Publications by authors named "Rafael Picon"

Article Synopsis
  • The CheckMate-743 trial showed that nivolumab plus ipilimumab improves overall survival in patients with unresectable pleural mesothelioma compared to chemotherapy, but lacked representation of Latin American patients.
  • A retrospective study evaluated this treatment's effectiveness and safety in 96 LATAM patients, focusing on their demographic and clinical characteristics, with a median follow-up of 24.1 months.
  • Results indicated median progression-free survival of 8 months and overall survival of 22 months, confirming treatment benefits similar to other findings, with manageable adverse events reported.
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Introduction: Ultra-processed food (UPF) intake has been associated with a higher risk of obesity, hypertension, type 2 diabetes, and cardiovascular diseases. The initial data on the relationship between UPF consumption and cancer risk were derived from retrospective observational studies with conflicting results. This systematic review and meta-analysis of prospective cohort studies aimed to investigate the association between UPF consumption and gastrointestinal cancer risk.

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Colorectal cancer (CRC) is the third most common and deadliest cancer globally. Regimens using 5-fluorouracil (5FU) and Oxaliplatin (OXA) are the first-line treatment for CRC, but tumor recurrence is frequent. It is plausible to hypothesize that differential cellular responses are triggered after treatments depending on the genetic background of CRC cells and that the rational modulation of cell tolerance mechanisms like autophagy may reduce the regrowth of CRC cells.

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Intestinal fungi play an important role in the health-disease process. We observed that in liver diseases, fungal infections lead to high mortality. In this review, we were able to gather and evaluate the available scientific evidence on intestinal mycobiota and liver diseases.

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Aim: To assess the impact of the different stages of acute kidney injury (AKI) on the prognosis of patients hospitalized with decompensated cirrhosis.

Methods: This was a prospective cohort study of consecutive patients admitted in two tertiary hospitals in southern Brazil. Participants were considered eligible if they were admitted for acute decompensation of cirrhosis.

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Objectives: To determine the prevalence of potential interactions in COVID19 patients receiving lopinavir/ritonavir (LPV/r). The secondary objective was to develop recommendations and identify the risk factors associated with presenting potential interactions with LPV/r.

Subjects And Methods: Cross-sectional and multicenter study with the participation of 2 hospitals.

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Objectives: To assess population-based prevalence, risk factors, hospitalization, and infection fatality rates (IFR) associated with COVID-19.

Methods: We conducted two household surveys among the non-institutionalized adult population from May 30 to June 17, 2020, in Lajeado, an 84,000-inhabitant industrial city in southern Brazil. Primary outcome was prevalence of SARS-CoV-2 infection.

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Objectives: To determine the prevalence of potential interactions in COVID-19 patients receiving lopinavir/ritonavir (LPV/r). The secondary objective was to develop recommendations and identify the risk factors associated with presenting potential interactions with LPV/r.

Subjects And Methods: Cross-sectional and multicenter study with the participation of 2 hospitals.

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Background: Novel drugs and combinations for immunosuppression (IS) after liver transplantation is one main reason for improved graft and patient survival seen in the last decades. The backbone of IS is still steroids and calcineurin inhibitors, although novel drugs are being introduced, such as the mammalian target of rapamycin inhibitors (mTOR inhibitor). The challenge today, along with increased patient survival, is the adverse effects of long-term use of immunosuppressive drugs, mainly nephrotoxicity and other serious adverse effects.

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Introduction And Aim: Different criteria are applied for the diagnosis of acute-on-chronic liver failure (ACLF). Our aim was to compare the performance of different ACLF diagnostic criteria for predicting mortality.

Materials And Methods: This was a prospective cohort study of adult cirrhotic patients admitted to a tertiary hospital for acute decompensation (AD) of cirrhosis.

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Cirrhosis has four different stages that encompass mild stable compensated cirrhosis, stable cirrhosis with prior decompensation, acutely decompensated cirrhosis and acute-on-chronic liver failure. A worse ALBI score has been associated to an increased mortality in a recent study involving patients with stable cirrhosis and prior decompensation.

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Background: Spontaneous bacterial peritonitis is a serious complication in cirrhotic patients, and changes in the microbiological characteristics reported in the last years are impacting the choice of antibiotic used for treatment.

Objective: The aim of the present study is to evaluate the changes in the epidemiology and bacterial resistance of the germs causing spontaneous bacterial peritonitis over three different periods over 17 years.

Methods: All cirrhotic patients with spontaneous bacterial peritonitis and positive culture of ascites fluid were retrospectively studied in a reference Hospital in Southern Brazil.

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Article Synopsis
  • The study aimed to validate the effectiveness of certain prognostic scores for predicting mortality in Brazilian patients with acute decompensation of cirrhosis and acute-on-chronic liver failure.
  • It utilized a prospective cohort design to compare the chronic liver failure-consortium scores (CLIF-C AD and CLIF-C ACLF) against other models, including MELD and Child-Pugh, focusing on 28-day and 90-day mortality rates.
  • Results indicated that the CLIF-C ACLF score was notably effective in predicting mortality in ACLF patients, while both CLIF-C AD and other scores showed similar predictive capabilities for patients with acute decompensation.
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Knowing the usual clinical practice is relevant for evaluations in health care and economic policies of management of hypertension. This study aimed to describe the usual management of hypertension in the Brazilian primary healthcare system through a systematic review and meta-analysis. The search of population-based studies conducted in Brazil was undertaken using PubMed, EMBASE, and Brazilian databases.

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Background: The prevalence of hypertension among elderly persons has been assessed in several circumscribed studies scattered across Brazil, and no representative data about this exist for the whole country. In this meta-analysis with a systematic review of the literature, we provide a summary estimate of hypertension among elderly persons in Brazil and present the trend in prevalence of the condition from 1980 to 2010.

Methods: Population-based prevalence studies carried out between 1980 and 2010 were identified by two independent reviewers, without language restrictions, in electronic databases.

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Background: The prevalence of hypertension in emerging nations was scarcely described to date. In Brazil, many population-based surveys evaluated the prevalence in cities throughout the country. However, there is no population-based nationwide study of prevalence of hypertension.

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Background: A phytotherapic compound containing Pimpinella anisum L., Foeniculum vulgare Miller, Sambucus nigra L., and Cassia augustifolia is largely used in Brazil for the treatment of constipation.

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Objectives: Since 2002, the treatment with cholinesterase inhibitors (CHEIs) for Alzheimer's disease (AD) has been paid for by the public health system of the Brazilian Ministry of Health for any patient that fulfills clinical criteria established by an evidence-based guideline developed and published by the Ministry. The aim of this study was to evaluate compliance of prescription patterns to the national guideline for use of CHEIs' in the southern Brazilian state of Rio Grande do Sul.

Methods: We created a regional expert-committee reference center to review all prescriptions of CHEIs and to send feedback to physicians whenever prescriptions without compliance to the guideline were noted.

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Background: The epidemiology of asthma has been investigated with questionnaires, such as the International Study of Asthma and Allergies in Childhood protocol.

Aim: To investigate the performance of the questions of the International Study of Asthma and Allergies in Childhood questionnaire to diagnose asthma in adolescents.

Methods: This is a population-based cross-sectional study of adolescents in the Syndrome of Obesity and Risk Factors for Cardiovascular Disease study.

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Objective: To analyze the effect of diabetes on general and cardiovascular disease (CVD) mortality and morbidity in southern Brazil.

Research Design And Methods: A population-based cohort study of 1,091 individuals was conducted. Diabetes was ascertained by medical history.

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