Navegando por Palavras-chave "Liver diseases"
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- ItemAcesso aberto (Open Access)Análise morfológica dos fígados e rins no binômio materno-fetal após tratamento de ratas prenhes com Ritonavir durante toda a prenhez(Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2007-07-01) Carvalho, Adelino Moreira De; Simões, Ricardo Santos [UNIFESP]; Oliveira, Fábio Hideo Martins; Simões, Manuel de Jesus [UNIFESP]; Oliveira-filho, Ricardo Martins; Nakamura, Mary Uchiyama [UNIFESP]; Kulay Júnior, Luiz [UNIFESP]; Universidade José do Rosário Vellano Faculdade de Ciências Médicas; Universidade Federal de São Paulo (UNIFESP); Irmandade da Santa Casa de Misericórdia de São Paulo Faculdade de Ciências Médicas Departamento de Obstetrícia; Universidade de São Paulo (USP)PURPOSE: to evaluate the effect of the chronic administration of three different doses of Ritonavir in the liver and kidneys of pregnant albino rats and their concepts from a morphological standpoint. METHODS: forty pregnant albino EPM-1 Wistar rats were randomly divided into four groups: Contr (vehicle control), and three experimental groups, Exp20, Exp60, Exp180, which received daily 20, 60 or 180 mg/kg of Ritonavir, respectively. The drug and the vehicle (propyleneglycol) were orally administered by gavage, from the first up to the 20th day of pregnancy. At the last experimental day, all the animals were sacrificed under deep anesthesia, and fragments from the maternal and fetal liver and kidneys were taken and prepared for histological analysis by light microscope. RESULTS: no morphological changes were identified in Exp20 and control group. In the Exp60 group, we found hepatocytes with signs of atrophy and apoptosis (eosinophilic cytoplasm and picnotic nuclei) and marked sinusoid capillary vasodilation (congestion). The proximal convoluted tubules of maternal kidneys and liver showed eosinophilic areas and hyperchromatic nuclei, as well as signs of vasodilation. The maternal kidneys and livers of the Exp180 rats presented more prominent morphological changes than the ones of Exp60. Regarding the fetal organs, no histomorphological abnormalities were observed in all the groups. CONCLUSIONS: our results show that the administration of Ritonavir to pregnant rats, in higher than conventional doses causes morphological changes in the maternal liver and kidneys. On the other hand, the lack of abnormalities in the fetal organs may be due to the protective role of glycoprotein P.
- ItemEmbargoEfetividade do protocolo de seguimento dos pacientes portadores de carcinoma hepatocelular submetidos a transplante de fígado no Estado de São Paulo(Universidade Federal de São Paulo, 2024-08-28) Takenaka, Vanessa Suemi [UNIFESP]; Gonzales, Adriano Miziara [UNIFESP]; Massarollo, Paulo Celso Bosco; Pugliese, Vincenzo; http://lattes.cnpq.br/2026297584459610; http://lattes.cnpq.br/5725342608697013; http://lattes.cnpq.br/6234829429056217; http://lattes.cnpq.br/1650050413368675Objetivo: Avaliar o percentual de falha na identificação de pacientes portadores de carcinoma hepatocelular (CHC) submetidos à transplante hepático (TxH) fora dos critérios válidos no Brasil - Critérios de Milão/Brasil (CMB) no momento do transplante, avaliar as variáveis clínico-epidemiológicas e sobrevida global destes pacientes. Métodos: Foram coletadas informações do banco de dados da Central de Transplantes do Estado de São Paulo, de pacientes submetidos à TxH com doador falecido em situação especial por CHC, no período entre janeiro de 2012 a janeiro de 2022. Classificados em dois grupos: Dentro do CMB e fora do CMB, baseado no estadiamento anatomopatológico dos fígados explantados. Resultados: Dos 1115 pacientes transplantados em São Paulo nesse período por CHC, 988 (88,6%) estavam dentro dos CMB no momento do TxH e 127 (11,4%) foram transplantados fora dos CMB. Comparando os grupos os pacientes que foram inscritos após downstaging (11,6% dentro CMB e 25,2% fora CMB -p<0,001), estadiamento na inscrição como CMB (dentro CMB 16,9% e fora CMB 21,3%; p = 0,015), estadiamento no exame de imagem pré-TxH (dentro CMB 22,8% e fora CMB 44,1% ; p <0,001), e maior nível de AFP no exame de inscrição analisando o log AFP (p=0,004) e AFP pré-transplante (dentro CMB de 74,63 ng/mL e fora CMB de 252,27 ng/mL – p=003), foram os que tiveram maior chance de serem transplantados além do CMB. A sobrevida em 5 anos dos pacientes dentro dos CMB foi de 68% e dos pacientes que estavam fora dos CMB de 46%, com diferença estatisticamente significativa (p< 0,0001). Conclusões: O protocolo de seguimento para assegurar que os pacientes portadores de CHC sejam submetidos a transplante de fígado dentro dos critérios estabelecidos falha em 11,4%, com pior sobrevida nesse grupo. Os pacientes com maior risco de serem transplantados além dos critérios são: submetidos à downstaging, estadiamento mais avançado na inscrição e no pré-TxH, e maior nível de AFP no exame de inscrição e pré-TxH.
- ItemAcesso aberto (Open Access)Prospective study of bacteremia rate after elective band ligation and sclerotherapy with cyanoacrylate for esophageal varices in patients with advanced liver disease(Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, 2011-12-01) Bonilha, Danielle Queiroz [UNIFESP]; Correia, Lucianna Motta [UNIFESP]; Monaghan, Marie; Lenz, Luciano [UNIFESP]; Santos, Marcus [UNIFESP]; Libera, Ermelindo Della [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); King's College London School of Medicine; Laboratório FleuryCONTEXT: Band ligation (BL) is the most appropriate endoscopic treatment for acute bleeding or prophylaxis of esophageal variceal bleeding. Sclerotherapy with N-butyl-2-cyanoacrylate (CY) can be an alternative for patients with advanced liver disease. Bacteremia is an infrequent complication after BL while the bacteremia rate following treatment with CY for esophageal varices remains unknown. OBJECTIVES: To evaluate and compare the incidence of transient bacteremia between cirrhotic patients submitted to diagnostic endoscopy, CY and BL for treatment of esophageal varices. METHODS: A prospective study comprising the period from 2004 to 2007 was conducted at Hospital of Universidade Federal de São Paulo (UNIFESP), UNIFESP, SP, Brazil. Cirrhotic patients with advanced liver disease (Child-Pugh B or C) were enrolled. The patients were divided into two groups according treatment: BL Group (patients undergoing band ligation, n = 20) and CY Group (patients receiving cyanoacrylate injection for esophageal variceal, n = 18). Cirrhotic patients with no esophageal varices or without indication for endoscopic treatment were recruited as control (diagnostic group n = 20). Bacteremia was evaluated by blood culture at baseline and 30 minutes after the procedure. RESULTS: After 137 scheduled endoscopic procedures, none of the 58 patients had fever or any sign suggestive of infection. All baseline cultures were negative. No positive cultures were observed after CY or in the control group - diagnostic endoscopy. Three (4.6 %) positive cultures were found out of the 65 sessions of band ligation (P = 0.187). Two of these samples were positive for coagulase-negative staphylococcus, which could be regarded as a contaminant. The isolated microorganism in the other case was Klebsiella oxytoca. The patient in this case presented no evidence of immunodeficiency except liver disease. CONCLUSIONS: There was no significant difference in bacteremia rate between these three groups. BL or CY injection for non-bleeding esophageal varices may be considered as low-risk procedures regarding bacteremia even when performed on patients with advanced liver disease.
- ItemAcesso aberto (Open Access)Questionário para Avaliação de Qualidade de Vida em Portadores de Doença Hepática Crônica: Tradução e Validação do CLDQ – Chronic Liver Disease Questionnaire(Universidade Federal de São Paulo (UNIFESP), 2009-04-29) Mucci, Samantha [UNIFESP]; Nogueira-Martins, Luiz Antonio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The aim of this study was to carry out the translation from English into Portuguese and the transcultural adaptation of the Chronic Liver Disease Questionnaire to use in Brazil. The instrument was translated from the original version (English) into Portuguese language by the authors and then, it was revised. The degree of difficulty of the translations and equivalence for bilingual translators were evaluated. The instrument was, then, applied in 20 patients with chronic liver disease randomly selected. It was easy to the patients understand the instrument, all the questions had been considered applicable by the patients, and the cultural equivalence of the CLDQ was demonstrated without changes in the original translation. The translation and the transcultural adaptation of CLDQ into Portuguese, in Brazil, had been carried out, having been fulfilled to this important stage for its validation and use in our way.