Browsing by Author "Borges, N"
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- Doença de Paget da MamaPublication . Trindade, F; Borges, N; Cardoso, C; Ferreira, AA doença de Paget da mama (DPM) caracteriza-se clinicamente por lesões de eczema no mamilo ou aréola. Está associada com carcinoma da mama em 97% dos casos, com ou sem evidência de nódulo na palpação mamária ou alterações imagiológicas. Apresenta-se um caso clínico de uma doente de 66 anos, com um quadro com cerca de 2 anos de evolução de uma placa eritematosa e descamativa, ao nível do mamilo e aréola mamária esquerda. Na palpação mamária não se detectou a presença de nódulos ou de adenopatias axilares. A biópsia da lesão confirmou o diagnóstico da doença de Paget. A mamografia e a ecografia mamária não demonstraram alterações. A doente foi submetida a intervenção cirúrgica – mastectomia simples. No exame histológico da mama observou-se a presença de carcinoma intraductal. A DPM pode estar associada com nódulos mamários, alterações mamográficas ou tumor mamário oculto. Em 25% dos casos não existe massa palpável nem alterações mamográficas, mas ocorre carcinoma mamário, pelo que se deve ter elevado nível de suspeita.
- Hodgkin's Lymphoma in Crohn's Disease Treated with InfliximabPublication . Carvalho, D; Russo, P; Bernardes, C; Saiote, J; Ramos, G; Mascarenhas, L; Borges, N; Ramos, JINTRODUCTION: Lymphoproliferative disorders, particularly non-Hodgkin's and Hodgkin's lymphomas, are rare in patients with inflammatory bowel diseases. The use of thiopurines and infection by Epstein-Barr virus are well-known cofactors that can raise its prevalence. Other risk factors such as disease activity and biological treatment are the subject of discussion, without enough data in the literature to confirm a potential association. METHODS: We report a case of Hodgkin's lymphoma in a patient who had been treated with azathioprine and was on long-term monotherapy with infliximab. CONCLUSIONS: We stress the importance of recognizing the possible occurrence of a lymphoproliferative disorder in association with anti-tumor necrosis factor-α therapy.
- Outcomes of Long Pouch Gastric Bypass (LPGB): 4-Year Experience in Primary and Revision CasesPublication . Ribeiro, R; Pouwels, S; Parmar, C; Pereira, J; Manaças, L; Guerra, A; Borges, N; Ribeiro, J; Viveiros, OBackground: One of the most important complications of the one anastomosis gastric bypass (OAGB) is enterobilio acid reflux (EBAR). We report the concept of the long pouch Roux-en-Y gastric bypass (LPRYGB) meaning a Roux-en-Y with a long pouch and a 100-cm alimentary limb to avoid EBAR, with a long biliopancreatic limb to increase metabolic effects. Methods: A total of 300 LPRYGB cases in a 4-year period, with a 90% follow-up rate, were analysed. Anthropometric, technical feasibility, morbidity, weight loss and comorbidity outcomes were analysed. Results: The percentage total weight loss (%TWL) was 30.5% at 4 years of follow-up (32.3% in primary and 28.3% in revisions). Six intra-operative (2%) and 28 postoperative complications (9.3%) were seen. Out of this 28 complications, 11 (3.6%) were late complications. Reoperations were performed in 15 patients (5.0%). Clinically relevant EBAR was present in 3 cases only (1%) 4 years after the operation. Conclusions: The LPRYGB combines the main advantages of the OAGB (light restriction and moderate malabsorption) with the anti-reflux effect from the Roux-en-Y diversion.
- Parceiros Sexuais (Assintomáticos e sem Lesões Penianas Visíveis) de Mulheres com HPV GenitalPublication . Trindade, F; Borges, N; Azevedo, TSeleccionaram-se 83 parceiros sexuais (assintomáticos e sem lesões no pénis, observáveis a olho nu ou por peniscopia) de mulheres com diagnóstico de HPV genital.Utilizou-se como exame complementar de diagnóstico a técnica de captura híbrida, que avaliou a presença de HPV alto/ médio risco associado com neoplasia. Dos 10 doentes que apresentaram HPV alto/médio risco, 8 foram tratados com imiquimod e 7 ficaram curados.
- Tumor de Buschke-Löwenstein: um Caso em Doente com Coinfeção Vírus da Imunodeficiência Humana e Vírus Papiloma HumanoPublication . Santos, L; Borges, N; Nunes, S; Ramos, J; Almeida, C; Paixão, IO tumor de Buschke-Löwenstein (TBL) é uma variante rara de condiloma acuminatum que possui comportamento maligno pelo crescimento local, mas não apresenta potencial metastático. Afeta primariamente a área genital e, menos frequentemente a região perianal. Os fatores de risco para o seu desenvolvimento incluem a terapêutica imunossupressora e a infeção VIH. Possui elevada taxa de recorrência e de transformação maligna, sendo a cirurgia o tratamento inicial recomendado. Apresenta-se um caso de TBL perianal e anal num doente com infeção VIH cuja histologia não revelou transformação maligna e para o qual a terapêutica cirúrgica isolada foi eficaz. Revê-se o conhecimento atual sobre esta entidade tendo em atenção a história natural nos indivíduos infetados pelo VIH.
- Unveiling the Metabolic Effects of GlycomacropeptidePublication . Pena, MJ; Costa, R; Rodrigues, I; Martins, S; Guimarães, JT; Faria, A; Calhau, C; Rocha, JC; Borges, NFor many years, the main nitrogen source for patients with phenylketonuria (PKU) was phenylalanine-free amino acid supplements. Recently, casein glycomacropeptide (GMP) supplements have been prescribed due to its functional and sensorial properties. Nevertheless, many doubts still persist about the metabolic effects of GMP compared to free amino acids (fAA) and intact proteins such as casein (CAS). We endeavour to compare, in rats, the metabolic effects of different nitrogen sources. Twenty-four male Wistar rats were fed equal energy density diets plus CAS (control, n = 8), fAA (n = 8) or GMP (n = 8) for 8 weeks. Food, liquid intake and body weight were measured weekly. Blood biochemical parameters and markers of glycidic metabolism were assessed. Glucagon-like peptide-1 (GLP-1) was analysed by ELISA and immunohistochemistry. Food intake was higher in rats fed CAS compared to fAA or GMP throughout the treatment period. Fluid intake was similar between rats fed fAA and GMP. Body weight was systematically lower in rats fed fAA and GMP compared to those fed CAS, and still, from week 4 onwards, there were differences between fAA and GMP. None of the treatments appeared to induce consistent changes in glycaemia, while insulin levels were significantly higher in GMP. Likewise, the production of GLP-1 was higher in rats fed GMP when compared to fAA. Decreased urea, total protein and triglycerides were seen both in fAA and GMP related to CAS. GMP also reduced albumin and triglycerides in comparison to CAS and fAA, respectively. The chronic consumption of the diets triggers different metabolic responses which may provide clues to further study potential underlying mechanisms.