Repositório da Unidade Local de Saúde São José

Institution's Scientific Repository

The Repository of the Local Health Unit of São José is constituted by São José Hospital, Sto. António dos Capuchos Hospital, Sta. Marta Hospital, Dona Estefânia Hospital, Curry Cabral Hospital, Júlio de Matos Hospital, Dr. Alfredo da Costa Maternity, the Dr. Gama Pinto Ophthalmology Institute, the Health Centres of Central Lisbon and the Health Centre of Sacavém. It was created within the RCAAP (Portugal Open Access Science Repository) project framework and it aims to digitally divulge the scientific knowledge produced by its professionals as well as to allow open access to all of the knowledge gathered, centralised, preserved and released, so as to give greater visibility and impact to the investigation developed by the Local Health Unit of São José.

Useful Links

Find more about the Open Access Policy of Unidade Local de Saúde de São José!

Tel HSJ +351 218 841 2 80 / 40

Tel HDE +351 213 596 4 34 / 36

Email repositorio@ulssjose.min-saude.pt

Recent Submissions

Autosomal Dominant Polycystic Kidney Disease Inflammation Biomarkers in the Tolvaptan Era.

Publication . Lapão, Tânia; Barata, Rui; Jorge, Cristina; Flores, Carlos; Calado, Joaquim

With the approval of tolvaptan as the first specific medicine for the treatment of rapidly progressive Autosomal Dominant Polycystic Kidney Disease (ADPKD), biomarker discovery has gained renewed interest as it is widely recognized that these will be crucial in clinical decision-making, serving as either prognostic or predictive tools. Since the marketing authorization was first issued in 2015 for ADPKD, tolvaptan has remained the sole pharmacological compound specifically targeting the disease. For ADPKD patients it is an invaluable medicine for retarding disease progression. Although the field of overall biomarker discovery and validation has been detailed in several publications, the role of inflammation remains largely overlooked in ADPKD. The current work aims to provide the reader with an updated review of inflammation biomarkers research in ADPKD, highlighting the role of urinary MCP-1 (monocyte chemoattractant protein-1) as the most promising tool.

2025-01-28Review

Open access

The Influence of Tumor Burden Score and Lymph Node Metastasis on the Survival Benefit of Adjuvant Chemotherapy in Intrahepatic Cholangiocarcinoma.

Publication . Kawashima, Jun; Endo, Yutaka; Woldesenbet, Selamawit; Khalil, Mujtaba; Akabane, Miho; Cauchy, François; Shen, Feng; Maithel, Shishir; Popescu, Irinel; Kitago, Minoru; Weiss, Matthew J; Martel, Guillaume; Pulitano, Carlo; Aldrighetti, Luca; Poultsides, George; Ruzzente, Andrea; Bauer, Todd W; Gleisner, Ana; Pinto Marques, Hugo; Groot Koerkamp, Bas; Endo, Itaru; Pawlik, Timothy M

Introduction: While postoperative adjuvant chemotherapy (AC) is generally recommended for intrahepatic cholangiocarcinoma (ICC), its benefit remains debated. This study aimed to identify patients that may benefit from AC following liver resection of ICC. Methods: Patients who underwent liver resection for ICC between 2000 and 2023 were identified from an international multi-institutional database. Individual multivariable Cox models were used to evaluate the interaction between each prognostic factor and the effect of AC on survival. Results: Among 1412 patients, 431 (30.5%) received AC. Both higher tumor burden score (TBS; hazard ratio [HR] 0.95, 95% confidence interval [CI] 0.91-1.00; p = 0.033) and metastatic lymph node status (HR 0.58, 95% CI 0.38-0.89; p = 0.014) demonstrated interactions with the survival benefit from receipt of AC. Interaction plots highlighted how AC was associated with improved survival beyond a TBS of approximately 6. Notably, among 555 (39.3%) patients with TBS <6 and N0 or Nx status, 5-year overall survival (OS) was no different between patients who received AC versus individuals who did not (55.1% [95% CI 48.9-62.1] vs. 58.7% [95% CI 49.8-69.2]; p = 0.900). In contrast, among 857 (60.7%) patients with TBS ≥6 or N1 status, AC was associated with improved 5-year OS (30.7% [95% CI 26.2-36.0] vs. 33.0% [95% CI 26.9-40.5]; p = 0.018). Conclusions: TBS and lymph node status may be useful in a multidisciplinary setting to inform decisions about AC planning for ICC patients following curative-intent resection.

2025-06Text

Open access

Spectrum of Cutaneous Lesions in a Cohort of Patients With Neurofibromatosis Type 2.

Publication . Fialho, Maria C; Garrido, Pedro M; Santos-Coelho, Miguel; Ferreirinha, Ana; Martins, Bárbara D; Passos, João; Moura, Cecília

Background: Neurofibromatosis type 2 (NF2) is a rare autosomal dominant syndrome with a predisposition to the development of central nervous system tumors, ophthalmic manifestations, and dermatological lesions. The latter are present in 70-95% of patients and can precede the evolution of other tumors. However, they are not included in the diagnostic criteria and are frequently undervalued during follow-up. Methods: An observational cross-sectional study characterizing cutaneous lesions in a cohort of NF2 patients was carried out. Dermatological examinations were performed, and lesions were classified into neural cutaneous tumors (superficial, SNCT, and deep, DNCT), hyperpigmented patches (HyperP), and hypopigmented patches (HypoP). The Dermatology Life Quality Index (DLQI) and EQ-5D questionnaires were applied to evaluate the impact on quality of life. Results: Nineteen patients with a mean age of 36 years were included. Sixteen (84%) patients had cutaneous lesions, mostly developed 10 or more years before the diagnosis. SNCT, DNCT, and HyperP showed similar frequencies (58%). HypoP were observed in only one patient. HyperP developed, on average, earlier than NCT (9.6 vs. 16.5 SNCT, 17.0 DNCT; years). The excised lesions had different histological patterns, including neurofibromas, schwannomas, and a hybrid tumor. Most patients reported a low impact of cutaneous manifestations on the quality of life (DLQI 0 or 1). Conclusions: Cutaneous lesions are frequent in NF2 and may precede the diagnosis by several years. Their identification is important to establish the diagnosis earlier and potentially reduce morbidity and mortality.

2025-02Text

Open access

Assessment of Competencies of Clinical Research Professionals and Proposals to Improve Clinical Research in Portugal.

Publication . Bogas, Mónica; Antas, Joana; Magalhães, Cátia; Revige, Mafalda; Guerra, Liliana; Ribeiro, Cheila; Eça, Rita Cunha; Nunes, Filipa; Lopes, Ana; Costa, Luís; Gonçalves, Mónica; Pedrosa, Jorge; Capela, Andreia; Gregório, Tiago; Dias, Patrícia; Alfaro, Tiago; Pais, Ana; Soares, Rui; Queirós, Ana; Torres, Tiago; Assis, Joana; Maia, Joana; Ferreira, Margarida; Horta, Luís; Carreiro, Rita; Almeida, João; Meireles, Maria João; Loução, Carla; António, Sofia; Lopes, Catarina; Coelho, Pedro; Costa, Rita; Santana, Margarida; Sousa, Nuno

Background: Clinical studies are coordinated by multidisciplinary teams, which often lack adequate training and competencies. In this study, ROCHE and AICIB (Agency for Clinical Research and Biomedical Innovation) conducted a self-assessment survey aiming to evaluate the competency of clinical research professionals to conduct clinical research in Portugal and promote the identification of key actions to address priority gaps. Methods: Clinical research professionals from 10 Portuguese centres answered an electronic survey, adapted and translated from the Joint Task Force for Clinical Trial Competency (JTFCTC) framework. Representatives of the centres, ROCHE and AICIB held a meeting to discuss the survey results, identify priority gaps and propose recommendations. Results: A total of 109 participants answered the questionnaire with the following national geographical distribution: North (n = 46), Centre Region (n = 16), and Lisbon metropolitan area (n = 47). A considerable proportion were Investigators (44.0%) and had more than 10 years of experience (34.9%). The eight JTFCTC Domains scored under 60% in the level of knowledge, with Investigators achieving overall higher scores. To address these gaps, key actions were proposed, such as enhancing training and educational opportunities, fostering collaboration and networking, and investing in infrastructure and resources. Conclusion: This study was the first to assess clinical trial competency in Portugal, registering a high participation rate. The study highlights the need to develop a national plan of action, in a collaborative effort, between clinical research centres, universities, industry, regulatory authorities, national agencies, and patient organizations. This will not only contribute to elevate the quality of studies but also improve compliance with international standards, ultimately benefiting both researchers and patients.

2025Text

Open access

PRESERFLO Microshunt™ versus Non-Penetrating Deep Sclerectomy for Glaucoma Management, One-Year Results.

Publication . Cunha, Bruna; Gil, Pedro; Lopes, Edgar; Elisa-Luís, Maria; Reina, Maria; Gomes, Teresa; Cardigos, Joana

Purpose: To compare the short-term efficacy and safety of the PRESERFLO™ MicroShunt (PF) versus Non-Penetrating Deep Sclerectomy (NPDS) with Esnoper®. Methods: Retrospective comparative cohort study at a tertiary hospital including 79 eyes from 79 patients submitted to surgery (32 PF implantation, Group 1 and 47 NPDS, Group 2) between January 2022 and August 2023, with one year follow-up. Outcome measures included intraocular pressure (IOP), complications, surgical duration, postoperative major and minor interventions. Surgical failure was defined as IOP>21 mmHg or <20% reduction from baseline, IOP<5 mmHg, major postoperative intervention, or loss of light perception. Conversely, success was defined as the absence of these failure criteria: complete success without glaucoma medications, and qualified success with. Results: Baseline characteristics, including age, sex, IOP, number of IOP-lowering medications, and visual field defects, were comparable between groups (p>0.05). After one year, IOP decreased significantly in both groups (PF: 20.13±6.20 to 15.00±3.15 mmHg; NPDS: 19.57±5.73 to 13.30±3.59 mmHg, both p<0.001). Complete success rates were 28.1% for PF and 40.4% for NPDS (p=0.189), while surgical failure was significantly higher in the PF group (65.6% vs 38.3%, p=0.015). Major reinterventions were more frequent with PF (10 vs 3, p=0.005), partly due to encapsulated blebs, while NPDS required more minor interventions (2 vs 17, p=0.002). Complication rates were similar (31.3% vs 14.9%, p=0.073), but surgical duration was shorter in the PF group (60.03±17.95 min vs 69.91±15.23 min, p=0.008). Conclusion: PF and NPDS share comparable safety profiles. Although PF surgery is faster, it is associated with a higher rate of major postoperative interventions and failure. NPDS, while requiring more minor interventions, such as goniopuncture and needling, rarely demands major re-interventions. NPDS is known for its meticulous and technically challenging technique, but once mastered, it can result in fewer invasive re-interventions and improved efficacy.

2025Text

Open access