449 resultados para Cryptogenic Cirrhosis


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Pós-graduação em Fisiopatologia em Clínica Médica - FMB

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Hepatitis C virus (HCV) is a serious public health problem and is the leading cause of liver transplantation due to cirrhosis and hepatocellular carcinoma. In Brazil, it is estimated that there are approximately 2 to 3 million HCV chronic carriers. Few data regarding HCV infection are available in West region of Minas Gerais State. Due to the absence of an effective vaccine against this important human pathogen and the high costs of antiviral treatment, it is important to conduct epidemiological studies with the purpose of carry out the planning and implementation of measures to prevent hepatitis C in different populations. Therefore, the aim of this study is to describe the epidemiological aspects of HCV patients from West region of Minas Gerais State, Brazil. Sociodemographic data and risk factors for HCV infection were determined from 74 HCV patients from Uberlandia city (Minas Gerais State). Reactive anti-HCV sera samples were submitted to HCV RNA and genotype detection. Most of individuals were male (63.5%) with mean age of 51 years and presenting low socioeconomic status. HCV genotype was determined among 40 samples and the frequencies were: genotype 2 (45%), 1 (37.5%) and 3 (17.5%). Hepatitis C virus (HCV) infection was common among male and low socioeconomic status individuals.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Osteoporosis is well recognized as a cirrhosis complication; however, most studies assessing this condition included only patients on liver transplantation lists with an elevated rate of bone diseases. While general population studies show that handgrip strength is clearly associated with bone mineral density, until now this tool has not been applied to cirrhotic patients in relation to their bone condition. This study aimed to evaluate whether handgrip strength, bone and liver tests may be useful as predictors of bone disease in cirrhotic outpatients. 129 subjects were included (77 men and 52 women). Dual energy X-ray absorptiometry was applied to evaluate lumbar-spine and femoral-neck T scores. Osteoporosis/osteopenia rates were 26.3%/35.6% in the lumbar spine and 6.9%/41.8% in the femoral neck, respectively. Model selections were based on backward procedures to find the best predictors of low T scores. For lumbar spine, only low handgrip strength and high parathyroid hormone levels were clearly related to low T scores. For femoral neck, only age was associated with low T scores. Handgrip strength may serve as an effective predictor of low lumbar spine T score among cirrhotic outpatients. As cirrhosis affects the lumbar spine more than the femoral neck, these results suggest that handgrip strength should be tested in all cirrhotic patients as a first indicator of bone health. This article is protected by copyright. All rights reserved.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Pós-graduação em Fisiopatologia em Clínica Médica - FMB

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Infection with hepatitis C virus is a worldwide public health problem it affects about 170 to 250 million people worldwide may lead to complications such as cirrhosis and hepatocellular carcinoma. Patients with chronic hepatitis C most often is inadequate nutrient intake, macro and micronutrients, which induces changes in nutritional status and lipid profi le. Supplementation with vitamin C has shown benefi t. Limited information is available on levels of vitamin C in this type of illness. The study aimed to evaluate the effect of regular intake of orange juice on the nutritional and dietetic of patients with chronic hepatitis C infection. The study enrolled 23 patients volunteers, 13 men and 10 women treated at the Special Health Service of Araraquara (SESA). They consumed for 8 weeks 500 mL.d-1 of pasteurized orange juice. At baseline and after 8 weeks of juice intake the patients were evaluated for anthropometric parameters. The dietary intervention with 500 mL.d-1 with orange juice during the 8 weeks did not alter the nutritional status of patients.

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Liver cirrhosis (LC) is a disease with high mortality rates and its only definitive treatment is the orthotopic liver transplantation (OLT). Unfortunately, not all patients have access to OLT and many of them end up dying on the transplant waiting list. The use of branched chain amino acids (BCAA) is widely known as an effective treatment for improving the quality of life of these patients. For the first time, in this paper we documented a great improvement of clinical and laboratorial tests of a patient treated with BCAA, which allowed him to be out of the transplant waiting list. In addition to the increase of the MELD score, the patient achieved restabilization of body weight and recovery of the quality of life registered by the SF-36 questionnaire.

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Hepatic encephalopathy (HE) is a functional disorder of the central nervous system (CNS) associated with liver failure, either end-stage chronic liver disease or fulminant hepatic failure. Its pathogenesis remains complex and poorly understood. In view of recent advances in the management of HE, the Brazilian Society of Hepatology endorsed a monothematic meeting regarding HE in order to gather experts in the field to discuss related data and to draw evidence-based recommendations concerning: management of HE and intracranial hypertension in FHF, treatment of episodic HE in cirrhosis, controversies in the management of EH including difficult to treat cases and diagnostic and treatment challenges for minimal HE. The purpose of this review is to summarize the lectures and recommendations made by the panel of experts of the Brazilian Society of Hepatology.

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The real role of renal transplantation in hepatic fi brosis progression caused by hepatitis C virus is still unpredictable. Histological evaluation of the liver is the best form to estimate fi brosis evolution, although semiquantitative analysis carries important limitations. Objective: To apply a morphometric quantitative assay on hepatic fi brosis progression in renal recipients with hepatits C. Methods: Thirty patients were initially evaluated, but only seven were included. They underwent the fi rst biopsy near the transplantation date and the second biopsy at least 4 years later. The immunosuppressant therapy adopted in all cases was azatioprine and micofenolate. Fibrosis progression rate (FPR) was calculated before and after the surgery date in each patient according to Metavir score and morphometric analysis. Results: The FPR calculated by Metavir score showed no statistical difference between pre- and post-transplantation (p=0.9). The FPR calculated by the morphometric analysis was 0.58 ± 0.78 before transplantation and 3.0 ± 3.3 after the surgery, with statistical signi- fi cance between these values (p=0.0026). Conclusion: In the sample assessed, the progression of hepatic fi brosis was documented and quantifi ed only by the morphometric analysis, which is as a promising approach to histological evaluation of these patients.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Pós-graduação em Pesquisa e Desenvolvimento (Biotecnologia Médica) - FMB