Centro Hospitalar S Joao

Porto, Portugal

Centro Hospitalar S Joao

Porto, Portugal
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Bartosch C.,Centro Hospitalar S Joao | Manuel Lopes J.,Centro Hospitalar S Joao | Manuel Lopes J.,University of Sfax | Manuel Lopes J.,University of Porto | And 2 more authors.
Advances in Anatomic Pathology | Year: 2011

This review focuses on the most common diagnostic pitfalls and helpful morphologic and immunohistochemical markers in the differential diagnosis between the different subtypes of endometrial carcinomas, including: (1) endometrioid versus serous glandular carcinoma, (2) papillary endometrioid (not otherwise specified, villoglandular and nonvillous variants) versus serous carcinoma, (3) endometrioid carcinoma with spindle cells, hyalinization, and heterologous components versus malignant mixed müllerian tumor, (4) high-grade endometrioid versus serous carcinoma, (5) high-grade endometrioid carcinoma versus dedifferentiated or undifferentiated carcinoma, (6) endometrioid carcinoma with clear cells versus clear cell carcinoma, (7) clear cell versus serous carcinoma, (8) undifferentiated versus neuroendocrine carcinoma, (9) carcinoma of mixed cell types versus carcinoma with ambiguous features or variant morphology, (10) Lynch syndrome-related endometrial carcinomas, (11) high-grade or undifferentiated carcinoma versus nonepithelial uterine tumors. As carcinomas in the endometrium are not always primary, this review also discusses the differential diagnosis between endometrial carcinomas and other gynecological malignancies such as endocervical (glandular) and ovarian/peritoneal serous carcinoma, as well as with extra-gynecologic metastases (mainly breast and colon). Copyright © 2011 by Lippincott Williams & Wilkins.


Araujo J.R.,University of Porto | Correia-Branco A.,University of Porto | Ramalho C.,Centro Hospitalar S Joao | Keating E.,University of Porto | Martel F.,University of Porto
Journal of Nutritional Biochemistry | Year: 2013

The long-chain polyunsaturated fatty acids (LC-PUFAs) arachidonic (AA) and docosahexaenoic (DHA) acids are essential for fetal development. Gestational diabetes mellitus (GDM) is a pregnancy disorder associated with perinatal and lifelong risk complications for both the mother and the newborn. Our aim was to investigate the influence of GDM, and some of its associated conditions, upon the placental uptake of AA and DHA. Uptake of 14C-AA and 14C-DHA by human trophoblasts obtained from normal pregnancies (NTB cells) was mediated by both saturable (for lower substrate concentrations) and non-saturable (for higher substrate concentrations) mechanisms. Uptake of both fatty acids was inhibited by other LC-PUFAs and, markedly, by the long-chain acyl-CoA synthetase (ACSL) inhibitor, triacsin C. Human trophoblasts obtained from GDM pregnancies (DTB cells) showed a significantly lower 14C-AA and 14C-DHA accumulation, through a decrease in both the saturable and the non-saturable components of uptake, which was associated with a decrease in ACSL1 mRNA levels. Uptake of LC-PUFAs by NTB cells increased (by 20-25%) after short-term exposure to TNF-α (14C-AA and 14C-DHA) and insulin (14C-DHA). In conclusion, GDM, distinctly from its associated conditions, markedly decreases placental uptake of LC-PUFAs, which probably contributes to the deleterious effects of this disease for the newborn. © 2013 Elsevier Inc.


Araujo J.R.,University of Porto | Correia-Branco A.,University of Porto | Moreira L.,University of Porto | Ramalho C.,Centro Hospitalar S Joao | And 2 more authors.
Pediatric Research | Year: 2013

Background:The mechanisms whereby gestational diabetes mellitus (GDM) increases the risk of fetal overgrowth and development of metabolic diseases later in life are likely to involve changes in nutrient supply to the fetus. Hence, in this work, we hypothesize that GDM may affect folic acid (FA) supply to the placenta and fetus.Methods:We compared 3 H-FA uptake by human cytotrophoblasts isolated from normal pregnancies (normal trophoblasts; NTB cells) and GDM pregnancies (diabetic trophoblasts; DTB cells) and investigated the effect of GDM hallmarks on 3 H-FA uptake by BeWo cells.Results: 3 H-FA uptake by NTB and DTB cells was time dependent and acidic pH stimulated. When compared with NTB, 3 H-FA uptake by DTB cells was more sensitive to acidic pH changes and to 5-methyltetrahydrofolate and pemetrexed (PTX) inhibition, indicating a proportionally greater involvement of the proton-coupled folate transporter (PCFT). A 4-h exposure of BeWo cells to lipopolysaccharide (LPS, 1-10 μg/ml) or to high levels of tumor necrosis factor- (TNF-, 300 ng/l) significantly reduced 3 H-FA uptake. Moreover, hyperleptinemic conditions (100 ng/ml leptin) decreased 3 H-FA uptake by BeWo cells in a time-dependent manner when compared with normoleptinemic conditions (1 ng/ml leptin).Conclusion:GDM modulates 3 H-FA uptake by the syncytiotrophoblast, and leptin as well as TNF- downregulate it. Copyright © 2013 International Pediatric Research Foundation, Inc.


Oliveira C.,University of Porto | Pinheiro H.,University of Porto | Figueiredo J.,University of Porto | Seruca R.,University of Porto | And 2 more authors.
The Lancet Oncology | Year: 2015

Familial gastric cancer comprises at least three major syndromes: hereditary diffuse gastric cancer, gastric adenocarcinoma and proximal polyposis of the stomach, and familial intestinal gastric cancer. The risk of development of gastric cancer is high in families affected b-y these syndromes, but only hereditary diffuse gastric cancer is genetically explained (caused by germline alterations of CDH1, which encodes E-cadherin). Gastric cancer is also associated with a range of several cancer-associated syndromes with known genetic causes, such as Lynch, Li-Fraumeni, Peutz-Jeghers, hereditary breast-ovarian cancer syndromes, familial adenomatous polyposis, and juvenile polyposis. We present contemporary knowledge on the genetics, pathogenesis, and clinical features of familial gastric cancer, and discuss research and technological developments, which together are expected to open avenues for new genetic testing approaches and novel therapeutic strategies. © 2015 Elsevier Ltd.


Dias J.A.,Centro Hospitalar S Joao
Zdravniski Vestnik | Year: 2013

Eosinophilic oesophagitis was first described in 1992. Although there are some areas unclear in the pathophysiology, much has been unveiled. An increasing number of children and adolescents have this entity. Diagnosis relies on clinical, endoscopic and histological features. Biopsies of the oesophagus, although important, may not show all the events that lead to signs and symptoms. Although there have been consensus and guidelines published, it is clear that new diagnostic tools and therapeutic modalities are needed to address patients affected by this condition. Some relevant features of morphology, diagnosis and treatment are reviewed.


Magro F.,University of Porto | Magro F.,Centro Hospitalar S Joao | Abreu C.,Centro Hospitalar S Joao | Abreu C.,University of Porto
Best Practice and Research: Clinical Gastroenterology | Year: 2014

Immunosuppression induced by drugs increase the risk of infections in Crohn's disease (CD) patients. The vaccination rate in CD patients is usually low due to inaccurate information concerning the safety and efficacy of vaccines. Vaccines and immunoglobulins, are artificial ways of protection from common infectious diseases and they have had a major effect on mortality. Herein we detail the need of protection induced by vaccines of measles, varicella, Zoster, papillomavirus, shingles, pneumococcal invasive disease, influenza, hepatitis A and B in CD at diagnosis and during the course of the disease even during immunosuppression periods but with different singularities. Vaccination in CD travellers and the matters related to immunization of household healthy members of immunosuppressed patients are also discussed. © 2014 Elsevier Ltd. All rights reserved.


Silva-Dias A.,University of Porto | Miranda I.M.,University of Porto | Branco J.,University of Porto | Monteiro-Soares M.,University of Porto | And 4 more authors.
Frontiers in Microbiology | Year: 2015

We have performed the characterization of the adhesion profile, biofilm formation, cell surface hydrophobicity (CSH) and antifungal susceptibility of 184 Candida clinical isolates obtained from different human reservoirs. Adhesion was quantified using a flow cytometric assay and biofilm formation was evaluated using two methodologies: XTT and crystal violet assay. CSH was quantified with the microbial adhesion to hydrocarbons test while planktonic susceptibility was assessed accordingly the CLSI protocol for yeast M27-A3 S4. Yeast cells of non-albicans species exhibit increased ability to adhere and form biofilm. However, the correlation between adhesion and biofilm formation varied according to species and also with the methodology used for biofilm assessment. No association was found between strain's site of isolation or planktonic antifungal susceptibility and adhesion or biofilm formation. Finally CSH seemed to be a good predictor for biofilm formation but not for adhesion. Despite the marked variability registered intra and inter species, C. tropicalis and C. parapsilosis were the species exhibiting high adhesion profile. C. tropicalis, C. guilliermondii, and C. krusei revealed higher biofilm formation values in terms of biomass. C. parapsilosis was the species with lower biofilm metabolic activity. © 2015 Silva-Dias, Miranda, Branco, Monteiro-Soares, Pina-Vaz and Rodrigues.


Maximo V.,University of Porto | Rios E.,University of Porto | Rios E.,Centro Hospitalar S Joao | Sobrinho-Simoes M.,University of Porto | Sobrinho-Simoes M.,Centro Hospitalar S Joao
International Journal of Surgical Pathology | Year: 2014

Oncocytic cell represents a special phenotype of neoplastic cells reflecting a unique biologic process characterized by the huge proliferation of morphologically abnormal mitochondria in the cytoplasm of neoplastic cells. This phenotype is driven by quite specific molecular mechanisms that interfere with mitochondrial function and metabolism. The oncocytic phenotype is more common in tumors arising in tissues presenting low proliferative rate, such as thyroid, kidney, salivary glands, adrenal cortex, and parathyroid glands, and it is superimposed on the genotypic and conventional histologic features of the tumors. In this short review, we address the similarity of the molecular alterations and of the biological features of the neoplastic cells in the oncocytic tumors of the different organs. We also discuss the differential diagnosis of benign and malignant oncocytic tumors as well as the prognosis of the malignant ones. We conclude that this rather unique phenotype, which is observed in tumors from different organs, indicates common metabolic alterations that may represent a useful target for therapeutic purposes. © The Author(s) 2014.


Pinheiro H.,University of Porto | Oliveira C.,University of Porto | Seruca R.,University of Porto | Carneiro F.,University of Porto | Carneiro F.,Centro Hospitalar S Joao
Best Practice and Research: Clinical Gastroenterology | Year: 2014

Hereditary Diffuse Gastric Cancer is an autosomal dominant inherited gastric cancer syndrome caused by germline alterations in CDH1 (E-cadherin) and CTNNA1 (alpha-E-catenin) genes. Germline CDH1 alterations encompass small frameshifts, splice-site, nonsense, and missense mutations, as well as large rearrangements. Most CDH1 truncating mutations are pathogenic, and several missense CDH1 mutations have a deleterious effect on E-cadherin function. CDH1 testing should be performed in probands. Screening of at-risk individuals is indicated from the age of consent following counselling with a multidisciplinary team. In mutation-positive individuals prophylactic gastrectomy is recommended. Endoscopic surveillance is an option for those refusing/postponing gastrectomy, those with mutations of undetermined significance, and in CDH1- negative families. Ongoing research focus on the search of genetic causes other than CDH1 or CTNNA1 germline defects; assessment of the pathogenicity and penetrance of CDH1 missense mutations and identification of somatic mechanisms behind the progression from early (indolent) lesions to invasive (lethal) carcinomas. © 2014 Elsevier Ltd. All rights reserved.


Magro F.,University of Porto | Peyrin-Biroulet L.,University of Lorraine | Sokol H.,French Institute of Health and Medical Research | Aldeger X.,University of Girona | And 9 more authors.
Journal of Crohn's and Colitis | Year: 2014

The incidence of lymphoproliferative disorders (LD) is increasing in developed countries. Patients with inflammatory bowel disease (IBD) exposed to thiopurines are at additional risk of three specific forms of LD: Epstein-Barr-Virus-related post-transplant like LD, hepato-splenic T-cell lymphoma and post-mononucleosis lymphoproliferation. The risk of the two latter forms of LD can be reduced when considering specific immunosuppressive strategies in young males. It is still unclear whether the risk of uterine cervix abnormalities is increased in IBD women, irrespective of the use of immunosuppressants. Given the excess risk demonstrated in various other contexts of immunosuppression, it is currently recommended that all women with IBD, particularly those receiving immunosuppressants, strictly adhere to a screening program of cervical surveillance and undergo vaccination against HPV, when appropriate. Patients with IBD receiving immunosuppressants are at increased risk of skin cancers. The risk of non-melanoma skin cancer is notably increased in patients receiving thiopurines. Recent data suggest that the risk of melanoma is mildly increased in patients exposed to anti-TNF therapy. All IBD patients should adhere to a program of sun protection and dermatological surveillance, whose details should take into account the other non-IBD-related risk factors. © 2013 The Authors.

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