http://comum.rcaap.pt/handle/123456789/1936 2013-05-20T00:42:15Z 2013-05-20T00:42:15Z Magro, F Correia, L Lago, P Macedo, G Peixe, P Portela, F Ferreira, A Gonçalves, R et al http://comum.rcaap.pt/handle/123456789/3879 2013-04-05T14:02:33Z 2012-01-01T00:00:00Z

Title: Decisões clínicas na doença de Crohn Authors: Magro, F; Correia, L; Lago, P; Macedo, G; Peixe, P; Portela, F; Ferreira, A; Gonçalves, R; et al Abstract: Introduction: Crohn s disease is a chronic inflammatory disease from gastrointestinal tract. The increase in incidence and heterogeneity of this pathology, with different presentations and prognostics leads to a constant concern in developing and improving its classification and treatment. Objectives: To establish recommendations (based on level of evidence and recommendation grades) to 5 questions considered as the clinical challenges of the therapeutic approach in Crohn s disease. Methods: The methodology adopted by the working group DC2 (Desafios Clínicos na Doença de Crohn) was based on the selection of 5 questions, by voting, and establishing recommendations to each question proposed to each subgroup. Discussion and approval of reflexions and final recommendations was carried out in a consensus meeting. Conclusion: It has been possible to base conclusions about the questions under study on evidence, being recommended: 1) having Crohn s disease under 40 years old, structuring phenotype disease and anal disease are predictive factors of bad prognostic; 2) it is possible to consider suspension of biologics in patients with endoscopic remission and normal biomarkers; 3) patients with biochemical markers of disease activity (CRP and calprotectina) have more probability of relapse; 4) in failure of biologics it is essential to assure that treatment with the first drug was optimized: with infliximab it s demonstrated that either reduction of the administration range or increasing the dose allows to recover the response in the majority of patients; as for adalimumab, patients should change from bimonthly to weekly administrations; 5) in case of Crohn s disease with intestinal surgery, use of therapeutic to reduce postoperative recurrence is indicated, particularly immunosupressors and biologics.

2012-01-01T00:00:00Z Rolanda, C http://comum.rcaap.pt/handle/123456789/3878 2013-04-05T13:54:44Z 2011-01-01T00:00:00Z

Title: Colecistectomia Videolaparoscópica Transumbilical Single Site com Equipamento de Laparoscopia Convencional Authors: Rolanda, C Abstract: artigo intitulado Colecistectomia videolaparoscópica transumbilical (single site) com equipamento de laparoscopia convencional recentemente publicado por Alves Júnior e colaboradores mereceu-nos atenção e algumas considerações que gostaria de partilhar. Embora aborde uma temática tradicionalmente adstrita à Cirurgia Geral, vale a pena revisitar alguns conceitos e perceber o contexto actual da cirurgia minimamente invasiva (MIS), onde também temos lugar enquanto gastrenterologistas.

2011-01-01T00:00:00Z Antunes, H Nascimento, J Peixoto, P http://comum.rcaap.pt/handle/123456789/3876 2013-04-08T13:48:35Z 2013-01-01T00:00:00Z

Title: Peutz-Jeghers syndrome: capsule endoscopy to stage disease Authors: Antunes, H; Nascimento, J; Peixoto, P

2013-01-01T00:00:00Z Moreira-Pinto, J Ferreira, A Rolanda, C Correia-Pinto, J http://comum.rcaap.pt/handle/123456789/3592 2013-01-10T16:06:12Z 2012-01-01T00:00:00Z

Title: Natural orifice transesophageal endoscopic surgery: state of the art Authors: Moreira-Pinto, J; Ferreira, A; Rolanda, C; Correia-Pinto, J Abstract: The main goal of Natural Orifice Transluminal Endoscopic Surgery (NOTES) is performing surgery avoiding skin incisions. Theoretical advantages of NOTES include decreased postoperative pain, reduction/elimination of general anesthesia, improved cosmetic outcomes, elimination of skin incision-related complications such as wound infections and hernias, and increased overall patient satisfaction. Although various forms of port creation to accomplish thoracic NOTES procedures have been proposed, transesophageal NOTES has been shown to be the most reliable one. The evolution of endoscopic submucosal transesophageal access resulted in the development of per-oral endoscopic myotomy (POEM), which had a fast transition to clinical practice. The authors present a review of the current state of the art concerning transesophageal NOTES, looking at its potential for diagnostic and therapeutic interventions as well as the hurdles yet to be overcome.

2012-01-01T00:00:00Z