SUZANE KIOKO ONO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Gastroenterologia, Faculdade de Medicina - Docente
P ICHC, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/07 - Laboratório de Gastroenterologia Clínica e Experimental, Hospital das Clínicas, Faculdade de Medicina
P ICHC, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/07 - Laboratório de Gastroenterologia Clínica e Experimental, Hospital das Clínicas, Faculdade de Medicina
11 resultados
Resultados de Busca
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- Liver elastography can predict degree of advanced fibrosis for autoimmune hepatitis in biochemical remission(2023) PARANAGUA-VEZOZZO, Denise Cerqueira; TERRABUIO, Debora Raquel Benedita; REINOSO-PEREIRA, Gleicy Luz; MOUTINHO, Renata; ONO, Suzane Kioko; SALAS, Veronica Walwyn; FRANCA, Joao Italo Dias; ALVES, Venancio Avancini Ferreira; CANCADO, Eduardo Luiz Rachid; CARRILHO, Flair JoseBackground and AimThe aim was to analyze the concordance of liver stiffness measurement (LSM) either by transient elastography (TE) or ARFI with liver biopsy in autoimmune hepatitis (AIH) patients with biochemical remission and to identify those with histological remission. Liver biopsy is still the golden standard for AIH diagnosis. However, it is an invasive procedure and these patients, most of the time, require many biopsies, so it would be valuable to search for noninvasive method that could select all these patients and keep under observation. MethodsThirty-three patients with AIH were submitted for liver biopsy to evaluate histological remission after at least 18 months of normal aminotransferases. The efficiency of LSM and fibrosis stages was tested by a receiver operating characteristic curve analysis (AUROC). ResultsOne patient (3%) was F0, 6 (18.2%) were F1, 8 (24.2%) were F2, 10 (30.3%) were F3, and 8 (24.2%) were F4, according to METAVIR. Thirteen of thirty-three (39.4%) patients did not achieve histological remission. AUROC for F4 stage was 0.83 (IC: 0.76-0.99) for TE and 0.78 (IC: 0.65-0.95) for ARFI. Optimal LSM cutoff values were 12.3 kPa (Se = 87.5%, Sp = 88%) for TE and 1.65 m/s (Se = 87.5%, Sp = 76%) for ARFI. The tests were unable to differentiate patients with histological activity from those in histological remission (P < 0.05). ConclusionTE and ARFI accurately identify liver fibrosis by METAVIR score in AIH patients with biochemical remission. No cutoff value was detected to indicate whether the patient achieved histological remission.
- Translational medical research and liver transplantation: systematic review(2018) NACIF, Lucas Souto; KIM, Vera; GALVAO, Flavio; ONO, Suzane Kioko; PINHEIRO, Rafael Soares; CARRILHO, Flair Jose; D'ALBUQUERQUE, Luiz CarneiroTranslational medicine has become a priority, but there is still a big difference between the arrival of new treatments and investment. Basic science should not be neglected because the translation from basic research is not sustained in the absence of basic research. The purpose of this literature review was to analyze the translational medicine in the liver transplant field: liver ischemia-reperfusion injury (IRI), immunosuppression, clinical and surgical complications, small-for-size syndrome (SFSS), rejection, and ongoing innovations (liver machine, liver preservation, artificial livers, and regenerative medicine). We performed a systematic literature review that were updated in October 2016. The searches were performed in the Cochrane Central Register of Controlled Trials and Review, PubMed/Medline, Embase, and LILACS databases. All the selected studies on the management of translational medical research in liver transplantation (LT) were analyzed. Initially the search found 773 articles. Methodological viewing and analysis of the articles, followed by the application of scientific models, including translational medicine in the liver transplant field. In conclusions, this review demonstrates the application of scientific research with translation medical benefits regarding the LT. The literature has a great tendency, improvements and investments in the study of translational medicine in LT. Innovative studies and technologies from basic science help to clarify clinical doubts. Moreover, evidence increases the importance of scientific research in quality of clinical practice care.
- Concordance of non-invasive mechanical and serum tests for liver fibrosis evaluation in chronic hepatitis C(2017) PARANAGUA-VEZOZZO, Denise C.; ANDRADE, Adriana; MAZO, Daniel F. C.; NUNES, Vinicius; GUEDES, Ana L.; RAGAZZO, Taisa G.; MOUTINHO, Renata; NACIF, Lucas S.; ONO, Suzane K.; ALVES, Venancio A. F.; CARRILHO, Flair J.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) [FibroScan (R)/ARFI technology (Virtual Touch (R))] and SM [FIB-4/aspartate aminotransferase-to-platelet 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%) were treatment-naive. The optimal cut-off values for predicting F >= 2 stage fibrosis assessed by TE were 6.6 kPa, 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 kPa, ARFI was 1.48 m/s, APRI was 0.75, and FIB-4 was 2. For F = 4, TE was 12.2 kPa, 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.
- Assessment of Adherence to Prescribed Therapy in Patients with Chronic Hepatitis B(2016) ABREU, Rodrigo Martins; FERREIRA, Camila da Silva; FERREIRA, Aline Siqueira; REMOR, Eduardo; NASSER, Paulo Dominguez; CARRILHO, Flair Jose; ONO, Suzane KiokoEvidence shows that treatment for hepatitis B virus (HBV) can suppress viral load. Among the factors directly linked to therapeutic success is adherence to the treatment. Several instruments to assess adherence are available, but they are not validated for use in chronic hepatitis B. The purpose of this paper was to adapt and validate the ""Assessment of Adherence to Antiretroviral Therapy Questionnaire-HIV"" (CEAT-VIH) for patients with chronic hepatitis B (referred to herein as CEAT-HBV). The validity of the adapted questionnaire evidence was established through concurrent, criterion, and construct validities. We found negative and significant correlation between the domain ""degree of compliance to antiviral therapy"" assessed by CEAT-HBV and the Morisky test (r = -0.62, P < 0.001) and between the domain ""barriers to adherence"" and HBV viral load (r = -0.42, P < 0.001). In terms of the construct's discriminative capacity, scores greater than or equal to 80 detected antiviral therapy success, which are necessary for the prediction of an undetectable HBV viral load. Thus, a cutoff value of 80.5 was set with a value of 81% for sensitivity and 67% for specificity. The CEAT-HBV identified 43% (n = 79) non-adherent patients and was shown to be a useful tool in clinical practice.
- The Impact of Artificial Intelligence on Waiting Time for Medical Care in an Urgent Care Service for COVID-19: Single-Center Prospective Study(2022) BIN, Kaio Jia; MELO, Adler Araujo Ribeiro; ROCHA, Jose Guilherme Moraes Franco da; ALMEIDA, Renata Pivi de; COBELLO JUNIOR, Vilson; MAIA, Fernando Liebhart; FARIA, Elizabeth de; PEREIRA, Antonio Jose; BATTISTELLA, Linamara Rizzo; ONO, Suzane KiokoBackground: To demonstrate the value of implementation of an artificial intelligence solution in health care service, a winning project of the Massachusetts Institute of Technology Hacking Medicine Brazil competition was implemented in an urgent care service for health care professionals at Hospital das Clinicas of the Faculdade de Medicina da Universidade de Sao Paulo during the COVID-19 pandemic. Objective: The aim of this study was to determine the impact of implementation of the digital solution in the urgent care service, assessing the reduction of nonvalue-added activities and its effect on the nurses' time required for screening and the waiting time for patients to receive medical care. Methods: This was a single-center, comparative, prospective study designed according to the Public Health England guide ""Evaluating Digital Products for Health."" A total of 38,042 visits were analyzed over 18 months to determine the impact of implementing the digital solution. Medical care registration, health screening, and waiting time for medical care were compared before and after implementation of the digital solution. Results: The digital solution automated 92% of medical care registrations. The time for health screening increased by approximately 16% during the implementation and in the first 3 months after the implementation. The waiting time for medical care after automation with the digital solution was reduced by approximately 12 minutes compared with that required for visits without automation. The total time savings in the 12 months after implementation was estimated to be 2508 hours. Conclusions: The digital solution was able to reduce nonvalue-added activities, without a substantial impact on health screening, and further saved waiting time for medical care in an urgent care service in Brazil during the COVID-19 pandemic.
- Access to antiviral therapy for chronic hepatitis B during COVID-19(2022) BERTOLLI, Marilia Rocha; ROCHA, Priscilla Alves; PINTO, Vanusa Barbosa; ONO, Suzane KiokoAbstract OBJECTIVE: Hepatitis B is an important public health concern. Currently, the COVID-19 pandemic is a major challenge for health systems, and the access to pharmacologic and non-pharmacologic treatment of chronic diseases, such as hepatitis B, may have been affected due to the contingency measures. This study aimed to evaluate the access to antiviral therapy during the ongoing pandemic. METHODS: This was a descriptive analysis of the access to treatment for chronic hepatitis B at a tertiary-level university hospital in São Paulo, integrated with the Brazilian health system. The study was conducted from April to December 2020. RESULTS: Access to antiviral therapy for 225 patients was assessed. The majority of the population was male (59%). The main type of service was the Programa Medicamento em Casa (Home Medication Delivery Program), which was availed by 144 (64%) patients. Women had poorer access to antiviral therapy (56%, p<0.05), and patients registered in the HMDP (68%, p<0.05) had better access. The age group of >48 years represented 70% of the group without access to antiviral therapy. Twenty-two pharmaceutical appointments were conducted through phone calls with patients without access to antiviral therapy. CONCLUSION: This study contributes to the rationalization of efforts in a public health crisis through the identification of groups with the highest risk of poor access to antiviral therapy and the demonstration of the benefits of a medication delivery system.
conferenceObject DETECTION OF MACROSCOPIC LIVER MORPHOLOGICAL CHANGES ON COMPUTED TOMOGRAPHY USING A DEEP LEARNING TECHNIQUE.(2022) ROCHA, Bruno; FERREIRA, Lorena Carneiro; VIANNA, Luis Gustavo Rocha; FERREIRA, Luma Gallacio Gomes; CICONELLE, Ana Claudia Claudia Martins; NORONHA, Alex Da Silva; CORTEZ, Joao M.; NOGUEIRA, Lucas Salume Lima; LEITE, Jean Michel Rocha Sampaio; SILVA FILHO, Mauricio Ricardo Moreira Da; LEITE, Claudia Da Costa; FELIX, Marcelo De Maria; NOMURA, Cesar Higar; GUTIERREZ, Marco Antonio; CERRI, Giovanni Guido; CARRILHO, Flair Jose; ONO, Suzane KiokoconferenceObject INFLUENCE OF CYP3A4, CYP3A5, POR AND ABCB1 GENES ON TACROLIMUS RESPONSE IN LIVER TRANSPLANT RECIPIENTS(2022) NALDI, Graziella D'A. R.; PEREIRA, Thales Dalessandro; FOSSALUZA, Victor; NACIF, Lucas; D'ALBUQUERQUE, Luiz Augusto Carneiro; CARRILHO, Flair J.; ONO, Suzane KiokoconferenceObject ABNORMAL LIVER ENZYMES IN PATIENTS AFTER COVID-19 HOSPITALIZATION IN A TERTIARY HOSPITAL - OBSERVATIONAL COHORT STUDY.(2022) ONO, Suzane Kioko; GONCALVES, Fabio Augusto Rodrigues; VAISBERG, Victor Van; TRINDADE, Evelinda Marramon; SUMITA, Nairo Massakazu; LICHTENSTEIN, Arnaldo; ALVES, Venancio A. F.; CARRILHO, Flair Jose- Moving Fast Toward Hepatitis B Virus Elimination(2021) BASSIT, Leda; ONO, Suzane Kioko; SCHINAZI, Raymond F.Currently, there are two safe and effective therapeutic strategies for chronic hepatitis B treatment, namely, nucleoside analogs and interferon alpha (pegylated or non-pegylated). These treatments can control viral replication and improve survival; however, they do not eliminate the virus and therefore require long-term continued therapy. In addition, there are significant concerns about virus rebound on discontinuation of therapy and the development of fibrosis and hepatocellular carcinoma despite therapy. Therefore, the search for new, more effective, and safer antiviral agents that can cure hepatitis B virus (HBV) continues. Anti-HBV drug discovery and development is fundamentally impacted by our current understanding of HBV replication, disease physiopathology, and persistence of HBV covalently closed circular DNA (cccDNA). Several HBV replication targets are the basis for novel anti-HBV drug development strategies. Many of them are already in clinical trial phase 1 or 2, while others with promising results are still in preclinical stages. As research intensifies, potential HBV curative therapies and modalities in the pipeline are now on the horizon.