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  1. Article: Hepatocellular carcinoma screening in NAFLD: The paradox of nearly half the cases arising in non-cirrhotic low risk patients.

    Machado, Mariana Verdelho

    Annals of hepatology

    2023  Volume 28, Issue 3, Page(s) 101101

    MeSH term(s) Humans ; Non-alcoholic Fatty Liver Disease/diagnosis ; Non-alcoholic Fatty Liver Disease/epidemiology ; Non-alcoholic Fatty Liver Disease/pathology ; Carcinoma, Hepatocellular/diagnosis ; Carcinoma, Hepatocellular/epidemiology ; Carcinoma, Hepatocellular/pathology ; Liver Neoplasms/diagnosis ; Liver Neoplasms/epidemiology ; Liver Neoplasms/pathology ; Risk Factors ; Liver Cirrhosis/pathology
    Language English
    Publishing date 2023-04-28
    Publishing country Mexico
    Document type Editorial
    ZDB-ID 2188733-0
    ISSN 1665-2681
    ISSN 1665-2681
    DOI 10.1016/j.aohep.2023.101101
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 6221: Show issues Location:
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  2. Article: MASLD treatment-a shift in the paradigm is imminent.

    Machado, Mariana Verdelho

    Frontiers in medicine

    2023  Volume 10, Page(s) 1316284

    Abstract: MASLD prevalence is growing towards the leading cause of end-stage liver disease. Up to today, the most effective treatment is weight loss. Weight loss interventions are moving from lifestyle changes to bariatric surgery or endoscopy, and, more recently, ...

    Abstract MASLD prevalence is growing towards the leading cause of end-stage liver disease. Up to today, the most effective treatment is weight loss. Weight loss interventions are moving from lifestyle changes to bariatric surgery or endoscopy, and, more recently, to a new wave of anti-obesity drugs that can compete with bariatric surgery. Liver-targeted therapy is a necessity for those patients who already present liver fibrosis. The field is moving fast, and in the near future, we will testify to a disruptive change in MASLD treatment, similar to the paradigm-shift that occurred for hepatitis C almost one decade ago with direct antiviral agents.
    Language English
    Publishing date 2023-12-11
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2775999-4
    ISSN 2296-858X
    ISSN 2296-858X
    DOI 10.3389/fmed.2023.1316284
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: New Developments in Celiac Disease Treatment.

    Machado, Mariana Verdelho

    International journal of molecular sciences

    2023  Volume 24, Issue 2

    Abstract: Celiac disease (CD) is a common autoimmune disease affecting around 1% of the population. It consists of an immune-mediated enteropathy, triggered by gluten exposure in susceptible patients. All patients with CD, irrespective of the presence of symptoms, ...

    Abstract Celiac disease (CD) is a common autoimmune disease affecting around 1% of the population. It consists of an immune-mediated enteropathy, triggered by gluten exposure in susceptible patients. All patients with CD, irrespective of the presence of symptoms, must endure a lifelong gluten-free diet (GFD). This is not an easy task due to a lack of awareness of the gluten content in foods and the extensive incorporation of gluten in processed foods. Furthermore, a GFD imposes a sense of limitation and might be associated with decreased quality of life in CD patients. This results in gluten contamination in the diet of four out of five celiac patients adhering to a GFD. Furthermore, one in three adult patients will report persistent symptoms and two in three will not achieve full histological recovery when on a GFD. In recent years, there has been extensive research conducted in the quest to find the holy grail of pharmacological treatment for CD. This review will present a concise description of the current rationale and main clinical trials related to CD drug therapy.
    MeSH term(s) Adult ; Humans ; Celiac Disease/diagnosis ; Quality of Life ; Glutens ; Diet, Gluten-Free ; Food
    Chemical Substances Glutens (8002-80-0)
    Language English
    Publishing date 2023-01-04
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2019364-6
    ISSN 1422-0067 ; 1422-0067 ; 1661-6596
    ISSN (online) 1422-0067
    ISSN 1422-0067 ; 1661-6596
    DOI 10.3390/ijms24020945
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  4. Article: The Growing Landscape of NAFLD-Associated Hepatocellular Carcinoma and Its Impact in Surveillance.

    Machado, Mariana Verdelho

    GE Portuguese journal of gastroenterology

    2023  Volume 31, Issue 1, Page(s) 14–23

    Abstract: Liver cancer is globally the third leading cause of death from cancer. Hepatocellular carcinoma (HCC) develops in patients with underlying liver disease. The fraction of HCC attributed to nonalcoholic fatty liver disease (NAFLD) shows an accelerated ... ...

    Abstract Liver cancer is globally the third leading cause of death from cancer. Hepatocellular carcinoma (HCC) develops in patients with underlying liver disease. The fraction of HCC attributed to nonalcoholic fatty liver disease (NAFLD) shows an accelerated increase in the last decades, being already responsible for 15% of all HCC cases. Similar to other causes of liver cirrhosis, patients with NAFLD-associated cirrhosis should be enrolled in HCC-screening programs, yet these patients are under-screened, and currently are less than half likely to be proposed for HCC screening as compared to patients with HCV-associated cirrhosis. NAFLD-associated HCC has the peculiarity of occurring in precirrhotic phases in 20-50% of the cases. Currently, HCC screening in precirrhotic NAFLD patients is not routinely recommended, since the risk of developing HCC is very low. However, because NAFLD affects one-third of the worldwide population, noncirrhotic NAFLD already accounts for 6% of HCC cases. As such, it is pressing to develop stratification tools, in order to personalize the individual risk of HCC development in a patient with NAFLD, allowing precision HCC-screening programs. This review summarizes the epidemiology of NAFLD-associated HCC with a critical analysis of current HCC-screening recommendations.
    Language English
    Publishing date 2023-08-02
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2835774-7
    ISSN 2387-1954 ; 2341-4545
    ISSN (online) 2387-1954
    ISSN 2341-4545
    DOI 10.1159/000531397
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: MASLD treatment—a shift in the paradigm is imminent

    Mariana Verdelho Machado

    Frontiers in Medicine, Vol

    2023  Volume 10

    Abstract: MASLD prevalence is growing towards the leading cause of end-stage liver disease. Up to today, the most effective treatment is weight loss. Weight loss interventions are moving from lifestyle changes to bariatric surgery or endoscopy, and, more recently, ...

    Abstract MASLD prevalence is growing towards the leading cause of end-stage liver disease. Up to today, the most effective treatment is weight loss. Weight loss interventions are moving from lifestyle changes to bariatric surgery or endoscopy, and, more recently, to a new wave of anti-obesity drugs that can compete with bariatric surgery. Liver-targeted therapy is a necessity for those patients who already present liver fibrosis. The field is moving fast, and in the near future, we will testify to a disruptive change in MASLD treatment, similar to the paradigm-shift that occurred for hepatitis C almost one decade ago with direct antiviral agents.
    Keywords MASLD ; treatment ; obesity ; weight loss ; liver disease-targeted drugs ; Medicine (General) ; R5-920
    Language English
    Publishing date 2023-12-01T00:00:00Z
    Publisher Frontiers Media S.A.
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article: Liquid Diagnosis of Hepatic Encephalopathy: Are We There Already?

    Verdelho Machado, Mariana

    GE Portuguese journal of gastroenterology

    2020  Volume 27, Issue 6, Page(s) 378–382

    Language English
    Publishing date 2020-09-28
    Publishing country Switzerland
    Document type Editorial
    ZDB-ID 2835774-7
    ISSN 2387-1954 ; 2341-4545
    ISSN (online) 2387-1954
    ISSN 2341-4545
    DOI 10.1159/000510059
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  7. Article: Aerobic Exercise in the Management of Metabolic Dysfunction Associated Fatty Liver Disease.

    Machado, Mariana Verdelho

    Diabetes, metabolic syndrome and obesity : targets and therapy

    2021  Volume 14, Page(s) 3627–3645

    Abstract: Sedentarism is the pandemic of modern times. It is associated with several medical conditions including obesity, type 2 diabetes mellitus, cardiovascular diseases and also liver disease, particularly metabolic dysfunction associated fatty liver disease ( ... ...

    Abstract Sedentarism is the pandemic of modern times. It is associated with several medical conditions including obesity, type 2 diabetes mellitus, cardiovascular diseases and also liver disease, particularly metabolic dysfunction associated fatty liver disease (MAFLD). In an era when MAFLD is the most prevalent chronic liver disease worldwide, whilst no pharmacological therapy has been approved for it, exercise has proved to be effective in improving liver steatosis. Interestingly, exercise decreases liver fat even in the absence of weight loss. The challenge for the clinician is to motivate the obese patient with MAFLD, and associated co-morbidities, who has crystallized a sedentary behavior, at times when every need is at the distance of a click on the Internet, and the entire world can be visited behind a screen. In this review, the aggregate evidence on the mechanisms and effects of exercise in the management of MAFLD is summarized, with simple recommendations for everyday clinical practice.
    Language English
    Publishing date 2021-08-11
    Publishing country New Zealand
    Document type Journal Article ; Review
    ZDB-ID 2494854-8
    ISSN 1178-7007
    ISSN 1178-7007
    DOI 10.2147/DMSO.S304357
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Celiac Disease Revisited.

    Calado, João / Verdelho Machado, Mariana

    GE Portuguese journal of gastroenterology

    2021  Volume 29, Issue 2, Page(s) 111–124

    Abstract: Celiac disease (CD) is a systemic disease triggered by gluten ingestion in genetically predisposed individuals. It manifests primarily as an autoimmune enteropathy associated with specific circulating autoantibodies and a human leukocyte antigen ... ...

    Abstract Celiac disease (CD) is a systemic disease triggered by gluten ingestion in genetically predisposed individuals. It manifests primarily as an autoimmune enteropathy associated with specific circulating autoantibodies and a human leukocyte antigen haplotype (HLA-DQ2 or HLA-DQ8). It afflicts roughly 1% of the population, though the majority of patients remain undiagnosed. Diarrhea and malabsorption are classic manifestations of CD; however, both children and adults can be paucisymptomatic and present extraintestinal manifestations such as anemia, osteoporosis, and abnormal liver tests. CD screening is not recommended for the general population, and it should be focused on high-risk groups. CD diagnosis is challenging and relies on serological tests, duodenal histology, and genetic testing. Particularly difficult presentations to manage are seronegative patients, seropositive patients without villus atrophy, and patients who have started a gluten-free diet before the diagnostic workup. The only proven treatment is a lifelong gluten-free diet. We present an in-depth review on the physiopathology and management of CD, with a particular emphasis on diagnostic challenges.
    Language English
    Publishing date 2021-03-17
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2835774-7
    ISSN 2387-1954 ; 2341-4545
    ISSN (online) 2387-1954
    ISSN 2341-4545
    DOI 10.1159/000514716
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  9. Article ; Online: Benign inheritable disorders of bilirubin metabolism manifested by conjugated hyperbilirubinemia-A narrative review.

    Morais, Mariana B / Machado, Mariana Verdelho

    United European gastroenterology journal

    2022  Volume 10, Issue 7, Page(s) 745–753

    Abstract: Bilirubin, a breakdown product of heme, is normally glucuronidated and excreted by the liver into bile. Failure of this system can lead to a buildup of conjugated bilirubin in the blood, resulting in jaundice. Hyperbilirubinemia is an important clinical ... ...

    Abstract Bilirubin, a breakdown product of heme, is normally glucuronidated and excreted by the liver into bile. Failure of this system can lead to a buildup of conjugated bilirubin in the blood, resulting in jaundice. Hyperbilirubinemia is an important clinical sign that needs to be investigated under a stepwise evaluation. Inherited non-hemolytic conjugated hyperbilirubinemic conditions include Dubin-Johnson syndrome (caused by mutations affecting ABCC2 gene) and Rotor syndrome (caused by the simultaneous presence of mutations in SLCO1B1 and SLCO1B3 genes). Although classically viewed as benign conditions requiring no treatment, they lately gained an increased interest since recent studies suggested that mutations in the responsible genes leading to hyperbilirubinemia, as well as minor genetic variants, may result in an increased susceptibility to drug toxicity. This article provides a comprehensive review on the pathophysiology of Dubin-Johnson and Rotor syndromes, presenting the current knowledge concerning the molecular details and basis of these conditions.
    MeSH term(s) Bilirubin ; Heme/metabolism ; Humans ; Hyperbilirubinemia/etiology ; Hyperbilirubinemia/genetics ; Hyperbilirubinemia, Hereditary/diagnosis ; Hyperbilirubinemia, Hereditary/genetics ; Jaundice, Chronic Idiopathic/diagnosis ; Jaundice, Chronic Idiopathic/genetics ; Liver-Specific Organic Anion Transporter 1/genetics
    Chemical Substances Liver-Specific Organic Anion Transporter 1 ; SLCO1B1 protein, human ; Heme (42VZT0U6YR) ; Bilirubin (RFM9X3LJ49)
    Language English
    Publishing date 2022-07-20
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2728585-6
    ISSN 2050-6414 ; 2050-6406
    ISSN (online) 2050-6414
    ISSN 2050-6406
    DOI 10.1002/ueg2.12279
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Impact of pretransplant frailty and sarcopenia on the post-transplant prognosis of patients with liver cirrhosis: a systematic review.

    Ferreira, Alexandre Pimentel / Machado, Mariana Verdelho

    European journal of gastroenterology & hepatology

    2022  Volume 33, Issue 1S Suppl 1, Page(s) e883–e897

    Abstract: Introduction: Frailty and sarcopenia associate with increased mortality in patients with liver cirrhosis on the transplant waitlist. We conducted a systematic review on the impact of pretransplant frailty and sarcopenia on post-transplant outcomes in ... ...

    Abstract Introduction: Frailty and sarcopenia associate with increased mortality in patients with liver cirrhosis on the transplant waitlist. We conducted a systematic review on the impact of pretransplant frailty and sarcopenia on post-transplant outcomes in adult patients with liver cirrhosis.
    Methods: We performed a search in Medline, Embase and Cochrane Central. Of the 12276 references initially recovered, 34 were included.
    Results: Frailty and sarcopenia presented a negative impact on post-transplant outcomes and seemed to associate with an overall two-fold reduction in early and 50% reduction in late survival, for severe conditions, according to the largest cohorts. These patients required longer ICU and hospitalization time, had higher rates of sepsis and respiratory complications and lower graft-survival. The reversibility of frailty depended on the severity of functional impairment and on the co-morbidities contributing to frailty. Reversibility of sarcopenia occurred in only a minority of patients, in unbiased studies.
    Conclusion: Frailty and sarcopenia are double-edged swords: patients with frailty/sarcopenia should be prioritized for liver transplantation due to increased mortality on the waitlist; however, severe frailty/sarcopenia may justify delisting because it associates with dismal prognosis post-liver transplantation. Patients presenting mild to moderate frailty/sarcopenia, should be submitted to liver transplantation before those conditions worsen to a level that significantly impacts post-liver transplantation outcomes.
    MeSH term(s) Adult ; Frailty/complications ; Frailty/diagnosis ; Humans ; Liver Cirrhosis/complications ; Liver Cirrhosis/diagnosis ; Liver Cirrhosis/surgery ; Liver Transplantation/adverse effects ; Prognosis ; Sarcopenia/etiology
    Language English
    Publishing date 2022-01-28
    Publishing country England
    Document type Journal Article ; Systematic Review
    ZDB-ID 1034239-4
    ISSN 1473-5687 ; 0954-691X
    ISSN (online) 1473-5687
    ISSN 0954-691X
    DOI 10.1097/MEG.0000000000002291
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    In stock of ZB MED Cologne/Königswinter

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