Hospital de Santa Maria
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2133 research outputs found
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Optical Coherence Tomography-Guided Full Plastic Jacket in Spontaneous Coronary Artery Dissection
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Extraskeletal osteosarcoma: A European Musculoskeletal Oncology Society study on 266 patients
Get PDFPURPOSE:
Prognosis of extraskeletal osteosarcoma (ESOS) is reported to be poorer than that of skeletal osteosarcoma. This multicenter retrospective study aimed to evaluate factors influencing ESOS prognosis.
PATIENTS AND METHODS:
Members of the European Musculoskeletal Oncology Society (EMSOS) submitted institutional data on patients with ESOS.
RESULTS:
Data from 274 patients treated from 1981 to 2014 were collected from 16 EMSOS centres; 266 patients were eligible. Fifty (18.7%) had metastases at diagnosis. Of 216 patients with localised disease, 211 (98%) underwent surgery (R0 = 70.6%, R1 = 27%). Five-year overall survival (OS) for all 266 patients was 47% (95% CI 40-54%). Five-year OS for metastatic patients was 27% (95% CI 13-41%). In the analysis restricted to the 211 localised patients who achieved complete remission after surgery 5-year OS was 51.4% (95% CI 44-59%) and 5-year disease-free survival (DFS) was 43% (95% CI 35-51%). One hundred twenty-one patients (57.3%) received adjuvant or neoadjuvant chemotherapy and 80 patients (37.9%) received radiotherapy. A favourable trend was seen for osteosarcoma-type chemotherapy versus soft tissue sarcoma-type (doxorubicin ± ifosfamide) regimens. For the 211 patients in complete remission after surgery, patient age, tumour size, margins and chemotherapy were positive prognostic factors for DFS and OS by univariate analysis. At multivariate analysis, patient age (≤40 years versus >40 years) (P = 0.05), tumour size (P = 0.0001) and receipt of chemotherapy (P = 0.006) were statistically significant prognostic factors for survival.
CONCLUSION:
Patient age and tumour size are factors influencing ESOS prognosis. Higher survival was observed in patients who received perioperative chemotherapy with a trend in favour of multiagent osteosarcoma-type regimen which included doxorubicin, ifosfamide and cisplatin.info:eu-repo/semantics/publishedVersio
Tumor de Células Germinativas Primário da Próstata – descrição de um caso raro
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Protocol for a randomised, double-masked, sham-controlled phase 4 study on the efficacy, safety and tolerability of intravitreal aflibercept monotherapy compared with aflibercept with adjunctive photodynamic therapy in polypoidal choroidal vasculopathy: the ATLANTIC study
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The purpose of this study is to compare the efficacy and safety of intravitreal aflibercept (IVA) with sham photodynamic therapy (sPDT) versus IVA with verteporfin PDT (vPDT) in a Caucasian population with treatment-naive polypoidal choroidal vasculopathy (PCV), enrolling into a treat and extend (T&E) regimen.
METHODS AND ANALYSIS:
Randomised, double-masked, sham-controlled, multicentre phase 4 investigator-driven clinical trial. The primary outcomes are (1) change in best-corrected visual acuity (BCVA) from baseline and (2) polyp regression at week 52, assessed by indocyanine green angiography (ICGA). Fifty patients with treatment-naive PCV will be recruited from Portuguese and Spanish clinical sites. Eligible patients will receive monthly IVA for 3 months (week 0, week 4 and week 8). At week 16, all patients will repeat ICGA and undergo central randomisation (1:1 ratio) into one of the following groups: Group 1-IVA T&E + vPDT; Group 2-IVA T&E + sPDT. PDT will be performed at week 16, week 28 and week 40 in the presence of active polyps. After week 16, the presence of macular fluid on optical coherence tomography will determine the schedule of observations. When present, the interval between visits/injections will decrease 2 weeks (minimum 6 weeks). When not, the interval between visits/injections will increase 2 weeks (maximum 12 weeks). Efficacy will be evaluated based on BCVA, central retinal thickness and polyp regression. Safety parameters will include assessment of intraocular pressure, adverse events and serious adverse events.
ETHICS AND DISSEMINATION:
This study was designed and shall be implemented and reported in accordance with the International Conference on Harmonisation (ICH) Harmonised Tripartite Guidelines for Good Clinical Practice, with applicable local regulations and with the ethical principles laid down in the Declaration of Helsinki. The study received approval from Comissão de Ética para a Investigação Clínica and Comité Ético de investigación Clínica del Hospital Universitari de Bellvitge.
TRIAL REGISTRATION NUMBER:
This study is registered under the EudraCT number: 2015-001368-20 and the ClinicalTrials.gov Identifier: NCT02495181.info:eu-repo/semantics/publishedVersio
Subacute L5 Paresis Following a Capoeira Presentation
Get PDFA young female suffered minor low back trauma during a capoeira presentation. She was initially
diagnosed with an acute episode of uncomplicated low back and radicular pain. She kept training and
competing until developing paresthesia and weakness of the right leg six weeks later. Physical
examination revealed sensory and motor deficits compatible with L5 nerve root compression. The MRI
revealed an L5-S1 disc extrusion compressing the right L5 nerve root. Nerve root decompression and
partial discectomy were performed, and seven months later she was competing without restrictions.
We present our approach and discuss possible pathological mechanisms that may explain this unusual
presentation.info:eu-repo/semantics/publishedVersio
Da Colheita de Órgãos ao Transplante: O Papel do Gabinete Coordenador de Colheita e Transplantação
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Humanitude: Realização da Humanidade numa Sociedade Tecnológica
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The quest for biomarkers in schizophrenia: from neuroimaging to machine learning.
Get PDFSchizophrenia is a severe mental disorder and one of the leading causes of disease burden worldwide. It represents a source of significant suffering and disability to the affected individuals, and is associated with substantial societal and economical costs.
The diagnosis of schizophrenia still depends exclusively on the detection of symptoms that are also present in other mental disorders. This situation causes overlapping of the boundaries of the diagnostic categories and constitutes a source of diagnostic errors. Moreover, current treatment algorithms do not take into account the substantial interindividual variability in response to antipsychotic drugs. As a result, around one-third of patients are treatment-resistant to first line antipsychotic drugs. This deleterious consequence is associated with poor individual outcomes and elevated healthcare costs.
Neuroimaging research in schizophrenia has shed some light in a vast array of structural and functional connectivity abnormalities and neurochemical (dopamine and glutamate) imbalances, which may constitute ‘organic surrogates’ of this disorder. However, the neuroimaging field, so far, has not been able to identify biomarkers that could facilitate early detection and allow individualised treatment management.
This paper reviews neuroimaging studies from different modalities that may provide relevant biomarkers for schizophrenia.
We discuss how the current application of novel Machine Learning methods to the analyses of imaging data is allowing the translation of such findings into potential biomarkers enabling the prediction of clinical outcomes at the individual level, towards the development of innovative and personalised treatment strategies.info:eu-repo/semantics/publishedVersio
Neck Pain and Acute Dysphagia
Get PDFThe acute tendinitis of the longus colli muscle is an unusual diagnosis in the cases of acute dysphagia with cervical pain. Is a self-limiting condition caused by abnormal calcium hydroxyapatite deposition in the prevertebral space and can cause pharyngeal swelling with impaired swallow. It is absolutely critical to make the differential diagnosis with deep cervical infections in order to avoid invasive treatments.info:eu-repo/semantics/publishedVersio
Pathways from paranoid conviction to distress: exploring the mediator role of Fears of Compassion in a sample of people with psychosis
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