Browsing by Issue Date, starting with "2018"
Now showing 1 - 10 of 143
Results Per Page
Sort Options
- Experiência do HFF em DISEPublication . Adónis, C; Costa, E; Rito, J; Órfão, J; Melo, M; Freire, F
- Reclassification of Treatment Strategy by Routine Coronary Pressure Assessment-Episode 7 of the Saga: The More You Look, the More You Find It!Publication . Van Belle, E; Vincent, F; Raposo, L; Baptista, SB; Dupouy, P
- Killian-Jamieson diverticulum mimicking a suspicious thyroid lesionPublication . Schmitt, W; Germano, AKillian-Jamieson diverticulum represents a rare form of esophageal diverticulum originating on the anterolateral wall of the cervical esophagus. Despite its rarity, it is crucial to recognize this entity, with such specific imaging findings, to avoid unnecessary invasive procedures such as fine-needle aspiration or even surgery.
- Polymicrobial interactions influence the agr copy number in Staphylococcus aureus isolates from diabetic foot ulcersPublication . Matias, C; Serrano, I; Van-Harten, S; Mottola, C; Mendes, J; Tavares, L; Oliveira, MDiabetic foot ulcers are a major complication of diabetes and are often colonised by complex bacterial communities, where Staphylococcus aureus is frequently co-present with Pseudomonas aeruginosa. These bacteria interact through quorum sensing, encoded in S. aureus by the accessory gene regulator (agr). Typing and copy number of S. aureus agr were assessed here to give insights on strain variability and possible interspecies influence. As agr is classified in four genetic groups, agr-I, agr-II, agr-III and agr-IV, the agr type of 23 S. aureus diabetic foot ulcers isolates was evaluated by PCR and gene copy number determined by qPCR, including in S. aureus present in polymicrobial infections. agr-I and agr-II were found to be present in 52 and 39% of the isolates, respectively. In two isolates, no agr type was identified, and types III and IV were not detected. Interestingly, agr-II copy number was higher in dual suspensions than in S. aureus single suspension. We conclude that agr type I was the most frequent in clinical centers in Lisbon, and variations in agr-I and agr-II copy numbers were strain specific. Variations in agr copy number in dual suspensions suggests that P. aeruginosa may influence S. aureus agr-II gene regulation, confirming an interaction between these two bacteria. This is a first approach to characterise agr variation in S. aureus from diabetic foot ulcers in vitro.
- Incontinência urinária femininaPublication . Barcelos, A; Cebola, A; Varregoso, J
- Endometriosis: A Rare Cause of Large Bowel Obstruction.Publication . Alexandrino, G; Lourenço, L; Carvalho, R; Sobrinho, C; Horta, D; Reis, JLarge bowel obstruction can result in significant morbidity and mortality, especially in cases of acute complete obstruction. There are many possible causes, the most common in adults being colorectal cancer. Endometriosis is a benign disease, and the most affected extragenital location is the bowel, especially the rectosigmoid junction. However, transmural involvement and acute occlusion are very rare events. We report an exceptional case of acute large bowel obstruction as the initial presentation of endometriosis. The differential diagnosis of colorectal carcinoma may be challenging, and this case emphasizes the need to consider intestinal endometriosis in females at a fertile age presenting with gastrointestinal symptoms and an intestinal mass causing complete large bowel obstruction.
- Tuberculose: a propósito de um caso clínicoPublication . Calú, M
- A Rare Cause of Abdominal Pain in a Patient with Acute Necrotizing Pancreatitis.Publication . Branco, C; Cardoso, M; Lourenço, C; Santos, L; Horta, V; Coimbra, E; Reis, JINTRODUCTION: Walled-off necrosis (WON) is a potentially lethal late complication of acute pancreatitis (AP) and occurs in less than 10% of AP cases. It can be located in or outside the pancreas. When infected, the mortality rate increases and can reach 100% if the collection is not drained. Its treatment is complex and includes, at the beginning, intravenous antibiotics, which permit sepsis control and a delay in the therapeutic intervention, like drainage. Nowadays, a minimally invasive approach is advised. Depending on the location of the collection, computed tomography (CT)-guided drainage or endoscopic necrosectomy are the primary options, then complemented by surgical necrosectomy if needed. Infected WON of the abdominal wall has been rarely described in the literature and there is no report of any infection with Citrobacter freundii. CASE: We present the case of a 61-year-old man with necrotizing AP complicated by WON of the left abdominal wall, infected with Citrobacter freundii that was successfully treated with CT-guided percutaneous drainage and intravenous antibiotics. CONCLUSION: Infected WON accounts for considerable mortality and its location in the abdominal wall is rare; it can be treated with antibiotics and CT-guided drainage with no need for further intervention.
- High resolution mass spectrometry-based methodologies for identification of Etravirine bioactivation to reactive metabolites: In vitro and in vivo approaches.Publication . Godinho, A; Martins, I; Nunes, J; Charneira, C; Grilo, J; Silva, D; Pereira, S; Soto, K, et al.Drug bioactivation to reactive metabolites capable of covalent adduct formation with bionucleophiles is a major cause of drug-induced adverse reactions. Therefore, elucidation of reactive metabolites is essential to unravel the toxicity mechanisms induced by drugs and thereby identify patient subgroups at higher risk. Etravirine (ETR) was the first second-generation Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI) to be approved, as a therapeutic option for HIV-infected patients who developed resistance to the first-generation NNRTIs. Additionally, ETR came into market aiming to overcome some adverse effects associated with the previously used efavirenz (neurotoxicity) and nevirapine (hepatotoxicity) therapies. Nonetheless, post-marketing reports of severe ETR-induced skin rash and hypersensitivity reactions have prompted the U.S. FDA to issue a safety alert on ETR. Taking into consideration that ETR usage may increase in the near future, due to the possible use of the drug for coinfection with malaria and HIV, the development of reliable prognostic tools for early risk/benefit estimations is urgent. In the current study, high resolution mass spectrometry-based methodologies were integrated with MS3 experiments for the identification of reactive ETR metabolites/adducts: 1) in vitro incubation of the drug with human and rat liver S9 fractions in the presence of Phase I and II co-factors, including glutathione, as a trapping bionucleophile; and 2) in vivo, using urine samples from HIV-infected patients on ETR therapy. We obtained evidence for multiple bioactivation pathways leading to the formation of covalent adducts with glutathione and N-acetyl-L-cysteine. These results suggest that similar reactions may occur with cysteine residues of proteins, supporting a role for ETR bioactivation in the onset of the toxic effects elicited by the drug. Additionally, ETR metabolites stemming from amine oxidation, with potential toxicological significance, were identified in vitro and in vivo. Also noteworthy is the fact that new metabolic conjugation pathways of glucuronide metabolites were demonstrated for the first time, raising questions about their potential toxicological implications. In conclusion, these results represent not only a contribution towards the elucidation of new metabolic pathways of drugs in general but also an important step towards the elucidation of potentially toxic ETR pathways, whose understanding may be crucial for reliable risk/benefit estimations of ETR-based regimens.
- Massive pericardial effusion caused by hypothyroidism.Publication . Schmitt, W; Roque, D; Germano, AAlthough mild pericardial effusion is a usual finding in patients with hypothyroidism, massive pericardial effusion or pericardial tamponade is rare and customarily related to severe hypothyroidism. The diagnosis of hypothyroidism should be considered in the differential of patients presenting with unexplained pericardial effusion, even when signs and symptoms of hypothyroidism are nonexistent.