| 5 | Direct-acting antivirals for chronic hepatitis C treatment: The experience of two tertiary university centers in Brazil显示文摘BACKGROUND Hepatitis C virus(HCV)treatment has undergone major changes in recent years.Previous interferon-based therapies have been replaced by oral direct-acting antivirals(DAA)regimens,with high sustained virologic response(SVR)rates,and a lower incidence of adverse events(AEs).AIM To evaluate the efficacy and safety of DAAs for HCV treatment in subjects from two tertiary university centers in Brazil.METHODS This is a multicenter retrospective cohort study of 532 patients with chronic hepatitis C(CHC),undergoing treatment with interferon-free regimens from November 2015 to November 2019.The therapeutic regimen was defined by the current Brazilian guidelines for HCV management at the time of treatment.Demographic,anthropometric,clinical,and laboratory variables were evaluated.SVRs were assessed at 12 to 24 wk after therapy by intention-to-treat(ITT),and modified ITT(m-ITT)analysis.AEs and serious adverse events(SAEs)were registered.In the statistical analysis,a P value of<0.05 was considered significant.RESULTS The mean age was 56.88 years,with 415(78.5%)being HCV genotype 1,followed by genotype 3(20.1%).Moreover,306(57.5%)subjects had cirrhosis,and a third of them had decompensated cirrhosis.Sofosbuvir(SOF)plus daclatasvir±ribavirin was the most frequently used treatment(66.9%),followed by SOF plus simeprevir(21.2%).The overall ITT SVR was 92.6%(493/532),while the m-ITT SVR was 96.8%(493/509).Variables associated with treatment failure via ITT evaluation were hepatic encephalopathy(OR:4.320;95%CI:1.920-9.721,P=0.0004),presence of esophageal varices(OR:2.381;95%CI:1.137-4.988,P=0.0215),previous portal hypertensive bleeding(OR:2.756;95%CI:1.173-6.471,P=0.02),higher model for end-stage liver disease scores(OR:1.143,95%CI:1.060–1.233,P=0.0005),lower serum albumin levels(OR:0.528,95%CI:0.322-0.867,P=0.0115),higher serum creatinine(OR:1.117,95%CI:1.056-1.312,P=0.0033),and international normalized ratio(INR)levels(OR:5.542,95%CI:2.023-15.182,P=0.0009).AEs were reported in 41.1%(211/514)of patients,and SAEs in 3.7%.The female gender,higher body mass index,esophageal varices,higher INR values,and longer treatment duration were independently associated with AE occurrence.CONCLUSION Treatment with oral DAAs attains a high SVR rate,with fewer SAEs in a real-life cohort of subjects with CHC,from two tertiary university centers in Brazil. | Mariana Sandoval Lourenço Patricia Momoyo Y Zitelli Marlone Cunha-Silva Arthur Ivan N Oliveira Cláudia P Oliveira Tiago Sevá-Pereira Flair JoséCarrilho Mario G Pessoa Daniel F Mazo | 2022 | World Journal of Hepatology2022，14，1： | 1 |
| 12 | Platelet-rich plasma application in diabetic ulcers:A review显示文摘There are 422 million diabetic people in the world.25%of these individuals are diagnosed with diabetic foot ulcer(DFU).20%of patients with DFU will suffer amputation of the lower limbs.Following amputation procedures,the mortality rate of patients is over 70%in 5 years.Diabetes has no cure and,therefore,treatment aims to prevent and treat its complications.Autologous platelet-rich plasma(PRP)has been shown to be a therapeutic tool for many types of disorders,including the treatment of DFU.This manuscript aims to carry out a review to provide more knowledge about the efficacy and safety of autologous PRP for wound closure in patients with DFU.The majority of studies included in this review state that PRP promotes improvement of DFU lesions by accelerating tissue healing processes.However,many studies have a small sample size and thus require larger sample range in order to improve robustness of data in the literature. | Victoria Pereira Simão Carolina Souza Cury Gabriel Mota Zamariolli Tavares Gabriel Calixto Ortega Arthur Cichetto Ribeiro Gabriel Silva Santos JoséFábio Santos Duarte Lana | 2022 | World Journal of Dermatology2022，10，1： | 0 |
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