Browsing by Author "Carvalho, A"
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- Annual costs of chronic hepatitis B disease states in PortugalPublication . Raluy, M; De Cock, E; Tato-Marinho, R; Areias, J; Calinas, F; Carvalho, A; Matos, L; Rodrigues, B; Macedo, G; Velosa, J; Perelman, J
- Chronic Hepatitis C Treated with Peginterferon alfa plus Ribavirin in Clinical PracticePublication . Velosa, J; Serejo, F; Bana, T; Redondo, I; Simão, A; Vale, AM; Pires, S; Macedo, G; Marinho, R; Peixe, P; Sarmento, J; Matos, L; Calinas, F; Carvalho, A; Figueiredo, AFrom 1907 patients with chronic hepatitis C proposed for treatment, we analysed 1380 (1124 naive and 256 treatment-experienced) with complete follow-up. Genotype and HCV RNA quantification were assayed by commercial tests. Viremia was considered high if >800,000IU/mL, and low if <400,000IU/mL. Liver fibrosis was staged in 614 patients. RESULTS: Genotype 1 was the most frequent (60%), followed by 3 (25%), 4 (9%) and 2 (2%); 3.2% had other or unclassified genotype. Genotype 1 was more prevalent in central Portugal and genotype 4 in the south. Viremia was =800,000IU/mL in 54.6% and <400,000IU/mL in 34.6% of the patients, particularly in genotype 2 (p<0.03) and 4 (p<0.001). Genotype non-1 had a significantly lower viral load (p=0.004). Mild or moderate fibrosis was present in 71.7% and bridging fibrosis or cirrhosis in 28.3%, with no differences among genotypes. Treatment was discontinued in 19.8%. SVR was achieved in 55.3% of naive and 36.3% of re-treated patients. CONCLUSIONS: Standard treatment of chronic hepatitis C in real-life achieves similar results obtained in clinical trials, despite differences of demographic and viral parameters.
- Complicação Rara Após Gastrectomia TotalPublication . Ribas, S; Gomes; Pereira, R; Carvalho, A
- Divertículo de Meckel perfurado por palito: relato de um caso clínicoPublication . Goulart, A; Pereira, R; Leão, P; Gomes, C; Carvalho, A
- Divertículo de Meckel perfurado por palito: relato de um caso clínicoPublication . Goulart, A; Pereira, R; Leão, P; Gomes, C; Carvalho, A
- Internamentos por Linfadenite Cervical num Serviço de Pediatria GeralPublication . Lito, D; Pignatelli, D; Simões, AS; Carvalho, A; Cunha, F
- Kawasaki Disease: A Rare Case of a Non-pediatric PatientPublication . Ramos, M; Seguro Paula, F; Carvalho, A; Pinheiro, M; Ramos, AKawasaki disease (KD) is an inflammatory condition more common in children but rare in adults, where diagnosis can be challenging due to nonspecific symptoms. Early recognition is essential to prevent severe complications. We present the case of a 26-year-old male with adult-onset KD who initially presented with vague symptoms, resulting in diagnostic delays. The condition progressed to life-threatening cardiovascular complications, including coronary artery aneurysms, underscoring the critical need for prompt identification and management. Timely treatment with intravenous immunoglobulin and corticosteroids led to clinical improvement and prevention of further cardiac damage. This case highlights the importance of heightened clinical awareness of KD in adults and the necessity of a proactive diagnostic approach. Future research should aim to refine diagnostic criteria for adult KD and explore strategies for improving early detection and long-term cardiovascular outcomes in this rare population.
- Meningite criptocócica em doentes com infecção VIH - análise retrospectiva dos casos seguidos no H.S.Marcos entre 1998 e 2004Publication . Ângela, C; Leal, D; Carvalho, A; Oliveira, N; Pimentel, T; Ferreira, MS
- Practical Guidance on the Detection of NTRK Fusions in Sarcomas: Current Status and Diagnostic ChallengesPublication . Fernandes, I; Macedo, D; Gouveia, E; Ferreira, A; Lima, J; Lopez, D; Melo-Alvim, C; Carvalho, A; Tavares, P; Rodrigues-Santos, P; Cardoso, P; Magalhães, M; Vieira, P; Brito, J; Mendes, C; Rodrigues, J; Netto, E; Oliveira, V; Sousa, C; Henriques Abreu, M; Pina, F; Vasques, HSarcomas are a rare and heterogeneous group of mesenchymal malignant tumors and account for approximately 1% of all adult cancers and around 20% of all pediatric solid tumors in Europe. Technology advances have enabled a more accurate and efficient characterization of the molecular mechanisms underlying the pathogenesis of sarcoma subtypes and revealed novel and unexpected therapeutic targets with prognostic/predictive biomarkers, namely the neurotrophic tyrosine receptor kinase (NTRK) gene fusion. The NTRK fusion assessment has recently become a standard part of management for patients with unresectable locally advanced or metastatic cancers and has been identified in various tumor types. In the more prevalent adult and pediatric sarcomas, NTRK fusions are present in 1% and 20%, respectively, and in more than 90% of very rare subsets of tumors. The inhibition of TRK activity with first-generation TRK inhibitors has been found to be effective and well tolerated in adult and pediatric patients, independently of the tumor type. Overall, the therapeutic benefit to those patients compensates for the difficulties of identifying NTRK gene fusions. However, the rarity and diagnostic complexity of NTRK gene fusions raise several questions and challenges for clinicians. To address these issues, an expert panel of medical and pediatric oncologists, radiologists, surgeons, orthopedists, and pathologists reviewed the recent literature and discussed the current status and challenges, proposing a diagnostic algorithm for identifying NTRK fusion sarcomas. The aim of this article is to review the updated information on this issue and to provide the experts' recommendations and practical guidance on the optimal management of patients with soft tissue sarcomas, infantile fibrosarcoma, gastrointestinal stromal tumors, and osteosarcoma.
- Primary cutaneous actinomycosis caused by Actinomyces meyeri as first manifestation of HIV infectionPublication . Gomes, J; Pereira, T; Carvalho, A; Brito, CPrimary cutaneous actinomycosis is very uncommon. We report a patient with cutaneous actinomycosis with multiple lesions without any detectable extra-cutaneous lesions. In our patient the actinomycosis was the presenting manifestation of HIV infection.