Pedro Gaburri
Universidade Federal de Juiz de Fora, Clínica Médica, Faculty Member
The authors present their experience with the follow-up of 60 cases of Crohn's disease, from 1970 until 1998, in the city of Juiz de Fora, Minas Gerais state, a county of the Southeast region of Brazil, and analyse the epidemiology of... more
The authors present their experience with the follow-up of 60 cases of Crohn's disease, from 1970 until 1998, in the city of Juiz de Fora, Minas Gerais state, a county of the Southeast region of Brazil, and analyse the epidemiology of disease to improve the understanding of its behaviour in the country. The incidence rates increased greatly in the last 28 years. In the group studied 53.3% were men, 90% white, 71.7% non-smokers, 93.3% non-alcoholics, and all, but two, lived in urban area; 58.3% had their symptoms started at the age between 11 and 30 years and 30% were in the second decade of life. Relatives with Crohn's disease were seen in 6.7%, and the most common symptoms observed at the beginning of disease were: abdominal pain (78.3%), diarrhea (68.3%), weight loss (26.7%) and small bowel obstruction or localized peritonitis (15%). The ileum was involved in 90% and five cases (8.3%) with lesions restricted to the colon were observed. Two patients died because they were non-responders despite any therapy schedule and had sepsis after surgery. The effect of several substances used in the treatment is described, being prednisone the most effective in controlling the active disease. Other drugs as aminosalicilates, metronidazol and immunomodulators are also considered to avoid the side-effects of long-term use of steroides. Comments are made about the clinical evolution, surgeries and response to many treatments adopted. The authors conclude that Crohn's disease is increasing its incidence rate in Brazil and probably in South America formerly considered as a region of low frequency.
Research Interests:
Research Interests:
Base de dados : LILACS. Pesquisa : 124592 [Identificador único]. Referências encontradas : 1 [refinar]. Mostrando: 1 .. 1 no formato [Detalhado]. página 1 de 1, 1 / 1, LILACS, seleciona. para imprimir. Fotocópia. experimental, Documentos... more
Base de dados : LILACS. Pesquisa : 124592 [Identificador único]. Referências encontradas : 1 [refinar]. Mostrando: 1 .. 1 no formato [Detalhado]. página 1 de 1, 1 / 1, LILACS, seleciona. para imprimir. Fotocópia. experimental, Documentos relacionados. Id: 124592. ...
Research Interests:
Research Interests:
Research Interests:
Acute pancreatitis is one of the complications associated with severe primary and secondary hypertriglyceridemia. The frequency of hypertriglyceridemia in patients with pancreatitis ranges from 4 to 53%. The elevation in serum... more
Acute pancreatitis is one of the complications associated with severe primary and secondary hypertriglyceridemia. The frequency of hypertriglyceridemia in patients with pancreatitis ranges from 4 to 53%. The elevation in serum triglycerides probably induces the release of free fatty acids, responsible for the pancreatic damage. During a three year study, nine patients with acute pancreatitis due to hypertriglyceridemia were followed up at the University Hospital of Federal University and at the "Hospital Monte Sinai" (Juiz de Fora, MG, Brazil). Suggestive clinical manifestations, especially superior abdominal pain, nausea, vomiting and ileus, were found in all the patients; however, only three showed elevated serum amylase levels. All had triglyceride levels above 1000 mg/dl (11.3 mmol/L). The evolution after clinical treatment was good in eight patients (two needed parenteral nutrition). The only death observed was due to shock and acute respiratory distress, refractory to clinical management. The maintenance treatment aimed at withdrawing the predisposing conditions and reduction of the triglyceride levels prevented recurrence of acute pancreatitis episodes during the 23 months of follow-up.
Research Interests:
Research Interests:
Research Interests:
SUMMARY AIM: To compare the level of physical activity (PA), exercise capacity, and body composition before and after infliximab-induced clinical remission in patients with Crohn's disease (CD). METHODS: This prospective longitudinal... more
SUMMARY AIM: To compare the level of physical activity (PA), exercise capacity, and body composition before and after infliximab-induced clinical remission in patients with Crohn's disease (CD). METHODS: This prospective longitudinal study evaluated 44 adult outpatients with active CD before infliximab administration and 24 weeks after infliximab therapy. The patients were evaluated for PA in daily life, exercise capacity, muscle strength, and body composition. RESULTS: 38 (86.4%) patients achieved infliximab-induced remission at 24 weeks and presented an increment in the number of steps taken of 1092 (7440±2980 vs. 6348±3177, respectively; p=0.006). The inactive time was reduced when compared to the baseline value (454.2±106.3 vs. 427.9±97.8, respectively; p=0.033). There was no difference in the distance walked before and after infliximab therapy, while there was an increase in the fat mass index in responders to infliximab compared to the baseline (19.1±7.6 vs. 14.9±5.8; p=0....
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Abstract TO THE EDITOR: Worldwide, gallstones and alcohol abuse are the most common causes of acute pancreatitis (AP). However, 1030|[percnt]| of patients have been considered to have idiopathic acute pancreatitis (IAP)(1, 2).
Research Interests:
Research Interests:
A substantial number of patients with... more
A substantial number of patients with Crohn's disease (CD) become dependent on steroids after induction therapy. Treatment with azathioprine (AZA) may be beneficial in such patients. The present open-label study evaluated the long-term safety and efficacy of AZA in steroid-dependent CD patients. Adult patients with steroid-dependent CD were enrolled for AZA therapy over a 7-year period. The average dose of AZA was 2.0-3.0 mg/kg per day, adjusted according to clinical response and occurrence of adverse effects. Steroid therapy was tapered off according to a predefined schedule. Long-term outcome and adverse reactions were evaluated. Sixty-nine patients were prospectively included. Steroid-free remission was achieved in 68-81% of patients, partial response in 14.5-27.3% and failure to respond to AZA in 4-15.9% over the initial 48 months. However, the rate of wean from steroid therapy decreased to 53-60% while the rate of failure increased from 6.7% to 17.6% after this period. A breakthrough of symptoms during continuous AZA therapy was common, particularly after 48 months on AZA. The mean leukocyte count at the end of 12 months of therapy was significantly lower in patients who achieved complete response on AZA than in the non-responders (5197 +/- 1250 cells/mm(3) vs 8340 +/- 1310 cells/mm(3), respectively; P < 0.01). Azathioprine was relatively well-tolerated and the incidence of serious adverse effects was small. Azathioprine was relatively safe and moderately effective for long-term maintenance of steroid-free clinical remission in corticosteroid-dependent CD patients. Patients were more successfully weaned from prednisone treatment, and clinical remission was more often maintained during the first 48 months of AZA therapy. A significant decrease in the white blood cell count at the end of 12 months on AZA was the single factor associated with weaning from steroid dependence.
Research Interests:
... Flávio Meirelles de; Paulo, Gustavo Andrade de; Pace, Fábio Heleno Lima; Alves, Rodrigo Andrade; Froede, Edilson Cavalcante; Meirelles ... um período de três anos, nove pacientes com pancreatite aguda por hipertrigliceridemia foram... more
... Flávio Meirelles de; Paulo, Gustavo Andrade de; Pace, Fábio Heleno Lima; Alves, Rodrigo Andrade; Froede, Edilson Cavalcante; Meirelles ... um período de três anos, nove pacientes com pancreatite aguda por hipertrigliceridemia foram admitidos no Hospital Universitário da ...
Research Interests:
Research Interests:
Background: The relationship of small intestinal bacterial overgrowth (SIBO) with systemic and intestinal inflammation in patients with Crohn's disease (CD) is uncertain. We aimed to determine the prevalence of and predictors of SIBO... more
Background: The relationship of small intestinal bacterial overgrowth (SIBO) with systemic and intestinal inflammation in patients with Crohn's disease (CD) is uncertain. We aimed to determine the prevalence of and predictors of SIBO and to explore the potential relationship between SIBO and intestinal and/or systemic inflammation in adult CD outpatients. Methods: In this cross-sectional study, between June 2013 and January 2015, 92 CD patients (34 males, 58 females, mean age 39.7 ± 12.5 yr) and 97 controls (40 men, 57 women; mean age 37.6 ± 14.2 yr) with non-chronic gastrointestinal complaints were assessed for presence of SIBO using the H2/CH4 glucose breath test (GBT). Multivariate logistic regression was performed to investigate the potential association between SIBO and demographic, disease-related data, systemic markers of inflammation (C-reactive protein and erythrocyte sedimentation rate), and biomarker of intestinal inflammation (fecal calprotectin concentration [FCC])....
Research Interests:
Research Interests:
Research Interests:
The prospective assessment of Clostridium difficile infection (CDI) impact in inflammatory bowel disease (IBD) flare in outpatient setting has been poorly investigated. We aimed to evaluate the prevalence and the associated factors with... more
The prospective assessment of Clostridium difficile infection (CDI) impact in inflammatory bowel disease (IBD) flare in outpatient setting has been poorly investigated. We aimed to evaluate the prevalence and the associated factors with CDI in IBD outpatients presenting colitis flares as well as the outcomes following treatment. In this prospective cohort study, conducted from October, 2014, to July, 2016, 120 IBD patients (55% presenting colitis flare) and 40 non-IBD controls were assessed for CDI. Multivariate regression analysis was performed to identify predictors of CDI. Outcome analysis was estimated for recurrent CDI, hospitalization, colectomy, and CDI-associated mortality. The number of patients with CDI was significantly higher in IBD patients experiencing flares than in both inactive IBD and non-IBD groups (28.8 vs. 5.6 vs. 0%, respectively; p = 0.001). Females (OR = 1.39, 95% CI, 1.13-17.18), younger age (OR = 0.77, 95% CI, 0.65-0.92), steroid treatment (OR = 7.42, 95% C...
Research Interests:
Summary Introduction: Protein-energy malnutrition in Crohn's disease (CD) has been reported in 20 to 92% of patients, and is associated with increased morbidity and mortality and higher costs for the health system. Anti-TNF drugs are... more
Summary Introduction: Protein-energy malnutrition in Crohn's disease (CD) has been reported in 20 to 92% of patients, and is associated with increased morbidity and mortality and higher costs for the health system. Anti-TNF drugs are a landmark in the clinical management, promoting prolonged remission in patients with CD. It is believed that the remission of this disease leads to nutritional recovery. The effect of biological therapy on body composition and nutritional status is unclear. Method: Prospective study of body assessment by bioelectrical impedance method in patients with moderate to severe CD undergoing treatment with infliximab. The main outcome was the body composition before and after 6 months of anti-TNF therapy. Results: There was a predominance of females (52%) with a mean age of 42±12 years. Most patients were eutrophic at baseline and remained so. There was an increase in all parameters of body composition after anti-TNF treatment: BMI (22.9±3.2 versus 25±3.8;...
We studied the prevalence and predictors of small-intestinal bacterial overgrowth (SIBO) in Crohn's disease (CD) outpatients and the relationship between SIBO and intestinal and/or systemic inflammation. The relationship of SIBO with... more
We studied the prevalence and predictors of small-intestinal bacterial overgrowth (SIBO) in Crohn's disease (CD) outpatients and the relationship between SIBO and intestinal and/or systemic inflammation. The relationship of SIBO with systemic and intestinal inflammation in CD patients is unclear. In this cross-sectional study, conducted between June, 2013 and January, 2015, 92 CD patients and 97 controls with nonchronic gastrointestinal complaints were assessed for the presence of SIBO using the H2/CH4 glucose breath test. Multivariate logistic regression was performed to investigate the potential association between SIBO and demographic, disease-related data, systemic markers of inflammation (C-reactive protein, and erythrocyte sedimentation rate), and biomarker of intestinal inflammation [fecal calprotectin concentration (FCC)]. The SIBO rate was significantly higher in CD patients than in controls (32.6% vs. 12.4%, respectively, P=0.0008). Patients with and without SIBO were ...
Research Interests:
To the Editor: The benign intracranial hyperten-sion (BIH), or pseudotumor cerebri, is a rare clinical condition with unknown eti-ology, described as the increase of intra-cranial pressure with a normal composi-tion of cerebrospinal fluid... more
To the Editor: The benign intracranial hyperten-sion (BIH), or pseudotumor cerebri, is a rare clinical condition with unknown eti-ology, described as the increase of intra-cranial pressure with a normal composi-tion of cerebrospinal fluid (CSF) in the absence of a space ...
Research Interests:
Base de dados : LILACS. Pesquisa : 108211 [Identificador único]. Referências encontradas : 1 [refinar]. Mostrando: 1 .. 1 no formato [Detalhado]. página 1 de 1, 1 / 1, LILACS, seleciona. para imprimir. Fotocópia. experimental, Documentos... more
Base de dados : LILACS. Pesquisa : 108211 [Identificador único]. Referências encontradas : 1 [refinar]. Mostrando: 1 .. 1 no formato [Detalhado]. página 1 de 1, 1 / 1, LILACS, seleciona. para imprimir. Fotocópia. experimental, Documentos relacionados. Id: 108211. ...
Research Interests:
... Autor: Gaburri, Pedro Duarte; Castro, Lincoln Eduardo Vieira Vilela de; Ferreira, José Olindo Duarte; Lopes, Marcelo Henrique Marques; Ribeiro, Alessandra Maria Barreto; Alves, Rodrigo Andrade; Froede, Edilson Cavalcante; Oliveira,... more
... Autor: Gaburri, Pedro Duarte; Castro, Lincoln Eduardo Vieira Vilela de; Ferreira, José Olindo Duarte; Lopes, Marcelo Henrique Marques; Ribeiro, Alessandra Maria Barreto; Alves, Rodrigo Andrade; Froede, Edilson Cavalcante; Oliveira, Karla Silva de; Gaburri, Ana Karla ...
Research Interests:
Base de dados : LILACS. Pesquisa : 247716 [Identificador único]. Referências encontradas : 1 [refinar]. Mostrando: 1 .. 1 no formato [Detalhado]. página 1 de 1, 1 / 1, LILACS, seleciona. para imprimir. Fotocópia. Souza, Aécio Flávio... more
Base de dados : LILACS. Pesquisa : 247716 [Identificador único]. Referências encontradas : 1 [refinar]. Mostrando: 1 .. 1 no formato [Detalhado]. página 1 de 1, 1 / 1, LILACS, seleciona. para imprimir. Fotocópia. Souza, Aécio Flávio Meirelles de. ...
Research Interests: Treatment Outcome, Adolescent, Física, Inflammatory Bowel Disease, Prospective studies, and 15 moreHumans, Ulcerative colitis, Female, Male, Young Adult, Follow-up studies, Clinical Sciences, Middle Aged, Adult, Time Factors, Azathioprine, Inflammatory Bowel Diseases, Cohort Studies, Immunosuppressive Agents, and Adrenal cortex hormones
Research Interests:
Background: Studies assessing the efficacy of azathioprine (AZA) in steroid-dependent ulcerative colitis (UC) are scarce. The aim of this study was to assess the long-term efficacy and safety of AZA in patients with steroid-dependent UC,... more
Background: Studies assessing the efficacy of azathioprine (AZA) in steroid-dependent ulcerative colitis (UC) are scarce. The aim of this study was to assess the long-term efficacy and safety of AZA in patients with steroid-dependent UC, as well as factors associated with sustained response. Material/methods: In this prospective observational study 46 adult subjects with steroid-dependent UC were included for AZA therapy during a 12-month period. AZA dosage was adjusted according to clinical response and occurrence of adverse events. Steroid therapy was tapered according to protocol. The primary endpoint was the rate of steroid-free remission to AZA at the end of 12 months. Secondary endpoints included clinical relapse, cumulative steroid dose and safety of treatment. Results: On an intention-to-treat basis, the proportion of patients remaining in steroid-free remission at the end of 12 months was 0.54. The median time until complete steroid withdrawal was 5 months. A significant decrease in the relapse rate and in requirement for steroids were observed during 12 months on AZA compared with the prior year (P=0.000). Demographic, dose of AZA, steroid use, and disease-related data did not correlate with remission. Only disease duration <24 months was associated to steroid-free remission (P=0.03, OR 3.60 95% CI 1.95-9.74). Serious adverse events related to AZA were uncommon. Conclusions: AZA demonstrated sustained efficacy for maintenance of clinical remission without steroids and steroid sparing through 12 months of therapy in steroid-dependent UC. Patients with early onset UC are those who most probably will achieve sustained steroid-free remission while on AZA.
Research Interests:
Internal pancreatic fistulas (IPF) are an uncommon but well-recognized complication of chronic pancreatitis (CP) that are associated with significant morbidity and mortality. Because of their low incidence, management is still... more
Internal pancreatic fistulas (IPF) are an uncommon but well-recognized complication of chronic pancreatitis (CP) that are associated with significant morbidity and mortality. Because of their low incidence, management is still controversial. The aims of this study are to report the 8-year experience with IPF management in a Brazil University-affiliated hospital and to propose a management algorithm. A centralized diagnostic index was used to retrospectively identify all patients with IPF admitted to a teaching hospital from 1995 to 2003. The patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s medical records were reviewed for clinical features, diagnostic work-up, treatment strategies, response to therapy, and the length of hospital stay. All patients underwent contrast-enhanced computed tomography of the abdomen and endoscopic retrograde cholangiopancreatography, to guide the therapeutic modality to be offered. Conservative therapy included withholding of oral feedings in conjunction with total parenteral nutrition, octreotide subcutaneously, and multiple paracentesis or thoracentesis. Interventional therapy was either endoscopic or surgical. IPF was identified in 11 (7.3%) of 150 patients with CP. They ranged in age from 24 to 47 years (mean 36.1), with a male to female ratio of 10:1. All patients had underlying alcoholic CP. The presentation was pancreatic ascites in 9 patients and pleural effusion in 2 cases. Five patients were undergoing the conservative treatment, all presenting main pancreatic duct (MPD) dilatation; endoscopic placement of transpapillary pancreatic duct stent was performed in 4 patients who presented partial MPD stricture or disruption; surgical therapy was performed in 2 patients exhibiting complete MPD obstruction or disruption. Stents were removed 3 to 6 weeks after initial placement. IPF resolved in 10 of 11 patients (90.9%) within 6 weeks. The resolution of IPF was faster (13 +/- 5 vs. 25 +/- 13 days, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01) and the length of hospital stay was significantly shorter (17.2 +/- 5.6 vs. 31.2 +/- 4.4 days, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01) in patients subject to interventional treatment compared with those treated conservatively. There was 1 death due to sepsis in a patient managed conservatively; no death was recorded in the interventional therapy group. There was no recurrence of IPF at a mean follow-up of 38 months. Our results suggest that interventional therapy should be considered the best approach for the management of IPF in patients presenting MPD disruption or obstruction. Conservative therapy must be reserved for those showing MPD dilatation without ductal disruption or stricture. Early interventional therapy reduced hospital stay and convalescence, which likely resulted in lower healthcare overall costs.
Research Interests:
Psychological disturbances are frequent in Crohn's disease (CD) patients. However, epidemiological studies of non-western CD populations are limited and may be confounded by genetic and disease-related influences. The aim of this... more
Psychological disturbances are frequent in Crohn's disease (CD) patients. However, epidemiological studies of non-western CD populations are limited and may be confounded by genetic and disease-related influences. The aim of this study was to assess the prevalence and risk factors for depression and symptoms of anxiety in Brazilian patients with CD. In this cross-sectional study, 110 CD patients and 110 control subjects with erosive esophagitis were assessed for depression and anxiety symptoms using the Beck Depression Inventory and the Hospital Anxiety and Depression Scale. The Crohn's and control groups were similar with regard to socio-demographic data. Compared with the controls, the CD patients had a significantly higher prevalence of depressed mood (25.4% vs. 8.2%, P=0.003). There was no significant difference in the prevalence of anxiety between CD subjects (33.6%) and controls (22.7%). Depressed mood rates were higher among those who had active disease and greater CD...
Research Interests:
Research Interests:
Research Interests:
... Id: 62090. Autor: Mansur, Maria Cristina d'Ascensäo; Martins, Claytn Roberto Costa; Gaburri, Pedro Duarte; Dahbar, Nadim; Breder, Mário Nei Rodrigues. Título: Hemorragia digestiva e pseudoxantoma elástico / Upper gastrointestinal... more
... Id: 62090. Autor: Mansur, Maria Cristina d'Ascensäo; Martins, Claytn Roberto Costa; Gaburri, Pedro Duarte; Dahbar, Nadim; Breder, Mário Nei Rodrigues. Título: Hemorragia digestiva e pseudoxantoma elástico / Upper gastrointestinal bleeding and pseudoxanthoma elasticum. ...
Research Interests: Surgery and Observation
The authors describe the case of a young Brazilian woman who was treated of ileocolonic Crohn's disease sparing rectum, as confirmed by colonoscopy and histopathological examination. After a 4-year course of sulfasalazine treatment,... more
The authors describe the case of a young Brazilian woman who was treated of ileocolonic Crohn's disease sparing rectum, as confirmed by colonoscopy and histopathological examination. After a 4-year course of sulfasalazine treatment, she presented with skin facial lesions in vespertilio, fever, arthralgias and high titers of anti-ANA and LE cells. A sulfasalazine-induced lupus syndrome was diagnosed, because after sulfasalazine withdrawal and a short course of prednisone, the clinical symptoms disappeared and the laboratory tests returned to normal. Mesalazine 3 g/day was started and the patient remained well for the next 3 years, when she was again admitted with fever, weakness, arthralgias, diplopy, strabismus and hypoaesthesia in both hands and feet, microhematuria, haematic casts, hypocomplementemia and high titers of autoimmune antibodies. A diagnosis of associated systemic lupus erythematosus was made. Although a pulsotherapy with methylprednisolone was started, no improvem...