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Donato G, de Medeiros Filho JEM, Melo M. Hepatic and cardiac shear wave elastography in the assessment of hereditary transthyretin amyloidosis. Med Clin (Barc) 2024; 162:308-309. [PMID: 38044183 DOI: 10.1016/j.medcli.2023.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/21/2023] [Accepted: 10/25/2023] [Indexed: 12/05/2023]
Affiliation(s)
- Glaudir Donato
- Center of Medical Sciences, Federal University of Paraíba, João Pessoa, Brazil
| | | | - Marcelo Melo
- Center of Medical Sciences, Federal University of Paraíba, João Pessoa, Brazil; Department of Cardiology, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Brazil.
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Lobato CMDO, Codes L, Silva GF, Souza AFM, Coelho HSM, Pedroso MLA, Parise ER, Lima LMSTDB, Borba LA, Evangelista AS, Rezende REF, Cheinquer H, Kuniyoshi ASO, Aires RS, Quintela EHD, Mendes LSC, Nascimento FCV, Medeiros Filho JEMD, Ferraz MLCG, Abdala E, Bittencourt PL. Direct antiviral therapy for treatment of hepatitis C: A real-world study from Brazil. Ann Hepatol 2020; 18:849-854. [PMID: 31537509 DOI: 10.1016/j.aohep.2019.08.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 07/31/2019] [Accepted: 08/06/2019] [Indexed: 02/04/2023]
Abstract
INTRODUCTION AND OBJECTIVES Direct antiviral agents (DAAs) including sofosbuvir (SOF), daclatasvir (DCV), simeprevir (SIM) and ombitasvir, paritaprevir and dasabuvir were introduced 2015 in Brazil for treatment of hepatitis C virus (HCV) infection. The aims of this study were to assess effectiveness and safety of HCV treatment with DAA in real-life world in a highly admixed population from Brazil. MATERIALS AND METHODS All Brazilian reference centers for HCV treatment were invited to take part in a web-based registry, prospectively conducted by the Brazilian Society of Hepatology, to assess outcomes of HCV treatment in Brazil with DAAs. Data to be collected included demographics, disease severity and comorbidities, genotype (GT), viral load, DAA regimens, treatment side effects and sustained virological response (SVR). RESULTS 3939 patients (60% males, mean age 58±10 years) throughout the country were evaluated. Most had advanced fibrosis or cirrhosis, GT1 and were treated with SOF/DCV or SOF/SIM. Overall SVR rates were higher than 95%. Subjects with decompensated cirrhosis, GT2 and GT3 have lower SVR rates of 85%, 90% and 91%, respectively. Cirrhosis and decompensated cirrhosis in GT1 and male sex and decompensated cirrhosis in GT3 were significantly associated with no SVR. Adverse events (AD) and serious AD occurred in 18% and 5% of those subjects, respectively, but less than 1% of patients required treatment discontinuation. CONCLUSION SOF-based DAA regimens are effective and safe in the heterogeneous highly admixed Brazilian population and could remain an option for HCV treatment at least in low-income countries.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Luiz Augusto Borba
- Ambulatório de Hepatites Virais da Prefeitura Municipal de Criciúma, Criciúma, SC, Brazil
| | | | | | - Hugo Cheinquer
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | | | | | | | | | | | | | - Edson Abdala
- Universidade de São Paulo, São Paulo, SP, Brazil
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Lira MMP, de Medeiros Filho JEM, Baccin Martins VJ, da Silva G, de Oliveira Junior FA, de Almeida Filho ÉJB, Silva AS, Henrique da Costa-Silva J, de Brito Alves JL. Association of worsening of nonalcoholic fatty liver disease with cardiometabolic function and intestinal bacterial overgrowth: A cross-sectional study. PLoS One 2020; 15:e0237360. [PMID: 32845887 PMCID: PMC7449384 DOI: 10.1371/journal.pone.0237360] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 07/23/2020] [Indexed: 12/15/2022] Open
Abstract
Background & aims Non-alcoholic fatty liver disease (NAFLD) has been associated with small bowel bacterial overgrowth (SIBO) and cardiometabolic dysfunction. This cross-sectional study aimed to evaluate the cardio-metabolic parameters and SIBO in patients with different degrees of hepatic fibrosis estimated by NAFLD fibrosis score (NFS). Methods Subjects (n = 78) were allocated to three groups: Healthy control (n = 30), NAFLD with low risk of advanced fibrosis (NAFLD-LRAF, n = 17) and NAFLD with a high risk of advanced fibrosis (NAFLD-HRAF, n = 31). Anthropometrics, blood pressure, electrocardiogram and heart rate variability (HRV) were evaluated. Only the NAFLD-LRAF and NAFLD-HRAF groups were submitted to blood biochemical analysis and glucose hydrogen breath tests. Results The NAFLD-HRAF group had higher age and body mass index when compared to the control and NAFLD-LRAF groups. The prevalence of SIBO in the NAFLD group was 8.33%. The low frequency/high-frequency ratio (LF/HF ratio) was augmented in NAFLD-LRAF (p < 0.05) when compared with control group. NAFLD-HRAF group had a wide QRS complex (p < 0.05) and reduced LF/HF ratio (p < 0.05) compared to the control and NAFLD-LRAF groups. Serum levels of albumin and platelets were more reduced in the NAFLD-HRAF subjects (p < 0.05) than in the NAFLD-LRAF. Conclusions NAFLD impairs cardiac autonomic function. Greater impairment was found in subjects with a worse degree of hepatic fibrosis estimated by NFS. Hypoalbuminemia and thrombocytopenia were higher in subjects with a worse degree of hepatic fibrosis, whereas prevalence of SIBO positive was similar between the groups.
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Affiliation(s)
- Marília Marques Pereira Lira
- Department of Nutrition, Health Sciences Center, Federal University of Paraiba, João Pessoa, Brazil
- Department of Internal Medicine, Medical Sciences Center, Federal University of Paraiba, João Pessoa, Brazil
- Lauro Wanderley Hospital, Federal University of Paraiba, João Pessoa, Brazil
| | - José Eymard Moraes de Medeiros Filho
- Department of Internal Medicine, Medical Sciences Center, Federal University of Paraiba, João Pessoa, Brazil
- Lauro Wanderley Hospital, Federal University of Paraiba, João Pessoa, Brazil
| | - Vinícius José Baccin Martins
- Department of Physiology and Pathology, Health Sciences Center, Federal University of Paraiba, João Pessoa, Brazil
| | - Gitana da Silva
- Lauro Wanderley Hospital, Federal University of Paraiba, João Pessoa, Brazil
| | | | | | - Alexandre Sérgio Silva
- Department of Physical Education, Health Sciences Center, Federal University of Paraiba, João Pessoa, Brazil
| | - João Henrique da Costa-Silva
- Department of Physical Education and Sport Sciences, Federal University of Pernambuco, Vitória de Santo Antão, PE, Brazil
| | - José Luiz de Brito Alves
- Department of Nutrition, Health Sciences Center, Federal University of Paraiba, João Pessoa, Brazil
- * E-mail: ,
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Queiroga MDLAD, Paraná R, Medeiros Filho JEMD, Figueiredo GCA, Araújo APD, Leite HWS, Aquino IDS, Melo Neto LHDA. GAMMA GLUTAMYLTRANSFERASE IMPACT IN THERAPEUTIC RESPONSE OF CHRONIC HEPATITIS C: a systematic review of the literature. Arq Gastroenterol 2016; 52:239-46. [PMID: 26486294 DOI: 10.1590/s0004-28032015000300016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 03/17/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND The standard treatment of chronic hepatitis C is the administration of pegylated interferon α2a or α2b in combination with ribavirin, but adverse effects can be observed, as well as the high cost of this therapy. Therefore, there is interest in understanding the predictors of sustained virologic response, as the gamma glutamyltransferase. OBJECTIVE To evaluate the serum levels of gamma glutamyltransferase as a predictor of response to treatment with pegylated interferon α and ribavirin in chronic hepatitis C. METHODS This is a systematic review of literature, conducted by consulting PUBMED, LILACS, MEDLINE, SCOPUS, Cochrane electronic databases, and active search of articles selected between January 2000 and April 2013. RESULTS A total of 4,785 titles were identified. Out of those material, following inclusion and exclusion criteria, 273 abstracts were selected, by two independent researchers. After reading those texts, the reviewers consensually included ten studies for systematization and classification, according to the criteria of the Oxford Scale. 1B studies are predominant (prospective cohort study - six studies). Rapid virologic response and early virological response were considered as estimates for the sustained virological response. The frequency of virologic response was identified in three studies and early virological response in two, with a total of 392 and 413 patients, respectively; sustained virologic response was reported in nine articles corresponding to 3,787 patients (76.5 %). CONCLUSION Gamma glutamyltransferase is a predictor of sustained virologic response in the treatment of chronic hepatitis C with pegylated interferon α2a or α2b associated with ribavirin.
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Affiliation(s)
| | - Raymundo Paraná
- Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina, Universidade Federal da Bahia, Salvador, BA, BR
| | | | - Giovannini Cesar A Figueiredo
- Centro de Ciências Biológicas e da Saúde, Unidade Acadêmica de Ciências Médicas, Universidade Federal de Campina Grande, Campina Grande, PB, BR
| | - Ananda Peixoto de Araújo
- Centro de Ciências Biológicas e da Saúde, Unidade Acadêmica de Ciências Médicas, Universidade Federal de Campina Grande, Campina Grande, PB, BR
| | - Hagley Walson Soares Leite
- Centro de Ciências Biológicas e da Saúde, Unidade Acadêmica de Ciências Médicas, Universidade Federal de Campina Grande, Campina Grande, PB, BR
| | - Itiel de Souza Aquino
- Centro de Ciências Biológicas e da Saúde, Unidade Acadêmica de Ciências Médicas, Universidade Federal de Campina Grande, Campina Grande, PB, BR
| | - Leonardo Honório de A Melo Neto
- Centro de Ciências Biológicas e da Saúde, Unidade Acadêmica de Ciências Médicas, Universidade Federal de Campina Grande, Campina Grande, PB, BR
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