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- Montelukast in 2 atopic patients with intolerance to nonsteroidal anti-inflammatory drugs and paracetamol: 5-year follow-upPublication . Morais-Almeida, M; Marinho, S; Gaspar, A
- Periodontal impact of surgically induced dental lesions in mandibular osteodistraction: an animal study.Publication . Soares Correia, PE; Wehrbein, H; Mommaerts, MYAIM: The objective of the study was to evaluate the impact of dental lesions on the periodontium, in a canine model of mandibular osteodistraction. MATERIAL AND METHODS: In six adult male Beagle dogs, an osteotomy was made between the right second lateral incisor and canine, and a distraction device placed. The roots adjacent to the osteotomy were deliberately damaged by the reciprocating saw and chisel, with preservation of the attached gingiva. The osteodistraction protocol used was: latency of 7 days, rate of distraction 1mm per day, and rhythm once a day for 5 days. Vital staining was carried out with tetracycline, Xylenol Orange and Calcein Green. The dogs were sacrificed after 12 weeks of consolidation and the specimens were evaluated with light microscopy (native, polarized light, fluorescence, and after toluidin blue staining). RESULTS: The periodontal ligament (PDL) regeneration was observed in the 2500 slices examined. Cementum and dentine lesions were repaired by cellular cementum. Loose dentine and cementum-dentine fragments were embedded in regenerated PDL and their surface repaired by cementum. By means of light microscopic examination and within the limited observation time, no degenerative pulpal changes were found, when the pulp canal was not entered. Extensive pulp exposure and destruction resulted in ingrowth of the PDL and bone-like tissue. In that case, cellular cementum also lined the dentine surface of the pulp canal. CONCLUSION: Although there was an extensive reparative response to the para-pulpal lesions, none of the changes observed showed evidence of a loss of functional integrity of the periodontium at the distraction site. The fate of the tooth with exposed pulp canal remains uncertain.
- Enterocolic phlebitis" mimicking a primary tumor of the cecum--a rare presentation of an unusual entity.Publication . Cruz, J; Almeida, M; Soares, JIntestinal vasculitis is an infrequent entity in the absence of systemic vasculitis or chronic inflammatory bowel disease. The primary involvement of gut restricted to mesenteric venous territory is exceedingly rare. We report a pseudotumoural lesion of the cecum caused by localized phlebitis and venulitis associated with thrombosis, with a putative immune etiology, in a young adult presenting with obstructive intestinal crisis.
- Systemic corticosteroid hypersensitivity in childrenPublication . Sousa, NG; Santa Marta, C; Morais-Almeida, MWe describe 5 cases of immediate-type reactions to systemic corticosteroids observed during the last 2 decades in boys aged 2, 4, 8, 9, and 10 years. Symptoms ranged from generalized urticaria and angioedema to anaphylactic shock immediately after administration. Oral betamethasone was implicated in 2 cases, oral prednisolone in 2 cases, and intravenous prednisolone in 1 case. The parents of patient 5 refused the skin tests. The remaining patients underwent skin prick tests with the following undiluted corticosteroids: parenteral prednisolone, oral prednisolone, parenteral methylprednisolone, parenteral dexamethasone, parenteral hydrocortisone, and oral betamethasone. If the results were negative, intradermal tests were performed with the same drugs at increasing concentrations. Skin test results were positive for all suspect corticosteroids, thus indicating an immunoglobulin E-mediated mechanism. Two patients had positive skin test results to other corticosteroids, suggesting cross-reactivity. An oral challenge test was performed with deflazacort in 4 cases and with betamethasone in 1 case; the results were negative.
- Schwannoma, a rare tumor of the seminal vesiclePublication . Furtado, AM; Carrasquinho, E; Ferreira, M; Afonso, A; Ferrito, FWe present a rare case of a schwannoma of the seminal vesicle that occurred in a 43-year-old male with symptoms of the lower urinary tract. Ultrasonography and magnetic resonance imaging documented a solid mass in the patient's left seminal vesicle. A transvesical approach with a transtrigonal midline incision was successfully performed. The microscopic aspect was compatible with schwannoma.
- Allergic conjunctivitis and conjunctival provocation tests in atopic dogs.Publication . Lourenço-Martins, AM; Delgado, E; Neto, I; Peleteiro, MC; Morais-Almeida, M; Correira, JHINTRODUCTION: Canine atopic dermatitis (cAD) is a very common disease, but little is known about eye involvement. The conjunctival provocation test (CPT) is used in human to study the ocular response to allergenic stimuli and to evaluate anti-allergic therapy. To our knowledge it has not been used in dogs. OBJECTIVES: To evaluate the prevalence of ocular signs in a population of atopic dogs and relate these with clinical cAD scores; and the usefulness of CPT for dust mites in atopic dogs with itchy eyes. PROCEDURES: Sixty cAD patients were evaluated for (i) ocular signs of allergic conjunctivitis including conjunctival hyperemia, chemosis, epiphora, ocular discharge, pruritus and corneal involvement, graded 0 to 3 according to severity, and (2) cAD Extent and Severity Index (CADESI-03). Additionally, CPTs for Dermatophagoides farinae (n = 12) and Dermatophagoides pteronyssinus (n = 12) were performed in sensitized atopic dogs and 24 control dogs. RESULTS: Periocular and ocular signs of allergy were present in 60% (36/60) of cases. Conjunctival hyperemia (90%) was the most common sign. Severity of ocular signs was significantly correlated with eye pruritus (r(s) = 0.690, P = <0.001) and skin lesions score for head region (r(s) = 0.261, P = 0.04). A highly significant difference (P < 0.001, Fisher test) was found in CPTs between the test and the control groups. CONCLUSION: Allergic conjunctivitis signs associated with cAD seem under valuated so these patients would benefit from an ophthalmologic evaluation. Furthermore, we found CPT to be a reliable, easy to perform and safe test for the etiologic diagnosis of allergic conjunctivitis in the dog.
- Hev b 5: latex allergen implicated in clinically relevant cross-reactivity with maniocPublication . Gaspar, A; Raulf-Heimsoth, M; Rihs, HP; Pires, G; Morais-Almeida, M
- Control of Allergic Rhinitis and Asthma Test (CARAT) can be used to assess individual patients over timePublication . Fonseca, JA; Nogueira-Silva, L; Morais-Almeida, M; Sá-Sousa, A; Azevedo, LF; Ferreira, J; Branco-Ferreira, M; Rodrigues-Alves, R; Bugalho-Almeida, A; Bousquet, JBACKGROUND: The Control of Allergic Rhinitis and Asthma Test (CARAT10) has been proposed as the first tool to implement the Allergic Rhinitis and its Impact on Asthma initiative guidelines in clinical practice. To serve this purpose, it must have adequate properties to assess the control of an individual over time. This study aimed to prospectively assess the test-retest reliability, responsiveness and longitudinal validity of CARAT10. METHODS: Adults with asthma and allergic rhinitis were enrolled at 4 outpatient clinics of Portuguese central hospitals. At each of the two visits, 4 to 6 weeks apart, patients filled out CARAT10 and additional questionnaires, followed by a medical evaluation blinded to the questionnaires' answers. RESULTS: From the 62 patients included, 51 patients completely filled out CARAT10 at both visits. The test-retest reliability, computed as an intra-class correlation coefficient, was 0.82. Regarding responsiveness, a significant change (p = 0.002) of CARAT10 score in clinically unstable patients was observed (95%CI -5.08; -1.31) and the Guyatt's responsiveness index was 1.54. As for the longitudinal validity assessment, the correlation coefficients of the changes of CARAT10 scores with those of ACQ5 and symptoms VAS ranged from 0.49 to 0.65, while with the physician assessment of control they ranged from 0.31 to 0.41. CONCLUSION: CARAT10 has good test-retest reliability, responsiveness and longitudinal validity. It can be used to assess control of allergic rhinitis and asthma, both to compare groups in clinical studies and to evaluate individual patients in clinical practice.
- Aspirin desensitization in a woman with inherited thrombophilia and recurrent miscarriage.Publication . Santos, N; Gaspar, A; Livramento, S; Sampaio, G; Morais-Almeida, MWomen with inherited thrombophilia and recurrent miscarriage might benefit from preconceptional antiagreggation with low-dose acetylsalicylic acid (ASA), but concerns about severe adverse reactions may prevent physicians from performing this treatment in patients with ASA hypersensitivity. We report the first known case of ASA desensitization in a 41-year-old woman with inherited thrombophilia, who had homozygosity (4G/4G polymorphism) of the plasminogen activator inhibitor-1 (PAI-1) gene and first trimester recurrent miscarriage, and had previously presented with anaphylaxis to ASA. Desensitization was completed despite one self-limited adverse reaction, and the patient has maintained a daily ASA intake of 100 mg with good tolerance.