Browsing by Author "Pedro, A"
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- Ano global de luta contra a dor: dor pós-cirúrgicaPublication . Pedro, A
- Cancro do ovário na adolescência – um caso clínicoPublication . Miranda, M; Paixão, C; Pedro, A; Pereira, JSSmall cell carcinoma of the ovary, hypercalcemic type is a rare and aggressive tumor affecting young women. The mechanism of development is unclear and there have been relatively few clinical studies reported in literature. The authors present a clinical case of a 15-year-old girl with a small cell carcinoma of the ovary
- Carcinóide estrumal associado a teratoma quístico maduro do ovário: um caso clínicoPublication . Osório, F; Franco, A; Pedro, A; Faustino, F; Nazaré, ADermoid ovarian cysts are the most common germ-cells tumours of the ovary, but strumal carcinoid transformation is rare. The authors report the case of an asymptomatic 20 year-old woman, referred to the gynaecological outpatient clinic, because of the ultrasound finding of an adnexal cyst. On physical examination a right adnexal mass was identified. A repeat ultrasound revealed an ovarian mass measuring 11.5cm, with characteristics that were suggestive of an ovarian teratoma. A CT-scan was performed that was also suggestive of this diagnosis. Tumoral markers were negative, except for CA19.9. The patient was submitted to laparoscopic right adnexectomy and histopathological examination revealed an ovarian bigerminal mature cystic teratoma with strumal carcinoid transformation, but no capsular invasion. Currently, 18 months after surgery the patient is pregnant and remains symptom free.
- A case of follicular variant of papillary thyroid carcinoma in a mature cystic teratoma in a young womanPublication . Dias, G; Caeiro, F; Costa, T; Pedro, A; Pereira, JSMalignant transformation of a teratoma occurs in 1-2% of cases, with carcinoma of the thyroid being extremely rare. It is usually diagnosed in the postoperative histopathological exam. We describe a case of thyroid carcinoma in a mature cystic teratoma.
- Dor crónica pós cirúrgicaPublication . Pedro, A; Coucelo, G
- Ganglion Impar Neurolysis in the Management of Pelvic and Perineal Cancer-Related Pain.Publication . Ferreira, F; Pedro, ACancer-related pain is a very prevalent problem in all stages, with 10% of patients requiring invasive techniques for adequate pain management. Ganglion impar neurolysis has been used in the treatment of pelvic-perineal pain with efficacy and rare complications, but only a few case or series reports in cancer patients have been published. We report the case of a patient presenting with an ovarian carcinoma (FIGO stage IIIC), who had several disease relapses at the colorectal transition and need for palliative colic prosthesis. She presented later with anorectal pain associated with a rectovaginal fistula, which had an important impact on the activities of her daily life. She was submitted to two ganglion impar neurolyses, which resulted in improved pain control for a total of 5 months, an important improvement in her quality of life, and reduction of opioid consumption. The authors aim to alert to the importance of pain control and to address the fourth step of the WHO analgesic ladder as an option for cancer patients, including palliative patients.
- HPV type-specific distribution in a group of women attending at Hospital Fernando Fonseca, LisbonPublication . Santos, S; Pista, A; Pedro, A; Álvares, C; Ribeiro, C; Costa, C; Inácio, N; Pereira, S; Verdasca, NIntroduction: Genital HPV infection is very frequent. Nevertheless, type-specific distribution can vary greatly in different populations. Aim: To assess the HPV frequency and type-specific distribution in a highly ethnically diverse region and its association with gynecological cytology. Material and Methods: From March to July 2009, 419 LBC samples (ThinPrep) were collected from women 16-79 years old, attending Hospital Fernando Fonseca and associated Primary Health Care Centers. HPV genotyping was performed using CLINICAL ARRAY HPV 2. Statistical analysis was performed (Chi-Square test). Results: Out of 419 women (median age: 41 years), 74.0% were Caucasian and 21.0% African. Overall, 90.2% of the women had a normal cytology, 4.3% had ASCUS, 3.1% LSIL, 1.7% HSIL, and 0.7% had invasive carcinoma. HPV infection was detected in 25.8% of the cases, whereas in 75.0% of women between 20-45 years. HR-HPV genotypes were identified in 57.8% of the infected women. The most frequent HR-HPV types were HPV16 (11.4%), HPV52 (8.5%), HPV31 and 58 (7.2% each). Multiple infections (2-6 genotypes) were observed in 34.2%. HPV58, 16, 31, and 52 (9.5%, 7.4%, 7.4%, 7.4%, respectively) were the most frequent genotypes. HPV DNA was detected in 19.6% of the women with normal cytology, of which 31.0% had multiple infections. In ASCUS, LSIL, HSIL and invasive carcinoma, HPV was detected in 66.7%, 100%, 100%, and 66.7%, respectively. HPV16, 31, 52, 58 and 42 were most frequent among Caucasian and HPV16, 83, 52, 53 and 54 among African women. HPV16 and 18 were found in 4.5% and 1.0% of the women. Infection by multiple HPV was related to lesion grade (p=0.042). Conclusion: Our results are consistent with the data observed in the literature. Our findings can help achieve a better understanding of the wide spectrum of HPV infection and can contribute to a baseline for future assessment of screening and immunization strategies.
- Hysteroscopic tubal sterilization with Essure ® : a 7 year observational studyPublication . Miranda, M; Bruno, D; Caeiro, F; Pedro, A; Pereira, JSIntroduction: Hysteroscopic sterilization with the Essure® device is a method of contraception considered safe and effective already applied in more than 200,000 women. This study aims to evaluate the efficacy of this method of contraception and the adverse events associated with the placement of Essure®, including pain during the procedure and postprocedure complications. Material and methods: We performed a retrospective observational study with inclusion of all the women submitted to Essure® placement in a large urban hospital in Portugal, from January 2008 to December 2015 (7 years). The variables age, parity, duration and intercurrences of the procedure, follow-up exams and final outcome were evaluated. The statistical analysis was performed with STATA 12.1. Results: Of the 118 women only 100 finished the procedure with 16.9% reporting moderate or severe pain. Although less than 3 intrauterine rings were found in 8.5% of cases, the success rate was 92%. The complications described were tubal perforation (0.8%), pregnancy (1 case) and incorrect positioning of the implants (3%). Discussion/Conclusion: The success rate of the procedure was very close to that described in the literature with a low incidence of complications. That advantages make it an idea method for women with high surgical risk and multiple co-morbidities
- Novas terapêuticas no controle da dor crónicaPublication . Font, ML; Coucelo, G; Pedro, A
- Um novo olhar sobre endometriosePublication . Santos, V; Caeiro, F; Pedro, A; Pereira, JS