Browsing by Author "Fernandes, S."
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- Dermatite estreptocócica perianalPublication . Fernandes, S.; Afanas, N.; Tavares, L.; Castanheira, J.A Dermatite Estreptocócica Perianal causada pelo estreptococo β – hemolítico do grupo A (EβHA), é uma entidade bem definida, mas mal conhecida e sub diagnosticada, levando por isso a um tratamento tardio, expondo a criança às complicações habituais como dor na defecação, obstipação, rectorragia com realização de exames invasivos que isso implica, podendo também haver a suspeita de abuso sexual com todas as suas consequências. Quando tratada precocemente apresenta-se com um quadro clínico leve e de fácil resolução. Os autores descrevem o caso clínico de um adolescente de 11 anos a quem foi feito o diagnóstico de Dermatite Estreptocócica Perianal e um breve resumo teórico. ABSTRACT Perianal Streptococcal Dermatitis caused by group A beta-hemolytic streptococcus, is a well defined identity but frequently not recognized; the delay in treatment exposes children to the usual complications such as painful defecation, constipation, rectal bleeding during invasives exams and suspicion of sexual abuse. When treated at an early stage it has a good and faster resolution. The autors describe a clinical report of an eleven years’ old boy with Perianal Streptococcal Dermatitis and with a short review of the subject.
- Juvenile systemic sclerosis: review of 15 patientsPublication . Sousa, S.; Fernandes, S.; Estanqueiro, P.; Zilhão, C.; Resende, C.; Ramos, F.; Salgado, M.; Guedes, M.; Gomes, J.; Santos, M.
- The risk of disabling, surgery and reoperation in Crohn's disease - A decision tree-based approach to prognosisPublication . Dias, C.; Pereira Rodrigues, P.; Fernandes, S.; Portela, F.; Ministro, P.; Martins, D.; Sousa, P.; Lago, P.; Rosa, I.; Correia, L.; Moura Santos, P.; Magro, F.INTRODUCTION: Crohn's disease (CD) is a chronic inflammatory bowel disease known to carry a high risk of disabling and many times requiring surgical interventions. This article describes a decision-tree based approach that defines the CD patients' risk or undergoing disabling events, surgical interventions and reoperations, based on clinical and demographic variables. MATERIALS AND METHODS: This multicentric study involved 1547 CD patients retrospectively enrolled and divided into two cohorts: a derivation one (80%) and a validation one (20%). Decision trees were built upon applying the CHAIRT algorithm for the selection of variables. RESULTS: Three-level decision trees were built for the risk of disabling and reoperation, whereas the risk of surgery was described in a two-level one. A receiver operating characteristic (ROC) analysis was performed, and the area under the curves (AUC) Was higher than 70% for all outcomes. The defined risk cut-off values show usefulness for the assessed outcomes: risk levels above 75% for disabling had an odds test positivity of 4.06 [3.50-4.71], whereas risk levels below 34% and 19% excluded surgery and reoperation with an odds test negativity of 0.15 [0.09-0.25] and 0.50 [0.24-1.01], respectively. Overall, patients with B2 or B3 phenotype had a higher proportion of disabling disease and surgery, while patients with later introduction of pharmacological therapeutic (1 months after initial surgery) had a higher proportion of reoperation. CONCLUSIONS: The decision-tree based approach used in this study, with demographic and clinical variables, has shown to be a valid and useful approach to depict such risks of disabling, surgery and reoperation.