Browsing by Author "Fassio, Eduardo"

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    A Latin American survey on demographic aspects of hospitalized, decompensated cirrhotic patients and the resources for their management
    (2020) Vorobioff, Julio D.; Contreras, Fernando; Tanno, Federico; Hernandez, Lucia; Bessone, Fernando; Colombato, Luis; Adi, Jose; Fassio, Eduardo; Felgueres, Mirta; Fernandez, Guillermo; Gaite, Luis; Gibelli, Diana; Gomez Darrichon, Hernan; Lafage, Matias; Lombardo, Daniel; Lopez, Susana; Mateo, Alejandro; Mendizabal, Manuel; Pecoraro, Julieta; Ruf, Andres; Ruiz, Pablo; Severini, Javier; Stieben, Teodoro; Sixto, Marcela; Zarate, Fabian; de la Barra Barraza, Sergio; Donoso Sierra, Irene; Rivas Pacheco, Violeta; Roblero, Juan P.; Rojas, Juan O.; Ruiz Gonzalez, Patricio; San Martin Rodriguez, Diego; Sierralta, Armando; Urzua Manchego, Alvaro; Valdes, Eliana; Yaquich, Pamela; Wolff, Rodrigo; Beltran Valdivia, Flor; Gallegos, Roxana C.; Galloso, Rocio; Marcelo, Julio S.; Montes, Pedro; Tenorio, Laura; Veramendi, Isabel; Alava, Elizabeth; Armijos, Ximena; Benalcazar, Gonzalo; Carrera, Enrique; Pazmino, Galo F.; Marriott Diaz, Eduardo; Garassini, Miguel; Marrero, Rosalia P.; Infante, Mirta; Paez Suarez, Dayron; Gutierrez, Jose C.; Villadoniga Reyes, Carmen M.; Serrano, Yoel M.; Hernandez Hernandez, Rivardo; Martinez Martinez, Orelvis; Perez Gonzalez, Teresita; Andara, Maria T.; Sanchez Hernandez, Marco; Gerona, Solange; Garcia, Ivan; de la Tijera, Fatima; Pessoa Lopez, Edmundo; Torres, Kenia; Garzon, Martin
    Introduction & objectives: Liver cirrhosis is a major cause of mortality worldwide. Adequate diagnosis and treatment of decompensating events requires of both medical skills and updated technical resources. The objectives of this study were to search the demographic profile of hospitalized cirrhotic patients in a group of Latin American hospitals and the availability of expertise/facilities for the diagnosis and therapy of decompensation episodes.
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    Drug-induced liver injury: A management position paper from the Latin American Association for Study of the liver
    (2021) Bessone, Fernando; Hernandez, Nelia; Tagle, Martin; Arrese, Marco; Parana, Raymundo; Mendez-Sanchez, Nahum; Ridruejo, Ezequiel; Mendizabal, Manuel; Dagher, Lucy; Contreras, Fernando; Fassio, Eduardo; Pessoa, Mario; Brahm, Javier; Silva, Marcelo
    Idiosyncratic drug-induced liver injury (DILI) caused by xenobiotics (drugs, herbals and dietary supplements) is an uncommon cause of liver disease presenting with a wide range of phenotypes and disease severity, acute hepatitis mimicking viral hepatitis to autoimmune hepatitis, steatosis, fibrosis or rare chronic vascular syndromes. Disease severity ranges from asymptomatic liver test abnormalities to acute liver failure. DILI has been traditionally classified in predictable or intrinsic (dose-related) or unpredictable (not dose-related) mechanisms. Few prospective studies are assessing the real prevalence and incidence of hepatotoxicity in the general population. DILI registries represent useful networks used for the study of liver toxicity, aimed at improving the understanding of causes, phenotypes, natural history, and standardized definitions of hepatotoxicity. Although most of the registries do not carry out population-based studies, they may provide important data related to the prevalence of DILI, and also may be useful to compare features from different countries. With the support of the Spanish Registry of Hepatotoxicity, our Latin American Registry (LATINDILI) was created in 2011, and more than 350 DILI patients have been recruited to date. This position paper describes the more frequent drugs and herbsinduced DILI in Latin America, mainly focusing on several features of responsible medicaments. Also, we highlighted the most critical points on the management of hepatotoxicity in general and those based on findings from our Latin American experience in particular. (C) 2021 Fundacion Clinica Medica Sur, A.C. Published by Elsevier Espana, S.L.U.
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    Genetic Ancestry, Race, and Severity of Acutely Decompensated Cirrhosis in Latin America
    (2023) Farias, Alberto Queiroz; Vilalta, Anna Curto; Zitelli, Patricia Momoyo; Pereira, Gustavo; Goncalves, Luciana L.; Torre, Aldo; Diaz, Juan Manuel; Gadano, Adrian C.; Mattos, Angelo Z.; Mendes, Liliana S. C.; Alvares-da-Silva, Mario R.; Bittencourt, Paulo L.; Benitez, Carlos; Couto, Claudia Alves; Mendizabal, Manuel; Toledo, Claudio L.; Mazo, Daniel F. C.; Barradas, Mauricio Castillo; Raposo, Eva M. Uson; Padilla-Machaca, P. Martin; Miranda, Adelina Zarela Lozano; Male-Velazquez, Rene; Lyra, Andre Castro; Davalos-Moscol, Milagros B.; Hernandez, Jose L. Perez; Ximenes, Rafael O.; Silva, Giovanni Faria; Beltran-Galvis, Oscar A.; Huezo, Maria S. Gonzalez; Bessone, Fernando; Rocha, Tarciso D. S.; Fassio, Eduardo; Terra, Carlos; Marin, Juan I.; Casas, Patricia Sierra; de la Pena-Ramirez, Carlos; Parera, Ferran Aguilar; Fernandes, Flavia; Zago-Gomes, Maria da Penha; Mendez-Guerrero, Osvely; Marciano, Sebastian; Mattos, Angelo A.; Oliveira, Joao C.; Guerreiro, Gabriel T. S.; Codes, Liana; Arrese, Marco; Nardelli, Mateus J.; Silva, Marcelo O.; Palma-Fernandez, Renato; Alcantara, Camila; Garrido, Cristina Sanchez; Trebicka, Jonel; Gustot, Thierry; Fernandez, Javier; Claria, Joan; Jalan, Rajiv; Angeli, Paolo; Arroyo, Vicente; Moreau, Richard; ACLARA Study Collaborators
    BACKGROUND & AIMS: Genetic ancestry or racial differences in health outcomes exist in diseases associated with systemic inflammation (eg, COVID-19). This study aimed to investigate the association of genetic ancestry and race with acute-on chronic liver failure (ACLF), which is characterized by acute systemic inflammation, multi-organ failure, and high risk of short-term death. METHODS: This prospective cohort study analyzed a comprehensive set of data, including genetic ancestry and race among several others, in 1274 patients with acutely decompensated cirrhosis who were nonelectively admitted to 44 hospitals from 7 Latin American countries. RESULTS: Three hundred ninety-five patients (31.0%) had ACLF of any grade at enrollment. Patients with ACLF had a higher median percentage of Native American genetic ancestry and lower median percentage of European ancestry than patients without ACLF (22.6% vs 12.9% and 53.4% vs 59.6%, respectively). The median percentage of African genetic ancestry was low among patients with ACLF and among those without ACLF. In terms of race, a higher percentage of patients with ACLF than patients without ACLF were Native American and a lower percentage of patients with ACLF than patients without ACLF were European American or African American. In multivariable analyses that adjusted for differences in sociodemographic and clinical characteristics, the odds ratio for ACLF at enrollment was 1.08 (95% CI, 1.03-1.13) with Native American genetic ancestry and 2.57 (95% CI, 1.84-3.58) for Native American race vs European American race CONCLUSIONS: In a large cohort of Latin American patients with acutely decompensated cirrhosis, increasing percentages of Native American ancestry and Native American race were factors independently associated with ACLF at enrollment.
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    Latin American Association for the study of the liver (ALEH) practice guidance for the diagnosis and treatment of non-alcoholic fatty liver disease
    (2020) Pablo Arab, Juan; Dirchwolf, Melisa; Alvares-da-Silva, Mario Reis; Barrera, Francisco; Benitez, Carlos; Castellanos-Fernandez, Marlene; Castro-Narro, Graciela; Chavez-Tapia, Norberto; Chiodi, Daniela; Cotrim, Helma; Cusi, Kenneth; Marques Souza de Oliveira, Claudia Pinto; Diaz, Javier; Fassio, Eduardo; Gerona, Solange; Girala, Marcos; Hernandez, Nelia; Marciano, Sebastian; Masson, Walter; Mendez-Sanchez, Nahum; Leite, Nathalie; Lozano, Adelina; Padilla, Martin; Panduro, Arturo; Parana, Raymundo; Parise, Edison; Perez, Marlene; Poniachik, Jaime; Carlos Restrepo, Juan; Ruf, Andres; Silva, Marcelo; Tagle, Martin; Tapias, Monica; Torres, Kenia; Vilar-Gomez, Eduardo; Costa Gil, Jose Eduardo; Gadano, Adrian; Arrese, Marco
    Non-alcoholic fatty liver disease (NAFLD) currently represents an epidemic worldwide. NAFLD is the most frequently diagnosed chronic liver disease, affecting 20-30% of the general population. Furthermore, its prevalence is predicted to increase exponentially in the next decades, concomitantly with the global epidemic of obesity, type 2 diabetes mellitus (T2DM), and sedentary lifestyle. NAFLD is a clinical syndrome that encompasses a wide spectrum of associated diseases and hepatic complications such as hepatocellular carcinoma (HCC). Moreover, this disease is believed to become the main indication for liver transplantation in the near future. Since NAFLD management represents a growing challenge for primary care physicians, the Asociacion Latinoamericana para el Estudio del Higado (ALEH) has decided to organize this Practice Guidance for the Diagnosis and Treatment of Non-Alcoholic Fatty Liver Disease, written by Latin-American specialists in different clinical areas, and destined to general practitioners, internal medicine specialists, endocrinologists, diabetologists, gastroenterologists, and hepatologists. The main purpose of this document is to improve patient care and awareness of NAFLD. The information provided in this guidance may also be useful in assisting stakeholders in the decision-making process related to NAFLD. Since new evidence is constantly emerging on different aspects of the disease, updates to this guideline will be required in future. (C) 2020 Published by Elsevier Espana, S.L.U. on behalf of Fundacion Cilnica Medica Sur, A.C.
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    Serious liver injury induced by Nimesulide: an international collaborative study
    (2021) Bessone, Fernando; Hernandez, Nelia; Mendizabal, Manuel; Ridruejo, Ezequiel; Gualano, Gisela; Fassio, Eduardo; Peralta, Mirta; Fainboim, Hugo; Anders, Margarita; Tanno, Hugo; Tanno, Federico; Parana, Raymundo; Medina-Caliz, Inmaculada; Robles-Diaz, Mercedes; Alvarez-Alvarez, Ismael; Niu, Hao; Stephens, Camilla; Colombato, Luis; Arrese, Marco; Reggiardo, M. Virginia; Ono, Suzane Kioko; Carrilho, Flair; Lucena, M. Isabel; Andrade, Raul J.
    Nimesulide is a non-steroidal anti-inflammatory drug still marketed in many countries. We aim to analyze the clinical phenotype, outcome, and histological features of nimesulide-induced liver injury (nimesulide-DILI). We analyzed 57 cases recruited from the Spanish and Latin American DILI registries. Causality was assessed by the RUCAM scale. Mean age of the whole case series was 59 years (86% women) with a median time to onset of 40 days. A total of 46 patients (81%) were jaundiced. Nimesulide-DILI pattern was hepatocellular in 38 (67%), mixed in 12 (21%), and cholestatic in 7 (12%) cases. Transaminases were elevated with a mean of nearly 20-fold the upper limit of normality (ULN), while alkaline phosphatase showed a twofold mean elevation above ULN. Total bilirubin showed a mean elevation of 13-fold the ULN. Liver histology was obtained in 14 cases (25%), most of them with a hepatocellular pattern. Median time to recovery was 60 days. Overall, 12 patients (21%) developed acute liver failure (ALF), five (8.8%) died, three underwent liver transplantation (5.3%), and the remaining four resolved. Latency was <= 15 days in 12 patients (21%) and one patient developed ALF within 7 days from treatment initiation. Increased total bilirubin and aspartate transaminase levels were independently associated with the development of ALF. In summary, nimesulide-DILI affects mainly women and presents typically with a hepatocellular pattern. It is associated with ALF and death in a high proportion of patients. Shorter (<= 15 days) duration of therapy does not prevent serious nimesulide hepatotoxicity, making its risk/benefit ratio clearly unfavorable.
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    The case for simplifying and using absolute targets for viral hepatitis elimination goals
    (2021) Razavi, Homie; Blach, Sarah; Razavi-Shearers, Devin; Abaalkhail, Faisal; Abbas, Zaigham; Abdallah, Ayat; Ferreira, Paulo Abrao; Abu Raddad, Laith Jamal; Adda, Danjuma; Agarwal, Kosh; Aghemo, Alessio; Ahmed, Aijaz; Al-Busafi, Said A.; Al-hamoudi, Waleed; Al-Kaabi, Saad; Al-Romaihi, Hamad; Aljarallah, Badr; AlNaamani, Khalid; Alqahtani, Saleh; Alswat, Khalid; Altraif, Ibrahim; Asselah, Tarik; Bacon, Bruce; Bessone, Fernando; Bizri, Abdul Rahman; Block, Tim; Bonino, Ferruccio; BranclaoMello, Carlos Eduardo; Browny, Kimberly; Bruggmann, Philip; Brunetto, Maurizia Rossana; Buti, Maria; Cabezas, Joaquin; Calleja, Jose Luis; Batanjer, Erika Castro; Chan, Henry Lik-Yuen; Chang, Henry; Chen, Chien-Jen; Christensen, Peer Brehm; Chuang, Wan-Long; Cisneros, Laura; Cohen, Chari; Colombo, Massimo; Conway, Brian; Cooper, Curtis; Craxi, Antonio; Crespo, Javier; Croes, Esther; Cryer, Donna; de Barros, Fernando Passos Cupertino; Derbala, Moutaz; Dillon, John; Doss, Wahid; Dou, Xiaoguang; Doyle, Joseph; Duberg, Ann-Sofi; Dugan, Ellen; Dunn, Rick; Dusheiko, Geoffrey; El Khayat, Hisham; EI-Sayed, Manal H.; Eshraghian, Ahad; Esmat, Gamal; Mur, Rafael Esteban; Ezzat, Sameera; Falconer, Karolin; Fassio, Eduardo; Ferrinho, Paulo; Flamm, Steven; Flisiak, Robert; Foster, Graham; Fung, James; Garcia-Samaniego, Javier; Gish, Robert G.; Goncales, Fernando; Halota, Waldemar; Hamoudi, Waseem; Hassany, Mohamed; Hatzakis, Angelos; Hay, Susan; Himatt, Sayed; Hoepelman, I. M.; Hsu, Yao-Chun; Hui, Yee Tak; Hunyady, Bela; Jacobson, Ira; Janjua, Naveed; Janssen, Harry; Jarcuska, Peter; Kabagambe, Kenneth; Kanto, Tatsuya; Kao, Jia-Horng; Kaymakoglu, Sabahattin; Kershenobich, David; Khamis, Faryal; Kim, Dong Joon; Kim, Young; Kondili, Loreta A.; KottiliI, Shyamasundaran; Kramvis, Anna; Kugelmas, Marcelo; Kurosaki, Masayuki; Lacombe, Karine; Lagging, Martin; Lao, WaiCheung; Lavanchy, Daniel; Lazarus, Jeffrey, V; Lee, Alice; Lee, Samual S.; Levyl, Miriam; Liakina, Valentina; Lim, YoungSuk; Liu, Shuang; Maddrey, Willis; Malekzade, Reza; Marinho, Rui Tato; Mathur, Poonam; Maticic, Mojca; Mendes Correa, Maria Cassia; Mera, Jorge; Merat, Shahin; Mogawer, Sherif; Mohamed, Rosmawati; Muellhaupti, Beat; Muljono, David; Mostafa, Ibrahim; Nahum, Mendez Sanchez; Nawaz, Arif; Negro, Francesco; Ninburg, Michael; Ning, Qing; Ntiri-Reid, Boatemaa; Nymadawa, Pagbajabyn; Oevrehus, Anne; Ormeci, Necati; Orrego, Mauricio; Osman, Alaa; Oyunsuren, Tsendsuren; Pant, Calvin; Papaevangelou, Vassiliki; Papatheodoridis, George; Popping, Stephanie; Prasad, Papu; Prithiviputh, Rittoo; Qureshi, Huma; Ramji, Alnoor; Razavi-Shearer, Kathryn; Reddy, Rajender; Remak, William; Richter, Clemens; Ridruejo, Ezequiel; Robaeys, Geert; Robert, Stuart; Roberts, Lewis; Roudot-Thoraval, Francoise; Saab, Sammy; Said, Sanaa; Salamat, Amjad; Sanai, Faisal; Sanchez-Avila, Juan Francisco; Schiff, Eugene; Schinazi, Raymond; Sebastiani, Giada; Seguin-Devaux, Carole; Shanmugam, R. P.; Sharara, Ala; Shilton, Sonjelle; Shouval, Daniel; Sievert, William; Simonova, Marieta; Sohrabpour, Amir Ali; Sonderup, Mark; Soza, Alejandro; Spearman, C. Wendy; Steinfurth, Nancy; Sulkowski, Mark; Tan, Soek-Siam; Tanaka, Junko; Tashi, Dhondup; Thein, Hla-Hla; Thompson, Peyton; Tolmane, Ieva; Toy, Mehlika; Valantinas, Jonas; Van de Vijver, David; Velez-Moller, Patricia; Vince, Adriana; Waked, Imam; Wang, Su; Wedemeyer, Heiner; Wong, Vincent; Xie, Qing; Yamada, Seiji; Yang, Hwai-, I; Yesmembetov, Kakharman; Yilmaz, Yusuf; Younossi, Zobair; Yu, Ming-Lung; Yuen, Man-Fung; Yurdaydin, Cihan; Yusuf, Aasim; Zekry, Amany; Zeuzem, Stefan
    The 69th World Health Assembly endorsed the Global Health Sector Strategy for Viral Hepatitis, embracing a goal to eliminate hepatitis infection as a public health threat by 2030. This was followed by the World Health Organization's (WHO) global targets for the care and management of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. These announcements and targets were important in raising awareness and calling for action; however, tracking countries' progress towards these elimination goals has provided insights to the limitations of these targets. The existing targets compare a country's progress relative to its 2015 values, penalizing countries who started their programmes prior to 2015, countries with a young population, or countries with a low prevalence. We recommend that (1) WHO simplify the hepatitis elimination targets, (2) change to absolute targets and (3) allow countries to achieve these disease targets with their own service coverage initiatives that will have the maximum impact. The recommended targets are as follows: reduce HCV new chronic cases to <= 5 per 100 000, reduce HBV prevalence among 1-year-olds to <= 0.1%, reduce HBV and HCV mortality to <= 5 per 100 000, and demonstrate HBV and HCV year-to-year decrease in new HCV- and HBV-related HCC cases. The objective of our recommendations is not to lower expectations or diminish the hepatitis elimination standards, but to provide clearer targets that recognize the past and current elimination efforts by countries, help measure progress towards true elimination, and motivate other countries to follow suit.