São João da Madeira, Portugal
São João da Madeira, Portugal

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Barroca H.,Centro Hospitalar Of S Joao | Marques C.,Centro Hospitalar Of S Joao
Acta Cytologica | Year: 2016

According to the World Health Organization (WHO), the new classification of lymphomas is mainly based on morphological, immunophenotypical, and molecular criteria. Consequently, this new approach has led from the substantial role that architecture played in the past to a secondary panel highlighting the role of fine-needle biopsy (FNB). Applied together with other ancillary techniques, such as flow cytometry (FC), FNB is a potential tool for the diagnosis of lymphomas, and enlarged lymph nodes represent an excellent target for the implementation of this technique. Despite the difficulties inherent in this technology, which might pose problems in differential diagnosis, in the majority of cases this joint work allows an accurate diagnosis of malignancy and even correct subcharacterization in routine lymphomas. Additionally, in selected cases, other molecular techniques like FISH and PCR can also be performed on FNB specimens, helping in the characterization and diagnosis of lymphomas. In this review, we discuss the basic aspects of the combination of FNB cytology and FC in the diagnosis and subclassification of lymphomas. The preanalytical phase is extensively discussed. The advantages, disadvantages, and technical limitations of this joint work are addressed in general and in terms of the accurate subclassification of lymphomas. © 2016 S. Karger AG, Basel


Alves D.,Centro Hospitalar Of S Joao | Sampaio M.,Centro Hospitalar Of S Joao | Figueiredo R.,Centro Hospitalar Of S Joao | Leao M.,Centro Hospitalar Of S Joao
American Journal of Medical Genetics, Part A | Year: 2013

Lateral meningocele syndrome is a rare disorder of unknown etiology, first described in 1977 and subsequently reported in nine other patients. These patients present distinctive craniofacial features and skeletal abnormalities in addition to multiple lateral meningoceles, suggesting a connective tissue disorder. Autosomal dominant inheritance is clearly suggested in one family and could explain familiar aggregation in another. We describe a simplex case of lateral meningocele syndrome with bicuspid aortic valve, supporting the hypothesis of a connective tissue basis for this disorder and further expanding the phenotype. © 2013 Wiley Periodicals, Inc.


Bartosch I.,Centro Hospitalar Of S Joao | Bartosch C.,Centro Hospitalar Of S Joao | Egipto P.,Centro Hospitalar Of S Joao | Silva A.,Centro Hospitalar Of S Joao
Burns | Year: 2013

Retrospective studies are essential to evaluate and improve the efficiency of care of burned patients. This study analyses the work done in the burn unit of Hospital de S. João in the north of Portugal. A retrospective review was performed in patients admitted from 2006 to 2009. The study population was characterised regarding patient demographics, admissions profile, burn aetiology, burn site, extension and treatment. Multiple linear and logistic regression models were done in order to elucidate which of these factors influenced the mortality and length of stay. The characteristics before and after the creation of the burn unit, as well as the similarities and differences with the published data of other national and international burn units, are analysed. © 2012 Elsevier Ltd and ISBI. All rights reserved.


Barroca H.,Centro Hospitalar Of S Joao | Bom-Sucesso M.,Centro Hospitalar Of S Joao
Cytopathology | Year: 2014

Fine needle biopsy (FNB) with cytology has long been regarded as an excellent technique as the first choice for diagnosing adult tumours. Being an inexpensive minimally invasive technique with high accuracy and diagnostic immediacy through rapid on-site evaluation, it is also ideal for implementation in the paediatric setting, particularly in developing countries. Furthermore, it allows complementary and advanced procedures such as flow cytometry, polymerase chain reaction (PCR) or fluorescence in situ hybridization (FISH), among others, which enhances the diagnostic capacity of this technique and gives it a key role in risk stratification and therapeutic decision-making for several tumours. The advantages of FNB are optimized in the setting of a multidisciplinary team where cytologist, clinician and radiologist play leading roles. Paediatric tumours are rare and most ancillary techniques are cost-effective but complex to be implemented in small centres with limited experience in paediatric pathology. Therefore reference centres are essential, in order to establish teams with extensive experience and expertise. Hence, any child with a suspected malignancy should be directly referred to a paediatric oncology unit. Focusing on a practical approach to the assessment of paediatric lymphadenopathies and non-central nervous system solid tumours we review the effectiveness of FNB as applied concurrently with ancillary techniques in a multidisciplinary approach to the diagnosis, prognosis and therapeutic decisions of paediatric tumours and tumour-like lesions. © 2013 John Wiley & Sons Ltd.


Nunes S.T.,University of Porto | Nunes S.T.,Centro Hospitalar Of S Joao | Rego G.,University of Porto | Nunes R.,University of Porto
CIN - Computers Informatics Nursing | Year: 2014

Health information systems are becoming common because they are important tools to support decision making and assist nurses in their daily interventions. The Information System for Nursing Practice promotes consistent nursing records, as it is directed to the nursing practice and process. The aims of this study were to identify and describe the most frequent type of nursing actions in the care plan for a patient after acute myocardial infarction, considering the seven-axis model of the International Classification of Nursing Practice and the rate of health education given to patients during hospitalization. A cross-sectional analysis was performed retrospectively by searching the computerized database of the Information System for Nursing Practice. We verified some gaps in information with regard to unidentified records of diagnoses and interventions. During hospitalization, the most used interventions were in the fields of observing (40%) and managing (23%). Interventions associated with management of signs and symptoms were more frequent and were performed in 84.9% of the patients. In the field of informing, health education in relation to diet was performed in 21.7% of the patients; exercise, in 16%; and tobacco, in 11.3%. The use of nursing records and information systems can improve nursing care coordination and care plan management. © 2014 Wolters Kluwer Health.


Abreu C.,Centro Hospitalar Of S Joao | Santos L.,Centro Hospitalar Of S Joao | Poinhos R.,University of Porto | Sarmento A.,Centro Hospitalar Of S Joao
Infection | Year: 2013

Purpose and methods: Acute acalculous cholecystitis (AAC) is an uncommon condition related to serious clinical conditions, such as surgery, trauma, burn injuries and sepsis. The diagnosis of AAC remains challenging to make, since it generally occurs as a secondary event in acutely ill patients with another disease. Imaging evaluation is crucial, and well-known criteria are accepted for the diagnosis. To our knowledge, only case reports of AAC related to 12 malaria adult patients have been published. In this series, seven cases of AAC from a cohort of 42 adult patients with severe imported falciparum malaria [according to the World Health Organization (WHO) criteria] are presented. The aim is to report the cases and look for malaria conditions that may affect the incidence of this unusual malaria complication. Results: Ultrasonography revealed gallbladder with wall thickening in all patients, plus other(s) major criteria. Each patient presented five to nine WHO severe malaria criteria: all had hyperparasitaemia and hyperbilirubinaemia. All patients developed renal failure, six pulmonary oedema/acute respiratory distress syndrome (ARDS) (five were mechanically ventilated) and five shock. Treatment was non-operative in five patients, cutaneous cholecystostomy was done in two and the outcome was favourable in all. Conclusions: Patients with AAC have significantly more commonly five or more criteria of severe malaria: renal insufficiency, pulmonary oedema/ARDS, parasitaemia higher than 30 %, nosocomial infection and a prolonged intensive care unit (ICU) stay. Increased awareness for this unusual and potentially severe complication of malaria is needed. © 2013 Springer-Verlag Berlin Heidelberg.


Nunes S.R.T.,University of Porto | Nunes S.R.T.,Centro Hospitalar Of S Joao | Rego G.,University of Porto | Nunes R.,University of Porto
Experimental and Clinical Cardiology | Year: 2014

To optimally improve health status after a myocardial infarction it is essential for patients to understand the seriousness of the disease and improve their self-management. Aims: To describe patients' perceptions of preventive care, after experiencing a first episode of an acute myocardial infarction in a central hospital in Portugal and to analyze the intent to change behaviors and real changes six months after myocardial infarction. Methods: Longitudinal descriptive study; 106 patients aged between 35 and 64 years, who had cardiovascular risk factors and a first experience of myocardial infarction were selected. Data was collected in two structured interviews. Results: Of the patients, 18% had never, by their own accord, chosen to use preventive care services. During hospitalization, 43% described preventive care as a negative perception. Patients showed intent to change their habits but after discharge, they had difficulties in self-management of disease, maintaining monitoring or changing their cardiovascular risk factors such as physical activity (41%), blood pressure (37%), and eating habits (24%). Conclusions: There were considerable discrepancies between the intention and action in behavioral changes in patients after a myocardial infarction. Regarding the patients' perceptions, there is a need to improve their involvement in the management of disease. © 2013 et al.; licensee Cardiology Academic Press.


PubMed | Centro Hospitalar Of S Joao, University of Porto and CUF Descobertas and CUF Infante Santo Hospital
Type: Journal Article | Journal: The Journal of asthma : official journal of the Association for the Care of Asthma | Year: 2016

This study aimed to estimate the prevalence of asthma-like symptoms, current asthma (CA), asthma diagnostic tests, and inhaled medication use in a nationwide pediatric population (<18 years).Pediatric-specific data from a cross-sectional, population-based telephone survey (INAsma study) in Portugal were analyzed. CA was defined as lifetime asthma and (1) wheezing, (2) waking with breathlessness, or (3) asthma attack in the previous 12 months, and/or (4) taking asthma medication at the time of the interview.In total, 716 children were included. The prevalence of asthma-like symptoms was 39.4% [95% confidence interval (95% CI): 35.7-43.3]. The most common symptoms were waking with cough (30.9%) and wheezing (19.1%). The prevalence of CA was 8.4% (95% CI: 6.6-10.7). Among children with CA, 79.9% and 52.9% reported prior allergy testing and pulmonary function testing (PFT), respectively. Inhaled medication use in the previous 12 months was reported by 67.6% (reliever inhalers, 40.1%; controller inhalers, 41.5%). Those who only used inhaled reliever medications experienced more asthma attacks [odds ratio (OR): 2.69]. Significantly fewer children with CA living in rural areas than those living in urban areas had undergone PFT or used inhaled medication (OR: 0.06 for PFT, 0.20 for medication].The prevalence of CA in the Portuguese pediatric population was 8.4%. Only half of children with CA had ever undergone PFT; more than half did not use controller inhalers, and those who only used reliever inhalers reported more asthma attacks. These findings suggest that asthma management has been substandard, mainly in rural areas.


PubMed | University of Porto, Centro Hospitalar Of S Joao, Instituto Gulbenkian Of Ciencia Igc and Centro Hospitalar Of Coimbra
Type: | Journal: Scientific reports | Year: 2016

One of the hallmarks of cancer is its unlimited replicative potential that needs a compensatory mechanism for the consequential telomere erosion. Telomerase promoter (TERTp) mutations were recently reported as a novel mechanism for telomerase re-activation/expression in order to maintain telomere length. Pancreatic endocrine tumors (PETs) were so far recognized to rely mainly on the alternative lengthening of telomeres (ALT) mechanism. It was our objective to study if TERTp mutations were present in pancreatic endocrine tumors (PET) and could represent an alternative mechanism to ALT. TERTp mutations were detected in 7% of the cases studied and were mainly associated to patients harbouring hereditary syndromes. In vitro, using PET-derived cell lines and by luciferase reporter assay, these mutations confer a 2 to 4-fold increase in telomerase transcription activity. These novel alterations are able to recruit ETS transcription factor members, in particular GABP- and ETV1, to the newly generated binding sites. We report for the first time TERTp mutations in PETs and PET-derived cell lines. Additionally, our data indicate that these mutations serve as an alternative mechanism and in an exclusive manner to ALT, in particular in patients with hereditary syndromes.


PubMed | Porto Nursing College and Centro Hospitalar Of S Joao
Type: Journal Article | Journal: Nursing children and young people | Year: 2016

Theme: Complex health care and chronic disease management.

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