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Comparing the Continuous Geboes Score With the Robarts Histopathology Index: Definitions of Histological Remission and Response and Their Relation to Faecal Calprotectin Levels
No full textBackground and aims: The histological status of ulcerative colitis [UC] patients in clinical and endoscopic remission has gained space as an important prognostic marker and a key component of disease monitoring. Our main aims were to compare two histological indexes-the continuous Geboes score [GS] and the Robarts Histopathology index [RHI]-regarding their definitions of histological remission and response, and the ability of faecal calprotectin [FC] levels to discriminate between these statuses.
Methods: This was an analysis of three prospective cohorts including 422 patients previously enrolled in other studies.
Results: The two continuous scores [GS and RHI] were shown to be significantly correlated [correlation coefficient of 0.806, p < 0.001] and particularly close regarding their definition of histological response: 95% and 88% of all patients classified as having/not having [respectively] histological response according to RHI also did so according to GS. Moreover, median FC levels in patients with histological response were lower than those in patients without histological response [GS: 73.00 vs 525.00, p < 0.001; RHI: 73.50 vs 510.00, p < 0.001]; a similar trend was observed when FC levels of patients in histological remission were compared to those of patients with histological activity [GS: 76.00 vs 228.00, p < 0.001; RHI: 73.50 vs 467.00, p < 0.001]. FC levels allowed us to exclude the absence of histological remission [according to RHI] and absence of histological response [according to RHI and GS], with negative predictive values varying from 82% to 96%. However, optimization of the FC cut-off to exclude the absence of histological remission, as for the continuous GS, falls within values that resemble those of the healthy population.
Conclusion: The continuous GS and RHI histological scores are strongly correlated in their definitions of histological response. An absence of histological remission could only be excluded at physiological levels of FC.info:eu-repo/semantics/publishedVersio
Diálogo entre a glândula supra-renal e o rim na regulação do potássio: da fisiologia à fisiopatologia
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Klestadt’s Cyst: Clinical case report
No full textRelata-se o caso de uma mulher de 68 anos, com história de tumefação nasolabial direita, com 5 anos de evolução e com intercorrências infeciosas associadas. Ao exame objetivo apresentava uma lesão com cerca de 2,5cm, regular, móvel, não aderente aos planos profundos, com procidência e obstrução do vestíbulo nasal, elevação da cartilagem alar nasal e do lábio superior homolaterais. A tomografia computadorizada caracterizou uma lesão de densidade de tecidos moles que causava moldagem óssea subjacente e abaulamento interno da asa do nariz, com redução do vestíbulo nasal direito. Foi realizada enucleação quística por via intraoral. O exame anatomopatológico confirmou o diagnóstico de quisto de Klestadt. O pós-operatório decorreu sem intercorrências e sem evidência de recidiva a 1 ano. Revisão bibliográfica sobre o tema.info:eu-repo/semantics/publishedVersio
Doença Pulmonar Intersticial Associada ao Crizotinib no Tratamento de Cancro do Pulmão de Não Pequenas Células
Get PDFThe treatment of advanced non-small-cell lung cancer shifted with the development of molecular-targeted therapies, like the tyrosine kinase inhibitors. One example of tyrosine kinase inhibitors is crizotinib, an anaplastic lymphoma tyrosine kinase inhibitor, which targets an echinoderm microtubule-associated protein-like-4-anaplastic lymphoma kinase gene fusion. This mutation is found in only 2% to 7% of non-small-cell lung cancer cases. Although these new therapies have shown promising results, the occurrence of interstitial lung disease as a side effect could be problematic. As the diagnosis of drug-related-interstitial lung disease is difficult to make, computed tomography is an important diagnostic tool. The recognition of computed tomography manifestations of tyrosine kinase inhibitors -induced interstitial lung disease is the key for an early recognition and management of this pulmonary toxicity. We aim to raise awareness of tyrosine kinase inhibitors-induced interstitial lung disease, by reporting the first case of a Portuguese patient treated with crizotinib for non-small-cell lung cancer who developed drug-induced interstitial lung disease.info:eu-repo/semantics/publishedVersio
Overactive bladder symptom bother and health-related quality of life in patients with systemic lupus erythematosus and primary Sjögren syndrome
No full textThe objective of this paper is to assess overactive bladder (OAB) symptom bother (SB) and health-related quality of life (HRQL) among patients with systemic lupus erythematosus (SLE) and primary Sjögren syndrome (pSS).
METHODS:
We recruited adult SLE and pSS patients and two groups of age- and sex-matched controls. We applied the OAB questionnaire-short form (OABq-SF) to all participants to assess SB and HRQL and collected clinical information relevant for OAB. We compared the OABq-SF scores for SB and HRQL between patients and controls using univariate and multivariate linear regression analysis.
RESULTS:
We recruited 95 rheumatic patients (68 SLE, 27 pSS) and 231 controls. Compared to controls SLE patients showed higher OABq-SF SB scores (22.6 ± 20.4 vs 14.7 ± 17.0, p = 0.004) and lower HRQL scores (89.8 ± 15.8 vs 93.8 ± 11.4, p = 0.044). On multivariate analysis SLE was significantly associated with a higher SB score (ß-coefficient 7.13, p = 0.008) and tended to be associated with worse HRQL values (ß-coefficient -3.53, p = 0.055). Patients with pSS had numerically higher mean SB scores (22.8 ± 22.5 vs 16.2 ± 18.0, respectively, p = 0.107) and lower HRQL scores (91.0 ± 10.7 vs 93.2 ± 11.6, respectively, p = 0.369), although these differences were not statistically significant. Diagnosis of pSS was not significantly associated with SB or HRQL scores on univariate or multivariate analysis.
CONCLUSIONS:
Patients with SLE have significantly worse OAB-SB and poorer HRQL compared to controls. A similar trend was seen for pSS patients, especially for SB. These findings suggest that clinically subtle OAB symptoms may be present in rheumatic patients for whom, later on, bladder pain syndrome may occur.info:eu-repo/semantics/publishedVersio
Transfusão de Concentrado Eritrocitário
Get PDFIndicações para Transfusão de CE e CP, integrado no Curso sobre utilização racional de componentes sanguíneos e hemoderivados para internos de Formação Geral, realizada a 14 de Março de 2019N/
