São Brás de Alportel, Portugal
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Frias Vilaca A.,Fernando Pessoa University | Frias Vilaca A.,Centro Hospitalar Of Entre Douro E Vouga | Reis A.M.,Centro Hospitalar Of Entre Douro E Vouga | Vidal I.M.,Centro Hospitalar Of Entre Douro E Vouga
Insights into Imaging | Year: 2013

Air/gas outside the aero-digestive tract is abnormal; depending on its location, it is usually called emphysema, referring to trapped air/gas in tissues, or ectopic air/gas. It can be associated to a wide range of disorders, and although it usually is an innocuous condition, it should prompt a search for the underlying aetiology, since some of its causes impose an urgent treatment. In rare instances, it may itself represent a life-threatening condition, depending on the site involved and how quickly it evolves. Abnormal air/gas beyond viscera and serosal spaces, reaches its location following some anatomic boundaries, such as fascia, which may help search the source; however if the air pressure exceeds the strength of the tissues, or the time between the aggression and the imaging is too long, the air/gas is almost everywhere, which may hinder its cause. Good knowledge of the anatomic spaces and how they connect between them facilitates the quick detection of the cause. Teaching points • Ectopic air can be depicted on conventional radiographs; but CT is more sensitive and accurate • Visceral and retropharyngeal spaces directly communicate with mediastinum • Renal fascia is a single multilaminated structure, which contains potential space © 2013 The Author(s).


Pinto P.,Portuguese Oncology Institute | Rocha P.,Portuguese Oncology Institute | Veiga I.,Portuguese Oncology Institute | Guedes J.,Portuguese Oncology Institute | And 13 more authors.
Cancer Genetics | Year: 2011

Cetuximab and panitumumab are two monoclonal antibodies targeting the epidermal growth factor receptor that have been approved for treatment of metastatic colorectal cancer. Recent clinical trials found an association between KRAS mutation status and resistance to anti-epidermal growth factor receptor therapy, leading to the recommendation to perform KRAS mutation analysis before cetuximab or panitumumab treatment. This study was designed to compare and evaluate the efficacy of four different methodologies-high resolution melting, Sanger sequencing, DxS kit, and SNaPshot-for KRAS mutation detection in a clinical setting. In total, 372 samples from patients with metastatic colorectal cancer were analyzed by high resolution melting and SNaPshot, with 184 of those being further analyzed by Sanger sequencing and 188 with the DxS kit. Sensitivities were compared after consensus findings were determined by the presence of the same result in two of the three methodologies used in each case. The frequency of KRAS codon 12 and 13 mutations in our population was 43.5%, and a discordant finding was observed in 22 samples. Comparing to Sanger sequencing, significantly more consensus mutations were detected by the DxS kit (P = 0.0139), high resolution melting (P = 0.0004), and SNaPshot (P = 0.00001), but no statistically significant differences were found among the three methodologies with higher sensitivity. © 2011 Elsevier Inc.


Resende V.A.C.,Centro Hospitalar Of Entre Douro E Vouga | Da Silva J.B.,Centro Hospitalar Of Entre Douro E Vouga | Neto A.C.,Centro Hospitalar Of Entre Douro E Vouga | Leal F.J.F.,Centro Hospitalar Of Entre Douro E Vouga | And 2 more authors.
Coluna/ Columna | Year: 2013

Objective: To verify the presence of the sedimentation sign in patients with lumbar spinal stenosis (LSS) in comparison to those without LSS. Methods: Retrospective, cross-sectional and descriptive study. Review of the imaging processes of patients with LSS operated between January 1, 2008 and December 31, 2009, comparing with patients without LSS observed in outpatient consultations. Patients were divided into two groups: group I had 34 patients with a diagnosis of LSS. Diagnostic criteria: existence of low back pain and/or neurogenic claudication and/or radiculopathy, associated with an anteroposterior canal diameter of less than 10 mm. Group II had 40 patients observed in outpatient consultations for low back pain without clinical LSS. The canal diameter was measured and the presence of the sedimentation sign between D12 and S1 was verified. Results: A positive sedimentation sign was identified in 31 of the 34 patients in group I (91.2%); only below the stenosis in two of these 31 patients. The sign was not observed in the patients in group II. A statistically significant correlation was observed between the variables "canal diameter" and "presence of sedimentation sign" (p < 0.01) in the group of patients with lumbar spinal stenosis. Conclusion: The diagnosis of LSS is not always easy due to the frequent dissonance between the clinical and imaging findings. The sedimentation sign is positive in patients with LSS between L1 and L5 and can be a valid sign to complement the diagnosis of LSS.


Peixoto V.,Centro Hospitalar Of Entre Douro E Vouga | Faria A.L.,Centro Hospitalar Of Entre Douro E Vouga | Goncalves M.,Centro Hospitalar Of Entre Douro E Vouga | Macedo J.,Centro Hospitalar Of Entre Douro E Vouga | And 5 more authors.
World Journal of Clinical Oncology | Year: 2014

AIM: To analyze the costs of cancer drugs administered in a Portuguese Hospital compared with the Karolinska Institute study. METHODS: To evaluate spending on cancer drugs, we retrospectively analyzed data on the overall costs of cancer drugs, obtained at the Department of Medical Oncology of the Centro Hospitalar de Entre Douro e Vouga, between 2004 and 2010. In this comparative study we selected only drugs belonging to the following groups: chemotherapy, targeted therapy, immunotherapy and endocrine therapy. The selected drugs were further grouped according to their market placement year: ≤ 1998, 1999 to 2002, 2003 to 2005, and 2006 to 2010. Drugs used as supportive therapy and bisphosphonates were excluded. RESULTS: The overall costs of cancer drugs increased gradually between 2004 and 2008 (from €1911947 to €3666284), with an increase in the number of patients treated during this period. The expenditure decreased in 2009 (€3438155) and increased again in 2010 (€3673116), but the costs increment was not the same as in previous years. Chemotherapy and targeted therapy were responsible for most of the expenditure. Drugs placed on the national market before 1999 accounted for more than 50% of the expenditure up to 2007. From 2008, these drugs represented less than 50% of the total expenditure. Cancer drugs placed between 1999 and 2002 accounted for 25%-35% of the costs in all the years studied, while drugs placed between 2003 and 2005 accounted for less than 30%. Drugs placed between 2006 and 2010 were responsible for less than 10% of the expenditure. CONCLUSION: In this study, older drugs were responsible for most of the expenditure up to 2007, which is in agreement with the Karolinska study. © 2014 Baishideng Publishing Group Co., Limited. All rights reserved.


Correia M.,Centro Hospitalar Of Entre Douro E Vouga | Moreira L.,Centro Hospitalar Of Entre Douro E Vouga | Moreira F.,Centro Hospitalar Of Entre Douro E Vouga
Acta Medica Portuguesa | Year: 2011

Duodenocaval fistula is a type of digestive fistula rarely described in the literature. It usually manifests by sepsis associated with gastrointestinal bleeding. The treatment is surgical and the prognosis usually not favorable. We describe the case of a woman admitted to our hospital with sepsis, having been diagnosed with a duodenocaval fistula secondary to perforation of the digestive tract by a foreign body. Surprisingly, the fistula sealed by itself, without the need of surgery, and with a favorable evolution. © 2011 CELOM.


Vilaca A.F.,Centro Hospitalar Of Entre Douro E Vouga | Rodrigues P.,Centro Hospitalar Of Entre Douro E Vouga | Scigliano H.,Laboratorio de Anatomia Patologica Dr. Albino Oliveira Lda | Pinto J.,Centro Hospitalar Of Entre Douro E Vouga | Reis A.,Centro Hospitalar Of Entre Douro E Vouga
Journal of Radiology Case Reports | Year: 2011

Solid Pseudopapillary Tumor of the pancreas is a rare nonfunctioning tumor. It is considered a low-grade malignancy that is apparently curable with surgical complete excision in most instances. We present a case of solid pseudopapillary pancreatic tumor that represented a challenge to the radiologists. This case highlights its possible various appearances and the need to the radiologist to be familiar with them.


PubMed | Centro Hospitalar Of Entre Douro E Vouga
Type: Case Reports | Journal: Acta reumatologica portuguesa | Year: 2012

Systemic sclerosis (SS) is a rare severe autoimmune disease involving the connective tissue. The pathophysiology is not clearly understood. It is characterized by a remarkable clinical heterogeneity, and virtually all organs can be affected. Concerning diagnosis, the presence of antinuclear antibodies (ANA) can be found in more than 90% of patients, but the diagnosis is made gathering clinical manifestations, autoimmune panel, nailfold capillaroscopy and in some cases biopsy of the organ involved. The disease course is also weakly understood, although some serological patterns can be distinguished. Current therapeutic options target few aspects of pathologic mechanism and clinical management remains a challenge.The authors presented a rare case of a SS ANA negative, which demonstrates the diagnostic challenge of this disease.


PubMed | Centro Hospitalar Of Entre Douro E Vouga
Type: Case Reports | Journal: Journal of radiology case reports | Year: 2012

Solid Pseudopapillary Tumor of the pancreas is a rare nonfunctioning tumor. It is considered a low-grade malignancy that is apparently curable with surgical complete excision in most instances. We present a case of solid pseudopapillary pancreatic tumor that represented a challenge to the radiologists. This case highlights its possible various appearances and the need to the radiologist to be familiar with them.


Sousa E.,Centro Hospitalar Of Entre Douro E Vouga | Valente P.,Centro Hospitalar Of Entre Douro E Vouga | Santos M.,Centro Hospitalar Of Entre Douro E Vouga
Acta Reumatologica Portuguesa | Year: 2011

Systemic sclerosis (SS) is a rare severe autoimmune disease involving the connective tissue. The pathophysiology is not clearly understood. It is characterized by a remarkable clinical heterogeneity, and virtually all organs can be affected. Concerning diag nosis, the presence of antinuclear antibodies (ANA) can be found in more than 90% of patients, but the diagnosis is made gathering clinical manifestations, autoimmune panel, nailfold capillaroscopy and in some cases biopsy of the organ involved. The disease course is also weakly understood, although some serological patterns can be distinguished. Current therapeutic options target few aspects of pathologic mechanism and clinical management remains a challenge. The authors presented a rare case of a SS ANA negative, which demonstrates the diagnostic challenge of this disease.


PubMed | Centro Hospitalar Of Entre Douro E Vouga
Type: Case Reports | Journal: Acta medica portuguesa | Year: 2012

Duodenocaval fistula is a type of digestive fistula rarely described in the literature. It usually manifests by sepsis associated with gastrointestinal bleeding. The treatment is surgical and the prognosis usually not favorable. We describe the case of a woman admitted to our hospital with sepsis, having been diagnosed with a duodenocaval fistula secondary to perforation of the digestive tract by a foreign body. Surprisingly, the fistula sealed by itself, without the need of surgery, and with a favorable evolution.

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