| 1 | Direct-acting antivirals for chronic hepatitis C treatment: The experience of two tertiary university centers in Brazil显示文摘BACKGROUND Hepatitis C virus(HCV)treatment has undergone major changes in recent years.Previous interferon-based therapies have been replaced by oral direct-acting antivirals(DAA)regimens,with high sustained virologic response(SVR)rates,and a lower incidence of adverse events(AEs).AIM To evaluate the efficacy and safety of DAAs for HCV treatment in subjects from two tertiary university centers in Brazil.METHODS This is a multicenter retrospective cohort study of 532 patients with chronic hepatitis C(CHC),undergoing treatment with interferon-free regimens from November 2015 to November 2019.The therapeutic regimen was defined by the current Brazilian guidelines for HCV management at the time of treatment.Demographic,anthropometric,clinical,and laboratory variables were evaluated.SVRs were assessed at 12 to 24 wk after therapy by intention-to-treat(ITT),and modified ITT(m-ITT)analysis.AEs and serious adverse events(SAEs)were registered.In the statistical analysis,a P value of<0.05 was considered significant.RESULTS The mean age was 56.88 years,with 415(78.5%)being HCV genotype 1,followed by genotype 3(20.1%).Moreover,306(57.5%)subjects had cirrhosis,and a third of them had decompensated cirrhosis.Sofosbuvir(SOF)plus daclatasvir±ribavirin was the most frequently used treatment(66.9%),followed by SOF plus simeprevir(21.2%).The overall ITT SVR was 92.6%(493/532),while the m-ITT SVR was 96.8%(493/509).Variables associated with treatment failure via ITT evaluation were hepatic encephalopathy(OR:4.320;95%CI:1.920-9.721,P=0.0004),presence of esophageal varices(OR:2.381;95%CI:1.137-4.988,P=0.0215),previous portal hypertensive bleeding(OR:2.756;95%CI:1.173-6.471,P=0.02),higher model for end-stage liver disease scores(OR:1.143,95%CI:1.060–1.233,P=0.0005),lower serum albumin levels(OR:0.528,95%CI:0.322-0.867,P=0.0115),higher serum creatinine(OR:1.117,95%CI:1.056-1.312,P=0.0033),and international normalized ratio(INR)levels(OR:5.542,95%CI:2.023-15.182,P=0.0009).AEs were reported in 41.1%(211/514)of patients,and SAEs in 3.7%.The female gender,higher body mass index,esophageal varices,higher INR values,and longer treatment duration were independently associated with AE occurrence.CONCLUSION Treatment with oral DAAs attains a high SVR rate,with fewer SAEs in a real-life cohort of subjects with CHC,from two tertiary university centers in Brazil. | Mariana Sandoval Lourenço Patricia Momoyo Y Zitelli Marlone Cunha-Silva Arthur Ivan N Oliveira Cláudia P Oliveira Tiago Sevá-Pereira Flair JoséCarrilho Mario G Pessoa Daniel F Mazo | 2022 | World Journal of Hepatology2022，14，1： | 1 |
| 3 | Femtosecond nonlinear losses in multimode optical fibers显示文摘Multimode optical fibers are attracting a growing interest for their capability to transport high-power laser beams,coupled with novel nonlinear optics-based applications.However,optical fiber breakdown occurs when beam intensities exceed a certain critical value.Optical breakdown associated with irreversible modifications of the refractive index,triggered by multiphoton absorption,has been largely exploited for fiber material microstructuration.Here we show that,for light beam intensities slightly below the breakdown threshold,nonlinear absorption strongly affects the dynamics of a propagating beam as well.We experimentally analyze this subthreshold regime and highlight the key role played by spatial self-imaging in graded-index fibers for enhancing nonlinear optical losses.We characterize the nonlinear power transmission properties of multimode fibers for femtosecond pulses propagating in the near-infrared spectral range.We show that an effective N-photon absorption analytical model is able to describe the experimental data well. | MARIO FERRARO FABIO MANGINI MARIO ZITELLI ALESSANDRO TONELLO ANTONIO DE LUCA VINCENT COUDERC STEFAN WABNITZ | 2021 | Photonics Research2021，9，12： | 0 |
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