIB-4 scores.Cirrhosis is present, 3 years after SVR, in more than half of HCV-cACLD patients even with the normalisation of liver function parameters, serological non-invasive tests and TE values. The low diagnostic accuracy of non-invasive methods after SVR reinforces the need for long-term surveillance.

Transient elastography

Hepatitis C

Liver disease

Chronic liver disease

10.1111/liv.15058

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Citations (19)

Effectiveness of 8 weeks of glecaprevir/pibrentasvir in treatment-naive hepatitis C patients with liver cirrhosis: results from the real-world Spanish Hepa-C registry

Journal of Hepatology (2020)

Juan Turnés Manuel Hernández‐Guerra Raquel Souto Rodríguez Inmaculada Fernández J.A. Carrión

HEPA

Hepatitis C

10.1016/s0168-8278(20)31192-2

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Citations (1)

FRI-225-Universal access to direct-acting antivirals treatment is not not enough to prevent late stage presentation of hepatitis C infection

Journal of Hepatology (2019)

Joaquín Cabezas Inmaculada Fernández Susana Llerena J.A. Carrión Adolfo Gallego

Presentation (obstetrics)

10.1016/s0618-8278(19)30970-3

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Citations (6)

Neutrophil and Monocyte Function in Patients with Chronic Hepatitis C Undergoing Antiviral Therapy with Regimens Containing Protease Inhibitors with and without Interferon

PLoS ONE (2016)

Martina Gambato Noelia Caro‐Pérez Patricia González Núria Cañete Zoe Mariñó

Real-life data showed an increased incidence of bacterial infections in patients with advanced liver disease receiving a protease inhibitor (PI)-containing antiviral regimen against hepatitis C (HCV). However, the causes of this event are unknown. We hypothesized that PIs might impair innate immune responses through the inhibition of proteases participating in the anti-bacterial functions of neutrophils and monocytes. The aims of the study were to assess phagocytic and oxidative burst capacity in neutrophils and monocytes obtained from patients receiving a PI containing-antiviral regimen, and to determine cytokine secretion after neutrophil stimulation with flagellin. Forty patients with chronic HCV (80% with cirrhosis) were enrolled in the study, 28 received triple therapy (Group A) with pegylated-interferon and ribavirin for 4 weeks followed by the addition of a PI (telaprevir, boceprevir or simeprevir), and 12 patients received an interferon-free regimen (Group B) with simeprevir and sofosbuvir. Phagocytosis and oxidative burst capacity were analyzed by flow cytometry at baseline, week 4, and week 8 of therapy. In neutrophils from Group A patients, oxidative burst rate and oxidative enzymatic activity per cell significantly decreased throughout the study period (p = 0.014 and p = 0.010, respectively). Pairwise comparisons showed a decrease between baseline and week 4 and 8 of therapy. No differences were observed after the introduction of the PI. The oxidative enzymatic activity per cell in monocytes significantly decrease during the study period (p = 0.042) due to a decrease from baseline to week 8 of therapy (p = 0.037) in patients from Group A. None of these findings were observed in Group B patients. Cytokine secretion did not significantly change during the study in both groups. In conclusion, our data suggest that the use interferon (rather than the PI) has a deleterious effect on neutrophil and monocyte phagocytic and oxidative burst capacity in this cohort of patients with HCV-related advanced liver fibrosis.

Simeprevir

Respiratory burst

Hepatitis C

Telaprevir

Boceprevir

Regimen

Pegylated interferon

10.1371/journal.pone.0166631

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Citations (5)

High efficacy of Sofosbuvir plus Simeprevir in a large cohort of Spanish cirrhotic patients infected with genotypes 1 and 4

Liver International (2017)

Zoe Mariñó J.M. Pascasio-Acevedo Adolfo Gallego M. Diago Carme Baliellas

Hepatitis C (HCV) therapy with Sofosbuvir (SOF)/Simeprevir (SMV) in clinical trials and real-world clinical practice, showed high rates of sustained virological response (SVR) in non-cirrhotic genotype (GT)-1 and GT-4 patients. These results were slightly lower in cirrhotic patients. We investigated real-life effectiveness and safety of SOF/SMV with or without ribavirin (RBV) in a large cohort of cirrhotic patients.This collaborative multicentre study included data from 968 patients with cirrhosis infected with HCV-GT1 or 4, treated with SOF/SMV±RBV in 30 centres across Spain between January-2014 and December-2015. Demographic, clinical, virological and safety data were analysed.Overall SVR was 92.3%; the majority of patients were treated with RBV (62%) for 12 weeks (92.4%). No significant differences in SVR were observed between genotypes (GT1a:94.3%; GT1b:91.7%; GT4:91.1%). Those patients with more advanced liver disease (Child B/C, MELD≥10) or portal hypertension (platelet count≤100×109 /L, transient elastography≥21 Kpa) showed significantly lower SVR rates (84.4%-91.9%) than patients with less advanced liver disease (93.8%-95.9%, P<.01 in all cases). In the multivariate analysis, the use of RBV, female gender, baseline albumin≥35 g/L, MELD<10 and lack of exposure to a triple therapy regimen were independent predictors of SVR (P<.05). Serious adverse events (SAEs) and SAE-associated discontinuation events occurred in 5.9% and 2.6%.In this large cohort of cirrhotic patients managed in the real-world setting in Spain, SOF/SMV±RBV yielded to excellent SVR rates, especially in patients with compensated liver cirrhosis. In addition, this combination showed to be safe, with low rates of SAEs and early discontinuations.

Sofosbuvir

Simeprevir

Regimen

Liver disease

Hepatitis C

Discontinuation

10.1111/liv.13470

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Citations (13)

Natural history and prognostic factors of compensated cirrhosis secondary to non-alcoholic steatohepatitis in Catalonia

Journal of Hepatology (2020)

Octavi Bassegoda Jesús Rivera Serra Matamala Isabel Rosa Ma Morillas Teresa Broquetas

Steatohepatitis

10.1016/s0168-8278(20)30795-9

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Citations (0)

801 LONG-TERM EVOLUTION OF LIVER FIBROSIS IN MILD–MODERATE CHRONIC HEPATITIS C: STUDY WITH PAIRED BIOPSIES

Journal of Hepatology (2013)

Núria Cañete Miguel López Isabel Ojanguren Isabel Cirera Montserrat García–Retortillo

10.1016/s0168-8278(13)60803-x

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Citations (0)

Tratamiento de la hepatitis crónica C

Jano: Medicina y humanidades (2008)

J.A. Carrión

Source

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Hepatitis C virus superinfection of liver grafts: a detailed analysis of early exclusion of non-dominant virus strains

Journal of General Virology (2010)

Santseharay Ramírez Sofía Pérez‐del‐Pulgar J.A. Carrión Mairene Coto‐Llerena L. Mensa

Liver transplantation (LT) of hepatitis C virus (HCV)-infected grafts into HCV-infected recipients leads to superinfection with two different virus strains. To characterize the virological outcomes of HCV superinfection immediately after LT, we performed phylogenetic analysis of a fragment of the NS5B gene in donor and recipient serum samples prospectively collected before and after LT, starting on day 1. In four of six cases, the donor strain finally prevailed, while in the remaining two cases, the native recipient strain overtook the donor quasispecies. Clonal sequence analysis showed that, in three cases, the expelled strain was undetectable 1 day after LT. Our study shows that superinfection with a different HCV strain can lead to the exclusion of one strain by the other as soon as the first day after LT. This would suggest that competition might not be limited to the replication level, but could also take place during virus entry.

Superinfection

Viral quasispecies

NS5B

Strain (injury)

10.1099/vir.0.018929-0

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Citations (37)