Browsing by Author "Castro, C."
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- Disseminated Well-Differentiated Gastro-Entero-Pancreatic Tumors Are Associated with Metabolic SyndromePublication . Santos, Ana P; Castro, C.; Antunes, Luís; Henrique, Rui; Cardoso, Helena; MP, MonteiroThe association of well-differentiated gastro-entero-pancreatic neuroendocrine tumors (WD GEP-NETs) with metabolic syndrome (MetS), abdominal obesity, and fasting glucose abnormalities was recently described. The aim of this study was to evaluate whether the presence of MetS or any MetS individual component was also influenced by GEP-NET characteristics at diagnosis. A cohort of patients with WD GEP-NETs (n = 134), classified according to primary tumor location (gastrointestinal or pancreatic), pathological grading (G1 (Ki67 ≤ 2%) and G2 (>3 ≤ 20%) (WHO 2010), disease extension (localized, loco-regional, and metastatic), and presence of hormonal secretion syndrome (functioning/non-functioning), was evaluated for the presence of MetS criteria. After adjustment for age and gender, the odds of having MetS was significantly higher for patients with WD GEP-NET grade G1 (OR 4.35 95%CI 1.30-14.53) and disseminated disease (OR 4.52 95%CI 1.44-14.15). GEP-NET primary tumor location or secretory syndrome did not influence the risk for MetS. None of the tumor characteristics evaluated were associated with body mass index, fasting plasma glucose category, or any of the individual MetS components. Patients with GEP-NET and MetS depicted a higher risk of presenting a lower tumor grade and disseminated disease. The positive association between MetS and GEP-NET characteristics further highlights the potential link between the two conditions.
- Fasceíte necrotizante e síndrome de choque tóxico estreptocócico numa criança com varicelaPublication . Cunha, O.; Mota, T.C.; Lopez, M.G.; Santos, E.; Lisboa, L.; Morgado, H.; Lima, F.F.; Castro, C.; Ribeiro, A.Introdução: A fasceíte necrotizante é uma infecção grave dos tecidos moles, geralmente causada por Streptococcus pyogenes. É uma complicação rara da varicela e o diagnóstico numa fase precoce é pouco frequente. Caso clínico: Apresenta-se o caso clínico de uma criança de oito anos de idade com varicela, complicada de fasceíte necrotizante e síndrome de choque tóxico estreptocócico, que necessitou de procedimentos invasivos e de um internamento prolongado em Unidade de Cuidados Intensivos Pediátrica. Conclusão: Os autores alertam para a importância do diagnóstico precoce das potenciais complicações da varicela, nomeadamente da fasceíte necrotizante, pois a precocidade da actuação é determinante para o seu prognóstico. A fasceíte necrotizante deve ser considerada sempre que uma criança com varicela se apresente com eritema, calor e induração da pele e tecidos moles, associado a uma recorrência da febre ou à sua persistência ao quarto dia após o início do exantema. ABSTRACT Introduction: The necrotizing fasciitis, a severe infection of soft tissues, usually caused by Streptococcus pyogenes, is a rare complication of chickenpox; early diagnosis is uncommon. Case report: We present a case of an eight-year-old child with chickenpox, complicated by a necrotizing fasciitis and streptococcal toxic shock, which required invasive procedures and prolonged hospitalization in an Intensive Care Unit Pediatric. Conclusions: The authors emphasize the importance of the potential complications of chickenpox, particularly the necrotizing fasciitis, as an early diagnosis and intervention are crucial for the outcome. The necrotizing fasciitis should be considered whenever a child with chickenpox presents with erythema, warmth, and induration of the skin and soft tissues, associated with a recurrence of fever or its persistence by the fourth day after the rash onset.
- Visceral Obesity and Metabolic Syndrome Are Associated with Well-Differentiated Gastroenteropancreatic Neuroendocrine TumorsPublication . Santos, A.; Santos, A.; Castro, C.; Raposo, L.; Pereira, S.; Torres, I.; Henrique, R.; Cardoso, H.; Monteiro, M.The determinants for gastroenteropancreatic neuroendocrine tumors (GEP-NET) recent burden are matters of debate. Obesity and metabolic syndrome (MetS) are well established risks for several cancers even though no link with GEP-NETs was yet established. Our aim in this study was to investigate whether well-differentiated GEP-NETs were associated with obesity and MetS. Patients with well-differentiated GEP-NETs (n = 96) were cross-matched for age, gender, and district of residence with a control group (n = 96) derived from the general population in a case-control study. Patients presented gastro-intestinal (75.0%) or pancreatic (22.9%) tumors, grade G1 (66.7%) or G2 (27.1%) with localized disease (31.3%), regional metastasis (16.7%) or distant metastasis (43.8%) at diagnosis, and 45.8% had clinical hormonal syndromes. MetS was defined according to Joint Interim Statement (JIS) criteria. Well-differentiated GEP-NETs were associated with MetS criteria as well as the individual components' waist circumference, fasting triglycerides, and fasting plasma glucose (p = 0.003, p = 0.002, p = 0.011 and p < 0.001, respectively). The likelihood of the association was higher when the number of individual MetS components was greater than four. MetS and some individual MetS components including visceral obesity, dyslipidemia, and increased fasting glucose are associated with well-differentiated GEP-NET. This data provides a novel insight in unraveling the mechanisms leading to GEP-NET disease.