Navegando por Palavras-chave "liver disease"

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    Differentiating cirrhosis and chronic hepatospienic schistosorniasis using MRI
    (Amer Roentgen Ray Soc, 2008-03-01) Bezerra, Alexandre Sergio de Araujo [UNIFESP]; D'Ippolito, Giuseppe [UNIFESP]; Caldana, Rogerio Pedreschi [UNIFESP]; Leopoldino, Denise D.; Batista, Giovani Rodrigues [UNIFESP]; Borges, Durval Rosa [UNIFESP]; Lopes Filho, Gaspar de Jesus [UNIFESP]; Ahmed, Muneeb; Universidade Federal de São Paulo (UNIFESP); SARAH Network Hosp Reabilitat; Beth Israel Deaconess Med Ctr
    OBJECTIVE. the objective of our study was to identify which imaging features may be used to differentiate between cirrhosis and chronic hepatosplenic schistosomiasis and to assess image interpretation agreement for MRI findings.MATERIALS and METHODS. Retrospective review of 27 patients with alcoholic or virus-induced cirrhosis and 24 patients with chronic hepatosplenic schistosorniasis who underwent MRI (1.5 T) of the abdomen was performed. Images were interpreted independently by two radiologists evaluating the following MRI features: hepatic fissure widening, irregularity of hepatic contours, periportal fibrosis, hepatic parenchyma heterogeneity, and splenic siderotic nodules. Left, right, and caudate hepatic lobe measurements were obtained, and the splenic index was measured. the Fisher's exact test, chi-square test, and Student's t test were used to compare both groups, and regression analysis was performed. Observer agreement was measured using kappa and intraclass correlation tests.RESULTS. Periportal fibrosis, heterogeneity of hepatic parenchyma, and splenic siderotic nodules were more frequent in the group with schistosomiasis (p < 0.05), with periportal fibrosis showing the largest difference in presence and distribution (peripheral greater than central). the transverse diameter of the right hepatic lobe, caudate lobe-right lobe ratio, and splenic index were larger in patients with chronic schistosomiasis (P < 0.001). At multiple regression analysis, splenic siderotic nodules, splenic index, and caudate lobe-right lobe ratio were predictive of schistosomiasis. Observer agreement was substantial or almost perfect for almost all variables analyzed (K or r = 0.81-1.00).CONCLUSION. the presence of peripheral periportall fibrosis,heterogeneity of hepatic parenchyma, and splenic siderotic nodules, and the splenic index and caudate lobe-right lobe ratio are useful features for differentiating alcoholic or virus-induced cirrhosis from chronic schistosomiasis using MRI.
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    Histological evolution of hepatitis C virus infection after renal transplantation
    (Wiley-Blackwell, 2012-11-01) Oliveira Uehara, Silvia Naomi de [UNIFESP]; Emori, Christini Takemi [UNIFESP]; Pereira, Patrícia da Silva Fucuta [UNIFESP]; Perez, Renata M.; Medina Pestana, Jose Osmar; Lanzoni, Valeria Pereira; Souza e Silva, Ivonete Sandra [UNIFESP]; Benedito Silva, Antonio Eduardo [UNIFESP]; Ferraz, Maria Lucia Cardoso Gomes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal do Rio de Janeiro (UFRJ)
    Background: information regarding histological progression of hepatitis C after renal transplant (RTx) is scarce. Aims: To analyze clinical and laboratory evolution and histological progression of hepatitis C in patients evaluated before and after RTx.Methods: Twenty-two HCV-infected patients submitted to liver biopsy pre- and post-RTx were included. A semiquantitative analysis of necroinflammatory activity and fibrosis staging was performed and the two biopsies were compared.Results: Patients were mostly men (73%) with mean age of 36 +/- 9 yr. Time post-transplant was 4 +/- 2 yr and time between biopsies was 5 +/- 2 yr. An elevation of alanine aminotransferase (p = 0.041) and aspartate aminotransferase (p = 0.004) levels was observed in the post-transplant period. Fibrosis progression after renal transplantation was observed in 11 (50%) of the patients, and necroinflammatory activity worsening was observed in 7 (32%) of the patients. the histological progression occurred even among those without significant histological lesions in pre-transplant biopsy.Conclusion: the findings of this study suggest that the practice of indicating treatment in the pre-transplant phase based mainly on histological disease should be revised, because a high proportion of patients present disease progression. Because interferon cannot be used safely after RTx, treatment should be indicated for all ESRD patients with hepatitis C.
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    Role of gamma-glutamyl transferase activity in patients with chronic hepatitis C virus infection
    (Blackwell Publishing Asia, 2004-03-01) Souza e Silva, Ivonete Sandra de [UNIFESP]; Ferraz, MLCG; Perez, R. M.; Lanzoni, V. P.; Figueiredo, V. M.; Silva, AEB; Universidade Federal de São Paulo (UNIFESP)
    Background: Increased serum gamma-glutamyl transferase (GGT) levels are frequently observed in chronic hepatitis C virus (HCV) infection. However, the significance of this finding remains unclear. the purpose of the present paper was to assess the relationship between GGT levels and clinical, biochemical and histological features in chronic HCV-infected carriers.Methods: Patients with a liver biopsy presenting anti-HCV and HCV-RNA were evaluated. Age, gender, risk factors of transmission, serum alanine aminotransferase (ALT), GGT and alkaline phosphatase (ALP) levels and histological features were assessed in all. Data were analyzed statistically by the chi(2) test and multivariate logistic regression analysis.Results: Among 201 patients studied, elevated GGT levels and bile duct damage were observed in 48% and 35% of them, respectively. No association was seen between GGT level and bile duct damage or between GGT level and hepatic steatosis. Inititally, age >40 years (P=0.007), elevated ALT (P=0.01), grading of inflammatory activity (P=0.004) and staging of fibrosis (P<0.001) were found to be associated with elevated GGT levels. After multivariate regression analysis, histology grading 3 and 4 inflammation activity (P=0.01) and staging 3 and 4 fibrosis (P=0.01) remained independently associated with elevated GGT level.Conclusions: A significant number of patients with chronic HCV infection had elevated serum GGT levels. Furthermore, this enzyme seemed to be useful as an indirect marker of more advanced liver disease in chronic hepatitis C. (C) 2004 Blackwell Publishing Asia Pty Ltd.