ALBERTO QUEIROZ FARIAS
Projetos de Pesquisa
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 Evaluation of the Small Intestine by Video Capsule Endoscopy in Patients Candidates for Liver Transplantation(2012) FYLYK, Sonia N.; TOBARU, Andre; MESTIERI, Luiz H.; FARIAS, Alberto Q.; CARRILHO, Flair J.; D'ALBUQUERQUE, Luiz Augusto C.; MOURA, Eduardo G. De; SAKAI, PauloIntroduction: Recent studies suggest that in cirrhotic patients the small intestine can be affected by the consequences of a system of portal hypertension (PTH). This segment of the gastrointestinal tract, however, is hardly accessible for study. The video capsule endoscopy (VCE) is considered the gold standard exam for the investigation of small bowel diseases, especially vascular diseases of the intestinal mucosa. Objective: Evaluation of the findings of PTH in the mucosa of the small bowel of cirrhotic patients, candidates for liver transplantation (LT). Patients and Methods: Prospective, single-center, controlled study. All patients signed informed consent and the study was approved by the ethics committee. 21 patients were submitted to VCE and esophagogastroduodenoscopy (14 patients with liver cirrhosis candidates to LT and 7 control cases, with normal liver function and no evidence of PTH). Inclusion criteria: - Patients with liver cirrhosis of viral and/or alcoholic etiology and with indication for LT (Child-Pugh score A, B or C and MELD < 20). Patients submitted or not to endoscopic treatment of esophagogastric varices or GAVE. - Patients over 18 years. - Patients who agree to participate in the study. Exclusion criteria: - Patients with history of abdominal surgery and intestinal transit abnormalities. - Intestinal sub-occlusion or suspected gastroparesis. - Patients with congestive heart disease. - Patients with potentially hemorrhagic lesions that can contribute to anemia (ulcers, polyps) and not related to PTH. Results: The mucosal lesions of the small intestine secondary to portal hypertension were more common in cirrhotic patients than in control patients: 13/14 (92.8%) vs. 1/7 (14.2%). The reticular pattern of the mucosa (hypertensive enteropathy) was the most important finding of the cases (10/14 -71.4%), followed by vascular ectasia-like and varices of the jejunum and ileum (7/14 - 50%). Conclusion: This group of patients has significant changes in the mucosa of the small intestine secondary to PTH and this segment of the gastrointestinal tract may represent a site of bleeding, often classified as obscure. The VCE is an important tool for the identification of these lesions, contributing to a more accurate etiologic diagnosis.conferenceObject Impact of the Severity of End-Stage Liver Disease in Cardiac Remodeling(2012) SILVESTRE, O. M.; BACAL, F.; FARIAS, A. Q.; ANDRADE, J. L.; FURTADO, M.; PUGLIESE, V.; ANDRAUS, W.; RAMOS, D. S.; BELLETI, E.; ALBUQUERQUE, L. A. C.; CARRILHO, F. J.Purpose: The impact of end-stage liver disease (ESLD) in cardiac remodeling of patients with cirrhosis is unknown. Our aim was to correlate the severity of ESLD with morphologic and functional heart changes. Methods and Materials: 184 patients underwent a protocol providing data on the severity of ESLD and undergoing echocardiography to assess the diameters of the left atrium and right ventricle; the systolic and diastolic diameters of the left ventricle, interventricular septum, and posterior wall of the left ventricle; systolic pulmonary artery pressure; ejection fraction; and diastolic function. Severity of ESLD was assessed by the Model for End-Stage Liver Disease (MELD) score. Results: Left-atrial diameter (r=0.323; IC 95% 0.190-0.455; p<0.001), left-ventricular diastolic diameter (r=0.177; IC 95% 0.033-0.320; p=0.01) and systolic pulmonary artery pressure (r=0.185; IC 95% 0.036-0.335; p=0.02) significantly correlated with MELD score. Patients with MELD >16 had significantly higher left-atrial diameter and systolic pulmonary artery pressure, compared with patients with MELD scores <16 points. Conclusions: Changes in cardiac structure and function correlate with the severity of ESLD.conferenceObject Serum B-type natriuretic peptide is more accurate than ascites analyses in the diagnosis of heart failure-related ascites(2012) FARIAS, Alberto Q.; SILVESTRE, Odilson M.; GARCIA-TSAO, Guadalupe; SEGURO, Luis; MAZO, Daniel F.; BACAL, Fernando; ANDRADE, Jose L.; GONCALVES, Luciana L.; CARRILHO, Flair J.; D'ALBU-QUERQUE, Luiz C.conferenceObject Impact of the severity of end-stage liver disease in cardiac remodeling(2012) SILVESTRE, Odilson M.; BACAL, Fernando; RAMOS, Danusa; BELLETI, Elisangela; ANDRADE, Jose L.; PUGLIESE, Vincenzo; ANDRAUS, Wellington; FURTADO, Meive; CARRILHO, Flair J.; D'ALBUQUERQUE, Luiz C.; FARIAS, Alberto Q.Background: The impact of end-stage liver disease (ESLD) severity in cardiac remodeling of patients with cirrhosis is unknown. Our aim was to correlate the severity of ESLD with morphologic and functional heart changes. Methods: 184 patients underwent a protocol providing data on the severity of ESLD and undergoing echocardiography to assess the diameters of the left atrium and right ventricle; the systolic and diastolic diameters of the left ventricle, interventricular septum, and posterior wall of the left ventricle; systolic pulmonary artery pressure; ejection fraction; and diastolic function. Severity of ESLD was assessed by the Model for End-Stage Liver Disease (MELD) score. Results: Left-atrial diameter (r=0.323; IC 95% 0.190-0.455; p<0.001), left-ventricular diastolic diameter (r=0.177; IC 95% 0.033-0.320; p=0.01) and systolic pulmonary artery pressure (r=0.185; IC 95% 0.036-0.335; p=0.02) significantly correlated with MELD score. Patients with MELD ≥16 had significantly higher left-atrial diameter and systolic pulmonary artery pressure, compared with patients with MELD scores <16 points. Conclusions: Changes in cardiac structure and function, as assessed by echocardiography, correlate with the severity of ESLD in patients with cirrhosis.conferenceObject CONVENTIONAL AND NOVEL CARDIOVASCULAR RISK FACTORS IN LIVER TRANSPLANT RECIPIENTS (LTR)(2012) ALVARES-DA-SILVA, M. R.; OLIVEIRA, C.; STEFANO, J. T.; OKAMATSU, E.; BARBEIRO, H.; BARBEIRO, D. F.; SORIANO, F.; FARIAS, A. Q.; CARRILHO, F. J.; D'ALBUQUERQUE, L. A. C.