4%; 95% CI: −9 8% to + 1%) In G2/G3 rapid responders, SVR was mo

4%; 95% CI: −9.8% to + 1%). In G2/G3 rapid responders, SVR was more common for standard 24-week duration than for shortened durations (+4.1%; 95% CI: +0.1% to + 8.5), but this benefit was not significant when ribavirin was weight-adjusted and the short duration was 16 weeks (−1.7%; 95% CI: −6.1% to + 2.7%) and for G2 patients (+1.6%; 95% CI:

−0.2% to + 5.5%). Conclusion: Long durations of P/R therapy improve SVR, regardless of genotype. This effect is nonetheless negligible in rapid responders, with the most favorable conditions for SVR (G2, G1 with low viral load, and G3 with weight-adjusted ribavirin regimen). (HEPATOLOGY 2011;) The standard of care for chronic hepatitis C is the combination of peg-interferon plus ribavirin that leads to hepatitis C virus (HCV) eradication in 60% of cases, with variations depending on the Romidepsin purchase characteristics of host and virus and, in particular, viral genotype.1,2 Patients infected with genotype 1 (G1) are the most difficult to cure: they achieve sustained virologic response (SVR) in under 50% of cases in pivotal studies.1, 2 This BMN 673 explains the considerable recent efforts to develop new antiviral molecules specific

to G1 strains, including boceprevir3 and telaprevir.4 However, despite their virologic efficacy, concerns are raised regarding the induction of viral cross-resistance,5 which could impede long-term viral elimination. This leaves the systematic use of these molecules as first-line treatments in naïve G1 patients open to debate, particularly in patients with genetic susceptibility for SVR with standard treatment, such as the CC polymorphism Racecadotril of the interleukin-28B (IL-28B) gene.6 Moreover, no similar therapeutic advances have been made for

HCV genotype 2 (G2) and 3 (G3) strains, which are reputed to be the most sensitive to standard treatment, with SVR rates of 80%-90%. With standard pegylated interferon (peg-IFN) plus ribavirin therapy, the concept of response-guided duration therapy (i.e., adjusting treatment duration according to the outcome of HCV viral load under treatment) has been widely investigated, particularly in two situations. In the 70% of G2/G3 patients and the 15% of G1 patients who develop a rapid virological response (RVR), as defined by undetectable HCV viral load at week 4, the aim was to reduce treatment duration to lower the risk of adverse events and cost of treatment. G2 and G3 patients were thus tested for receiving a 12-16-week treatment duration versus the standard 24-week therapeutic regimen, whereas G1 patients were tested for receiving a 24-week duration versus the standard 48-week regimen. The second situation involved G1 patients who develop slow virologic response, as defined by a decrease in viral load of over 2 log between baseline and week 12, followed by subsequent HCV RNA loss before week 24. In these patients, the aim was to extend treatment duration beyond the standard 48 weeks to increase the probability of SVR.

“Various methods of using skeletal anchorage for the intru

“Various methods of using skeletal anchorage for the intrusion of overerupted maxillary molars have been reported; however, it is difficult to intrude the overerupted upper second molars because of the low bone density in the region of the tuberosity. This article illustrates a new treatment method using partial fixed edgewise appliances and miniscrews to intrude the overerupted upper second molars. The miniscrews were applied to reinforce the anchorage of the upper first

molar. The intrusive force was generated by the Ni-Ti wire. The clinical results showed a significant intrusion effect without root resorption or periodontal problems. This report demonstrates that the combination of partial conventional selleck inhibitor fixed appliances with miniscrews is a simple and effective treatment option to intrude overerupted upper second molars, especially in situations where miniscrews cannot be inserted directly next to the second molar.

“This clinical report presents an implant-retained obturator overdenture solution for a Prosthodontic Diagnostic Index Class IV maxillectomy patient with a large oronasal communication and severe facial asymmetry, loss of upper lip and midfacial support, severe impairment of mastication, deglutition, phonetics, and speech intelligibility. Due to insufficient MAPK Inhibitor Library bone support to provide satisfactory zygomaticus implant anchorage, conventional implants were placed in the body of the left zygomatic arch and in the right maxillary

tuberosity. Using a modified impression technique, a cobalt-chromium alloy framework with three overdenture attachments was constructed to retain a complete maxillary obturator. Patient-reported Avelestat (AZD9668) functional and quality of life measure outcomes were dramatically improved after treatment and at the two-year follow-up. “
“The Great East Japan Earthquake in March 2011 destroyed many communities, and as a result many older victims lost their removable dentures. No previous studies have documented the prevalence of denture loss after a natural disaster or examined its negative impact. Therefore, investigation of the consequences of such a disaster on oral health is of major importance from a public health viewpoint. Three to five months after the disaster, questionnaire surveys were conducted in two coastal towns, Ogatu and Oshika, located in the area of Ishinomaki city, Miyagi prefecture. Among the survey participants, 715 individuals had used one or more removable dentures before the disaster, and these comprised the population analyzed. The effect of denture loss on oral health-related quality life (OHRQoL) was examined by a modified Poisson regression approach with adjustment for sex, age, subjective household economic status, dental caries, tooth mobility, psychological distress (K6), access to a dental clinic, physical activity, and town of residence. There were 123 (17.2%) participants who had lost their dentures.

fibrin glue Presenting Author:


fibrin glue Presenting Author:

YOUN JUNG PARK Additional Authors: JAE HYUCK JANG, SUNG HA BAE, MI HEE PARK, KYUNG SOO LEE, JONG WON PARK, CHANG WHAN KIM, SOK WON HAN Corresponding Author: Tyrosine Kinase Inhibitor Library research buy YOUNJUNG PARK Affiliations: Bucheon St. Mary’s Hospital, College of Medicine, Bucheon St. Mary’s Hospital, College of Medicine, Bucheon St. Mary’s Hospital, College of Medicine, Bucheon St. Mary’s Hospital, College of Medicine, Bucheon St. Mary’s Hospital, College of Medicine, Bucheon St. Mary’s Hospital, College of Medicine, Bucheon St. Mary’s Hospital, College of Medicine Objective: Ampullary adenoma is glandular dysplastic lesions that arise in and around the duodenal ampulla. Endoscopic ampullectomy is the treatment of choice for an ampullary adenoma. However, regenerative tissue developed at the post-ampullectomy site can mimic the ampullary adenoma. Methods: We retrospectively reviewed the medical records of a patient treated for the ampullary adenoma. Results: A 67-year-old woman underwent screening esophagogastroduodenoscopy.

A protruding mass-like lesion selleck products was found at the ampulla of Vater (Figure A). Histological examination of the lesion revealed tubular adenoma with low grade atypism (Figure B). An endoscopic snare ampullectomy was performed. The microscopic ampullectomy specimen showed an adenoma, and the margin of specimen was free of the adenoma. Forty days after the ampullectomy, the patient visited the emergency department due to fever and abdominal pain. Acute cholangitis was suspected from the clinical findings. Endoscopic retrograde cholangiopancreatography was performed, and a recurrent protruding mass was found at the

ampullectomy site (Figure C). We performed an ampullectomy again suspecting that this lesion was recurrent or remnant adenoma. However, the ampullectomy specimen revealed the regenerative epithelium, not true adenoma (Figure D). Conclusion: Regenerative epithelial tissue can mimic recurrent check or remnant adenoma after an ampullectomy. Key Word(s): 1. Ampullary adenoma; 2. endoscopic ampullectomy Presenting Author: PUTU PRATHIWI PRIMADHARSINI Additional Authors: HENDRA KONCORO, LUH PUTU IIN INDRAYANI MAKER, GDE SOMAYANA, I KETUT MARIADI, I GUSTI AGUNG SURYADARMA, NYOMAN PURWADI, I DEWA NYOMAN WIBAWA Corresponding Author: PUTU PRATHIWI PRIMADHARSINI Affiliations: Udayana University/Sanglah General Hospital, Udayana University/Sanglah General Hospital, Udayana University/Sanglah General Hospital, Udayana University/Sanglah General Hospital, Udayana University/Sanglah General Hospital, Udayana University/Sanglah General Hospital, Udayana University/Sanglah General Hospital Objective: Upper gastrointestinal (UGI) malignancy is one of major causes of cancer related death. However, data of UGI malignancy in Indonesian health care center were limited. This study was aimed to determine the prevalence of UGI malignancy in patients undergoing esophagogastroduodenoscopy in Sanglah General Hospital Denpasar.

In addition, infection-inhibiting activity against M  oryzae was

In addition, infection-inhibiting activity against M. oryzae was significantly enhanced in rice leaf sheaths pretreated with 10 μg/ml DMBQ. H2O2 generation was observed in rice leaves pretreated with DMBQ, and PAL, POX, CHS and PR10a were significantly expressed in these leaves. These results suggested that DMBQ can protect rice from blast disease caused by M. oryzae. “
“Forty-nine Phytophthora isolates were obtained from roots and crown of apricot trees with symptoms of decline grown in commercial orchards in Malatya, Elazığ and FK506 Diyarbakır provinces, Turkey, in 2011 and 2013. All of the recovered isolates were identified as Phytophthora palmivora on the basis

of morphological characteristics. Blast analysis of ITS region sequences of rDNA of 5 isolates revealed 100% identity with a reference Acalabrutinib ic50 isolates of P. palmivora from GenBank. Isolates of P. palmivora were pathogenic

on 12-month-old wild apricot rootstock ‘Zerdali’ plants that were wound inoculated on the roots and on the crown. This study demonstrated that P. palmivora is the cause of the crown and root rot found on apricot in Turkey. To our knowledge, this is the first report of P. palmivora on this host plant. “
“Foliar spray with BABA led to a significant reduction of lesion development in Brassica carinata caused by Alternaria brassicae. To get better insight mafosfamide into molecular mechanisms underlying priming of defence responses by BABA, expression pattern of BcWRKY genes and marker genes for the SA and JA pathway namely PR-1 and PDF 1.2 was examined. Q-RT-PCR analysis revealed priming of BcWRKY70, BcWRKY11 and BcWRKY53 gene expression in BABA-pretreated Brassica plants challenged with pathogen. However, the expression of BcWRKY72 and BcWRKY18

remained unchanged. Furthermore, BcWRKY7 gene was found to be upregulated in water-treated plants in response to pathogen indicating its role in susceptibility. In addition, BABA application potentiated expression of defence genes PR-1, PDF1.2 and PAL in response to the pathogen. In conclusion, BABA-primed expression of BcWRKY70, BcWRKY11 and BcWRKY53 genes is strongly correlated with enhanced expression of PR-1, PDF1.2 and PAL hence suggesting their role in BABA-induced resistance. “
“Accumulating functional genomic data in rice are unveiling the role of regulatory genes and their significance in modulating responses to complex traits like stress tolerance. Rice Osmyb4 is one such gene coding for transcription factor, and the homologous and heterologous ectopic expression has proved increased tolerance to several abiotic stress and few biotic stresses in plants. Nevertheless, the role of this gene in rice plants for disease resistance has not been studied.

Alexandrium ostenfeldii cells are generally considered to be larg

Alexandrium ostenfeldii cells are generally considered to be larger, and longer than wide, while A. peruvianum cells appear smaller and slightly wider than long. The straight (or sometimes irregular) anterior and posterior right margins of the

narrow 1′ plate of A. ostenfeldii (Paulsen 1904) form a distinct angle around a large ventral pore, whereas in A. peruvianum the right anterior margin of this plate is typically curved, and the enclosed pore is smaller (Balech and de Mendiola 1977). The s.a. plate in A. ostenfeldii is generally low and wide with a horizontal anterior margin and a slightly oblique right end that makes it appear like a door-latch. In A. peruvianum, this plate is A-shaped or triangular. The 6″ plate is also typically wider in A. ostenfeldii compared to A. peruvianum. G. dimorpha was described from material collected in a coastal selleck compound Mediterranean lagoon of Southern France (Biecheler 1952) and appears distinct from the former two species by a conspicuously wide and anteriorly extended 1′ plate and a horseshoe-shaped s.a. plate that penetrates into the epitheca. Given that the identity of the latter species has not been accepted by some authors (Balech 1995), and examination of the type material was not possible, this species has never been formally transferred to the genus Alexandrium.

Although morphological differences GPCR Compound Library cost among A. ostenfeldii and A. peruvianum, were well defined in the material originally investigated, further studies on samples from other locations revealed that distinctive plate characters vary considerably

among and within geographic populations and even within strains (Balech 1995, MacKenzie et al. 1996, Cembella et al. 2000, Lim et al. 2005, Kremp et al. 2009). Given this extensive morphological variation, recent A. ostenfeldii and A. peruvianum identifications have been made with reservations, and scientists repeatedly emphasized the necessity selleck kinase inhibitor to re-assess the validity of distinctive characters (Lim et al. 2005, Kremp et al. 2009). Consistent assignment has furthermore been complicated by the lack of consensus regarding the weight of the different diagnostic features: while some investigators have given priority to the s.a. shape (Bravo et al. 2006, Tomas et al. 2012), others considered the anterior 1′ margin most important (MacKenzie et al. 1996, Kremp et al. 2009). In addition to these inconsistencies, morphogenetic identification is not simple either, despite the availability of extensive sequence data and recognition of specific genetic signatures (Touzet et al. 2011). GenBank contains numerous identical sequences from isolates assigned to A. ostenfeldii and A. peruvianum. The need for clear identification guidelines and a better taxonomic understanding of the A. ostenfeldii group is becoming more and more evident, since blooms of the respective species have increased significantly in the past decades. Both A. ostenfeldii and A.

Such constructs

Such constructs selleck kinase inhibitor lead to complex instruments that are a challenge for both patients and those administering it. Language and social context related issues also require its adaptation and validation in different parts of the world [55, 56]. More importantly, what really needs to be evaluated is whether the information collected adds to the management of the individual or in comparison of cohorts beyond what is obtained from the assessment tools described above. hrQOL instruments often tend to be less sensitive to smaller differences in outcome assessments and this can lead to difficult conclusions. In one recent analysis comparing the value

of prophylaxis over episodic replacement therapy, it was concluded that there is not enough evidence to justify prophylaxis based on hrQOL data [57]. Therefore, it is not only important to use an appropriate hrQOL instrument but to also ensure that these are not administered in isolation but only as an adjunct to more specific assessment of bleeding, joint status Akt inhibitor and activities. One will then need to decide whether hrQOL assessment is indeed providing data that has incremental value in the management of these patients or in healthcare planning. As we attempt to move towards collecting data on outcomes, one of the lacunae in the field is the lack

of definitions of specific complications or the response to therapies. In fact, except for the severity of haemophilia and the high- and low-titre inhibitors, there were in the past no other definitions in haemophilia [58]. Even joints and muscle bleeds and the titre at which to consider inhibitors significant are not defined. All these are of vital importance in pivotal studies for assessment of CFC as well as Pregnenolone for the long-term assessments of PWH. An ISTH SSC group has recently provided these definitions, along with those for types of prophylaxis and assessment of after acute haemarthrosis and surgical haemostasis [59]. Another group is working on definitions of endpoints in clinical studies

[60]. All these will help in better study designs and outcomes data collection. Another hurdle to significant data collection in the past has been the lack of cooperative groups. This prevented data from being pooled and analysed as large cohorts. Over the past few years, this is changing. There are now several efforts towards cooperative data collection. One of the oldest, is the PEDNET group in Europe, a collaboration of 30 centres in 16 countries [61]. A system of well-defined data collection established nearly 15 years ago, has now led to a very robust database which has allowed some very important conclusions to be drawn, particularly with regard to inhibitors in previously untreated patients as well as other aspects of haemophilia management.

In contrast, this imaging method has been reported to be useful f

In contrast, this imaging method has been reported to be useful for assessing the therapeutic effect and identifying distant metastasis. While adequate objective comparison with other tests has not yet been made, FDG-PET is expected to play an important role in the clinical setting in the future (LF006735 level 1, LF107656 level 2b). Liver scintigraphy is not indicated

as an imaging method for the diagnosis of hepatocellular carcinoma because of its low detection capability on account of the limited spatial resolution. FDG-PET is based on the principle that this substance is taken up by tumor cells that show active glucose metabolism and Fulvestrant mw specifically accumulates in these cells by blocking the metabolic pathway. In metastatic liver cancer, with a decrease in the accumulation of FDG in the surrounding normal tissues, good FDG-PET images with a higher tumor/normal ratio can be obtained. However, for hepatocellular carcinomas showing a high degree of differentiation, FDG is dephosphorylated

again after phosphorylation and spreads out of the cells without showing sufficient accumulation. Therefore, FDG-PET is not recommended for the detection of primary hepatocellular carcinomas, because it is expensive, is not listed in the national health-care FK506 supplier system and is not superior to conventional diagnostic imaging modalities such as CT and/or MRI. In contrast, it is expected to be useful for the diagnosis of extrahepatic metastases and for assessment of the effect of therapy; thus, FDG-PET may have a role during systemic chemotherapy for hepatocellular carcinoma. CQ13 Is histologic diagnosis by needle biopsy necessary for a definitive diagnosis of hepatocellular carcinoma? Histologic diagnosis is not necessary when the diagnosis of hepatocellular carcinoma is determined by diagnostic imaging. (grade D) Histologic diagnosis by biopsy is indicated when imaging findings are atypical.

In such cases, the indications should be carefully determined according to individual patients. (grade C1) The diagnostic sensitivity of ultrasound-guided needle biopsy for hepatocellular carcinoma is 88.1–90% (LF104651 level 1, LF000872 level 1), the PPV is 100%, Methamphetamine negative predictive value (NPV) is 13–51.7% and the accuracy is 89.4–91% (LF104651 level 1, LF000872 level 1). False negatives are noted in 10–10.6% (LF000872 level 1, LF104651 level 1). The diagnostic sensitivity of fine needle biopsy for tumors 10 mm or less in diameter is 72.7% (24/33 nodules) (LF104651 level 1). Of 160 patients (225 benign or malignant lesions) who underwent resection determined by integrated diagnostic imaging without preoperative needle biopsy, the diagnosis made by preoperative diagnostic imaging was reported as correct in 156 patients (97.5%) (221 lesions, 98.2%) (LF022163 level 1). Serious complications associated with needle biopsy include needle tract seeding and hemorrhage. The incidence of the former is reported to be 1.6–3.

“The cheetah Acinonyx jubatus

“The cheetah Acinonyx jubatus XL765 nmr has suffered dramatic range contractions and population declines as a result of habitat degradation, prey depletion and conflict with humans. Of further concern is that many of Africa’s remaining cheetah populations persist in human-dominated and highly fragmented landscapes, where their ecology is poorly understood and population data are lacking. Presence–absence surveys may be a practical means to collect these data; however, failing to account for detection error can lead to biased estimates and misleading inferences; potentially having deleterious consequences for species conservation. The goal of this study was to identify how

an occupancy modelling technique that explicitly accounts for detectability could be used for quantifying cheetah status in human-impacted landscapes. Replicated camera-trap and track surveys of 100-km2 sample units were used to estimate the proportion of area occupied by cheetahs and to determine the survey effort required to inform conservation planning. Based on Selinexor research buy our results, 16 km [±standard error (SE) = 12–22] of walking or 193 camera-trap nights (±SE = 141–292) are required to confirm cheetah absence at a given 100-km2 grid cell (with 95% certainty). Accounting for detection resulted in an overall

cheetah occurrence estimate of 0.40 (SE = 0.13), which is 16% higher than the traditional presence–absence estimate that ignores detection error. We test a priori hypotheses to investigate factors limiting cheetahs using an occurrence probability model of their preferred prey. The results show that both cheetahs and their

prey were strongly negatively influenced by human settlements. Our study provides an unbiased estimate of occurrence that can be used to compare status across different sites and as a basis for long-term monitoring. Based on our results, we suggest that track and/or camera-trap surveys coupled with site occupancy models may be useful Olopatadine for targeted monitoring of cheetahs across their distribution. “
“Based on ecological information, the distribution range of Tatra vole Microtus tatricus from Central European Carpathian Mountains is distinctly fragmented even at the level of individual mountain ranges. To investigate genetic differentiation between populations, we used 17 microsatellite loci to assess population genetic parameters in 83 Tatra voles from eight localities in Western and one in High Tatra Mountains in Slovakia, including a non-continuous temporal sample spanning from 1978 to 2008. Bayesian analyses of individuals resulted in five clusters, showing congruence between relatedness of sampled individuals and geographical origin. Clustering was supported with F-statistics that showed moderate to pronounced genetic differentiation between clusters, but it was not consistent with isolation by distance analysis.

8 However, almost all RCTs comparing propranolol or nadolol to pl

8 However, almost all RCTs comparing propranolol or nadolol to placebo or to other pharmacotherapy excluded patients with advanced cirrhosis, especially patients with refractory ascites. Therefore, there is insufficient evidence on the relative risks and benefits of NSBB use in this subgroup of ill patients. The question of whether

the risk/benefit ratio favors the use of NSBB in patients with advanced cirrhosis remains unresolved. In this issue of HEPATOLOGY, Didier Lebrec, who originally described the effectiveness of propranolol in reducing the risk of variceal bleeding, and his colleagues from Clichy Selinexor attempt to answer this crucial question. They report the results of an observational study on the survival of 151 patients with cirrhosis with refractory ascites,9 as defined by the International Ascites Club.10 Of the 151 patients enrolled, 77 (51%) had esophageal varices and were taking propranolol, whereas the remaining 74 patients without varices (except four cases) were not. It is unclear whether propranolol was given as primary or secondary prophylaxis against variceal bleeding. Patients treated with propranolol had a significantly lower median survival of 5 months versus 20 months in patients not taking propranolol. Multivariable analysis showed that treatment with NSBB was one of the four

selleck compound predictors of mortality in this population of patients with cirrhosis. The authors concluded that propranolol was potentially harmful in patients with cirrhosis with refractory ascites, and therefore should be contraindicated. Before accepting the conclusion of this study, which involves a strong clinical recommendation, we believe that the characteristics

of the study and the quality of the results should be scrupulously evaluated. First, the study was not an RCT, which is the best way to evaluate the effects of specific medications. This is because the allocation of treatment by randomization is the only way to prevent selection bias. When treatment allocation is not randomized, unrecognized but often substantial differences between patient groups may alter the interpretation of results. For example, the group not receiving propranolol did not Rapamycin clinical trial have varices, and this difference immediately separates the two groups of patients into different risk categories for mortality.1 However, the HVPG before the initiation of treatment was similar in both groups. It is important to emphasize that the HVPG was measured only in selected patients in both groups. It is possible that the HVPG may have been higher in the NSBB group if measurements were carried out in all patients; this possible difference could then explain the higher mortality in the patients treated with propranolol. Second, the causes of death in two-thirds of cases were either progression of HCC or sepsis, 25 patients died from unknown causes, and nine patients were unaccounted for.

Gomez et al [9] have further contributed to our understanding of

Gomez et al.[9] have further contributed to our understanding of decompensation in cirrhosis. In particular, the group focused on patients from Latin America with the main objective to evaluate the 6-year cumulative incidence see more of overall mortality or transplantation, HCC, and major clinical outcomes of hepatic decompensation. The authors evaluated a large Cuban cohort of HCV patients with cirrhosis with two different

stages of compensated disease with the absence (stage 1) and presence of varices (stage 2). The study was conducted as a prospective longitudinal “inception cohort” study. Between 2004 and 2007, 402 patients were included in the study if they were >18 years of age, had confirmed

find more diagnosis of cirrhosis based on clinical, laboratory, and imaging findings, or histology, without a history of decompensation and absence of alcoholism. Patients were excluded if there was concurrent liver disease, concomitant diseases with reduced life expectancy, psychiatric disease, or HCC. Noninvasive studies were relied on to make the diagnoses of cirrhosis in some patients. This may influence the findings, as noninvasive testing can occasionally misdiagnose cirrhosis. The primary outcome of the study was overall mortality or liver transplantation. Secondary outcomes were diagnosis of HCC, variceal hemorrhage, ascites, hepatic encephalopathy, spontaneous bacterial peritonitis, jaundice, and development of varices in patients (in stage 1 patients only). Similar to previous studies, the authors found that patients with stage 2 disease with varices had poorer outcomes when compared to stage 1 disease without varices. The cumulative overall mortality or liver transplantation at 312 weeks was significantly lower in stage 1 cirrhosis without varices (15%) compared to stage 2 cirrhosis with varices (45%). Also consistent with previously published results, the incidence

of HCC at 312 weeks was significantly lower in patients with stage 1 cirrhosis (9%) compared to stage 2 cirrhosis (29%). Notably, C-X-C chemokine receptor type 7 (CXCR-7) patients were screened for HCC every 6 months with liver ultrasonography and α-fetoprotein determination throughout the study. Similar to previous findings, ascites was the most common first decompensating event, at 15%. Variceal hemorrhage and hepatic encephalopathy each occurred as the first decompensating event in 5% of patients. The occurrence of clinical decompensation was different in patients with stage 1 and 2 cirrhosis. One possible explanation is that patients both with (higher HVPG) and without varices (lower HVPG) were included. Patients with stage 2 cirrhosis with varices had a higher 6-year cumulative incidence of decompensation at 66% but stage 1 patients without varices had a significantly lower incidence, at 26%.