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Falcão F, Faísca P, Viegas I, de Oliveira JT, Requicha JF. Feline oral cavity lesions diagnosed by histopathology: a 6-year retrospective study in Portugal. J Feline Med Surg 2020; 22:977-983. [PMID: 32031045 DOI: 10.1177/1098612x19900033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this study was to analyse the frequency of oral cavity lesions in cats, their anatomical location and histological diagnosis, and the effect of life stage, breed and sex on different diagnoses. METHODS For this purpose, a retrospective study comprising 297 feline oral cavity lesions was performed over a 6-year period between 2010 and 2015. Histopathological records from the DNAtech Pathology Laboratory (Lisbon, Portugal) were analysed. RESULTS The incidence of oral disease was higher in male cats (n = 173; 58.4%), mature adults (ranging from 7 to 10 years old [n = 88; 33.0%]) and in the European Shorthair breed (n = 206; 73.6%). The gingiva was the site where oral lesions were most commonly found, with 128 samples (43.1%). Incisional biopsies were used to obtain the majority of samples (n = 256; 86.2%), while excisional biopsies and punch biopsies were performed in 36 (12.1%) and five (1.7%) cases, respectively. Inflammatory and neoplastic lesions accounted for 187 (63%) and 110 (37%) of the studied cases, respectively. Malignancies were found in >80% of neoplastic cases. Feline chronic gingivostomatitis was the most common histological diagnosis (n = 116; 39.1%), followed by squamous cell carcinoma (n = 49; 16.5%) and eosinophilic granuloma complex (n = 33; 11.1%). CONCLUSIONS AND RELEVANCE The present work, involving a large series of samples of feline oral cavity lesions, from numerous geographically scattered practices and all examined at a reference veterinary pathology laboratory, adds important new understanding of the epidemiology of feline oral disease.
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Affiliation(s)
- Filipa Falcão
- CBIOS - Faculty of Veterinary Medicine, Lusófona University, Lisbon, Portugal
| | - Pedro Faísca
- CBIOS - Faculty of Veterinary Medicine, Lusófona University, Lisbon, Portugal.,DNAtech, Lisbon, Portugal
| | - Inês Viegas
- CBIOS - Faculty of Veterinary Medicine, Lusófona University, Lisbon, Portugal
| | - Joana Tavares de Oliveira
- CBIOS - Faculty of Veterinary Medicine, Lusófona University, Lisbon, Portugal.,Petvet Clinical Centers, Porto, Portugal
| | - João Filipe Requicha
- CBIOS - Faculty of Veterinary Medicine, Lusófona University, Lisbon, Portugal.,Department of Veterinary Sciences, University of Trás-os-Montes e Alto Douro, Vila Real, Portugal
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Azevedo Kauppila L, Coelho M, Franco AC, Teodoro T, Peralta AR, Bentes C, Falcão F, Albuquerque L. Anti–Glutamic Acid Decarboxylase Encephalitis Presenting With Choreo‐Dystonic Movements and Coexisting Electrographic Seizures. Mov Disord Clin Pract 2019; 6:483-485. [DOI: 10.1002/mdc3.12800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 05/22/2019] [Accepted: 05/27/2019] [Indexed: 11/11/2022] Open
Affiliation(s)
- Linda Azevedo Kauppila
- Department of Neurosciences and Mental Health, NeurologyHospital de Santa Maria, Centro Hospitalar Lisboa Norte Lisbon Portugal
| | - Miguel Coelho
- Department of Neurosciences and Mental Health, NeurologyHospital de Santa Maria, Centro Hospitalar Lisboa Norte Lisbon Portugal
- Faculty of MedicineUniversity of Lisbon Lisbon Portugal
- Clinical Pharmachology UnitInstituto de Medicina Molecular Lisbon Portugal
| | - Ana Catarina Franco
- Department of Neurosciences and Mental Health, NeurologyHospital de Santa Maria, Centro Hospitalar Lisboa Norte Lisbon Portugal
| | - Tiago Teodoro
- Department of Neurosciences and Mental Health, NeurologyHospital de Santa Maria, Centro Hospitalar Lisboa Norte Lisbon Portugal
- Faculty of MedicineUniversity of Lisbon Lisbon Portugal
- Neurology Department, St George's University of London London United Kingdom
- Instituto de Medicina Molecular Lisbon Portugal
| | - Ana Rita Peralta
- Department of Neurosciences and Mental Health, NeurologyHospital de Santa Maria, Centro Hospitalar Lisboa Norte Lisbon Portugal
- Faculty of MedicineUniversity of Lisbon Lisbon Portugal
- Electroencephalography and Sleep Laboratory, Department of Neurosciences and Mental Health, NeurologyHospital de Santa Maria, Centro Hospitalar Lisboa Norte Lisbon Portugal
| | - Carla Bentes
- Department of Neurosciences and Mental Health, NeurologyHospital de Santa Maria, Centro Hospitalar Lisboa Norte Lisbon Portugal
- Faculty of MedicineUniversity of Lisbon Lisbon Portugal
- Electroencephalography and Sleep Laboratory, Department of Neurosciences and Mental Health, NeurologyHospital de Santa Maria, Centro Hospitalar Lisboa Norte Lisbon Portugal
| | - Filipa Falcão
- Department of Neurosciences and Mental Health, NeurologyHospital de Santa Maria, Centro Hospitalar Lisboa Norte Lisbon Portugal
| | - Luísa Albuquerque
- Department of Neurosciences and Mental Health, NeurologyHospital de Santa Maria, Centro Hospitalar Lisboa Norte Lisbon Portugal
- Faculty of MedicineUniversity of Lisbon Lisbon Portugal
- Instituto de Medicina Molecular Lisbon Portugal
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3
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Mousinho F, Mendes T, Sousa E Santos P, Azevedo AP, Mousinho G, Malcata C, Viegas E, Madureira B, Falcão F, Gomes AP, Lima F. Bisoprolol-induced thrombocytopenia: A case report. J Clin Pharm Ther 2017; 43:280-283. [PMID: 28868658 DOI: 10.1111/jcpt.12614] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 08/07/2017] [Indexed: 11/27/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Thrombocytopenia, not associated with bone marrow primary disease, is a common clinical problem. The possibility of drug-induced thrombocytopenia must be considered, especially in hospitalized patients. Drugs can cause thrombocytopenia by several mechanisms including direct bone marrow or other organ toxicity, and immune reactions. CASE DESCRIPTION We describe a patient presenting with thrombocytopenia likely related to bisoprolol. WHAT IS NEW AND CONCLUSION We report a case of bisoprolol-induced thrombocytopenia which resolved with drug discontinuation and steroid therapy. We review the mechanisms involved in drug-induced immune thrombocytopenia.
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Affiliation(s)
- F Mousinho
- Hematology Department, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - T Mendes
- Hematology Department, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - P Sousa E Santos
- Hematology Department, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - A P Azevedo
- Clinical Pathology Department, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal.,Centre for Toxicogenomics and Human Health Genetics, Oncology and Human Toxicology, Universidade Nova de Lisboa, Lisboa, Portugal.,NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal.,Instituto Superior de Ciências da Saúde Egas Moniz, Monte da Caparica, Portugal
| | - G Mousinho
- ImunoHemotherappy Department, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - C Malcata
- Portuguese Institute of Blood and Transplantation, Centro de Sangue e da Transplantação de Lisboa, Lisboa, Portugal
| | - E Viegas
- Pharmaceutical Services, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - B Madureira
- Pharmaceutical Services, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - F Falcão
- Pharmaceutical Services, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - A P Gomes
- Hematology Department, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - F Lima
- Hematology Department, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
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Mousinho F, Sousa e Santos P, Viegas E, Madureira B, Gomes A, Falcão F, Lima F. Azacitidine in the Treatment of Myelodysplastic Syndromes: Retrospective Analysis. Leuk Res 2017. [DOI: 10.1016/s0145-2126(17)30231-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cavaco P, Santos AS, Cortés C, Lopes C, Madureira B, Viegas E, Falcão F. PS-099 Drug-drug interactions in fluoropyrimidines-based regimens used in colorectal cancer treatment. Eur J Hosp Pharm 2015. [DOI: 10.1136/ejhpharm-2015-000639.422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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6
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Parola A, Chambel P, Farinha H, Falcão F. CP-076 Post-marketing active pharmacovigilance in a central hospital. Eur J Hosp Pharm 2015. [DOI: 10.1136/ejhpharm-2015-000639.72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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7
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Cavaco P, Santos AS, Cortés C, Lopes C, Madureira B, Viegas E, Falcão F. PS-099 Drug-drug interactions in fluoropyrimidines-based regimens used in colorectal cancer treatment. Eur J Hosp Pharm 2015. [DOI: 10.1136/ejhpharm-2015-000639.445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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8
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Parrinha A, Lobo Alves M, Branco R, Goulão I, Fernandes C, Lopes C, Madureira B, Cavaco P, Santos S, Carreira S, Viegas E, Falcão F. CP-019 Hospital pharmacists’ interventions in a central hospital. Eur J Hosp Pharm 2014. [DOI: 10.1136/ejhpharm-2013-000436.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Laranjeira T, Calixto L, Borges Santos M, Mirco A, Mendes M, Falcão F. PS-047 Co-prescription of simvastatin and potent inhibitors of CYP3A4; monitoring system in hospital. Eur J Hosp Pharm 2014. [DOI: 10.1136/ejhpharm-2013-000436.398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Geraldes R, Sousa PR, Fonseca AC, Falcão F, Canhão P, Pinho e Melo T. Nontraumatic convexity subarachnoid hemorrhage: different etiologies and outcomes. J Stroke Cerebrovasc Dis 2013; 23:e23-30. [PMID: 24119619 DOI: 10.1016/j.jstrokecerebrovasdis.2013.08.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 08/08/2013] [Accepted: 08/10/2013] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Nontraumatic convexity subarachnoid hemorrhage (cSAH) is a rarely reported condition with multiple etiologies. We report the clinical presentation, imaging findings, etiologies, and long-term outcomes of a case series of cSAH. METHODS We retrospectively analyzed consecutive cases of cSAH, admitted at a Stroke Unit of a tertiary hospital (January 2006 to March 2012). Recorded variables were demographics, clinical presentation, complementary investigation, etiology, and outcome. RESULTS We included 15 patients (9 men, median age of 65 years), 7% of the 210 nontraumatic SAH patients in this period. The most common clinical manifestation was a focal neurologic deficit. Predominant location of the cSAH was frontal. In 5 cases, there was a clinical significant internal carotid artery (ICA) atheromatous stenosis, ipsilateral to cSAH. Two patients had a possible cerebral amyloid angiopathy (CAA) at presentation. There were 2 cases of reversible cerebral vasoconstriction syndrome, 1 cerebral venous thrombosis, 2 dural fistulae, and 3 undetermined. Short-term outcomes were good in most patients. At follow-up (24.3 months), 2 of the patients with undetermined etiology had a lobar hematoma conferring a severe disability, and the diagnosis of CAA was made. There were no other relevant events or added disability in the other patients. CONCLUSIONS Significant ICA atherosclerotic stenosis was the most frequent cause of cSAH in our series, reinforcing that cSAH should prompt vascular imagiological evaluation including cervical vessels. Outcomes in cSAH seem to be related to etiology. Patients with undetermined etiology should be followed up because cSAH may be the first manifestation of CAA.
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Affiliation(s)
- Ruth Geraldes
- Stroke Unit, Department of Neurosciences (Neurology), Hospital de Santa Maria, Lisbon, Portugal.
| | - Paulo R Sousa
- Stroke Unit, Department of Neurosciences (Neurology), Hospital de Santa Maria, Lisbon, Portugal
| | - Ana C Fonseca
- Stroke Unit, Department of Neurosciences (Neurology), Hospital de Santa Maria, Lisbon, Portugal
| | - Filipa Falcão
- Stroke Unit, Department of Neurosciences (Neurology), Hospital de Santa Maria, Lisbon, Portugal
| | - Patrícia Canhão
- Stroke Unit, Department of Neurosciences (Neurology), Hospital de Santa Maria, Lisbon, Portugal
| | - Teresa Pinho e Melo
- Stroke Unit, Department of Neurosciences (Neurology), Hospital de Santa Maria, Lisbon, Portugal
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Calixto L, Laranjeira T, Mirco A, Rebocho MJ, Falcão F. GRP-077 Generic Mycophenolate Mofetil in Heart Transplant Recipients: Implementation of Active Pharmacovigilance. Eur J Hosp Pharm 2013. [DOI: 10.1136/ejhpharm-2013-000276.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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12
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Alves ML, Ribeiro N, Alves S, Neves C, Falcão F. The degree of patient satisfaction with diltiazem gel in the treatment of anal fissures. Eur J Hosp Pharm 2012. [DOI: 10.1136/ejhpharm-2012-000074.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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13
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Calixto L, Atalaia A, Laranjeira T, Mirco A, Falcão F. Antibiotic prophylaxis and incidence of endocarditis and mediastinitis in patients undergoing cardiac surgery. Eur J Hosp Pharm 2012. [DOI: 10.1136/ejhpharm-2012-000074.371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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15
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Fonseca AC, Geraldes R, Pires J, Falcão F, Bentes C, Melo TPE. Improvement of sleep architecture in the follow up of a patient with bilateral paramedian thalamic stroke. Clin Neurol Neurosurg 2011; 113:911-3. [PMID: 21676536 DOI: 10.1016/j.clineuro.2011.05.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Revised: 04/26/2011] [Accepted: 05/14/2011] [Indexed: 10/18/2022]
Abstract
Normal sleep architecture and arousal require an intact thalamus. Thalamic vascular lesions, particularly in the paramedian region may cause arousal disturbances and hypersomnolence. Although hypersomnolence is one of the main characteristics of acute bilateral paramedian thalamic infarcts, there are only scarce reports in literature concerning polysomnographic follow-up of these patients. The few reported cases in literature show that sleep stages do not significantly change from the acute to chronic phase. We present a case report of a patient with a bilateral paramedian thalamic infarct in which a polysomnographic evaluation of sleep was performed four days and five months after stroke. In the acute phase, polysomnography showed an impairment of phase 2 NREM and absence of phase 3 and 4 NREM with absent sleep spindles. After the acute stroke phase, hypersomnolence improved and sleep spindles reappeared as well as phase 3 and 4 of NREM sleep. Our patient clear clinical and polysomnographic improvement makes us suppose that in this case the initial impairment could have been essentially due to a functional transitory impairment of the thalamocortical and corticothalamic connections. This case report is peculiar because it discloses a marked improvement of sleep architecture which to the best of our knowledge has not been clearly described before.
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Affiliation(s)
- Ana Catarina Fonseca
- Department of Neurosciences (Neurology), Hospital de Santa Maria, Av. Prof. Egas Moniz, 1649-035 Lisboa, Portugal.
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Abstract
Background and purpose N-terminal probrain natriuretic peptide, which is mainly produced by the heart, is increased in acute stroke. We aimed to determine if N-terminal probrain natriuretic peptide could be a biomarker for ischemic stroke with a cardioembolic cause. Methods Consecutive sample of acute stroke patients admitted to a Stroke Unit. Ischemic stroke subtype was classified using the TOAST classification. Blood samples were drawn within 72 h after stroke onset. Serum N-terminal probrain natriuretic peptide concentration was measured using an electrochemiluminescence immunoassay. Mean values of N-terminal probrain natriuretic peptide were compared between patients with hemorrhagic stroke vs. ischemic stroke, cardioembolic stroke vs. noncardioembolic stroke, cardioembolic stroke with atrial fibrillation vs. noncardioembolic stroke using t-test. Receiver operating characteristic curves were used to test the ability of N-terminal probrain natriuretic peptide values to identify cardioembolic stroke and cardioembolic stroke with atrial fibrillation. Results Ninety-two patients were included (66 with ischemic stroke) with a mean age of 58·6 years. Twenty-eight (42·4%) ischemic strokes had a cardioembolic cause. Mean N-terminal probrain natriuretic peptide values for cardioembolic stroke were significantly higher ( P < 0·001) (491·6; 95% confidence interval 283·7–852·0 pg/ml) than for noncardioembolic ischemic stroke (124·7; 86·3–180·2 pg/ml). The area under the receiver operating characteristic curve for N-terminal probrain natriuretic peptide in cardioembolic stroke was 0·77. The cut-off point with the highest sensitivity and specificity was set at 265·5 pg/ml (71·4% and 73·7% respectively). The area under the curve of N-terminal probrain natriuretic peptide for cardioembolic stroke related to atrial fibrillation was 0·92, cut-off was set at 265·5 pg/ml (sensitivity 94·4%, specificity 72·9%). Conclusion N-terminal probrain natriuretic peptide is a biomarker with a good accuracy to predict ischemic stroke of cardioembolic cause, namely associated with atrial fibrillation.
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Affiliation(s)
- Ana Catarina Fonseca
- Department of Neurology, Hospital de Santa Maria, University of Lisbon, Lisboa, Portugal
| | | | - Teresa Pinho e Melo
- Department of Neurology, Hospital de Santa Maria, University of Lisbon, Lisboa, Portugal
| | - Filipa Falcão
- Department of Neurology, Hospital de Santa Maria, University of Lisbon, Lisboa, Portugal
| | - Patrícia Canhão
- Department of Neurology, Hospital de Santa Maria, University of Lisbon, Lisboa, Portugal
| | - José M. Ferro
- Department of Neurology, Hospital de Santa Maria, University of Lisbon, Lisboa, Portugal
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Carvalho M, Laranjo M, Paiva A, Abrantes A, Falcão F, Botelho M, Oliveira C. 178 Phenotypic profile of triple negative and hormonal receptors positive breast cancer cells treated with growth factors for mammospheres formation – preliminary results. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)70209-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Abstract
We aimed to describe and classify headaches associated with acute stroke, by interviewing patients consecutively admitted to a stroke unit using a validated headache questionnaire and the International Classification of Headache Disorders of the International Headache Society (IHS). One hundred and twenty-four patients (61% ischaemic and 39% haemorrhagic stroke) reported headache. Headaches started mostly on the day of stroke, were more often continuous, pressure-type, bilateral and located in the anterior region, were increased by movement and by cough and lasted for a mean of 3.8 days. Tension-type was the most frequent type of headache. Eleven per cent of headaches could not be classified using the criteria of the IHS. Previous primary headache was documented in 71 patients. The presence of nausea/vomiting due to acute stroke can confound headache classification using the IHS criteria. In up to half of the patients, headache seems to be a reactivation of previous primary headache.
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Affiliation(s)
- A Verdelho
- Department of Neurosciences, Santa Maria Hospital, University of Lisbon, Lisbon, Portugal
| | - JM Ferro
- Department of Neurosciences, Santa Maria Hospital, University of Lisbon, Lisbon, Portugal
| | - T Melo
- Department of Neurosciences, Santa Maria Hospital, University of Lisbon, Lisbon, Portugal
| | - P Canhão
- Department of Neurosciences, Santa Maria Hospital, University of Lisbon, Lisbon, Portugal
| | - F Falcão
- Department of Neurosciences, Santa Maria Hospital, University of Lisbon, Lisbon, Portugal
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Gouveia LO, Castanho P, Ferreira JJ, Guedes MM, Falcão F, e Melo TP. Chiropractic manipulation: reasons for concern? Clin Neurol Neurosurg 2007; 109:922-5. [PMID: 17904731 DOI: 10.1016/j.clineuro.2007.08.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2007] [Revised: 07/31/2007] [Accepted: 08/10/2007] [Indexed: 01/30/2023]
Abstract
Chiropractic's popularity is rising among the general population. Moreover, few studies have been conducted to properly evaluate its safety. We report three cases of serious neurological adverse events in patients treated with chiropractic manipulation. The first case is a 41 years old woman who developed a vertebro-basilar stroke 48 h after cervical manipulation. The second case represents a 68 years old woman who presented a neuropraxic injury of both radial nerves after three sessions of spinal manipulation. The last case is a 34 years old man who developed a cervical epidural haematoma after a chiropractic treatment for neck pain. In all three cases there were criteria to consider a causality relation between the neurological adverse events and the chiropractic manipulation. The described serious adverse events promptly recommend the implementation of a risk alert system.
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Affiliation(s)
- Liliana Olim Gouveia
- Department of Neurology, Hospital de Santa Maria, Av. Prof Egas Moniz, 1649-035 Lisbon, Portugal.
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Canhão P, Batista P, Falcão F. Lumbar Puncture and Dural Sinus Thrombosis – A Causal or Casual Association? Cerebrovasc Dis 2005; 19:53-6. [PMID: 15528885 DOI: 10.1159/000081912] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2004] [Accepted: 06/22/2004] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND A few cases of cerebral venous thrombosis (CVT) were reported after a lumbar puncture (LP), suggesting a causal association. The purpose of our study was to document that LP might predispose to CVT by decreasing blood flow velocities (BFV) in veins or dural sinus. METHODS We performed a transcranial Doppler ultrasound study to register the mean BFV of the straight sinus (SS) before, during and after LP. RESULTS Thirteen patients were studied. LP induced a decrease of 47% of mean BFV in the SS. The mean decrease of BFV was significant immediately at the end (p = 0.003), 30 min after (p = 0.015) and more than 6 h after LP (p = 0.008). CONCLUSIONS LP induced a sustained decrease of mean BFV in the SS. The decrease of venous blood flow is a possible mechanism contributing to the occurrence of CVT.
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Affiliation(s)
- Patrícia Canhão
- Neurology Department, Hospital de Santa Maria, PT-1649 Lisboa, Portugal.
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Abstract
BACKGROUND Treatment of cerebral sinus thrombosis with thrombolytics has been reported in cases with a deteriorating clinical course despite anticoagulant therapy. The rationale of this treatment is to promote rapid recanalisation of the occluded sinus. OBJECTIVES To review the available evidence on the efficacy and safety of thrombolysis in confirmed cerebral sinus thrombosis. SEARCH STRATEGY We searched the Cochrane Stroke Group trials register (March 2003), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 1, 2003), MEDLINE (1966 to March 2003), EMBASE (1980 to March 2003), and reference lists of all relevant publications. SELECTION CRITERIA We aimed to analyse separately unconfounded randomised controlled trials comparing thrombolytic agent with placebo, or thrombolytic agent with antithrombotic therapy, or thrombolytic agent and antithrombotic with antithrombotic alone, in patients with dural sinus thrombosis (confirmed by MR venography, intra-arterial venography or CT venography). DATA COLLECTION AND ANALYSIS Two groups of reviewers independently applied the inclusion criteria. MAIN RESULTS No randomised controlled trials were found. REVIEWER'S CONCLUSIONS There is currently no available evidence from randomised controlled trials regarding the efficacy or safety of thrombolytic therapy in dural sinus thrombosis. A randomised controlled trial is justified to test this therapy especially in patients predicted to have a poor prognosis.
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Affiliation(s)
- Alfonso Ciccone
- Azienda Ospedale Niguarda Ca' GrandaDepartment of NeurologyPiazza Ospedale Maggiore 3MilanoItaly20162
| | - Patrícia Canhão
- Santa Maria HospitalDepartment of NeurologyAv Prof Egas MonizLisboaPortugal1649‐045
| | - Filipa Falcão
- Hospital Rainha Santa IsabelServiço de NeurologiaAv Xanana Gusmão Apt 45Torres NovasPortugal2350‐754
| | - José M Ferro
- Santa Maria HospitalDepartment of NeurologyAv Prof Egas MonizLisboaPortugal1649‐045
| | - Roberto Sterzi
- Azienda Ospedaliera Sant'AnnaDirettore UO NeurologiaVia Napoleona, 50ComoItaly22100
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Canhão P, Falcão F, Ferro JM. Thrombolytics for cerebral sinus thrombosis: a systematic review. Cerebrovasc Dis 2003; 15:159-66. [PMID: 12646773 DOI: 10.1159/000068833] [Citation(s) in RCA: 129] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2002] [Accepted: 06/19/2002] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND PURPOSE The use of thrombolytics is frequently mentioned in patients with cerebral venous or dural sinus thrombosis (CVDST) who deteriorate despite anticoagulant therapy. The aim of this review was to collect all the published information about their use in CVDST and to assess their efficacy and safety. METHODS To find cases of CVDST treated with thrombolytics, we performed a MEDLINE search from 1966 to July 2001, checked all reference lists of studies found and hand searched volumes of 11 journals. Data was extracted by means of a standardised data extraction form. Proportions and 95% confidence intervals (CI) were calculated for outcomes and complications of thrombolytics. Cases were stratified according to variables that may influence the outcome and subgroups were compared by odds ratios and 95% CI. RESULTS No randomised clinical trial (RCT) was found. Seventy-two studies (169 patients) were included. Urokinase was the thrombolytic most frequently administered (76%). In the majority of cases the thrombolytic was locally infused in the occluded sinus (88%). At discharge, 10 cases (7%; 95% CI 3-12%) were dependent and 9 cases (5%; 95% CI 2-9%) died. Intracranial haemorrhages occurred in 17% of cases. In 5% they were associated with clinical deterioration. Extracranial haemorrhages occurred in 21%, but only 2% required blood transfusion. CONCLUSIONS Thrombolytics appeared to be reasonably safe in CVDST, but its efficacy cannot be assessed from the published data. Considering that CVDST is an uncommon disease, a randomised controlled trial to assess effectiveness and safety of local thrombolytics in cases of CVDST with poor prognosis is difficult but not impossible to undertake, on a multicentre international collaboration trial.
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Affiliation(s)
- Patricia Canhão
- Neurology Department, Hospital de Santa Maria, Lisbon, Portugal.
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Sousa R, Silvestre M, Almeida e Sousa L, Falcão F, Dias I, Silva T, De Oliveira C, Oliveira HM. Transvaginal ultrasonography and hysteroscopy in postmenopausal bleeding: a prospective study. Acta Obstet Gynecol Scand 2001; 80:856-62. [PMID: 11531638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
OBJECTIVE To determine the diagnostic value of transvaginal ultrasonography and hysteroscopy in patients with postmenopausal bleeding. MATERIAL AND METHODS Between January 1, 1998 and June 30, 1999, 88 outpatient women with postmenopausal bleeding were enrolled in a prospective study. They underwent transvaginal ultrasonography and hysteroscopy, and were submitted to directed biopsy during hysteroscopy. Findings were classified as normal endometrium, suggestive of atrophy, focal abnormality (benign or suspicious), and diffuse thickness (benign or suspicious). Data was compared with the final diagnosis, established by histological examination, as atrophy, benign pathology, atypical hyperplasia and endometrial carcinoma. RESULTS Among 88 women enrolled, 15 were excluded because hysteroscopy was impossible, and four had abandoned the study. The histological findings were scanty material in 12 (17.4%), atrophy in 24 (34.8%), cystic atrophy in one (1.4%), normal endometrium in five (7.2%), tuberculous endometritis in one (1.4%), polyps in 12 (17.4%), leiomyoma in one (1.4%), non-atypical hyperplasia in three (4.3%), atypical hyperplasia in one (1.4%) and endometrial carcinoma in nine cases (13.0%). For the assessment of endometrial carcinoma, ultrasonography revealed sensitivity 77.8%, specificity 93.3%, positive predictive value 63.6%, negative predictive value 96.6%; and hysteroscopy revealed sensitivity of 88.9%, specificity 98.3%, positive predictive value 88.9%, negative predictive value 98.3%. The combined use of both methods revealed sensitivity 100%, specificity 91.7%, positive predictive value 64.3%, negative predictive value 100%. CONCLUSIONS Both imagiological methods were found to be useful screening tests for endometrial carcinoma. Hysteroscopy was a superior diagnostic procedure.
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Affiliation(s)
- R Sousa
- Department of Gynecology, University Hospital of Coimbra, 3049 Coimbra-Codex, Portugal
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Jardim O, Matos R, Falcão F, Dinis M, Oliveira C. [Aggressive angiomyxoma of the vulva]. ACTA MEDICA PORT 2001; 14:507-10. [PMID: 11878162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
An unusual myxoid and vascular appearing neoplasm of the vulva, termed an Aggressive Angiomyxoma, is described in two cases report. The clinical presentation and recurrence pattern were typical for previously described neoplasms of the same cellular pattern. The histopathology, difficulties in determining the surgical margins, and the treatment of this tumor are discussed.
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Affiliation(s)
- O Jardim
- Serviço de Ginecologia/Obstetríca, Hospitais da Universidade de Coimbra, Coimbra
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Ciccone A, Canhão P, Falcão F, Ferro JM, Sterzi R. Thrombolysis for cerebral vein and dural sinus thrombosis. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2001. [DOI: 10.1002/14651858.cd003693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Coimbra H, Pereira HS, Real FC, Sampaio MG, Lagarto R, Falcão F, Santos AA. [Hysterosalpingography in the diagnosis of pelvic endometriosis]. ACTA MEDICA PORT 2000; 13:255-8. [PMID: 11234488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Endometriosis is a common cause of chronic pelvic pain. Laparoscopy is considered the gold standard for definitive diagnosis. This work aims to evaluate whether hysterosalpingography (14SG), a cheaper and more accessible examination, is worth while as a diagnostic tool in this pathology. Thirty patients submitted to laparoscopy for chronic pelvic pain where retrospectively studied. Three different observers evaluated their hysterosalpingographies. The imaging diagnoses were classified as suggestive or not suggestive of external pelvic endometriosis. With laparoscopy, 18 patients had endometriosis, 11 with mild lesions by Acosta classification. Compared to laparoscopy, HSG diagnosis, when made by at least two observers, revealed a sensitivity of 55.5%, a specificity of 75%, a positive predictive value of 77%, and a negative predictive value of 53%. In the presence of clinical pathologic uterosacral--US ligaments and/or sterility, the specificity of HSG may be 100%, but the sensitivity falls below the 40%. We concluded that in a population with chronic pelvic pain, HSG is not a first choice diagnostic tool. This examination only permits the identification of 1/3 of the patients with external endometriosis, being unable to exclude its presence. However, it may be useful in patients with infiltrative endometriosis of the US ligaments.
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Affiliation(s)
- H Coimbra
- Serviço de Ginecologia, Hospitais da Universidade de Coimbra, Coimbra
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Coimbra H, Brancho EC, Falcão F, De Oliveira HM. [Thoracic endometriosis]. ACTA MEDICA PORT 2000; 13:115-8. [PMID: 11026150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Endometriosis was first described by Russel more than one-hundred years ago and still remains a clinical entity of difficult comprehension, with totally aberrant symptomatology, particularly in extra-genital situations. The present article describes a clinical case of recurring right-sided catamenial pneumothorax in a 45 year-old caucasian woman. In her last episode of right chest pain the X-ray film showed, besides the presence of a pneumothorax, a nodular image, later identified by CT scan as being a transdiaphragmatic hernia with hepatic content. The patient was then submitted to diagnostic and therapeutic thoracotomy and the diaphragmatic endometriosis was confirmed. Finally, a total hysterectomy with bilateral salpingo-ophorectomy was performed and the patient's condition remained uneventful with combined hormone therapy. The clinical presentation, pathogenesis, and therapeutic resolution of this nosological entity are briefly discussed.
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Affiliation(s)
- H Coimbra
- Serviço de Ginecologia, Hospitais da Universidade de Coimbra
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Abstract
No data have been published on the role of vascular risk factors for perimesencephalic nonaneurysmal subarachnoid hemorrhage (PMSAH). In a case-control study we compared the prevalence of vascular risk factors in 40 consecutive patients who suffered a perimesencephalic subarachnoid hemorrhage with that in two controls groups: (a) 120 subjects registered with a general practitioner (GP: matched at a 3:1 ratio for age and sex) and (b) 81 proxies of patients of a hospital outpatient clinic. A conditional multivariate logistic regression model was performed taking into account the matched design. Hypertension was more frequent among PMSAH patients than among the two control group subjects for men and women. Among women, smoking was more common in PMSAH than in the GP control group. The conditional multivariate logistic regression model confirmed that hypertension was an independent risk factor for PMSAH (P = 0.036) Hypertension is a preventable risk factor of PMSAH.
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Affiliation(s)
- P Canhão
- Department of Neurology, Hospital Santa Maria, Lisbon, Portugal
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Abstract
The pharmacokinetic parameters of vancomycin in a neonatal population have been characterized to enable development of optimum dosage guidelines for neonatal intensive-care units and to examine the relationship between these pharmacokinetic parameters and various demographic, developmental and clinical factors which might be associated with changes in the kinetic profile of vancomycin. Forty-four infants (twenty-five males and nineteen females) with suspected or proven Gram-positive infection and who received intravenous vancomycin between October 1993 and December 1996 were included in this retrospective analysis. Gestational age ranged from 25 to 40 weeks and postconceptional age at the time of the study ranged from 28 to 45 weeks. Sixty case-studies were obtained from the forty-four patients, with one period of study corresponding to one week or one cycle of therapy. Vancomycin pharmacokinetic parameters were determined by use of a one-compartment model. By regression analysis the current weight (g) was shown to be the stronger covariate, and both vancomycin clearance (L h(-1)) and volume of distribution (L) had to be normalized. The vancomycin volume of distribution depended on the postconceptional age with a cut-off at 32 weeks, whereas vancomycin clearance depended on the presence or absence of concomitant treatment with indomethacin or of mechanical ventilation, or both. On the basis of the pharmacokinetic parameters obtained we suggest initial dosage guidelines for vancomycin ranging from 10 mg kg(-1) every 8 h to 10 mg kg(-1) every 12 h, depending on the demographic and clinical characteristics of the patients. The results obtained enabled application of better a priori and a posteriori dosage schedules to infants in neonatal intensive-care units by use of the Bayesian approach, although further prospective study is recommended before direct extrapolation to patients in other settings.
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Affiliation(s)
- R Silva
- Pharmacy Department, São Francisco Xavier Hospital, Lisboa, Portugal
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Ferro JM, Pinto AN, Falcão I, Rodrigues G, Ferreira J, Falcão F, Azevedo E, Canhão P, Melo TP, Rosas MJ, Oliveira V, Salgado AV. Diagnosis of stroke by the nonneurologist. A validation study. Stroke 1998; 29:1106-9. [PMID: 9626279 DOI: 10.1161/01.str.29.6.1106] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE The first medical contact of an acute stroke victim is often a nonneurologist. Validation of stroke diagnosis made by these medical doctors is poorly known. The present study seeks to validate the stroke diagnoses made by general practitioners (GPs) and hospital emergency service physicians (ESPs). METHODS Validation through direct interview and examination by a neurologist was performed for diagnoses of stroke made by GPs in patients under their care and doctors working at the emergency departments of 3 hospitals. RESULTS Validation of the GP diagnosis was confirmed in 44 cases (85%); 3 patients (6%) had transient ischemic attacks and 5 (9%) suffered from noncerebrovascular disorders. Validation of the ESP diagnosis was confirmed in 169 patients (91%); 16 (9%) had a noncerebrovascular diagnosis. Overall, the most frequent conditions misdiagnosed as stroke were neurological in nature (cerebral tumor, 3; subdural hematoma, 1; seizure, 1; benign paroxysmal postural vertigo, 1; peripheral facial palsy, 2; psychiatric condition, 6; and other medical disorders, 7). CONCLUSIONS In the majority of cases, nonneurologists (either GPs or ESPs) can make a correct diagnosis of acute stroke. Treatment of acute stroke with drugs that do not cause serious side effects can be started before evaluation by a neurologist and CT scan.
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Affiliation(s)
- J M Ferro
- Department of Neurology, Hospital de Santa Maria, Lisbon, Portugal.
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Fonseca C, Ceia F, Falcão F, Luís AS. [Clinical pharmacokinetics. Present and future]. ACTA MEDICA PORT 1996; 9:185-6. [PMID: 9005694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Carvalho A, Fonseca C, Falcão F, Pereira TA, Freitas O, Parrinha A, Costa M, Rodrigues MJ, Ceia F, Luís AS. [Individualized monitoring of the therapy with gentamycin using pharmacokinetic methods. Which method to choose?]. ACTA MEDICA PORT 1996; 9:187-95. [PMID: 9005695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Gentamicin has an excellent cost/efficacy ratio for gram negative infections treatment. Its use is often limited in clinical practice by its narrow safety margins and a high incidence of toxicity. Gentamicin related nephrotoxicity is a major adverse effect, mostly in patients with other concomitant potential risk factors. As many other Authors we have found in our Internal Medicine Service during 1992 a gentamicin related nephrotoxicity incidence of 22.5%. Various empiric methods and nomograms have shown a significant incidence of error in predicting individualized gentamicin dosage regimens. Pharmacokinetics methods have demonstrated much better results regarding efficacy and toxicity. The aim of this prospective study carried out during 1993-1994 was to individualize by pharmacokinetics methods dosage regimens of gentamicin in patients with one or more concomitant risk factors of nephrotoxicity. The purpose of pharmacokinetics dosage regimens has been to achieve trough serum concentrations of gentamicin in therapeutics range-0.5 to 2 micrograms/ml-on the first 24 to 48 hours of treatment, and the maintenance in this range during all the treatment, avoiding both toxic and under therapeutic levels. The incidence of gentamicin related nephrotoxicity has been evaluated in this population. Twenty patients were studied: 18 males and 2 females aged 59.6 years (19 to 85). All had one or more potential risk factors for nephrotoxicity-65 years or more: 13, previous renal failure: 6, other nephrotoxic drugs: 10, diuretics: 4, dehydration: 5, congestive heart failure: 5, diabetes: 3, hypertension: 3. For the first 10 patients gentamicin dosage regimens have been determined by Sawchuk-Zaske pharmacokinetics method and for the subsequent 10 patients by Bayesian method. The two subpopulations had no significant differences regarding mean age, sex and potential risk factors for nephrotoxicity. Results of Sawchuk-Zaske method: 53 trough gentamicin serum concentration were obtained; 86.8% were within the therapeutic range, 7.5% were toxic and 5.7% were under therapeutic. Results of Bayesian method: 44 determinations of gentamicin through concentrations were obtained; 86.3% within therapeutic range, 2.4% were toxic and 11.3% were under therapeutic. A great variability in pharmacokinetic patient's profile has been found and explains the great variability of individualized dosage regimens of gentamicin (30 to 320 mg/day). No patients had gentamicin related nephrotoxicity. Both pharmacokinetics methods lead to a efficient and save employment of gentamicin in patients with previous renal failure and other potential risk factors for nephrotoxicity.
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Affiliation(s)
- A Carvalho
- Serviço de Medicina, Serviços Farmacêuticos, Hospital de S. Francisco Xavier, Lisboa
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Nahata MC, Bootman JL, Zadák Z, Soeters PB, Goldberg LA, Stremetzne S, Jaehde U, Streit M, Kreuser ED, Thiel E, Schunack W, Calvert RT, Feely M, Chrystyn H, Mangues MA, Ginovart G, Moral MA, Lopes AP, Farré R, Demestre X, Altirriba O, Kloft C, Beyer J, Steuer J, Siegert W, Bever J, Bialer M, Sussan S, Salach OA, Danenberg HD, Laor A, Barnett MI, Cosslett AG, Cohen J, Marini P, Bassi C, Bonzanini A, Cassani T, Ore G, Mangiante G, Scroccaro G, Kaczan M, Eriksen J, Toft B, Jandová M, Vlček J, Klemerová V, Sobotka L, Ayestarán A, López R, Montoro JB, Pou L, Estíbalez A, Pascual B, Aumente MD, Panadero MD, Caraballo M, Pozo JC, Perez JL, Falcão AC, Fernández de Gatta MM, Dominguez-Gil A, Caramona MM, Lanao JM, Fendrich Z, Zajic J, Bellés MMD, Casabó AVG, Jiménez TNV, Hervás BMA, Abad GFJ, Casterá MDE, Aminian M, Mangues MA, Clopés A, Branco C, Badell I, Pardo N, Palací C, Bonal J, Rialp G, Bara B, Nobilis M, Bláha V, Havel E, Květina J, Brátová M, Solichová D, Mullerova M, Svoboda D, Pokrajac M, Miljković B, Simić D, Brzaković B, Galetin A, Pinheiro RL, Carrondo AP, Sieradzki E, Strauss K, Olejarz E, Marzec A, Kaużny J, Szymura-Oleksiak J, Wyska E, Jarosz B, Kosowicz I, Fabirkiewicz K, Cherian R, Vodoz AL, Imsand B, Belli D, Rochat T, Müllerová H, Falcão F, Carvalho A, Pereira T, Fonseca C, Freitas O, Resende M, Parrinha A, Costa M, Pessanha MA, Ferreira A, Mourão L, Ceia F, Lima M, Tavares R, SalesLuis A, Carlos S, Pereira MEA, Carmo JAD, Lacerda JMF, Morais JA, Beaufils C, Duff M, Zamparutti P, Assicot P, Bohor M, Angelini B, Lambert M, Manelli JC, Gayte-Sorbier A, Bongrand MC, Timon-David P, Fiqueira IC, Lourenco R, Silva PA, Rodrigues MO, Fischer A, Schorr W, Radziwill R, Lihtamo M, Jäppinen A, Tuovinen K, Pekkala M, Nuutinen L, Morató L, Lorente L, Muñoz J, Monges P, Blancard A, Lacarelle B, Denis JP, Bongrand MC, Penot-Ragon C, Gouin F, Petitcollot N, Tinguely I, Beney J, Marty S, Reymond JP, Bussels J, Robays H, Litzinger A, Rohda-Bohler R, Salek MS, Turpin S, Derby E, Millar B, Maggs C, Santiago LM, Batel M, Cajaraville G, Tarnés MJ, Díaz MJ, Pozo C, Plazaola A, Vuelta M, Díaz-Munío E, Ferrer A, Lozano A, Guerra R, Pontón JL, Robays H, Kint K, Verstraetep A, Eini DE, Ojala RK, Kontra KM, Naaranlahti TJP, Martorell M, Oliveras M, Juste C, Lopez MT, Hidalgo E, Cabañas MJ, Barroso C, Llop JM, Rey M, Diaz-Munio E, Pastó L, Tubau M, Gómez-Bellver MJ, Rodriguez J, Gómez JM, Gónzalez ML, Gol V, Fuentes V, Ramón S, Girona L, Castelló T, Olona M, García L, Girón C, Monteserín C, Gonzalez P, Alberola C, Feio JAL, Pharm D, Batel Marques FJ, Borges AM, Salek S, Escoms MC, Caro I, Ticó N, Hidalgo M, Bruguera R, Jodar R, Dowell JM, Davey PG, Malek M, Díaz-Munío E, Vuelta M, Pastó L, Rev M, Ferrer I, Llop JM, Marti T, Ibars M, Delporte JP, Ansseau M, Albert A, Sibourg M, Gaspard O, Deprez M, Ndougsa HM, Poma M, Tamés MJ, Macek K, Vlček J, Fendrich Z, Klejna M, Dhillon S, Castro I, Newton M, Zupanets IA, Chernyh VP, Bezdetko NB, Popov SB, Velieva MN, Babajeya SM, Mamedov YD, Mammedov YD, Veliev PM, Nasudari AA, Bandalieva AA, Nordbo S, Smith-Solbakken M, Myklctun R, Berge W, Thormodsen M, Zupanets LA, Kicenko LS, Plusch SI, Isaev SG, Vokrouhlický L, Souček R, Kuneš P, Nývlt O, Potselueva LA, Egorova SN, Kadirova EA, Ziganshina LE, Chaloupka J, Genger K. Abstracts of papers and posters advanced activities in pharmaceutical care 24th European Symposium on Clinical Pharmacy. Pharm World Sci 1995. [PMCID: PMC7101703 DOI: 10.1007/bf01890522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Carvalho A, Fonseca C, Falcão F, Ceia F. [Cefoxitin: its role in the therapy of anaerobic infections]. ACTA MEDICA PORT 1993; 6:467-71. [PMID: 8285118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Cefoxitin is a second generation cephalosporin commonly used to treat anaerobic and mixed infections. The authors reviewed the recently published data about the efficacy of cefoxitin; its utility in different clinical entities, patterns of resistance and resistance mechanisms, indications and reliability of in vitro susceptibility testing. These data indicate the need for determining susceptibility patterns of anaerobics at each hospital and point out to the essential close communication between the microbiologist and clinician to the rational treatment of anaerobic infections.
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Affiliation(s)
- A Carvalho
- Serviço de Medicina, Hospital de S. Francisco Xavier, Lisboa
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Abstract
One of the factors possibly responsible for leakage at a colo-rectal anastomosis is a deficient blood-supply. The rectal circulation was studied in 30 cadavers by injection of colloidal barium sulfate with colored gelatin into the hypogastric and inferior mesenteric arteries. It was noted that there was uniformity of supply to the wall of the organ; the blood-supply derived from the hypogastric arteries in subjects over 50 years of age was minor; the predominant blood-supply was derived from the superior rectal artery. These findings suggest that the hypogastric arteries usually provide only a minor supply in persons over 50 years of age and that obstruction of the inferior mesenteric artery associated with the impaired blood-supply inherent in the rectal dissection must be included in the factors responsible for leakage at the colorectal anastomosis.
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Affiliation(s)
- J Patrício
- Department of Surgery, Hospitais da Universidade de Coimbra, Portugal
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