Browsing by Author "Almeida, S."
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- Classification and clinical behavior of blastic plasmacytoid dendritic cell neoplasms according to their maturation-associated immunophenotypic profilePublication . Martín-Martín, L.; López, A.; Vidriales, B.; Caballero, M.; Rodrigues, A.; Ferreira, S.; Lima, M.; Almeida, S.; Valverde, B.; Martínez, P.; Ferrer, A.; Candeias, J.; Ruíz-Cabello, F.; Buadesa, J.; Sempere, A.; Villamor, N.; Orfao, A.; Almeida, J.Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare subtype of leukemia/lymphoma, whose diagnosis can be difficult to achieve due to its clinical and biological heterogeneity, as well as its overlapping features with other hematologic malignancies. In this study we investigated whether the association between the maturational stage of tumor cells and the clinico-biological and prognostic features of the disease, based on the analysis of 46 BPDCN cases classified into three maturation-associated subgroups on immunophenotypic grounds. Our results show that blasts from cases with an immature plasmacytoid dendritic cell (pDC) phenotype exhibit an uncommon CD56- phenotype, coexisting with CD34+ non-pDC tumor cells, typically in the absence of extramedullary (e.g. skin) disease at presentation. Conversely, patients with a more mature blast cell phenotype more frequently displayed skin/extramedullary involvement and spread into secondary lymphoid tissues. Despite the dismal outcome, acute lymphoblastic leukemia-type therapy (with central nervous system prophylaxis) and/or allogeneic stem cell transplantation appeared to be the only effective therapies. Overall, our findings indicate that the maturational profile of pDC blasts in BPDCN is highly heterogeneous and translates into a wide clinical spectrum -from acute leukemia to mature lymphoma-like behavior-, which may also lead to variable diagnosis and treatment.
- Cobertura vacinal das vacinas meningocócica e pneumocócica num centro de saúde de Vila Nova de GaiaPublication . Santos, H.; Pinto, E.; Valente, I.; Marinheiro, M.; Almeida, S.; Pinto, M. E.Objectivos: A vacinação é um dos melhores exemplos de prevenção primária em saúde. Este estudo pretendeu estimar a cobertura das vacinas meningocócica (MnC) e pneumocócica (Pn7) numa coorte de crianças utentes de um centro de saúde do Norte de Portugal. Métodos: Realização de um estudo longitudinal de uma amostra representativa das crianças nascidas entre 2000 e 2003. Os dados foram recolhidos dos registos de vacinação do centro de saúde. Resultados: Foram recolhidos dados de 290 crianças, 41,4% raparigas. A cobertura vacinal 2000-2003 foi de 76,9% para a MnC e 41,4% para a Pn7. Quarenta e sete por cento tinham ambas as vacinas. O número das crianças que fizeram pelo menos uma dose de MnC ou Pn7 foi máximo em 2002. No período estudado, 3,8% (MnC) e 21.5% (Pn7) das 290 crianças iniciou mas não terminou a vacinação. A mediana da primeira dose foi de 11 meses para a MnC, e 6,5 meses para a Pn7. Noventa e sete por cento das crianças com vacinação completa para Pn7 também a tinham para a MnC, mas somente em 52% das crianças acontecia o inverso (p<0,001). A proporção das crianças que receberam outras vacinas extra plano foi de 24.4% dentro das crianças que receberam MnC e Pn7 e de 4,0% nas restantes (p<0,001). Conclusões: Encontrou-se uma cobertura vacinal elevada para ambas as vacinas, apesar dos custos para os utentes. A maioria da cobertura para a MnC foi devido à vacinação no segundo ano da vida, exigindo apenas 1 dose. Um número considerável de crianças iniciou mas não terminou a programa de vacinação. A idade da primeira toma diminuiu entre 2000 e 2003, proporcionando uma melhor cobertura no período mais vulnerável da doença. Observou-se uma associação entre a administração de Pn7 e MnC, e outras vacinas extra plano. Palavras-chave: Cobertura vacinal, vacina meningocócica, vacina pneumocócica, vacinas conjugadas.
- Genes, crianças e pediatras: acondroplasiaPublication . Rocha, M.; Pinto-Basto, J.; Almeida, S.; Martins, M.; Lima, M.
- High Sensitivity Troponin T: A Biomarker of Ventricular Wall Stress in Acutely Decompensated Heart FailurePublication . Ferreira, J.; Santos, M.; Almeida, S.; Marques, I.; Bettencourt, P.; Cyrne-Carvalho, H.
- High-Sensitivity Troponin T: A Biomarker for Diuretic Response in Decompensated Heart Failure PatientsPublication . Ferreira, J.; Santos, M.; Almeida, S.; Marques, I; Bettencourt, P.; Cyrne-Carvalho, H.Background. Patients presenting with acutely decompensated heart failure (ADHF) and positive circulating cardiac troponins were found to be a high-risk cohort. The advent of high-sensitive troponins resulted in a detection of positive troponins in a great proportion of heart failure patients. However, the pathophysiological significance of this phenomenon is not completely clear. Objectives. The aim of this study is to determine the early evolution and clinical significance of high-sensitivity troponin T (hsTnT) in ADHF. Methods. Retrospective, secondary analysis of a prospective study including 100 patients with ADHF. Results. Globally, high-sensitivity troponin T decreased from day 1 to day 3 (P = 0,039). However, in the subgroup of patients who remained decompensated no significant differences in hsTnT from day 1 to day 3 were observed (P = 0,955), whereas in successfully compensated patients a significant reduction in hsTnT levels was observed (P = 0,025). High-sensitivity troponin T decrease was correlated with NTproBNP reduction (P = 0,007). Patients with hsTnT increase had longer length of stay (P = 0,033). Conclusions. Episodes of ADHF are associated with transient increases in the blood levels of hsTnT that are reduced with effective acute episode treatment. The decrease in hsTnT can translate less myocardial damage along with favourable ADHF treatment.
- Measles outbreak in a tertiary level hospital, Porto, Portugal, 2018: challenges in the post-elimination eraPublication . Sá Machado, R.; Perez Duque, M.; Almeida, S.; Cruz, I.; Sottomayor, A.; Almeida, I.; R Oliveira, J.; Antunes, D.A measles outbreak has been occurring in a healthcare setting in Porto, Portugal, since early March 2018, posing public health challenges for a central hospital and the community. Up to 22 April, 96 cases were confirmed, 67 in vaccinated healthcare workers, mostly between 18-39 years old. Following identification of the first cases, control measures were rapidly implemented. Concomitantly, other measles cases were notified in the Northern Region of the country. No common epidemiological link was identified.
- Mineralocorticoid Receptor Antagonism in Acutely Decompensated Chronic Heart FailurePublication . Ferreira, J.; Santos, M.; Almeida, S.; Marques, I.; Bettencourt, P.; Cyrne-Carvalho, H.
- Mineralocorticoid receptor antagonism in acutely decompensated chronic heart failurePublication . Ferreira, J.P.; Santos, M.; Almeida, S.; Marques, I.; Bettencourt, P.; Cyrne-Carvalho, H.
- Mineralocorticoid receptor antagonism in acutely decompensated chronic heart failurePublication . Ferreira, J.; Santos, M.; Almeida, S.; Marques, I.; Bettencourt, P.; Cyrne-Carvalho, H.Spironolactone was likely to provide faster congestion relief. -------------------------------------------------------------------------------- Abstract Background/objectives Mineralocorticoid receptor antagonist (MRA) use in acutely decompensated chronic heart failure (ADCHF) may improve congestion through diuretic effect and prevent neurohormonal activation. We aimed to evaluate the clinical effect and safety of spironolactone in ADCHF. Methods Prospective, experimental, single-center, and single-blinded trial. Patients were treated with: standard ADCHF therapy or oral spironolactone 50–100 mg/d plus standard ADCHF therapy. Results During a 1 year period, 100 patients were enrolled, 50 included in the treatment group. Mean (SD) spironolactone dose (mg) at day 1 was 94.5 ± 23.3 and at day 3 was 62.7 ± 24.3. Worsening renal function (increase in pCr ≥ 0.3 mg/dL from day 1 to day 3) was more likely to occur in control group (20% vs. 4%; p = 0.038), serum potassium did not differ between groups, and plasma NTproBNP had a significant decrease in spironolactone group at day 3 (median [IQR], 2488 [4579] vs. 1555 [1832]; p = 0.05). Furthermore, a greater proportion of patients in the treatment group were free of congestion at day 3: less edema, rales, jugular venous pressure (JVP) and orthopnea (all, p < 0.05). In addition, a significantly higher proportion of patients were on oral furosemide at day 3 (44% vs. 82%; p < 0.001). Conclusions Our study supports the safety of high dose spironolactone in ADCHF and suggests a positive impact in the resolution of congestion. The important findings of our pilot study need to be confirmed in larger trials.
- Mineralocorticoid Receptor Antagonism in Acutely Decompensated Chronic Heart FailurePublication . Ferreira, J.; Santos, M.; Almeida, S.; Marques, I.; Bettencourt, P.; Cyrne-Carvalho, H.