Browsing by Author "Costa, AR"
Now showing 1 - 5 of 5
Results Per Page
Sort Options
- Cervical Mediastinoscopy: Safety Profile, Feasibility and Diagnostic Accuracy in a Decade in a Single CenterPublication . Santos Silva, J; Costa, AR; Calvinho, P
- Current Trends and Perceptions of the Portuguese Gynecology Experts on Hormonal Intrauterine Contraception: The DIOGIN StudyPublication . Brito, M; Costa, AR; Pacheco, A; Rebelo, C; Castro, MG; Martins, I; Palma, FOverview and Aims: Intrauterine systems (IUS) are one of the most effective forms of long acting reversible birth control, with low failure rates and high continuity and satisfaction rates. Still, they account for a small proportion of contraception use, which may be due to several myths and misperceptions. With this study, we aimed to assess Portuguese experts’ perceptions on potential benefits and fears that may limit women’s contraception choice and to identify current trends in clinical practice. Methods and Population: We performed an observational, descriptive and analytical study in which gynecologists/obstetricians were invited to answer an anonymous questionnaire by call or email made of multiple-choice questions on IUS use. Results: A total of 482 Portuguese Gynecologists answered the survey, of which 97.1% revealed that the insertion of IUS is a common procedure in their current clinical practice. More than 95% considered the insertion of IUS an easy procedure and a safe contraceptive method. Cost-efficacy and the fact that this method doesn’t rely on womens action to be effective were the top benefits for IUS users, perceived by the physicians. On the other hand, concern about having a foreign object inside the body and fear of insertion pain were perceived by the physicians as the top barriers to IUS use. Female gynecologists perceived a higher degree of pain associated with IUS insertion (p=0.021). Overall, gynecology experts’ opinions were conservative regarding IUS recommendations to women. Conclusions: The results of this study provide a general insight towards Portuguese gynecologists’ perceptions, opinions and attitudes on the use of IUS. Most of the experts consider IUS a safe contraception method but, on the other hand, there is still concern about its use in particular female conditions which may in part contribute to the low rate of IUS use in Portuguese women.
- Estetrol/Drospirenone – an Advance on CHC with Ethinyl Estradiol?Publication . Palma, F; Pacheco, A; Costa, AR; Rebelo, C; Bombas, TA contraceção hormonal combinada (CHC) é um dos métodos contracetivos mais utilizados em todo o mundo. As questões relacionadas com a segurança, particularmente o risco tromboembólico (TE), estão em permanente avaliação. A combinação estetrol/ drospirenona (E4/DRSP) é um contracetivo oral combinado (COC) eficaz, com um perfil de hemorragia estável e regular e efeito favorável na pele e no controlo do peso. Tem menor impacto nos fatores pró-trombóticos que as combinações com etinilestradiol (EE), o que configura um perfil de maior segurança, que importa confirmar em estudos de base populacional.
- Lobar Lung Transplantation: A Single-Center 10-Year ExperiencePublication . Cruz, Z; Neri, F; Roxo, M; Figueiredo, C; Moita, C; Costa, AR; Santos Silva, J; Reis, J; Maciel Barbosa, J; Calvinho, P; Semedo, LBackground: The shortage of donors for lung transplants is the main limitation of the preceding. Lobar transplantation is an alternative especially useful in patients with short stature and small thoracic cavities. The aim of this study was to perform a descriptive analysis of Portuguese patients who underwent lobar lung transplantation. Methods: A retrospective study was conducted, and patients submitted to lobar lung transplantation from January 2012 to December 2023 were evaluated. A descriptive analysis was made, including demographic data, lung diseases, waiting list dynamics, pre-transplant evaluations, and post-transplant outcomes. Results: Sixteen lobar transplants were performed with a predominance of female patients and a median age of 47 years. Most patients had interstitial lung disease or bronchiectasis either due to cystic fibrosis or non-cystic fibrosis. The median predicted total lung capacity (pTLC) ratio was 0.73. The median waiting list time was 6 months with 9 urgent transplants and 1 emergent lobar retransplant. Extracorporeal membrane oxygenation (ECMO) was used in pre-, intra-, and postoperative periods. Most transplanted lobes were the median lobe (ML) + right upper lobe (RUL) and left upper lobe (LUL). The median length of stay was 58 days, with complications such as PDG grade 3, bronchial tree ischemia, and concentrical stenosis of bronchial anastomosis. Six patients died in this period, 1 in the immediate postoperative period and 5 during the post-transplant hospitalization, with a median survival of 20.7 months and a 1-year and 5-year survival rate of 60%. Conclusion: Our results show a population with an increased waiting list converging in many urgent cases, with an early mortality and high primary graft dysfunction rate. Nevertheless, mid- and long-term survival are promising.
- Major Pulmonary Surgery in Patients with Compromised Lung FunctionPublication . Gonçalves Pereira, R; Branco, J; Narciso Rocha, F; Figueiredo, C; Costa, AR; Santos Silva, J; Eurico Reis, J; Calvinho, PIntroduction: The risk stratification of lung resection is fundamentally based on the results of pulmonary function tests. In patients considered to be at risk, major surgery is generally denied, opting for potentially less curative therapies. Objective: To evaluate the postoperative outcomes of major lung surgery in a group of patients deemed high risk. Methods: We performed a retrospective review of clinical records of all patients submitted to lobectomy, bilobectomy or pneumonectomy in a 3-year period in a reference Thoracic Surgery Unit. The patients were then divided in two groups: group A composed of patients with normal preoperative pulmonary function and group B which included patients with impaired lung function, defined as FEV1 and/or DLCO ≤60%. Results: A total of 234 patients were included, 181 (77.4%) in group A and 53 (22.6%) in group B. In group B, patients had more smoking habits, were more often associated with chronic obstructive pulmonary disease and were also more frequently submitted to thoracotomy. When surgery was motivated by primary lung cancer this group had a more advanced clinical stage of the disease. In the postoperative period, these patients had longer hospital stay, longer chest drainage time and greater need for oxygen therapy at home, however, no statistically significant difference was noted in morbidity or mortality. Conclusions: Major thoracic surgery can be safely performed in selected patients considered to be high risk for resection by pulmonary function tests. A potentially curative surgery should not be denied based on respiratory function tests alone.