Browsing by Author "Costa, JM"
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- An uncommon diagnosis done by colonoscopyPublication . Costa, RS; Costa, JM; Ferreira, A; Gonçalves, R; Rolanda, C
- Compreender a Sintomatologia Depressiva após a Cirurgia Bariátrica: o Papel do Peso, da Alimentação e da Imagem CorporalPublication . Sousa, P; Bastos, AP; Venâncio, C; Vaz, AR; Brandão, I; Costa, JM; Machado, P; Conceição, EINTRODUCTION: Depressive symptoms have been reported as prevalent after bariatric surgery. This study aims to analyze the role of weight, eating behaviors and body image in depressive symptomatology in bariatric surgery patients assessed post-operatively. MATERIAL AND METHODS: This is a cross-sectional study including 52 bariatric surgery patients assessed post-operatively with a follow-up time ranging from 22 to 132 months. Psychological assessment included a clinical interview (Eating Disorder Examination) to assess eating disorders psychopathology, and three self-report measures: Outcome Questionnaire 45 - general distress; Beck Depression Inventory - depressive symptoms; and Body Shape Questionnaire - body image. RESULTS: Our data show that depressive symptoms after surgery are associated with loss of control over eating, increased concerns with body image, and body mass index regain. Multiple linear regressions was tested including these variables and showed that body mass index regain after surgery, loss of control over eating and concerns with body image significantly explained 50% of the variance of post-operative depressive symptoms, being the concern with body image the most significant variable: greater dissatisfaction with body image was associated with more depressive symptoms. DISCUSSION: The results of this study showed that a subgroup of patients presents a significant weight gain after bariatric surgery, which is associated with episodes of loss of control over eating, concerns with body image and depressive symptoms. CONCLUSION: These results stress the relevance of body image concerns after surgery and the importance of clinically addressing these issues to optimize psychological functioning after bariatric surgery.
- A granular cell tumor: an unusual colon polypPublication . Leal, T; Carvalho, S; Costa, JMWe read with interest the article by Sevilla Ribota et al1 that described an unexpected finding of a granular cell tumour (GCT) of the rectum, which was removed by band ligation-assisted mucosectomy. We present a similar case of a GCT of the cecum, which was resected using a different endoscopic procedure.
- Intragastric Penetration of the Connecting Tube After Laparoscopic Adjustable Gastric BandingPublication . Costa, S; Machado, A; Gonçalves, B; Costa, JM; Gonçalves, R
- Kaposi sarcoma-An unusual cause of asymptomatic anemiaPublication . Costa, JM; Leal, T; Carvalho, SD; Gonçalves, R; Arroja, B
- Metastatic small bowel occlusion as initial presentation of squamous cell carcinoma of the lungPublication . Costa, RS; Vieira, AL; Costa, JM; Fernandes, B; Ferreira, A
- Symptomatic Hyponatremia after Bowel Preparation: Report of Two Cases and Literature ReviewPublication . Costa, JM; Soares, JBINTRODUCTION: Bowel preparation for colonoscopy and/or colorectal surgery can cause electrolyte imbalances. The risk of electrolyte imbalances seems to be related to the type of bowel cleansing solution, age of patients and comorbidities. CASE REPORT: We report two cases of symptomatic hyponatremia (focal neurological signs and coma) after bowel preparation with sodium picosulfate/magnesium citrate for colonoscopy. In both cases, symptoms related to hyponatremia rapidly disappeared after sodium level correction with intravenous administration of hypertonic saline (3% NaCl). DISCUSSION: Electrolyte imbalances are more common with sodium phosphate-based solutions (NaP) and sodium picosulfate/magnesium citrate, in patients older than 65, in patients treated with thiazide diuretics, angiotensin-converting-enzyme inhibitor, betablockers or antidepressants and in gastrectomized patients. These patients should use macrogol-based solutions (polyethylene glycol). CONCLUSION: In patients at risk (patient > 65 years old, patients taking thiazide diuretics, angiotensin-converting-enzyme inhibitors, beta-blockers and antidepressants and with previous gastrectomy) we recommend macrogol-based solutions
- Synchronous intraductal papillary mucinous neoplasm and a pancreatic neuroendocrine tumor: more than a coincidence?Publication . Costa, JM; Carvalho, SB; Soares, JBBACKGROUND: Although the association between intraductal papillary mucinous neoplasm of the pancreas (IPMN) and pancreatic neuroendocrine tumor (PNET) has been increasingly reported, whether this association is real or coincidence remains unclear. We report a case of synchronous IPMN and a PNET which were diagnosed preoperatively and discuss the tumorigenesis, clinicopathological features and management of these rare tumors based on the published literature. CASE REPORT: A 56-year-old male was incidentally diagnosed with a 14 mm branch duct IPMN and a 3.6 mm non-functional PNET during an evaluation due to persistent upper abdominal pain via endoscopic ultrasound. Close follow-up of the patient was decided as the IPMN had no worrisome features. A review of twenty-two previously reported cases of synchronous IPMN and PNET indicated that: a) only seven cases were diagnosed preoperatively; b) abdominal pain was the main presenting symptom; c) IPMN was the dominant tumor and presented with low grade dysplasia; d) the PNET was small and non-functional and had an indolent behavior; and e) only one case underwent radiologic follow-up. DISCUSSION: IPMN are associated with other pancreatic and extrapancreatic malignancies. Thus, the entire pancreatic parenchyma should be examined closely during the evaluation of an IPMN in order to exclude other pancreatic lesions, for example, a PNET.
- Tender red subcutaneous nodules in an adult female: a challenging diagnosisPublication . Costa, JM; Costa, RS; Carvalho, SDPancreatic panniculitis is an uncommon and rare skin complication of systemic fat necrosis associated with pancreatitis post-ampullectomy. Besides the rarity of the condition, the clinical history and physical examination for diagnosis is also important.