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Repositório do Hospital Prof. Doutor Fernando Fonseca (3.786 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.

ANPAT - Artigos

Mostrando recursos 1 - 20 de 30

  1. Severe Systemic Lupus Erythematosus presentation in patient with alternative complement pathway mutations

    Pereira, F; Cunha, L; Campos, P; Gaspar, A; Manso, RT; Soto, K
    Systemic lupus erythematosus (SLE) is an autoimmune disease which can involve almost any organ, making its difficult therapeutic approach. Immune complex deposition can often activate complement, accounting for many of SLE clinical manifestations and laboratory findings. We present a case of a patient who presented with acute pancreatitis and acute kidney injury as onset manifestations of SLE, later developing neurological manifestations, who was successfully treated with rituximab, plasma exchange and steroids as induction therapy. Persistently low C3 level led to a genetic analysis of the complement system components. We found three polymorphisms in the alternative pathway of complement regulators (complement factor H c2669 G>T, p.Ser890Ile and c3019...

  2. IgA nephropathy in a young adult with nephrotic syndrome: Case report

    Cassis, J; Sousa, H; Manso, RT; Ramos, S; Machado, D
    IgA nephropathy has many clinical presentations, of which nephrotic syndrome is possibly the rarest. Recently, the association of IgA nephropathy with minimal change disease was better described with patients having complete response to steroid therapy and no progression to CKD. We report a similar case in a young male presenting with nephrotic syndrome.

  3. Intracardiac leiomyomatosis presenting as an intraoperative consultation.

    Alves, AJ; Ferreira, MA; Gallego-Poveda, J; Matos, A; Costa-Silva, A; Nobre, A; Lopez-Beltran, A
    Intravenous leiomyomatosis (IVL) is an extremely rare variant of leiomyoma in which nodular masses of tumor grow within venous channels. Rarely, the tumor can reach the vena cava and right heart. We present a case of a 45-year-old woman, admitted with rapidly evolving exertional dyspnea. Cardiac ultrasonography revealed a "mass in the right chambers". She was submitted to right atriotomy plus tumorectomy, with intraoperative consultation requested. Grossly, the tumor was polypoid, firm, with a smooth surface. The frozen section showed a lesion composed of tortuous vessels and some areas with a fibrillar eosinophil extracellular matrix and others with spindle cells,...

  4. Causes of Death in an Acute Psychiatric Inpatient Unit of a Portuguese General Hospital

    Barbosa, S; Sequeira, M; Castro, S; Manso, R; Klut, C; Trancas, B; Santos, NB; Maia, T
    INTRODUCTION: Psychiatric patients are at increased risk of death from a number of natural and unnatural causes. This study examines the mortality causes of all psychiatric inpatients of an acute psychiatric unit at a general hospital in Portugal for sixteen years (1998 to 2013). MATERIAL AND METHODS: Twenty-one inpatients died at the inpatient unit between 1998 and 2013 (average 1.3 per year). A retrospective study through case-file review was carried to collect demographic characteristics, medical and psychiatry diagnosis. Patients transferred to other wards during their admission were not included. RESULTS: Circulatory system diseases were the most prevalent causes of death, occurring in 2/3 of patients...

  5. Causes of Death in an Acute Psychiatric Inpatient Unit of a Portuguese General Hospital

    Barbosa, S; Sequeira, M; Castro, S; Manso, RT; Klut, C; Trancas, B; Santos, NB; Maia, T
    INTRODUCTION: Psychiatric patients are at increased risk of death from a number of natural and unnatural causes. This study examines the mortality causes of all psychiatric inpatients of an acute psychiatric unit at a general hospital in Portugal for sixteen years (1998 to 2013). MATERIAL AND METHODS: Twenty-one inpatients died at the inpatient unit between 1998 and 2013 (average 1.3 per year). A retrospective study through case-file review was carried to collect demographic characteristics, medical and psychiatry diagnosis. Patients transferred to other wards during their admission were not included. RESULTS: Circulatory system diseases were the most prevalent causes of death, occurring in 2/3 of patients...

  6. Inflammatory Myofibroblastic Tumor of the Bladder: 2 Rare Cases Managed with Laparoscopic Partial Cystectomy

    Lopes, S; Furtado, A; Oliveira, R; Cebola, A; Graça, B; Coelho, M; Ferrito, F; Gomes, FC
    Two cases of inflammatory myofibroblastic tumor (IMT) of the bladder are reported here. Both patients were male and presented with macroscopic hematuria; in the first case terminal hematuria was associated with irritative voiding symptoms. The second case was a smoker with hematuria unresponsive to medical treatment and anemia. Clinical presentation, pathological features, treatment, and prognosis are discussed. Due to rarity of this pathological condition, there are no guidelines concerning treatment and follow-up. We present our follow-up scheme and highlight the use of laparoscopic partial cystectomy as a successful treatment approach.

  7. A Case Report of Nonvasculitic Autoimmune Inflammatory Meningoencephalitis with Sensory Ganglionopathy: A Rare Presentation of Sjögren Syndrome

    Peres, J; Cruz, S; Oliveira, R; Santos, L; Valverde, A
    A 68-year-old Caucasian female was admitted to the emergency department with a progressive history of behavioural symptoms and anxiety followed by visual and auditory hallucinations, forgetfulness, and impaired gait in the previous 3 months. On examination she was psychotic and had a postural and rest tremor of the upper limbs, cogwheel rigidity of the four limbs, retropulsion on standing position, and inability to walk. During the following 2 weeks she developed xerostomia and unilateral parotiditis that improved with steroids. A simultaneous improvement of the cognitive abilities allowed for the detection of sensory ataxia of the lower limbs. Sensory ganglionopathy was...

  8. Cytomorphological features of blastic plasmacytoid dendritic cell neoplasm on FNA and cerebrospinal fluid cytology: a review of 6 cases.

    Ferreira, J; Gasparinho, MG; Fonseca, R
    BACKGROUND: Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematopoietic tumor that was once believed to be derived from natural killer cells and is now recognized as originating from precursors of plasmacytoid dendritic cells. It generally involves the skin and has an aggressive clinical course. Due to its highly malignant behavior, a fast and accurate diagnosis of this condition is of the utmost importance. METHODS: Six cytology specimens from 5 patients diagnosed with BPDCN were reviewed as well as their clinical records. Findings were compared with 3 previously published cases. RESULTS: Two exfoliative cytology specimens (cerebrospinal fluid) and 4 fine-needle aspiration specimens (3 lymph...

  9. High-risk features in potentially resectable colon cancer: a prospective MDCT-pathology agreement study

    Santiago, I; Rodrigues, E; Germano, A; Costa, A; Manso, R; Gomes, A; Leichsenring, C; Geraldes, V
    Neoadjuvant chemotherapy in potentially resectable high-risk Stage II and Stage III colon cancer has demonstrated promising results in the PRODIGE 22-ECKINOXE Phase II trial. Identification of adverse morphologic features, namely T3 with >5 mm extramural extension/T4 stages and/or N2, is fundamental and requires accurate noninvasive imaging. Our aim was to assess the value of optimized preoperative MDCT to stratify potentially resectable colon cancer patients for neoadjuvant therapy. METHODS: this is an observational prospective cross-sectional radiologic-pathologic agreement study. All patients with colon cancer referred to our Institution's Radiology department for preoperative MDCT staging between 01-10-2013 and 11-02-2015 underwent independent reading based on axial...

  10. High-risk features in potentially resectable colon cancer: a prospective MDCT-pathology agreement study

    Santiago, I; Rodrigues, E; Germano, A; Costa, A; Manso, RT; Gomes, A; Leichsenring, C; Geraldes, V
    Neoadjuvant chemotherapy in potentially resectable high-risk Stage II and Stage III colon cancer has demonstrated promising results in the PRODIGE 22-ECKINOXE Phase II trial. Identification of adverse morphologic features, namely T3 with >5 mm extramural extension/T4 stages and/or N2, is fundamental and requires accurate noninvasive imaging. Our aim was to assess the value of optimized preoperative MDCT to stratify potentially resectable colon cancer patients for neoadjuvant therapy. METHODS: this is an observational prospective cross-sectional radiologic-pathologic agreement study. All patients with colon cancer referred to our Institution's Radiology department for preoperative MDCT staging between 01-10-2013 and 11-02-2015 underwent independent reading based on axial...

  11. Crise de retenção esplénica major num adulto com drepanocitose

    Paula, F; Amaral, M; Oliveira, Alves; Alves, J
    A crise de retenção esplénica é uma complicação, frequentemente, fatal da drepanocitose. É rara em adultos, pela elevada incidência de autoesplenectomia durante a infância. Heterozigóticos com traços de drepanocitose e de beta-talassémia têm fenótipos menos graves, podendo manter um baço funcional até à idade adulta. Descrevemos um caso de crise de retenção esplénica num homem de 19 anos, com concentração mínima de hemoglobina de 2,9g/dL, que resolveu após esplenectomia emergente. Os poucos casos descritos na literatura acarretam uma mortalidade elevada. Um diagnóstico rápido e actuação imediata são necessários para garantir a sobrevivência. É apresentada uma revisão da fisiopatologia e da...

  12. Saúde para todos – especialidades: cooperação em saúde com a República Democrática de São Tomé e Príncipe na área da anatomia patológica

    Gonçalves, L; Ferreira, M
    O programa “Saúde para Todos – Especialidades” é um programa de cooperação na área da saúde ancorado em São Tomé e Príncipe (STP), desenvolvido e sustentado pelo Instituto Marquês de Valle Flôr (IMVF) com o apoio principal da Cooperação Portuguesa (através do Camões – Instituto da Cooperação e da Língua) e da Fundação Calouste Gulbenkian e em parceria com o Ministério da Saúde da República Democrática de São Tomé e Príncipe.

  13. Tentativa de orquidectomia parcial: a propósito de um caso clínico

    Dores, J; Graça, B; Manso, R; Gomes, FC
    Introduc¸ão: Até ao fim dos anos 80 defendia-se que qualquer nódulo testicular suspeito devia ser excisado com orquidectomia radical. No entanto, com o aumento do diagnóstico incidental de massas testiculares, a maior acuidade dos exames extemporâneos e a evidência das vantagens potenciais da orquidectomia parcial, questionou-se se seria necessário sacrificar, sempre, todo o testículo, mesmo na presenc¸a de um testículo contralateral normal. Caso clínico: Apresentamos o caso de um doente de 23 anos, com o diagnóstico de um nódulo testicular com 7,5 mm, não palpável, assintomático e marcadores tumorais negativos. Foi submetido a orquidectomia parcial guiada por ecografia e exame extemporâneo, no entanto, por suspeita anatomopatológica de provável...

  14. Tentativa de orquidectomia parcial: a propósito de um caso clínico

    Dores, J; Graça, B; Manso, RT; Gomes, FC
    Introduc¸ão: Até ao fim dos anos 80 defendia-se que qualquer nódulo testicular suspeito devia ser excisado com orquidectomia radical. No entanto, com o aumento do diagnóstico incidental de massas testiculares, a maior acuidade dos exames extemporâneos e a evidência das vantagens potenciais da orquidectomia parcial, questionou-se se seria necessário sacrificar, sempre, todo o testículo, mesmo na presenc¸a de um testículo contralateral normal. Caso clínico: Apresentamos o caso de um doente de 23 anos, com o diagnóstico de um nódulo testicular com 7,5 mm, não palpável, assintomático e marcadores tumorais negativos. Foi submetido a orquidectomia parcial guiada por ecografia e exame extemporâneo, no entanto, por suspeita anatomopatológica de provável...

  15. Duodeno-colic fistula as a rare presentation of lung cancer - surgical treatment of a stage IV oligometastatic lung disease

    Nunes, V; Santiago, I; Marinho, R; Pires, D; Theias, R; Gomes, A; Pignatelli, N
    INTRODUCTION: Rare adenosquamous carcinomas have no defined standard approach given their low incidence. They present with nonspecific imaging characteristics and are described as having worse prognosis than other lung malignancies, with greater likelihood of local invasion and early metastasis. PRESENTATION OF CASE: Male caucasian patient, 43 years, 26 pack-year smoking history, presented with watery diarrhea, early emesis and loss of 25% body weight (20kg) in four weeks. Colonoscopy identified a left colonic mass. Abdominal CT/ultrasound showed a large fistulous lesion between the 4th portion of the duodenum and left colon. CT showed a solid mass in the right upper lung lobe. Endoscopy and...

  16. Duodeno-colic fistula as a rare presentation of lung cancer - surgical treatment of a stage IV oligometastatic lung disease

    Nunes, V; Santiago, I; Marinho, R; Pires, D; Manso, RT; Gomes, A; Pignatelli, N
    INTRODUCTION: Rare adenosquamous carcinomas have no defined standard approach given their low incidence. They present with nonspecific imaging characteristics and are described as having worse prognosis than other lung malignancies, with greater likelihood of local invasion and early metastasis. PRESENTATION OF CASE: Male caucasian patient, 43 years, 26 pack-year smoking history, presented with watery diarrhea, early emesis and loss of 25% body weight (20kg) in four weeks. Colonoscopy identified a left colonic mass. Abdominal CT/ultrasound showed a large fistulous lesion between the 4th portion of the duodenum and left colon. CT showed a solid mass in the right upper lung lobe. Endoscopy and...

  17. An 18-year-old woman with a 34-cm metaplastic breast carcinoma

    Gomes, A; Santos, V; Dias, G; Manso, RT; Gonçalves, L; Coiteiro, M; Gaspar, H; Nazaré, A
    Metaplastic breast carcinomas (MBCs) are rare malignancies usually with poor prognosis. We report a case of an 18-year-old African female patient who presented with a 34-cm tumor on the right breast. Biopsy showed an extensively necrotic MBC negative for estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 (triple negative). A modified right radical mastectomy was performed, followed by adjuvant chemotherapy. Histology confirmed a widely necrotic undifferentiated malignant tumor, with strong and diffuse expression of vimentin and B-cell lymphoma 2, focal high-molecular-weight keratins and focal CD34 expression; Ki67 was >90%. There was no skin, deep margin or lymph...

  18. Pseudomyxoma peritonei: a clinical case of this poorly understood condition

    Oliveira, AM; Rodrigues, C; Borges, A; Martins, A; Santos, S; Pires, F; Araújo, JM; Deus, JR
    BACKGROUND: Pseudomyxoma peritonei is an uncommon condition with an estimated incidence of one to two per million (worldwide) per year. It is characterized by the peritoneal deposition of mucinous tumors, most commonly of the appendix, and occasionally from the ovary, coupled by mucinous ascites. CASE PRESENTATION: We report the case of a 76-year-old woman who presented with increased abdominal girth and dyspnea for 2 weeks. She was diagnosed as a case of pseudomyxoma peritonei. She was submitted to right oophorectomy, omentectomy, and pseudomyxoma debulking. The histology was compatible with a mucinous tumor of colorectal/appendicular origin. Chemotherapy was not administered because of...

  19. p63 expression in normal skin and usual cutaneous carcinomas.

    Reis-Filho, J; Torio, B; Albergaria, A; Schmitt, F
    BACKGROUND: p63 is a p53 homologue that is mapped to chromosome 3q27. This gene encodes six different isoforms, which have either transactivating or dominant negative effects on p53-reporter genes. It has been described that in contrast to p53, p63 seems not to be associated with tumor predisposition, as neither p63 knockout mouse models nor germline p63 mutations are related to an increased risk of tumorigenesis. It has been demonstrated that p63 is a reliable keratinocyte stem cell marker and that it is involved in the maintenance of the stem cell population. Scant data on p63 expression in normal skin, basal...

  20. Maspin expression in normal skin and usual cutaneous carcinomas

    Reis-Filho, J; Torio, B; Albergaria, A; Schmitt, F
    Maspin is a serine protease inhibitor whose gene is located on 3q27. Several lines of evidence point towards its putative role as tumor suppressor gene and angiogenesis inhibitor; however, there are compelling data showing that maspin is also expressed in the nuclear compartment and might be associated with the differentiation of specific cell lineages. No systematic study of maspin expression in normal skin and usual skin carcinomas have been published so far. We semiquantitatively analyzed the distribution and immunoreactivity pattern of maspin in 14 squamous cell carcinomas (SCCs) and 16 basal cell carcinomas (BCCs) and in the adjacent normal epidermis...

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