Beruflich Dokumente
Kultur Dokumente
Maro/2013
UM RETRATO
DO TRANSPLANTE
HEPTICO NO
BRASIL
Perfectovir:
IPs no Brasil
O Ministro
e o Fgado em
Pernambuco
O superespecialista
e o ensino mdico
Baccarat:
Hepatites
em Paris
ndice
Sociedade Brasileira de Hepatologia
Diretoria Binio
2011-2013
Presidente: Henrique Srgio de Moraes Coelho (RJ)
1 Vice-presidente: Maria Lucia Gomes Ferraz (SP)
2 Vice-presidente: Jos Carlos Ferraz Fonseca (AM)
3 Vice-presidente: Francisco Jos Dutra Souto (MT)
Secretrio-geral: Mrio Reis lvares-da-Silva (RS)
Secretrio-adjunto: Jorge Andr de Segadas Soares (RJ)
Tesoureira: Letcia Cancela Nabuco (RJ)
2 Tesoureiro: Andr de Castro Lyra (BA)
Representante AMB: Edna Strauss (SP)
Editor Boletim SBH: Mrio Reis lvares-da-Silva (RS)
Comisso de Admisso: Henrique Srgio M. Coelho
(RJ), Fbio Marinho do Rego Barros (PE), Edmundo Pessoa
Lopes Neto (PE)
Editor Arquivos de Gastroenterologia: Alberto Queiroz
Farias (SP)
2
2
2
3
4
8
10
12
16
18
20
22
Expediente da diretoria
Editorial
Crditos Boletim SBH
Seo Espao Porta Hepatologia do Milnio 2013
Seo Artria Heptica Um retrato do Transplante Heptico no Brasil
Seo Clulas Endoteliais Ensino Mdico
Seo Placa Ductal Pesquisa em Hepatologia no Brasil
Seo Clulas Estreladas Perfectovir: os inibidores de protease no Brasil
Seo Clulas de Kupffer O Fgado em Pernambuco
Seo Espao de Disse Cristal Room Baccarat
Seo Transporte Biliar Eventos Mdicos no Brasil
Seo Zona 3 Notcias SBH
Editorial
TXH SRU VLQDO QR 5LR GH -DQHLUR WDPEpP QmR DQGD
EHP FRP R IHFKDPHQWR VXFHVVLYR GR 3URJUDPD GH
transplante do Hospital dos Servidores do Estado e
DJRUDWDPEpPGR+RVSLWDOGH%RQVXFHVVRUHIHUrQFLD
~QLFDQR5-SDUDWUDQVSODQWHHPFULDQoDV
3RGHUtDPRVHVWDUPXLWRIHOL]HVVHQmRWUDEDOKiVVHPRV
nos locais para os quais estes pacientes sero
referidos e no convivssemos com a realidade dos
SRVWRVGHVD~GHHKRVSLWDLVS~EOLFRVRTXHGLFXOWDUi
sobremaneira nossa misso.
Assistimos com tristeza o descaso das autoridades
com assuntos que nos so muito caros e que
dizem respeito ao futuro da Hepatologia nacional;
a decadncia consentida e administrada pelos
*RYHUQRV IHGHUDLV XP DSyV RXWUR GRV KRVSLWDLV
XQLYHUVLWiULRVGR0LQLVWpULRGD(GXFDomRH&XOWXUD
e a reduo progressiva dos programas pblicos
GH WUDQVSODQWH KHSiWLFR SULYLOHJLDQGR GH DOJXPD
PDQHLUDRVKRVSLWDLVSULYDGRV
Dou como exemplo o Hospital Universitrio
&OHPHQWLQR)UDJD)LOKRGD8)5-UHIHUrQFLDHVWDGXDO
HP KHSDWLWHV YLUDLV FkQFHU GH ItJDGR H WUDQVSODQWH
TXHYLYHKRMHVHXSLRUPRPHQWRGHVGHDLQDXJXUDomR
HP FRP HPHUJrQFLD IHFKDGD SURLELomR GH
DEHUWXUD GH QRYRV SURQWXiULRV VXVSHQVmR GH
H[DPHV SRU DSDUHOKR TXHEUDGRV H VXD FDSDFLGDGH
GH LQWHUQDomR KRVSLWDODU UHGX]LGD SDUD D PHWDGH
6DOiULRV PHGtRFUHV DFRPSDQKDP HVWH FHQiULR TXH
SURYDYHOPHQWHVHUHSHWHHPRXWURVKRVSLWDLVGR0(&
1DYHUGDGHRV+8VIHGHUDLVVmRyUImRVH[FHWXDQGR
WDOYH]RGH3RUWR$OHJUH1mRpGHHVWUDQKDUMiTXH
WUDWDVHGHXPDUHGHGHKRVSLWDLVGR0(&TXDQGR
RGLQKHLURGD6D~GHHVWiFRPR0LQLVWpULRGD6D~GH
2 | Boletim SBH
HEPATOLOGIA
DO MILNIO
2013
Raymundo
Paran (BA)
1R+HSDWRORJLDGR0LOrQLRRVGRLVGLDVTXHVH
VHJXHPDR0RQRWHPiWLFRVHUmRGHGLFDGRVjVKHSDWLWHV
virais com forte nfase no uso dos DAAs na vida real.
Boletim SBH | 3
Um retrato do Transplante
Heptico no Brasil
Mrio Reis
OYDUHVGD6LOYD56
4 | Boletim SBH
Renato: )RLHPPDUFRGH2SDFLHQWHPRU-
UHXQDPHVDDRQDOGRWUDQVSODQWHLQIDUWRDJXGRGR
PLRFiUGLR3RXFRDQWHVRGLUHWRUGDIDFXOGDGHHQWURX
QR FHQWUR FLU~UJLFR 7XGR EHP" 5HVSRQGL TXH
VLPXPDPDUDYLOKDRGLUHWRUGHXDVFRVWDVHRSD-
FLHQWHSDURX1DQHFURSVLDLQIDUWR1RGLDVHJXLQWH
RVHJXQGRSDFLHQWHGDODQRVSURFXURXHQRVGLVVH
3RGHPHRSHUDUTXHHXQmRYRXPRUUHU(OHHVWi
YLYRDWpKRMHHDJUDGHFHPRVDHOHWRGRVRVGLDV
Agnaldo: No HC-UFMG, foi em 1994, em um
SDFLHQWHFRPFLUURVHSRU+&9HiOFRRO'XUDQWHR
SUHSDURHOHFRQWDYDTXHPRWRULVWDGH{QLEXVXUED-
QRHP%+EHELDXPDGRVHDFDGDYLDJHP)RLXP
YDOHQWH6DELDTXHHUDQRVVRSULPHLUR7[+1RSyV-
RSHUDWyULRSHUPDQHFHXQD87,SRUORQJRSHUtRGR
QRVVDLQVHJXUDQoD&RQVFLHQWHHDFRUGDGRVXSRUWRX
R WXER RURWUDTXHDO TXH QmR RXVDPRV UHWLUDU PDV
SRVDYDSDUDIRWRVHGDYDHQWUHYLVWDVSRUHVFULWR9HLR
DIDOHFHUDQRVGHSRLVUHFLGLYDGRYtUXV&
Ilka:(PGLDGHVHWHPEURRSULPHLUR)RL
PXLWRERQLWR2GRHQWHVDELDTXHHUDRSULPHLURH
FRQRXSOHQDPHQWHHPWRGRV
Boletim SBH: &RPRIRLUHFHELGRRWUDQVSODQWH
KHSiWLFRQRVHXPHLR"8PDYDQoR"8PSUR-
blema?
Huygens: 1LQJXpPDFUHGLWDYDTXHVHULDSRVVtYHOR
7;+HPXPKRVSLWDOS~EOLFRFRPUHFXUVRVHVFDV-
VRV/HPEURGHXPDKLVWyULDPLQKDOKDHVWXGDQWH
de medicina, assistia a uma aula sobre cirrose na nos-
VDIDFXOGDGHGHPDLRGHHXPDOXQRSHU-
JXQWRXDRSURIHVVRUVREUHDSRVVLELOLGDGHGH7[+QR
KRVSLWDODRTXHRSURIHVVRUUHVSRQGHXQRVSUy[L-
PRVDQRVLPSRVVtYHOGLDVGHSRLV]HPRVR
SULPHLUR$8QLYHUVLGDGH)HGHUDOGR&HDUiVHPSUH
QRVDSRLRXHVHRUJXOKDGHWHURPDLRUVHUYLoRGH7[+
GRQRUWHQRUGHVWHHXPGRVSULQFLSDLVGRSDtV0DV
DSDUWLUGHTXDQGRSDVVDPRVDUHDOL]DUPDLVGH
WUDQVSODQWHVSRUDQRID]HQGRFRPTXHFLUXUJLDV
HOHWLYDVGHRXWURVVHUYLoRVVHMDPIUHTXHQWHPHQWHVXV-
SHQVDVWHPRVJHUDGRLQVDWLVIDomRHQWUHRVFROHJDV
Ilka: 3RLVpDVGLFXOGDGHVVmRDVPHVPDVHPWRGRV
RVOXJDUHV$OJXQVFROHJDVDFKDPTXHYRFrDWUDSDOKD
D87,REORFRDHQIHUPDULDTXHURXEDRVUHVLGHQWHV
HDLQGDFDPFRPLQYHMDSRUTXHDFKDPTXHFRQVH-
JXLPRVPDLVFRLVDV
Agnaldo: (P 0LQDV QmR IRL GLIHUHQWH 2 WUDQV-
SODQWHIRLUHFHELGRFRPRXPSUREOHPD0XLWRVFUL-
WLFDYDPDLQLFLDWLYDRKRVSLWDOQmRWHPGLQKHLUR
QHPSUDYHUPtIXJRYDLWUDQVSODQWDUItJDGR"9mR
TXHEUDUR+RVSLWDO'XUDQWHRSULPHLURWUDQVSODQ-
WHXPFROHJDPDLVSHUYHUVROLJDYDSDUDREORFRHLQ-
GDJDYDMiPRUUHX"HFRPSOHWDYD(VVDRSHUDomR
YDLGXUDUK1DTXHOHPRPHQWRQmRSRGtDPRV
HYLWDUDUDLYDRVHQWLPHQWRGHyGLRFRQWUDRVTXH
DFKiYDPRVPHVTXLQKRVHHQFLXPDGRV1yVPRVWUD-
PRVTXHR7[+pXPDJUDQGHPiTXLQDSDUDSX[DU
XPD LQVWLWXLomR SDUD IUHQWH H TXH VXDV H[LJrQFLDV
WUD]HPEHQHItFLRSDUDWRGRV
Renato:(P5LR3UHWRIRLGLIHUHQWH2WUDQVSODQWH
IRLUHFHELGRFRPDOHJULD2'HSDUWDPHQWRGH&LUXU-
JLDHVWDYDGRQRVVRODGR23URI$OGHQLV%RULPIRL
IXQGDPHQWDOQDLPSODQWDomRGRSURJUDPD
Carneiro: O transplante, desde o incio, foi conside-
UDGRXPJUDQGHDYDQoRHQmRXPSUREOHPD2VSUR-
EOHPDVpTXHWHULDPTXHVHUUHVROYLGRVSDUDYLDELOL]DU
o transplante!
Boletim SBH:&RPRpFRPSRVWDDHTXLSHDWX-
DOPHQWH"4XDQWRVFLUXUJL}HV"4XDQWRVKHSDWR-
logistas?
Huygens: 6RPRV FLUXUJL}HV H KHSDWRORJLVWDV
PDLVLQIHFWRORJLVWDHSDWRORJLVWD
Agnaldo:6mRFLUXUJL}HVVHQGRTXHVHUHYH]DP
FRPRXWURVSDUDDUHWLUDGDGHyUJmRVGRVGRDGRUHV
$3URID/XFLDQD)DULDKHSDWRORJLVWDWHPDX[LOLRGH
outros 5 no atendimento ambulatorial e hospitalar
GRVSDFLHQWHV
Ilka: 1RVVDHTXLSHpPDLVHQ[XWDFLUXUJL}HV
KHSDWRORJLVWDV H JDVWURHQWHURORJLVWDV (VWDPRV
FRQWUDWDQGRPDLVXPFLUXUJLmR
Carneiro: 6RPRVFLUXUJL}HVVHQLRUHVHMXQLRUHV
alm de 4 hepatologistas, em mdia, designados pela
*DVWURFOtQLFD$OpPGLVWRSDWRORJLVWDVHLQIHFWR-
ORJLVWDV[RVQRSURJUDPD
Renato: 6mRFLUXUJL}HVHKHSDWRORJLVWDV
Boletim SBH: H intensivistas e anestesistas
HVSHFtFRVSDUDRJUXSR"
Ilka:6LP6mRLQWHQVLYLVWDVHDQHVWHVLVWDVTXH
HVWmRVHUHQRYDQGRFRPXPJUXSRPDLVMRYHP
Huygens:(VWHpXPGLIHUHQFLDO7HPRVLQWHQVL-
YLVWDVTXHSDVVDPYLVLWDSHODPDQKmHjWDUGHH
DQHVWHVLVWDVWUHLQDGRV
Renato: 7HPRV DQHVWHVLVWDV VHQGR TXH R FKHIH
Boletim SBH | 5
'U/RERHVWiFRQRVFRGHVGHRSULPHLURWUDQVSODQWH
7HPRVWDPEpPLQWHQVLYLVWDVOLJDGRVDRJUXSR
Agnaldo:1yVWHPRVDQHVWHVLVWDVHVSHFtFRVPDVD
WHUDSLDLQWHQVLYDpFRPXPDRXWURVSDFLHQWHVRSHUD-
GRV
Boletim SBH: Quantos transplantes de fgado
a equipe j realizou?
Huygens: Foram at agora 788 transplantes, 127
HP
Agnaldo:5HDOL]DPRVWUDQVSODQWHVGHVGH
Ilka: )RUDPDWpRPRPHQWR
Renato:
Carneiro: No total, 1282 transplantes, sendo que
QRV~OWLPRVDQRV
Boletim SBH:2JUXSRGLVS}HGHHQIHUPHLUDV
coordenadoras(s) em tempo integral?
Ilka: 6LP6mRHQIHUPHLUDVHWpFQLFDGHHQIHUPD-
JHPQRDPEXODWyULR
Huygens: Sim, e ela de extrema importncia para
RVHUYLoR&RQKHFHWRGRVRVSDFLHQWHVFRQWURODDOLVWD
GHHVSHUDHRUJDQL]DRVDPEXODWyULRVHWDPEpPFR-
RUGHQDDHTXLSHPXOWLSURVVLRQDOSURPRYHQGRUHX-
QL}HVFRPRVSDFLHQWHVHIDPLOLDUHV(DLQGDSDUWLFLSD
GDVFDSWDo}HVGHyUJmRVHRUJDQL]DRVKRUiULRVGDV
cirurgias!
Renato: (QID+HOHQHVWiGHVGHRLQtFLRGRSURJUD-
PD
Agnaldo: 6LPHODVVHUHYH]DPQDDVVLVWrQFLDDRSUp
HSyVWUDQVSODQWHQDVUHWLUDGDVHQDVYLVLWDVDRVSD-
FLHQWHVLQWHUQDGRV
Carneiro:7HPRVHQIHUPHLUDVFRRUGHQDGRUDVHHV-
WDPRVFRQWUDWDQGRPDLVQmRVySDUDR7[+PDV
tambm para o transplante de pncreas, intestino e
PXOWLYLVFHUDO
Boletim SBH:&RPRpIHLWDDGLYLVmRGHWDUH-
IDVHQWUHFOtQLFRVHFLUXUJL}HV"$VFRPSHWrQFLDV
variam de acordo com a fase do transplante
(imediato ou tardio)?
Agnaldo: 1RLQtFLRpUDPRVDSHQDVFLUXUJL}HV&RP
os hepatologistas se agregando ao grupo, progressi-
YDPHQWHRVFLUXUJL}HVFDUDPPDLVUHVWULWRVDRVSUR-
FHGLPHQWRVFLU~UJLFRV1mRKiGLVWLQomRHQWUHDVID-
VHVLPHGLDWDRXWDUGLDQRDWHQGLPHQWRGRVSDFLHQWHV
Huygens:1D87,RVSDFLHQWHVVmRDFRPSDQKDGRV
SRULQWHQVLYLVWDVGDQRVVDHTXLSH1DHQIHUPDULDSRU
FLUXUJL}HVHKHSDWRORJLVWDVQRSULPHLURPrVPDLV
SHORVFLUXUJL}HVHHPVHJXLGDSHORVKHSDWRORJLVWDV
Ilka:RVKHSDWRORJLVWDVFXLGDPGRSUpHRVFLUXUJL}HV
GRSyVRSHUDWyULRPDVGLVFXWLPRVRVFDVRVHPFRQ-
6 | Boletim SBH
MXQWR
Carneiro:2VFLUXUJL}HVDFRPSDQKDPGRSyVRSH-
UDWyULRLPHGLDWRDWpRPrV$SyVRWUDQVSODQWDGR
SDVVDDVHUDFRPSDQKDGRSHORKHSDWRORJLVWDFOtQLFR
Renato: 7RGRVID]HPWXGRGRSUpDRSyVFODURTXHDV
GHFLV}HVHVSHFtFDVFRPFDGDiUHDGRFRQKHFLPHQWR
Boletim SBH:&RPRVmRRUJDQL]DGRVRVDP-
bulatrios? Quem os atende?
Agnaldo: 7HPRV DWHQGLPHQWR DPEXODWRULDO HP
WXUQRVSRUVHPDQDPDQKmVHWDUGHVGHOHV
DWHQGLGRVSHORVFOtQLFRV3DFLHQWHVGHSUpHSyV7[+
VmRDWHQGLGRVQRVPHVPRVSHUtRGRV$FKDPRVLVVR
importante porque h uma grande troca de informa-
o}HVQDVDODGHHVSHUD
Carneiro: A triagem est aberta diariamente, feita
SRUFOtQLFRVHFLUXUJL}HVHPVHXVDPEXODWyULRV2V
clnicos atendem os pacientes em lista de espera e h
XPDPEXODWyULRGHFLUXUJLDTXHYrRVSDFLHQWHVPDLV
SUy[LPRVGRWUDQVSODQWHFRP0(/'PDLVHOHYDGR
Ilka:6mRDPEXODWyULRVGHKHSDWRORJLDSDUDRSUp-
7[+DSDUWLUGRVTXDLVRVSDFLHQWHVYmRSDUDDP-
EXODWyULRVGHOHV}HVIRFDLVFDUFLQRPDKHSDWRFHOXODU
0(/'DWpGHDHDFLPDGH
Renato: &LUXUJL}HVHKHSDWRORJLVWDVSDUWLFLSDPGRV
DPEXODWyULRV
Huygens:+iDPEXODWyULRGHWULDJHPSUp7[+
UHDOL]DGRSRUFLUXUJL}HVDPEXODWyULRGHFDUFLQR-
PD KHSDWRFHOXODU WDPEpP FRP XP FLUXUJLmR H
DPEXODWyULRGHSUHSDURHVHJXLPHQWRGRVSDFLHQWHV
HPOLVWDDFDUJRGRVKHSDWRORJLVWDV2DPEXODWyULR
GHSyV7[+pIHLWRHPWXUQRVSHORVKHSDWRORJLVWDV
Boletim SBH: 1D DYDOLDomR SUp7[+ TXDLV
consultorias so obrigatrias? Quais so as op-
FLRQDLV"([LVWHPDPEXODWyULRVHVSHFtFRV"
Agnaldo: As rotineiras, com otorrinolaringolista,
RIWDOPRORJLVWDHRGRQWyORJR1DVPXOKHUHVJLQHFR-
ORJLVWDHQRVKRPHQVDFLPDGHDQRVXURORJLVWD
$YDOLDo}HV FRP FDUGLRORJLVWDV RX SQHXPRORJLVWDV
VRPHQWHHPFDVRVHVSHFtFRV
Renato:'HURWLQDFDUGLRORJLDSQHXPRORJLDDQHV-
WHVLDRGRQWRORJLDVHUYLoRVRFLDOSVLFRORJLDHQXWUL-
omR
Huygens: 1HQKXPD DYDOLDomR p URWLQHLUD H[FHWR
DYDOLDomRJLQHFROyJLFD([LVWHXPSURWRFRORHPTXH
H[DPHVHVSHFtFRVFRPRHVSLURPHWULDHFLQWLORJUDD
PLRFiUGLFD VmR UHDOL]DGRV 3RU H[HPSOR SDFLHQWHV
GLDEpWLFRVFRPPDLVGHDQRVVmRVXEPHWLGRVj
FLQWLORJUDD PLRFiUGLFD &DVR KDMD DQRUPDOLGDGHV
RFDUGLRORJLVWDpFRQVXOWDGR1mRKiDPEXODWyULRV
HVSHFtFRV
Ilka: $YDOLDomR FDUGLROyJLFD HUD URWLQD DJRUD
DSHQDVVHKRXYHUDOWHUDomRQRHFRFiUGLR'HURWLQD
DYDOLDomRSVLFRVVRFLDO
pFRPXQLFDGR"&RPRpWRPDGDDGHFLVmRGH
prosseguir ou no com o transplante?
WUDQVSODQWHHPVHXJUXSR"&RVWXPDPLQGLFDU
cirurgia baritrica pr-transplante?
Carneiro:3DUDQyVDDYDOLDomRFDUGLROyJLFDpREUL-
JDWyULD WHPRV XP FDUGLRORJLVWD [R QR JUXSR
4XDQGRKiWHPSRKiELORSDFLHQWHSDVVDSRUDYD-
OLDo}HV QD 8URORJLD RX *LQHFRORJLD 2GRQWRORJLD
2IWDOPRORJLD3VLFRORJLDH1XWULomR
Carneiro:8PGRVFLUXUJL}HVVHQLRUHVVHPSUHHVWi
FRPRWHOHIRQHTXHUHFHEHDVOLJDo}HVGD&HQWUDO(OH
FKHFD R UHFHSWRU FRP D (QIHUPHLUD &RRUGHQDGRUD
(PFDVRVGXYLGRVRVRXWURVPHPEURVGRJUXSRVmR
FRQVXOWDGRV
Ilka: $IDOWDGHSHVVRDO1mRFRQVLJRPDLVFLUXUJL}HV
SDUDDXPHQWDUDHTXLSH
Agnaldo: 2SUREOHPDFHQWUDOpDUHPXQHUDomRWDO
FRPRpSUDWLFDGDQRKRVSLWDOXQLYHUVLWiULR
Agnaldo:6LPDFHLWDPRV-DPDLVLQGLFDPRVEDULi-
WULFDSUp7[+
Ilka:2FLUXUJLmRUHVROYHHRFOtQLFRGiDSDODYUD-
QDODSyVH[DPHPLQXFLRVR
Ilka:2TXHUHVROYHpDHVWUXWXUDIDPLOLDUDGHTXDGD
Carneiro: $FRORFDomRHPOLVWDGRVSDFLHQWHVpUHDOL-
zada pelos mdicos que o atenderam, desde que pre-
HQFKLGRVRVFULWpULRVGHQLGRVHPQRVVRVSURWRFRORV
2VFDVRVGXYLGRVRVYmRSDUDXPDUHXQLmRVHPDQDO
PXOWLGLVFLSOLQDU
Boletim SBH:4XHPpWRRVLFNWRWUDQVSODQW
em seu grupo?
Ilka:6RPHQWHDTXHOHVREHVRVFRP,0&!HVWH-
DWRVH!LVTXHPLDDIULR!KRUDVRXSDUDGD
FDUGLRUUHVSLUDWyULD!PLQXWRV
Carneiro:&DGDFDVRpDYDOLDGRLQGLYLGXDOPHQWHH
VmRGLVFXWLGRVQDVUHXQL}HVPXOWLGLVFLSOLQDUHVSDUD
WRPDUXPDGHFLVmRGHJUXSR
Huygens:3DFLHQWHVFRPDOWDVGRVHVGHYDVRSUHVVR-
res, spticos, ou portadores de cardiopatias e pneu-
PRSDWLDVGHVFRPSHQVDGDV
Renato:)D]HPRVGHWXGRSDUDHYLWDUWUDQVSODQWH
I~WLO3DFLHQWHVVpSWLFRVHFRPLPSRUWDQWHLQVWDELOL-
dade hemodinmica e os casos de hepatite fulminante
TXHFKHJDPWDUGHGHPDLVHQWUDPQDFDWHJRULD
Ilka:7RRVLFNWRWUDQVSODQWVmRRVPpGLFRVeFDGD
caso complicado que aceitamos! Nos casos fulminan-
WHVQmRWUDQVSODQWDPRVFRPQRUDGUHQDOLQDDFLPDGH
NJLQIHFWDGRVFRPOHVmRFHUHEUDOJUDYHRXDFLPD
GHDQRV
Renato:$GHFLVmRpWRPDGDSRUTXHPHVWiFRPR
WHOHIRQHGDXQLGDGH6HRGRDGRUpVXEyWLPRKiQH-
FHVVLGDGHGHFRQIHUrQFLD
Renato: $SULQFtSLRVHRSDFLHQWHQmRPRUUHXGR
fgado, o fgado bom! Basicamente 2 fatores nos
ID]UHFXVDUXPItJDGRVHSVHHHVWHDWRVH!2
0(/'TXHIRLXPDYDQoRWDOYH]WHQKDQRVWUD]LGR
XPFRPSOLFDGRUDFHUWH]DGHTXHYDLFKHJDUXP
ItJDGRPHOKRU$VVLPPXLWRVyUJmRVVmRGHVSHUGLoD-
GRVHWDQWRVSDFLHQWHVPRUUHPHPOLVWD
Agnaldo: QmRWHPRVXPDUHJUDQmRHVWDEHOHFHPRV
OLPLWHVSRUYDORUGH0(/'
Huygens:(YLWDPRVWUDQVSODQWDUFRP,0&!
PDVQXQFDLQGLFDPRVEDULiWULFD
Huygens: 1mRUHVROYHPDVVHJXLPRVDUHJUD
Carneiro:6HPRSomRPHOKRUQRPRPHQWRVHJXL-
PRV
Agnaldo: 2WDPDQKRGH0LQDVGLFXOWDDLGHQWL-
FDomRGHGRDGRUHVHDFRQUPDomRGHPRUWHHQFH-
IiOLFDPRWLYRSDUDRVWtPLGRVtQGLFHVGHFDSWDomRGH
ItJDGRQRHVWDGR2%UDVLOFRPRXPWRGRSUHFLVD
DXPHQWDUDFDSWDomRWHPRVHVWDGRVFDSWDQGRHPWD-
[DVHXURSHLDVHRXWURVSUDWLFDPHQWHVHPDWLYLGDGH
Boletim SBH | 7
o
c
i
d
M
o
Ensin
o superespecialista
e o sistema de sade
brasileiro.
0DULD+HOHQD,WDTXL/RSHV56
8 | Boletim SBH
FXODUHVGR0(&GHJUDGXDQGR
mdicos com formao integral ca-
SD]HV GH WUDEDOKDU HIHWLYDPHQWH QR
nvel de ateno primria de sade.
Ainda para este nvel existem opor-
tunidades de especializao em pro-
JUDPDV GH 5HVLGrQFLD HP 6D~GH GD
)DPtOLD ( SDUD RV GHPDLV QtYHLV Ki
necessidade da formao em progra-
PDVGH5HVLGrQFLD(VSHFLDOL]Do}HVH
reas de Atuao (conforme termi-
nologia da Associao Mdica Brasi-
leira) diversas.
O nmero de mdicos em ativida-
GH QR %UDVLO FKHJRX D HP
RXWXEUR GH VHJXQGR UHJLVWURV
GR &RQVHOKR )HGHUDO GH 0HGLFLQD
&)0 6DEHVH GR LPSRUWDQWH SUR-
EOHPD UHODWLYR j GLVWULEXLomR GHVVHV
PpGLFRV QR WHUULWyULR QDFLRQDO EHP
como da falta de uma poltica estabe-
OHFLGDSDUDHVWHP2PHVPRRFRUUH
QD HVFROKD GDV HVSHFLDOLGDGHV GLIH-
rentemente de alguns pases em que
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Boas formas de comear o ano.
Tudo funcionou bem: de aulas a dis-
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des para discutir tpicos mais espec-
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met sobre pratos de vidro artesanal.
18 | Boletim SBH
Boletim SBH | 19
CONGRESSOS MDICOS
NO BRASIL
Organizar um encontro mdico, seja ele um grande
congresso ou um pequeno encontro fechado, traz sempre
alguma cefaleia e muitos desafios. O que no me mata,
me fortalece!, j disse Nietzsche, e se ele organizasse
encontros talvez repetisse essa frase como a um mantra.
Organizar significa administrar conflitos: a sociedade
quer consistncia cientfica, mas tambm lucros, os
congressistas, bom programa, salas confortveis e
inscrio acessvel, muitos dos convidados internacionais
s viajam de executiva, alguns no dispensam o fee, a
grade cientfica precisa acomodar os muitos egos, e a
indstria quer participar, mas segurar o patrocnio, fingindo
desinteresse. Os hotis, cada vez mais caros e sem
muitas concesses, e os centros de eventos, ento... Sim,
os desafios so muitos. Mas o Brasil est na moda, o
que se ouve no exterior. O que isto tem feito com nosso
mercado de eventos mdicos?
O Boletim SBH foi atrs, conferir o que vem acontecendo
neste meio com uma das principais empresas do setor,
a CCM Worldwide, responsvel por vrios grandes
congressos em Gastro-Hepatologia e Endoscopia
Digestiva, como a SBAD e que vai organizar o prximo
Pan-Americano de Gastroenterologia, em Buenos Aires.
Seus diretores, Eduardo Corra da Silva e Alessandro
Alex Irigoyen da Costa matam a curiosidade do Boletim.
20 | Boletim SBH
Boletim SBH | 21
| Seo Zona 3 |
Evento
Local
22 e 23/03
Luso-brasileiro de Hepatologia
Porto Alegre, RS
03 a 05/05
Workshop Brasil-Inglaterra
Fernando de Noronha, PE
21 e 22/06
Hepatoaids
So Paulo, SP
27 a 29/06
Goinia, GO
10 a 12/07
Hepatologia do Milnio
Salvador, BA
04 a 07/08
Gramado, RS
29 a 31/08
FITx
So Paulo, SP
02 a 05/10
Rio de Janeiro, RJ
22 | Boletim SBH
Boletim SBH | 23
SUPERIORIDADE EVIDENCIADA ,
CURA COMPROVADA .
1
PREPARE-SE PARA A
EVOLUO
REFERNCIAS: 1 - Awad T, Thorlund K, Hauser G, Stimac D, Mabrouk M, Gluud C. Peginterferon alpha-2a is associated with higher sustained virological response than peginterferon alfa-2b in chronic hepatitis C: systematic review of randomized trials. Hepatology
2010;51(4):1176-84. 2 - Swain MG, Lai MY, Shiffman ML. A sustained virologic response is durable in patients with chronic hepatitis C treated with peginterferon alfa-2a and ribavirin. Gastroenterology 2010;139:15931601. 3 - Zeuzem S. Interferon-based therapy
for chronic hepatitis C: current and future perspectives. Nature Clinical Practice Gastroenterology & Hepatology 2008;5(11):610-22.