Browsing by Author "Saiote, J"
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- Corpo Estranho no Bulbo DuodenalPublication . Saiote, J; Duarte, P; Bentes, T
- Fistulization of J-PEG Jejunal Tube into the Colon in a Patient Treated with Duodopa® Infusion: A Case ReportPublication . Russo, P; Costa, M; Silva, M; de Sousa, A; Carvalho, D; Saiote, J; Mendes, MThe continuous delivery of a levodopa/carbidopa gel suspension (Duodopa®) into the small bowel through a jejunal tube inserted via percutaneous endoscopic gastrostomy represents a new treatment method in advanced Parkinson disease. Some severe device-related complications have been described in the last few years. Some of them are associated with phytobezoar formation at the pigtail of the catheter. We present the case of a Parkinson disease patient treated with the Duodopa infusion system complicated by jejunal tube fistulization into the colon. We suggest a possible treatment strategy for this complication, which has not been described in the literature to date.
- Gastrointestinal: Diarrhea and Bowel Thickening in Elderly Patients: a Diagnosis to Keep in MindPublication . Gamelas, V; Saraiva, R; Duarte Santos, J; Borges, V; Saiote, J; Costa Simões, J
- 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.
- Intramural Hematoma of the Esophagus After Thrombolysis for Ischemic StrokePublication . Silva, MJ; Saiote, J; Salvado, V; Paiva Nunes, A; Duarte, PIntramural dissecting hematoma is an unusual esophageal condition with a threatening presentation but excellent prognosis when managed conservatively.We report the case of an 88-year-old woman who developed an intramural hematoma of the esophagus after intravenous thrombolysis for an acute ischemic stroke. Before thrombolysis, nasogastric intubation was attempted unsuccessfully. She was kept on nil by mouth, intravenous hydration, proton pump inhibitor, antiemetics,and an antibiotic initiated 2 days before for periodontal disease. The esophageal hematoma regressed, and she resumed oral diet asymptomatically.To our knowledge, this is the first report of this type of lesion after thrombolysis for an ischemic stroke. A brief discussion and literature review are presented.
- Lymphoproliferative Disorders in Inflammatory Bowel Disease Patients: Is It the Drugs or the DiseasePublication . Bernardes, C; Russo, P; Carvalho, D; Saiote, J; Ramos, JIntroduction: Systemic inflammatory diseases are related to an increased risk of lymphoproliferative disorders. Although inflammatory bowel disease (IBD) was also associated with these conditions, population-based studies failed to demonstrate this relationship, and most studies only identified a very small number of cases. In the last few years, concerns arose regarding the role of thiopurines and tumour necrosis factor-alpha (TNF-α)-blocking agents in the development of lymphoma, influencing therapeutic decisions in IBD patients. The aim of this study was to describe a case series of IBD patients who developed a lymphoproliferative disorder in our tertiary referral centre. Material and methods: The clinical records of all IBD patients who were observed in our unit between January 2007 and December 2016 were retrospectively reviewed, and IBD subjects who were diagnosed with a lymphoproliferative disorder were selected. Clinical and demographic data regarding both conditions were collected. Results: Six IBD patients were diagnosed with a lymphoma - 4 Hodgkin lymphomas and 2 B-cell non-Hodgkin lymphomas - of which 3 corresponded to primary colonic lymphomas. Immunohistochemical analysis detected the presence of Epstein-Barr virus in the tumour cells of 2 patients, both of them with Hodgkin lymphomas. Only 2 patients were previously treated with thiopurines or anti-TNF-α drugs; none of the remaining had any history of immunosuppressive treatment. Discussion and conclusions: Despite major attention being currently focused on the effect of treatment, which may play the main role in the increased susceptibility to lymphoma in IBD patients, and although it may be difficult to demonstrate, IBD itself may contribute to the development of lymphoproliferative disorders, particularly primary intestinal lymphomas.
- Pneumatosis Cystoides Intestinalis Provocada pela AcarbosePublication . Barbosa, J; Quintela, C; Saiote, J; Mateus Dias, AA "Pneumatosis Cystoides Intestinalis" é uma situação clínica rara que se caracteriza pela presença de múltiplos quistos de conteúdo gasoso ao nível da submucosa ou subserosa na parede do tracto gastrointestinal. A pneumatose intestinal classifica-se em idiopática e secundária. Na última forma admite-se uma relação causal com doença pulmonar obstrutiva crónica, conectivites, amiloidose, colites infecciosas, oclusão intestinal, isquémia, doença de Crohn, fármacos e iatrogenia cirúrgica e endoscópica. O espectro de manifestações clínicas compreende dor abdominal, oclusão intestinal, diarreia e hemorragia digestiva. Todavia, é frequentemente assintomática ou constitui um achado incidental no decurso de uma investigação não relacionada. Os autores apresentam o caso clínico de uma doente com pneumatose quística intestinal associada à utilização terapêutica de um antidiabético oral - acarbose (inibidor da alfa-glucosidase).
- Primary HIV Infection in a Crohn's Disease Patient Receiving Infliximab Maintenance TherapyPublication . Bernardes, C; Russo, P; Carvalho, D; Saiote, J; Ramos, J
- Rectorragias Como Forma de Apresentação de AmebíasePublication . Quintela, C; Saiote, J; Bettencourt, MJ; David Marques, AA amebíase é uma doença infecciosa com diferentes formas de apresentação. Trata-se de um doente de 32 anos, sexo masculino, raça caucasiana, natural e residente em Lisboa, admitido na consulta de Proctologia por rectorragias. O exame objectivo e a avaliação laboratorial não mostraram alterações. Na sigmoidoscopia observaram-se úlceras entre 3 e 5 mm na mucosa rectal e da sigmoideia com friabilidade. A histologia revelou: manutenção da arquitectura, sem depleção das células caliciformes, infiltrado inflamatório intenso, misto com muitos polimorfonucleares neutrófilos e agregados linfóides da lâmina própria, criptite e úlcera com exsudado necroinflamatório, identificando-se Entamoeba histolytica. Medicado com metronidazol com resolução clínica, endoscópica e histológica.
- Safe Use of Infliximab for the Treatment of Severe Perianal Crohn's Disease After Diagnosis and Treatment of LymphomaPublication . Bernardes, C; Russo, P; Carvalho, D; Saiote, J; Ramos, JInflammatory bowel disease is associated with an increased likelihood of developing lymphoma. However, it is still controversial if this risk may be attributed to the disease itself or rather represents an effect of immunosuppressive treatment. Although tumor necrosis factor alpha (TNFα) is a key cytokine for cancer immunosurveillance, the potential relationship between anti-TNFα agents and the pathogenesis of lymphoproliferative disorders remains unclear. Here, we describe the case of a patient with severe perianal Crohn's disease, treated with infliximab monotherapy, whose unusual presentation with acute groin pain required surgical intervention and led to the diagnosis of diffuse large B-cell lymphoma. However, 10 months after this episode, treatment with infliximab was restarted because the patient continued with refractory and disabling perianal disease. Currently, with a follow-up of 36 months, under infliximab 10 mg/kg every 4 weeks, he maintains mild perianal Crohn's disease and persists in sustained clinical and imaging remission of the lymphoproliferative disorder.