ALBERTO QUEIROZ FARIAS
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Unidades Organizacionais
Departamento de Gastroenterologia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
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conferenceObject URINARY BIOMARKER NGAL IN PATIENTS WITH HEPATORENAL SYNDROME: ACCURACY STUDY IN PREDICTION OF NO RESPONSE TO THERAPY WITH ALBUMIN AND TERLIPRESSIN(2016) XIMENES, R. O.; HELOU, C.; DINIZ, M.; BARBEIRO, D.; SOUZA, H.; D'ALBUQUERQUE, L. A.; CARRILHO, F.; FARIAS, A.- Procedural-Related Bleeding in Hospitalized Patients With Liver Disease (PROC-BLeeD): An International, Prospective, Multicenter Observational Study(2023) INTAGLIATA, Nicolas M.; RAHIMI, Robert S.; HIGUERA-DE-LA-TIJERA, Fatima; SIMONETTO, Douglas A.; FARIAS, Alberto Queiroz; MAZO, Daniel F.; BOIKE, Justin R.; STINE, Jonathan G.; SERPER, Marina; PEREIRA, Gustavo; MATTOS, Angelo Z.; MARCIANO, Sebastian; DAVIS, Jessica P. E.; BENITEZ, Carlos; CHADHA, Ryan; MENDEZ-SANCHEZ, Nahum; DELEMOS, Andrew S.; MOHANTY, Arpan; DIRCHWOLF, Melisa; FORTUNE, Brett E.; NORTHUP, Patrick G.; PATRIE, James T.; CALDWELL, Stephen H.BACKGROUND & AIMS: Hospitalized patients with cirrhosis frequently undergo multiple procedures. The risk of procedural-related bleeding remains unclear, and management is not standardized. We conducted an international, prospective, multicenter study of hospitalized patients with cirrhosis undergoing nonsurgical procedures to establish the incidence of procedural-related bleeding and to identify bleeding risk factors. METHODS: Hospitalized patients were prospectively enrolled and monitored until surgery, transplantation, death, or 28 days from admission. The study enrolled 1187 patients undergoing 3006 nonsurgical procedures from 20 centers. RESULTS: A total of 93 procedural-related bleeding events were identified. Bleeding was reported in 6.9% of patient admissions and in 3.0% of the procedures. Major bleeding was reported in 2.3% of patient admissions and in 0.9% of the procedures. Patients with bleeding were more likely to have nonalcoholic steatohepatitis (43.9% vs 30%) and higher body mass index (BMI; 31.2 vs 29.5). Patients with bleeding had a higher Model for End-Stage Liver Disease score at admission (24.5 vs 18.5). A multivariable analysis controlling for center variation found that high-risk procedures (odds ratio [OR], 4.64; 95% confidence interval [CI], 2.44-8.84), Model for End Stage Liver Disease score (OR, 2.37; 95% CI, 1.46-3.86), and higher BMI (OR, 1.40; 95% CI, 1.10-1.80) independently predicted bleeding. Preprocedure international normalized ratio, platelet level, and antithrombotic use were not predictive of bleeding. Bleeding prophylaxis was used more routinely in patients with bleeding (19.4% vs 7.4%). Patients with bleeding had a significantly higher 28-day risk of death (hazard ratio, 6.91; 95% CI, 4.22-11.31). CONCLUSIONS: Procedural-related bleeding occurs rarely in hospitalized patients with cirrhosis. Patients with elevated BMI and decompensated liver disease who undergo high-risk procedures may be at risk to bleed. Bleeding is not associated with conventional hemostasis tests, preprocedure prophylaxis, or recent antithrombotic therapy.
article 44 Citação(ões) na Scopus Epidemiology of HCC in Brazil: incidence and risk factors in a ten-year cohort(2014) PARANAGUA-VEZOZZO, Denise C.; ONO, Suzane K.; ALVARADO-MORA, Monica V.; FARIAS, Alberto Q.; CUNHA-SILVA, Marlone; FRANCA, Joao I. D.; ALVES, Venancio A. F.; SHERMAN, Morris; CARRILHO, Flair JoseBackground and aim. The lack of information about hepatocellular carcinoma (HCC) in Brazil weakens health policy in preventing deaths from the illness. The aim of this study was to establish the cumulative incidence and the risk factors for hepatocellular carcinoma development in patients under a surveillance program. Material and methods. 884 patients with compensated cirrhosis were prospectively followed up for at least five years, from August 1998 until August 2008, with at least one annual ultrasonography liver examination and serum alpha fetoprotein (AFP) measurement. Results. Among 884 patients, 72 (8.1%) developed a tumor with a median follow up of 21.4 months. In the hepatocellular carcinoma group, hepatitis C virus infection was the major etiological factor (65.3%), 56.9% (41/72) were male and the mean average age was 57 +/- 10 years. The annual incidence of hepatocellular carcinoma was 2.9%. 79.2% (57/72) of HCCs were detected within Milan Criteria, and the mean survival time was 52.3 months, significantly higher than for those outside Milan, with a mean time of 40.6 months (p = 0.0003). Conclusion. The annual incidence of HCC among this large series of Brazilian cirrhotic patients was around 2.9% with a detection rate of 8.1%, or a cumulative incidence rate over five years of 14.3%. The three variables related to HCC risk were low serum albumin [HR: 0.518 (0.46-0.78)], high AFP > 20 ng/mL [HR: 3.16 (1.86-5.38)], and ethnicity (Brazilian-East Asian descendants vs. other mixed Brazilian ethnicities) [HR: 2.86 (1.48-5.53)].conferenceObject PATIENTS WITH ACUTE ON CHRONIC LIVER FAILURE ARE AT HIGHER RISK OF PROCEDURAL-RELATED BLEEDING(2023) INTAGLIATA, Nicolas M.; RAHIMI, Robert S.; TIJERA, Fatima Higuera De La; SIMONETTO, Douglas A.; FARIAS, Alberto Q.; MAZO, Daniel Ferraz De Campos; BOIKE, Justin Richard; STINE, Jonathan G.; SERPER, Marina; PEREIRA, Gustavo; MATTOS, Angelo; MARCIANO, Sebastian; DAVIS, Jessica; BENITEZ, Carlos; CHADHA, Ryan; MENDEZ-SANCHEZ, Nahum; DELEMOS, Andrew S.; MOHANTY, Arpan; DIRCHWOLF, Melisa Melisa; FORTUNE, Brett; NORTHUP, Patrick Grant; PATRIE, James; CALDWELL, Stephen H.conferenceObject Acute-on-chronic liver failure (ALCF) and liver transplantation(2018) NACIF, L.; AQUINO, F.; TANIGAWA, R.; ANDRAUS, W.; HADDAD, L.; PINHEIRO, R.; MARTINO, R.; ROCHA-SANTOS, V.; FARIAS, A.; D'ALBUQUERQUE, L. Carneiro; ALVES, V.bookPart Hemorragia digestiva alta varicosa(2014) LUZ, Gustavo Oliveira; SENA, Clarissa Ribeiro Villar; SAKAI, Paulo; FARIAS, Alberto Queiroz; ARTIFON, Everson Luiz de AlmeidaconferenceObject Robust identification of patient subgroups in acute decompensated cirrhosis(2023) PALOMINO, Sara; HUERGO, Estefania; USON, Eva; SANCHEZ, Cristina; LAGANI, Vincenzo; KIANI, Narsis; PLANELL, Nuria; GURBINDO, Unai; TREBICKA, Jonel; FARIAS, Alberto Q.; CARACENI, Paolo; RAUTOU, Pierre-Emmanuel; GOMEZ-CABRERO, DavidconferenceObject Continuous infusion of terlipressin for hepatorenal syndrome therapy: evaluation of efficacy and safety in real-life setting(2020) LINHARES, Fernanda S.; COSTA, Julia G. F.; CUNHA-SILVA, Marlone; PEREIRA, Tiago; FARIAS, Alberto Queiroz; CARRILHO, Flair Jose; MAZO, DanielconferenceObject Endogenous Heparinoid Effects during Bacterial Infections in Patients with Cirrhosis Do Not Impair Thombin Generation: A Prospective Study(2018) MOTTA, Marina; ROCHA, Tania Rubia Flores; MIGITA, Beatriz Yuri; BATISTA, Juliana Medeiros; D'AMICO, Elbio Antonio; D'ALBUQUERQUE, Lutz Augusto Cameiro; CARRILHO, Flair Jose; FARIAS, Alberto Q.bookPart Sangramento Gastrintestinal(2016) ROCHA, Evandra Cristina Vieira da; SPOSETO, Valdinélia Bomfim Barban; FARIAS, Alberto Queiroz