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Browsing by Author "Tato Marinho, R"

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  • Hepatology in the COVID Era: Another C Virus, again Challenging the Liver
    Publication . Peixe, P; Calinas, F; Tato Marinho, R
    2020Journal article Open access Show more
  • Interventional Algorithm in Gastrointestinal Bleeding-An Expert Consensus Multimodal Approach Based on a Multidisciplinary Team
    Publication . Rodrigues, A; Carrilho, A; Almeida, N; Baldaia, C; Alves, A; Gomes, M; Gonçalves, L; Robalo Nunes, A; Leal Pereira, C; Silva, MJ; Aguiar, J; Órfão, R; Duarte, P; Tato Marinho, R
    The approach to the patient with gastrointestinal bleeding (GIB) can be very complex. A multidisciplinary panel of physicians with expertise in Gastroenterology, Anesthesiology, and Transfusion Medicine worked together to provide the best knowledge and guide clinical practitioners in the real setting of health institutions, characterized by disparate availability of human and technical resources. The authors propose a global and personalized approach according to different clinical scenarios to improve the outcomes of patients with GIB, for whom the reduction of inappropriate transfusions is crucial. The goal of this document is to provide clear and objective guidance through interventional algorithms toward a goal-directed approach according to the clinical situation and supported by the latest available scientific data on GIB management in different settings.
    2020Journal article Open access Show more
  • Transmural Remission Improves Clinical Outcomes Up to 5 years in Crohn's Disease
    Publication . Raimundo Fernandes, S; Serrazina, J; Ayala Botto, I; Leal, T; Guimarães, A; Lemos Garcia, J; Rosa, I; Prata, R; Carvalho, D; Neves, J; Campelo, P; Ventura, S; Silva, A; Coelho, M; Sequeira, C; Oliveira, AP; Portela, F; Ministro, P; Tavares de Sousa, H; Ramos, J; Claro, I; Gonçalves, R; Araújo Correia, L; Tato Marinho, R; Cortez Pinto, H; Magro, F
    Introduction: Evidence supporting transmural remission (TR) as a long-term treatment target in Crohn's disease (CD) is still unavailable. Less stringent but more reachable targets such as isolated endoscopic (IER) or radiologic remission (IRR) may also be acceptable options in the long-term. Methods: Multicenter retrospective study including 404 CD patients evaluated by magnetic resonance enterography and colonoscopy. Five-year rates of hospitalization, surgery, use of steroids, and treatment escalation were compared between patients with TR, IER, IRR, and no remission (NR). Results: 20.8% of CD patients presented TR, 23.3% IER, 13.6% IRR and 42.3% NR. TR was associated with lower risk of hospitalization (odds-ratio [OR] 0.244 [0.111-0.538], p < 0.001), surgery (OR 0.132 [0.030-0.585], p = 0.008), steroid use (OR 0.283 [0.159-0.505], p < 0.001), and treatment escalation (OR 0.088 [0.044-0.176], p < 0.001) compared to no NR. IRR resulted in lower risk of hospitalization (OR 0.333 [0.143-0.777], p = 0.011) and treatment escalation (OR 0.260 [0.125-0.540], p < 0.001), while IER reduced the risk of steroid use (OR 0.442 [0.262-0.745], p = 0.002) and treatment escalation (OR 0.490 [0.259-0.925], p = 0.028) compared to NR. Conclusions: TR improved clinical outcomes over 5 years of follow-up in CD patients. Distinct but significant benefits were seen with IER and IRR. This suggests that both endoscopic and radiologic remission should be part of the treatment targets of CD.
    2023-02Journal article Open access Show more