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Gonçalves Pimenta DA, Meira L, Rolo R, Ferreira L. Sarcoidosis-like reaction secondary to adalimumab treatment in a patient with axial spondyloarthritis. Monaldi Arch Chest Dis 2022; 93. [PMID: 35791620 DOI: 10.4081/monaldi.2022.2343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 06/23/2022] [Indexed: 11/23/2022] Open
Abstract
Anti-TNF agents, namely adalimumab, are safe drugs that represent an important arsenal in the treatment of immune-mediated inflammatory diseases. "Paradoxical effects" have been described with their use. A sarcoidosis "like" reaction induced by these agents is rare and is characterized by a systemic granulomatous reaction indistinguishable from sarcoidosis. We present a 55-year-old male patient, with axial spondyloarthritis, treated with with adalimumab. About 17 months under this therapy, he complained of dry cough and wheezing. Chest CT showed a peri-lymphatic and pericisural micronodular pattern and hilo-mediastinal lymph nodes, suggestive of sarcoidosis. Angiotensin converting enzyme was increased. Assuming the hypothesis of a sarcoidosis-like reaction secondary to adalimumab this therapy was discontinued with progressive improvement in the patient's complaints and in the radiological changes.
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Affiliation(s)
| | - Leonor Meira
- Pneumology Unit, Portuguese Institute of Oncology (IPO), Porto.
| | - Rui Rolo
- Pneumology Unit, Hospital of Braga.
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2
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Coelho DB, Boaventura R, Meira L, Guimarães S, Moura CS, Mota P, Melo N, Carvalho A, Pereira JM, Magalhães A, Morais A, Novais Bastos H. The Role of Ultrasonography in the Diagnosis and Decision Algorithm for the Management of Pneumothorax after Transbronchial Lung Cryobiopsy. Respiration 2021; 101:67-75. [PMID: 34818255 DOI: 10.1159/000518140] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 12/01/2020] [Accepted: 06/23/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Pneumothorax is one of the main complications of transbronchial lung cryobiopsy (TBLC). Chest ultrasound (CUS) is a radiation-free alternative method for pneumothorax detection. OBJECTIVE We tested CUS diagnostic accuracy for pneumothorax and assessed its role in the decision algorithm for pneumothorax management. Secondary objectives were to evaluate the post-procedure pneumothorax occurrence and risk factors. METHODS Eligible patients underwent TBLC, followed by chest X-ray (CXR) evaluation 2 h after the procedure, as our standard protocol. Bedside CUS was performed within 30 min and 2 h after TBLC. Pneumothorax by CUS was defined by the absence of lung sliding and comet-tail artefacts and confirmed with the stratosphere sign on M-mode. Pneumothorax size was determined through lung point projection on CUS and interpleural distance on CXR and properly managed according to clinical status. RESULTS Sixty-seven patients were included. Nineteen pneumothoraces were detected at 2 h after the procedure, of which 8 (42.1%) were already present at the first CUS evaluation. All CXR-detected pneumothoraces had a positive CUS detection. There were 3 discordant cases (κ = 0.88, 95% CI: 0.76-1.00, p < 0.001), which were detected by CUS but not by inspiration CXR. We calculated a specificity of 97.5% (95% CI: 86.8-99.9) and a sensitivity of 100% (95% CI: 87.2-100) for CUS. Pneumothorax rate was higher when biopsies were taken in 2 lobes and if histology had pleural representation. Final diagnosis was achieved in 79.1% of patients, with the most frequent diagnosis being hypersensitivity pneumonitis. Regarding patients with large-volume pneumothorax needing drainage, the rate of detection was similar between CUS and CRX. CONCLUSION CUS can replace CXR in detecting the presence of pneumothorax after TBLC, and the lung point site can reliably indicate its size. This useful method optimizes time spent at the bronchology unit and allows immediate response in symptomatic patients, helping to choose optimal treatment strategies, while preventing ionizing radiation exposure.
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Affiliation(s)
- David Barros Coelho
- Department of Pneumology, Centro Hospitalar São João, Porto, Portugal, .,Faculty of Medicine, University of Porto, Porto, Portugal,
| | - Rita Boaventura
- Department of Pneumology, Centro Hospitalar São João, Porto, Portugal
| | - Leonor Meira
- Department of Pneumology, Centro Hospitalar São João, Porto, Portugal.,Department of Pneumology, Hospital de Braga, Braga, Portugal
| | - Susana Guimarães
- Department of Pathology, Centro Hospitalar São João, Porto, Portugal
| | | | - Patrícia Mota
- Department of Pneumology, Centro Hospitalar São João, Porto, Portugal.,Faculty of Medicine, University of Porto, Porto, Portugal
| | - Natália Melo
- Department of Pneumology, Centro Hospitalar São João, Porto, Portugal
| | - André Carvalho
- Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Radiology, Centro Hospitalar São João, Porto, Portugal
| | | | - Adriana Magalhães
- Department of Pneumology, Centro Hospitalar São João, Porto, Portugal
| | - António Morais
- Department of Pneumology, Centro Hospitalar São João, Porto, Portugal.,Faculty of Medicine, University of Porto, Porto, Portugal.,IBMC/i3S - Instituto de Biologia Molecular e Celular/Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
| | - Helder Novais Bastos
- Department of Pneumology, Centro Hospitalar São João, Porto, Portugal.,Faculty of Medicine, University of Porto, Porto, Portugal.,IBMC/i3S - Instituto de Biologia Molecular e Celular/Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
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Bastos HN, Osório NS, Castro AG, Ramos A, Carvalho T, Meira L, Araújo D, Almeida L, Boaventura R, Fragata P, Chaves C, Costa P, Portela M, Ferreira I, Magalhães SP, Rodrigues F, Castro RS, Duarte R, Guimarães JT, Saraiva M. Correction: A Prediction Rule to Stratify Mortality Risk of Patients with Pulmonary Tuberculosis. PLoS One 2020; 15:e0242455. [PMID: 33175913 PMCID: PMC7657489 DOI: 10.1371/journal.pone.0242455] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Patout M, Meira L, D'Cruz R, Lhuillier E, Kaltsakas G, Arbane G, Suh ES, Hart N, Murphy PB. Neural respiratory drive predicts long-term outcome following admission for exacerbation of COPD: a post hoc analysis. Thorax 2019; 74:910-913. [PMID: 31028235 DOI: 10.1136/thoraxjnl-2018-212074] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 05/15/2018] [Revised: 03/20/2019] [Accepted: 04/01/2019] [Indexed: 11/03/2022]
Abstract
Neural respiratory drive (NRD), as reflected by change in parasternal muscle electromyogram (EMGpara), predicts clinical deterioration and safe discharge in patients admitted to hospital with an acute exacerbation of COPD (AECOPD). The clinical utility of NRD to predict the long-term outcome of patients following hospital admission with an AECOPD is unknown. We undertook a post hoc analysis of a previously published prospective observational cohort study measuring NRD in 120 patients with AECOPD. Sixty-nine (57.5%) patients died during follow-up (median 3.6 years). Respiratory failure was the most common cause of death (n=29; 42%). In multivariate analysis, factors independently associated with an increased mortality included NRD (HR 2.14, 95% CI 1.29 to 3.54, p=0.003), age (HR 2.03, 95% CI 1.23 to 3.34, p=0.006), PaCO2 at admission (HR 1.83, 95% CI 1.06 to 3.06, p=0.022) and long-term oxygen use (HR 2.98, 95% CI 1.47 to 6.03, p=0.002). NRD at hospital discharge could be measured in order to assess efficacy of interventions targeted to optimise COPD and reduce mortality following an AECOPD. Original clinicaltrial.gov number: NCT01361451.
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Affiliation(s)
- Maxime Patout
- Lane Fox Clinical Respiratory Physiology Research Centre, Centre for Human and Applied Physiological Science, School of Basic and Biomedical Science, King's College, London, UK .,Service de Pneumologie, Oncologie thoracique et Soins Intensifs Respiratoires, Normandie Univ, UNIRouen, EA3830-GRHV, Institute for Research and Innovation in Biomedicine (IRIB) and Rouen University Hospital, Rouen, France
| | - Leonor Meira
- Lane Fox Respiratory Service, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Pulmonology Department, Centro Hospitalar São João, Porto, Portugal
| | - Rebecca D'Cruz
- Centre for Human and Applied Physiological Science, School of Basic and Biomedical Science, King's College, London, UK.,National Institute for Health Research Biomedical Research Centre, Guy's and St Thomas' NHS Foundation Trust and King's College, London, UK
| | - Elodie Lhuillier
- Lane Fox Clinical Respiratory Physiology Research Centre, Centre for Human and Applied Physiological Science, School of Basic and Biomedical Science, King's College, London, UK.,Service de Pneumologie, Oncologie thoracique et Soins Intensifs Respiratoires, Normandie Univ, UNIRouen, EA3830-GRHV, Institute for Research and Innovation in Biomedicine (IRIB) and Rouen University Hospital, Rouen, France
| | - Georgios Kaltsakas
- Lane Fox Clinical Respiratory Physiology Research Centre, Centre for Human and Applied Physiological Science, School of Basic and Biomedical Science, King's College, London, UK
| | - Gill Arbane
- Lane Fox Clinical Respiratory Physiology Research Centre, Centre for Human and Applied Physiological Science, School of Basic and Biomedical Science, King's College, London, UK.,Lane Fox Respiratory Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Eui-Sik Suh
- Lane Fox Clinical Respiratory Physiology Research Centre, Centre for Human and Applied Physiological Science, School of Basic and Biomedical Science, King's College, London, UK.,Centre for Human, Aerospace and Physiological Sciences, King's College, London, UK
| | - Nicholas Hart
- Lane Fox Clinical Respiratory Physiology Research Centre, Centre for Human and Applied Physiological Science, School of Basic and Biomedical Science, King's College, London, UK.,Centre for Human, Aerospace and Physiological Sciences, King's College, London, UK
| | - Patrick Brian Murphy
- Lane Fox Clinical Respiratory Physiology Research Centre, Centre for Human and Applied Physiological Science, School of Basic and Biomedical Science, King's College, London, UK.,Centre for Human, Aerospace and Physiological Sciences, King's College, London, UK
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Amorim A, Meira L, Redondo M, Ribeiro M, Castro R, Rodrigues M, Martins N, Hespanhol V. Chronic Bacterial Infection Prevalence, Risk Factors, and Characteristics: A Bronchiectasis Population-Based Prospective Study. J Clin Med 2019; 8:E315. [PMID: 30845638 PMCID: PMC6463080 DOI: 10.3390/jcm8030315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 02/27/2019] [Accepted: 03/01/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Few data are available on chronic bacterial infections (CBI) in bronchiectasis patients. Given that CBI seems to trigger longer hospital stays, worse outcomes, and morbimortality, this study was undertaken to assess CBI prevalence, characteristics, and risk factors in outpatients with bronchiectasis. METHODS A total of 186 patients followed in a bronchiectasis tertiary referral centre in Portugal were included. Demographic data and information on aetiology, smoking history, mMRC score, Bronchiectasis Severity Index (BSI) score, sputum characteristics, lung function, exacerbations, and radiological involvement degree were collected. RESULTS Patients included (mean age 54.7 ± 16.2 years; 60.8% females) were followed up for a period of 3.8 ± 1.7 years. The most common cause of bronchiectasis was infection (31.7%) followed by immune deficiencies (11.8%), whereas in 29% of cases, no cause was identified. Haemophilus influenzae (32.3%) and Pseudomonas aeruginosa (30.1%) were the most common CBI-associated possible pathogenic microorganisms. CBI patients presented a higher follow-up time than no-CBI patients (p = 0.003), worse lung function, BSI (p < 0.001), and radiological (p < 0.001) scores, and more prominent daily sputum production (p = 0.002), estimated mean volume (p < 0.001), and purulent sputum (p < 0.001). The number of exacerbations/year (p = 0.001), including those requiring hospital admission (p = 0.009), were also higher in the CBI group. Independent CBI predictors were BSI score (OR 3.577, 95% CI 1.233⁻10.378), sputum characteristics (OR 3.306, 95% CI 1.107⁻9.874), and radiological score (OR 1.052, 95% CI 1.004⁻1.102). CONCLUSION According to the CBI status, two different sub-groups of patients were found on the basis of several clinical outcomes, emphasizing the importance of routine sputum microbiological monitoring. Further studies are needed to better characterize CBI profiles and to define the individual clinical impact of the most prevalent pathogenic microorganisms.
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Affiliation(s)
- Adelina Amorim
- Pulmonology Department, Centro Hospitalar S. João, 4200-319 Porto, Portugal.
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.
| | - Leonor Meira
- Pulmonology Department, Centro Hospitalar S. João, 4200-319 Porto, Portugal.
| | - Margarida Redondo
- Pulmonology Department, Centro Hospitalar S. João, 4200-319 Porto, Portugal.
| | - Manuela Ribeiro
- Clinical Pathology Department, Centro Hospitalar S. João, 4200-319 Porto, Portugal.
| | - Ricardo Castro
- Radiology Department, Centro Hospitalar S. João, 4200-319 Porto, Portugal.
| | - Márcio Rodrigues
- Radiology Department, Centro Hospitalar S. João, 4200-319 Porto, Portugal.
| | - Natália Martins
- Pulmonology Department, Centro Hospitalar S. João, 4200-319 Porto, Portugal.
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.
- Institute for Research and Innovation in Health (i3S), University of Porto, 4200-135 Porto, Portugal.
| | - Venceslau Hespanhol
- Pulmonology Department, Centro Hospitalar S. João, 4200-319 Porto, Portugal.
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.
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Meira L, Chaves C, Araújo D, Almeida L, Boaventura R, Ramos A, Carvalho T, Osório NS, Castro AG, Rodrigues F, Guimarães JT, Saraiva M, Bastos HN. Predictors and outcomes of disseminated tuberculosis in an intermediate burden setting. Pulmonology 2019; 25:320-327. [PMID: 30819659 DOI: 10.1016/j.pulmoe.2018.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 10/28/2018] [Accepted: 11/16/2018] [Indexed: 12/18/2022] Open
Abstract
SETTING University-affiliated hospital located in Porto, North Portugal, an area with a low to intermediate incidence of tuberculosis (TB). OBJECTIVE To identify predictors and outcomes of disseminated TB (dTB). DESIGN A cohort of patients diagnosed with TB between 2007 and 2013 was retrospectively analysed. Patients with dTB criteria were characterized and compared to single organ TB cases. Factors independently associated with dTB were determined by multivariate logistic regression analysis. RESULTS A total of 744 patients were analysed, including 145 with dTB. Independent risk factors for dTB were pharmacological immunosuppression (OR 5.6, 95% CI 2.8-11.3), HIV infection (OR 5.1, 95% CI 3.1-8.3), chronic liver failure or cirrhosis (OR 2.3, 95% CI 1.4-4.1) and duration of symptoms (OR 2.3, 95% CI 1.4-3.8). Compared to single organ TB, the clinical presentation of dTB patients differed by the absence of haemoptysis (OR 3.2, 95% CI 1.3-8.4) and of dyspnoea (OR 1.9, 95% CI 1.2-3.1), presence of weight loss (OR 1.8, 95% CI 1.1-2.9), night sweats (OR 1.7, 95% CI 1.1-2.7) and bilateral lung involvement (OR 4.4, 95% CI 2.8-7.1). Mortality and time until culture conversion were higher for dTB patients, although not reaching statistical significance. CONCLUSION Immunosuppressive conditions and chronic liver failure or cirrhosis were associated with increased risk of dTB. The haematogenous spread may be dependent on longer symptomatic disease and usually progresses with bilateral lung involvement.
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Affiliation(s)
- L Meira
- Department of Pneumology, Centro Hospitalar São João, Porto, Portugal
| | - C Chaves
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - D Araújo
- Department of Pneumology, Centro Hospitalar São João, Porto, Portugal
| | - L Almeida
- Department of Pneumology, Centro Hospitalar São João, Porto, Portugal
| | - R Boaventura
- Department of Pneumology, Centro Hospitalar São João, Porto, Portugal
| | - A Ramos
- Department of Clinical Pathology, Centro Hospitalar São João, Porto, Portugal; Institute of Public Health, University of Porto, Porto, Portugal
| | - T Carvalho
- Department of Clinical Pathology, Centro Hospitalar São João, Porto, Portugal; Institute of Public Health, University of Porto, Porto, Portugal
| | - N S Osório
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - A G Castro
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - F Rodrigues
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - J T Guimarães
- Department of Clinical Pathology, Centro Hospitalar São João, Porto, Portugal; Institute of Public Health, University of Porto, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal
| | - M Saraiva
- i3S - Instituto de Investigação e Inovação em Saúde, University of Porto, Portugal; IBMC - Instituto de Biologia Molecular e Celular, University of Porto, Porto, Portugal
| | - H N Bastos
- Department of Pneumology, Centro Hospitalar São João, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal; i3S - Instituto de Investigação e Inovação em Saúde, University of Porto, Portugal; IBMC - Instituto de Biologia Molecular e Celular, University of Porto, Porto, Portugal.
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Pais MC, Maia T, Peixoto A, Meira L, Albuquerque A, Lopes J, Capela J. Diarrhea as a form of presentation of medullary thyroid carcinoma. Porto Biomed J 2018; 3:e18. [PMID: 31595246 PMCID: PMC6726287 DOI: 10.1016/j.pbj.0000000000000018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 06/01/2018] [Indexed: 12/01/2022] Open
Abstract
A case is presented of a 57-year-old man consulting for chronic diarrhea. Based on subsequent findings (thyroid nodule and metastases), the possibility of metastatic medullary thyroid carcinoma (MTC) was raised. Thyroidectomy allowed diagnosing a multicentric left lobe MTC. MTC is a rare cause of diarrhea, but should be considered, especially in the presence of signs or symptoms of alarm or nonresponse to empirical therapy.
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Affiliation(s)
| | | | | | - Leonor Meira
- Serviço de Pneumologia, Faculdade de Medicina do Porto, Hospital São João, Porto, Portugal
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Boaventura R, Meira L, Coelho D, Morais A, Novais E Bastos H. Role of ultrasound in the decision algorithm for pneumothorax – a pilot study. Imaging 2018. [DOI: 10.1183/13993003.congress-2018.pa382] [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: 11/05/2022] Open
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Meira L, Almeida LM, Pereira AL, Damas C, Amorim A. Home intravenous antibiotic therapy - Preliminary experience of a pulmonology department. Pulmonology 2018; 24:263-264. [PMID: 29898874 DOI: 10.1016/j.pulmoe.2018.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 04/07/2018] [Accepted: 04/12/2018] [Indexed: 11/16/2022] Open
Affiliation(s)
- L Meira
- Pulmonology Department, Centro Hospitalar de São João, Portugal.
| | | | - A Luísa Pereira
- Pharmaceutical Department, Centro Hospitalar de São João, Portugal
| | - C Damas
- Pulmonology Department, Centro Hospitalar de São João, Portugal
| | - A Amorim
- Pulmonology Department, Centro Hospitalar de São João, Portugal; Faculdade de Medicina da Universidade do Porto, Portugal
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10
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Meira L, Damas C. Intestinal obstruction - Not everything is as it seems. Pulmonology 2018; 24:203-204. [PMID: 29650432 DOI: 10.1016/j.pulmoe.2018.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 03/11/2018] [Accepted: 03/13/2018] [Indexed: 11/15/2022] Open
Affiliation(s)
- L Meira
- Pulmonology Department, Centro Hospitalar São João, Oporto, Portugal.
| | - C Damas
- Pulmonology Department, Centro Hospitalar São João, Oporto, Portugal
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Abstract
Alpha-1 antitrypsin deficiency (AATD) is an autosomal co-dominant disease characterised by low serum levels of this molecule. Its epidemiology remains unknown in many countries, mainly due to its underdiagnosed state and lack of patients' registries. We aim to evaluate and characterise a sample of Portuguese individuals tested for AATD, between 2006 and 2015, based on a retrospective analysis from the database of a laboratory offering AATD genetic diagnosis service. 1684 individuals were considered, covering almost every region in Portugal. Genetic diagnosis resulted from requests of clinicians from different areas of expertise, mainly pulmonology (35.5%). Most subjects could be distributed into more common genotypes: MZ (25.4%, n = 427), MS (15.5%, n = 261), SZ (11.2%, n = 188), ZZ (9.4%, n = 158) and SS (5.6%, n = 95). 9.5% of the subjects were found to carry at least one rare deleterious allele, including the recently described PGaia, Q0Oliveira do Douro, Q0Vila Real and a novel SGaia variant. This study comprises 417 subjects (24.7%) with severe to very severe AATD and 761 carriers (45.2%), 22.7% of those identified by familial screening. The present study represents the most complete survey of AATD in Portugal so far and discloses a high rate of severe and very severe deficiency cases, attributed not only to ZZ and SZ genotypes but also to a large number of rare combinations with other null and deficiency alleles. It also uncovers a low awareness to AATD among the medical community, highlighting the need to create a Portuguese national registry and AATD guidelines and increase the awareness about this condition.
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Affiliation(s)
- Leonor Meira
- a Pulmonology Department , Centro Hospitalar de São João, Alameda Prof. Hernâni Monteiro Porto , Portugal
| | - Rita Boaventura
- a Pulmonology Department , Centro Hospitalar de São João, Alameda Prof. Hernâni Monteiro Porto , Portugal
| | - Susana Seixas
- b Instituto de Investigação e Inovação em Saúde, Universidade do Porto (I3S) , Porto , Portugal.,c Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP) , Porto , Portugal
| | - Maria Sucena
- a Pulmonology Department , Centro Hospitalar de São João, Alameda Prof. Hernâni Monteiro Porto , Portugal
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Meira L, Boaventura R, Araújo D, Cardoso V, Santos V, Morais A, Fernandes G, Magalhães A, Queiroga H, Hespanhol V. Advanced lung cancer – does BMI matter? Lung Cancer 2017. [DOI: 10.1183/1393003.congress-2017.pa4240] [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: 11/05/2022]
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13
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Meira L, Boaventura R, Araújo D, Santos V, Cardoso V, Morais A, Fernandes G, Magalhães A, Queiroga H, Hespanhol V. Metastatic disease in non-small cell lung cancer: is it all the same? Lung Cancer 2017. [DOI: 10.1183/1393003.congress-2017.pa4268] [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: 11/05/2022]
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14
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Peixoto Boaventura RD, Meira L, Jacob M, Santos V, Araújo D, Cardoso AV, Fernandes G, Magalhães A, Morais A, Queiroga H, Hespanhol V. Body mass index in early stage lung cancer – should we be vigilant? Lung Cancer 2017. [DOI: 10.1183/1393003.congress-2017.pa4239] [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: 11/05/2022]
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da Costa Dias de Sousa C, Meira L, Sucena M. Alpha-1 antitrypsin deficiency – a potentially fatal disease. Genes Environ 2017. [DOI: 10.1183/1393003.congress-2017.pa4463] [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: 11/05/2022] Open
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16
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Araújo D, Meira L, Moreira C, Morais A. Neumonía eosinofílica como manifestación paraneoplásica de un adenocarcinoma de colon. Arch Bronconeumol 2016; 52:224-5. [DOI: 10.1016/j.arbres.2015.04.015] [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] [Received: 03/03/2015] [Revised: 04/16/2015] [Accepted: 04/20/2015] [Indexed: 11/24/2022]
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Dabó H, Meira L, Neves I, Marinho A, Gomes I. Combined intrapleural therapy in infectious pleural effusion. Rev Port Pneumol (2006) 2015; 21:105-106. [PMID: 25926377 DOI: 10.1016/j.rppnen.2014.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 12/06/2014] [Accepted: 12/10/2014] [Indexed: 06/04/2023] Open
Affiliation(s)
- H Dabó
- Serviço de Pneumologia, Centro Hospitalar do São João, EPE, Porto, Portugal.
| | - L Meira
- Serviço de Pneumologia, Centro Hospitalar do São João, EPE, Porto, Portugal
| | - I Neves
- Serviço de Pneumologia, Centro Hospitalar do São João, EPE, Porto, Portugal
| | - A Marinho
- Serviço de Pneumologia, Centro Hospitalar do São João, EPE, Porto, Portugal
| | - I Gomes
- Serviço de Pneumologia, Centro Hospitalar do São João, EPE, Porto, Portugal
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Abstract
The personality, psychosomatic symptoms and family characteristics of 55 shunted hydrocephalic children older than four years were studied. Hydrocephalic childrens' self-concept, measured by the Children's Appereception Test, was found to be very significantly poorer than that of the control children. They also frequently showed behaviour disorders of the MBD-type, e.g. concentration difficulties, aggressiveness, fastidious eating and nervousness. The hydrocephalic childrens' families showed very significantly more cohesion and less rigidity, and significantly less authoritarianism than average Finnish families. When examining the parents' attitudes to their sick child, one third of the children were seen to be in a healthy role, with parental expectations realistically related to the child's abilities. One third of the children were seen as "babies", with unnecessarily over-protective attitudes on the part of their parents, and one third as "scapegoats", with accusatory attitudes from their mother and father. Those in the role of "scapegoats" had the poorest perceptual skills, the highest frequencies of behaviour disorders and the poorest self-concept.
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