Browsing by Author "Silva, C"
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- Abcesso hepático piogénico: a propósito de um caso clínicoPublication . Germano, E; Silva, C; Figueiredo, A; Sá, A
- Artropatia dos joelhos como manifestação inicial de neoplasia pulmonarPublication . Inês, L; Santos, MJ; Silva, C; Braña, A; Nour, D; Reis, P; Malcata, AB; Porto, AApresentamos o caso de uma doente de 46 anos que recorreu ao serviço de urgência por dor e tumefacção dos joelhos com 3 meses de evolução. Na subsequente observação em Reumatologia identificou--se a presença de baqueteamento digital nas mãos e pés (com cerca de 1 ano de evolução) e edema dos membros inferiores. As radiografias dos ossos longos demonstraram a presença de periostose. A investigação de causas de osteoartropatia hipertrófica secundária revelou a existência de uma neoplasia pulmonar volumosa, que não apresentou no exame clínico quaisquer manifestações respiratórias.
- Um Caso de Dor Contínua em Mulher JovemPublication . Barcelos, A; Silva, C; Reis, P; Malcata, AB; Porto, A
- Complications of ear mold impressions: two case reportsPublication . Silva, C; Amorim, AM; Gapo, C; Paiva, A
- Differential male and female adrenal cortical steroid hormone and cortisol responses to interleukin-6 in humansPublication . Silva, C; Inês, L; Nour, D; Straub, RH; Pereira da Silva, JAEvidence from experimental animal studies show that sex hormones influence the glucocorticoid response to a variety of inflammatory and noninflammatory stimuli. In this study we assessed gender differences in the response of ACTH and cortisol in normal young male and female humans following intravenous infusion of human IL-6 in various dosages. Males presented a significantly stronger ACTH production in response to IL-6 than females. Peak cortisol response, however, was similar in males and females. Cortisol/ACTH ratios were significantly higher in females than in males, both at baseline and after each of the IL-6 dosages. These results suggest that an effective glucocorticoid response requires similar levels of IL-6 in males and females. However, they also suggest that the adrenals of males and females have different sensitivities to ACTH (higher in females) and possibly also to direct IL-6 stimulation.
- Fasciíte Necrotizante e Lúpus Eritematoso SistémicoPublication . Barcelos, A; Silva, C; Pereira da Silva, JA; Malcata, AB
- Gitelman syndromePublication . Cotovio, P; Silva, C; Oliveira, N; Costa, FHypokalaemia is a common clinical disorder, the cause of which can usually be determined by the patient's clinical history. Gitelman syndrome is an inherited tubulopathy that must be considered in some settings of hypokalaemia. We present the case of a 60-year-old male patient referred to our nephrology department for persistent hypokalaemia. Clinical history was positive for symptoms of orthostatic hypotension and polyuria. There was no history of drugs consumption other than potassium supplements. Complementary evaluation revealed hypokalaemia (2.15 mmol/l), hypomagnesaemia (0.29 mmol/l), metabolic alkalosis (pH 7.535, bicarbonate 34.1 mmol/l), hypereninaemia (281.7 U/ml), increased chloride (160 mmol/l) and sodium (126 mmol/l) urinary excretion and reduced urinary calcium excretion (0.73 mmol/l). Renal function, remainder serum and urinary ionogram, and renal ultrasound were normal. A diagnosis of Gitelman syndrome was established. We reinforced oral supplementation with potassium chloride and magnesium sulfate. Serum potassium stabilised around 3 mmol/l. The aim of our article is to remind Gitelman syndrome in the differential diagnosis of persistent hypokalaemia
- Otologic Wegener's granulomatosisPublication . Mesquita-Oliveira, P; Silvestre, N; Silva, C; Romão, J
- Síndroma seco: da clínica ao diagnósticoPublication . Silva, C; Malcata, ABAs queixas secas (xerostomia e xeroftalmia) são comuns na prática clínica diária, quer da Reumatologia, quer da Medicina Familiar. A correcta avaliação das suas causas implica uma detalhada história clínica, associada ao exame objectivo cuidado, complementado depois, pelos exames auxiliares de diagnóstico. Os autores apresentam uma revisão do tema, tendo como objectivo uma avaliação sistemática das causas mais frequentemente encontradas em ambulatório.
- The Portuguese Society of Rheumatology position paper on the use of biosimilarsPublication . Fonseca, JE; Gonçalves, J; Araújo, F; Cordeiro, I; Teixeira, F; Canhão, H; Pereira da Silva, JA; Garcês, S; Miranda, LC; Ramiro, Sofia; Roxo, Ana; Pimentel-Santos, FM; Tavares, V; Neto, A; Sepriano, A; Malcata, A; Faustino, A; Silva, C; Ambrósio, C; Duarte, C; Miguel, C; Barcelos, F; Santos, H; Cunha, I; Ramos, JC; Melo-Gomes, JA; Pimentão, JB; Costa, L; Maurício, L; Silva, M; Bernardes, M; Bogas, M; Coelho, PC; Monteiro, P; Aguiar, R; André, R; Leitão, R; Pimenta, S; Meirinhos, T; Fernandes, S; Las, V; Castelão, WBiotechnological drugs have become a fundamental resource for the treatment of rheumatic patients. Patent expiry of some of these drugs created the opportunity for biopharmaceutical manufacturers to develop biosimilar drugs intended to be as efficacious as the originator product but with a lower cost to healthcare systems. Due to the complex manufacturing process and highly intricate structure of biologicals, a biosimilar can never be an exact copy of its reference product. Consequently, regulatory authorities issued strict preclinical and clinical guidelines to ensure safety and efficacy equivalence and, in September 2013, the biosimilar of infliximab was the first biosimilar monoclonal antibody to be authorized for use in the European Union. The current document is a position statement of the "Sociedade Portuguesa de Reumatologia" (Portuguese Society of Rheumatology) on the use of biosimilar drugs in rheumatic diseases. Two systematic literature reviews were performed, one concerning clinical trials and the other one concerning international position papers on biosimilars. The results were presented and discussed in a national meeting and a final position document was discussed, written and approved by Portuguese rheumatologists. Briefly, this position statement is contrary to automatic substitution of the originator by the biosimilar, defends either a different INN or the prescription by brand name, supports that switching between biosimilars and the originator molecule should be done after at least 6 months of treatment and based on the attending physician decision and after adequate patient information, recommends the registration of all biosimilar treated patients in Reuma.pt for efficacy, safety and immunogenicity surveillance, following the strategy already ongoing for originators, and opposes to extrapolation of indications approved to the originator to completely different diseases and/or age groups without adequate pre-clinical, safety or efficacy data.