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Oliveira do Hospital, Portugal

Rolanda C.,Hospital Braga | Rolanda C.,University of Minho | Rolanda C.,Icvs 3Bs Pt Government Associ Laboratory | Caetano A.C.,Hospital Braga | And 4 more authors.
Best Practice and Research: Clinical Gastroenterology | Year: 2013

Endoscopy adverse events (AEs), or complications, are a rising concern on the quality of endoscopic care, given the technical advances and the crescent complexity of therapeutic procedures, over the entire gastrointestinal and bilio-pancreatic tract. In a small percentage, not established, there can be real emergency conditions, as perforation, severe bleeding, embolization or infection. Distinct variables interfere in its occurrence, although, the awareness of the operator for their potential, early recognition, and local organized facilities for immediate handling, makes all the difference in the subsequent outcome. This review outlines general AEs' frequencies, important predisposing factors and putative prophylactic measures for specific procedures (from conventional endoscopy to endoscopic cholangio-pancreatography and ultrasonography), with comprehensive approaches to the management of emergent bleeding and perforation. © 2013 Elsevier Ltd. All rights reserved.


Silva N.,Hospital Braga | Costa M.,Hospital Braga | Silva A.,Hospital Braga | Sa C.,Hospital Braga | And 5 more authors.
Endocrinologia y Nutricion | Year: 2013

We report a neonatal case of systemic pseudohypoaldosteronism type 1 caused by a novel mutation in the SCNN1A gene (homozygous c.1052. +. 2dupT in intron 3) in which the patient presented with life-threatening hyperkalemia, hyponatremia and metabolic acidosis. It remains uncertain if there is genotype-phenotype correlation, due to the rarity of the disease. This mutation, which to our best knowledge has not been described before, was associated with a very severe phenotype requiring aggressive therapy. © 2012 SEEN.


Moreira Goncalves B.,Hospital Braga | Fontainhas V.,Hospital Braga | Caetano A.C.,Hospital Braga | Caetano A.C.,University of Minho | And 9 more authors.
Revista Espanola de Enfermedades Digestivas | Year: 2013

Objective: malignant colorectal polyp, defined by submucosally invasive adenocarcinoma, is the earliest form of clinically relevant colorectal cancer (CRC). After endoscopic resection additional surgery may be necessary, although decision criteria remain debatable. The objective of this study was to assess oncologic outcomes in terms of locoregional disease and to identify areas of improvement that may facilitate patients' management. Methods: retrospective study of 40 patients with T1 CRC endoscopically resected between 2007 and 2012. Clinicopatho-logical features were assessed and correlated with residual disease (RD), defined as presence of adenocarcinoma in intestinal wall and/ or lymph nodes. Results: thirty-one patients underwent surgery while 9 were followed-up. After surgery, RD was confirmed in 15 (48.4%) patients: 8 (53.3%) wall disease, 5 (33%) nodal metastasis, and 2 (13.3%) with both. No recurrence was detected in the follow-up group. The characteristics of the lesions that were associated with DR were sessile configuration (p = 0.03), the degree of differentiation G3 (p = 0.01) and intercepted/indeterminate margins (p = 0.01). Twenty-two patients were operated because of inadequate evaluation, mainly due to piecemeal resection, and half of them were disease free. Postoperative complications were found in 9 (30%) patients, mainly anastomotic leakage that was associated with rectum anterior resection (p = 0.03). Conclusions: surgery should be considered in the presence of any risk factor for residual disease, while follow-up can be offered in low risk settings. Was also demonstrated a clear need for technical improvement in endoscopic resection and pathology evaluation in order to prevent unnecessary surgeries. © 2013 ARÁN EDICIONES, S. L.

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