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Browsing by Author "Coutinho, J"

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  • Carcinomas Espinocelulares Cutâneos em Doente com Epidermólise Bolhosa Distrófica Recessiva
    Publication . Medeiros, S; Amaro, C; Oliveira, J; Catorze, G; Miguel, J; Coutinho, J; Vieira, R; Pacheco, A; Afonso, A; Cardoso, J
    As epidermólises bolhosas (EB) hereditárias são um grupo heterogéneo de doenças bolhosas geneticamente determinadas. Caracterizam-se clinicamente por fragilidade mucocutânea que se traduz pela formação de 1,2 bolhas após traumatismos mínimos. Nas formas distróficas, principalmente na forma recessiva, as lesões cutâneas evoluem de forma crónica levando à formação de múltiplas cicatrizes atróficas e estão associadas a uma maior 2 frequência de carcinomas espinocelulares (CEC), em particular nos casos de longa evolução. Os autores descrevem o caso de um doente, com 42 anos de idade, com epidermólise bolhosa distrófica recessiva - variante Hallopeau-Siemens (EBDR-HS), que desenvolveu dois carcinomas espinocelulares da pele, tendo um deles metastizado para os gânglios loco-regionais, em breve período de tempo.
    2006Journal article Open access Show more
  • Characteristics and Outcomes of Patients With Cerebral Venous Sinus Thrombosis in SARS-CoV-2 Vaccine–Induced Immune Thrombotic Thrombocytopenia
    Publication . Sánchez van Kammen, M; Aguiar de Sousa, D; Poli, S; Cordonnier, C; Heldner, M; van de Munckhof, A; Krzywicka, K; van Haaps, T; Ciccone, A; Middeldorp, S; Levi, M; Kremer Hovinga, J; Silvis, S; Hiltunen, S; Mansour, M; Arauz, A; Barboza, M; Field, T; Tsivgoulis, G; Nagel, S; Lindgren, E; Tatlisumak, T; Jood, K; Putaala, J; Ferro, J; Arnold, M; Coutinho, J; Sharma, A; Elkady, A; Negro, A; Günther, A; Gutschalk, A; Schönenberger, S; Buture, A; Murphy, S; Paiva Nunes, A; Tiede, A; Puthuppallil Philip, A; Mengel, A; Medina, A; Hellström Vogel, Å; Tawa, A; Aujayeb, A; Casolla, B; Buck, B; Zanferrari, C; Garcia-Esperon, C; Vayne, C; Legault, C; Pfrepper, C; Tracol, C; Soriano, C; Guisado-Alonso, D; Bougon, D; Zimatore, D; Michalski, D; Blacquiere, D; Johansson, E; Cuadrado-Godia, E; De Maistre, E; Carrera, E; Vuillier, F; Bonneville, F; Giammello, F; Bode, F; Zimmerman, J; d’Onofrio, F; Grillo, F; Cotton, F; Caparros, F; Puy, L; Maier, F; Gulli, G; Frisullo, G; Polkinghorne, G; Franchineau, G; Cangür, H; Katzberg, H; Sibon, I; Baharoglu, I; Brar, J; Payen, JF; Burrow, J; Fernandes, J; Schouten, J; Althaus, K; Garambois, K; Derex, L; Humbertjean, L; Lebrato Hernandez, L; Kellermair, L; Morin Martin, M; Petruzzellis, M; Cotelli, M; Dubois, MC; Carvalho, M; Wittstock, M; Miranda, M; Skjelland, M; Bandettini di Poggio, M; Scholz, M; Raposo, N; Kahnis, R; Kruyt, N; Huet, O; Sharma, P; Candelaresi, P; Reiner, P; Vieira, R; Acampora, R; Kern, R; Leker, R; Coutts, S; Bal, S; Sharma, S; Susen, S; Cox, T; Geeraerts, T; Gattringer, T; Bartsch, T; Kleinig, T; Dizonno, V; Arslan, Y
    Importance: Thrombosis with thrombocytopenia syndrome (TTS) has been reported after vaccination with the SARS-CoV-2 vaccines ChAdOx1 nCov-19 (Oxford-AstraZeneca) and Ad26.COV2.S (Janssen/Johnson & Johnson). Objective: To describe the clinical characteristics and outcome of patients with cerebral venous sinus thrombosis (CVST) after SARS-CoV-2 vaccination with and without TTS. Design, setting, and participants: This cohort study used data from an international registry of consecutive patients with CVST within 28 days of SARS-CoV-2 vaccination included between March 29 and June 18, 2021, from 81 hospitals in 19 countries. For reference, data from patients with CVST between 2015 and 2018 were derived from an existing international registry. Clinical characteristics and mortality rate were described for adults with (1) CVST in the setting of SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia, (2) CVST after SARS-CoV-2 vaccination not fulling criteria for TTS, and (3) CVST unrelated to SARS-CoV-2 vaccination. Exposures: Patients were classified as having TTS if they had new-onset thrombocytopenia without recent exposure to heparin, in accordance with the Brighton Collaboration interim criteria. Main outcomes and measures: Clinical characteristics and mortality rate. Results: Of 116 patients with postvaccination CVST, 78 (67.2%) had TTS, of whom 76 had been vaccinated with ChAdOx1 nCov-19; 38 (32.8%) had no indication of TTS. The control group included 207 patients with CVST before the COVID-19 pandemic. A total of 63 of 78 (81%), 30 of 38 (79%), and 145 of 207 (70.0%) patients, respectively, were female, and the mean (SD) age was 45 (14), 55 (20), and 42 (16) years, respectively. Concomitant thromboembolism occurred in 25 of 70 patients (36%) in the TTS group, 2 of 35 (6%) in the no TTS group, and 10 of 206 (4.9%) in the control group, and in-hospital mortality rates were 47% (36 of 76; 95% CI, 37-58), 5% (2 of 37; 95% CI, 1-18), and 3.9% (8 of 207; 95% CI, 2.0-7.4), respectively. The mortality rate was 61% (14 of 23) among patients in the TTS group diagnosed before the condition garnered attention in the scientific community and 42% (22 of 53) among patients diagnosed later. Conclusions and relevance: In this cohort study of patients with CVST, a distinct clinical profile and high mortality rate was observed in patients meeting criteria for TTS after SARS-CoV-2 vaccination.
    2021-11Journal article Open access Show more
  • Decompressive Surgery in Cerebral Venous Sinus Thrombosis Due to Vaccine‐Induced Immune Thrombotic Thrombocytopenia
    Publication . Krzywicka, K; Aguiar de Sousa, D; Cordonnier, C; Bode, F; Field, T; Michalski, D; Pelz, J; Skjelland, M; Wiedmann, M; Zimmermann, J; Wittstock, M; Zanotti, B; Ciccone, A; Bandettini di Poggio, M; Borhani‐Haghighi, A; Chatterton, S; Aujayeb, A; Devroye, A; Dizonno, V; Geeraerts, T; Giammello, F; Günther, A; Ichaporia, N; Kleinig, T; Kristoffersen, E; Lemmens, R; De Maistre, E; Mirzaasgari, Z; Payen, JF; Putaala, J; Petruzzellis, M; Raposo, N; Sadeghi‐Hokmabadi, E; Schoenenberger, S; Umaiorubahan, M; Sylaja, P; van de Munckhof, A; Sánchez van Kammen, M; Lindgren, E; Jood, K; Scutelnic, A; Heldner, M; Poli, S; Kruip, M; Arauz, A; Conforto, A; Aaron, S; Middeldorp, S; Tatlisumak, T; Arnold, M; Coutinho, J; Ferro, J
    Background and purpose: Cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) is an adverse drug reaction occurring after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. CVST-VITT patients often present with large intracerebral haemorrhages and a high proportion undergoes decompressive surgery. Clinical characteristics, therapeutic management and outcomes of CVST-VITT patients who underwent decompressive surgery are described and predictors of in-hospital mortality in these patients are explored. Methods: Data from an ongoing international registry of patients who developed CVST within 28 days of SARS-CoV-2 vaccination, reported between 29 March 2021 and 10 May 2022, were used. Definite, probable and possible VITT cases, as defined by Pavord et al. (N Engl J Med 2021; 385: 1680-1689), were included. Results: Decompressive surgery was performed in 34/128 (27%) patients with CVST-VITT. In-hospital mortality was 22/34 (65%) in the surgical and 27/94 (29%) in the non-surgical group (p < 0.001). In all surgical cases, the cause of death was brain herniation. The highest mortality rates were found amongst patients with preoperative coma (17/18, 94% vs. 4/14, 29% in the non-comatose; p < 0.001) and bilaterally absent pupillary reflexes (7/7, 100% vs. 6/9, 67% with unilaterally reactive pupil, and 4/11, 36% with bilaterally reactive pupils; p = 0.023). Postoperative imaging revealed worsening of index haemorrhagic lesion in 19 (70%) patients and new haemorrhagic lesions in 16 (59%) patients. At a median follow-up of 6 months, 8/10 of surgical CVST-VITT who survived admission were functionally independent. Conclusions: Almost two-thirds of surgical CVST-VITT patients died during hospital admission. Preoperative coma and bilateral absence of pupillary responses were associated with higher mortality rates. Survivors often achieved functional independence.
    2023-05Journal article Open access Show more
  • Mycetoma of the Foot—Diagnosis of the Etiologic Agent and Surgical Treatment
    Publication . Mestre, T; Vieira, R; Coutinho, J
    2015Journal article Open access Show more
  • Parathyroid Cyst: Differential Diagnosis
    Publication . Silva, R; Cavadas, D; Vicente, C; Coutinho, J
    Parathyroid cysts are rare lesions of the cervical region and less frequently of the mediastinum. They occur mostly in women and are usually asymptomatic. They generally occur in the fourth and fifth decades of life and mainly are non-functioning. They commonly present as a neck mass that is found incidentally during surgery or in imaging test. Its importance lies in the difficulty in diagnosis, often confusing itself with thyroid pathology. The diagnosis is usually made intraoperatively, confirmed by histopathological examination.The aim of this paper is to report a case of parathyroid cyst that mimics a thyroid nodule.
    2020Journal article Open access Show more