DENISE CERQUEIRA PARANAGUA VEZOZZO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- Brazilian society of hepatology recommendations for the diagnosis and treatment of hepatocellular carcinoma(2015) CARRILHO, Flair J; MATTOS, Angelo Alves de; VIANEY, Alex F; VEZOZZO, Denise Cerqueira P; MARINHO, Fábio; SOUTO, Francisco J; COTRIM, Helma P; COELHO, Henrique Sergio M; SILVA, Ivonete; GARCIA, José Huygens P; KIKUCHI, Luciana; LOFEGO, Patricia; ANDRAUS, Wellington; STRAUSS, Edna; SILVA, Giovanni; ALTIKES, Isaac; MEDEIROS, Jose Eymard; BITTENCOURT, Paulo L; PARISE, Edison RABSTRACT Hepatocellular carcinoma is a malignancy of global importance and is associated with a high rate of mortality. Recent advances in the diagnosis and treatment of this disease make it imperative to update the recommendations on the management of the disease. In order to draw evidence-based recommendations concering the diagnosis and management of hepatocellular carcinoma, the Brazilian Society of Hepatology has sponsored a single-topic meeting in João Pessoa (PB). All the invited pannelists were asked to make a systematic review of the literature and to present topics related to the risk factors for its development, methods of screening, radiological diagnosis, staging systems, curative and palliative treatments and hepatocellular carcinoma in noncirrhotic liver. After the meeting, all panelists gathered together for the discussion of the topics and the elaboration of those recommendations. The text was subsequently submitted for suggestions and approval of all members of the Brazilian Society of Hepatology through its homepage. The present paper is the final version of the reviewed manuscript containing the recommendations of the Brazilian Society of Hepatology.
- Significance of CT scan and color Doppler duplex ultrasound in the assessment of Abernethy malformation(2015) NACIF, Lucas Souto; PARANAGUA-VEZOZZO, Denise Cerqueira; GALVAO, Flavio Henrique Ferreira; ROCHA, Manoel S.; ANDRAUS, Wellington; CARRILHO, Flair Jose; D'ALBUQUERQUE, Luiz CarneiroBackground: Abernethy malformation is a rare congenital vascular abnormality in which the portal vein bypasses the liver and drains directly into the inferior vena cava. Diagnosis is complex and requires good quality imaging methods to identify details in systemic and portal circulation in order to establish diagnostic confirmation and treatment strategy. In this study we highlight the significance of the use of CT scans and Color Doppler Duplex Ultrasound for the diagnosis, treatment and evolution assessment in two adults with Abernethy malformation. Case presentation: The diagnosis and the treatment of two patients with Abernethy malformation by CT scan and Color Doppler Duplex Ultrasound is described. One patient was submitted to liver transplantation due to chronic liver disease and multiple nodules diagnosed as adenoma. The other patient had normal liver function and a mild neurological and psychomotor dysfunction, therefore we adopted clinical treatment and close liver parenchyma evaluation and nodule surveillance, using an imaging approach involving intercalating CT scan and Color Doppler Duplex Ultrasound every 6 months. We highlight some important direct and indirect findings of non-invasive imaging methods. Conclusion: Abernethy malformation requires meticulous image diagnosis to improve treatment and avoid iatrogenic procedures. CT scans and Color Doppler Duplex Ultrasound are both efficient methods for diagnosis, treatment planning and evolution assessment of patients with Abernethy malformation.
- HIGHER VALUES IN LIVER ELASTOGRAPHY AND MELD SCORE ARE MORTALITY PREDICTORS ON LIVER TRANSPLANT WAITING LIST(2018) NACIF, Lucas Souto; PARANAGUA-VEZOZZO, Denise C.; MATSUDA, Alina; ALVES, Venancio Avancini Ferreira; CARRILHO, Flair J.; FARIAS, Alberto Queiroz; D'ALBUQUERQUE, Luiz Carneiro; ANDRAUS, WellingtonBackground: Liver elastography have been reported in hepatocellular carcinoma (HCC) with higher values; however, it is unclear to identify morbimortality risk on liver transplantation waiting list. Aim: To assess liver stiffness, ultrasound and clinical findings in cirrhotic patients with and without HCC on screening for liver transplant and compare the morbimortality risk with elastography and MELD score. Method: Patients with cirrhosis and HCC on screening for liver transplant were enrolled with clinical, radiological and laboratory assessments, and transient elastography. Results: 103 patients were included (without HCC n=58 (66%); HCC n=45 (44%). The mean MELD score was 14.7 +/- 6.4, the portal hypertension present on 83.9% and the mean transient elastography value was 32.73 +/- 22.5 kPa. The median acoustic radiation force impulse value of liver parenchyma was 1.98 (0.65-3.2) m/s and 2.16 (0.59-2.8) m/s in HCC group. The HCC group was significantly associated with HCV infection (OR 26.84; p<0.0001), higher levels of serum alpha-fetoprotein (OR 5.51; p=0.015), clinical portal hypertension (OR 0.25; p=0.032) and similar MELD score (p=0.693). The area under the receiver operating characteristics (AUROC) showed sensitivity and specificity for serum alpha-fetoprotein (cutoff 9.1 ng/ml), transient elastography value (cutoff value 9 kPa), and acoustic radiation force impulse value (cutoff value 2.56 m/s) of 50% and 86%, 92% and 17% and 21% and 92%, respectively. The survival group had a mean transient elastography value of 31.65 +/- 22.2 kPa vs. 50.87 +/- 20.9 kPa (p=0.098) and higher MELD scores (p=0.035). Conclusion: Elastography, ultrasound and clinical findings are important non-invasive tools for cirrhosis and HCC on screening for liver transplant. Higher values in liver elastography and MELD scores predict mortality.
- Liver Elastography in Acute Cellular Rejection After Liver Transplantation(2020) NACIF, Lucas Souto; GOMES, Caroline de Cassia; PARANAGUA-VEZOZZO, Denise; CASSENOTE, Alex Jones Flores; PINHEIRO, Rafael Soares; WAISBERG, Daniel Reis; ROCHA-SANTOS, Vinicius; MARTINO, Rodrigo Bronze de; ARANTES, Rubens Macedo; DUCATTI, Liliana; HADDAD, Luciana; GALVAO, Flavio; ANDRAUS, Wellington; CARRILHO, Flair Jose; D'ALBUQUERQUE, Luiz Carneiro
- Acute acalculous cholecystitis during zika virus infection in an immunocompromised patient(2018) ONO, Suzane Kioko; BASSIT, Leda; VAISBERG, Victor Van; ALVES, Venancio Avancini Ferreira; CALDINI, Elia G.; HERMAN, Brian D.; SHABMAN, Reed; FEDOROVA, Nadia B.; PARANAGUA-VEZOZZO, Denise; SAMPAIO, Caroline Torres; LAGES, Rafael Bandeira; TERRABUIO, Debora; ANDRAUS, Wellington; SCHINAZI, Raymond F.; CARRILHO, Flair Jose
conferenceObject Diagnostic Accuracy of Elastography, Alfa Fetoprotein and Ultrasound Findings in Screening for Hepatocellular Carcinoma in Patients on Liver- Transplant Waiting List(2014) NACIF, Lucas S.; VEZOZZO, Denise C. P.; MATSUDA, Alina; ANDRAUS, Wellington; PINHEIRO, Rafael S.; ONO, Suzane K.; CARRILHO, Flair J.; D'ALBUQUERQUE, Luiz C.