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Schaltz-Buchholzer F, Biering-Sørensen S, Lund N, Monteiro I, Umbasse P, Fisker AB, Andersen A, Rodrigues A, Aaby P, Benn CS. Early BCG Vaccination, Hospitalizations, and Hospital Deaths: Analysis of a Secondary Outcome in 3 Randomized Trials from Guinea-Bissau. J Infect Dis 2019; 219:624-632. [PMID: 30239767 DOI: 10.1093/infdis/jiy544] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 09/11/2018] [Indexed: 11/14/2022] Open
Abstract
Background This study was performed to examine the effects of early BCG vaccination on the risk, cause, and severity of infant hospitalizations. The analysis included 3 trials randomizing low-weight neonates to early BCG vaccination (intervention) versus no BCG vaccination (usual practice in low-weight neonates, control), with hospitalizations as secondary outcome. Methods Hospitalization data were collected at the pediatric ward of the National Hospital. Effects of BCG vaccination on hospitalization risk were assessed in Cox models providing overall and major disease-group incidence rate ratios (IRRs). Severity was assessed by means of in-hospital case-fatality rates and compared by group as cohort study risk ratios (RRs). Results Among 6583 infants (3297 in BCG group, 3286 controls), there were 908 infant hospitalizations (450 BCG, 458 controls) and 135 in-hospital deaths (56 BCG, 79 controls). The neonatal (28 days), 6-week, and infant (1-year) BCG versus control hospitalization IRRs were 0.97 (95% confidence interval [CI], .72-1.31), 0.95 (.73-1.24), and 0.96 (.84-1.10). Corresponding BCG versus control case-fatality rate RRs were 0.58 (95% CI, .35-.94), 0.56 (.35-.90), and 0.72 (.53-.99). BCG vaccination tended to reduce neonatal and infant sepsis hospitalization rates (IRR, 0.75 [95% CI, .50-1.13] and 0.78 [.55-1.11], respectively), and it reduced the neonatal in-hospital sepsis mortality rate (RR, 0.46; 95% CI, .22-.98). There were no confirmed hospitalizations for tuberculosis. Conclusions BCG vaccination did not affect hospitalization rates but reduced in-hospital mortality rates significantly, primarily by preventing fatal cases of sepsis. The observed beneficial effects of BCG on the in-hospital mortality rate were entirely nonspecific. Clinical Trials Registration NCT00146302, NCT00168610, and NCT00625482.
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Carneiro IM, Rodrigues A, Pinho L, de Jesus Nunes-Santos C, de Barros Dorna M, Moschione Castro APB, Pastorino AC. Chediak-Higashi syndrome: Lessons from a single-centre case series. Allergol Immunopathol (Madr) 2019; 47:598-603. [PMID: 31477396 DOI: 10.1016/j.aller.2019.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 04/11/2019] [Accepted: 04/29/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Chediak-Higashi syndrome (CHS) is a rare and potentially fatal autosomal recessive disease characterized by frequent bacterial infections, bleeding tendency, oculocutaneous albinism, photosensitivity and progressive neurologic dysfunction. Owing to the rarity of this condition, the objective of this study was to describe patients with CHS. METHODS Retrospective evaluation of patients followed in a paediatric tertiary centre of Allergy and Immunology of São Paulo, Brazil, between 1986 and 2018 with a confirmed diagnosis of CHS. Data were obtained from medical records. Demographic aspects, family history, clinical findings, laboratory data, diagnosis, treatment and outcome were described. RESULTS A total of 14 patients (five male) were included. Clinical manifestations were first recognized at a median age of two months (at birth-20 months). Median age at diagnosis was 1.7 years (0-5 years). All patients had recurrent infections. Albinism was present in 13 patients and silvery or light hair was present in 14. Seven patients developed hemophagocytic lymphohistiocytosis (HLH); the median age at the diagnosis of HLH was 5.7 years (2.6-6.7 years) and the median interval between the diagnosis of CHS and HLH was 3.3 years (0-5 years). Four of the most recently diagnosed patients underwent bone marrow transplantation (BMT). Nine patients are deceased, and one was lost to follow-up. The median age of death was 6.7 years (3.8-22 years). Five patients died of HLH, one of lymphoma, and three of infection. All the patients who had HLH before the year of 2000 died of HLH. The two most recently diagnosed patients with HLH were able to cure the HLH, although they died of other causes. Four patients are alive, three of them after successful BMT. CONCLUSION Thirty years of follow up showed an improvement in the prognosis in patients with CHS. The better understanding of the underlying biological mechanisms of HLH allowed the standardization of management protocols, resulting in survival improvement. BMT is the only treatment that can change CHS prognosis, which emphasizes the need for early identification of the disease.
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Pereira IA, Vieira I, Rodrigues A, Pousa I, Oliveira J, Cassiano M, Oliveira C, Rosinha A, Azevedo I, Soares M. P2.01-70 Therapy with Osimertinib in Patients with T790M Mutation: Experience of a Portuguese Oncology Center. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Pereira FF, Lopes A, Cruz A, Cassiano M, Rosinha A, Oliveira C, Rodrigues A, Oliveira J, Pousa I, Azevedo I, Soares M. EP1.04-31 Immunotherapy in Advanced Non-Small Cell Lung Cancer Previously Treated: Real World Data. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Pasquier M, Carron PN, Rodrigues A, Dami F, Frochaux V, Sartori C, Deslarzes T, Rousson V. An evaluation of the Swiss staging model for hypothermia using hospital cases and case reports from the literature. Scand J Trauma Resusc Emerg Med 2019; 27:60. [PMID: 31171019 PMCID: PMC6555718 DOI: 10.1186/s13049-019-0636-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 05/21/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Swiss staging model for hypothermia uses clinical indicators to stage hypothermia and guide the management of hypothermic patients. The proposed temperature range for clinical stage 1 is < 35-32 °C, for stage 2 is < 32-28 °C, for stage 3 is < 28-24 °C, and for stage 4 is below 24 °C. Our previous study using 183 case reports from the literature showed that the measured temperature only corresponded to the clinical stage in the Swiss staging model in approximately 50% of cases. This study, however, included few patients with moderate hypothermia. We aimed to expand this database by adding cases of hypothermic patients admitted to hospital to perform a more comprehensive evaluation of the staging model. METHODS We retrospectively included patients aged ≥18 y admitted to hospital between 1.1.1994 and 15.7.2016 with a core temperature below 35 °C. We added the cases identified through our previously published literature review to estimate the percentage of those patients who were correctly classified and compare the theoretical with the observed temperature ranges for each clinical stage. RESULTS We included 305 cases (122 patients from the hospital sampling and the 183 previously published). Using the theoretically derived temperature ranges for clinical stages resulted in 185/305 (61%) patients being assigned to the correct temperature range. Temperature was overestimated using the clinical stage in 55/305 cases (18%) and underestimated in 65/305 cases (21%); important overlaps in temperature existed among the four stage groups. The optimal temperature thresholds for discriminating between the four stages (32.1 °C, 27.5 °C, and 24.1 °C) were close to those proposed historically (32 °C, 28 °C, and 24 °C). CONCLUSIONS Our results provide further evidence of the relationship between the clinical state of patients and their temperature. The historical proposed temperature thresholds were almost optimal for discriminating between the different stages. Adding overlapping temperature ranges for each clinical stage might help clinicians to make appropriate decisions when using clinical signs to infer temperature. An update of the Swiss staging model for hypothermia including our methodology and findings could positively impact clinical care and future research.
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Chagas-Júnior O, Sonego C, Scheffer M, Özkömür A, Bertolini M, Rodrigues A, Gertz L, Cerveri A, Hernández P. New rigid internal fixation layout for sagittal split osteotomy: finite element analysis comparison against other two estabilished methods. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Coutinho F, Oliveira J, Rodrigues A, Castro M, Carvalho M, Sousa L, Aguas F. Ultrasound Guided Ovarian Mass Biopsy in women with suspicious sonographic features. Australas J Ultrasound Med 2019. [DOI: 10.1002/ajum.12154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Davila R, Rodrigues A, Espinola L, Bueno N, Cavalcanti S, Camino R, Luz J. Longitudinal evaluation effects of phototherapy with low power laser in mandibular movements, pain and edema after orthognathic surgery. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gomes AC, Pinho R, Ponte A, Rodrigues A, Rodrigues J, Sousa M, Silva JC, Carvalho J. EVALUATION OF THE SENSITIVITY OF THE EXPRESS-VIEW MODE OF THE MIROCAM CAPSULE ENDOSCOPY PLATFORM COMPARED TO CONVENTIONAL READING IN OBSCURE GASTROINTESTINAL BLEEDING. ESGE DAYS 2019 2019. [DOI: 10.1055/s-0039-1681197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Silva JC, Rodrigues J, Pinho R, Rodrigues A, Ponte A, Sousa M, Gomes AC, Silva AP, Carvalho J. NEED FOR ENTEROSCOPY IN OBSCURE DIGESTIVE HAEMORRHAGE: VALIDATION OF DISCRIMINATIVE SCORE. ESGE DAYS 2019 2019. [DOI: 10.1055/s-0039-1681263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Gomes AC, Pinho R, Rodrigues A, Ponte A, Rodrigues J, Sousa M, Silva JC, Pavão-Borges V, Carvalho J. HIGH REBLEEDING RATE IN PATIENTS EVALUATED FOR OBSCURE GASTROINTESTINAL BLEEDING AFTER A FALSE-NEGATIVE DEEP ENTEROSCOPY. ESGE DAYS 2019 2019. [DOI: 10.1055/s-0039-1681262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Sousa M, Pinho R, Ponte A, Rodrigues A, Silva J, Gomes C, Carvalho J. INTER-OBSERVER AGREEMENT IN BROTZ CLEANING SCALES FOR CAPSULE ENDOSCOPY. ESGE DAYS 2019 2019. [DOI: 10.1055/s-0039-1681728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Rodrigues A, Mascarenhas L, Gama A, Mourão I, Nogueira H, Rosado V, Padez C. Waist-to-height ratio and its association with sedentary behaviour in a sample of Portuguese male children. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz035.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Rodrigues C, Ward S, Trovão N, Rodrigues A. 220 SEXpertise - Approach to Sexual Health in the Medical Consultation Setting. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.01.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gomes AC, Pinho R, Ponte A, Rodrigues A, Rodrigues J, Sousa M, Silva JC, Carvalho J. IS IT POSSIBLE TO PREDICT THE INFLAMMATORY ACTIVITY OF SMALL BOWEL CROHN'S DISEASE IN CAPSULE ENDOSCOPY USING THE ICCE CRITERIA? ESGE DAYS 2019 2019. [DOI: 10.1055/s-0039-1681750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Guerreiro I, Barros-Silva D, Lopes P, Cunha A, Lobo J, Rodrigues A, Soares M, Antunes L, Henrique R, Jerónimo C. Correlative analysis of gene expression changes and PD-L1 immunoexpression in non-small cell lung cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy493.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Pazello R, Souza C, Filho G, Pereira J, Kolossovski V, Menegatti J, Rodrigues A, Weis P, Wolf P, Hajar F, Rahal D, Koslov J, Claus C. Laparoscopic Supracervical Hysterectomy and Sacrocervicopexy with Extraction of the Surgical Specimen by the Posterior Colpotomy for the Treatment of Uterine Prolapse. J Minim Invasive Gynecol 2018. [DOI: 10.1016/j.jmig.2018.09.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Wu Q, Craciunescu O, Rodrigues A, Meltsner S, Wang C, Gao H, Kelsey C. Commissioning and Clinical Implementation of a Laying Down Technique for Total Skin Irradiation. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Trotter J, Kirkpatrick J, McSherry F, Rodrigues A, Dworkin M, Zomorodi A, Gonzalez L, Herndon J, Hauck E. Long-term Outcomes and Imaging Response for Image-Guided Stereotactic Radiosurgery (IG-SRS) of Brain Arteriovenous Malformations (AVM). Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Pazello R, Souza C, Filho G, Menegatti J, Rodrigues A, Pereira J, Kolossovski V, Rahal D, Koslov J, Hajar F, Wolf P, Weis P. Laparoscopic Nerve-Sparing Radical Hysterectomy for Cervical Cancer Using Karl Storz IMAGE1 S Comparing with Striker 1088 HD. J Minim Invasive Gynecol 2018. [DOI: 10.1016/j.jmig.2018.09.721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rodrigues A, Wang C, Wu Q, Limon D, Mowery Y, Niedzwiecki D, Brizel D. Adaptive IMRT Planning Improves Pharyngeal Sparing for Oropharyngeal Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Coelho S, Carneiro F, Rodrigues A, Cárdia J, Ferreira C, Cunha A, Teixeira A, Soares M. P3.CR-15 Squamous Cell Carcinoma Diagnosed While on Immunotherapy for Lung Adenocarcinoma: A Unique Clinical Case. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sales C, Vieira I, Cassiano M, Oliveira C, Vieira C, Ferreira M, Rodrigues A, Ferreira A, Pousa M, Couto R, Leal C, Abreu J, Teixeira M, Pereira D, Sousa S, Abreu M. Genetic signatures always suggest undertreatment? Experience with PAM50. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy270.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Charaghvandi KR, Van't Westeinde T, Yoo S, Houweling AC, Rodrigues A, Verkooijen HM, Philippens MEP, van Asselen B, Horton JK, van den Bongard HJGD. Single dose partial breast irradiation using an MRI linear accelerator in the supine and prone treatment position. Clin Transl Radiat Oncol 2018; 14:1-7. [PMID: 30406210 PMCID: PMC6215022 DOI: 10.1016/j.ctro.2018.09.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 08/20/2018] [Accepted: 09/03/2018] [Indexed: 11/25/2022] Open
Abstract
Background In selected patients with early-stage and low-risk breast cancer, an MRI-linac based treatment might enable a radiosurgical, non-invasive alternative for current standard breast conserving therapy. Aim To investigate whether single dose accelerated partial breast (APBI) to the intact tumor in both the prone and supine radiotherapy positions on the MRI-linac is dosimetrically feasible with respect to predefined coverage and organs at risk (OAR) constraints. Material & methods For 20 patients with cTis or low-risk cT1N0M0 non-lobular breast carcinoma, previously treated with single dose preoperative APBI in the supine (n = 10) or prone (n = 10) position, additional intensity modulated radiotherapy plans with 7 coplanar beams in the presence of a 1.5T magnetic field were generated. A 20 Gy and 15 Gy dose was prescribed to the gross tumor and clinical target volume, respectively. The percentage of plans achieving predefined organ at risk (OAR) constraints, currently used in clinical practice, was assessed. Dosimetry differences between the prone versus supine approach and the MRI-linac versus clinically delivered plans were evaluated. Results All MRI-linac plans met the coverage and predefined OAR constraints. The prone approach appeared to be more favorable with respect to the chest wall, and ipsilateral lung dose compared to the supine position. No dosimetric differences were observed for the ipsilateral breast. No treatment position was clearly more beneficial for the skin or heart, since dosimetry varied among parameters. Overall, the MRI-linac and clinical plans were comparable, with minor absolute dosimetric differences. Conclusion MRI-linac based single dose APBI to the intact tumor is a promising and a dosimetrically feasible strategy in patients with low-risk breast cancer. Preliminary OAR dosimetry favored the prone radiotherapy position.
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Goncalves Teixeira PM, Barbosa AR, Guerreiro C, Mosalina A, Dias T, Goncalves Almeida J, Silva M, Caeiro D, Rodrigues A, Braga P, Fontes-Carvalho R, Gama V. P3601Pre-existent vs. new-onset atrial fibrillation after transcatheter aortic valve implantation: predictors and outcomes. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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