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| 1 | Crohn's disease environmental factors in the developing world: A case-control study in a statewide catchment area in Brazil显示文摘AIM To identify environmental risk factors associated with the development of Crohn's disease(CD) in order to reassess the hygiene hypothesis.METHODS A hospital-based, case-control study was carried out with CD patients(n = 145) and controls(n = 163)representing a socioeconomically diverse statewide catchment area in Brazil. Controls were recruited from caregivers of patients seen in different outpatient clinics at the same hospital. A multi-item survey with 94 questions regarding family history of CD, perinatal and childhood circumstances, living conditions, tobacco use and familial socioeconomic status was carried out by interviewers. RESULTS On the univariate analysis, predictive variables for CD included being male, under age of 40, a high education level, urban dweller, smaller family size, exposure to enteric pathogens and user of treated water(P < 0.005). On the multivariate analysis, variables significantly associated with CD were male gender(OR = 2.09), under age 40(OR = 3.10), white(OR = 2.32), from a small family in childhood(OR = 2.34) and adulthood(OR = 3.02), absence of viral infections in childhood(OR = 2.23), exposure to enteric pathogens(OR = 2.41), having had an appendectomy(OR = 2.47) and prior or current smoker(OR = 2.83/1.12). CONCLUSION Most variables supporting the 'hygiene hypothesis' are associated with the development of CD but are not independent predictors of the diagnosis. | Valéria Cristina Loureiro Salgado Ronir Raggio Luiz Neio Boechat Bianca C Schorr Isabella S Leao Tiago Nunes Cyrla Zaltman | 2017 | World Journal of Gastroenterology2017，23，30： | 2 |
| 2 | Overweight is associat- ed with low hemoglobin levels in adolescent girls 显示文摘 | URSULA V B RONIR R L GLORIA V D V | 2013 | Obes Res2013，7，3： | 1 |
| 3 | Fibrosis assessment using Fibro Meter combined to first generation tests in hepatitis C显示文摘AIM To evaluate the performance of FibroMeter^(Virus3G) combined to the first generation tests aspartate aminotransferase-to-platelet ratio index(APRI) or Forns index to assess significant fibrosis in chronic hepatitis C(CHC).METHODS First generation tests APRI or Forns were initially applied in a derivation population from Rio de Janeiro in Brazil considering cut-offs previously reported in the literature to evaluate significant fibrosis.FibroMeter^(Virus3G) was sequentially applied to unclassified cases from APRI or Forns.Accuracy of non-invasive combination of tests,APRI plus FibroMeter^(Virus3G) and Forns plus FibroMeter^(Virus3G) was evaluated in the Brazilian derivation population.APRI plus FibroMeter^(Virus3G) combination was validated in a population of CHC patients from Angers in France.All patients were submitted to liver biopsy staged according to METAVIR score by experienced hepatopathologists.Significant fibrosis was considered as METAVIR F≥2.The fibrosis stage classification was used as the reference for accuracy evaluation of non-invasive combination of tests.Blood samples for the calculation of serum tests were collected on the same day of biopsy procedure or within a maximum 3 mo interval and stored at-70 ℃.RESULTS Seven hundred and sixty CHC patients were included(222 in the derivation population and 538 in the validation group).In the derivation population,the FibroMeter^(Virus3G) AUROC was similar to APRI AUROC(0.855 vs 0.815,P=0.06) but higher than Forns AUROC(0.769,P<0.001).The best FibroMeter^(Virus3G) cut-off to discriminate significant fibrosis was 0.61(80% diagnostic accuracy;75% in the validation population,P=0.134).The sequential combination of APRI or Forns with FibroMeter^(Virus3G) in derivation population presented similar performance compared to FibroMeter^(Virus3G) used alone(79% vs 78% vs 80%,respectively,P=0.791).Unclassified cases of significant fibrosis after applying APRI and Forns corresponded to 49% and 54%,respectively,of the total sample.However,the combination of APRI or Forns with FibroMeter^(Virus3G) allowed 73% and 77%,respectively,of these unclassified cases to be correctly evaluated.Moreover,this combination resulted in a reduction of FibroMeter^(Virus3G) requirement in approximately 50% of the entire sample.The stepwise combination of APRI and FibroMeter^(Virus3G) applied to the validation population correctly identified 74% of patients with severe fibrosis(F≥3).CONCLUSION The stepwise combination of APRI or Forns with FibroMeter^(Virus3G) may represent an accurate lower cost alternative when evaluating significant fibrosis,with no need for liver biopsy. | Maria Chiara Chindamo Jerome Boursier Ronir Raggio Luiz Isabelle Fouchard-Hubert Vera Lúcia Nunes Pannain Joao Marcello de Araújo Neto Henrique Sérgio Moraes Coelho Renata de Mello Perez Paul Calès Cristiane Alves Villela-Nogueira | 2017 | World Journal of Hepatology2017，9，6： | 1 |
| 4 | Risk factors associated with inflammatory bowel disease: A multicenter case-control study in Brazil显示文摘BACKGROUND The etiology of inflammatory bowel disease(IBD)is unknown,but it is believed to be multifactorial.The hygiene hypothesis proposes that better hygiene conditions would lead to less infectious disease during childhood and favor the development of immune-mediated diseases.AIM To test the hygiene hypothesis in IBD by assessing the environmental risk factors associated with IBD development in different regions of Brazil with diverse socioeconomic development indices.METHODS A multicenter case-control study was carried out with 548 Crohn’s disease(CD)and 492 ulcerative colitis(UC)outpatients and 416 healthy controls,from six IBD centers within different Brazilian states at diverse socioeconomic development stages.A semi-structured questionnaire with 87 socioeconomic and environmental questions was applied.Logistic regression model was created to assess the odds ratio(OR)with P value and 95%confidence intervals(CI).RESULTS Predictive variables for both diseases(CD and UC)were women[odd ratios(OR)=1.31;OR=1.69],low monthly family income(OR=1.78;OR=1.57),lower number of cohabitants(OR=1.70;OR=1.60),absence of vaccination(OR=3.11;OR=2.51),previous history of bowel infections(OR=1.78;OR=1.49),and family history of IBD(OR=5.26;OR=3.33).Associated risk factors for CD were age(18-39 years)(OR=1.73),higher educational level(OR=2.22),absence of infectious childhood diseases(OR=1.99).The UC predictive variables were living in an urban area(OR=1.62),inadequate living conditions(OR=1.48)and former smokers(OR=3.36).Appendectomy was a risk factor for CD(OR=1.58)with inverse association with UC(OR=4.79).Consumption of treated and untreated water was associated with risk of CD(OR=1.38)and UC(OR=1.53),respectively.CONCLUSION This is the first examining environmental exposures as risk factors for inflammatory bowel disease in Brazil.Most of the variables associated with disease risk support the role of the hygiene hypothesis in IBD development. | Valéria Cristina Loureiro Salgado Ronir Raggio Luiz Neio Lucio Fernandes Boéchat Isabella Sued Leao Bianca do Carmo Schorr JoséMiguel Luz Parente Daniela Calado Lima Eduardo Santos Silveira Júnior Genoile Oliveira Santana Silva Neogélia Pereira Almeida Andrea Vieira Maria Luiza Queiroz de Bueno Júlio Maria Chebli érika Ruback Bertges Luísa Martins da Costa Brugnara Columbano Junqueira Neto Stefania Burjack Gabriel Campbell Luana Letiza Discacciati Joao Paulo Silva Cézar Tiago Nunes Gilaad G Kaplan Cyrla Zaltman | 2020 | World Journal of Gastroenterology2020，26，25： | 1 |
| 5 | Levels of salivary IgA antibodies to Candida spp. in HIV-infected adult patients: A systematic review显示文摘 | Luciana Pomarico Ivete Pomarico Ribeiro de Souza Glória Fernanda Barbosa de Araújo Castro Ricardo Palmier Teles Ronir Raggio Luiz Lucianne Cople Maia | 2009 | Journal of Dentistry2009，，1： | 1 |
| 6 | Acute Kidney Injury Network Criteria as a Predictor of Hospital Mortality in Cirrhotic Patients With Ascites显示文摘 | Juliana Ribeiro de Carvalho Cristiane Alves Villela-Nogueira Ronir Raggio Luiz Paula Lustosa Guzzo Juliana Maria da Silva Rosa Eduardo Rocha Henrique Sérgio Moraes Coelho Renata de Mello Perez | 2012 | Journal of Clinical Gastroenterology2012，，3： | 1 |
| 7 | Ecological study of gastric cancer in Brazil:Geographic and time trend analysis显示文摘AIM:To investigate the geographic distributions and time trends of gastric cancer(GC)incidence and mortality in Brazil.METHODS:An ecological study of the DATASUS registry was conducted by identifying hospitalizations for GC between January 2005 and December 2010.The data included information on the gender,age,and town of residence at the time of hospital admission and death.RESULTS:The GC rates,adjusted according to available hospital beds,decreased from 13.8 per 100000in 2005 to 12.7 per 100000 in 2010.The GC rates decreased more among the younger age groups,in which the male-to-female difference also decreased in comparison to the older age groups.Although the lethality rates tended to increase with age,young patients were proportionally more affected.The spatial GC distribution showed that the rates were higher in the south and southeast.However,while the rates decreased in the central-west and south,they increased in the northern regions.A geographic analysis showed higher rates of GC in more urbanized areas,with a coast-toinland gradient.Geographically,GC lethality overlapped greatly with the hospital admission rates.CONCLUSION:The results of this study support the hypothesis of a critical role for environmental factors in GC pathogenesis.The declining rates in young patients,particularly males,suggest a relatively recent decrease in the exposure to risk factors associated with GC.The spatial distribution of GC indicates an ongoing dynamic change within the Brazilian environment. | César Augusto Amorim Jéssica Pronestino Moreira Luisa Rial Antonio José Carneiro Homero Soares Foga?a Celeste Elia Ronir Raggio Luiz Heitor Siffert Pereira de Souza | 2014 | World Journal of Gastroenterology2014，20，17： | 0 |
| 8 | Increasing pancreatic cancer is not paralleled by pancreaticoduodenectomy volumes in Brazil:A time trend analysis显示文摘Background: Currently, surgical resection represents the only curative treatment for pancreatic cancer(PC), however, the majority of tumors are no longer resectable by the time of diagnosis. The aim of this study was to describe time trends and distribution of pancreaticoduodenectomies(PDs) performed for treating PC in Brazil in recent years. Methods: Data were retrospectively obtained from Brazilian Health Public System(namely DATASUS) regarding hospitalizations for PC and PD in Brazil from January 2008 to December 2015. PC and PD rates and their mortalities were estimated from DATASUS hospitalizations and analyzed for age, gender and demographic characteristics. Results: A total of 2364 PDs were retrieved. Albeit PC incidence more than doubled, the number of PDs increased only 37%. Most PDs were performed in men(52.2%) and patients between 50 and 69 years old(59.5%). Patients not surgically treated and those 70 years or older had the highest in-hospital mortality rates. The most developed regions(Southeast and South) as well as large metropolitan integrated municipalities registered 76.2% and 54.8% of the procedures, respectively. LMIM PD mortality fluctuated, ranging from 13.6% in 2008 to 11.8% in 2015. Conclusions: This study suggests a trend towards regionalization and volume-outcome relationships for PD due to PC, as large metropolitan integrated municipalities registered most of the PDs and more stable mortality rates. The substantial differences between PD and PC increasing rates reveals a limiting step on the health system resoluteness. Reduction in the number of hospital beds and late access to hospitalization, despite improvement in diagnostic methods, could at least in part explain these findings. | Lucila M Perrotta de Souza Jessica PL Moreira Homero S Fogaca José Marcus Raso Eulálio Ronir R Luiz Heitor SP de Souza | 2019 | Hepatobiliary & Pancreatic Diseases International2019，18，1： | 0 |
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