25 results on '"Damião F"'
Search Results
2. New closed-form expressions for SNR estimates of Nakagami fading channels by the method of moments
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Queiroz, Wamberto J. L., Almeida, Danilo B. T., Madeiro, Francisco, de M. Cardoso, José V., Pereira, Damião F. L., and Alencar, Marcelo S.
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- 2018
- Full Text
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3. Modelagem Computacional de Estruturas Renais
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Damião, F. N., Neves, L. A., Nascimento, A. V., Nascimento, M. Z., Magjarevic, R., editor, Nagel, J. H., editor, Müller-Karger, Carmen, editor, Wong, Sara, editor, and La Cruz, Alexandra, editor
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- 2008
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4. TWO-STAGED APPROACH FOR MANAGEMENT OF A COMPLEX INTRA-THORACIC ESOPHAGOGASTRIC ANASTOMOTIC DEHISCENCE
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Serrazina, J., additional, Damião, F., additional, Noronha Ferreira, C., additional, Moura, M., additional, Matos, H., additional, Braga, T., additional, Freire, J.P., additional, Carrilho-Ribeiro, L., additional, and Tato Marinho, R., additional
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- 2022
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5. P373 Psoriasis and psoriasiform skin lesions in patients with Inflammatory Bowel Disease treated with infliximab: a pharmacokinetic analysis
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Rodrigues, I, primary, Damião, F, additional, Serrazina, J, additional, Fernandes, S, additional, Bernardo, S, additional, Gonçalves, A R, additional, Moura Santos, P, additional, Baldaia, C, additional, Valente, A, additional, Correia, L, additional, and Tato Marinho, R, additional
- Published
- 2021
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6. P428 Early and Late Fecal Calprotectin Remission - Analysis of a proactive Therapeutic Drug Monitoring Treatment Protocol
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Pedro, J, primary, Rodrigues, I, additional, Damião, F, additional, Fernandes, S, additional, Gonçalves, A R, additional, Bernardo, S, additional, Baldaia, C, additional, Valente, A, additional, Moura Santos, P, additional, Correia, L, additional, and Tato Marinho, R, additional
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- 2021
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7. Quality in Endoscopic Retrograde Cholangiopancreatography: Adverse Events and Their Predictive Factors
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de Sousa Damião, F, additional, Noronha Ferreira, C, additional, Moura, M, additional, Freitas, C, additional, Costa, P, additional, Rios Crespo, R, additional, Rita Carvalho, J, additional, Palma, R, additional, Marques, A, additional, Almeida, A, additional, Carrilho Ribeiro, L, additional, and Tato Marinho, R, additional
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- 2021
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8. Endoscopic Removal of a Migrated Gastric Band
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de Sousa Damião, F, additional, Noronha Ferreira, C, additional, Nogueira, F, additional, Chiado, C, additional, Chiado, A, additional, Carrilho Ribeiro, L, additional, Coutinho, J, additional, and Tato Marinho, R, additional
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- 2021
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9. Quality In Endoscopic Retrograde Cholangiopancreatography: Utility Of A Prospective Database To Monitor Adherence To Quality Indicators
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de Sousa Damião, F, additional, Noronha Ferreira, C, additional, Moura, M, additional, Freitas, C, additional, Costa, P, additional, Rios Crespo, R, additional, Rita Carvalho, J, additional, Palma, R, additional, Marques, A, additional, Almeida, A, additional, Carrilho Ribeiro, L, additional, and Tato Marinho, R, additional
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- 2021
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10. Productive performance of tomato cultivation (Solanum lycopersicum) using staking in the semi-arid region of Paraíba and its mesoregions
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Djair Alves da Mata, Daniel Alves da Mata, Valdeir de Souza Oliveira, Ivana Tito Sousa, Mirelly Miguel Porcino, José Roberto Santana da Silva, Damião Franceilton Marques de Sousa, and Romildo Araújo Macena
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family farming ,productivity ,sustainability ,General Works - Abstract
The productive performance of tomato cultivation (Solanum lycopersicum) using staking in semi-arid conditions in the Paraíba region is of utmost importance for establishing sustainable and high-quality agriculture, driving various socio-economic aspects of the region. This study aims to evaluate tomato productivity using staking in the semi-arid region of Paraíba and its mesoregions. The methodology involves data analysis from the 2017 Agricultural Census and research in highly relevant academic databases. Results for the studied mesoregions demonstrate the significant role of family farming in agricultural production across all mesoregions of Paraíba, with particularly strong presence in the Sertão Paraibano, Agreste Paraibano, and Mata Paraibana. Total tomato production using staking amounted to 2,336 tons in the Sertão Paraibano, 813 tons in the Borborema, 208 tons in the Agreste Paraibano, and 90 tons in the Mata Paraibana. The quantity sold was 2,321 tons in the Sertão Paraibano, 811 tons in the Borborema, 204 tons in the Agreste Paraibano, and 86 tons in the Mata Paraibana. Total production value reached 2,356 thousand reais in the Sertão Paraibano, 562 thousand reais in the Borborema, 381 thousand reais in the Agreste Paraibano, and 181 thousand reais in the Mata Paraibana. In summary, these findings are crucial for understanding the dynamics of the staked tomato market and can guide marketing strategies and economic development across different mesoregions.
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- 2024
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11. Modelagem Computacional de Estruturas Renais
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Damião, F. N., primary, Neves, L. A., additional, Nascimento, A. V., additional, and Nascimento, M. Z., additional
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- 2007
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12. Dizeres da revista Veja: memória e intervocalidade na composição da estética da voz de sucesso
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Damião Francisco Boucher and Thiago Barbosa Soares
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discursos de sucesso ,estética da voz de sucesso ,intervocalidade ,sujeitos de sucesso ,Philology. Linguistics ,P1-1091 - Abstract
RESUMO Esse artigo visa analisar como é posto em manutenção a estética da recepção do sucesso. Em específico, analisa-se a matéria da revista Veja, Quem é Aurora, a cantora norueguesa citada pela Fuvest, publicada em 2019. Em razão da veiculação das materialidades sobre a voz cujos efeitos produzem sujeitos e sentidos do sucesso, busca-se compreender o funcionamento das memórias da voz de sucesso no entrelaçamento dessas com a tessitura discursiva sobre a voz/sujeito em ascensão. Para tal observação, sustentada pela noção de interdiscurso, utiliza-se o aparato teórico-metodológico da Análise do Discurso de linha francesa. Mobiliza-se a interdiscursividade na perspectiva da “intervocalidade”, embasando essa abordagem pela noção do pré-construído de sucesso (Soares, 2018a, 2018b, 2018c). Dessa forma, pretende-se compreender a movência dos pré-construídos de sucesso como parte dinâmica da plataforma de alcance da fama, ressignificando seu funcionamento a partir do sucesso como memória constitutiva da estética vocal. Como resultado, espera-se compreender os funcionamentos discursivos midiáticos buscando responder como a manutenção da estética da recepção, em boa medida, provém dos pré-construídos de sucesso, engendrados nas redes de dizeres sobre a fama.
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- 2023
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13. INTERPELACIÓN VOCAL
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Thiago Barbosa Soares and Damião Francisco Boucher
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Discurso del éxito ,Doblaje ,Estética de la voz ,Medios ,Voz del éxito ,Philology. Linguistics ,P1-1091 ,Literature (General) ,PN1-6790 - Abstract
Este trabajo tiene como objetivo analizar las modalidades de los dichos[1] sobre la voz del éxito en el ámbito del doblaje de películas. A partir de esta propuesta de análisis, también buscamos entender cómo los medios de comunicación utilizan la memoria sobre la voz, especialmente para desarrollar una red particular de sentidos con el fin de establecer la voz como un objeto de éxito. Para lograr estos objetivos, utilizamos el marco teórico y metodológico del Análisis del Discurso, específicamente las nociones de procesos parafrásticos y polisémicos en la distinción entre "desplazamiento" y "conmutación de sentidos", arraigados en la aplicación del concepto de silencio constitutivo y otros dispositivos indispensables en la dinámica de descripción-interpretación. Utilizamos como corpus el reportaje de Fantástico del 12 de diciembre de 2021, titulado "Doblaje pop: conoce la voz detrás de grandes personajes". Como resultado de este análisis, esperamos comprender cómo la voz y sus efectos de sentido constituyen y transforman a los sujetos del común en sujetos de prestigio a través de la conmutación de los efectos de éxito generados en grandes celebridades del ámbito cinematográfico.
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- 2023
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14. Revolução e Nihilismo em Raízes do Brasil, 1936
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Damião Farias
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revolução ,nihilismo ,Nietzsche ,Raízes do Brasil ,Sérgio B. de Holanda ,Modern ,B790-5802 - Abstract
Resumo: O artigo aborda o tema “Revolução”, analisado por Holanda em Raízes do Brasil (1936). A leitura foi mediada pela filosofia de Nietzsche, onde exploramos as noções de má consciência, ideal ascético e as críticas à modernidade. Além de duas referências explícitas ao filósofo, as abrangentes noções nietzschianas subsidiam as avaliações de Holanda sobre os “novos tempos” no Brasil. No entanto, a crítica do brasileiro foi direcionada àquelas “superfetações liberais”, dado o seu caráter exógeno às tradições brasileiras. Em contrapartida, considerou positivos os valores do personalismo, subjacentes ao nosso modo de vida, favoráveis à criação de forma política concernente à sociedade.
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- 2021
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15. A SEGURANÇA NACIONAL. UMA NOVA ABORDAGEM FACE AO TERRORISMO MARÍTIMO EM ÁFRICA
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Damião Fernandes Capitão Ginga
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segurança nacional ,terrorismo marítimo ,áfrica ,oceanos ,Political science ,International relations ,JZ2-6530 - Abstract
A conceptualização operacional da Segurança Nacional é frequentemente identificada como sendo difusa e cada vez mais abrangente, mormente por na atualidade esta se encontrar relacionada ao contexto geopolítico e aos atores em referência. A análise conceptual aqui apresentada tem como objetivo principal abordar o conceito de Segurança Nacional, fazendo uma correlação com o crescimento do terrorismo marítimo no continente africano em geral, tendo como enfoque particular a sua incidência nas suas regiões, enquadrado pelos debates das relações internacionais. A hipótese central do trabalho é de que a abordagem ao fenómeno do terrorismo marítimo no continente africano deverá ser tratada ao nível de um regime de segurança conjunto entre os Estados africanos. Nesta perspetiva, paralelamente ao enquadramento conceptual surgem como elementos centrais neste ensaio, a abordagem ao papel dos Estados na segurança territorial face ao crescimento das ameaças terroristas no mar em todo continente e a identificação dos principais desafios que se colocam à segurança nacional, nesta região do globo, onde a abordagem securitária conjunta entre os Estados se revelou fundamental, para contrariar a tendência ascendente dos movimentos do terrorismo transnacional.
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- 2020
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16. O problema da forma
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Damião Farias
- Subjects
Raízes do Brasil ,Friedrich Nietzsche ,Forma e conteúdo ,History (General) ,D1-2009 ,Latin America. Spanish America ,F1201-3799 - Abstract
O artigo problematiza o tema da forma na obra Raízes do Brasil, edição de 1936. Para realizar a interpretação, buscamos aporte em autores que tiveram confluências com o modernismo no Brasil e em outros países. Assim trabalhamos, sobretudo, com Nietzsche. Acreditamos ter alcançado êxito em demonstrar os vínculos das abordagens de Holanda em direções estético-expressivas sobre os ajustamentos e dissonâncias entre forma e conteúdo, cultura e Estado na história brasileira, nos períodos do Império e República. Holanda perscrutou os tempos brasileiros e divisou o distanciamento progressivo das formas políticas liberais em relação aos valores culturais do personalismo que caracterizaram a nossa história. Sua proposição é, ainda que difícil de ser vislumbrada, a favor de nova configuração da política em termos congênitos à específica cultura nacional, com o objetivo de melhor expressar os valores personalistas, em regime oligárquico/aristocrático, o que supostamente abriria a história brasileira para a criação de novas possibilidades.
- Published
- 2021
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17. Modelagem Computacional de Estruturas Renais.
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Magjarevic, R., Nagel, J. H., Müller-Karger, Carmen, Wong, Sara, La Cruz, Alexandra, Damião, F. N., Neves, L. A., Nascimento, A. V., and Nascimento, M. Z.
- Abstract
The efficiency of systems for radiographic images acquisition, as well as for computer aided diagnosis (CAD) is verified currently by means of phantoms or images selected by the researcher, compromising the reliability of the evaluation. In this work it is presented an algorithm that simulates the integrated kidney structures. The structures are built by the overlapping layer method, where a layer can be understood as a slice of the three-dimensional object. The urether, veins and arteries are represented by cylinders. The spatial arrangement of the arterial system is determined by the branching angle between 35 and 55 degrees, which are values defined according to the shape of the region and on the patients anatomical characteristics. The branch diameters are decreased in steps of 10% after bifurcation and there is a rotation of 90° of the branching plane, which guarantee asymmetric branching. The results obtained, evaluated by two specialists, are compatible with real anatomies, respecting the anatomical particularities. This degree of representation will allow the verification of the influence of radiological parameters, morphometric peculiarities and stage of the diseases on the quality of the images, as well as on the performance of the CAD. [ABSTRACT FROM AUTHOR]
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- 2008
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18. A estética do sucesso vocal: discursos engendrados na construção de vozes de sucesso midiático
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Thiago Barbosa Soares and Damião Francisco Boucher
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Discursos de sucesso ,Estética da voz de sucesso ,Sujeitos de sucesso ,Language and Literature ,Literature (General) ,PN1-6790 - Abstract
Este estudo visa analisar como é produzido um tipo de estética vocal, a partir de uma performatividade acerca de dizeres sobre vozes de sucesso. Acreditamos que, por conta dos discursos veiculados sobre a materialização da voz que (re)produz sujeitos e sentidos do sucesso, exista também uma discursivização complexa da estética da recepção do sucesso. Para a observação de tanto, empregaremos o aparato teórico metodológico da Análise do Discurso francesa, especialmente norteado pela noção de pré-construído, de pressuposto e subentendido, de intra e interdiscurso, bem como de deslizamentos (efeitos) metafóricos. Assim, investigaremos os funcionamentos discursivos midiáticos que tornam possível afirmar que a recepção da voz, em boa medida, engendra uma estética vocal de sucesso e, consequentemente, dá suporte à manutenção dessa determinada escuta. Em específico, analisaremos matérias da revista Rolling Stone, “Quando Michael se Tornou Michael” (SHEFFIELD, 2010), “Amy Winehouse 1983-2011” (ELISCU, 2011), e “Voz Imortal” (CAVALCANTI, 2015), publicadas nos anos de 2010, 2011 e 2015 respectivamente.
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- 2020
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19. MICROPROPAGAÇÃO DO KIWI CV. HAYWARD
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SCALIZE FÁBIO EDUARDO, MÔRO FABÍOLA VITTI, and DAMIÃO FILHO CARLOS FERREIRA
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micropropagação ,kiwi ,cotilédones ,aclimatação ex vitro ,Plant culture ,SB1-1110 - Abstract
O presente trabalho teve como objetivo desenvolver um protocolo para a obtenção de mudas de kiwi (Actinidia chinensis Planch), cv. Hayward, por meio do cultivo in vitro de cotilédones. Utilizou-se o meio de MURASHIGE & SKOOG (1962) -- MS, suplementado com dois tipos de auxina (AIA e AIB) e uma citocinina (BAP). Foram verificados os efeitos de três doses de auxinas (0,125; 0,250 e 0,375 mg.L-1), combinadas com três doses de citocinina (0,5; 1,0 e 1,5 mg.L-1) na capacidade morfogênica dos explantes. Procedeu-se o estudo histológico dos órgãos das plântulas obtidas in vitro, e verificou-se, também, a capacidade de aclimatação das mudas ex vitro. A menor dose de AIB (0,125 mg.L-1), independentemente das doses de BAP, foi a mais eficaz na morfogênese dos explantes. Não foram verificadas alterações histológicas e anatômicas das plântulas obtidas in vitro. Aos três meses após o cultivo ex vitro dos explantes, verificou-se a sobrevivência de 88% das plantas transplantadas em condições de campo.
- Published
- 2001
20. O planejamento e a gestão para o desenvolvimento sustentável: o caso da cidade de Jundiaí
- Author
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Damião Felipe Clemente Filho and Luis Paulo Bresciani
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Political institutions and public administration (General) ,JF20-2112 - Abstract
O presente artigo aborda a forma como o crescimento ocorre, e de que forma o planejamento e a gestão das políticas públicas conciliaram os objetivos de desenvolvimento e sustentabilidade na cidade de Jundiaí, enfatizando a preservação ambiental como condição necessária à melhoria da qualidade de vida das pessoas. Muitas ações com foco no conceito de sustentabilidade foram identificadas entre os anos de 1995 e 2005, período deste estudo, como a coleta seletiva de lixo, o tratamento de esgoto, e a criação do comitê de preservação do Rio Jundiaí, dentre outras. A evolução experimentada pela cidade nos últimos dez anos tem como explicação: investimentos na infra-estrutura e planejamento estratégico. Esta pesquisa teve como base informações de natureza documental e de entrevistas semi-estruturadas realizadas com gestores públicos, dirigentes empresariais e lideranças de associações civis, que atuaram na cidade durante o período estudado.
- Published
- 2008
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21. Porto-sinusoidal vascular liver disorder with portal hypertension: Natural history and long-term outcome.
- Author
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Magaz M, Giudicelli-Lett H, Abraldes JG, Nicoară-Farcău O, Turon F, Rajoriya N, Goel A, Raymenants K, Hillaire S, Téllez L, Elkrief L, Procopet B, Orts L, Nery F, Shukla A, Larrue H, Degroote H, Aguilera V, Llop E, Turco L, Indulti F, Gioia S, Tosetti G, Bitto N, Becchetti C, Alvarado E, Roig C, Diaz R, Praktiknjo M, Konicek AL, Olivas P, Fortea JI, Masnou H, Puente Á, Ardèvol A, Navascués CA, Romero-Gutiérrez M, Scheiner B, Semmler G, Mandorfer M, Damião F, Baiges A, Ojeda A, Simón-Talero M, González-Alayón C, Díaz A, García-Criado Á, De Gottardi A, Hernández-Guerra M, Genescà J, Drilhon N, Noronha Ferreira C, Reiberger T, Rodríguez M, Morillas RM, Crespo J, Trebicka J, Bañares R, Villanueva C, Berzigotti A, Primignani M, La Mura V, Riggio O, Schepis F, Verhelst X, Calleja JL, Bureau C, Albillos A, Nevens F, Hernández-Gea V, Tripathi D, Rautou PE, and García-Pagán JC
- Subjects
- Humans, Female, Middle Aged, Male, Retrospective Studies, Adult, Prognosis, Aged, Liver Transplantation statistics & numerical data, Liver Transplantation methods, Ascites etiology, Ascites diagnosis, Hepatic Encephalopathy etiology, Hepatic Encephalopathy epidemiology, Hepatic Encephalopathy diagnosis, Young Adult, Adolescent, Follow-Up Studies, Hypertension, Portal diagnosis, Hypertension, Portal complications
- Abstract
Background & Aims: Current knowledge of the natural history of patients with porto-sinusoidal vascular disorder (PSVD) is derived from small studies. The aim of the present study was to determine the natural history of PSVD and prognostic factors in a large multicenter cohort of patients., Methods: We performed a retrospective study on patients with PSVD and signs of portal hypertension (PH) prospectively registered in 27 centers., Results: A total of 587 patients were included, median age of 47 years and 38% were women. Four-hundred and one patients had an associated condition, which was graded as severe in 157. Median follow-up was 68 months. At diagnosis, 64% of patients were asymptomatic while 36% had a PH-related complication: PH-related bleeding in 112 patients, ascites in 117, and hepatic encephalopathy in 11. In those not presenting with bleeding, the incidence of first bleeding was 15% at 5 years, with a 5-year rebleeding rate of 18%. The 5-year cumulative incidence of new or worsening ascites was 18% and of developing portal vein thrombosis was 16%. Fifty (8.5%) patients received a liver transplantation and 109 (19%) died, including 55 non-liver-related deaths. Transplant-free survival was 97% and 83% at 1 and 5 years, respectively. Variables independently associated with transplant-free survival were age, ascites, serum bilirubin, albumin and creatinine levels at diagnosis and severe associated conditions. This allowed for the creation of a nomogram that accurately predicted prognosis., Conclusions: The prognosis of PSVD is strongly determined by the severity of the associated underlying conditions and parameters of liver and renal function., Impact and Implications: Porto-sinusoidal vascular liver disorder (PSVD) is a rare entity that usually affects young people, frequently causes severe complications of portal hypertension, and may reduce life expectancy. To date, there is scarce information regarding its clinical manifestations, natural history and prognostic factors. The present study, including the largest number of patients with PSVD reported so far, shows that overall, when managed at centers of expertise, the prognosis of patients with PSVD is good, with LT-free survival rates of 83% and 72% at 5 and 10 years, respectively. Presence and severity of an underlying associated condition, presence of ascites, age and bilirubin, albumin and creatinine levels were associated with poor prognosis. These results are important to know for hepatologists. A final model combining these parameters enabled development of a nomogram that predicts prognosis with good discrimination and calibration capacity and can be easily applied in clinical practice., (Copyright © 2024 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.)
- Published
- 2025
- Full Text
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22. Liver Transplantation for Porto-sinusoidal Vascular Liver Disorder: Long-term Outcome.
- Author
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Magaz M, Giudicelli-Lett H, Nicoară-Farcău O, Rajoriya N, Goel A, Raymenants K, Hillaire S, Crespo G, Téllez L, Elkrief L, Fondevila C, Orts L, Nery F, Shukla A, Larrue H, Fundora Y, Degroote H, Aguilera V, LLop E, Turco L, Indulti F, Gioia S, Tosetti G, Bitto N, Becchetti C, Alvarado E, Roig C, Diaz R, Praktiknjo M, Konicek AL, Soy G, Olivas P, Fortea JI, Masnou H, Puente Á, Ardèvol A, Álvarez-Navascués C, Romero M, Scheiner B, Semmler G, Mandorfer M, Damião F, Baiges A, Turon F, Simón-Talero M, González-Alayón C, Díaz A, García-Criado Á, de Gottardi A, Reverter E, Blasi A, Genescà J, Roux O, Francoz C, Noronha Ferreira C, Reiberger T, Rodríguez M, Morillas RM, Crespo J, Trebicka J, Bañares R, Villanueva C, Berzigotti A, Primignani M, La Mura V, Riggio O, Schepis F, Procopet B, Verhelst X, Calleja JL, Bureau C, Albillos A, Nevens F, Hernández-Gea V, Tripathi D, Rautou PE, Durand F, and García-Pagán JC
- Subjects
- Humans, Creatinine, Neoplasm Recurrence, Local, Retrospective Studies, Liver Transplantation, Carcinoma, Hepatocellular, Vascular Diseases, Liver Neoplasms
- Abstract
Background: Porto-sinusoidal vascular liver disorder (PSVD) is a rare disease that occasionally requires liver transplantation (LT), despite usually presenting preserved liver function. There remains a paucity of data pertaining to LT in PSVD. The aim was to identify features associated with post-LT outcomes in PSVD., Methods: Retrospective multicentre study of 79 patients who received LT for PSVD., Results: Median post-LT follow-up was 37 (range 1-261) mo. Refractory ascites 24 (30%), hepatic encephalopathy 16 (20%), and hepatopulmonary syndrome 13 (16.3%) were the most frequent indications for LT. Hepatocellular carcinoma was the indication in only 2 patients. Twenty-four patients died, 7 due to liver and 17 to non-liver related causes. Post-LT survival was 82.2%, 80.7%, and 68.6% at 1, 2, and 5 y, respectively. Post-LT survival was significantly better in patients without (n = 58) than in those with a persistent severe PSVD-associated condition (n = 21). Pre-LT hyperbilirubinemia levels and creatinine >100 µmol/L were also independently associated with poor survival. Six patients (7.6%) required a second LT. Recurrence of PSVD was confirmed by liver biopsy in only 1 patient and in 3 further patients it was likely., Conclusions: LT in PSVD is associated with an acceptable outcome in the absence of associated severe conditions. However, persistence of a severe associated condition, pre-LT high bilirubin levels, or creatinine >100 µmol/L impact outcome, and these are features that should be considered when evaluating PSVD patients for LT. PSVD recurrence is possible after LT and needs to be explored, at least, in cases of posttransplant portal hypertension., Competing Interests: V.H.-G. received speaker fees from Gore. J.C.G.-P. advises for GORE, Cook, and Shionogi. The other authors declare no conflicts of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2023
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23. Duodenal Gangliocytic Paraganglioma: A Unique Cause of Abdominal Pain.
- Author
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Reis D, Damião F, Noronha Ferreira C, Cruz R, Vitorino E, Carrilho Ribeiro L, and Tato Marinho R
- Published
- 2019
- Full Text
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24. Anticoagulation in Cirrhosis and Portal Vein Thrombosis Is Safe and Improves Prognosis in Advanced Cirrhosis.
- Author
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Noronha Ferreira C, Reis D, Cortez-Pinto H, Tato Marinho R, Gonçalves A, Palma S, Leite I, Rodrigues T, Pedro AJ, Alexandrino P, Serejo F, Sobral Dias M, Ferreira P, Vasconcelos M, Damião F, Xavier Brito L, Baldaia C, Fatela N, Ramalho F, and Velosa J
- Subjects
- Aged, Anticoagulants adverse effects, End Stage Liver Disease surgery, Female, Heparin, Low-Molecular-Weight therapeutic use, Humans, Liver Transplantation, Male, Middle Aged, Prognosis, Proportional Hazards Models, Recurrence, Retrospective Studies, Severity of Illness Index, Survival Rate, Thrombosis etiology, Warfarin therapeutic use, Anticoagulants therapeutic use, End Stage Liver Disease etiology, Hemorrhage chemically induced, Liver Cirrhosis complications, Portal Vein, Thrombosis drug therapy
- Abstract
Background: The role of portal vein thrombosis (PVT) in the natural history of cirrhosis is controversial., Aims: We analyzed the safety and effect of anticoagulant therapy (AT) on PVT recanalization and orthotopic liver transplant (OLT)-free survival., Methods: Eighty consecutive patients from a prospective registry of cirrhosis and non-tumoral PVT at a tertiary center were analyzed. AT effect on PVT recanalization and OLT-free survival was determined by time-dependent Cox regression analysis., Results: Average MELD score was 15 ± 7. Portal hypertension-related complications at PVT diagnosis were present in 65 (81.3%) patients. Isolated portal vein trunk/branch thrombosis was present in 53 (66.3%) patients. AT was started in 37 patients. AT was stopped in 17 (45.9%) patients, in 4 (10.8%) due to bleeding events. No variceal bleeding occurred while on AT. Anticoagulation was restarted in 6/17 (35.2%) patients due to rethrombosis. In 67 patients with adequate follow-up imaging, AT significantly increased the rate of PVT recanalization compared with those who did not receive anticoagulation [51.4% (18/35) vs 6/32 (18.8%), p = 0.005]. OLT-free survival after a median follow-up of 25 (1-146) months was 32 (40%). Although there was no significant effect of AT on overall OLT-free survival, OLT-free survival was higher among patients with MELD ≥ 15 receiving AT compared to those who did not (p = 0.011). Baseline MELD at PVT detection independently predicted PVT recanalization (HR 1.11, 95% CI 1.01-1.21, p = 0.027) and mortality/OLT (HR 1.12, 95% CI 1.05-1.19, p < 0.001)., Conclusions: Although AT did not improve overall OLT-free survival, it was associated with higher survival in advanced cirrhosis. Anticoagulation increased PVT recanalization and should be maintained after PVT recanalization to avoid rethrombosis.
- Published
- 2019
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25. Incidence, predictive factors and clinical significance of development of portal vein thrombosis in cirrhosis: A prospective study.
- Author
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Noronha Ferreira C, Marinho RT, Cortez-Pinto H, Ferreira P, Dias MS, Vasconcelos M, Alexandrino P, Serejo F, Pedro AJ, Gonçalves A, Palma S, Leite I, Reis D, Damião F, Valente A, Xavier Brito L, Baldaia C, Fatela N, Ramalho F, and Velosa J
- Subjects
- Aged, Female, Humans, Incidence, Liver Cirrhosis mortality, Male, Middle Aged, Portugal epidemiology, Prospective Studies, Risk Factors, Venous Thrombosis etiology, Liver Cirrhosis complications, Portal Vein, Venous Thrombosis epidemiology
- Abstract
Background and Aims: The role of portal vein thrombosis (PVT) in the natural history of cirrhosis is controversial. There are few prospective studies validating risk factors for development of PVT. We analysed the incidence, factors associated with PVT development and its influence on cirrhosis decompensations and orthotopic liver transplant (OLT)-free survival., Methods: In this prospective observational study between January 2014 and March 2019, 445 consecutive patients with chronic liver disease were screened and finally 241 with cirrhosis included. Factors associated with PVT development and its influence on cirrhosis decompensations and OLT-free survival by time dependent covariate coding were analysed., Results: Majority of patients belonged to Child-Pugh class A 184 (76.3%) and the average MELD score was 10 ± 5. Previous cirrhosis decompensations occurred in 125 (52.1%), 63 (26.1%) were on NSBB and 59 (27.2%) had undergone banding for bleeding prophylaxis. Median follow-up was 29 (1-58) months. Cumulative incidence of PVT was 3.7% and 7.6% at 1 and 3 years. Previous decompensation of cirrhosis and low platelet counts but not NSBB independently predicted the development of PVT. During follow-up, 82/236 (34.7%) patients developed cirrhosis decompensations. OLT-free survival was 100% and 82.8% at 3 years, with and without PVT respectively. MELD score, but not PVT, independently predicted cirrhosis decompensations (HR 1.14; 95%CI:1.09-1.19) and OLT-free survival (HR 1.16;95%CI:1.11-1.21)., Conclusion: Previous decompensations of cirrhosis and thrombocytopenia predict PVT development in cirrhosis suggesting a pathophysiologic role for severity of portal hypertension. PVT development did not independently predict cirrhosis decompensations or lower OLT-free survival., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Published
- 2019
- Full Text
- View/download PDF
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