Browsing by Author "Sousa, H"
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- Accuracy of Faecal Calprotectin and Neutrophil Gelatinase B-associated Lipocalin in Evaluating Subclinical Inflammation in UlceRaTIVE Colitis-the ACERTIVE study.Publication . Magro, F; Lopes, S; Coelho, R; Cotter, J; Castro, F; Sousa, H; Salgado, M; Andrade, P; Vieira, A; Figueiredo, P; Caldeira, P; Sousa, A; Duarte, M; Ávila, F; Silva, J; Moleiro, J; Mendes, S; Giestas, S; Ministro, P; Sousa, P; Gonçalves, R; Gonçalves, B; Oliveira, A; Chagas, C; Torres, J; Dias, C; Lopes, J; Borralho, P; Afonso, J; Geboes, K; Carneiro, F; Portuguese IBD Study Group [GEDII].BACKGROUND AND AIMS: Mucosal healing and histological remission are different targets for patients with ulcerative colitis, but both rely on an invasive endoscopic procedure. This study aimed to assess faecal calprotectin and neutrophil gelatinase B-associated lipocalin as biomarkers for disease activity in asymptomatic ulcerative colitis patients. METHODS: This was a multicentric cross-sectional study including 371 patients, who were classified according to their endoscopic and histological scores. These results were evaluated alongside the faecal levels of both biomarkers. RESULTS: Macroscopic lesions [i.e. endoscopic Mayo score ≥1] were present in 28% of the patients, and 9% had active disease according to fht Ulcerative Colitis Endoscopic Index of Severity. Moreover, 21% presented with histological inflammation according to the Geboes index, whereas 15% and 5% presented with focal and diffuse basal plasmacytosis, respectively. The faecal levels of calprotectin and neutrophil gelatinase B-associated lipocalin were statistically higher for patients with endoscopic lesions and histological activity. A receiver operating characteristic-based analysis revealed that both biomarkers were able to indicate mucosal healing and histological remission with an acceptable probability, and cut-off levels of 150-250 μg/g for faecal calprotectin and 12 μg/g for neutrophil gelatinase B-associated lipocalin were proposed. CONCLUSIONS: Faecal calprotectin and neutrophil gelatinase B-associated lipocalin levels are a valuable addition for assessment of disease activity in asymptomatic ulcerative colitis patients. Biological levels of the analysed biomarkers below the proposed thresholds can rule out the presence of macroscopic and microscopic lesions with a probability of 75-93%. However, caution should be applied whenever interpreting positive results, as these biomarkers present consistently low positive predictive values.
- Ecoendoscopia digestiva na prática clínica parte II a: utilidade na avaliação do pâncreasPublication . Rodrigues, C; Pereira, E; Caldeira, A; Santos, A; Sousa, H; Banhudo, ADesde a altura em que foi desenvolvida, na década de 80, a ecoendoscopia tem vindo a assumir uma importância crescente no diagnóstico de várias doenças pancreáticas benignas e malignas. O papel que detém actualmente na abordagem da patologia pancreática veio confirmar a razão histórica da sua implementação. Pela proximidade do transdutor e reduzida interferência acústica, a ecoendoscopia fornece imagens ultrassonográficas de alta resolução do pâncreas e com grande detalhe anatómico, acrescentando à informação obtida por tomografia computorizada ou por ressonância magnética aspetos essenciais na investigação dos doentes com suspeita de patologia pancreática. A ecoendoscopia tem, além disso, a capacidade única de guiar a punção aspirativa de lesões pancreáticas e estruturas adjacentes para obtenção de um diagnóstico cito-histológico. Nos últimos anos, a aplicação à ecoendoscopia de novas modalidades da ultrassonografia, como a elastografia e o uso de contrastes, tem revelado resultados promissores e está a ampliar as potencialidades desta técnica. Na sequência de artigos de revisão sobre ecoendoscopia, este primeiro capítulo da segunda parte pretende abordar as principais indicações desta técnica no diagnóstico da patologia do pâncreas, bem como os achados endossonográficos que a caracterizam.
- IgA nephropathy in a young adult with nephrotic syndrome: Case reportPublication . Cassis, J; Sousa, H; Manso, RT; Ramos, S; Machado, DIgA nephropathy has many clinical presentations, of which nephrotic syndrome is possibly the rarest. Recently, the association of IgA nephropathy with minimal change disease was better described with patients having complete response to steroid therapy and no progression to CKD. We report a similar case in a young male presenting with nephrotic syndrome.
- IgA nephropathy in a young adult with nephrotic syndrome: Case reportPublication . Cassis, J; Sousa, H; Manso, RT; Ramos, S; Machado, DIgA nephropathy has many clinical presentations, of which nephrotic syndrome is possibly the rarest. Recently, the association of IgA nephropathy with minimal change disease was better described with patients having complete response to steroid therapy and no progression to CKD. We report a similar case in a young male presenting with nephrotic syndrome.
- The who-when-why triangle of CAM use among Portuguese IBD patientsPublication . Portela, F; Dias, C; Caldeira, P; Cravo, M; Deus, JR; Gonçalves, R; Lago, P; Morna, H; Peixe, P; Ramos, J; Sousa, H; Tavares, L; Vasconcelos, H; Magro, F; Ministro, PThe use of complementary and alternative medicines is increasing among chronic patients, particularly those afflicted with inflammatory bowel diseases. AIM: This study aimed to address the prevalence of complementary and alternative medicines use among Portuguese inflammatory bowel diseases' patients. METHODS: Patients were invited to fill an anonymous questionnaire concerning the use of complementary and alternative medicines. RESULTS: Thirty-one per cent of the patients reported having used complementary and alternative medicines in the past, whereas 12% were using them by the time the questionnaire was administered. Fifty-nine per cent of the users did not share this information with their physician, whereas 14% and 8% discontinued their medication and periodical examination, respectively. Steroids prescription (OR=2.880) and a higher instruction level (OR=3.669) were predictors of complementary and alternative medicines use in this cohort. CONCLUSIONS: Roughly a third of Portuguese IBD patients had used CAM. Steroid treatment and an academic degree are associated with CAM use. Given the potential side effects and interactions, patient information about the benefits and limitations of conventional and complementary treatments should be reinforced.