Percorrer por autor "Vara-Luiz, Francisco"
A mostrar 1 - 10 de 13
Resultados por página
Opções de ordenação
- Chronic Intestinal failure and short bowel syndrome in adults : the state of the artPublication . Vara-Luiz, Francisco; Glória, Luísa; Mendes, Ivo; Carlos, Sandra; Guerra, Paula; Nunes, Gonçalo; Oliveira, Cátia Sofia; Ferreira, Andreia; Santos, Ana Paula; Fonseca, JorgeBackground: 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.
- Clinical nutrition in Portuguese gastroenterology departments : a multicentric studyPublication . Vara-Luiz, Francisco; Glória, Luísa; Mocanu, Irina; Curado, António; Medeiros, Isabel; Duarte, Maria Antónia; Banhudo, António; Ferreira, Susana; Vaz, Ana Margarida; Bastos, Isabel; Fonseca, JorgeBackground: Hospital nutrition is a major public health problem, as up to 50% of hospitalized patients suffer from undernutrition. Adequate nutritional support (NS) decreases morbidity/mortality, shortens the length of stay, and reduces costs. We aimed to evaluate the engagement of Portuguese gastroenterology departments in NS, especially in artificial nutrition (AN). Methods: Cross-sectional multicentric study, using an online survey sent to 31 Portuguese gastroenterology departments. Results: Nine centers were involved, and all departments were engaged in NS activities. The most performed nutrition technique was endoscopic gastrostomy and not all departments had the expertise to perform all nutrition procedures, namely, endoscopic jejunostomy. Two departments had an AN outpatient clinic. Five centers were involved in hospital nutrition committees. Only four performed systematic nutritional evaluation of every patient on admission. Two departments developed research in the nutrition field. An increase staff and nutrition training were pointed out as suggestions to improve NS. Conclusions: This study outlines a broad picture of NS/AN in Portuguese gastroenterology departments. Medical nutritional training and increasing nutrition teams’ staff may contribute to developing NS/AN. Multidisciplinary management of nutrition-related disorders is of utmost importance, and gastroenterologists are expected to be at the core of hospital nutrition.
- Duodenal angiolipoma : a rare tumor causing recurrent upper gastrointestinal bleedingPublication . Vara-Luiz, Francisco; Nunes, Gonçalo; Oliveira, Carla; Mendes, Ivo; Dahlstedt-Ferreira, Catrine; Currais, Pedro; Pinto-Marques, Pedro; Fonseca, JorgeDuodenal angiolipoma is a rare adipocytic tumor, with non-specific symptoms precluding an early diagnosis. We present a case of a 67-year-old female admitted due to upper gastrointestinal bleeding. The upper endoscopy and endoscopic ultrasound evaluation showed a subepithelial lesion in the third portion of the duodenum. Endoscopic excision was performed using a standard polypectomy technique after endoloop placement. Histopathology was compatible with duodenal angiolipoma. The authors highlight duodenal angiolipoma as a rare adipocytic tumor potentially causing gastrointestinal bleeding, which can be safely treated with endoscopic excision.
- Dysphagia aortica : an uncommon and potentially life-threatening conditionPublication . Vara-Luiz, Francisco; Fernandes, Eduardo; Barbosa, Fábio Pé D’Arca; Albuquerque, Ana; Marques, Ana Valada; Fonseca, Jorge
- Endoscopic extraction of two giant stone bezoars using mechanical and laser lithotripsyPublication . Oliveira, Carla; Nunes, Gonçalo; Vara-Luiz, Francisco; Oliveira, Gabriel Paiva de; Nunes, Ana; Fonseca, Jorge
- Endoscopic treatment of bile duct stones after bariatric Roux-en-Y gastric bypass through endoscopic ultrasound-directed transgastric ERCPPublication . Vara-Luiz, Francisco; Nunes, Gonçalo; Pinto-Marques, Pedro; Oliveira, Carla; Mendes, Ivo; Patita, Marta; Fonseca, JorgeEndoscopic retrograde cholangiopancreatography (ERCP) is technically challenging after Roux-en-Y gastric bypass (RYGB) [1]. Standard approaches include enteroscopy-assisted and laparoscopy-assisted ERCP, which present difficult implementation in clinical practice [2]. The authors report endoscopic ultrasound-directed transgastric ERCP (EDGE) for the treatment of bile duct stones in RYGB patients ([Video 1]).
- Endoscopic ultrasound-guided cholecystoduodenostomy followed by stone clearance using electrohydraulic and mechanical lithotripsy in a frail patient with acute cholecystitisPublication . Vara-Luiz, Francisco; Mendes, Ivo; Nunes, Gonçalo; Palma, Carolina; Patita, Marta; Fonseca, Jorge; Pinto-Marques, Pedro
- Endoscopic vacuum therapy of a refractory esophagopleural fistula in a patient with Boerhaave syndrome, using an innovative hybrid stentPublication . Mendes, Ivo; Nunes, Gonçalo; Vara-Luiz, Francisco; Vaz, João; Luz, Carlos; Fonseca, Jorge; Pinto-Marques, Pedro
- Fatal case of progressive Mpox in a patient with AIDS : viral enteropathy and malabsorption demanding the use of full parenteral ARV and endovenous cidofovirPublication . Caria, João; Vara-Luiz, Francisco; Maia, Inês; Joosten, Anneke; Val-Flores, Luís; Pinheiro, Hélder; Póvoas, Diana; Germano, Nuno; Maltez, FernandoWe report a fatal case of disseminated mpox infection that progressed over more than three months in an HIV-infected patient with acquired immunodeficiency syndrome (AIDS). Mucocutaneous, pleuropulmonary, central nervous system, and gastrointestinal involvement was documented. This course of disease resembles progressive vaccinia, a formerly reported disease caused by uncontrolled replication of smallpox vaccination orthopoxviruses in immunosuppressed patients. Severe small bowel involvement jeopardized normal oral tecovirimat and antiretroviral therapy absorption. This problem prompted the use of full parenteral antiretrovirals and endovenous cidofovir. Although a remarkable decrease in HIV viral load occurred in six days, mpox infection continued to progress, and the patient died of septic shock. This case offers new clinical insights on the presentation of severe disease in AIDS patients. Moreover, this case alerts for the need for prompt therapy initiation in patients at risk of ominous clinical progression.
- First case report of pancreatic angiomyolipoma diagnosed by EUS-guided fine-needle biopsyPublication . Vara-Luiz, Francisco; Patita, Marta; Pinto-Marques, Pedro; Mendes, Ivo; Canastra, Ana Ramos