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The nodular lesions are no longer seen in any of the sequences. There is a subcapsular hipointense area in dynamic T1-weighted MR images, causing capsular retraction (arrow in b) suggestive of a fibrotic area. There are small vessels (dashed arrows) but no suspicious nodular enhancing areas are seen.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ana L. Santos, Hélder Cardoso, Marco Silva, Adriana Moreira, Guilherme Macedo" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Ana L." 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"documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Ann Hepatol. 2021;21C:" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:8 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letters to the Editor</span>" "titulo" => "New model predicting gastroesophageal varices and variceal hemorrhage in patients with chronic liver disease" "tienePdf" => "en" "tieneTextoCompleto" => "en" "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Yongxin Chen, Xiaofei Li" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Yongxin" "apellidos" => "Chen" ] 1 => array:2 [ "nombre" => "Xiaofei" "apellidos" => "Li" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1665268120301903?idApp=UINPBA00004N" "url" => "/16652681/000000210000000C/v1_202102250957/S1665268120301903/v1_202102250957/en/main.assets" ] ] "en" => array:12 [ "idiomaDefecto" => true "titulo" => "In Reply" "tieneTextoCompleto" => true "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Ling-ling He, Jia-li Ma, Yu Jiang, Jun-ru Yang, Ping Li, Yao Zhang, Hong-shan Wei" "autores" => array:7 [ 0 => array:3 [ "nombre" => "Ling-ling" "apellidos" => "He" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "fn1" ] ] ] 1 => array:3 [ "nombre" => "Jia-li" "apellidos" => "Ma" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "fn1" ] ] ] 2 => array:3 [ "nombre" => "Yu" "apellidos" => "Jiang" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Jun-ru" "apellidos" => "Yang" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Ping" "apellidos" => "Li" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "Yao" "apellidos" => "Zhang" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 6 => array:4 [ "nombre" => "Hong-shan" "apellidos" => "Wei" "email" => array:1 [ 0 => "drwei@ccmu.edu.cn" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Capital Medical University Affiliated Beijing Ditan Hospital, Department of Gastroenterology, Beijing, China" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Capital Medical University Affiliated Beijing Ditan Hospital, Department of Medical Ultrasound, Beijing, China" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We thank Drs. Chen and Li for their interest <a class="elsevierStyleCrossRef" href="#bib0005">[1]</a> in our recently published article <a class="elsevierStyleCrossRef" href="#bib0010">[2]</a>, and respond herein to their comments.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Firstly, the model for end-stage liver disease (MELD) and Child–Pugh scores are important indicators of liver dysfunction severity in chronic liver disease (CLD) patients. We have included these indicators in many of our studies. For example, to evaluate the utility of these two scores for predicting the prognosis of chronic hepatitis B (CHB) patients with variceal hemorrhage following endoscopic therapy (ET), data from 828 CHB patients were analyzed. Multivariate Cox analysis demonstrated that age, neutrophil-to-lymphocyte ratio (NLR), γ-glutamyl transferase (GGT) level, and MELD score are the independent predictors of mortality, while the Child–Pugh score is not <a class="elsevierStyleCrossRef" href="#bib0015">[3]</a>. In another retrospective study, we examined clinical features and outcomes among patients with cirrhosis due to chronic hepatitis B or C virus (HBV or HCV) infection and other etiologies. In the subset of cirrhotic patients exhibiting variceal hemorrhage following ET, Cox analysis demonstrated that age, lymphocyte %, hemoglobin level, GGT level, direct bilirubin level, albumin level, and MELD score are factors independently associated with a high risk of mortality <a class="elsevierStyleCrossRef" href="#bib0020">[4]</a>.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The MELD and Child-Pugh scores are considered indicators of end-stage liver disease. In the study commented on by Drs. Chen and Li, we focused on variables diagnostic of early liver cirrhosis and esophageal varices, rather than on disease severity and survival in patients with late-stage liver cirrhosis. In this study population, almost no patient suffered from ascites, hepatic encephalopathy, or other indicators of late-stage liver disease.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Secondly, we agree that body weight and body mass index are important indicators of the chronic viral hepatitis progression. However, due to the limitations of the retrospective study, we were unable to obtain these data. However, we have included these indicators in our ongoing research studies.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Finally, direct measurement of the hepatic venous pressure gradient (HVPG) requires invasive techniques difficult to implement in most hospitals in China. Therefore, to create a metric predictive of the presence of gastroesophageal varices (in chronic HBV infection and CLD due to other etiologies) without the use of invasive procedures, the study commented on by Drs. Chen and Li did not include the HVPG.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors have no conflict of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-12-31" "fechaAceptado" => "2021-01-04" "NotaPie" => array:1 [ 0 => array:3 [ "etiqueta" => "1" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Contributed equally to this manuscript.</p>" "identificador" => "fn1" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "[1]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "New model predicting gastroesophageal varices and variceal hemorrhage in patients with chronic liver disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Y. Chen" 1 => "X. Li" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Ann Hepatol." "fecha" => "2020 Oct 16" "volumen" => "S1665-2681" "numero" => "20" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "[2]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "New model predicting gastroesophageal varices and variceal hemorrhage in patients with chronic liver disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "J.L. Ma" 1 => "L.L. He" 2 => "Y. Jiang" 3 => "J.R. Yang" 4 => "P. Li" 5 => "Y. Zang" 6 => "H.S. Wei" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.aohep.2019.12.007" "Revista" => array:7 [ "tituloSerie" => "Ann Hepatol." "fecha" => "2020 May-Jun" "volumen" => "19" "numero" => "3" "paginaInicial" => "287" "paginaFinal" => "294" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32197976" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "[3]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A new algorithm for predicting long-term survival in chronic hepatitis B patients with variceal bleeding after endoscopic therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:12 [ 0 => "L. He" 1 => "P. Li" 2 => "Y. Jiang" 3 => "J. Hu" 4 => "J. Ma" 5 => "X. Ye" 6 => "J. Yang" 7 => "Y. Zhou" 8 => "X. Liang" 9 => "Z. Ai" 10 => "Y. Lin" 11 => "H. Wei" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.dld.2019.01.004" "Revista" => array:7 [ "tituloSerie" => "Dig Liver Dis." "fecha" => "2019 Aug" "volumen" => "51" "numero" => "8" "paginaInicial" => "1166" "paginaFinal" => "1171" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30723020" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "[4]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical Features and Outcomes of Repeated Endoscopic Therapy for Esophagogastric Variceal Hemorrhage in Cirrhotic Patients: Ten-Year Real-World Analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:8 [ 0 => "J.L. Ma" 1 => "L.L. He" 2 => "P. Li" 3 => "Y. Jiang" 4 => "J.L. Hu" 5 => "Y.L. Zhou" 6 => "X.X. Liang" 7 => "H.S. Wei" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "Gastroenterol Res Pract." "fecha" => "2020 May 15" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/16652681/000000210000000C/v1_202102250957/S1665268121000120/v1_202102250957/en/main.assets" "Apartado" => array:4 [ "identificador" => "82754" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/16652681/000000210000000C/v1_202102250957/S1665268121000120/v1_202102250957/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1665268121000120?idApp=UINPBA00004N" ]
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