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1Concordance of non-invasive mechanical and serum tests for liver fibrosis evaluation in chronic hepatitis C显示文摘AIM To determine the sensitivity and specificity of liver stiffness measurement(LSM) and serum markers(SM) for liver fibrosis evaluation in chronic hepatitis C.METHODS Between 2012 and 2014,81 consecutive hepatitis C virus(HCV) patients had METAVIR score from liver biopsy compared with concurrent results from LSM [transient elastography(TE) [FibroS can~/ARFI technology(Virtual Touch~)] and SM [FIB-4/aspartate aminotransferase-toplatelet ratio index(APRI)].The diagnostic performance of these tests was assessed using receiver operating characteristic curves.The optimal cut-off levels of each test were chosen to define fibrosis stages F ≥ 2,F ≥ 3 and F = 4.The Kappa index set the concordance analysis.RESULTS Fifty point six percent were female and the median age was 51 years(30-78).Fifty-six patients(70%) weretreatment-na?ve.The optimal cut-off values for predicting F ≥ 2 stage fibrosis assessed by TE were 6.6 kP a,for acoustic radiation force impulse(ARFI) 1.22 m/s,for APRI 0.75 and for FIB-4 1.47.For F ≥ 3 TE was 8.9 kP a,ARFI was 1.48 m/s,APRI was 0.75,and FIB-4 was 2.For F = 4,TE was 12.2 kP a,ARFI was 1.77 m/s,APRI was 1.46,and FIB-4 was 3.91.The APRI could not distinguish between F2 and F3,P = 0.92.The negative predictive value for F = 4 for TE and ARFI was 100%.Kappa index values for F ≥ 3 METAVIR score for TE,ARFI and FIB-4 were 0.687,0.606 and 0.654,respectively.This demonstrates strong concordance between all three screening methods,and moderate to strong concordance between them and APRI(Kappa index = 0.507).CONCLUSION Given the costs and accessibility of LSM methods,and the similarity with the outcomes of SM,we suggest that FIB-4 as well as TE and ARFI may be useful indicators of the degree of liver fibrosis.This is of particular importance to developing countries.Denise C Paranaguá-Vezozzo Adriana Andrade Daniel F C Mazo Vinicius Nunes Ana L Guedes Taisa G Ragazzo Renata Moutinho Lucas S Nacif Suzane K Ono Venancio A F Alves Flair J Carrilho 2017World Journal of Hepatology2017,9,8:7
2Percutaneous radiofrequency ablation for early hepatocellular carcinoma: Risk factors for survival显示文摘AIM: To evaluate outcomes of radiofrequency ablation(RFA) therapy for early hepatocellular carcinoma(HCC) and identify survival- and recurrence-related factors. METHODS: Consecutive patients diagnosed with early HCC by computed tomography(CT) or magnetic resonance imaging(MRI)(single nodule of ≤ 5 cm, or multi-(up to 3) nodules of ≤ 3 cm each) and who underwent RFA treatment with curative intent between January 2010 and August 2011 at the Instituto do Cancer do Estado de S o Paulo, Brazil were enrolled in the study. RFA of the liver tumors(with 1.0 cm ablative margin) was carried out under CT-fluoro scan and ultrasonic image guidance of the percutaneous ablation probes. Procedure-related complications were recorded. At 1-mo post-RFA and 3-mo intervals thereafter, CT and MRI were performed to assess outcomes of complete response(absence of enhancing tissue at the tumor site) or incomplete response(enhancing tissue remaining at the tumor site). Overall survival and diseasefree survival rates were estimated by the Kaplan-Meier method and compared by the log rank test or simple Cox regression. The effect of risk factors on survival was assessed by the Cox proportional hazard model. RESULTS: A total of 38 RFA sessions were performed during the study period on 34 patients(age in years: mean, 63 and range, 49-84). The mean follow-up time was 22 mo(range, 1-33). The study population showed predominance of male sex(76%), less severe liver disease(Child-Pugh A, n = 26; Child-Pugh B, n = 8), and single tumor(65%). The maximum tumor diameters ranged from 10 to 50 mm(median, 26 mm). The initial(immediately post-procedure) rate of RFAinduced complete tumor necrosis was 90%. The probability of achieving complete response was significantly greater in patients with a single nodule(vs patients with multi-nodules, P = 0.04). Two patients experienced major complications, including acute pulmonary edema(resolved with intervention) and intestinal perforation(led to death). The 1- and 2-year overall survival rates were 82% and 71%, respectively. Sex, tumor size, initial response, and recurrence status influenced survival, but did not reach the threshold of statistical significance. Child-Pugh class and the model for end-stage liver disease score were identified as predictors of survival by simple Cox regression, but only Child-Pugh class showed a statistically significant association to survival in multiple Cox regression analysis(HR = 15; 95%CI: 3-76 mo; P = 0.001). The 1-and 2-year cumulative disease-free survival rates were 65% and 36%, respectively. CONCLUSION: RFA is an effective therapy for local tumor control of early HCC, and patients with preserved liver function are the best candidates.Luciana Kikuchi Marcos Menezes Aline L Chagas Claudia M Tani Regiane SSM Alencar Marcio A Diniz Venncio AF Alves Luiz Augusto Carneiro D’Albuquerque Flair José Carrilho 2014World Journal of Gastroenterology2014,20,6:5
3Gastro-duodenal disease in Africa: Literature review and clinical data from Accra, Ghana显示文摘Gastroduodenal disease(GDD)was initially thought to be uncommon in Africa.Amongst others,lack of access to optimal health infrastructure and suspicion of conventional medicine resulted in the reported prevalence of GDD being significantly lower than that in other areas of the world.Following the increasing availability of flexible upper gastro-intestinal endoscopy,it has now become apparent that GDD,especially peptic ulcer disease(PUD),is prevalent across the continent of Africa.Recognised risk factors for gastric cancer(GCA)include Helicobater pylori(H.pylori),diet,Epstein-Barr virus infection and industrial chemical exposure,while those for PUD are H.pylori,non-steroidal antiinflammatory drug(NSAID)-use,smoking and alcohol consumption.Of these,H.pylori is generally accepted to be causally related to the development of atrophic gastritis(AG),intestinal metaplasia(IM),PUD and distal GCA.Here,we perform a systematic review of the patterns of GDD across Africa obtained with endoscopy,and complement the analysis with new data obtained on premalignant gastric his-topathological lesions in Accra,Ghana which was compared with previous data from Maputo,Mozambique.As there is a general lack of structured cohort studies in Africa,we also considered endoscopy-based hospital or tertiary centre studies of symptomatic individuals.In Africa,there is considerable heterogeneity in the prevalence of PUD with no clear geographical patterns.Furthermore,there are differences in PUD within-country despite universally endemic H.pylori infection.PUD is not uncommon in Africa.Most of the African tertiary-centre studies had higher prevalence of PUD when compared with similar studies in western countries.An additional intriguing observation is a recent,ongoing decline in PUD in some African countries where H.pylori infection is still high.One possible reason for the high,sustained prevalence of PUD may be the significant use of NSAIDs in local or over-the-counter preparations.The prevalence of AG and IM,were similar or modestly higher over rates in western countries but lower than those seen in Asia..In our new data,sampling of 136 patients in Accra detected evidence of pre-malignant lesions(AG and/or IM)in 20 individuals(14.7%).Likewise,the prevalence of pre-malignant lesions,in a sample of 109 patients from Maputo,were 8.3%AG and 8.3%IM.While H.pylori is endemic in Africa,the observed prevalence for GCA is rather low.However,cancer data is drawn from country cancer registries that are not comprehensive due to considerable variation in the availability of efficient local cancer reporting systems,diagnostic health facilities and expertise.Validation of cases and their source as well as specificity of outcome definitions are not explicit in most studies further contributing to uncertainty about the precise incidence rates of GCA on the continent.We conclude that evidence is still lacking to support(or not)the African enigma theory due to inconsistencies in the data that indicate a particularly low incidence of GDD in African countries.Timothy N Archampong Richard H Asmah Cathy J Richards Vicki J Martin Christopher D Bayliss Edília Botao Leonor David Sandra Beleza Carla Carrilho 2019World Journal of Gastroenterology2019,25,26:3
4Differences in viral kinetics between genotypes 1 and 3 of hepatitis C virus and between cirrhotic and non-cirrhotic patients during antiviral therapy显示文摘AIM: To evaluate the impact of hepatitis C virus (HCV) infection with genotype 1 or 3 and the presence or absence of liver cirrhosis (LC) in the early viral kinetics response to treatment. METHODS: Naive patients (n = 46) treated with interferon-α (IFN-α) and ribavirin and followed up with frequent early HCV-RNA determinations were analysed. Patients were infected with genotype 1 (n = 28, 7 with LC) or 3 (n = 18, 5 with LC). RESULTS: The fi rst phase decline was larger in geno- type 3 patients than in genotype 1 patients (1.72 vs 0.95 log IU/mL, P < 0.001). The second phase slope decline was also larger in genotype 3 patients than in genotype 1 patients (0.87 vs 0.15 log/wk, P < 0.001). Differences were found in both cirrhotic and non-cirrhotic patients. Genotype 1 cirrhotic patients had a slower 2nd phase slope than non-cirrhotic patients (0.06 vs 0.18 log/wk, P < 0.02). None of genotype 1 cirrhotic patients had a 1st phase decline larger than 1 log (non-cirrhotic patients: 55%, P < 0.02). A similar trend toward a slower 2nd phase slope was observed in genotype 3 cirrhotic pa- tients but the 1st phase slope decline was not different. Sustained viral response was higher in genotype 3 pa- tients than in genotype 1 patients (72% vs 14%, P < 0.001) and in genotype 1 non-cirrhotic patients than in genotype 1 cirrhotic patients (19% vs 0%). A secondphase decline slower than 0.3 log/wk was predictive of non-response in all groups. CONCLUSION: Genotype 3 has faster early viral decline than genotype 1. Cirrhosis correlates with a slower 2nd phase decline and possibly with a lower 1st phase slope decline in genotype 1 patients.José Eymard Medeiros-Filho Isabel Maria Vicente Guedes de Carvalho Mello Joo Renato Rebello Pinho Avidan U Neumann Fernanda de Mello Malta Luiz Caetano da Silva Flair José Carrilho 2006World Journal of Gastroenterology2006,12,45:3
5Preservation of platelet function in patients with cirrhosis and thrombocytopenia undergoing esophageal variceal ligation显示文摘Background:Thrombocytopenia is a possible risk factor for bleeding after band ligation of esophageal varices.However,elevated von Willebrand factor(VWF)in cirrhosis improves platelet function and could decrease this risk.Our objective was to assess platelet function in patients with cirrhosis undergoing esophageal variceal ligation(EVL).Methods:The assessment consisted of platelet count,antigen and activity of VWF and VWF-cleaving protease ADAMTS-13 activity,and a platelet adhesion and aggregation test simulating vascular flow in vivo(Impact-RR)prior to EVL.Results:Totally 111 patients were divided into three groups according to platelet count:(1)<50×109/L(n=38,34.2%);(2)50×109/L to 100×109/L(n=47,42.3%);and(3)>100×109/L(n=26,23.4%).No statistically significant difference was found in the aggregate size of platelets[group 1:41.0(31.8–67.3)μm 2;group 2:47.0(33.8–71.3)μm 2;and group 3:47.0(34.0–66.0)μm 2;P=0.60]and no significant correlation was found between aggregate size and platelet count(Spearman r=0.07;P=0.47).Surface coverage was 4.1%(2.8%–6.7%),8.5%(4.0%–10.0%),and 9.0%(7.1%–12.0%)(P<0.001)in groups 1,2 and 3,respectively and correlated with platelet count(Spearman r=0.39;P<0.0001).There was no significant difference between groups in VWF or ADAMTS-13.Post-EVL bleeding occurred in six(5.4%)patients(n=2 in group 1,n=1 in group 2,and n=3 in group 3;P=0.32).Patients with bleeding had higher MELD scores[15.0(11.3–20.3)versus 12.0(10.0–15.0);P=0.025],but no difference was demonstrated for platelet function parameters.Conclusion:Platelet function is preserved even in the presence of thrombocytopenia,including in the patients with post-EVL bleeding.Evandro de Oliveira Souza Elbio Antonio D’Amico Tania Rubia Flores da Rocha Caroline Marcondes Ferreira Juliana Medeiros Batista Luiz Augusto CarneiroD’Albuquerque Flair Jose Carrilho Alberto Queiroz Farias 2020Hepatobiliary & Pancreatic Diseases International2020,19,6:3
6Quantitative scintigraphic analysis of the apical seal in Thermafil/Topseal and Real Seal 1/Realseal filled root canals显示文摘AIM: To investigate the microleakage of two different root canal obturation systems, using the nuclear medicine approach.METHODS: Twenty-six single-rooted extracted teeth were selected. The crowns were sectioned to obtain 15-mm long root segments and each tooth was prepared using rotary Pro File instruments. The roots were divided into 2 experimental groups using Real Seal 1 and Real Seal sealer or Thermafil and Top Seal sealer as well as two control groups. On the 7th and the 28 th day the apices were submersed in a solution of 99 m TcPertechnetate during 3 h. The radioactivity was counted using a γ camera. RESULTS: The present study showed that none of the root canal-filled teeth was leakage free. The statistical analyses were made using Kruskal-Wallis and statistical significance was assessed using α = 0.05. Although apical leakage measured in counts per minute(cpm) in the Thermafil/Top Seal group was lower than in the Real Seal/Real Seal group(363 916 ± 180 707.7 cpm vs533 427 ± 414 020.6 cpm) on 7th day and(1 678 200 ± 567 217.4 cpm vs 2 240 518 ± 383 356.7 cpm) on 28 th day, there was no statistical difference(P > 0.05). In the Thermafil/Top Seal group and Real Seal 1/Real Seal group it was found that over time, the number of counts increased between 7 d and 28 d(363 916 ± 180 707.7 cpm vs 1 678 200 ± 567 217.4 cpm) and(533 427 ± 414 020.6 cpm vs 2 240 518 ± 383 356.7 cpm), respectively, with statistically significant differences(Thermafil/Top Seal group, P = 0.015 and Real Seal 1/Real Seal group, P = 0.036).CONCLUSION:Both carrier-based Realseal 1 and Thermafil techniques showed a similar sealing effect,but none of the materials was leakage free.Manuel Marques Ferreira Margarida Abrantes Eunice Virgínia Carrilho Maria Filomena Botelho 2013World Journal of Stomatology2013,2,2:2
7A rapid and automated low resolution NMR method to analyze oil quality in intact oilseeds显示文摘Rosilene Aparecida Prestes Luiz Alberto Colnago Lucimara Aparecida Forato Lucinéia Vizzotto Etelvino Henrique Novotny Emanuel Carrilho 2007Analytica Chimica Acta2007,,2:2
8Association between the CYBA and NOX4 genes of NADPH oxidase and its relationship with metabolic syndrome in non-alcoholic fatty liver disease in Brazilian population显示文摘Background: Oxidative stress has been implicated in the progression of severe forms of non-alcoholic fatty liver disease(NAFLD). NADPH oxidase produces reactive oxygen species. In the present study, we investigated for the first time two single nucleotide polymorphisms(SNPs) in the regulatory region of genes encoding NADPH oxidase 4(NOX4) and p22 phox(CYBA) in NAFLD.Methods: A total of 207 biopsy-proven NAFLD patients [simple steatosis(n = 27); nonalcoholic steatohepatitis(NASH)(n = 180)] were evaluated. Genomic DNA was extracted from peripheral blood cells, and polymorphisms in CYBA(unregistered) and NOX4(rs3017887) were determined by direct sequencing of PCR.Results: Associations of CYBA-675 T/A with high-density lipoprotein(HDL)(TT vs TA vs AA; P < 0.01) and triglycerides(TGL)(TT vs XA; P < 0.01) were observed only in NASH patients. For polymorphisms in the NOX4 gene, NOX4(rs3017887) CA + AA genotypes was significant associated with alanine aminotransferase(ALT)(CA + AA vs CC; P = 0.02). However, there was no association of SNPs in the CYBA and NOX4 genes encoding the NADPH oxidase system proteins and the presence of NASH. Regarding the clinical results, it was observed that the most advanced degrees of fibrosis occurred in patients diagnosed with type 2 diabetes mellitus(66.9% vs 37.5%, P < 0.01) and those who were more obese(32.2 vs 29.0 kg/m2,P < 0.01). In addition, serum glucose and insulin levels increased significantly in the presence of NASH.Conclusions: There were associations between the presence of the allele A in the NOX4 SNP and a higher concentration of ALT in the NAFLD population; between the presence of the AA genotype in the polymorphism of the CYBA-675 T/A CYBA gene and a higher level of TGL and lower HDL in NASH patients. The presence of metabolic syndrome was associated with advanced degrees of fibrosis in NAFLD patients.Fabiola Rabelo Jose Tadeu Stefano Ana Mercedes Cavaleiro Rodrigo Vieira Costa Lima Daniel Ferraz de Campos Mazo Flair Jose Carrilho Maria Lúcia Correa-Giannellac Claudia P.Oliveiraa 2018Hepatobiliary & Pancreatic Diseases International2018,17,4:2
9Genetic ancestry analysis in non-alcoholic fatty liver disease patients from Brazil and Portugal显示文摘AIM:To study the association between genetic ancestry,non-alcoholic fatty liver disease(NAFLD) metabolic characteristics in two cohorts of patients,from Brazil and Portugal. METHODS:We included 131 subjects from Brazil [(n = 45 with simple steatosis(S. Steatosis) and n = 86 with nonalcoholic steatohepatitis(NASH)] and 90 patients from Portugal(n = 66,S. Steatosis; n = 24,NASH). All patients had biopsy-proven NAFLD. In histologic evaluation NAFLD activity score was used to assess histology and more than 5 points defined NASH in this study. Patients were divided into two groups according to histology diagnosis:simple steatosis or non-alcoholic statohepatitis. Genetic ancestry was assessed using real-time polymerase chain reaction. Seven ancestry informative markers(AT3-I/D,LPL,Sb19.3,APO,FYNull,PV92,and CKMM) with the greatest ethnicgeographical differential frequencies(≥ 48%) were used to define genetic ancestry. Data were analyzed using R PROJECTS software. Ancestry allele frequencies between groups were analyzed by GENEPOP onlineand the estimation of genetic ancestry contribution was evaluated by ADMIX-95 software. The 5% alpha-error was considered as significant(P < 0.05). RESULTS:In the Brazilian sample,NASH was significantly more frequent among the elderly patients with diabetes(NASH 56 ± 1.1 years old vs S. Steatosis 51 ± 1.5 years old,P = 3.7 x 10-9),dyslipidemia(NASH 63% vs S. Steatosis 37%,P = 0.009),higher fasting glucose levels(NASH 124 ± 5.2 vs S. Steatosis 106 ± 5.3,P = 0.001) and Homeostatic Model of Assessment index > 2.5 [NASH 5.3(70.8%) vs S. Steatosis 4.6(29.2%) P = 0.04]. In the Portuguese study population,dyslipidemia was present in all patients with NASH(P = 0.03) and hypertension was present in a larger percentage of subjects in the S. Steatosis group(P = 0.003,respectively). The genetic ancestry contribution among Brazilian and Portuguese individuals with NASH was similar to those with S. Steatosis from each cohort(Brazilian cohort:P = 0.75; Portuguese cohort:P = 0.97). Nonetheless,the genetic ancestry contribution of the Brazilian and Portuguese population were different,and a greater European and Amerindian ancestry contribution was detected in the Portuguese population while a higher African genetic ancestry contribution was observed in Brazilian population of both NASH and S. Steatosis groups.CONCLUSION:There was no difference between the genetic ancestry contribution among Brazilian and Portuguese individuals with NASH and S. Steatosis from each cohort.Lourianne Nascimento Cavalcante Jose Tadeu Stefano Mariana V Machado Daniel F Mazo Fabiola Rabelo Kiyoko Abe Sandes Flair Jose Carrilho Helena Cortez-Pinto Andre Castro Lyra Claudia P de Oliveira 2015World Journal of Hepatology2015,7,10:2
10Effects of Hepatitis C virus on cardiovascular risk in infected patients: A comparative study显示文摘C.P.M.S. Oliveira C.R. Kappel E.R. Siqueira V.M.R. Lima J.T. Stefano M.T. Michalczuk S.S. Marini H.V. Barbeiro F.G. Soriano F.J. Carrilho L.M.M.B. Pereira M.R. Alvares-da-Silva 2011International Journal of Cardiology2011,,:2
11Simulation of wind - driven ventilative coofing systems for an apartment building in Beijing and Shanghai 显示文摘Carrilho G Chen G Q Glicksman L R 2002Energy and Buildings2002,34,:1
12predictive factors for response to Lamivudine in chronic hepatitis B显示文摘Da Silva LC da Fonseca LE carrilho FJ 2000Rev Inst Med Trop Sao Paulo2000,42,:1
13Pro- and Anti-inflammatory Cytokines in Steatosis and Steatohepatitis显示文摘Fabiola Rabelo Claudia P. M. S. Oliveira Joel Faintuch Daniel F. C. Mazo Vicencia M. R. Lima Jose Tadeu Stefano Hermes V. Barbeiro Francisco G. Soriano Venancio A. Ferreira Alves Flair J. Carrilho 2010Obesity Surgery2010,,7:1
14Pilot study on the early shear strength of porcelain-dentin bonding using dual-cure cements显示文摘Braga RR Ballester RY Carrilho MR 1999J Prosthe Dent1999,81,3:1
15Evaluation of cell proliferation,epidermal growth factor receptor,and bcl-2 immunoexpression as prognostic factors for patients with World Health Organization grade 2 oligodendroglioma显示文摘Reis-Filho JS Faoro LN Carrilho C 2000Cancer2000,1588,4:1
16Epidemiology of hepatitis A and E virus infection in Brazil显示文摘F.J. Carrilho C. Mendes Clemente L.C. da Silva 2005Gastroenterologia y Hepatologia2005,,3:1
17Effect of the fattening diet on the development of the fatty acid profile in rabbits from weaing显示文摘CARRILHO M C LOPEZ M CAMPO M M 2009Meat Science2009,83,1:1
18Understanding Wax Printing; A Simple Micropatterning Process for Paper?Based Microfluidics显示文摘Carrilho E Martinez A W Whitesides G M 2009Anal Chem2009,81,16:1
19Vaccine-related HPV genotypes in women with and without cervical cancer in Mozambique: burden and potential for prevention 显示文摘Castellsague X Klaustermeier J Carrilho C etal 2008Int J Cancer2008,122,8:1
20Simple Telemedicine for Developing Regions; Camera Phones and Paper?Based Microfluidic Devices for Real-Time, Off-Site Diagnosis显示文摘Martinez A W Phillips S T Carrilho E 2008Anal Chem2008,,10:1
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