Browsing by Author "Oliveira, Claudia P."

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    Ability of a Combined FIB4/miRNA181a Score to Predict Significant Liver Fibrosis in NAFLD Patients
    (2021) Lima, Rodrigo Vieira Costa; Stefano, Jose Tadeu; Malta, Fernanda de Mello; Pinho, Joao Renato Rebello; Carrilho, Flair Jose; Arrese, Marco; Oliveira, Claudia P.
    Liver biopsy is the gold standard for assessing fibrosis, but there is a need to seek non-invasive biomarkers for this purpose. The aim of this study was to evaluate the correlation between the serum levels of the microRNAs miR-21, miR-29a, miR-122, miR-155 and miR-181a and the phenotypic expression of NAFLD. A cross-sectional study was carried out on 108 NAFLD patients diagnosed by liver biopsy. FIB-4 and NAFLD fibrosis scores were calculated. The comparison between the distributions of microRNA values according to the presence or absence of histological fibrosis (F2-F4) was performed. A multivariate logistic regression analysis was performed to build a score for predicting fibrosis using FIB-4 and Ln (miR-181a) as independent variables. Only miR-181a showed a statistical difference between patients with significant liver fibrosis (>F2) and those without (F0-F1) (p = 0.017). FIB-4 revealed an AUC on the ROC curve of 0.667 to predict clinically significant fibrosis (F2-F4). When assessed using the score in association with Ln (miR-181a), there was an improvement in the ROC curve, with an AUC of 0.71. miR-181a can be used as a non-invasive method of predicting fibrosis in NAFLD, and an association with FIB-4 has the potential to increase the accuracy of each method alone.
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    Diagnostic performance of three non-invasive fibrosis scores (Hepamet, FIB-4, NAFLD fibrosis score) in NAFLD patients from a mixed Latin American population
    (2020) Zambrano-Huailla, Rommel; Guedes, Laura; Stefano, Jose Tadeu; de Souza, Arthur A. Arrais; Marciano, Sebastian; Yvamoto, Erika; Michalczuk, Matheus Truccolo; Vanni, Denise Siqueira; Rodriguez, Hernan; Carrilho, Flair Jose; Alvares-da-Silva, Mario Reis; Gadano, Adrian; Arrese, Marco; Miranda, Adelina Lozano; Oliveira, Claudia P.
    Introduction and aims: Several non-invasive scoring systems have been developed and validated worldwide to predict the risk of liver fibrosis in nonalcoholic fatty liver disease (NAFLD). However, information about the performance of these systems in Latin American populations is scarce. Our aim was to evaluate the performance of the Hepamet Fibrosis Score, Fibrosis-4 (FIB-4) and the NAFLD Fibrosis Score (NFS) in a mixed Latin American group of NAFLD patients.
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    Liver transplantation in Latin America: reality and challenges
    (2023) Aguirre-Villarreal, David; Servin-Rojas, Maximiliano; Sanchez-Cedillo, Aczel; Chavez-Villa, Mariana; Hernandez-Alejandro, Roberto; Arab, Juan Pablo; Ruiz, Isaac; Avendano-Castro, Karla P.; Matamoros, Maria A.; Adames-Almengor, Enrique; Diaz-Ferrer, Javier; Rodriguez-Aguilar, Erika Faride; Paez-Zayas, Victor Manuel; Contreras, Alan G.; Alvares-da-Silva, Mario R.; Mendizabal, Manuel; Oliveira, Claudia P.; Navasa, Miquel; Garcia-Juarez, Ignacio
    Healthcare systems in Latin America are broadly heterogeneous, but all of them are burdened by a dramatic rise in liver disease. Some challenges that these countries face include an increase in patients requiring a transplant, insufficient rates of organ donation, delayed referral, and inequitable or suboptimal access to liver transplant pro-grams and post-transplant care. This could be improved by expanding the donor pool through the implementation of education programs for citizens and referring physicians, as well as the inclusion of extended criteria donors, living donors and split liver transplantation. Addressing these shortcomings will require national shifts aimed at improving infrastructure, increasing awareness of organ donation, training medical personnel, and providing equitable access to care for all patients.
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    NAFLD: Challenges and opportunities to address the public health problem in Latin America
    (2021) Pablo, Arab Juan; Antonio, Diaz Luis; Melisa, Dirchwolf; Mark, Henry E.; V. Lazarus, Jeffrey; Vaughan, Elly; Mendez-Sanchez, Nahum; Oliveira, Claudia P.; Gadano, Adrian; Arrese, Marco
    Non-alcoholic fatty liver disease (NAFLD) is reaching epidemic proportions worldwide. Collectively, Latin American countries have some of the highest obesity rates in the world and the fastest-growing prevalence of type 2 diabetes mellitus (T2DM). Since obesity and T2DM are intrinsically linked with NAFLD, epidemiological projections are worrisome. In addition to this adverse epidemiological setting, the region of Latin America faces unique challenges and obstacles to addressing the growing burden of NAFLD. In this article, on the occasion of the International NASH Day on June 10, 2021, we describe the main challenges and opportunities to improve care of people living with NAFLD in Latin America. Among the major challenges to be tackled are: lack of disease awareness, limited educational opportunities for healthcare personnel and general public, health system fragmentation, and lack of effective strategies for the prevention and effective treatment of NAFLD and common comorbidities, namely obesity and T2DM. Wide dissemination of current concepts on NAFLD, and extensive collaboration between scientific societies, governments, non-governmental organizations, pharmaceutical industry, and other stakeholders is urgently needed to advance the NAFLD public health policies agenda that allows us to address this disease with a whole of society approach. (c) 2021 Published by Elsevier Espa?a, S.L.U. on behalf of Fundaci?n Cl?nica M?dica Sur, A.C. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/