OBJECTIVE: To evaluate the effectiveness and safety of first-generation protease inhibitors for the treatment of genotype 1 hepatitis C virus-infected patients at Brazilian reference centers. METHODS: This multicenter cross-sectional study included hepatitis C virus genotype 1 monoinfected patients treated with Peg-interferon, ribavirin, and either boceprevir (n=158) or telaprevir (n=557) between July 2013 and April 2014 at 15 reference centers in Brazil. Demographic, clinical, virological, and adverse events data were collected during treatment and follow-up. RESULTS: Of the 715 patients, 59% had cirrhosis and 67.1% were treatment-experienced. Based on intention-to-treat analysis, the overall sustained viral response was 56.6%, with similar effectiveness in both groups (51.9% for boceprevir and 58% for telaprevir, p=0.190). Serious adverse events occurred in 44.2% of patients, and six deaths (0.8%) were recorded. Cirrhotic patients had lower sustained viral response rates than non-cirrhotic patients (46.9% vs. 70.6%, p<0.001) and a higher incidence of serious adverse events (50.7% vs. 34.8%, p<0.001). Multivariate analysis revealed that sustained viral response was associated with the absence of cirrhosis, viral recurrence after previous treatment, pretreatment platelet count greater than 100,000/mm3, and achievement of a rapid viral response. Female gender, age>65 years, diagnosis of cirrhosis, and abnormal hemoglobin levels/platelet counts prior to treatment were associated with serious adverse events. CONCLUSION: Although serious adverse events rates were higher in this infected population, sustained viral response rates were similar to those reported for other patient cohorts.

OBJETIVO: Avaliar a reconstrução de defeitos experimentais na uretra do cão com a implantação de segmentos tubulares de mucosa bucal autóloga. MÉTODOS: Procedeu-se à ressecção de cerca de 2 cm da uretra peniana de 20 cães. O defeito produzido foi corrigido por meio da anastomose de fragmento tubular de mucosa bucal autóloga, seccionado do lábio inferior. RESULTADOS: Entre os animais operados, 14 (70%) apresentaram jato urinário normal e seis (30%) evidenciaram estenose confirmada por meio de exame radiológico realizado aos 60 dias do pós-operatório. Durante a necrópsia verificou-se a integridade dos implantes no sulco uretral, associado a infiltrado inflamatório de neutrófilos, linfócitos piócitos e histiócitos. As análises histológicas revelaram que os fragmentos implantados estavam recobertos pelo epitélio uretral. CONCLUSÃO: A implantação de segmentos autólogos de mucosa bucal é adequada para a reconstrução de defeitos uretrais iatrogênicos no cão, embora possa resultar em estenose pós-operatória.

PURPOSE: Evaluate experimental urethral defects reconstruction in dogs through implantation of tubular oral autologous mucosa fragments. METHODS: About 2 cm of penile urethra was resected. The induced defect was repaired through anastomosis of tubular oral autologous mucosa fragment extracted from the lower lip. RESULTS: 14 (70%) of the operated dogs showed normal urinary flow and 6 (30%) revealed stenosis which was revealed by radiological examination carried out at 60 days post-operative. Necropsy findings showed the integrity of the implants to the urethral sulcus, and histological findings confirmed that the implanted fragments were covered by the urethral epithelium and inflammatory infiltration of neutrophils, lymphocytes and macrophages was present. CONCLUSION: Implantation of tubular oral autologous mucosa fragments is adequate to reconstruct urethral iatrogenic defects in dogs, although it may result in post-operative stenosis.

O uso da mucosa bucal para tratar a estenose uretral tem sido considerado um excelente método alternativo para substituir o tecido uretral. OBJETIVO: Investigar os resultados da realização da triangulação da anastomose término-terminal de fragmento de mucosa bucal na reconstrução uretral. MÉTODOS: Foram utilizados 12 cães entre 13 e 17 Kg, sem raça definida, aparentemente sadios. Após anestesia, introduziu-se sonda na uretra dos animais que foi mantida durante todo ato operatório. Inicialmente procedeu-se a ressecção de um fragmento de mucosa bucal do lábio superior e imerso em solução salina com cloranfenicol aquoso. A seguir procedeu-se a exposição da uretra peniana e ressecou-se um segmento de dois centrímetros. Foi realizada a triangulação da anastomose término-terminal do fragmento de mucosa bucal na reconstrução uretral. RESULTADOS: Após 60 dias observou-se a ocorrência de estenose em 25% dos animais. Foram observadas fístulas uretro-cutâneas e extravasamento de contraste no local das anastomoses. CONCLUSÃO: A triangulação da anastomose término-terminal de fragmento de mucosa bucal na reconstrução uretral não evita a ocorrência de estenose.

Oral mucosa has been considered an excellent alternative method to substitute for urethral tissue. OBJECTIVE: To investigate the results of a triangulation of an end-to-end anastomosis using oral mucosa for urethral reconstruction. METHODS: Twelve healthy dogs of no defined race weighing between 13 and 17 kg were anesthetized and an urethral catheter was maintained during the whole surgery. First, a piece of oral mucosa was removed from the superior lip and kept in saline solution containing aqueous chloramphenicol. Then, a 2 cm fragment of the urethra from the penis was removed and the oral mucosa was used to reconstruct the urethra. RESULTS: After 60 days we observed stenosis in 25% of the dogs. There were also urethral-cutaneous fistulas and constrast leakage at the site of anastomosis. CONCLUSION: The triangulation of an end-to-end anastomosis using oral mucosa for urethral reconstruction does not prevent the occurrence of stenosis.