FLAIR JOSE CARRILHO

(Fonte: Lattes)
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Departamento de Gastroenterologia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/07 - Laboratório de Gastroenterologia Clínica e Experimental, Hospital das Clínicas, Faculdade de Medicina - Líder

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  • conferenceObject
    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, Daniel
  • article 3 Citação(ões) na Scopus
    Brazilian cohort and genes encoding for drug-metabolizing enzymes and drug transporters
    (2020) KIM, Vera; WAL, Thijs van der; NISHI, Miriam Yumie; MONTENEGRO, Luciana Ribeiro; CARRILHO, Flair Jose; HOSHIDA, Yujin; ONO, Suzane Kioko
    Background & aim: Genetic variability in drug absorption, distribution, metabolism and excretion (ADME) genes contributes to the high heterogeneity of drug responses. The present study investigated polymorphisms of ADME genes frequencies and compared the findings with populations from other continents, available in the 1000 Genome Project (1 KGP) and the Exome Aggregation Consortium (ExAC) databases. Methodology & results: We conducted a study of 100 patients in Brazil and a total of 2003 SNPs were evaluated by targeted next-generation sequencing in 148 genes, including Phase I enzymes (n = 50), Phase II enzymes (n = 38) and drug transporters (n = 60). Overall, the distribution of minor allele frequency (MAF) suggests that the distribution of 2003 SNPs is similar between Brazilian cohort, 1 KGP and ExAC; however, we found moderate SNP allele-frequency divergence between Brazilian cohort and both 1000 KGP and ExAC. These differences were observed in several relevant genes including CYP3A4, NAT2 and SLCO1B1. Conclusion: We concluded that the Brazilian population needs clinical assessment of drug treatment based on individual genotype rather than ethnicity.
  • article 0 Citação(ões) na Scopus
    Preservation of platelet function in patients with cirrhosis and thrombocytopenia undergoing esophageal variceal ligation
    (2020) SOUZA, Evandro de Oliveira; D'AMICO, Elbio Antonio; ROCHA, Tania Rubia Flores da; FERREIRA, Caroline Marcondes; BATISTA, Juliana Medeiros; D'ALBUQUERQUE, Luiz Augusto Carneiro; CARRILHO, Flair Jose; FARIAS, Alberto Queiroz
    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-R (R)) prior to EVL. Results: Totally 111 patients were divided into three groups according to platelet count: (1) < 50 x 10(9)/L (n = 38, 34.2%); (2) 50 x 10(9)/L to 100 x 10(9)/L (n = 47, 42.3%); and (3) > 100 x 10(9) /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) mu m(2); group 2: 47.0 (33.8-71.3) mu m(2); and group 3: 47.0 (34.0-66.0) mu m(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.
  • article 14 Citação(ões) na Scopus
    Epidemiology of Liver Cancer in Latin America: Current and Future Trends
    (2020) CARRILHO, Flair Jose; PARANAGUA-VEZOZZO, Denise Cerqueira; CHAGAS, Aline Lopes; ALENCAR, Regiane Saraiva de Souza Melo; FONSECA, Leonardo Gomes da
    Over 38,000 cases of hepatocellular carcinoma (HCC) are estimated to occur in Latin America annually. The region is characterized by sociocultural heterogeneity and economic disparities, which impose barriers in addressing this major health issue. A significant proportion of patients are still diagnosed in the later stages of the disease, although efforts to implement effective screening programs have been reported by referral centers. While viral hepatitis remains the predominant etiology of liver disease among HCC cases in Latin America, a high prevalence of fatty liver disease in the region is a matter of concern, reflecting the current scenario in many Western countries. In addition, other risk factors such as alcohol, aflatoxin, and early-onset HCC in hepatitis B virus infection contribute to the burden of HCC in Latin America. Interventions to increase screening coverage, expand healthcare access, and implement continuing medical training are key challenges to be overcome.
  • conferenceObject
    MOLECULAR AND MUTATIONAL LANDSCAPE OF HEPATOCELLULAR CARCINOMA (HCC) RELATED TO NONALCOHOLIC STEATOHEPATITIS (NASH)
    (2020) PIQUE-GILI, Marta; PINYOL, Roser; TORRECILLA, Sara; WANG, Huan; MONTIRONI, Carla; RAMADORI, Pierluigi; WILLOUGHBY, Catherine E.; ANDREU-OLLER, Carmen; TORRES-MARTIN, Miguel; LEOW, Wei-Qiang; MOEINI, Agrin; TAIK, Patricia; GALLOFRE, Judit Peix; OLIVEIRA, Claudia P. M. S.; ALVES, Venancio A. F.; LACHENMAYER, Anja; ROESSLER, Stephanie; MINGUEZ, Beatriz; SCHIRMACHER, Peter; BOFFETTA, Paolo; DUFOUR, Jean-Francois; THUNG, Swan N.; REEVES, Helen; UZILOV, Andrew; CARRILHO, Flair J.; CHANG, Charissa Y.; HEIKENWAELDER, Mathias; SANYAL, Arun J.; FRIEDMAN, Scott L.; SIA, Daniela; LLOVET, Josep M.
  • article 19 Citação(ões) na Scopus
    BRAZILIAN SOCIETY OF HEPATOLOGY UPDATED RECOMMENDATIONS FOR DIAGNOSIS AND TREATMENT OF HEPATOCELLULAR CARCINOMA
    (2020) CHAGAS, Aline Lopes; MATTOS, Angelo Alves de; CARRILHO, Flair José; BITTENCOURT, Paulo Lisboa; VEZOZZO, Denise Cerqueira Paranaguá; HORVAT, Natally; ROCHA, Manoel de Souza; ALVES, Venâncio Avancini Ferreira; CORAL, Gabriela Perdomo; ALVARES-DA-SILVA, Mario Reis; BARROS, Fabio Marinho do Rego; MENEZES, Marcos Roberto; MONSIGNORE, Lucas Moretti; COELHO, Fabricio Ferreira; SILVA, Renato Ferreira da; SILVA, Rita de Cássia Martins Alves; BOIN, Ilka de Fatima Santana Ferreira; D`ALBUQUERQUE, Luiz Augusto Carneiro; GARCIA, José Huygens Parente; FELGA, Guilherme Eduardo Gonçalves; MOREIRA, Airton Mota; BRAGHIROLI, Maria Ignez Freitas Melro; HOFF, Paulo Marcelo Gehm; MELLO, Vivianne Barretto de; DOTTORI, Mariana Fonseca; BRANCO, Tiago Pugliese; SCHIAVON, Leonardo de Lucca; COSTA, Thaisa de Fátima Almeida
    ABSTRACT Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortality worldwide. The Brazilian Society of Hepatology (SBH) published in 2015 its first recommendations about the management of HCC. Since then, new data have emerged in the literature, prompting the governing board of SBH to sponsor a single-topic meeting in August 2018 in São Paulo. All the invited experts were asked to make a systematic review of the literature reviewing the management of HCC in subjects with cirrhosis. After the meeting, all panelists gathered together for the discussion of the topics and the elaboration of updated recommendations. The text was subsequently submitted for suggestions and approval of all members of the Brazilian Society of Hepatology through its homepage. The present manuscript is the final version of the reviewed manuscript containing the recommendations of SBH.
  • conferenceObject
    The symbiotic supplementation modulate gut microbiota, regulation beta-catenin expression and prevents weight gain in ob/ob mice with non-alcoholic fatty liver disease (NAFLD)
    (2020) DUARTE, Sebastiao Mauro Bezerra; STEFANO, Jose Tadeu; FRANCO, Lucas A. M.; MARTINS, Roberta Cristina Ruedas; BARBEIRO, Denise Frediani; NERI, Junia Marielle Teixeira Rodrigues; COGLIATI, Bruno; SABINO, Ester Cerdeira; CARRILHO, Flair Jose; OLIVEIRA, Claudia
  • conferenceObject
    Diagnostic performance of three non-invasive fibrosis scores (Hepamet, FIB-4, NAFLD score) on NAFLD in a mixed Latin American population
    (2020) ZAMBRANO-HUAILLA, Rommel; GUEDES, Laura; SOUZA, Arthur A. Arrais de; STEFANO, Jose Tadeu; MARCIANO, Sebastian; YVAMOTO, Erika; MICHALCZUK, Matheus Truccolo; VANNI, Denise Siqueira; RODRIGUEZ, Hernan; CARRILHO, Flair Jose; ALVARES-DA-SILVA, Mario Reis; ARRESE, Marco; GADANO, Adrian; MIRANDA, Adelina Lozano; OLIVEIRA, Claudia
  • article 10 Citação(ões) na Scopus
    Direct-Acting Antivirals and Hepatocellular Carcinoma: No Evidence of Higher Wait-List Progression or Posttransplant Recurrence
    (2020) PINERO, Federico; BOIN, Ilka; CHAGAS, Aline; QUINONEZ, Emilio; MARCIANO, Sebastian; VILATOBA, Mario; SANTOS, Luisa; ANDERS, Margarita; DUQUE, Sergio Hoyos; LIMA, Agnaldo Soares; MENENDEZ, Josemaria; PADILLA, Martin; PONIACHIK, Jaime; ZAPATA, Rodrigo; MARASCHIO, Martin; MENENDEZ, Ricardo Chong; MUNOZ, Linda; ARUFE, Diego; FIGUEROA, Rodrigo; MENDIZABAL, Manuel; GOMEZ, Sahara Hurtado; STUCCHI, Raquel; MACCALI, Claudia; SANDOVAL, Rodrigo Vergara; BERMUDEZ, Carla; MCCORMACK, Lucas; VARON, Adriana; GADANO, Adrian; MATTERA, Juan; RUBINSTEIN, Fernando; CARRILHO, Flair; SILVA, Marcelo
    The association between direct-acting antivirals (DAAs) and hepatocellular carcinoma (HCC) wait-list progression or its recurrence following liver transplantation (LT) remains uncertain. We evaluated the impact of DAAs on HCC wait-list progression and post-LT recurrence. This Latin American multicenter retrospective cohort study included HCC patients listed for LT between 2012 and 2018. Patients were grouped according to etiology of liver disease: hepatitis C virus (HCV) negative, HCV+ never treated with DAAs, and HCV+ treated with DAAs either before or after transplantation. Multivariate competing risks models were conducted for both HCC wait-list progression adjusted by a propensity score matching (pre-LT DAA effect) and for post-LT HCC recurrence (pre- or post-LT DAA effect). From 994 included patients, 50.6% were HCV-, 32.9% were HCV+ never treated with DAAs, and 16.5% were HCV+ treated with DAAs either before (n = 66) or after LT (n = 98). Patients treated with DAAs before LT presented similar cumulative incidence of wait-list tumor progression when compared with those patients who were HCV+ without DAAs (26.2% versus 26.9%; P = 0.47) and a similar HCC-related dropout rate (12.1% [95% CI, 0.4%-8.1%] versus 12.9% [95% CI, 3.8%-27.2%]), adjusted for baseline tumor burden, alpha-fetoprotein values, HCC diagnosis after listing, bridging therapies, and by the probability of having received or not received DAAs through propensity score matching (subhazard ratio [SHR], 0.9; 95% CI, 0.6-1.6; P = 0.95). A lower incidence of posttransplant HCC recurrence among HCV+ patients who were treated with pre- or post-LT DAAs was observed (SHR, 0.7%; 95% CI, 0.2%-4.0%). However, this effect was confounded by the time to DAA initiation after LT. In conclusion, in this multicenter cohort, HCV treatment with DAAs did not appear to be associated with an increased wait-list tumor progression and HCC recurrence after LT.
  • article 19 Citação(ões) na Scopus
    Gastrointestinal Manifestations and Associated Health Outcomes of COVID-19: A Brazilian Experience From the Largest South American Public Hospital
    (2020) MOURA, Diogo Turiani Hourneaux de; PROENCA, Igor Mendonca; MCCARTY, Thomas R.; SAGAE, Vitor Massaro Takamatsu; RIBEIRO, Igor Braga; OLIVEIRA, Guilherme Henrique Peixoto de; SOUZA, Gabriel Mayo Vieira de; HIRSCH, Bruno Salomao; SCATIMBURGO, Maria Vitoria Cury Vieira; THOMPSON, Christopher C.; CARRILHO, Flair Jose; CECCONELLO, Ivan; MOURA, Eduardo Guimaraes Hourneaux de
    OBJECTIVES: Brazil has rapidly developed the second-highest number of COVID-19 cases in the world. As such, proper symptom identification, including gastrointestinal manifestations, and relationship to health outcomes remains key. We aimed to assess the prevalence and impact of gastrointestinal symptoms associated with COVID-19 in a large quaternary referral center in South America. METHODS: This was a single-center cohort study in a COVID-19 specific hospital in Sao Paulo, Brazil. Consecutive adult patients with laboratory confirmed SARS-CoV-2 were included. Baseline patient history, presenting symptoms, laboratory results, and clinically relevant outcomes were recorded. Regression analyses were performed to determine significant predictors of the gastrointestinal manifestations of COVID-19 and hospitalization outcomes. RESULTS: Four-hundred patients with COVID-19 were included. Of these, 33.25% of patients reported gastrointestinal symptom. Diarrhea was the most common gastrointestinal symptom (17.25%). Patients with gastrointestinal symptoms had higher rates of concomitant constitutional symptoms, notably fatigue and myalgia (p <0.05). Gastrointestinal symptoms were also more prevalent among patients on chronic immunosuppressants, ACE/ARB medications, and patient with chronic kidney disease (p <0.05). Laboratory results, length of hospitalization, ICU admission, ICU length of stay, need for mechanical ventilation, vasopressor support, and in-hospital mortality did not differ based upon gastrointestinal symptoms (p> 0.05). Regression analyses showed older age [OR 1.04 (95% CI, 1.02-1.06)], male gender [OR 1.94 (95% CI, 1.12-3.36)], and immunosuppression [OR 2.60 (95% CI, 1.20-5.63)], were associated with increased mortality. CONCLUSION: Based upon this Brazilian study, gastrointestinal manifestations of COVID-19 are common but do not appear to impact clinically relevant hospitalization outcomes including the need for ICU admission, mechanical ventilation, or mortality.