Martins, I; Conceição, MG; Gomes, PP; Clode, N
A pregnancy complicated by typical hemolytic uremic syndrome (HUS) and hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome is reported. At 20 weeks of gestation, a case of HUS was diagnosed, with Shiga toxin-producing Escherichia coli identified. Plasmapheresis allowed continuation of the pregnancy for 5 weeks. Superimposed preeclampsia and HELLP syndrome were diagnosed after the establishment of nephrotic range proteinuria, hypertension and recurrence of hemolysis. This is a singular case, as it demonstrates that HELLP syndrome can superimpose upon HUS, a fact that can impact future research on reproductive immunology. It also reminds clinicians that the overlapping of clinical and...
Pereira Nunes, D; Tinoco, C; Oliveira E Carmo, D; Paço, J
The nasal dorsum framework plays a major role in nasal and facial harmony. This study presents a new approach to an already known technique, intermediate osteotomies, which can be used routinely in patients with cosmetically unpleasant changes in eyebrow-tip line features, allowing the acquisition of a natural, aesthetically agreeable and harmonious dorsum contour, while preserving nasal function. The approach was evaluated retrospectively in 50 consecutive patients at a tertiary referral hospital. Patients were asked to complete a survey to rate their satisfaction with the cosmetic outcome on a 5-point visual analog scale (VAS) and to compare the impact of nasal...
Caroça, C; Vicente, V; Campelo, P; Chasqueira, M; Caria, H; Silva, S; Paixão, P; Paço, J
Rubella infection can affect several organs and cause birth defects that are responsible for congenital rubella syndrome (CRS). Congenital hearing loss is the most common symptom of this syndrome, occurring in approximately 60% of CRS cases. Worldwide, over 100 000 babies are born with CRS every year. There is no specific treatment for rubella, but the disease is preventable by vaccination. Since 1969, the rubella vaccine has been implemented in many countries, but in Africa, only a few countries routinely immunize against rubella. The aim of this study was to estimate the rate of infection from the wild-type rubella virus...
Nunes, C; Pereira, AM; Morais-Almeida, M
In recent decades, both asthma prevalence and incidence have been increasing worldwide, not only due to the genetic background, but mainly because of the effect of a wide number of environmental and lifestyle risk factors. In many countries noncommunicable diseases, like asthma, are not yet considered a healthcare priority. This review will analyze and discuss disparities in asthma management in several countries and regions, such as access to healthcare human resources and medications, due to limited financial capacity to develop strategies to control and prevent this chronic disease. This review tries to explore the social and economic burden of asthma...
Pinheiro, R; Oliveira, A; Mendes-Bastos, P
Araújo, D; Padrão, E; Morais-Almeida, M; Cardoso, J; Pavão, F; Leite, R B; Caldas, A C; Marques, A
Phenotypic overlap between the two main chronic airway pulmonary diseases, asthma and chronic obstructive pulmonary disease (COPD), has been the subject of debate for decades, and recently the nomenclature of asthma-COPD overlap syndrome (ACOS) was adopted for this condition. The definition of this entity in the literature is, however, very heterogeneous, it is therefore important to define how it applies to Portugal.
Tabernero, J; Vyas, M; Giuliani, R; Arnold, D; Cardoso, F; Casali, PG; Cervantes, A; Eggermont, AM; Eniu, A; Jassem, J; Pentheroudakis, G; Peters, S; Rauh, S; Zielinski, CC; Stahel, RA; Voest, E; Douillard, JY; McGregor, K; Ciardiello, F
systems. If suitably developed clinically, manufactured to the correct standards and used appropriately, they can positively impact on the financial sustainability of healthcare systems. A critical consideration regarding the introduction of biosimilars into the clinic centres on the required information concerning all the respective procedures. This position paper aims to describe the issues revolving around biosimilars that are relevant to the field of oncology, especially the prescribers. More specifically, we discuss aspects related to definition, forms of biosimilars, labelling, extrapolation, interchangeability, switching, automatic substitution, clinical standards on safety and efficacy, responsibilities among prescribers and pharmacists, potential impact on financial burden...
Beets, G; Sebag-Montefiore, D; Andritsch, E; Arnold, D; Beishon, M; Crul, M; Dekker, JW; Delgado-Bolton, R; Fléjou, JF; Grisold, W; Henning, G; Laghi, A; Lovey, J; Negrouk, A; Pereira, P; Roca, P; Saarto, T; Seufferlein, T; Taylor, C; Ugolini, G; Velde, C; Herck, B; Yared, W; Costa, A; Naredi, P
ECCO essential requirements for quality cancer care (ERQCC) are checklists and explanations of organisation and actions that are necessary to give high-quality care to patients who have a specific tumour type. They are written by European experts representing all disciplines involved in cancer care.
ERQCC papers give oncology teams, patients, policymakers and managers an overview of the elements needed in any healthcare system to provide high quality of care throughout the patient journey. References are made to clinical guidelines and other resources where appropriate, and the focus is on care in Europe.
Colorectal cancer: essential requirements for quality care
Colorectal cancer (CRC) is...
Kanellakis, NI; Jacinto, T; Psallidas, I
Landmark studies on genetic alterations underlying NSCLC have led to tailored therapies http://ow.ly/4nq0Ps.
Morais-Almeida, M; Pité, H; Pereira, AM; Ferreira-Magalhães, M; Fonseca, JA
Linhares, D; Neves, N; Ribeiro da Silva, M; Almeida Fonseca, J
Traumatic fractures of the thoracic and lumbar spine are common causes of spine surgery. Pedicle screw fixation is usually chosen, using monosegmentar, short or long segment instrumentations, with or without bone graft. This review aims to evaluate the effect of transpedicular fixation in traumatic fractures of the thoracic and lumbar spine. A systematic search on controlled, randomized or quasi-randomized trials comparing different methods of surgical treatment of this fractures was performed, followed by a process of article selection, data extraction and bias assessment by 3 independent authors. Eight articles were included in a total of 5 comparisons, between different transpedicular...
Horácio, AN; Silva-Costa, C; Lopes, JP; Ramirez, M; Melo-Cristino, J
Since 2010 the 13-valent pneumococcal conjugate vaccine (PCV13) replaced the 7-valent vaccine (PCV7) as the leading pneumococcal vaccine used in children through the private sector. Although, neither of the PCVs were used significantly in adults, changes in adult invasive pneumococcal disease (IPD) were expected due to herd protection. We characterized n = 1163 isolates recovered from IPD in adults in 2012-2014 with the goal of documenting possible changes in serotype prevalence and antimicrobial resistance. Among the 54 different serotypes detected, the most frequent, accounting for half of all IPD, were serotypes: 3 (14%), 8 (11%), 19A (7%), 22F (7%), 14...
Guedes, MC; Borrego, LM; Proença, RD
Th17 cells, a CD4+ T-cell subset, produce interleukin (IL)-17, a pro-inflammatory cytokine that has been shown to be involved in several forms of infectious and noninfectious uveitis. Here, we explore the roles of this IL in uveitic disorders as well as in experimental autoimmune uveitis, the possible pathogenic implications of several cytokines associated with IL-17 and analyze the current outcomes and goals for drugs aiming for the IL-17 pathway.
Sousa, J; Brandão, D; Barreto, P; Ferreira, J; Almeida Lopes, J; Mansilha, A
To evaluate the results of the abdominal aortic aneurism endovascular treatment (EVAR), percutaneously and with local anesthesia, according to the concept of one day surgery.
MATERIAL AND METHODS:
Unicentric, retrospective analysis of patients with aorto-iliac aneurysmal disease, consecutively treated by EVAR with percutaneous access trough the Preclose technique (pEVAR), according to the outpatient criteria, with one overnight stay in the hospital. The technical success, exclusion of the aneurysmal sac, endoleak, re-intervention and mortality were evaluated.
Twenty consecutive patients (all male; mean age 74.65 years) were treated by EVAR with percutaneous access and local anesthesia, from which 95% (19) presented with abdominal aortic aneurysm...
Haider, H; Fackrell, K; Kennedy, V; Hall, DA
Over 70 million people in Europe and >50 million people in the USA are reported to experience tinnitus (the sensation of noise in the absence of any corresponding sound source). Tinnitus is a multidimensional concept. Individual patients may report different profiles of tinnitus-related symptoms which may each require a tailored management approach and an appropriate measure of therapeutic benefit. This systematic review concerns the patient perspective and has the purpose to find what symptoms are reported by people who experience tinnitus and by their significant others.
METHODS AND ANALYSIS:
This protocol lays out the methodology to define what dimensions of tinnitus-related symptoms...
Torres, T; Ferreira, A; Ferreira, P; Henriques, M; Leite, L; Magina, S; Marques Pinto, G; Oliveira, H; Sousa Basto, A; Tavares Bello, R; Varela, P; Massa, A; Selores, M; Filipe, P
Caroça, C; Pereira de Lima, J; Campelo, P; Carolino, E; Caria, H; Paço, J; Nunes-Silva, S
Background: Hearing loss is a problem with higher incidence in South Asia, Asia Pacific and sub-Saharan
Africa. In these countries there is also associated history of anemia and malaria.
Objective: This study aims to identify a putative role of Beta globin mutation - sickle cell trait and HL in São Tomé
and Príncipe population.
Methods: A retrospective case-control study of a convenience sample was collected during Otolaryngologist
Humanitarian Missions in São Tomé and Príncipe. Control group includes individuals with normal hearing in both
ears, and the case group has participants presenting bilateral or unilateral HL. It was evaluated the potential risk
factors and sickle cell trait with...
Caroça, C; de Matos, TM; Ribeiro, D; Lourenço, V; Martins, T; Campelo, P; Fialho, G; Silva, SN; Paço, J; Caria, Helena
Hearing loss (HL) is a common condition with both genetic and environmental causes, and it greatly impacts global health. The prevalence of HL is reportedly higher in developing countries such as the Sub-Saharan African island of São Tomé and Príncipe, where the deaf community is estimated to be less than 1% of the population. We investigated the role of the DFNB1 locus (GJB2 and GJB6 genes) in the etiology of nonsyndromic sensorineural hearing loss (NSSHL) in São Tomé and Príncipe. A sample of 316 individuals, comprising 136 NSSHL patients (92 bilateral, 44 unilateral) and 180 controls, underwent a clinical and...
Amaral, L; Silva, D; Couto, M; Nunes, C; Rocha, SM; Coimbra, MA; Coimbra, A; Moreira, A
Stein, A; Schwenke, C; Folprecht, G; Arnold, D
The administration and intensity of bevacizumab-based maintenance therapy after induction treatment with bevacizumab is still a matter of debate. Thus, the present meta-analysis and an indirect comparison were performed to clarify these issues.
PATIENTS AND METHODS:
Trials evaluating a separately defined "maintenance phase," with randomization after the induction phase, were selected. Three trials of maintenance with bevacizumab with or without a fluoropyrimidine (CAIRO3, SAKK 41/06, and AIO KRK 0207) were analyzed regarding the effect on progression-free survival (PFS) and overall survival (OS) of any maintenance therapy compared with observation alone and different maintenance intensities (bevacizumab with or without fluoropyrimidine) compared with observation...