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Repositório do Hospital Prof. Doutor Fernando Fonseca (3.798 recursos)

The Hospital Prof. Dr. Fernando Fonseca E.P.E. (HFF) institutional repository collects, preserves and disseminates the intellectual output of its professionals in digital format. Its aims are to increase the HFF’s investigation visibility and citation impact, to foster scientific communication and to preserve the HFF’s intellectual memory.

PATCLIN - Artigos

Mostrando recursos 1 - 18 de 18

  1. Performance evaluation of a new fourth-generation HIV combination antigen-antibody assay

    Mühlbacher, A; Schennach, H; van Helden, J; Hebell, T; Pantaleo, G; Bürgisser, P; Sousa, JG, et al.
    Education and diagnostic tests capable of early detection represent our most effective means of preventing transmission of human immunodeficiency virus (HIV). The importance of early detection is underlined by studies demonstrating increased life expectancy following early initiation of antiviral treatment. The Elecsys(®) HIV combi PT assay is a fourth-generation antigen-antibody combination assay developed to allow earlier detection of seroconversion, and to have increased sensitivity and improved specificity. We aimed to determine how early the assay could detect infection compared with existing assays; whether all HIV variants could be detected; and the assay's specificity using samples from blood donors, routine specimens,...

  2. International recommendations for the assessment of autoantibodies to cellular antigens referred to as anti-nuclear antibodies.

    Agmon-Levin, N; Agmon-Levin, J; Kallenberg, C; Sousa, MJ, et al.
    Anti-nuclear antibodies (ANA) are fundamental for the diagnosis of autoimmune diseases, and have been determined by indirect immunofluorescence assay (IIFA) for decades. As the demand for ANA testing increased, alternative techniques were developed challenging the classic IIFA. These alternative platforms differ in their antigen profiles, sensitivity and specificity, raising uncertainties regarding standardisation and interpretation of incongruent results. Therefore, an international group of experts has created recommendations for ANA testing by different methods. Two groups of experts participated in this initiative. The European autoimmunity standardization initiative representing 15 European countries and the International Union of Immunologic Societies/World Health Organization/Arthritis Foundation/Centers for...

  3. Tuberculosis diagnosis after bleach processing for early stage tuberculosis laboratory capacity building.

    David, S; Sutre, A; Sanca, A; Mané, A; Henriques, V; Portugal, C; Sancho, L; Cardoso, A; Paixão, E; Duarte, E; Leite, C; Salem, J; Antunes, A
    The diagnosis of tuberculosis is seriously hampered in the absence of standard biosafety laboratory facilities for specimen concentration and Mycobacterium tuberculosis culture. Within a laboratory twinning arrangement, heat-fixed direct smear and sediment from 74 bleach-processed and 20 non-processed specimens from Cumura Hospital, Guinea-Bissau, were sent to Lisbon for molecular evaluation of rifampicin resistance. Sequence analysis of a 369 base-pair rpoB locus detected 3.2% (3/94) resistant specimens. To our knowledge, this represents the first report on the molecular analysis of M. tuberculosis from bleach-processed sputum, an alternative to current diagnostic practice in low-resource settings.

  4. Molecular epidemiology of HIV type 1 infection in Portugal: high prevalence of non-B subtypes

    Esteves, A; Parreira, R; Venenno, T; Franco, M; Piedade, J; Sousa, JG; Canas-Ferreira, W
    In this study, we have investigated the diversity of current HIV-1 strains circulating in the metropolitan area of Lisbon, Portugal. A total of 217 HIV-1-positive blood samples, collected between October 1998 and December 2000, was genetically characterized in the gp120 C2V3C3 region (n = 205) or part of the gp41 N-terminal segment (n = 12) by heteroduplex mobility assay (HMA) and/or DNA sequencing. The HMA subtyping efficiency (number of samples unambiguously subtyped by HMA divided by the total number of samples subtyped) was 65.9% (143 of 217), with indeterminate migration patterns of subtype A and G strains contributing significantly to...

  5. Staphylococcus aureus reservoirs and transmission routes in a Portuguese Neonatal Intensive Care Unit: a 30-month surveillance study.

    Conceição, T; Sousa, M; Miragaia, M; Paulino, E; Barroso, R; Brito, MJ; Sardinha, T; Sancho, L; Carreiro, H; Sousa, JG; Machado, MC; Lencastre, H
    Although Staphylococcus aureus is a major cause of outbreaks in neonatal intensive care units (NICUs), there are no studies on the epidemiology of S. aureus isolates responsible for infection in Portuguese NICUs. Between July 2005 and December 2007, a total of 54 methicillin susceptible S. aureus (MSSA) isolates were recovered from 16 infected infants, parents, health care workers (HCWs), and the environment in a level III NICU. Isolates were characterized by pulsed-field gel electrophoresis (PFGE), spa typing, and multilocus sequence typing. Virulence determinants were detected by multiplex polymerase chain reaction. Three major MSSA clones were endemic in the NICU, representing...

  6. Spreading of HIV-1 subtype G and envB/gagG recombinant strains among injecting drug users in Lisbon, Portugal.

    Esteves, A; Parreira, R; Piedade, J; Venenno, T; Franco, M; Sousa, JG; Patrício, L; Brum, P; Costa, A; Canas-Ferreira, W
    We have evaluated the genetic diversity of HIV-1 strains infecting injecting drug users (IDUs) in Lisbon, Portugal. Heteroduplex mobility assay and/or phylogenetic analysis revealed that env (C2V3C3 or gp41) subtype B is present in 63.7% of the 135 viral samples studied, followed by subtypes G (23.7%), A (6.7%), F (5.2%), and D (0.7%). Similar analysis of gag (p24/p7) performed on 91 of the specimens demonstrated that 49.5% of the infections were caused by subtype G viruses; other gag subtypes identified were B (39.5%), F (3.3%), A and D (1.1.% each), and the recombinant circulating form CRF02_AG (5.5%). Discordant env/gag sub-types...

  7. Cystatin C as a marker of acute kidney injury in the emergency department

    Soto, K; Coelho, S; Rodrigues, B; Martins, H; Frade, F; Lopes, S; Cunha, L; Papoila, A; Devarajan, P
    BACKGROUND AND OBJECTIVES: The diagnosis of acute kidney injury (AKI) is usually based on changes in serum creatinine, which is a poor marker of early renal dysfunction. The discriminative and predictive abilities of serum and urinary cystatin C were examined for the prediction of AKI. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In this prospective cohort study, serum and urinary cystatin C were serially measured in a heterogeneous group of patients (n = 616) presenting to a tertiary care emergency department. The primary outcome was AKI, classified according to RIFLE and AKIN criteria. The secondary outcome was an adjudication based on clinical criteria...

  8. Implication of the RD(Rio)Mycobacterium tuberculosis sublineage in multidrug resistant tuberculosis in Portugal

    David, S; Duarte, E; Leite, C; Ribeiro, J; Maio, J; Paixão, E; Portugal, C; Sancho, L; Sousa, JG
    Multidrug and extensively drug resistant Mycobacterium tuberculosis are a threat to tuberculosis control programs. Genotyping methods, such as spoligotyping and MIRU-VNTR typing (Mycobacterial Interspersed Repetitive Units), are useful in monitoring potentially epidemic strains and estimating strain phylogenetic lineages and/or genotypic families. M. tuberculosis Latin American Mediterranean (LAM) family is a major worldwide contributor to tuberculosis (TB). LAM specific molecular markers, Ag85C(103) single nucleotide polymorphism (SNP) and RD(Rio) long-sequence polymorphism (LSP), were used to characterize spoligotype signatures from 859 patient isolates from Portugal. LAM strains were found responsible for 57.7% of all tuberculosis cases. Strains with the RD(Rio) deletion (referred to...

  9. Primary hyperparathyroidism with severe bone disease: osteitis fibrosa cystica vs. fibrous dysplasia. case report and review of the literature

    Leitão, MJ; Cuña, L; Pinheiro, N; Coelho, V; Oliveira, M; Araújo, JM
    Primary hyperparathyroidism _HPT. is associated with generalized skeletal changes, its full-blown osseous manifestations known as osteitis fibrosa cystica. Fibrous dysplasia _FD., a benign bone disorder, is differentiated from generalized fibrocystic disease caused by hyperparathyroidism. The classic triad of McCune–Albright syndrome includes polyostotic FD, patchy skin pigmentation, and sexual precocity. Other associated endocrinopathies are hyperthyroidism, Cushing’s syndrome, acromegaly, and HPT. We describe a patient with severe generalized and focal bone lesions and sexual precocity. HPT was diagnosed and treated with persistence of cystic bone lesions. The similarities between HPT and FD are discussed, focusing on a possible genetically determined mechanism to explain...

  10. Evaluation of liquid biphasic Granada medium and instant liquid biphasic Granada medium for group B streptococcus detection.

    Martinho, F; Prieto, E; Pinto, C; Castro, R; Morais, A; Salgado, L; Exposto, F
    INTRODUCTION: Group B streptococci (GBS) are transmitted from the mother to the newborn. Prevention of neonatal infection is achieved by intrapartum prophylaxis given to mothers colonized with GBS at 35 to 37 weeks of pregnancy. MATERIALS AND METHODS: Liquid biphasic Granada medium (LB) and instant liquid biphasic Granada medium (ILB) were evaluated for GBS detection. Vaginal swabs obtained from 300 women were inoculated onto LB or ILB, or onto Todd-Hewitt broth and analyzed with the ATB system (comparison method). RESULTS: Prevalence of GBS was 20% (61/300). LB and Todd-Hewitt with ATB detected GBS in 20% of women, and ILB in 19% of...

  11. Spoligtyping e polimorfismo do gene pncA: um cenário em duas etapas para o diagnóstico de mycobacterium bovis em Portugal

    David, S; Portugal, C; Antunes, A; Calado, A; Cardoso, A; Barros, V; Sancho, L; Sousa, JG
    The differential diagnosis of Mycobacterium bovis is important in the control of transmission to the human population and also for treatment since M. bovis is naturally resistant to pyrazinamide. Eleven clinical isolates from the Fernando Fonseca Hospital with Spoligotypes indicative of M. bovis, through the absence of spacers 39-43 but that also counted with the absence of spacer 38, were analyzed. For the identification of these strains, the phenotypic analysis of pyrazinamide resistance and study of the polymorphisms of the pncA and gyrB genes were carried out. The study of the pncA polymorphism revealed that the strains analyzed did not...

  12. Identificação molecular pelo método de Spoligotyping de estirpes do complexo Mycobacterium tuberculosis isoladas no Hospital Fernando Fonseca

    David, S; Portugal, C; Antunes, A; Cardoso, A; Calado, A; Barros, V; Sancho, L
    Spoligotyping was used in the genotyping of 219 isolates of the Mycobacterium tuberculosis complex, from patients of the Hospital Fernando Fonseca. This technique, based on PCR methodology, analyses a region of the chromosome specific of the Mycobacterium tuberculosis complex, the DR locus (Direct Repeat). With the aid of an international database, we showed that the predominant Spoligotypes belonged to the LAM family (Latino-American Mediterranean), 29.2 %. The LAM 9 family, with 12.3 %, left us attentive to the possible import of the disease through populations from South America, were it has been frequently identified. The genotypic families T1 and Haarlem,...

  13. Direct application of the INNO-LiPA Rif.TB line-probe assay for rapid identification of Mycobacterium tuberculosis complex strains and detection of rifampin resistance in 360 Mycobacterium tuberculosis complex strains and detection of rifampin resistance in 360 smear-positive respiratory specimens from an area of high incidence of multidrug-resistant tuberculosis

    Viveiros, M; Leandro, C; Rodrigues, L; Almeida, J; Bettencourt, R; Couto, I; Carrilho, L; Diogo, J; Fonseca, A; Lito, L; Lopes, J; Pacheco, T; Pessanha, M; Quirim, J; Sancho, L; Salfinger, M; Amaral, L
    The INNO-LiPA Rif.TB assay for the identification of Mycobacterium tuberculosis complex strains and the detection of rifampin (RIF) resistance has been evaluated with 360 smear-positive respiratory specimens from an area of high incidence of multidrug-resistant tuberculosis (MDR-TB). The sensitivity when compared to conventional identification/culture methods was 82.2%, and the specificity was 66.7%; the sensitivity and specificity were 100.0% and 96.9%, respectively, for the detection of RIF resistance. This assay has the potential to provide rapid information that is essential for the effective management of MDR-TB.

  14. High prevalence of ST121 in community-associated methicillin-susceptible Staphylococcus aureus lineages responsible for skin and soft tissue infections in Portuguese children

    Conceição, T; Aires-de-Sousa, M; Pona, N; Brito, MJ; Barradas, C; Coelho, R; Sardinha, T; Sancho, L; Sousa, JG; Machado, MC; Lencastre, H
    In order to evaluate the incidence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in Portugal, we analyzed a collection of 38 S. aureus isolates recovered from 30 children attending the pediatric emergency department of a central hospital in Lisbon due to skin and soft tissue infections. Molecular characterization identified seven clonal lineages among the 35 methicillin-susceptible S. aureus (MSSA) isolates, of which the major lineage PFGE A/t159/ST121 included 63% of the isolates. The three MRSA isolates belonged to the Pediatric clone PFGE D/t535/ST5-IV (n = 2) and to the European CA-MRSA clone PFGE G/t044/ST80-IVc (n = 1). All isolates harbored several virulence factors, namely, leukocidins....

  15. Contribution of spoligotyping to the characterization of the population structure of Mycobacterium tuberculosis isolates in Portugal

    David, S; Ribeiro, D; Antunes, A; Portugal, C; Sancho, L; Sousa, JG
    Tuberculosis is a major health problem in Portugal. To begin characterizing the population structure of Mycobacterium tuberculosis, spoligotyping was used for the systematic typing, through consecutive sampling, of patient isolates from the Amadora-Sintra area of Greater Lisbon. Distribution amongst major spoligotype families, including the Latin American Mediterranean (LAM), T, Haarlem and Beijing, was compared to that of the international spoligotype database SpolDB4 and to the European countries of traditional Portuguese immigration represented in SpolDB4. Spoligotypes from 665 isolates were analyzed and 97 shared international types (SITs) identified. In SpolDB4 Portugal is represented by part of the spoligotypes from this study explaining...

  16. Novos dados sobre os Spoligotypes de estirpes do complexo Mycobacterium tuberculosis isoladas no Hospital Fernando Fonseca (Amadora-Sintra, Portugal)

    David, S; Barros, V; Portugal, C; Antunes, A; Cardoso, A; Calado, A; Sancho, L; Sousa, JG
    O presente estudo populacional, que decorreu entre 1999 e 2003, foi baseado na utilização do Spoligotyping na genotipagem de 452 isolados do complexo Mycobacterium tuberculosis de doentes com tuberculose internados no Hospital Fernando Fonseca. Spoligotypes foram identificados como shared types (ST) recorrendo a uma base de dados internacional. Onze ST raros, não identificados na base de dados, acomodaram 8,4% dos isolados. Aliás, particular a Portugal poderá ser a predominância de ST identificados na base de dados mas não previamente classificados como famílias genotípicas, tais como o ST244, ST150 e ST389, representando 13,3 % do total. A identificação de isolados clínicos de M. africanum de...

  17. Prevalence of hepatitis E virus antibody in an non endemic population: prospective study

    Alberto, S; Pires, S; Félix, J; Figueiredo, A; Silva, L; Franco, M; Sousa, JG; Deus, JR

  18. Contribution of spoligotyping to the characterization of the population


    Tuberculosis is a major health problem in Portugal. To begin characterizing the population structure of Mycobacterium tuberculosis, spoligotyping was used for the systematic typing, through consecutive sampling, of patient isolates from the Amadora-Sintra area of Greater Lisbon. Distribution amongst major spoligotype families, including the Latin American Mediterranean (LAM), T, Haarlem and Beijing, was compared to that of the international spoligotype database SpolDB4 and to the European countries of traditional Portuguese immigration represented in SpolDB4. Spoligotypes from 665 isolates were analyzed and 97 shared international types (SITs) identified. In SpolDB4 Portugal is represented by part of the spoligotypes from this study explaining...

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