Browsing by Author "João, AL"
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- Ectodermal DysplasiasPublication . João, AL; Antunes, D; Cordeiro, AI; Paiva Lopes, MJEctodermal dysplasias are a heterogeneous group of rare inherited disorders. Molecular findings and clarification of cell sig naling processes and ectodermal-mesenchyme interaction enabled the development of a clinical-functional model, which in turn helps to explain clinical signs, with variability in severity, associated non-ectodermal abnormalities and overlap seen in many patients. We herein review the current state of knowledge regarding this distinct entity and illustrate with an elucidative case report. The need for early multidisciplinary intervention is highlighted, and further studies will focus on genetically-target therapeutic approaches.
- A Large Occipital Mass: Folliculitis KeloidalisPublication . João, AL; Cunha, N
- Multidrug-Resistant Bacteria in Diabetic Foot Infections: Experience from a Portuguese Tertiary CentrePublication . Pessoa E Costa, T; Duarte, B; João, AL; Coelho, M; Formiga, A; Pinto, M; Neves, JIn recent years, the emergence of antibiotic resistant pathogens made increasingly difficult to establish appropriate empiric antimicrobial therapy protocols for acute diabetic foot infection (DFI) treatment. Early recognition of the population at-risk for multidrug-resistant (MDR) bacterial infection is of paramount importance in order to decrease large-spectrum antibiotic overuse. This study used retrospective cohort study in a multidisciplinary tertiary diabetic foot unit. Patients with severe DFI were included and divided according to their infection resistance profile (susceptible vs MDR bacteria). Data regarding their comorbidities and length of hospital stay were collected. The primary endpoint was to determine the risk factors for MDR infections and to evaluate if these were associated with an increased length of stay (LOS). A total of 112 microbial isolates were included. Predominance of Gram-positive bacteria was observed and 22.3% of isolated bacteria were MDR. Previous hospitalisation was associated with a higher likelihood of MDR infection. MDR bacterial infection was also associated with an increased LOS (P = .0296). Our study showed a high incidence of MDR bacteria in patients with a DFI, especially in those who had a recent hospitalisation. MDR infections were associated with a prolonged LOS and represent a global public health issue for which emergent measures are needed.
- Syphilitic Hepatitis: a Rare Complication of Secondary Syphilis. A Case ReportPublication . Caldeira, M; João, AL; Pestana, M; Canha, I; Simões, G; Fernandes, CSyphilis is a sexually transmitted disease caused by Treponema pallidum, progressing through active and latent stages if left untreated. Hepatic involvement can occur in secondary syphilis, but this is an uncommon complication, with few published case reports. A 34-year-old man without significant medical history was admitted to the gastroenterology department with a 2-week history of unexplained jaundice and acute cholestatic hepatitis. He also presented with erythematous papules and plaques in the genital area, suggestive of secondary syphilis. T. pallidum hemaglutination assay and venereal disease research laboratory test were both positive, the latter with a 1:16 titer. The diagnosis of secondary syphilis with hepatic involvement was considered. The improvement of cutaneous and laboratory findings after intramuscular benzathine penicillin injection supported this hypothesis. Symptomatic cholestatic hepatitis is a rare feature of the systemic spectrum of secondary syphilis. The clinical and laboratorial response after penicillin treatment is a strong clue for this diagnosis.