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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.

CIR - Artigos

Mostrando recursos 1 - 20 de 30

  1. Abdominal tuberculosis: an old disease surprising young doctors.

    Sousa, M; Batista, J; Pacheco, P; Nunes, V
    Tuberculosis remains a worldwide public health concern. Atypical extrapulmonary presentations may delay the diagnosis and treatment. We present the case of an adult woman admitted to the emergency department with bowel obstruction. The putative intraoperative diagnostic hypothesis was ovarian cancer with peritoneal dissemination. Histopathological analysis showed a chronic granulomatous inflammatory disease with acid-fast bacilli. The patient was started on an alternative parenteral antituberculosis drug combination until oral feeding was available. Currently, 5 months after surgery, she is asymptomatic. Abdominal tuberculosis is the most frequent extrapulmonary site with a wide range of clinical presentations. Emergency laparotomy may be necessary in patients who...

  2. Retalho V-Y bilateral para reconstrução do períneo após amputação abdomino-perineal extraelevadora

    Rocha, R; Carneiro, C; João, A; Soares, A; Aparício, D; Fragoso, M; Marinho, R; Sousa, M; Leichsenring, C; Geraldes, V; Nunes, V
    A descrição da amputação abdominoperineal extraelevadora (ELAPE) para a ressecção de tumores do recto baixo ou da margem anal, a subsequente estandardização do tempo perineal e a definição das suas indicações precisas, veio colocar enfâse particular na necessidade de recorrer a técnicas de reconstrução do períneo para encerramento dos defeitos perineais provocados por ressecções mais alargadas. Apresentamos um caso de ELAPE por carcinoma pavimento-celular (CPC) da margem do ânus com necessidade de reconstrução do períneo com retalho miocutâneo V-Y bilateral e revemos a literatura quanto às opções existentes e respetivas vantagens, desvantagens e evidência existente.

  3. Excisão completa do mesocólon – revisão da literatura

    Carneiro, C; Rocha, R; Marinho, R; Gomes, A; Leichsenring, C; Geraldes, V; Nunes, V
    Desde a descrição da Excisão Total do Mesorreto (TME), a taxa de recidiva local da neoplasia do recto desceu de 20 a 40% para cerca de 10%(1,2). É neste contexto, que Hohenberger descreve em 2008 a Excisão Completa do Mesocólon (Complete Mesocolic Excision, CME)(3). Trata-se de uma técnica cirúrgica mais radical, tendo como base teórica e conceptual os mesmos princípios descritos por Heald para a TME. Com a CME estão descritas taxa de recidiva locorregional de 3,6% e sobrevida global aos 5 anos de 89%, resultados substancialmente melhores que os relatados na literatura utilizando a técnica convencional. Foi efetuada uma revisão da literatura com o...

  4. Impact of bowel resection margins in node negative colon cancer.

    Rocha, R; Marinho, R; Aparício, D; Fragoso, M; Sousa, M; Gomes, A; Leichsenring, C; Carneiro, C; Geraldes, V; Nunes, V
    Surgical intestinal resection margins in colon cancer are a longstanding debate in terms the optimal distance between the tumor and the colonic section line. The aim of this study is to define the oncological outcomes in relation to surgical margins, measured in terms or recurrence rate, time-to-recurrence, disease-free survival and overall survival in a population of node negative colon cancer patients. METHODS: We conducted a retrospective observational longitudinal single institution study. All patients submitted to colon cancer surgery between January 2006 and December 2010 were analyzed. Only node negative patients were included in the study, with analysis of 215 patient charts, divided...

  5. 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...

  6. 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...

  7. Oncological outcomes of colonic stents as “bridge to surgery” versus emergency surgery for obstructive colorectal cancer: A portuguese comparative study

    Lourenço, L; Sousa, M; Oliveira, AM; Gomes, A; Rodrigues, C; Santos, I; Horta, D; Pignatelli, N; Nunes, V; Reis, J
    Prémio Medtronic Investigação em Coloproctologia 2015, no XXV Congresso Nacional de Coloproctologia, que decorreu nos dias 26 e 27 de Novembro de 2015, no Porto.

  8. Colheita de córneas no Hospital Fernando Fonseca: o potencial e a realidade

    Gomes, A; Fernandes, A; Batista, A; Fernandes, AP
    Introdução: A disponibilidade de córneas para transplante continua a ser um fator limitante na resposta terapêutica a muitos doentes com patologia de córnea. A operacionalização do programa de colheita e transplante de córneas no Hospital Prof. Doutor Fernando Fonseca, EPE (HFF) teve início em 2012 e desde então tem sido preocupação do núcleo de Coordenação Hospitalar de Doação (NCHD) a otimização do número de colheitas respeitando os padrões de qualidade definidos pela legislação. Metodologia: Os autores apresentam uma análise retrospetiva de todos os óbitos ocorridos no HFF no ano de 2014, aplicando os critérios de seleção demográficos e clínicos bem...

  9. Management of brain-dead donors outside the intensive care unit: a necessary recourse

    Gomes, A; Rocha, R; Fernandes, A; Fernandes, AP

  10. An ontogenetic approach to gynecologic malignancies

    Santiago, I; Gomes, A; Heald, R
    Ontogenetic anatomy is the mapping of body compartments established during early embryologic development, particularly well demarcated in the adult pelvis. Traditional cancer surgery is based on wide tumour excision with a safe margin, whereas the ontogenetic theory of local tumour spread claims that local dissemination is facilitated in the ontogenetic compartment of origin, but suppressed at its borders in the early stages of cancer development. Optimal local control of cancer is achieved by whole compartment resection with intact margins following ontogenetic "planes". The principles embodied in this hypothesis are most convincingly supported by the results of the implementation of total...

  11. Spontaneous Rupture of Pancreatic Pseudocyst: Report of Two Cases.

    Rocha, R; Marinho, R; Gomes, A; Sousa, M; Pignatelli, N; Carneiro, C; Nunes, V
    Introduction. Pancreatic pseudocysts are a common complication of acute pancreatitis. Pancreatic pseudocyst's natural history ranges between its spontaneous regression and the settlement of serious complications if untreated, such as splenic complications, hemorrhage, infection, biliary complications, portal hypertension, and rupture. The rupture of a pancreatic pseudocyst to the peritoneal cavity is a dangerous complication leading to severe peritonitis and septic conditions. It requires emergent surgical exploration that is often of great technical difficulty and with important morbidity and mortality. Case Study. We present two cases of spontaneous rupture of pancreatic pseudocysts, managed differently according to the local and systemic conditions. Conclusion....

  12. Massive gastrointestinal bleeding after chemotherapy for gastric lymphoma

    Sousa, M; Gomes, A; Pignatelli, N; Nunes, V
    INTRODUCTION: Gastrosplenic fistula (GSF) is a rare condition almost always associated with lymphoma, with gastric and splenic involvement. CASE REPORT: We report a 52 year old male with gastric lymphoma admitted to the emergency department with hematemesis. The first chemotherapy cycle had been completed four weeks before. Oesophagoduodenoscopy showed a pulsatile ulcerated lesion. Surgical hemostasis was performed. Four days after surgery, the patient initiated sudden and massive upper gastrointestinal bleeding with hemodynamic compromise. A gastrosplenic fistula was recognized during emergency laparotomy and an en bloc total gastrectomy and splenopancreatectomy resection was performed, with massive blood transfusion. Patient was discharged 13 days after the...

  13. 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...

  14. 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...

  15. Imaging Screening of Catastrophic Neurological Events Using a Software Tool: Preliminary Results

    Fernandes, AP; Gomes, A; Veiga, J; Ermida, D; Vardasca, T
    BACKGROUND: In Portugal, as in most countries, the most frequent organ donors are brain-dead donors. To answer the increasing need for transplants, donation programs have been implemented. The goal is to recognize virtually all the possible and potential brain-dead donors admitted to hospitals. The aim of this work was to describe preliminary results of a software application designed to identify devastating neurological injury victims who may progress to brain death and can be possible organ donors. METHODS: This was an observational, longitudinal study with retrospective data collection. The software application is an automatic algorithm based on natural language processing for selected keywords/expressions present...

  16. Colorectal surgical mortality and morbidity in elderly patients: comparison of POSSUM, P-POSSUM, CR-POSSUM, and CR-BHOM

    Gomes, A; Rocha, R; Marinho, R; Sousa, M; Pignatelli, N; Carneiro, C; Nunes, V
    PURPOSE: This study aims to compare the predictive value of POSSUM, P-POSSUM, CR-POSSUM and CR-BHOM in colorectal surgical mortality and morbidity in patients over 80 years old. METHODS: This is a retrospective observational longitudinal study. A total of 991 patients who underwent major colorectal surgery between 2008 and 2012 in a secondary hospital in Portugal were screened, and 204 who were over 80 years old were included. Subgroup analysis was performed for malignant/benign disease and emergent/elective surgery. The main outcome measure was 30-day postoperative mortality and morbidity with Clavien-Dindo classification ≥ 2. RESULTS: Of the 204 patients included in this study, 155 had malignant disease,...

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

    Gomes, A; Santos, V; Dias, G; Manso, R; 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. 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...

  19. Metastização atípica de adenocarcinoma mucinoso do cólon

    Tomás, R; Aleixo, I; Martins, C; Dias, W; Nunes, V
    Doente do sexo masculino, de 70 anos de idade, com diagnóstico de neoplasia do cego foi submetido a hemicolectomia direita em 2002. A histologia da peça operatória revelou adenocarcinoma bem diferenciado do cego com componente mucinoso (estádio C de Dukes, pT 3 pN 1 pM x G 1 , margens cirúrgicas sem tecido neoplásico). Posteriormente foi submetido a quimioterapia adjuvante. Em Janeiro de 2007 o paciente foi submetido a cura cirúrgica de hidrocelo, tendo sido identificada intra-operatoriamente uma massa testicular volu- mosa de consistência dura, o que determinou a realização de orquidectomia direita. A histologia da peça operatória revelou tratar-se de...

  20. Ferida crónica em pé diabético: abordagem multidisciplinar

    Honório, M; Matos, S

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