Einstein-Sao Paulo最新文献

{"title":"Socioeconomic inequities in prostate cancer care: private versus public treatment settings pose a significant impact on overall survival.","authors":"Amanda Caroline de Souza Costa, Fernando Korkes, Jose Augusto Rinck Junior, Frederico Timóteo Silva Cunha, Luciana Holtz de Camargo Barros, Stênio de Cássio Zequi, Maria Nirvana da Cruz Formiga","doi":"10.31744/einstein_journal/2025AO0851","DOIUrl":"https://doi.org/10.31744/einstein_journal/2025AO0851","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of assistance from public and private health systems on the overall survival of patients with metastatic prostate cancer.</p><p><strong>Methods: </strong>A total of 213 patients with metastatic prostate cancer treated at the A.C. Camargo Cancer Center, either in the Unified Health System or a private system, from January 2014 to December 2018 were analyzed. Multivariate analysis of overall survival was performed to adjust for the type of health assistance and other clinical prognostic factors.</p><p><strong>Results: </strong>Of 213 included patients, 147 (69%) were from the private system and 66 (31%) were from the Unified Health System. There was a significant difference in the median age at diagnosis between the systems (63.4 years for patients in the private system versus 67.2 years for patients in the Unified Health System, p=0.027). No significant differences in performance status were observed between the groups (p=0.695). Patients treated in the public system had access to fewer treatment lines (2.59 lines in the public system versus 3.04 lines in the private system, p=0.024). Our data revealed a longer median survival for patients with private health care (115 months for patients with private health care versus 78 months for patients in the Unified Health System, p=0.009). Multivariate analysis revealed that patients in the public system had a 66% higher risk of death than those in the private system.</p><p><strong>Conclusion: </strong>Our data demonstrate that patients in the Unified Health System have access to fewer lines of therapy for metastatic prostate cancer, resulting in shorter median survival than patients treated in the private system.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eAO0851"},"PeriodicalIF":1.1,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dose-response relationships in Y90 resin microsphere radioembolization for patients with hepatocellular carcinoma: insights from a Brazilian cohort.","authors":"Marcela Juliano Silva Cunha, Francisco Leonardo Galastri, Felipe Nasser, Breno Boueri Affonso, Leonardo Guedes Moreira Valle, Priscila Mina Falsarella, Bruno Pagnin Schmid, Lilian Yuri Itaya Yamaga, Giovanna Sawaya Torre, Rodrigo Gobbo Garcia, Nelson Wolosker","doi":"10.31744/einstein_journal/2025AO1287","DOIUrl":"https://doi.org/10.31744/einstein_journal/2025AO1287","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the relationship between the absorbed dose and radiological response in patients with hepatocellular carcinoma undergoing resin microsphere radioembolization to enhance treatment precision and potentially adjust protocols for better outcomes.</p><p><strong>Methods: </strong>This single-center retrospective study was conducted at a quaternary care center in Brazil and comprised 27 patients with 58 target lesions treated between November 2014 and April 2023. The patients' dosimetric profiles were analyzed using advanced imaging software to assess post-treatment clinical and radiological responses. This study explored the correlation between the absorbed doses and tumor objective responses using statistical analyses to confirm the findings.</p><p><strong>Results: </strong>Higher absorbed doses were significantly associated with improved objective responses in the target lesions. The analysis demonstrated that achieving higher dosimetric thresholds correlated with better clinical outcomes, suggesting that a dose-response relationship is essential to optimize treatment protocols.</p><p><strong>Conclusion: </strong>These findings emphasize the importance of personalized dosimetry in managing hepatocellular carcinoma using resin microsphere radioembolization. By quantifying the absorbed dose and understanding its impact on tumor response, treatment strategies can be tailored to enhance efficacy and potentially shift palliative treatments toward curative outcomes. This study provides a crucial foundation for dosimetric adjustment and highlights the need for further research in this area, particularly in Brazil.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eAO1287"},"PeriodicalIF":1.1,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moebius Syndrome associated with syringomyelia: a case report.","authors":"Fernanda Kimie Yamamoto, Fernanda Marques de Deus, Renata de Araújo Monteiro Yoshida, Erasmo Barbante Casella, Romy Schmidt Brock Zacharias","doi":"10.31744/einstein_journal/2025RC0876","DOIUrl":"https://doi.org/10.31744/einstein_journal/2025RC0876","url":null,"abstract":"<p><strong>Background: </strong>Moebius Syndrome is a genetic condition that results in inability for facial mimicry due to palsy of cranial nerves VI and VII. Syringomyelia is characterized by a dilation of the central canal in the spinal cord, and is generally asymptomatic. Both disorders are diagnosed using imaging tests. A newborn with no facial movements upon physical examination was admitted to the delivery room of our hospital. A specialist confirmed the condition to be Moebius Syndrome. Further investigation using magnetic resonance imaging indicated that syringomyelia was associated with Moebius Syndrome. Given that syringomyelia is a silent myelopathy with a possible impact on the future health of the patient, careful analysis is recommended when diagnosing Moebius Syndrome. Few similar cases have been reported to date. Further studies are warranted to determine the actual association between these two conditions. Since syringomyelia diagnoses are often made when testing for other conditions, as in this study, neurological examinations of the brain should be expanded to include the spinal cord, in order to verify the presence of coexisting disorders.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eRC0876"},"PeriodicalIF":1.1,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chryseobacterium indologenes sepsis in a pediatric patient.","authors":"Felipe Krakauer, Raquel Pissiguelli, Marina Moranduzzo, Bruna Marques Tofaneto, Sophia Bastos Correa da Costa, Maryleen Brigitte Muñoz Guzman, Gabriel Frizzo Ramos, Saulo Brasil do Couto, Rafael Yanes Rodrigues da Silva, Luís Felipe Batista Hiar, Luisa Zagne Braz","doi":"10.31744/einstein_journal/2025RC1200","DOIUrl":"https://doi.org/10.31744/einstein_journal/2025RC1200","url":null,"abstract":"<p><strong>Background: </strong>Chryseobacterium indologenes is a Gram-negative aerobic bacillus commonly found in nosocomial environments, particularly in patients with prolonged hospital stays or those requiring long-term invasive devices. It primarily affects elderly and immunocompromised individuals. This microorganism is associated with multidrug resistance, which is a crucial factor in treatment decisions. Here, we report a case of C. indologenes infection in an infant following the ingestion of milk formula diluted with untreated water.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eRC1200"},"PeriodicalIF":1.1,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tenosynovitis caused by Trichosporon asahii in an immunocompetent patient.","authors":"Lais Lopes Pires, Mayara Gabriele Toledo, Hugo Rodrigues Alves, Isadora Cambruzzi, Guilherme Brezenski Rodrigues, Andrea D'avila Freitas, Natalia Chilinque Zambao da Silva","doi":"10.31744/einstein_journal/2025RC1095","DOIUrl":"https://doi.org/10.31744/einstein_journal/2025RC1095","url":null,"abstract":"<p><strong>Background: </strong>Fungal infections have become a public health problem owingdute to their progressive increase in recent decades and high morbidity rates. Fungal bone and joint infections result from direct inoculation, contiguous infection spread, or hematogenous seeding of organisms. Trichosporon spp. are yeast-like basidiomycetes, with Trichosporon asahii being the most common pathogenic species. This article describes a rare case of tenosynovitis caused by Trichosporon asahii in an immunocompetent patient. Treatment with voriconazole resulted in an excellent clinical response.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eRC1095"},"PeriodicalIF":1.1,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cross-sectional study on the expression of fibrinolytic system components and metalloproteinase-9 in women with early-stage and metastases breast cancer in Tucumán, Argentina.","authors":"Mariano Nicolás Áleman, María Constanza Luciardi, Rosa Silvina Guber, Analía Graciela Soria","doi":"10.31744/einstein_journal/2025AO1237","DOIUrl":"https://doi.org/10.31744/einstein_journal/2025AO1237","url":null,"abstract":"<p><strong>Background: </strong>In this study, standard coagulation, t-PA, PAI-1, DD, and MMP-9 tests were performed in a specific population of patient with early and metastatic breast cancer in Tucumán, Argentina. Only PAI-1 and MMP-9 levels increased in patients with early-stage breast cancer, suggesting that they may have evolved aggressively.</p><p><strong>Background: </strong>■ No clinically significant differences were observed in platelet counts or global coagulation test results.</p><p><strong>Background: </strong>■ t-PA values decreased in patients with metastases.</p><p><strong>Background: </strong>■ PAI-1, DD, and MMP-9 levels increased in patients with metastases.</p><p><strong>Background: </strong>■ High levels of PAI-1 and MMP-9 in the early stages could indicate an aggressive course in patients.</p><p><strong>Objective: </strong>The hemostatic and matrix metalloproteinase (MMP) systems are known to be altered in patients with breast cancer. This cross-sectional study aimed to explore the fibrinolysis components values and MMP-9 levels in a specific population of patients with early breast cancer and metastatic breast cancer in Tucumán, Argentina.</p><p><strong>Methods: </strong>This cross-sectional study included 63 patients without pathology or with benign breast pathology (GA Group), 48 patients with newly diagnosed primary breast cancer (GB Group), and 65 patients with metastatic breast cancer (GC Group). Levels of standard coagulation tests, tissue plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1), D-dimer (DD), and matrix metalloproteinases-9 (MMP-9) were measured in all groups.</p><p><strong>Results: </strong>PAI-1 and MMP-9 levels were higher in patient with early breast cancer than those with benign disease. However, the GC Group showed significantly higher PAI-1, DD, and MMP-9 levels than the GA Group. Furthermore, the t-PA concentrations in the GC Group were lower than those in the Control Group.</p><p><strong>Conclusion: </strong>Our findings suggest that higher levels of PAI-1 and MMP-9 in patients with early-stage breast cancer may be associated with a subgroup of patients with more aggressive disease progression. In addition, significant alterations in t-PA, PAI-1, DD, and MMP-9 concentrations were observed in advanced stages of the disease. However, basic laboratory tests, such as global coagulation tests, do not effectively differentiate stages in breast cancer. Therefore, further study is needed to explore these findings in greater detail.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eAO1237"},"PeriodicalIF":1.1,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of miRNA-mRNA interaction prediction tools based on experimental head and neck cancer data.","authors":"Bárbara Dos Santos Dias, Larissa Figueiredo Alves Diniz, Lucca D'Arco Corrêa, Rafael Pereira de Souza, Leticia Torres Ferreira, Denise da Cunha Pasqualin, Rafael de Cicco, Eloiza Helena Tajara da Silva, Patricia Severino","doi":"10.31744/einstein_journal/2025AO1372","DOIUrl":"https://doi.org/10.31744/einstein_journal/2025AO1372","url":null,"abstract":"<p><strong>Background: </strong>We evaluated the performance of TargetScan, miRDB, and miRWalk for predicting miRNA-mRNA interactions in HNSCC. Based on clinical tumor and cancer-free tissue data, miRWalk emerged as the most comprehensive tool. Validation using NanoString technology and MiRTarBase confirmed key predictions, highlighting the important roles of the PI3K-Akt and Wnt pathways. This study underscores the importance of integrating bioinformatics and experimental data to better understand HNSCC.</p><p><strong>Background: </strong>■ miRWalk had the highest predicted interactions and validated miRNA networks in HNSCC.</p><p><strong>Background: </strong>■ Around 3.3% of interactions overlapped across tools, emphasizing the need for multitool approaches.</p><p><strong>Background: </strong>■ Dysregulated genes and miRNAs were tied to cancerdriving PI3K-Akt and Wnt pathways.</p><p><strong>Background: </strong>■ The validated approach highlights the importance of integrating computational and molecular data.</p><p><strong>Objective: </strong>Head and neck squamous cell carcinoma (HNSCC) has a poor prognosis largely due to late diagnosis and a lack of reliable biomarkers. MicroRNAs (miRNAs), small non-coding RNAs that regulate gene expression, are promising biomarkers for HNSCC. This study evaluated miRNA-mRNA interactions in HNSCC using conventional computational tools and validated the results using molecular data.</p><p><strong>Methods: </strong>We compared three miRNA-mRNA interaction prediction tools, TargetScan, miRDB, and miRWalk, using differentially expressed miRNAs and mRNAs from HNSCC and cancer-free tissues. NanoString nCounter was used to measure miRNA and mRNA expression and the miRTarBase database was used to validate the predicted miRNA-mRNA interactions.</p><p><strong>Results: </strong>TargetScan and miRWalk provide a comprehensive overview of potential interactions, whereas miRDB provides functional insights. Our results identified 77 and 154 differentially expressed miRNAs and mRNAs in HNSCC, respectively. miRWalk predicted the highest number of miRNA-mRNA interactions, followed by miRDB and TargetScan. Only 3.3% of interactions were common among the tools. The MiRTarBase analysis confirmed a small subset of the predictions. Biological pathway analysis highlighted the dysregulation of PI3K-Akt and Wnt signaling; miRWalk was the best for elucidating how miRNAs modulate target mRNAs in these key pathways during HNSCC progression.</p><p><strong>Conclusion: </strong>miRWalk emerged as the most robust tool for predicting miRNA-mRNA interactions. Our findings highlight the importance of integrating bioinformatics predictions with experimental data to better understand the regulatory networks in HNSCC and identify potential biomarkers for diagnosis and therapy.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eAO1372"},"PeriodicalIF":1.1,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brazil's benign breast disease care profile and geospatial analysis.","authors":"Dayan Sansone, Daniela Farah, Afonso Celso Pinto Nazario, Marcelo Cunio Machado Fonseca","doi":"10.31744/einstein_journal/2025AO1132","DOIUrl":"10.31744/einstein_journal/2025AO1132","url":null,"abstract":"<p><strong>Background: </strong>We conducted a quantitative and geospatial analysis of coverage and displacement for the diagnosis and treatment of benign breast illnesses in Brazil's Unified Health System between 2008 and 2019. The results showed that treatment coverage and female displacement differed by region. The North and Midwest have different coverage and displacement rates compared with the other three major regions of the country. These findings demonstrate the importance of addressing gaps in healthcare service access, irrespective of their source, by enhancing the service capacity of existing institutions and ensuring that the healthcare system appropriately allocates resources.</p><p><strong>Objective: </strong>To quantitatively and geospatially analyze coverage and displacement for the diagnosis and treatment of benign breast diseases in the Brazilian Unified Health System between 2008 and 2019.</p><p><strong>Methods: </strong>Datasets from the Brazilian Ministry of Health were used to survey medical care for benign breast diseases in Brazil from 2008 to 2019. These data allowed for the determination of benign breast disease treatments, diagnoses, and patient displacement in each region of the country.</p><p><strong>Results: </strong>Most outpatient consultations were for diagnostic procedures. Approximately 4 million diagnostic procedures and 360,000 hospitalizations for treatment, of which 97% were surgeries, were conducted in this 12-year period. During this period, medical care for benign breast diseases cost more than USD 65 million. The treatment coverage and displacement rates of the female population differed by country region, with the North and Midwest showing patterns different from those of the other three major regions.</p><p><strong>Conclusion: </strong>Addressing disparities in healthcare service access, regardless of their source, by increasing the service capacity of existing facilities and ensuring correct resource allocation by the healthcare system is crucial.</p><p><strong>Background: </strong>■ Most outpatient consultations comprised diagnostic procedures.</p><p><strong>Background: </strong>■ In the past 12 years, medical care for benign breast diseases has cost >USD 65 million.</p><p><strong>Background: </strong>■ Women from North and Midwest Brazil had higher diagnosis and treatment displacement rates.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eAO1132"},"PeriodicalIF":1.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatorenal Syndrome: direct treatment costs and characteristics of patients admitted to intensive care.","authors":"Franciele Robes Hortelã, Rodrigo Sfredo Kruger, Valéria Filomena de Oliveira, Hipolito Carraro Junior, Dominique Araújo Muzzillo, Sérgio Candido Kowalski","doi":"10.31744/einstein_journal/2025GS0390","DOIUrl":"10.31744/einstein_journal/2025GS0390","url":null,"abstract":"<p><strong>Background: </strong>Hepatorenal Syndrome is a potentially reversible syndrome of endstage cirrhosis. It is a severe complication of cirrhosis that involves a high mortality rate and a significant economic impact on the healthcare system. This study shows the costs of the resources used for disease management and complications to be Int$14,189. Quantifying this figure contributes to an understanding of the economic impact of Hepatorenal Syndrome on patient survival.</p><p><strong>Objective: </strong>The purpose of this study was to describe the direct medical costs incurred in Brazil for the treatment of Hepatorenal Syndrome in intensive care and intermediate therapy care units, and to investigate the impact of this syndrome on patient survival.</p><p><strong>Methods: </strong>This longitudinal observational retrospective study included patients with Hepatorenal Syndrome admitted to the intensive and intermediate therapy care units of a public tertiary hospital. The cost generated by each patient was the sum of the direct costs and overheads.</p><p><strong>Results: </strong>Forty-four patients with 49 episodes of suspected Hepatorenal Syndrome were analyzed, 73% male, with a mean age of 55 years (SD= 11). Diagnosis was presumed in 21 episodes (43%), because not all of the Ascites International Club's criteria were met. Alcoholic cirrhosis was the main etiology (43%); 59% of the patients were Child-Pugh Class C at admission, with a mean (SD) model for end-stage liver disease score of 24.6 (8). Seventy-seven percent of the patients died, 32% from multiple organ failure, 29% of septic shock and 27% of hypovolemic shock. The median (IQR) of the total treatment cost for each patient was Int$14,819 (8,732-23,854). The median (IQR) length of intensive care unit stay in intensive care was 11 days (7-19). Patients with a presumed diagnosis did not have a higher hospitalization cost (p=0.249) than those with true Hepatorenal Syndrome.</p><p><strong>Conclusion: </strong>The treatment of Hepatorenal Syndrome represents a significant cost, and new resource allocation in strategic areas, such as the treatment and monitoring of patients with cirrhosis, is necessary to improve their outcomes.</p><p><strong>Background: </strong>■ The treatment of Hepatorenal Syndrome places a huge economic burden on healthcare systems.</p><p><strong>Background: </strong>■ Cost analysis studies of Hepatorenal Syndrome management can help to rationally allocate resources in healthcare.</p><p><strong>Background: </strong>■ Timely diagnosis and management of Hepatorenal Syndrome may reduce mortality, resource utilization and costs.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eGS0390"},"PeriodicalIF":1.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of liver transplantation on the quality of life of a cohort of high-risk recipients.","authors":"Heloisa Barboza Paglione, Daisa de Mesquita Escobosa, Beatriz Mesquita Pimenta, Bianca Della-Guardia, Amanda Pinter Carvalheiro da Silva Boteon, Yuri Longatto Boteon","doi":"10.31744/einstein_journal/2025AO0565","DOIUrl":"10.31744/einstein_journal/2025AO0565","url":null,"abstract":"<p><strong>Background: </strong>Liver transplantation significantly improves the health-related quality of life of patients with cirrhosis and high MELD scores. This study highlights rapid health-related quality of life gains after transplantation that were sustained during the one-year follow-up period, emphasizing the role of multidisciplinary care in achieving these outcomes.</p><p><strong>Objective: </strong>To assess the effects of liver transplantation on the health-related quality of life of patients with cirrhosis on the waiting list for transplantation.</p><p><strong>Methods: </strong>This retrospective study analyzed HRQOL using the EQ-5D questionnaire before (T0), and 3 (T3), 6 (T6), and 12 (T12) months after, transplantation. The questionnaire comprised five health status scores, which were also combined into a single utility score. Changes in each dimension and in the utility score were examined.</p><p><strong>Results: </strong>A total of 212 patients were included in the study, with a mean age of 54 (SD, 12) years, and a median Model for End-Stage Liver Disease score of 17 (Q1= 11; Q3= 24). The most frequent etiology was chronic alcoholism (26.9%). Improvements in EQ-5D utility scores were registered at all post-transplantation time points compared to the score at T0: an increase of 0.22 points (p<0.001) at T3, 0.27 (p<0.001) at T6, and 0.268 (p<0.001) at T12. Scores increased over time in all domains of the EQ-5D.</p><p><strong>Conclusion: </strong>In a large sample of high-risk transplant recipients, a significant improvement in HRQOL occurred three months after transplantation, and was sustained over the one-year follow-up period.</p><p><strong>Background: </strong>■ Liver transplantation improves health-related quality of life in patients with cirrhosis and high MELD scores.</p><p><strong>Background: </strong>■ Significant health-related quality of life improvements occur within three months of transplantation.</p><p><strong>Background: </strong>■ Multidisciplinary care programs enhance post-iver transplantation physical and mental recovery.</p><p><strong>Background: </strong>■ Sustained health-related quality of life gains highlight the long-term benefits of liver transplantation.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"23 ","pages":"eAO0565"},"PeriodicalIF":1.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}