Martins S.F.,University of Minho |
Garcia E.A.,Barretos Cancer Hospital |
Pardal F.,Braga Hospital |
Rodrigues M.,Braga Hospital |
And 3 more authors.
Cancer Genomics and Proteomics | Year: 2013
Background: Colorectal cancer (CRC) is the third most common type of cancer and the fourth most frequent cause of cancer death. Literature indicates that vascular endothelial growth factor is a predominant angiogenic factor and that angiogenesis plays an important role in the progression of CRC. Patients and Methods: The present series consisted of tissue samples obtained from 672 patients who had undergone large bowel resection between 2005 and 2010 at the Braga Hospital, Portugal. Archival paraffin-embedded CRC tissue and normal adjacent samples were used to build up tissue microarray blocks and VEGF-A, VEGF-C, VEGFR-2 and VEGFR-3 expression was immunohistochemically assessed. Results: We observed an overexpression of VEGF-C in CRC when tumour cells and normal-adjacent tissue were compared (p=0.004). In tumour samples, VEGF-C-positive cases were associated with VEGFR-3 expression (p=0.047). When assessing the correlation between VEGF-A, VEGF-C, VEGFR-2 and VEGFR-3 expressions and the clinicopathological data, it was revealed that VEGF-A positive cases were associated with male gender (p=0.016) and well-differentiated tumours (p=0.001); VEGF-C with colon cancers (p=0.037), exophytic (p=0.048), moderately-differentiated (p=0.007) and T3/T4 (p=0.010) tumours; VEGFR-2 with invasive adenocarcinoma (p=0.007) and VEGFR-3 with the presence of hepatic metastasis (p=0.032). Overall survival curves for CRC were statistically significant for rectal cancer, VEGF-C expression and stage III (p=0.019) and VEGFR-3 expression and stage IV (p=0.047). Conclusion: Quantification of VEGF-A, VEGF-C, VEGFR-2 and VEGFR-3 expression seems to provide valuable prognostic information in CRC and the correlation with clinicopathological data revealed an association with characteristics that contribute to progression, invasion and metastasis leading to poorer survival rates and prognosis.
Antunes H.,Braga Hospital |
Antunes H.,University of Minho |
Rodrigues H.,Unidade Local de Saude do Alto Minho |
Silva N.,Braga Hospital |
And 5 more authors.
Journal of Clinical Virology | Year: 2010
Background: In 2006, bronchiolitis due to adenovirus nosocomial infections resulted in the closure of a pediatric department in northern Portugal. Objectives: To determine the etiology of bronchiolitis in northern Portugal. Study design: It was a prospective multicenter study on the etiology of bronchiolitis during the respiratory syncytial virus (RSV) season (November-April). Children ≤24 months of age admitted for a first wheezing episode were included. Nasopharyngeal specimens were analyzed by an indirect immunofluorescent-antibody assay (IFA) for RSV, adenovirus (HAdV), parainfluenza (PIV) 1-3 and influenza (IV) A and B and by polymerase chain reaction (PCR) or reverse transcription-PCR for the same viruses and for human metapneumovirus (hMPV), bocavirus (HBoV), rhinovirus (HRV), coronaviruses (229/E; NL63; OC43; HKU1) and enterovirus. Results: During this period, 253 children were included, 249 IFA analyses and 207 PCRs were performed. IFA detected RSV in 58.1%; PCR increased it to 66.7%. IFA detected HAdV in 3.2%, PCR 10.0%. PCR detected IV A in 5; IV B in 2; PIV 1 in 6, PIV 2 in 4 and PIV 3 in 11 cases. HBoV, as single agent in 2 cases, and HRV were positive in 8 samples and hMPV in 11. With this virus panel, 19.7% remained without etiology. Conclusions: The most frequent agent was RSV, followed by HAdV. PCR can be cost-effective and more accurate than IFA, which is crucial for HAdV that may be associated with significant mortality (IFA alone did not detect 2/3 of the cases). © 2010 Elsevier B.V. All rights reserved.
Pereira G.,Braga Hospital |
Silva J.C.,Portuguese Institute of Oncology of Porto |
Monteiro E.,Portuguese Institute of Oncology of Porto
Head and Neck Oncology | Year: 2012
Background: The management of cervical lymph node metastases from an unknown primary tumor remains a controversial subject. Recently, Positron Emission Tomography (PET) has proved useful in the detection of these tumors, even after an unsuccessful conventional diagnostic workup. This study was performed to assess the role of PET in the detection of occult primary head and neck carcinomas. Methods: A retrospective analysis of a four year period at a tertiary referral oncology hospital was conducted. Results: Of the 49 patients with cervical metastases of carcinoma from an unknown primary, PET detected a primary in 9 patients and gave 5 false positive and 4 false negative results. Detection rate, sensitivity, specificity and accuracy were of 18.4%, 69.2%, 86.1% and 81.6%, respectively. PET was also of substantial benefit in detecting distant metastatic disease and, thus, altered therapeutic strategies in a significant amount of patients. Conclusions: Therefore, PET is a valuable tool in the management of patients with occult primary head and neck carcinoma, not only because it provides additional information as to the location of primary tumors, but also due to the fact that it can detect unexpected distant metastases. © 2012 Pereira et al.; licensee BioMed Central Ltd.
Role of central obesity in risk stratification after an acute coronary event: Does central obesity add prognostic value to the Global Registry of Acute Coronary Events (GRACE) risk score in patients with acute coronary syndrome?
Martins A.,University of Minho |
Ribeiro S.,Braga Hospital |
Goncalves P.,University of Minho |
Correia A.,Braga Hospital
Revista Portuguesa de Cardiologia | Year: 2013
Background: Accurate risk stratification is an important step in the initial management of acute coronary syndrome (ACS), and current guidelines recommend the use of risk scores, such as the Global Registry of Acute Coronary Events risk score (GRACE RS). Recent studies have suggested that abdominal obesity is associated with cardiovascular events in patients with ACS. However, little is known about the additional value of abdominal obesity beyond risk scores. The aim of our study was thus to assess whether waist circumference, a surrogate of abdominal adiposity, adds prognostic information to the GRACE RS. Methods: This was a retrospective cohort study of ACS patients admitted consecutively to a cardiac care unit between June 2009 and July 2010. The composite of all-cause mortality or myocardial reinfarction within six months of index hospitalization was used as the endpoint for the analysis. Results: A total of 285 patients were studied, 96.1% admitted for myocardial infarction (withor without ST elevation) and 3.9% for unstable angina. At the end of the follow-up period, 10 patients had died and the composite endpoint had been reached in 27 patients (9.5%). More than 70% of the study population were obese or overweight, and abdominal obesity was present in 44.6%. The GRACE RS showed poor predictive accuracy (area under the curve 0.60), and most of the GRACE variables did not reach statistical significance in multivariate analysis. The addition of waist circumference to the GRACE RS did not improve its discriminatory performance. Conclusion: Abdominal obesity does not add prognostic information to the GRACE RS to predict six-month mortality or myocardial reinfarction. © 2012 Sociedade Portuguesa de Cardiologia. All rights reserved.
PubMed | University of Minho and Braga Hospital
Type: | Journal: BMJ case reports | Year: 2016
A 73-year-old woman was admitted to the emergency room due to sudden-onset dyspnoea, altered mental status and haemodynamic instability. ECG showed a junctional rhythm, T-wave inversion in I, aVL and V2-V6 (present in a previous ECG), and no ST/T changes in the right precordial leads. Transthoracic echocardiography, however, revealed a severe depression of global systolic function of right ventricle with akinesia of free wall and a normal left ventricular function. Coronary angiography showed an occlusion of the proximal segment of the right coronary artery, which was treated with balloon angioplasty, and a chronic lesion of the anterior descending artery. The patient had a good recovery and was discharged on the 14th day. Myocardial perfusion scintigraphy (stress and rest) was performed a month later, showing a fixed perfusion defect in the apex and anterior wall (medium-apical), with no signs of ischaemia.
PubMed | St Antonio General Hospital, Hospital for Sick Children, University of Algarve, Hospital Universitario Central Of Asturias and 10 more.
Type: | Journal: Histopathology | Year: 2016
NUT midline carcinoma (NMC) is a rare undifferentiated and aggressive carcinoma that characteristically locates to the midline of the head and neck, and mediastinum. NMC is characterised by chromosomal rearrangements of the gene encoding nuclear protein in testis, NUT, at 15q14. The BRD4 gene on 19q13 is the most common translocation partner forming a fusion oncogene, BRD4-NUT. By the end of 2014, the International NUT Midline Carcinoma Registry had 48 patients treated for NMC. Laryngeal NMC are exceedingly rare and we report a case series of seven cases.We searched for cases in files of different hospitals as well as a thorough search of the English literature. The diagnosis of NMC is made by demonstration of NUT rearrangement either by immunohistochemistry, FISH or RT-PCR. We found three previously published cases and add in this series four cases of our own.NMC consists of monomorphic, often discohesive, cells with an epithelioid appearance and distinct nucleoli. The tumours typically show abrupt squamous differentiation. The mean age of the patients was 34 years, hence significantly lower than that for conventional laryngeal carcinoma. All tumours were located in the supraglottis and five patients died of the disease after 3, 7, 8, 9 and 11 months. Laryngeal NMC may be underdiagnosed and an increased awareness amongst pathologists is warranted. NMC has characteristic morphological features and positive immunostaining with the NUT antibody is diagnostic. Its aggressive behaviour demands a very intense treatment strategy and the need for its recognition is further emphasised by new promising treatment strategies. This article is protected by copyright. All rights reserved.
Beleza P.,Luz Saude Arrabida Hospital and Clipovoa |
Rocha J.,Braga Hospital |
Pinho J.,Braga Hospital
Neurologist | Year: 2015
Background: Nonconvulsive status epilepticus (NCSE) defines a prolonged electrographic seizure activity resulting in nonconvulsive symptoms. Semiology is a crucial element in diagnosis, etiological evaluation, and treatment plan of NCSE. It includes mostly generalized myoclonic status (GMS), focal simple motor status (FSMS), and dyscognitive status (DS). Review Summary: This review aims to guide clinicians in diagnosis, etiological evaluation, and treatment of patients with NCSE based on semiological presentation. Conclusions: Diagnosis of GMS and FSMS is based mainly on semiology, whereas DS often requires EEG for differential diagnosis with nonepileptic events. GMS and FSMS etiological investigation may be readily prioritized based on semiological type, whereas DS requires EEG for further classification in psychomotor status and absence status. Choice of appropriate treatment is dictated by the semiological presentation, EEG findings, and etiology. Surgery and other interventions including electroconvulsive therapy and vagal nerve stimulation should be considered in patients refractory to medical treatment. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
PubMed | University of Rome La Sapienza, Braga Hospital and University of Catanzaro
Type: | Journal: BMC cancer | Year: 2016
To test in multicenter setting if patients affected of metabolic syndrome (MetS) and initial widespread high grade prostatic intraepithelial neoplasia (wHGPIN) diagnosis are at higher risk of prostate cancer (PCa) on repeat biopsy.Patients clinical charts from three European Academic Hospital were reviewed in order to identify patients with initial diagnosis of HGPIN undergone to repeat biopsy. Inclusion and exclusion criteria were adopted to minimize patient heterogeneity. MetS was defined according to Word Heart Organization criteria while initial wHGPIN when 4 cores biopsy were involved. A multivariate logistic model was computed to assess the association between PCa and clinical-pathological variables.Overall 283 patients were scheduled. Median age was 67 years (IQR 62-72). MetS was diagnosed in 116/283 (41%) patients and PCa was detected in 84/283 (29.7%) patients. In particular, PCa was more frequently diagnosed in patients affected of wHGPIN and MetS (45/86, 52.3%) than in patients with wHGPIN and normal metabolic profile (28/95, 29.5%), p = 0.002. The multivariate logistic model confirmed that wHGPIN and MetS are independent risk factors for following PCa diagnosis, respectively OR 2.4 (95% CI 1.01-5.71, p = 0.04), OR 2.79 (95% CI 1.49-5.22, p = 0.01) while total PSA and DRE findings are not able to predict PCa at repeat biopsy, OR 1.05 (95% CI 0.98-1.03 p = 0.69) and OR 1.01 (95% CI 0.55-1.84, p = 0.96) respectively.wHGPIN is positively associated to PCa; assessing metabolic profile and repeat prostate biopsy is advisable in patients with initial diagnosis of wHGPIN.
Rocha S.,Braga Hospital
Arquivos de neuro-psiquiatria | Year: 2011
It was suggested that intravenous thrombolysis (IT) leads to larger extent recanalization in cardioembolic stroke. In this work we assess if this has beneficial clinical traduction. We evaluated 177 patients undergoing IT, which were categorized into cardioembolic (CE) and non-cardioembolic (NCE). National Institutes of Health Stroke Scale (NIHSS) and modified Rankin scale were compared. The mean age was 67.4 ± 12.01 and 53.8% were male. The mean NIHSS was: 14 (admission), 9 (24 h) and 6 (discharge), similar in subgroups. The difference between NIHSS at admission and 24 hours was 4.17 ± 4.92 (CE: 4.08 ± 4.71; NCE: 4.27 ± 5.17, p=0.900) and at admission and discharge there was an average difference of 6.74 ± 5.58 (CE: 6.97 ± 5.68; NCE: 6.49 ± 5.49, p=0.622). The mRS at discharge and 3 months was not significantly different by subtype, although individuals whose event was NCE are more independent at 3 months. Ours findings argue against a specific paper of IT in CE. It can result from heterogeneity of NCE group.
Beleza P.,Braga Hospital |
Pinho J.,Braga Hospital
Journal of Clinical Neuroscience | Year: 2011
About one-quarter of patients with refractory focal epilepsies have frontal lobe epilepsy (FLE). The typical seizure semiology for FLE includes unilateral clonic, tonic asymmetric or hypermotor seizures. Interictal electroencephalograms (EEG) usually reveal interictal epileptiform discharges and rhythmical midline theta, which has localizing value. The usefulness of ictal EEG recordings is limited by frequent muscle artifacts in motor seizures and because a large portion of the frontal lobe cortex is "hidden" to scalp electrodes. Ictal single photon emission CT and positron emission tomography are able to localize FLE in about one-third of patients only. A pre-surgical evaluation should include, whenever possible, a subclassification of FLE as dorsolateral frontal, mesial frontal or basal frontal lobe epilepsy to allow a minimal cortical resection. A review of the typical findings of seizure semiology, interictal and ictal EEG regarding the different FLE subtypes is given. Etiology, medical treatment and surgery are also discussed. © 2010 Elsevier Ltd. All rights reserved.