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Publications (9)9.93 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Immunocytoma is a non-Hodgkin’s indolent evolution B cell lymphoma. It accounts for approximately 1-3% of non-Hodgkin's limphomas and usually onsets in adults aged over 50 years old. It manifests as lymphadenopathy, splenomegaly, hepatomegaly and lymphcytosis in 15 -30% of cases and is rarely seen with pulmonary involvement. Monocloncal peaks of serum immunoglobulin often occur. These are IgM and rarely IgA. We present as an example a male patient aged 52 years old, with recurrent respiratory infections. Clinical work -up identified an immunocytoma IgA stage IV. Diagnosing an indolent lymphoma, we prophylactic polyspecific human immunoglobulin to treat the respiratory infection. Evidence of lymphoma progression leads us to prescribe combined cyclophosphamide (C), vincristine (V), prednisone (P) e rituximab (R) (CVP-R), which has obtained a partial response over two years.
    Revista portuguesa de pneumologia 01/2009; 15(1):121-127. · 0.56 Impact Factor
  • Ricardo Reis, Bebiana Conde, Abel Afonso
    Pneuma 01/2009; 5(3).
  • A. Santos Costa, Abel Afonso
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    ABSTRACT: Foreign-body aspiration is a frequent occurrence in children, but much less common in adults. The authors present a case report of a 57 year old adult, without any neurological disease, who aspirated a snail (Helix pomatia) during a meal.
    Revista portuguesa de pneumologia 01/2008; 14(3):415–419. · 0.56 Impact Factor
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    ABSTRACT: Surgery is the most common treatment for patients with non-small cell lung cancer (NSCLC) in stages I, II and in some patients in stage IIIA. However, for several rea- sons, not every patient in these stages is submitted to surgery. In this study, the authors present the clinical data of the patients diagnosed with NSCLC in surgical stages and analyse the factors that may be related to the survival rate. The retrospective study is based on the systematic revision of 32 consecutive cases diagnosed between Ja- nuary 1998 and December 2001. Every patient has been treated in the oncologic pneumology unit of the pneu- mology service of the Hospital Centre, Vila Real-Peso da Régua The analysed parameters were the following: age, sex, smoking habits, symptoms and performance status. The results of the following exams have also been analysed: Computed tomography, bronchoscopy, transtoracic aspiration biopsy and histological examens (exfoliativa cytology and surgical removed piece). It has also been evaluated the type of treat- ment and the survival rate, calculated using the Kaplan-Meier method. The period of time of this study included 32 individuals, 8 females, 24 males, aged between 31 and 81 years old- avera- ge 64,8 years old. Concerning smoking habits, 40,6% (n=13) were non-smokers, 50% (n=16) were smokers, and 9,4%(n=3) were ex-smokers. Only 16,6% of the NSCLC were in surgical stage: cIA 10 patients, cIB 10 patients, cIIA 0 patients; cIIB 4 patients; cIIIA 8 patients; distribution of the histological types: adenocarcinoma (n=16); squamous cell carcinoma (n=11); mixed pattern (n=1); neuroendocri- ne (n=2) others (n=2). The survival rate after 5 years of the patients submitted to surgery was 75% for pIA; 55% for pIB; 30% for pIIB e 33% for pIIIA. Although the surgery is the only potentially curative therapy for lung cancer, the percentage of patients in surgical state is low and the survival rate after 5 years is above 50% only in stage I (A and B) Key-words: Retrospective study, lung cancer, surgical stages.
    Revista portuguesa de pneumologia 01/2007; 12(6 Suppl 1):23. · 0.56 Impact Factor
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    ABSTRACT: The postoperative pulmonary complications (PPC) occur in 5-70% of the surgeries, related with its type. Atelectasis, tracheobronchial infection, pneumonia, bronchospasm, exar- cebation of underlying chronic lung disease, acute respira- tory insufficiency, prolonged mechanical ventilation (MV) or pleural effusion, are among the major pulmonary com- plications, and can lead to the increase of mortality. In this context some scales of PPC risk are known, namely the Lawrence Scale, the Epstein & colleagues Scale and the Tor- rington & Henderson Scale. Objective: To survey the use of Torrington & Henderson Scale in our sample. Methods: We reviewed 95 clinical processes, based on func- tional studies of corporal plethysmograph, carried during 12 months, from January to December 2005, with the risk assessment of PPC, using Torrington & Henderson Scale. We assessed the risk of develop PPC in patients who are undergoing thoracic surgery without pulmonary resection, abdominal, orthopaedic, head and neck surgery and had his- tory of tobacco use or respiratory symptoms or previous lung disease, such as COPD (Chronic Obstructive Pulmo- nary Disease) to evaluate its gravity. Until the end of this review, only 68 of the 95 surgeries proposed had become fulfilled and the statistical analysis was focused in this sample. Chi-square tests and indepen- dent samples t-test were used. Results: The sample had a mean age of 66 years (Max-82: Min-37), and 55.9% (38) were male. A low risk was found in 18 cases, a moderate risk in 45 cases and a high risk in 5 cases. PPC was observed in 60% (3) of high risk cases, 28.9% (13) at moderate risk cases and 27.8% (5) at low risk ones. 21 (30.9%) cases showed PPC. Respiratory insufficiency was observed in all cases, 80.1% (17) of cases required prolonged mechanical ventilation (MV), 4.4% (3) had pneumonia diagnosis, one case with atelectasis diagnosis and another case with exacerbation of underlying chro- nic lung disease. The total gastrectomy was always associated to PPC, relati- on with statistical significance (p=0,045), as tobacco habits was related with Pneumonia (p=0.035). A significant corre- lation between the existence of comorbidity and PPC (95.2%; p=0,044) was found. An increase of PPC after upper abdominal surgery (85.7%) and in male gender (57.1%) was found, although this associ- ations had no statistical significance (respectively, p=0.237 and p=0.889). Any significant correlations were found between respiratory symptoms or obesity and PPC. We also didn't found statis- tical differences related to the average age (p=0.164), the IMC (Index of Corporal Mass) (p=0.355) or the FEV1/ FVC (p=0.375), in the PPC cases. Conclusion: In this sample comorbidity seems to be an important risk factor of PPC, although this factor wasn't take into consideration in Torrington & Henderson Scale. Despite obesity was pointed out as a risk factor of PPC, in this sample, like in other studies, any association was found between these variables. These results justify the use of the Torrington & Hender- son Scale in the assessment of PPC risk. Key-words: Risk assessment, postoperative pulmonary com- plications, functional assessment.
    Revista portuguesa de pneumologia 01/2007; 12(6 Suppl 1):63-4. · 0.56 Impact Factor
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    Emerging infectious diseases 01/2006; 11(12):1976-7. · 5.99 Impact Factor
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    ABSTRACT: One to 2% of all lung tumors are carcinoid tumors. Bronchopulmonary carcinoid tumors are reported to represent 10% of all carcinoid tumors. These neoplasms are capable of producing a variety of substances including biologically active peptides and hormones, causing some well established syndromes. The authors report a case of a 52 year old man, caucasian, submitted to the ER with hemoptysis beginning in the same day. He had a history of hypertension, poorly controlled, known for a year, under medication with indapamid. During his admission, a high blood pressure (180/130 mmHg) and hypokalemia (3, 1 mEq/l) were registered. The thorax x-ray was considered normal. The direct smear (Gram and ZN) of sputum was negative. With the intent to fully understand the situation, the patient was hospitalized in the medicine department, being submitted to a wide range of exams oriented to the endocrine disturbance, including a challenge with fludrocortisone. All the results were considered normal, including the thoracic and abdominal CAT scan. He was discharged asymptomatic without any evidence of bleeding. His blood pressure was controlled with atenolol 100 mg and nifedipine 30 mg daily. The patient was submitted to flexible bronchoscopy, because he continued to suffer sporadic episodes of hemoptoic sputum. The procedure confirmed the presence of a neoplasm, cherry like, easily bleeding, completely obstructing the upper lobe bronchus. The cytology of the bronchial brushing reveals the existence of a large-cell poorly differentiated carcinoma. An upper left lobectomy was performed. A typical carcinoid was detected through the pathological examination. Currently the patient is without symptoms, with a normal hemodynamic status and with no need of antihypertensive medication. In the literature reviewed, the authors didn't find any clear reference to the association between carcinoid tumors and hypertension/hipokalemia. The main goal of this report is to discuss the possibility of existence of such an association.
    Revista portuguesa de pneumologia 12/2003; 9(5 Suppl):23-4. · 0.56 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Immunocytoma is a non-Hodgkin's indolent evolution B cell lymphoma. It accounts for approximately 1-3% of non-Hodgkin's limphomas and usually onsets in adults aged over 50 years old. It manifests as lymphadenopathy, splenomegaly, hepatomegaly and lymphcytosis in 15 -30% of cases and is rarely seen with pulmonary involvement. Monocloncal peaks of serum immunoglobulin often occur. These are IgM and rarely IgA. We present as an example a male patient aged 52 years old, with recurrent respiratory infections. Clinical work -up identified an immunocytoma IgA stage IV. Diagnosing an indolent lymphoma, we prophylactic polyspecific human immunoglobulin to treat the respiratory infection. Evidence of lymphoma progression leads us to prescribe combined cyclo- phosphamide (C), vincristine (V), prednisone (P) e rituximab (R) (CVP-R), which has obtained a partial response over two years.
    Revista portuguesa de pneumologia 15(1):121-7. · 0.56 Impact Factor
  • A Santos Costa, Abel Afonso
    [Show abstract] [Hide abstract]
    ABSTRACT: Foreign-body aspiration is a frequent occurrence in children, but much less common in adults. The authors present a case report of a 57 year old adult, without any neurological disease, who aspirated a snail (Helix pomatia) during a meal.
    Revista portuguesa de pneumologia 14(3):415-9. · 0.56 Impact Factor