Atalanta v Liverpool: Joel Matip and Naby Keita face late fitness tests before Champions League tie

Liverpool
Liverpool have won 1-0 away at Ajax and 2-0 at home against FC Midtjylland in the Champions League this season

Defender Joel Matip and midfielder Naby Keita face late fitness tests before Liverpool’s Champions League game at Atalanta on Tuesday (20:00 GMT).

The pair trained on Sunday, but midfielder Thiago Alcantara was absent as he recovers from a knee injury.

“We have to wait until the medical department gives us a green, orange or red light,” said manager Jurgen Klopp.

Liverpool have won both of their Champions League games this season and are top of Group D.

Meanwhile, Atalanta, who reached the quarter-finals of the 2019-20 competition, have picked up four points from their opening two matches and are second.

This will be Liverpool’s first European match against the Italian side and Klopp is expecting a tough game.

“They obviously have a really good atmosphere, a good mood and are a proper fighting unit,” said the German.

“They are very well organised; play their system with 100% conviction, they know exactly what everybody has to do.

“I know how good they are. I actually enjoyed the analysis, I enjoyed watching them because it’s really interesting.”

Premier League leaders Liverpool will be playing their sixth game in 18 days.

Matip has only featured twice this season and missed the past four matches, while Keita has been absent for five games because of a muscle injury.

Centre-half Virgil van Dijk is expected to miss most of the season with a cruciate knee ligament injury, while stand-in defender Fabinho sustained a hamstring problem in the 2-0 home win against Danish side FC Midtjylland last week.

“We have, in the moment, more centre-halves available than we probably will line up together, which is good,” added Klopp.

MATCH FACTS

Atalanta

  • Atalanta are set to face their third different English opponent, having previously met Everton in the 2017-18 Europa League (played two, won two) and Manchester City in the Champions League last season (played two, drew one, lost one).
  • Since losing their first three group-stage games in the Champions League last season, Atalanta have gone unbeaten in their past five group-stage games in the competition (won three, drew two), including both this season (won one, drew one).
  • Excluding qualifiers, Atalanta have only failed to score in one of their past 19 games in major European competition (4-0 v Dinamo Zagreb last season), while they have averaged 2.1 goals per game over the course of this run (40 goals in total).
  • Duvan Zapata has been directly involved in six goals in five Champions League starts for Atalanta (four goals and two assists), while he scored twice in their 2-2 draw against Ajax on matchday two.

Liverpool

  • Liverpool have lost all three of their away Champions League matches in Italy under manager Jurgen Klopp, losing to Roma in May 2018 and Napoli in October 2018 and September 2019.
  • Liverpool have won each of their past three away games in the Champions League group stage, after losing four in
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More Data Tie Biologics to Fewer Colectomies in Ulcerative Colitis

Trends in colectomy rates over the past 2 decades reinforced data that biologics may reduce the need for colectomy in ulcerative colitis (UC), a researcher reported here.

A temporal trends analysis found the prevalence of colectomy decreased from 10.8% in 2000 to 2.1% in 2019, and this decline coincided with a linear increase in the prevalence of biologic medication utilization in UC from 0.5% in 2000 to 12.8% in 2019 (P<0.001), according to George Khoudari, MD, of the Cleveland Clinic and Case Western Reserve University.

“Although prior smaller data sets have suggested a decrease, there were no population-based studies to evaluate biologics on colectomy,” senior author Miguel Regueiro, MD, also of the Cleveland Clinic,” said in an interview. “We felt that evaluation of a real world large population-based database would be important.”

Data were extracted from the commercial database Explorys, a repository of electronic health records data from 26 major integrated U.S. healthcare systems from, he explained in a presentation at the American College of Gastroenterology virtual meeting.

Using Systematized Nomenclature of Medicine Clinical Terms, the investigators identified all UC patients older than age 18 to examine the prevalence of UC-related colectomy and biologics utilization. Biologics included anti-tumor necrosis factor, anti-integrin, and anti-interleukin-12/23 agents.

Of 61,592,650 patients in the database, 46,430 were diagnosed with UC from 2000 to 2019. Of these, 15,020 (10.2%) had colectomy and 10,050 (6.8%) were treated with biologics. After adjusting for other therapies such as mesalamine, corticosteroids, and thiopurines, biologics were inversely related to colectomy (P<0.001, respectively, while there was no inverse relationship between mesalamine and colectomy (P<0.001).

According to Regueiro, current data support the effectiveness of earlier use of biologics in the disease course. “Earlier use allows for better rates of healing and less inflammation equates to less likely need for colectomy.” But is it possible that biologics just delay the need for colectomy, especially in severe cases? “For patients hospitalized, which is not the population we studied, yes this is possible,” he said. “However there is some information coming out soon that complete remission of severe cases would also lead to less surgery, not just in the short term but the long term.”

Edward L. Barnes, MD, of the University of North Carolina at Chapel Hill, commented that the study was “an important next step in demonstrating what now appears to be a strong signal of a decreasing colectomy rate in recent years with the increased prevalence of biologic use among UC patients.”

While gastroenterologists have been optimistic that biologics would reduce colectomies, “this was initially only a hope,” said Barnes, who was not involved with the research. The current study as well as others support a genuine effect on colectomy rates.

And given that the new analysis included some of the newest UC treatments, such as anti-integrin and anti-interleukin-12/23 therapies, “there is hope that, with continued advancement of our therapeutic armamentarium, we will see a progression of this trend,” he said.

But Barnes added, “It is important

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