Browsing by Author "Tomaz, J"
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- Pancreatite Hipertrigliceridémica: Tratamento Convencional Versus Troca Plasmática TerapêuticaPublication . Ferreira, DM; Lobo, F; Fonseca, JP; Mendes, PA; Aragão, A; Ferreira, M; Tomaz, J; Carvalho, AIntrodução:A pancreatite aguda (PA) por hipertrigliceridemia (HTG) pode ser tratada com troca plasmática terapêutica (TPT), com redução rápida dos valores de triglicerídeos. Contudo, não existem estudos comparativos definitivos que comprovem o real benefício desta terapêutica. Objetivo: Comparação dos métodos de tratamento (troca plasmática terapêutica versus convencional) em doentes com PA HTG, durante um período de 12 anos (2000-2012). Métodos: Estudo retrospetivo descritivo e inferencial de 37 doentes, avaliando: sexo, idade, antecedentes pessoais, gravidade, valores de TG e evolução consoante o tratamento (“TPT” ou terapêutica convencional “C”). Resultados: Os dois grupos TPT e C mostraram-se homogéneos quanto ao sexo (p = 0,647), idade (43,5 ± 9,74 anos TPT versus 45,30 ± 9,90 anos C; p = 0.320), pancreatite prévia (40% TPT vs 40,7% C; p = 1,0) alcoolismo crónico (50% TPT vs 70,4% C; p = 0,275) e gravidade pelo score de APACHE II (p = 0,054) e Ranson às 48 horas (p = 0,258). Dos doentes 45,95% apresentava mais de um fator de risco secundário para HTG. O grupo TPT apresentou maiores valores de TG à admissão: 4850 ± 2802 mg/dL vs 1845 ± 1858 mg/dL (p = 0,001). Não se verificaram diferenças na duração do internamento 14,2 ± 6,8 dias vs 13,5 ± 9,0 dias (p = 0,56) ou na taxa de mortalidade (p = 0,47). À data de alta a redução dos TG foi superior no grupo TPT: 4433,70 ± 2896,08 mg/dL - 91,41% vs 1582,95 ± 2051,06 mg/dL – 83,92% (p = 0,002). De referir seis intercorrências minor durante a troca plasmática terapêutica. Discussão/Conclusões: Apesar do viés de seleção (estudo retrospetivo), foi constatada uma maior redução dos TG por esta técnica. As intercorrências inerentes à técnica de troca plasmática terapêutica foram de simples resolução.
- Plasma exchange in severe acute relapses of multiple sclerosis - Results from a Portuguese cohortPublication . Correia, I; Ribeiro, JJ; Isidoro, L; Batista, S; Nunes, C; Macário, C; Borges, C; Tomaz, J; Sousa, LRelapses in Multiple Sclerosis (MS) are often associated with significant disability impairment which is resultant from poor response to corticosteroids. In such severe cases, plasma exchange (PLEX) may be used, although only a few studies with MS patients have been reported. Our objective was to evaluate the effectiveness of PLEX in severe relapses of MS. METHODS: Retrospective study of MS patients treated with PLEX in acute relapses. Data regarding EDSS, annualized relapse rate (ARR), treatment with corticosteroids, number of PLEX sessions, adverse events, and gadolinium enhancement in brain MRI were analysed. RESULTS: Included 46 patients, 76.09% female (n = 35) with mean age of 38.76 years and mean disease duration of 5.99 years, of which 84.78% had a Relapsing Remitting MS (n = 39), 15.22% Secondary Progressive MS (n = 7). The previous ARR was 1.1 and in 28.26% of the cases (n = 13) PLEX was used in the relapse that led to MS diagnosis. The majority of relapses had motor impairment (69.6%, n = 32), with a median EDSS increase of 1.5 points from baseline (maximum of 6.5) and higher than 1.5 points in 45.65% of cases (n = 21). Brain MRI was available in 69.57% of the cases (n = 32), and gadolinium enhancing lesions were present in 68.75% of cases (n = 22). Corticosteroids were used before PLEX in all patients for a mean of 6.09 days, without any immediate benefit in 41.30% of cases (n = 19), with the remaining cases showing only mild disability recovery. After a mean of 7.39 PLEX sessions, there was clinical benefit with complete EDSS recovery in 41.30% of patients (n = 19), and partial in 39.13% (n = 18). There were no adverse events related to PLEX in 89.13% of patients (n = 41) and in the remaining patients the reported adverse events included deep venous thrombosis (n = 1), anaemia (n = 1), fever (n = 1), hypoalbuminemia (n = 1) and arterial hypotension (n = 1). CONCLUSION: Our results support the use of PLEX in severe relapses unresponsive to corticosteroids, since it was an effective and relatively safe treatment for most of our patients.
- Prevalence of antibodies to a new histo-blood system: the FORS systemPublication . Jesus, C; Hesse, C; Rocha, C; Osório, N; Valado, A; Caseiro, A; Gabriel, A; Svensson, L; Moslemi, AR; Siba, WA; Srour, MA; Pereira, C; Tomaz, J; Teixeira, P; Mendes, FIn 1987, three unrelated English families were reported with a putative blood subgroup called Apae. Swedish researchers later found evidence leading to abolishment of the Apae subgroup and establishment instead of the FORS blood group system (System 31 - ISBT, 2012). It is important to know the prevalence of antibodies in order to make the best decisions in transfusion medicine. Cells expressing the Forssman saccharide, such as sheep erythrocytes, are needed to detect the anti-Forssman antibody. The aim of this study was to define the prevalence of human anti-Forssman antibody.
- Prevalência dos marcadores de infecção pelo vírus da hepatite B na população adulta do distrito de CoimbraPublication . Santos, A; Carvalho, A; Tomaz, J; Rodrigues, V; Coxinho, L; Bento, D; Sá, R; Porto, AAIM: To assess the prevalence of hepatitis B markers in the adult population of the Coimbra district, in the central region of Portugal. METHODS: The study included 657 subjects chosen aleatorily from 4 characteristic councils of the Coimbra district. They were questioned regarding risk factors and blood samples were taken for HBsAg, anti-HBs and anti-HBc testing. Anti-HCV was previously determined and it was positive in 0.45% of the cases. RESULTS: HBsAg was found in 0.91%. Anti-HBs and anti-HBc were both positive in 6.08%, anti-HBc without anti-HBs was found in 1.82% and anti-HBs without anti-HBc was found in 1.67% (11 cases, 8 vaccinated). The general prevalence of hepatitis B markers was 9.3%. Higher prevalences were found in the subjects over 50 years of age, 13.5% (p < 0.05), and in the urban area, 13.2% (p < 0.05). CONCLUSIONS: 1. The HBsAg prevalence in our region is 0.9%; 2. The general prevalence of hepatitis B markers is 9.3%; 3. HBsAg prevalence is higher than anti-HCV prevalence calculated in the same sample; 4. The prevalence of hepatitis B markers in our region is lower than in other Southern European countries.