Browsing by Author "Sousa, C"
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- Extrinsic allergic alveolitis: home exposure can´t be forgottenPublication . Sousa, C; Gonçalves, A; Ferraz, C; Vaz, LG
- Food Intake in Pregnant Women with Gestational Diabetes MellitusPublication . Lemos, A; Lopes, AR; Bernardo, J; Furtado, T; Sousa, CRationale: The aim of the present study was to verify the fulfillment of the nutritional requirements of macronutrients of pregnant women diagnosed with Gestational Diabetes Mellitus (GDM) at Lusíadas Lisboa Hospital. Inadequate glycemic control in GDM increases the risk of maternal, fetal and neonatal consequences, in this sense, nutritional therapy is essential during the follow-up of these pregnant women. Methods: Cross-sectional observational study. The study sample included 20 pregnant women diagnosed with GDM. Participants were asked to answer a questionnaire that included relevant data and to complete a three-day food record, for which they gave consent. A statistical analysis was performed with IBM® SPSS® 25. Results: The mean age measured was 35±4 years and 75% of the sample were in the 3º trimester. In the pre-gestational period, the sample had a Body Mass Index (BMI) of 26,2±5,3kg/m2 . The mean fasting capillary blood glucose was 89±9mg/dL and the postprandial was 119±19mg/dL. 75% reached the fasting glycemic objective and 95% the postprandial. It was also found that pregnant women who didn´t meet the goal set for fasting blood glucose, had higher pre-gestational BMI. In terms of macronutrients, it was found that 75% of the sample didn´t reach Total Energy Requirements (TER), 50% didn´t reach protein (1,1g/kg of current weight/day and 15-20% TER), 10% lipid (30% TER) and all carbohydrates (50-55% TER), with only 35% reaching the daily minimum of carbohydrates (175g). It was also found that sample didn´t reach 28g/day of fiber. Conclusions: The present study demonstrated the importance of an individualized nutritional intervention by a nutritionist with pregnant women diagnosed with GDM. The importance of this intervention is based on adherence to an adequate dietary pattern that prevents nutritional deficits, enhances clinical outcomes and contributes to the prevention of the incidence of GDM.
- 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.
- The reality of an Obesity Surgical Treatment Center in PortugalPublication . Lopes, AR; Bernardo, J; Furtado, T; Sousa, C; Lemos, AIntroduction: Obesity surgery is used as the most effective treatment for morbid obesity, with better cost-benefit, less morbidity and mortality. The present study aimed to analyze the results of a surgical center for obesity treatment and integrate them with the most recent scientific evidence. Methods: Retrospective cross-sectional observational study involving 270 patients aged 18 years or older, who underwent bariatric surgery between July 2008 and February 2020 in a private hospital in Portugal. Results: The sample presented an average age of 44 ± 12 years, being mostly female (83.7%). The average pre-surgery Body Mass Index was 41.1 ± 4.9 kg/m2 . The most performed surgery was Gastric Bypass (80.4%), followed by Gastric Banding (14.8%) and Gastric Sleeve (4.8%). One month after surgery, there was a percentage of excess weight lost (% EWL) of 25.2 ± 9.6%. After 6 months, there was an average % EWL of 67.2 ± 23.2%. One year after surgery, the average % EWL was 75.7 ± 25.7%, the average Body Mass Index was 29.3 ± 4.6 kg/m2 and the average weight loss percentage was 29.5 ± 9.4%. Conclusion: Gastric Bypass is the mostly performed surgery, because it is the Gold Standard method for surgical treatment of obesity in this center. On average, all surgeries performed have extremely positive results of excess weight lost. After 1 year, patients maintained an average weight loss percentage of 29.5 ± 9.4%, in line with data presented in a study that estimated an average recorded weight loss percentage of 28.9%. Data like those presented by the American Society for Nutrition (ASN), the Obesity Action Coalition (OAC), the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO), the International Society for the Perioperative Care of the Obese Patient (ISPCOP) and the American Society for Parenteral and Enteral Nutrition (ASPEN) (2019), indicate a target weight loss percentage between 20 and 45%.
- Thrombolysis in Patients Aged over 80 Years Is Equally Effective and SafePublication . Pego, PM; Nunes, AP; Ferreira, P; Sousa, C; Amaral-Silva, ABACKGROUND: Despite stroke's high prevalence in the elderly, intravenous thrombolysis is licensed in Europe only for patients younger than 80 years old. We aimed to compare the functional outcomes and complication rates in patients older versus younger than 80 years old treated with intravenous thrombolysis. METHODS: A retrospective observational study of patients who received intravenous thrombolysis in a stroke unit between January 1, 2009, and June 30, 2012, was conducted. Variables were compared between 2 subgroups (≤80 and >80 years). RESULTS: Overall, 512 patients underwent intravenous thrombolysis, of which 13.1% were over 80 years. The mean age was 65.4 years in the younger subgroup and 82.9 years in the older subgroup. Prior independence rates did not differ between the subgroups. Prevalence of atrial fibrillation and cardioembolic stroke was higher in the older subgroup (P = .004 and .026). Only 3% of the elderly with atrial fibrillation were taking oral anticoagulants. Symptoms-to-needle time was lower in the older subgroup (P = .048). Stroke severity was higher in patients over 80 years (P = .026). There was significant improvement in the National Institutes of Health Stroke Scale score 7 days after intravenous thrombolysis (P < .001) in both subgroups. The proportion of patients with 3 months' favorable outcome and independence, hemorrhagic transformation, and mortality rates were similar in both subgroups. CONCLUSIONS: Elderly patients' benefits and outcomes from intravenous thrombolysis treatment were identical to the younger subgroup without excess hemorrhagic transformation or mortality. These results favor the use of intravenous thrombolysis in patients over 80 years.