Biomedical subjects

Elza Cotrim Soares

Publications and source records attributed to Elza Cotrim Soares.

7 recordsLinked to original sources

PubMed2006

Decrease of type IV collagen and TIMP-1 serum levels after splenectomy in patients with schistosomiasis mansoni.

The role of the spleen in the process of liver fibrosis in schistosomiasis still needs clarification. The aim of this study was to assess the effect of splenectomy on serum levels of two markers of fibrosis, type IV collagen and TIMP-1, in patients with schistosomiasis mansoni. Twenty-four patients with hepatosplenic schistosomiasis mansoni participated in the study. Type IV collagen and TIMP-1 serum levels were measured preoperatively, and after 2 (POD-1) and 60 days (POD-2) of spleen removal. Before splenectomy, both type IV collagen and TIMP-1 serum levels were elevated in the majority of patients. After splenectomy, the levels of type IV collagen showed a significant decrease in relation to the preoperative values both in POD-1 (median pre-splenectomy: 143.7 ng/ml versus 77.01 ng/ml; p=0.04) and POD-2 (103.3 ng/ml; p=0.015). Serum levels of TIMP-1 also showed a significant decrease in relation to the preoperative values both in POD-1 (pre-splenectomy: 585.9 ng/ml versus 196.4 ng/ml; p=0.008) and POD-2 (97.4 ng/ml; p<0.001). There was no difference between POD-1 and POD-2 values for each serum marker. In conclusion, splenectomy in schistosomotic patients was associated with a decrease in serum markers of fibrosis levels, which persisted for at least 60 days. These results suggest that the spleen may play a role in the extra cellular matrix production, and therefore may contribute to liver fibrosis in schistosomiasis mansoni.

Adult↗

PubMed2006

High serum laminin and type IV collagen levels in schistosomiasis mansoni.

BACKGROUND: Fibrosis is the process of excessive deposition of collagen and other extra cellular matrix components and large amounts of these components have been shown in periovular schistosomal granulomas, especially in the liver. Laminin and type IV collagen have been investigated in various hepatic disorders but their accuracy in fibrosis detection and in the evaluation of its progression in schistosomiasis have not been fully explained. AIM: To measure the serum levels of two markers of fibrosis, laminin and type IV collagen in schistosomiasis. PATIENTS AND METHODS: Sixty-four patients with different clinical forms of schistosomiasis mansoni: intestinal (group I), hepatointestinal (group II), compensated (group III) and decompensated hepatosplenic (group IV) and 18 healthy volunteers were included. RESULTS: Serum type IV collagen and laminin levels were significantly increased in patients compared to controls. At about clinical forms, serum type IV collagen was increased in groups II and IV, compared to controls and was significantly higher in group IV than in group I. Serum laminin was significantly increased in groups II, III and IV and was significantly higher in group IV than in group II. Serum type IV collagen was closely correlated with serum laminin in groups II and IV. CONCLUSIONS: Connective tissue marker levels did not correlate with periportal thickness. In schistosomiasis mansoni there is an increase of type IV collagen and laminin levels at the initial stage of the disease, as well as in advanced forms. We also suggest that these markers may be a useful predictor of disease progression.

Adolescent↗

PubMed2005

Grading and staging chronic hepatitis C and its relation to genotypes and epidemiological factors in Brazilian blood donors.

Progression of chronic hepatitis C is known to be associated with some factors, but influence of HCV genotypes is still controversial. Association between HCV genotypes and other risk factors was examined to determine which factors are associated with progression of infection. One hundred consecutive anti-HCV positive volunteer blood donors were evaluated for several risk factors, examined for HCV genotypes, and submitted to hepatic biopsy and biochemical exams.HCV genotyping were carried out in 89 patients and hepatic biopsy in 78. Transmission routes were found to be illicit intravenous drug use (26%), Gluconergan use in a non-safe manner (48%) and blood transfusion (15%). HCV genotype was 1 in 45%, 3 in 40%, and it was not associated with the stage of fibrosis or with inflammatory activity. There was no significant association of factors related to infection, chronic alcohol use, or duration of illness, with progression of the lesion. There was a significant association of aminotransferase levels and the fibrosis stage. Univariate analysis showed that the age at contamination, patient's age, GT-gamma, and aminotransferase levels over three times the upper normal limits, were associated with fibrosis stages 2 to 4. Multivariate analysis detected age (odds ratio=1.19), and GT-gamma (odds ratio=2.02) as independent factors.

Adult↗

PubMed2004

Progression of liver fibrosis in blood donors infected with hepatitis C virus.

BACKGROUND/AIMS: Chronic hepatitis by HCV is progressive towards cirrhosis, with variable rate. We evaluated the rate of fibrosis progression (RFP), risk factors associated with advanced fibrosis (F3 and F4), and estimated the evolution time to cirrhosis. METHODS: We transversely selected 142 blood donors infected only with HCV, with a known route of infection, submitted to liver biopsy at admission. RFP= ratio between stage of fibrosis (METAVIR)/estimated duration of infection in years. Non-parametric tests and logistic regression analysis, with significance level of 5% were used. RESULTS: Median RFP was 0.086 U/year (0.05-0.142). Ten patients had F4 and 25 had F3. Median RFP values were significantly different (p=0.001) from one age group at contamination to the others and ALT and AST levels. There were no differences in the expected evolution to cirrhosis between intermediate fibrosers (F2) and the rapid fibrosers (F3 and F4). The independent variables associated with advanced fibrosis were ALT (OR 7.2) and GGT (OR 6.4) and age at inclusion (OR 1.12). CONCLUSION: This study suggests that RFP is extremely variable, it is exponential with age, and mainly influenced by host characteristics, especially age at contamination and possibly ethnical group. These asymptomatic patients had high percentage of fibrosis F2, F3 and F4.

Adult↗

PubMed2003

Nutritional risk factors for postoperative complications in Brazilian elderly patients undergoing major elective surgery.

OBJECTIVE: In this prospective study, we assessed nutritional and immunologic risk factors for infectious complications and deaths related to infection in elderly patients undergoing major elective surgery. METHODS: Seventy patients 60 y or older were enrolled in this study. The preoperative variables analyzed were body mass index, body mass index knee height, triceps skinfold, subscapular skinfold, mid-arm muscle circumference, mid-arm muscle area, albumin, transferrin, prealbumin, and retinol-binding protein levels, immunoglobulins G, A, and M, C3, and C4 levels, total lymphocyte counts, and the occurrence of delayed hypersensitivity reactions (multitest). RESULTS: Abnormally low levels of prealbumin (P = 0.004), retinol-binding protein (P = 0.05), and transferrin (P = 0.04) were related to infectious complications. Prealbumin levels (P = 0.02) and lymphocyte counts below 1500 cells/mm(3) (P = 0.04) were associated with mortality secondary to infection. Univariate regression analysis showed that levels of prealbumin (P = 0.02, odds ratio = 13.3, 95% confidence limits = 1.6, 110.9), retinol-binding protein (P = 0.03, odds ratio = 4.8, 95% confidence limits = 1.2, 19.3), and transferrin (P = 0.03; odds ratio = 4.2, 95% confidence limit = 1.2, 15.6) were associated with infectious complications. Multivariate analysis associated only prealbumin levels with infectious complications (P = 0.02, odds ratio = 13.3, 95% confidence limit = 1.6, 110.9). Regression analysis provided no conclusion regarding mortality because of the small number of deaths recorded. CONCLUSIONS: In patients with a good cardiac index (Goldman I and II) who underwent major elective surgery, prealbumin protein, retinol-binding protein, and transferrin levels below normal values represented a significant risk for postoperative infectious complications. Lymphocyte counts lower than 1500/m(3) and abnormal prealbumin values were associated with postoperative mortality secondary to infection. The anthropometric variables evaluated did not predict postoperative infectious complications and mortality.

Aged↗

PubMed2002

Five days of ceftriaxone to treat spontaneous bacterial peritonitis in cirrhotic patients.

BACKGROUND: The aim of this study was to determine whether a short course of ceftriaxone was sufficient to cure spontaneous bacterial peritonitis (SBP) in cirrhotic patients. METHODS: We studied 33 cirrhotic patients with SBP. All of them were treated with ceftriaxone, 1.0 g IV, every 12 h for 5 days. Twenty-one variables were recorded to evaluate their relationship to the resolution of SBP. RESULTS: The mean age of the patients was 45 years. Twenty-three were males and 10 females. The etiology of cirrhosis was alcoholic in 42% of the patients, and 82% of the patients belonged to Child-Pugh Class C. Hepatic encephalopathy was present in 39% of the patients. The most frequent organism causing SBP was Escherichia coli (60%). Resolution of SBP on day 5 of treatment was achieved in 73% of the patients. Total resolution of SBP after prolonged therapy with ceftriaxone or another agent. selected according to antibiotic susceptibility, was achieved in 94% of the patients. Hospital mortality was 12%. Multivariate analysis showed no factor that was significantly related to the resolution of SBP, but univariate analysis showed that renal impairment and positive culture tended to be related. CONCLUSIONS: A short course (5 days) of ceftriaxone is useful therapy for SBP. If the polymorphonuclear differential count in ascitic fluid is less than 250 cells/mm3 on day 5 of treatment, the antibiotic can be discontinued.

Adolescent↗

PubMedDate not supplied

Fine needle aspiration biopsy for improving the diagnostic accuracy of cut needle biopsy of focal liver lesions.

OBJECTIVE: To determine the value of fine needle aspiration biopsy (FNAB) in comparison to cut needle biopsy (CNB) for the diagnosis of malignancy of focal liver lesions. STUDY DESIGN: A retrospective analysis was conducted on 68 FNAB and 49 CNB procedures performed on 62 patients with focal liver lesions. RESULTS: Cytology permitted a diagnosis of the lesion in 78% of cases. When punctures with insufficient material were excluded (11), the diagnostic accuracy of FNAB was 93%. For the 49 patients who underwent both procedures, FNAB and CNB had the same diagnostic accuracy, 78%, when considered separately and of 88% when considered in combination. Sensitivity, specificity and positive predictive value were similar for the 2 techniques. The negative predictive value was 64% for FNAB and CNB used separately and reached 78% when the 2 techniques were combined. There were no complications during the execution of FNAB and CNB. CONCLUSION: FNAB is an effective and safe method for the diagnosis of focal hepatic lesions, with diagnostic accuracy similar to that of CNB. When the 2 techniques are combined, the accuracy of the diagnosis of malignancy of focal liver lesions increases.

Adult↗