Browsing by Author "Rodrigues, A"
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- Abcesso hepático piogénico: 4 casos clínicosPublication . Ferreira, P; Oliveira, J; Leitão, S; Rodrigues, A; Alves, F; Simão, A; Almiro, E; Porto, A
- Adenocarcinoma do pâncreas localmente avançado e metastizado com resposta completa a quimioterapiaPublication . Freire, P; Coelho, AJ; Rodrigues, A; Silva, MR; Lapa, P; Graça, B; Porto, AOs autores apresentam o caso clínico de doente do sexo feminino, 54 anos, raça branca, que recorreu ao médico assistente por dor abdominal associada a manifestações constitucionais. A ecografia revelou massa pancreática e formações nodulares hepáticas compatíveis com lesões secundárias, resultado posteriormente corroborado por tomografia computorizada, que acrescentou critérios de irressecabilidade, nomeadamente invasão dos vasos mesen- téricos e do duodeno. A biopsia ecoguiada obteve material cujo estudo anatomopatológico revelou tratar-se de adeno- carcinoma do pâncreas. Iniciou quimioterapia, verifican- do-se melhoria clínica progressiva. A reavaliação imagio- lógica, após 7 ciclos de tratamento, não detectou a lesão primitiva nem as lesões secundárias, sugerindo resposta completa. Foi mantido esquema regular de quimioterapia, persistindo a remissão 8 meses após a documentação da resposta completa.
- Artropatia inflamatória como forma de apresentação de hepatite: um caso clínicoPublication . Garcia, R; Velez, J; Ferreira, P; Rodrigues, A; Reis, C; Porto, A
- Avaliação da sensibilidade médica para o risco de gravidez não planeadaPublication . Nobre-Ramos, V; Rodrigues, A; Sousa, S; Bombas, T; Moura, PABSTRACT: In Portugal, about 94% of sexually active women who don`t want to become pregnant, use a contraceptive method. From these, oral hormonal contraceptives are the most used. Despite this, unplanned pregnancies are a reality. The current study aimed to evaluate physicians’ sensibility to contraceptive counselling on the introduction of new therapies in women with underlying medical conditions and in polymedicated ones. It was a survey study with ten closed-ended questions. Physicians who care for women of reproductive age in a tertiary referral centre (n= 181). It was conducted an opinion survey among physicians who care for women of childbearing age. The differences in medical opinion considering age, sex, medical / surgical specialties and years of clinical practice were analyzed. In the introduction of new therapies, asked about the contraceptive method in use: always 16,6% (n=30) of respondents, nearly always 28,7% (n=52) and sometimes 44,8% (n=81). From these, 62% (n=101) neither provided complete information nor remitted to family planning appointments. When pregnancy was contraindicated 38,7% (n=70) informed about a safe method. About 89,5% (n=162) of the respondents didn't attended updates on contraception in the last year. Even though 64,6% (n= 117) considered it useful taking into account clinical practise. The respondents had poor knowledge about the resources in family planning, 79% (n=118). The female doctor showed a greater information about family planning topics (p=0,001). The younger physicians (<35 years old) and those with few years of clinical practise (<8 years) referred more constantly the importance of professional qualification on family planning (p=0,034; p=0,034). Despite the care of women in childbearing age the issues on drug interactions haven't been addressed constantly. There is evidence of a poor knowledge of the respondents of existing resources which limits an effective contraceptive counselling.
- BioRePortAP, an electronic clinical record coupled with a database: an example of its use in a single centrePublication . Campanilho-Marques, R; Polido-Pereira, J; Rodrigues, A; Ramos, F; Saavedra, MJ; Costa, M; Martins, F; Pereira da Silva, JA; Canhão, H; Fonseca, JEAIMS: To evaluate the efficacy and safety of the treatment of psoriatic arthritis (PsA) patients with tumor necrosis factor (TNF) antagonists in the Rheumatology Department of Hospital de Santa Maria using the BioRePortAP. METHODS: The Portuguese Society of Rheumatology (SPR) developed an electronic medical chart coupled with a database for the follow up of PsA patients, the BioRePortAP, which was launched in May 2009. This evaluation was based on all the PsA patients that were on active treatment with TNF antagonists in September 2009 and were registered in the BioRePortAP. All the previous data on these patients were introduced in BioRePortAP using the prospective paper based follow up protocol that this Department was using since 1999. Only patients with more than 9 months of treatment were analyzed. RESULTS: Forty-two patients with PsA, actively treated with anti-TNF agents in September 2009, for at least 9 months, were analyzed in BioRePortAP. Twenty-three patients were male (55%) and nineteen were female (45%). The average age of these patients was 49.8+/-10.9 years old, the average disease duration was of 10.7+/-5.6 years and the mean duration of biological therapy was of 37.8+/-27.8 months. For the 81% of patients with peripheral joint disease there was a mean reduction of more than 80% in the swollen and tender joint counts, and almost 50% in the health assessment questionnaire (HAQ) value. In the 19% of the patients with axial involvement the reduction of BASDAI and BASFI was not statistically significative. On top of that, PASI score suffered a reduction of 64%. Fourteen patients (33.3%) had to switch their TNF antagonist treatment. 58.8% of the switches were due to adverse effects and 41.2% due to therapy failure. Regarding the 56 adverse reactions registered, only one was a severe reaction. The remaining adverse reactions were not severe and 67% of them were due to infections. DISCUSSION: The results of this first report of the use of the BioRePortAP in clinical practice confirm the efficacy and safety of TNF antagonist treatment in PsA. The results shown here elucidate the potential applications of BioRePortAP as a tool for efficacy and safety assessment of PsA patients treated with biotechnological drugs.
- Esofagite eosinofílica com aspecto endoscópico peculiarPublication . Freire, P; Portela, F; Rodrigues, A; Silva, MR; Andrade, P; Gouveia, H; Leitão, M
- Espondilodiscite abcesso epidural: A propósito de dois casos clinicosPublication . Grebe, HP; Ferreira, P; Carmo, C; Rodrigues, A; Almiro, E; Porto, A
- Linfocintigrafia com dextrano 99mTc (PM=70 000)Publication . Branco, JR; Pedroso de Lima, J; Rodrigues, A; Rocha, D; Canha, N
- Multicenter survey on the use of device-assisted enteroscopy in PortugalPublication . Pinho, R; Mascarenhas-Saraiva, M; Mão-de-Ferro, S; Ferreira, S; Almeida, N; Figueiredo, P; Rodrigues, A; Cardoso, H; Marques, M; Rosa, B; Cotter, J; Vilas-Boas, G; Cardoso, C; Salgado, M; Marcos-Pinto, RBACKGROUND: Device-assisted enteroscopies (DAEs) are recent endoscopic techniques that enable direct endoscopic small-bowel evaluation. OBJECTIVE: The objective of this article is to evaluate the implementation of DAEs in Portugal and assess the main indications, diagnoses, diagnostic yield, therapeutic yield and complication rate. METHODS: We conducted a multicenter retrospective series using a national Web-based survey on behalf of the Portuguese Small-Bowel Study Group. Participants were asked to fill out two online databases regarding procedural data, indications, diagnoses, endoscopic therapy and complications using prospectively collected institutional data records. RESULTS: A total of eight centers were enrolled in the survey, corresponding to 1411 DAEs. The most frequent indications were obscure gastrointestinal bleeding (OGIB), inflammatory bowel disease and small-bowel tumors. The pooled diagnostic yield was 63%. A relation between the diagnostic yield and the indications was clear, with a diagnostic yield for OGIB of 69% (p = 0.02) with a 52% therapeutic yield. Complications occurred in 1.2%, with a major complication rate of 0.57%. Perforations occurred in four patients (0.28%). CONCLUSION: DAEs are safe and effective procedures, with complication rates of 1.2%, the most serious of which is perforation. Most procedures are performed in the setting of OGIB. Diagnostic and therapeutic yields are dependent on the indication, hence appropriate patient selection is crucial
- Neoplasia de localização primária desconhecidaPublication . Ferreira, P; Rodrigues, A; Sá, A; Nascimento-Costa, JM; Porto, A