Browsing by Author "Santos, A"
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- Acute segmental renal infarction due to factor V LeidenPublication . Cabral-Ribeiro, J; Sousa, L; Calaza, C; Santos, AOBJECTIVE: Renal infarction is rare and has variable clinical presentations causing diagnostic difficulties. Although most renal infarctions are caused by an obvious thromboembolic factor some are only explained by hereditary or acquired thrombophilia. The authors present a case of segmental renal infarction associated with factor V Leiden. METHODS/ RESULTS: A 48-year-old man presented with right flank pain that was unresponsive to analgesia for renal colic. CT scan was performed revealing a partial renal infarction. The etiologic study was only positive to factor V Leiden. In spite of the diagnosis and treatment it resulted in atrophy of the affected renal area. CONCLUSIONS: Renal infarction can be a presentation of thrombophilia that should be searched in the absence of an obvious embolic factor. Renal CT scan is the best way to a rapid diagnosis and treatment.
- Ceacum-ilio-cutaneous fistula. A rare complication of urinary tuberculosisPublication . Cabral-Ribeiro, J; Rolanda, C; Santos, A
- Head-to-head comparison of two online nomograms for prostate biopsy outcome predictionPublication . Oliveira, M; Marques, V; Carvalho, AP; Santos, ALEVEL OF EVIDENCE: 2b. What's known on the subject? and What does the study add? In recent years, several nomograms were developed in an effort to decrease the number of unnecessary prostate biopsies. The European SWOP-PRI and the North American PCPT are among the most popular. However, evidence on the relative predictive accuracy is lacking. A head-to-head comparison on the diagnostic accuracy of two previously validated prostate cancer risk predictors on biopsy confirmed the superiority of these tools over PSA alone. Moreover, in the studied population, the European SWOP-PRI proved to be more accurate than the North American PCPT-CRC. OBJECTIVE: To compare the diagnostic accuracy of two previously validated prostate cancer risk predictors on biopsy. PATIENTS AND METHODS: In total, 390 consecutive patients submitted to 10-core systematic transrectal prostate biopsy at our institution were included in this retrospective study. External validation of a European (European Randomized Study of Screening for Prostate Cancer derived Prostate Risk Indicator; SWOP-PRI) and a North American (Prostate Cancer Prevention Trial Cancer Risk Calculator; PCPT-CRC) nomogram was performed. The predictive accuracy of these online available nomograms was calculated based on the area under the curve derived from receiver-operator characteristic curves and then compared using the DeLong method. RESULTS: Both tools were confirmed to be superior to prostate-specific antigen alone. Moreover, the SWOP-PRI (77.9%) displays a 7.96% increase in the predictive accuracy compared to the PCPT-CRC (69.9%) in a statistically significant fashion (P=0.002). CONCLUSIONS: The results obtained in the present study confirm the utility of nomograms with respect to biopsy outcome prediction in patients with suspicion of prostate cancer. In the current sample of patients, the European-based nomogram appears to be more accurate than the North American nonogram, which lacks information regarding prostate volume and prostatic ultrasonographic lesions. • To our knowledge, this is the first study to compare the accuracy of these popular risk calculators in a specific population.
- Hospital Resource Utilization and Treatment Cost of Skeletal-Related Events in Patients with Metastatic Breast or Prostate Cancer: Estimation for the Portuguese National Health SystemPublication . Félix, J; Andreozzi, V; Soares, M; Borrego, P; Gervásio, H; Moreira, A; Costa, L; Marcelo, F; Peralta, F; Furtado, I; Pina, F; Albuquerque, C; Santos, A; Passos-Coelho, JL; Portuguese Group for the Study of Bone MetastasesBACKGROUND: Skeletal-related events (SREs) occur frequently in patients with bone metastases as a result of breast (BC) and prostate (PC) cancers. They increase both morbidity and mortality and lead to extensive health-care resource utilization. METHODS: Health care resource utilization by BC/PC patients with at least one SRE during the preceding 12 months was assessed through retrospective chart review. SRE-treatment costs were estimated using the Portuguese Ministry of Health cost database and analyzed using generalized linear models. RESULTS: This study included 152 patients from nine hospitals. The mean (SD) annual SRE-treatment cost per patient was €5963 (€3646) and €5711 (€4347), for BC (n=121) and PC (n=31) patients, respectively. Mean cost per single episode ranged between €1485 (radiotherapy) and €13,203 (spinal cord compression). Early onset of bone metastasis (P = 0.03) and diagnosis of bone metastases at or after the occurrence of the first SRE (P < 0.001) were associated with higher SRE-treatment costs. CONCLUSION: These results reveal the high hospital SRE-treatment costs, highlighting the need for early diagnosis and treatment, and identify key factors determining the economic value of therapies for patients with skeletal metastases.
- Penile fracture: review of 7 casesPublication . Cabral-Ribeiro, J; Sousa, L; Silva, C; Mendes, V; Garcia, P; Santos, A
- Seminoma espermatocítico: Caso ClínicoPublication . Cabral-Ribeiro, J; Santos, A; Mendes, V; Sousa, L; Monteiro, P; Rodrigues, JO seminoma espermatocítico é uma variedade rara de tumor testicular, representando cerca de 2% de todos os tumores germinativos. Raramente metastiza, apresentando assim uma elevada taxa de cura, havendo casos de mau prognóstico associados a transformação sarcomatoide. Apresenta-se um caso clínico a partir do qual se faz uma revisão da literatura acerca das características clínicas, anatomopatológicas, do tratamento e prognóstico deste tipo de tumor.