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Almeida CR, Vieira L, Alves B, Sousa G, Cunha P, Antunes P. The ultimate technique for posterior rib fractures: the parascapular sub-iliocostalis plane block - A series of cases. Rev Esp Anestesiol Reanim (Engl Ed) 2023; 70:477-482. [PMID: 37678457 DOI: 10.1016/j.redare.2023.09.003] [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] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 06/21/2022] [Indexed: 09/09/2023]
Abstract
We report retrospectively a series of four cases involving the successful use of the recently described parascapular sub-iliocostalis plane block (PSIP), for lateral-posterior rib fractures. The efficacy of the PSIP block may potentially depend on different mechanisms of action: (1) direct action in the fracture site by craniocaudal myofascial spread underneath the erector spinae muscle (ESM); (2) spread to deep layers through tissue disruption caused by trauma, to reach the proximal intercostal nerves; (3) medial spread below the ESM, to reach the posterior spinal nerves; and (4) lateral spread in the sub-serratus (SS) plane to reach the lateral cutaneous branches of the intercostal nerves; while avoiding significant negative hemodynamic effects and other possible complications associated to other techniques leading that the PSIP may be considered an alternative in some clinical scenarios to the Erector Spinae Plane block or the Paravertebral block.
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Affiliation(s)
- C R Almeida
- Serviço Anestesiologia do Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - L Vieira
- Serviço Anestesiologia do Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - B Alves
- Serviço Anestesiologia do Centro Hospitalar Tondela-Viseu, Viseu, Portugal.
| | - G Sousa
- Serviço Anestesiologia do Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - P Cunha
- Serviço Anestesiologia do Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - P Antunes
- Serviço Anestesiologia do Centro Hospitalar Tondela-Viseu, Viseu, Portugal
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Monteiro J, Caetano A, Costa C, Pires M, Tavares A, Mariano M, Madeira P, Bonito N, Sousa G. Systemic inflammatory index as a predictor of BCG-refractory non-muscle invasive bladder cancer. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02585-x] [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: 11/11/2022] Open
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3
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Costa CA, Sousa M, Pires MR, Monteiro JC, Caetano A, Póvoa S, Pêgo A, Sousa G. P11.72.A Glioblastoma in elderly patients. Which is the best treatment option? Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.261] [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] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Glioblastoma (GBM) is the most common and aggressive primary malignant brain tumor in adults, and it is associated with a poor prognosis in the elderly. The current standard of care for newly diagnosed GBM is maximal surgical resection, followed by radiotherapy plus concomitant and adjuvant temozolomide (TMZ). In elderly patients with GBM, short-courses of radiotherapy with TMZ are used.
Material and Methods
We performed a single-center retrospective analysis of elderly GBM patients treated from 2013 to 2020. The primary endpoint was to evaluate progression free survival (PFS) and overall survival (OS) according to treatment received (TMZ and standard radiotherapy (60 Gy over a period of 6 weeks) vs TMZ and short-course radiotherapy (40 Gy in 15 fractions)). Secondary endpoints were analysis of population demographics and major toxicities associated to treatment.
Results
Twenty-two patients were identified. The median age was 72 years (range 65- 80), 18 (85.7%) patients were in ECOG-PS 0-1, 12 (57.1%) were males and all patients had undergone partial or complete resection surgery. Eleven (52.4%) patients received TMZ and standard radiotherapy and 10 (47.6%) patients received TMZ and short-course radiotherapy. Three (14.3%) patients had complete remission, 11 (52.4%) patients had partial response, 2 (9.5%) patients presented stable disease and 5 (23.8%) patients had disease progression. Median OS was 9 months (95% CI, 3.6 to 14.4) with TMZ with standard radiotherapy and 8 months (95% CI, 1.8 to 14.2) with TMZ and short-course radiotherapy (p=0.322). Median PFS was 5 months (95% CI, 2.8 to 7.2) with TMZ with standard radiotherapy and 6 months (95% CI, 3.1 to 8.9) with TMZ and short-course radiotherapy (p=0.944). Most common toxicities were hematological, with 5 (23.8%) patients presented thrombocytopenia grade 2 or higher. Five (23.8%) patients presented grade 3/4 toxicities (2 (9.5%) patients presented thrombocytopenia grade 4, 1 (4.8%) patient presented thrombocytopenia grade 3, and 2 (9.5%) patients presented anemia grade 3.
Conclusion
The prognosis of GBM remains poor besides standard therapy. TMZ and short-course radiotherapy should be an option in elderly patients due to its non-inferiority. Elderly patients should undergo a careful geriatric evaluation before starting treatment.
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Affiliation(s)
- C A Costa
- Instituto Português de Oncologia de Coimbra Francisco Gentil , Coimbra , Portugal
| | - M Sousa
- Instituto Português de Oncologia de Coimbra Francisco Gentil , Coimbra , Portugal
| | - M R Pires
- Instituto Português de Oncologia de Coimbra Francisco Gentil , Coimbra , Portugal
| | - J C Monteiro
- Instituto Português de Oncologia de Coimbra Francisco Gentil , Coimbra , Portugal
| | - A Caetano
- Instituto Português de Oncologia de Coimbra Francisco Gentil , Coimbra , Portugal
| | - S Póvoa
- Instituto Português de Oncologia de Coimbra Francisco Gentil , Coimbra , Portugal
| | - A Pêgo
- Instituto Português de Oncologia de Coimbra Francisco Gentil , Coimbra , Portugal
| | - G Sousa
- Instituto Português de Oncologia de Coimbra Francisco Gentil , Coimbra , Portugal
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Teixeira J, Sousa G, Delerue-Matos C, Morais S, Oliveira M. P19-13 Levels of fine and ultrafine particles in firefighters’ personal protective equipment storage rooms. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.662] [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: 10/14/2022]
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5
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Macedo F, Monteiro J, Pereira TC, Monteiro A, Felix Soares R, Bonito N, Sousa G. Therapeutic impact of determination of RAS mutations in the plasma of patient with colorectal cancer. Gastroenterol Hepatol Bed Bench 2022; 15:93-98. [PMID: 35611253 PMCID: PMC9123636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 08/29/2021] [Indexed: 11/21/2022]
Abstract
Stage IV colorectal cancer treatment includes targeted therapy depending on RAS status. During disease progression, loss or gain of RAS mutations could happen, supporting the hypothesis of the evolutionary pressure of therapy. Circulating tumor DNA (ctDNA) are nucleic acids released to the bloodstream by the tumor during its development and may be detected by liquid biopsy. The Idylla© Biocartis, a fully automated real-time-PCR-based molecular diagnostic system, was used in a patient with metastatic colorectal cancer with a NRAS mutation in progression after several therapeutic lines. The ctDNA mutational analysis was performed and revealed the absence of mutations in the KRAS, NRAS, and BRAF genes. The patient started the third line of palliative chemotherapy with irinotecan + cetuximab and achieved a partial response for the first time. The authors describe a case in which liquid biopsy determined the higher progression-free survival achieved.
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Correia Magalhães J, Soares R, de Sousa M, Basto R, Póvoa S, Garcia R, Mariano M, Broco S, Madeira P, Pazos I, Pego A, Carvalho T, Sousa G. Locally advanced triple negative breast cancer in older women – a single centre experience. J Geriatr Oncol 2021. [DOI: 10.1016/s1879-4068(21)00354-4] [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: 12/01/2022]
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Monteiro J, Amorim Costa C, Rebordão Pires M, Domingues I, Bonito N, Sousa G. Over 80 years old undergoing systemic cancer treatment – Who are these patients? J Geriatr Oncol 2021. [DOI: 10.1016/s1879-4068(21)00483-5] [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: 11/30/2022]
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Correia Magalhães J, de Sousa M, Basto R, Mariano M, Madeira P, Sousa G. Adjuvant hyperthermic intravesical chemotherapy in older patients diagnosed with intermediate and high-risk non-muscle invasive bladder cancer: effectiveness and safety. J Geriatr Oncol 2021. [DOI: 10.1016/s1879-4068(21)00349-0] [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: 11/26/2022]
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9
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Magalhaes J, De Sousa M, Basto R, Mariano M, Madeira P, Sousa G. Adjuvant hyperthermic intravesical chemotherapy in intermediate and high-risk non-muscle invasive bladder cancer. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)03198-0] [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: 11/26/2022] Open
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de Sousa M, Fraga T, Correia Magalhães J, Basto R, Paulo J, Jacinto P, Bonito N, Magalhães J, Figueiredo P, Sousa G. 69P HER2 status in RAS and BRAF wild-type metastatic colorectal cancer: Portuguese study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2065] [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: 10/20/2022] Open
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11
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Sousa MJ, Basto R, Magalhães JC, Costa C, Garcia R, Domingues I, Jesus E, Sousa G. P14.81 Brain metastases of lung adenocarcinoma - Clinicopathological profile and outcomes of a single-centre. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.185] [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] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Brain metastases (BM) in patients with non-small cell lung cancer (NSCLC) are considered a major determinant of overall survival (OS). Historically, surgical resection (SR), stereotactic radiosurgery (SRS), or/and whole-brain radiation therapy (WBRT) followed by chemotherapy has been the treatment modalities for BM from lung adenocarcinoma. Recent insights into the biology of adenocarcinoma have led to a wealth of novel therapies, including tyrosine kinase inhibitors (TKIs). Here, we review the pattern of brain metastasis in lung adenocarcinoma patients and management strategies in our centre.
MATERIAL AND METHODS
We performed a single-centre retrospective analysis of patients with lung adenocarcinoma and BM between 2017–2020. Data were collected from electronic medical records, including clinical and histopathological features and outcomes. Survival curves were estimated with the Kaplan-Meier method and compared using the log-rank test.
RESULTS
We identified 29 patients, 65% male, median age 65 years (range 38–84); 55% ECOG PS 0–1; 59% smokers; 55% had extracranial metastases (ECM) and 66% were symptomatic, 24% were EGFR mutated, the frequency of ALK rearrangement was 14%, in 14% the molecular testing was not performed. We treated 59% with WBRT, 12% with SRS, 11% with SR+WBRT and 4% with SR+SRS; 14% were referred for palliative care. Clinical deterioration during local therapy was observed in 32% of the patients and, consequently, they haven’t undergone systemic treatment. After local treatment, 26% received chemotherapy (CT) and 28% received TKIs therapy. Median OS (mOS) was 11.3 months (95% CI 2.4–20.3) for the CT subgroup; mOS for the TKIs subgroup was not reached, but the 1-year survival rate was 67%.
CONCLUSION
BM confers a worse prognosis in lung adenocarcinoma patients. Currently, targeted systemic treatments in patients with driver mutations improve survival and have demonstrated efficacy in lung adenocarcinoma metastatic to the brain. Further research is needed to find better treatments for BM in NSCLC patients with no driver mutations.
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Affiliation(s)
- M J Sousa
- Portuguese Oncology Institute of Coimbra, Coimbra, Portugal
| | - R Basto
- Portuguese Oncology Institute of Coimbra, Coimbra, Portugal
| | - J C Magalhães
- Portuguese Oncology Institute of Coimbra, Coimbra, Portugal
| | - C Costa
- Portuguese Oncology Institute of Coimbra, Coimbra, Portugal
| | - R Garcia
- Portuguese Oncology Institute of Coimbra, Coimbra, Portugal
| | - I Domingues
- Portuguese Oncology Institute of Coimbra, Coimbra, Portugal
| | - E Jesus
- Portuguese Oncology Institute of Coimbra, Coimbra, Portugal
| | - G Sousa
- Portuguese Oncology Institute of Coimbra, Coimbra, Portugal
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de Sousa M, Teixeira M, Bento C, Zorrinho I, Correia Magalhães J, Basto R, Caramujo C, Garcia A, Khouri L, Pires I, Branquinho F, Cardoso A, Leite A, Sousa G. 931TiP Malnutrition based on the GLIM criteria and the response to concurrent chemoradiotherapy in patients with squamous cell carcinoma of the head and neck. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1341] [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: 10/20/2022] Open
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13
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Basto R, Caramujo C, Ferreira Gomes I, Fraga T, Correia Magalhães J, Sousa M, Monteiro A, Pestana Santos A, Carvalho T, Albuquerque E, Sousa G. 1491P Assessment of psychiatric disorder in patients with metastatic breast cancer: A cross-sectional study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.819] [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: 12/01/2022] Open
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14
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Basto R, Magalhães JC, de Sousa M, Monteiro J, Domingues I, Jesus E, Sousa G. 87P Impact of chemoradiotherapy on the survival of patients with stage III NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)01929-8] [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: 10/21/2022]
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15
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Monteiro A, Pereira T, Macedo F, Soares R, Mariano M, Madeira P, Sousa G. Docetaxel plus androgen deprivation therapy in older versus younger patients with metastatic hormone-sensitive prostate cancer: Real-world data. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)36203-0] [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: 11/26/2022] Open
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16
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Macedo F, Monteiro J, Félix Soares R, Monteiro A, Cunha Pereira T, Baptista S, Amaral C, Veloso L, Gois C, Bonito N, Sousa G. 1844P Effectiveness of normal saline solution in maintaining the permeability of totally implantable venous catheters in adult cancer patients: Experience of an oncologic center. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1491] [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: 10/23/2022] Open
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Macedo F, Monteiro J, Monteiro A, Félix Soares R, Cunha Pereira T, Bonito N, Sousa G. 1836P Bacteraemia in cancer patients: An adverse prognostic factor and the relationship with chemotherapy. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1483] [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: 11/16/2022] Open
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Félix Soares R, Silva R, Rodrigues É, Amaral M, Nabais M, Cunha Pereira T, Peixoto M, Macedo F, Monteiro A, Pontes F, Domingues I, Garcia A, Rêgo I, Cunha Carvalho J, Chaves A, Jesus E, Vilão Ó, Sousa G. 1514P Patient-reported outcomes of early integration palliative care in quality of life and symptom burden in advanced lung cancer – A randomized study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.140] [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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Soares RF, Monteiro A, Macedo F, Pereira TC, Paulo J, Marques M, Bonito N, Jacinto P, Ribeiro J, Sousa G. P-208 Is there a role for adjuvant chemotherapy in ypN0 disease rectal cancer patients? Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.290] [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: 11/24/2022] Open
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20
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Monteiro A, Pereira TC, Soares RF, Macedo F, Paulo J, Marques M, Bonito N, Jacinto P, Ribeiro J, Sousa G. P-36 Prognostic value of tumor laterality and recurrence risk in patients with stage III colon cancer treated with adjuvant chemotherapy. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.118] [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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Pereira TC, Salgueiro F, Monteiro A, Soares RF, Macedo F, Jacinto P, Paulo J, Bonito N, Marques M, Ribeiro J, Sousa G. P-225 KRAS codon 12 and 13 mutations in metastatic colorectal cancer: Predictive marker in first-line bevacizumab-based chemotherapy. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.307] [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: 11/25/2022] Open
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22
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Peixoto M, Macedo F, Sousa M, Paulo J, Marques M, Jacinto P, Bonito N, Ribeiro J, Sousa G. P-263 The role of biologic targets in metastatic colorectal cancer in non-elderly patients: A single institutional analysis. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.345] [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: 10/23/2022] Open
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Soares RF, Pereira TC, Monteiro A, Macedo F, Paulo J, Marques M, Bonito N, Jacinto P, Ribeiro J, Sousa G. P-203 Restaging rectal cancer after neoadjuvant chemoradiation therapy: Is magnetic resonance imaging accurate enough? Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.285] [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: 10/23/2022] Open
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Sousa JP, Neves C, Jesus E, Chaves A, Lourenco C, Goncalves L, Sousa G. P852 Cancer-associated thrombotic diathesis: one of your worst nightmares. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.500] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
A 34-year-old male patient was diagnosed with undifferentiated sarcoma of the right thigh, with lung metastasis. He underwent primary lesion resection surgery and initiated chemotherapy with both doxorubicin and ifosfamide. Though primary tumor burden was substantially reduced, secondary lesions were found to be irresponsive to drug therapy, leading to regimen switching to both gemcitabine and docetaxel. Three months later, patient started complaining of atypical chest pain and palpitations. Electrocardiography revealed very frequent supraventricular ectopic complexes, while a transthoracic echocardiogram unveiled a pulmonary vein thrombus, which extended into the left atrium. This finding, which was further characterized by cardiovascular magnetic resonance imaging, prompted anticoagulation initiation, under the form of enoxaparin 1mg/kg bid. At this time, chemotherapeutic scheme was, again, swapped, and a cycle of both doxorubicin and olaratumab was introduced. A combined episode of inferolateral ST-segment elevation myocardial infarction and peripheral arterial embolism followed shortly thereafter. Emergent invasive coronary angiogram revealed no signs of both epicardial atherosclerosis and thrombus, whereas subsequent transthoracic echocardiography showed a massive left heart thrombus, extending into the aortic valve annulus. Anti-thrombotic approach involved increasing enoxaparin dosage to 1.5mg/kg bid but no fibrinolytic therapy. Despite a rather uneventful immediate clinical course, with no electric or hemodynamic instability and no limb-threatening ischemia, lamentably, patient died two weeks later, before thrombus definitive imaging reassessment. As no autopsy was performed, it is unclear whether a cardiovascular acute event or neoplasm inexorable progression is to blame as the primary cause of death.
Thrombosis is a common, costly and potentially fatal cancer complication. Patients receiving systemic chemotherapy for advanced diseased are at higher risk. Despite major management developments in the past fifteen years, evidence still supports traditional low-molecular-weight heparins as the first-line therapy and prognosis remains dismal.
Abstract P852 Figure.
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Affiliation(s)
- J P Sousa
- University Hospitals of Coimbra, Coimbra, Portugal
| | - C Neves
- Instituto Português de Oncologia de Coimbra, Cardiologia, Coimbra, Portugal
| | - E Jesus
- Instituto Português de Oncologia de Coimbra, Cardiologia, Coimbra, Portugal
| | - A Chaves
- Instituto Português de Oncologia de Coimbra, Cardiologia, Coimbra, Portugal
| | - C Lourenco
- University Hospitals of Coimbra, Coimbra, Portugal
| | - L Goncalves
- University Hospitals of Coimbra, Coimbra, Portugal
| | - G Sousa
- Instituto Português de Oncologia de Coimbra, Cardiologia, Coimbra, Portugal
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Domingues I, Carvalho J, Pratas E, Pinheiro S, Amaral S, Pereira T, Pontes F, Félix R, Chaves A, Mariano M, Carvalho T, Madeira P, Pêgo A, Broco S, Garcia R, Pazos I, Pais A, Sousa G. Illness perceptions, quality of life and mood in metastatic breast cancer patients. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz242.070] [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: 11/14/2022] Open
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26
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Rego I, Pontes F, Carvalho J, Pratas E, Chaves A, Martins R, Couto J, Ribeiro J, Rodrigues F, Sousa G. A single center experience with oral chemotherapy with capecitabine and temozolomide in metastatic neuroendocrine tumors. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.345] [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: 11/13/2022] Open
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Macedo F, Félix Soares R, Cunha Pereira T, Monteiro A, Bonito N, Broco S, Carvalho T, Mariano M, Sousa G. Founder mutations BRCA2 c.156_157insAlu in Portuguese population. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz095.060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Amaral S, Cunha Pereira T, Monteiro A, Garcia A, Pinto L, Gonçalves V, Mariano M, Broco S, Carvalho T, Sousa G. Hereditary breast and ovarian cancer syndrome: Descriptive analysis of a familial cancer clinic. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz095.047] [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: 11/14/2022] Open
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Carvalho J, Peixoto M, Cunha Pereira T, Garcia A, Mariano M, Broco S, Pazos I, Carvalho T, Ribeiro J, Sousa G. Male breast cancer, a heterogeneous entity: Experience from a cancer center. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz101.016] [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: 11/13/2022] Open
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Amaral S, Casal Moura M, Carvalho J, Chaves A, Jesus E, Sousa G. Prognostic significance of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz027.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Domingues I, Carvalho J, Pratas E, Pinheiro S, Amaral S, Bonito N, Jesus E, Ribeiro J, Chaves A, Pais A, Sousa G. A long-term analysis of imatinib palliative treatment in gastrointestinal stromal tumors. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.115] [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: 11/12/2022] Open
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Sousa C, Pinto L, Saraiva N, Rego I, Paulo J, Bastos J, Mariano M, Sousa G, Roda D, Miranda C, Melo G, Cruz M, Martins S, Kayla P. EP-1353: Breast Cancer In Young Women: A Retrospective Study. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31662-1] [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: 11/15/2022]
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Martins Branco D, Lopes S, Canario R, Freire J, Sousa G, Lunet N, Gomes B. Prevalence and recent time trend in aggressiveness of cancer care near the end of life: an expanded assessment in a cohort study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx382.002] [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: 11/13/2022] Open
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Sousa G, Pinho C, Santos A, Abelha FJ. Postoperative delirium in patients with history of alcohol abuse. Rev Esp Anestesiol Reanim 2017; 64:214-222. [PMID: 27641821 DOI: 10.1016/j.redar.2016.07.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 06/22/2016] [Accepted: 07/05/2016] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Postoperative delirium (POD) is an acute confusional state characterized by changes in consciousness and cognition, which may be fluctuating, developing in a small period of time. The aim of this study was to evaluate the relationship between alcohol abuse and the development of POD. METHODS We prospectively evaluated consecutively all postoperative patients admitted in the Post-anesthesia Care Unit over a 1-month period for delirium, using the Portuguese versions of the the Nursing Delirium Screening Scale. Before surgery, alcohol consumption was inquired and alcohol abuse was assessed by the CAGE (Cutting Down, Annoyance, Guilt and Eye-opener) questionnaire; a score ≥2 defined alcohol abuse. Fischer exact test or chi-square was applied for comparisons. Risk factors were analyzed in a multivariate analysis using a logistic regression with odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS Two hundred twenty-one patients were enrolled. Delirium was seen in 11% patients. The incidence of alcohol abuse was 10%. Patients with alcohol abuse were more frequently men (P<.001) and had a higher ASA physical status III/IV (P=.021). POD was more frequent in patients with alcohol abuse (30% vs. 9%; P=.002). Age (OR: 5.9; 95%CI: 2.2-15.9; P<.001 for patients ≥65years), ASA physical statusIII/IV (OR: 4.2; 95%CI: 1.7-10.7; P=.002) and alcohol abuse (OR: 4.2; 95%CI: 1.4-12.9; P=.013) were found to be independent predictors for POD. CONCLUSIONS Older patients, higher ASA physical status and alcohol abuse were more frequent in patients with POD. Alcohol abuse was considered an independent risk factor for POD.
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Affiliation(s)
- G Sousa
- Department of Anaesthesiology, Hospital de São João, Oporto, Portugal
| | - C Pinho
- Department of Anaesthesiology, Hospital de São João, Oporto, Portugal
| | - A Santos
- Department of Anaesthesiology, Hospital de São João, Oporto, Portugal
| | - F J Abelha
- Department of Anaesthesiology, Hospital de São João, Oporto, Portugal; Department of Anaesthesiology and Perioperative Medicine, Faculty of Medicine, University of Porto, Oporto, Portugal.
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Fernandes e Fernandes R, Garrido P, Silvestre L, Sousa G, Martins P, Ribeiro J, Pedro L, França C, Fernandes e Fernandes J. Abdominal Compartment Syndrome in Open Repair for Ruptured AAA: Can a Selective Prophylactic Open Abdomen Strategy Improve Survival? Eur J Vasc Endovasc Surg 2015. [DOI: 10.1016/j.ejvs.2015.06.067] [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: 11/16/2022]
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Nogueira A, Garcia R, Pinto L, Sousa G, Gervásio H. Breast cancer in a geriatric population — What do we need to change? J Geriatr Oncol 2014. [DOI: 10.1016/j.jgo.2014.09.043] [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: 11/25/2022]
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Marinho J, Pires A, Sousa G, Castela E. Right subclavian artery aneurysm in an adolescent with a bicuspid aortic valve. Pediatr Cardiol 2014; 34:1952-4. [PMID: 22968291 DOI: 10.1007/s00246-012-0502-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Accepted: 08/26/2012] [Indexed: 11/24/2022]
Abstract
Bicuspic aortic valve is the most common congenital cardiac anomaly (Fedak et al. 106:900-904, 2002), and it is associated with other structural anomalies of the aorta, such as coarctation, suggesting a common embryologic developmental mechanism (Mergan et al. 104:118-119, 2004). In more than a half of patients, it is associated with progressive dilation and aneurysm formation of the aorta (Warnes 89:965-966, 2003) despite normally functioning bicuspid aortic valves. In this context, aneurysms of the right subclavian artery are extremely rare, and even more so when associated with a right-sided aortic arch that has a left aberrant subclavian artery with a Kommerell diverticulum, as found in the reported case. These aneurysms represent a significant risk for thromboembolism and rupture, and elective surgical management should be advised, even for asymptomatic cases.
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Affiliation(s)
- J Marinho
- Department of Pediatric Cardiology, Hospital Pediátrico Carmona da Mota, Av. Afonso Romão, Santo António dos Olivais, 3000-602, Coimbra, Portugal
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Couto M, Gaspar A, Piedade S, Arêde C, Menezes M, Sousa MJ, Sousa G, Morais-Almeida M. IgE-mediated metamizol allergy and the usefulness of the cellular allergen stimulation test. Eur Ann Allergy Clin Immunol 2012; 44:113-116. [PMID: 22905592] [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: 06/01/2023]
Abstract
Metamizol is a pyrazolone-derivative nonsteroidal anti-inflammatory drug that is commonly associated with hypersensitivity reactions. Some of these reactions are IgE-mediated and potentially severe, which limits the diagnosis based on oral drug challenge. We describe 6 selective metamizol hypersensitivity cases, regarding clinical evaluation and diagnosis management, with focus on the usefulness of skin tests and the cellular allergen stimulation test (CAST). All patients were female, aged 27 to 50 years old. All had immediate reactions after metamizol administration: 3 had anaphylaxis and 3 had urticaria and angioedema. Skin prick tests with metamizol were positive in 2 patients. Intradermal tests were positive in the remaining, all with 1/100 dilution, and elicited systemic reactions in 2 of them. CAST to metamizol was negative in all cases. The patients tolerated other nonsteroidal anti-inflammatory drugs. Skin tests proved to be a good diagnostic method to identify IgE-mediated metamizol allergy, although skin tests elicited systemic symptoms in some cases. Despite this being a small sample, our results showed a very low sensitivity for CAST which differs from data previously reported in the literature.
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Affiliation(s)
- M Couto
- Immunoallergy Department, CUF-Descobertas Hospital, Lisbon, Portugal
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Gregorio M, Pinhel MA, Florim GM, Sousa G, Nakazone M, Martins D, Silva S, Crestani A, Santos ML, Ferraz Filho JR, Lauletta LF, Madureira L, Souza D, Tognola W. Relevance of Endothelial Nitric Oxide Sintase, Elastin and Endoglin Genetic Variants in Familial Intracranial Aneurysm (P01.025). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p01.025] [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: 11/15/2022] Open
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Azevedo J, Rosas M, Esteves M, Vieira Coelho M, Torres A, Gago M, Sousa G, Garrett C, Linhares P, Vaz R. P03-09 - Sexual health in Parkinson disease. Eur Psychiatry 2010. [DOI: 10.1016/s0924-9338(10)70859-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Roncon-Albuquerque R, Pires I, Martins R, Real R, Sousa G, von Hafe P. Ceftriaxone-induced acute reversible encephalopathy in a patient treated for a urinary tract infection. Neth J Med 2009; 67:72-75. [PMID: 19299850] [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: 05/27/2023]
Abstract
Encephalopathy is a rare side effect of third- and fourth-generation cephalosporins. Renal failure and previous disease of the central nervous system predispose to this neurotoxicity. We describe a case of encephalopathy with generalised triphasic waves in a patient with pre-existent cerebrovascular disease who was treated with ceftriaxone for a urinary tract infection. Early recognition of this complication is relevant given that ceftriaxone discontinuation reverted the neurological syndrome.
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Affiliation(s)
- R Roncon-Albuquerque
- Department of Internal Medicine, Faculty of Medicine of Porto, Hospital S. João, Porto, Portugal.
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Gago M, Rosas M, Linhares P, Ayres-Basto M, Sousa G, Vaz R. Transient Disabling Dyskinesias: A Predictor of Good Outcome in Subthalamic Nucleus Deep Brain Stimulation in Parkinson’s Disease. Eur Neurol 2008; 61:94-9. [DOI: 10.1159/000177941] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2008] [Accepted: 07/22/2008] [Indexed: 11/19/2022]
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Abstract
The weak D phenotype is the most common D variant, with a frequency of 0.2-1% in Caucasian individuals. There are several weak D types, with different frequencies in European countries, which may pose serologic problems and have the potential for alloimmunization. Samples from Portuguese individuals were tested for RhD by two or three distinct monoclonal and oligoclonal antisera, in direct agglutination tests. When discrepant results were observed, samples were tested with panels of monoclonal anti-D by LISS-indirect antiglobulin test. Cases that reacted weakly with IgM but positive with IgG anti-D were analysed by PCR-sequence-specific primers and real-time PCR. Ninety-nine samples were referred after being characterized as weak D. This genotype was recognized, with a preponderance of weak D type 2 (63.6%) over type 1 (16.2%) and 3 (14.1%). The high incidence of weak D type 2 in our population is in marked contrast to studies performed in other European populations and might be due to our sample selection criteria or ethnic variation. There are advantages in genotyping serologically depressed D samples to avoid the waste of D-negative RBC units and the use of immunoglobulin in pregnant women, who have no risk of alloimmunization.
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Affiliation(s)
- F Araújo
- Molecular Biology Centre, Department of Transfusion Medicine and Blood Bank, Hospital S. João, Oporto, Portugal.
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Vasconcelos E, Sousa AP, Seghatchian J, Maurício R, Figueiredo AC, Leitão C, Sousa G. The content of the LRS chamber provides a new quality tool for the characterization of the donor platelet profile. Transfus Apher Sci 2005; 32:221-5. [PMID: 15784457 DOI: 10.1016/j.transci.2004.10.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2004] [Accepted: 10/01/2004] [Indexed: 11/24/2022]
Abstract
Cobe Trima version 4 is an apheresis system designed for the collection of combinations of Red Blood Cells (RBC), Platelets (PLT) and plasma components from a single donor. The validation of this apheresis system for PLT components in our institution evidenced the LRS efficacy, as leucoreduction was attained on a 100% basis. However, there were some unexpected occurrences regarding the PLT content. Certain donations showed large disagreements between programmed and obtained yields, not being found clear reasons for those outcomes. Furthermore, the mean platelet volume (MPV) was relatively low when compared with other platelets components produced by other methodologies. An investigation was initiated in order to know whether these shortcomings were donor or process/instrument related. A link was established between the raw material (donor), the process/instrument and the final product, and a new tool was introduced by the study of the LRS chamber. The LRS chamber content was assessed and the PLT cellular indices and PLT aggregation states compared with those obtained from the respective donor and the final product from the same origin. The storage stability of the final products was also analyzed based on these same tests to investigate if the initial low MPV had any deleterious effect during the shelf life of the components. Twenty five plateletpheresis donors, three of them new ones, were randomly selected for this study. For the first time, the content of the LRS chamber was used as a quality tool for identification of the cause of unexpected yields. Large aggregates remained in the LRS chamber in certain donors who were prone to undergo spontaneous aggregation, making the platelet yields low and platelet MPV very small. Based on repeated failures and on this new quality parameter showing LRS chamber abnormality, two donors were temporarily deferred from the panel. While it was not possible to identify the causes, it is appropriate to raise the question whether these profiles were Trima version 4 specific or not. Hence, further investigation is needed for a better clarification. In short, the simultaneous analysis of products and LRS content provided useful information not only for the characterization of donor-related phenomena but also helped in the identification of potential shortcomings in the machine performance allowing for remedial action to be taken on evidence based data.
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Affiliation(s)
- E Vasconcelos
- Centro Regional de Sangue de Lisboa, Instituto Português do Sangue, Avenida do Brasil, 53, Pav. 17, 1700 Lisboa, Portugal.
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Ferreira SDRM, Tedesco AC, Sousa G, Zângaro RA, Silva NS, Pacheco MTT, Pacheco-Soares C. Analysis of mitochondria, endoplasmic reticulum and actin filaments after PDT with AlPcS 4. Lasers Med Sci 2004; 18:207-12. [PMID: 15042425 DOI: 10.1007/s10103-003-0282-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.3] [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: 09/10/2003] [Accepted: 10/28/2003] [Indexed: 11/30/2022]
Abstract
Photodynamic therapy (PDT) is a therapeutic modality for the treatment of tumors. This technique uses a visible light to activate a photosensitizer compounds, leading to a photo-oxidation process of biological tissue that can induce apoptosis or necrosis both in vivo and in vitro. However many of the cytotoxic effects remain an open question to be investigated. The cytotoxicity to specific cellular targets of classical photosensitizers used in the PDT in vitro has been analyzed in this work. The photosensitizing effects of Chloroaluminum Phthalocyanine Tetrasulfonate (AlPcS(4)) were studied on the mitochondria, cytoskeleton and endoplasmic reticulum of HeLa cells. The cells were irradiated with a diode laser (working at 670 nm; energy density of 4.5 J/cm(2 )and power density of 45 mW/cm(2)). The spectrofluorimetric analysis of the mitochondria showed changes in membrane potential. Cytoskeleton and endoplasmic reticulum showed basic alterations in distribution after PDT treatment, as an indicator of cellular death process.
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Affiliation(s)
- S D R M Ferreira
- Laboratory of Cellular and Tecidual Biology, Instituto de Pesquisa e Desenvolvimento, Universidade do Vale do Paraíba, Av. Shishima Hifumi 2911, 12244-000, São José dos Campos, SP, Brazil
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Abstract
OBJECTIVE The authors investigated the impact of patient suicides on trainees and psychiatrists and their utilization of supports. METHODS Graduates in practice and trainees of the residency program of the University of Toronto from 1980-1995 (N=495) were surveyed, retrospectively, with 239/495 responding (48%). Demographic and educational information, exposure to suicide, impact of the suicide(s), use of support systems, acute stress disorder and posttraumatic stress disorder symptoms, and impact of events and social relationship scores were collected. RESULTS One-half of the respondents (120/239) experienced at least one suicide of a patient, 62% of them (74/120) during postgraduate training. Biologically oriented psychiatrists in practice were more at risk for patient suicide. An important minority (one-quarter) among those who experienced patient suicide had substantially higher (morbid) scores than the overall group. They also scored higher on an acute stress disorder and a posttraumatic stress disorder symptom checklist. The impact was more severe when the patient suicide occurred during training than after graduation and was inversely correlated with clinicians' perceived social integration into their relational professional network. CONCLUSIONS The experience of patient suicide is common during training and in clinical practice. The majority of trainees and clinicians are able to cope normally with the trauma, but in an important minority the emotional impact approaches morbid levels. Training programs should prepare students for this occupational hazard and implement systematic protocols to support those trainees who are especially vulnerable to their patient's suicide and reduce their social isolation from their peer group. Formal and informal professional networks should heighten awareness of the impact of patient suicide on practicing colleagues and take adequate measures to support them.
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Affiliation(s)
- R Ruskin
- Joint General Psychiatry Program, Mount Sinai Hospital, Toronto, Ontario, Canada
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Abstract
The distribution of leucocyte subpopulations in platelet concentrates (PC) derived from pre-storage filtered platelet-rich plasma (PRP), the cell suspension obtained by reverse filter washing and the post-filtered PC, were monitored by immunophenotyping analysis using CD3, CD20 and CD33. Leucocyte activation analysis with the CD11b marker revealed that this molecule is up regulated in neutrophils taken from the filter. This, together with the loss of cell viability during the enrichment process, suggests that contact with the filter matrix and processing and storage of samples containing leucocytes may lead to activation and loss of leucocyte viability. These changes were found to be more pronounced in less stable myeloid cells and account for the differences reported among various authors which in some cases related to operational conditions such as the enrichment process used and the length of time between filtration and analysis of samples. Finally, statistical analysis of the results obtained by immunophenotypic studies indicate that post-filter samples (S) contain significantly higher numbers of CD33+ myeloid cells when compared to (PF) the pre-filter samples (65.03%+/-12.6 and 24.56%+/-14.73, p<0.0000), with a decrease in T cells (50.72%+/-14.80 in PF and 24.05+/-9.48 in the cell suspension (S), p<0.0007) and B cells (14.96+/-9.31 in PF and 9.9+/-5.22 in S, p<0.201). A new strategy for assessing the influence of the filtration process on residual leucocyte activation and viability is described. This has direct relevance to collection, processing, storage and quality monitoring of PC.
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Affiliation(s)
- H Trindade
- Centro de Histocompatibilidade do Sul, Campo dos Mártires da Pátria, 130, 1169-056 Lisboa, Portugal
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Sales-Luís ML, Galvao M, Carvalho M, Sousa G, Alves MM, Serrão R. Treatment of familial amyloidotic polyneuropathy (Portuguese type) by plasma exchange. Muscle Nerve 1991; 14:377-8. [PMID: 2027354] [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: 12/29/2022]
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