Percorrer por autor "Querido, Sara"
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- Fatal acute necrohaemorrhagic pancreatitis with massive intraperitoneal and retroperitoneal bleeding: a rare cause of exsanguinationPublication . Querido, Sara; Carvalho, Inês; Moleiro, Filipa; Póvoa, Pedro"An otherwise healthy 37-year-old man was admitted to hospital with uncontrollable vomiting and abdominal pain. Lithiasic acute pancreatitis was diagnosed on the basis of clinical symptoms along with raised serum amylase levels and compatible findings in ultrasonography and CT scan. Two Ranson criteria (lactate dehydrogenase over 350 U/L and aspartate aminotransferase over 250 U/L) were present at admission. The patient was transferred to an intensive care unit (ICU); intravenous crystalloids were prescribed and analgaesics were administered for pain relief. Unexpectedly, 10 h after ICU admission, he presented a cardiac arrest with a non-defibrillate rhythm and died after 40 min of advanced life support. An autopsy was performed and revealed acute necrohaemorrhagic pancreatitis with massive intraperitoneal and retroperitoneal haemorrhage. This case report summarises the epidemiology, pathophysiology and risk factors for fatal bleeding acute pancreatitis."
- Kinetics of torque teno virus viral load is associated with infection and de novo donor specific antibodies in the first year after kidney transplantation : a prospective cohort studyPublication . Querido, Sara; Martins, Catarina; Gomes, Perpétua; Pessanha, Maria Ana; Arroz, Maria Jorge; Adragão, Teresa; Casqueiro, Ana; Oliveira, Regina; Costa, Inês; Azinheira, Jorge; Paixão, Paulo; Weigert, AndréTorque teno virus (TTV) was recently identified as a potential biomarker for the degree of immunosuppression, and potentially as a predictor of rejection and infection in solid organ transplant patients. We evaluated TTV viral load in kidney transplant (KT) patients during the first year post-transplant to examine overall kinetics and their relationships with deleterious events, including episodes of infection and the formation of de novo donor-specific antibodies (DSAs). In a single-center, prospective observational cohort study, 81 KT patients were monitored at baseline, week 1, and month 1, 3, 6, 9 and 12, post-KT, and whenever required by clinical events. Kidney function, plasma TTV load, immunoglobulins and lymphocyte subpopulations were assessed at each time point. Twenty-six patients (32.1%) presented a total of 38 infection episodes post-KT. Induction immunosuppression with thymoglobulin, compared to basiliximab, was not associated with more infections (p = 0.8093). Patients with infectious events had lower T-cells (p = 0.0500), CD8+ T-cells (p = 0.0313) and B-cells (p = 0.0009) 1 month post-KT, compared to infection-free patients. Patients with infection also showed higher increases in TTV viral loads between week 1- month 1, post-KT, with TTV viral load variations >2.65 log10 cp/mL predicting the development of infectious events during the 12-month study period (p < 0.0001; sensitivity 99.73%; specificity 83.67%). Patients who developed de novo DSAs had lower TTV DNA viral loads at month 12 after KT, compared to patients who did not develop DSA (3.7 vs. 5.3 log10 cp/mL, p = 0.0023). Briefly, evaluating early TTV viremia is a promising strategy for defining infectious risk in the 1st year post-KT. The availability of standardized commercial real-time PCR assays is crucial to further validate this as an effective tool guiding immunosuppression prescription.
- Outcomes of living kidney donor candidates and living kidney recipient candidates with JC Polyomavirus and BK Polyomavirus viruriaPublication . Querido, Sara; Ormonde, Carolina; Adragão, Teresa; Costa, Inês; Pessanha, Maria Ana; Gomes, Perpétua; Weigert, AndréIntroduction. Recent data have emerged about a protective association between JCV viruria and chronic kidney disease (CKD). Material and Methods. Single-center retrospective cohort study; 230 living kidney donors (LKD) candidates and 59 potential living kidney receptors (LKR) were enrolled. Plasma and urinary JCV and BKV viral loads were measured in all LKD candidates and in nonanuric LKR candidates. Twenty-six living kidney transplant surgeries were performed. LKR were followed in order to evaluate BKV and JCV viremia and urinary viral shedding after KT. Results. In LKD candidates, JCV viruria was negatively associated with proteinuria of >200 mg/24 hours (JC viruric LKD: 12.5% vs JCV nonviruric LKD: 26.7%, p = 0.021, OR:0.393; 95% CI: 0.181–0.854). In a multivariate analysis, LKD candidates with JCV viruria had a lower risk of proteinuria of >200 mg/24 hours (p = 0.009, OR: 0.342, 95% CI: 0.153–0.764), in a model adjusted for age, gender, presence of hypertension, and eGFR <80 mL/min. Prevalence of JCV viruria was higher in LKD candidates when compared with LKR candidates (40.0% vs 1.7%, p < 0.001). Among the 26 LKR, 14 (53.8%) KT patients evolved with JCV viruria; 71.4% received a graft from a JCV viruric donor. Conclusion. Our data corroborate the recent findings of an eventual protective association between JCV viruria and kidney disease, and we extrapolated this concept to a South European population.