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Percorrer por autor "Ferreira, A"

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  • Chronic Intestinal Failure and Short Bowel Syndrome in Adults: The State of the Art
    Publication . Vara-Luiz, F; Glória, L; Mendes, I; Carlos, S; Guerra, P; Nunes, G; Oliveira, CS; Ferreira, A; Santos, AP; Fonseca, J
    Background: Short bowel syndrome (SBS) is a devastating malabsorptive condition and the most common cause of chronic intestinal failure (CIF). During the intestinal rehabilitation process, patients may need parenteral support for months or years, parenteral nutrition (PN), or hydration/electrolyte supplementation, as a bridge for the desired enteral autonomy. Summary: Several classification criteria have been highlighted to reflect different perspectives in CIF. The management of CIF-SBS in adults is a multidisciplinary process that aims to reduce gastrointestinal secretions, slow transit, correct/prevent malnutrition, dehydration, and specific nutrient deficiencies, and prevent refeeding syndrome. The nutritional support team should have the expertise to take care of these complex patients: fluid support; oral, enteral, and PN; disease/PN-related complications; pharmacologic treatment; and surgical prevention/treatment. Key messages: CIF-SBS is a complex disease with undesired consequences, if not adequately identified and managed. A comprehensive approach performed by a multidisciplinary team is essential to reduce PN dependence, promote enteral independence, and improve quality of life.
    2024Artigo científico Acesso aberto Ver mais
  • Chronic treatment with hydroxychloroquine and SARS-CoV-2 infection
    Publication . Ferreira, A; Oliveira-e-Silva, A; Bettencourt, P
    Hydroxychloroquine sulfate (HCQ) is being scrutinized for repositioning in the treatment and prevention of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This antimalarial drug is also chronically used to treat patients with autoimmune diseases. By analyzing the Portuguese anonymized data on private and public based medical prescriptions we have identified all cases chronically receiving HCQ for the management of diseases, such as systemic lupus erythematosus, rheumatoid arthritis, and other autoimmune diseases. Additionally, we have detected all laboratory confirmed cases of SARS-CoV-2 infection and all laboratory confirmed negative cases in the Portuguese population (mandatorily registered in a centrally managed database). Cross linking the two sets of data has allowed us to compare the proportion of HCQ chronic treatment (at least 2 grams per month) in laboratory confirmed cases of SARS-CoV-2 infection with laboratory confirmed negative cases. Out of 26 815 SARS-CoV-2 positive patients, 77 (0.29%) were chronically treated with HCQ, while 1215 (0.36%) out of 333 489 negative patients were receiving it chronically (P = .04). After adjustment for age, sex, and chronic treatment with corticosteroids and/or immunosuppressants, the odds ratio of SARS-CoV-2 infection for chronic treatment with HCQ has been 0.51 (0.37-0.70). Our data suggest that chronic treatment with HCQ confer protection against SARS-CoV-2 infection.
    2020-07-09Artigo científico Acesso aberto Ver mais
  • Colonoscopic findings in a true screening program for colorectal cancer (without previous fecal occult blood testing): the firts 500 procedures
    Publication . Soares, J; Lopes, S; Gonçalves, R; Ferreira, A; Pereira, P; Rolanda, C; Machado, A; Macedo, G
    2009Artigo científico Acesso aberto Ver mais
  • Complete blood count parameters as biomarkers of retinopathy of prematurity: a Portuguese multicenter study
    Publication . Fevereiro-Martins, M; Santos, AC; Marques-Neves, C; Guimarães, H; Bicho, M; Afonso, C; Ferreira, J; Espírito Santo, R; Teixeira, F; Rosa, R; Carneiro, CV; Ferreira, M; Matos, T; Neiva, L; Pereira, S; Aires, S; Parreira, R; Melnik, Z; Faria, J; Teixeira, J; Barros, P; Almeida, J; Malheiro, B; Rodrigues, PC; Albuquerque, L; Freitas, A; Barros, P; Kotchekova, N; Freitas, R; Silveira, AC; Ferreira, A; Morais, B; Teixeira, S; Mota, M; Guerra, M; Coimbra, L; Gigante, J; Ferreira, M; Lapa, P; Monteiro, M; Alfaiate, M; Rodrigues, T; Pina, T; Rosário, M; Silva, R; Breda, J; Bazenga, F; Pinto, JA
    Purpose: To evaluate complete blood count (CBC) parameters in the first week of life as predictive biomarkers for the development of retinopathy of prematurity (ROP). Methods: Multicenter, prospective, observational study of a cohort of preterm infants born with gestational age (GA) < 32 weeks or birth weight < 1500 g in eight Portuguese neonatal intensive care units. All demographic, clinical, and laboratory data from the first week of life were collected. Univariate logistic regression was used to assess risk factors for ROP and then multivariate regression was performed. Results: A total of 455 infants were included in the study. The median GA was 29.6 weeks, and the median birth weight was 1295 g. One hundred and seventy-two infants (37.8%) developed ROP. Median values of erythrocytes (p < 0.001), hemoglobin (p < 0.001), hematocrit (p < 0.001), mean corpuscular hemoglobin concentration (p < 0.001), lymphocytes (p = 0.035), and platelets (p = 0.003) of the group of infants diagnosed with ROP any stage were lower than those without ROP. Mean corpuscular volume (MCV) (p = 0.044), red blood cell distribution width (RDW) (p < 0.001), erythroblasts (p < 0.001), neutrophils (p = 0.030), neutrophils-lymphocytes ratio (p = 0.028), and basophils (p = 0.003) were higher in the ROP group. Higher values of MCV, erythroblasts, and basophils remained significantly associated with ROP after multivariate regression. Conclusion: In our cohort, the increase in erythroblasts, MCV, and basophils in the first week of life was significantly and independently associated with the development of ROP. These CBC parameters may be early predictive biomarkers for ROP.
    2023Artigo científico Acesso aberto Ver mais
  • Congenital intrahepatic shunt presenting as a pseudometastatic
    Publication . Ferreira, A; Pereira, P; Pardal, F; Macedo, G
    2009Artigo científico Acesso aberto Ver mais
  • Decisões clínicas na doença de Crohn
    Publication . Magro, F; Correia, L; Lago, P; Macedo, G; Peixe, P; Portela, F; Ferreira, A; Gonçalves, R; et al
    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.
    2012Artigo científico Acesso aberto Ver mais
  • Development of Dl1.72, a Novel Anti-DLL1 Antibody with Anti-Tumor Efficacy against Estrogen Receptor-Positive Breast Cancer
    Publication . Silva, G; Sales-Dias, J; Casal, D; Alves, S; Domenici, G; Barreto, C; Matos, C; Lemos, AR; Matias, AT; Kucheryava, K; Ferreira, A; Moita, MR; Braga, S; Brito, C; Cabral, MG; Casalou, C; Barral, DC; Sousa, PM; Videira, PA; Bandeiras, TM; Barbas, A
    Aberrant Notch signaling is implicated in several cancers, including breast cancer. However, the mechanistic details of the specific receptors and function of ligand-mediated Notch signaling that promote breast cancer remains elusive. In our studies we show that DLL1, a Notch signaling ligand, is significantly overexpressed in ERα+ luminal breast cancer. Intriguingly, DLL1 overexpression correlates with poor prognosis in ERα+ luminal breast cancer, but not in other subtypes of breast cancer. In addition, this effect is specific to DLL1, as other Notch ligands (DLL3, JAGGED1, and JAGGED2) do not influence the clinical outcome of ERα+ patients. Genetic studies show that DLL1-mediated Notch signaling in breast cancer is important for tumor cell proliferation, angiogenesis, and cancer stem cell function. Consistent with prognostic clinical data, we found the tumor-promoting function of DLL1 is exclusive to ERα+ luminal breast cancer, as loss of DLL1 inhibits both tumor growth and lung metastasis of luminal breast cancer. Importantly, we find that estrogen signaling stabilizes DLL1 protein by preventing its proteasomal and lysososmal degradations. Moreover, estrogen inhibits ubiquitination of DLL1. Together, our results highlight an unexpected and novel subtype-specific function of DLL1 in promoting luminal breast cancer that is regulated by estrogen signaling. Our studies also emphasize the critical role of assessing subtype-specific mechanisms driving tumor growth and metastasis to generate effective subtype-specific therapeutics.
    2021Artigo científico Acesso aberto Ver mais
  • A Different Kind of Colon Polyps
    Publication . Ferreira, A; Gonçalves, R; Rolanda, C
    2012Artigo científico Acesso aberto Ver mais
  • Diffuse Hepatic Metastasis—Or Not?
    Publication . Ferreira, A; Pereira, P; Rolanda, C
    2012Artigo científico Acesso aberto Ver mais
  • Doença de Still do adulto: como causa do síndrome febril indeterminado
    Publication . Diogo, M; Soares, J; Pimentel, T; Ferreira, A
    Fever of unknown origin remains a diagnostic challenge with up to 50% of unexplained cases. Adult-onset Still disease typically present high fever, arthralgia, rash, pharyngitis and serositis, lymphadenopathy and hepatosplenomegaly, inflammatory markers and hepatic enzymes elevation and negative immunological study. The authors present a 46-year old man with previous admissions for fever of unknown origin with a 3-week history of fever and systemic symptoms. The study disclosed anaemia, inflammatory markers and hepatic enzymes elevation, splenomegaly and negative serological and immunological studies. The patient posteriorly presented polyarthralgias and cutaneous rash. The introduction of corticotherapy resolved symptoms and laboratories alterations. Adult-onset Still disease is a heterogeneous and rare disease and the lack of serologic markers as a true gold standard makes diagnosis difficult.
    2010Artigo científico Acesso aberto Ver mais