Publications by authors named "Jorge Lopes"

35 Publications

Three-dimensional T1-weighted sequence for fetal intracranial hemorrhage: A step forward in the reconstruction and quantification of brain lesions.

Eur J Radiol 2021 Aug 16;143:109910. Epub 2021 Aug 16.

Department of Obstetrics, Paulista School of Medicine - Federal University of São Paulo (EPM-UNIFESP), São Paulo-SP, Brazil; Medical Course, Municipal University of São Caetano do Sul (USCS), Bela Vista Campus, São Paulo-SP, Brazil. Electronic address:

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http://dx.doi.org/10.1016/j.ejrad.2021.109910DOI Listing
August 2021

Fetal Cervical Lymphangioma: Magnetic Resonance Imaging and Three-Dimensional Reconstruction Modelling.

J Obstet Gynaecol Can 2020 Dec 7. Epub 2020 Dec 7.

Department of Obstetrics, Paulista School of Medicine - Federal University of São Paulo (EPM-UNIFESP), São Paulo-SP, Brazil; Medical course, Municipal University of São Caetano do Sul (USCS), Bela Vista Campus, São Paulo-SP, Brazil. Electronic address:

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http://dx.doi.org/10.1016/j.jogc.2020.08.022DOI Listing
December 2020

Omphalopagus in a Dichorionic Diamniotic Triplet Pregnancy: Prenatal and Postnatal 3D Models and Virtual Reality.

J Obstet Gynaecol Can 2021 Feb 10. Epub 2021 Feb 10.

Department of Obstetrics, Paulista School of Medicine - Federal University of São Paulo (EPM-UNIFESP), São Paulo-SP, Brazil. Electronic address:

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http://dx.doi.org/10.1016/j.jogc.2020.11.022DOI Listing
February 2021

Muscular Cysticercosis: An Incidental Finding in the Developed World.

JBJS Case Connect 2021 06 10;11(2). Epub 2021 Jun 10.

Serviço de Ortopedia e Traumatologia, Centro Hospitalar Universitário de São João, Porto, Portugal.

Case: We present a case of muscular cysticercosis incidentally diagnosed in a patient admitted for a femoral neck fracture and submitted to total hip arthroplasty.

Conclusion: Human cysticercosis is a parasitic infection representing a major health concern in developing countries. The clinical features are variable and depend on the anatomic location, cyst burden, cysticerci stage, and host inflammatory response. Diagnosis is commonly incidental, and prompt pattern recognition is key to diagnosis, adequate referral, and treatment. This is one of the first reports of hip arthroplasty in a patient with a history of parasitic infection (without the need for directed pathogen treatment).
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http://dx.doi.org/10.2106/JBJS.CC.20.00707DOI Listing
June 2021

Craniopagus twin: pre- and post-natal 3-dimensional virtual and physical models and virtual navigation created with free or open source software-an option for low-resource centers.

Childs Nerv Syst 2021 08 30;37(8):2651-2655. Epub 2021 Apr 30.

Department of Obstetrics, Paulista School of Medicine - Federal University of São Paulo (EPM-UNIFESP), Rua Belchior de Azevedo, 156 apto. 111 Torre Vitoria, CEP, São Paulo, SP, 05089-030, Brazil.

Background: Craniopagus twins represent a rare and complex congenital malformation characterized by conjoined twins fused at the cranium. Craniopagus is challenging for patients' families and surgeons, and accurate confirmation of the extent of cranial fusion is a complex process. Most information regarding the surgical anatomy of this rare condition is obtained through analysis of ultrasonographic, magnetic resonance, or computed tomographic images. A multidisciplinary team plays a key role in obtaining such information and in parental counseling and coordination of various complex processes for optimal postnatal care of these twins. The extent of fusion is usually determined based on conventional clinical methods, such as imaging studies.

Methods: Imaging software is being used in recent times to create three-dimensional reconstruction images and for virtual navigation to investigate the skulls and brains of craniopagus twins. However, the acquisition and maintenance costs of such sophisticated medical software may be unaffordable for medical centers in developing countries. To overcome this limitation, we investigated the role of open or free source software for accurate determination of complex malformations of the skull and brain of craniopagus twins.
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http://dx.doi.org/10.1007/s00381-021-05160-5DOI Listing
August 2021

Temporary Posterior Rehabilitation for Orthodontic Anchorage.

J Clin Orthod 2021 Feb;55(2):118-121

Department of Orthodontics, IMED-Porto Alegre, Porto Alegre, Brazil.

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February 2021

Congenital High Airway Obstruction Syndrome (CHAOS): Virtual Navigation in the Fetal Airways After Intrauterine Endoscopic Treatment.

J Obstet Gynaecol Can 2021 07 7;43(7):879-883. Epub 2020 Dec 7.

Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil. Electronic address:

Background: Congenital high airway obstruction syndrome (CHAOS) involves the partial or complete obstruction of the fetal upper airways, usually caused by atresia or stenosis of the larynx or trachea. The obstruction of bronchial tree leads to lung distension, diaphragmatic eversion, and cardiac dysfunction, which can result in fetal death.

Case: A primigravid 19-year-old was diagnosed with CHAOS at 19 weeks gestation. Virtual navigation using magnetic resonance imaging (MRI) data was used to visualize the fetal airways after intrauterine endoscopic laser decompression. A perforation in the fetal larynx/trachea was identified and the diagnosis was modified to tracheal stenosis. Cesarean delivery occurred at 31 weeks using an ex utero intrapartum treatment (EXIT) procedure. The neonatology team were unable to perform intubation, suggesting a final diagnosis of tracheal atresia. The male newborn weighed 1920 g and died 1 hour later.

Conclusion: 3D virtual bronchoscopy is a non-invasive approach to visualizing the fetal upper airways and can be used to diagnose and manage CHAOS.
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http://dx.doi.org/10.1016/j.jogc.2020.10.017DOI Listing
July 2021

Maternal-fetal physical model: image fusion obtained by white light scanner and magnetic resonance imaging.

J Matern Fetal Neonatal Med 2020 Nov 18:1-5. Epub 2020 Nov 18.

Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil.

Background: Physical fetal models developed from three-dimensional (3D) ultrasound or magnetic resonance imaging (MRI) scan data may be used for medical education purposes, for parental counseling/multidisciplinary team management and to improve the maternal-fetal attachment (MFA) in blind pregnant women.

Purpose: We proposed a new technique to create a maternal-fetal physical model by using MRI scan data to improve the MFA.

Methods: For the construction of the maternal-fetal physical model, two different processes were used. For the internal part of the maternal-fetal physical model, we used the segmentation and the 3D reconstruction made from the MRI scan data, and for the outside, we performed 3D scanning by using a white light scanner. After obtaining the 3D models, we used a registration tool to position them in alignment.

Conclusion: Maternal-fetal physical models improve the MFA by using both tactile and visual sensations of the pregnant woman and her fetus.
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http://dx.doi.org/10.1080/14767058.2020.1850682DOI Listing
November 2020

Virtual navigation for the improvement of parents counseling and the planning of fetal endoscopic myelomeningocele repair.

Childs Nerv Syst 2021 03 4;37(3):969-972. Epub 2020 Nov 4.

Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), Rua Belchior de Azevedo, 156 apto. 111 Torre Vitoria, São Paulo, SP, Brazil.

Background: Myelomeningocele (MMC) is the most severe form of spina bifida with intrauterine repairs becoming more prevalent. The development of three-dimensional ultrasound (3DUS) and magnetic resonance imaging (MRI) has drastically improved the visualization of fetal anatomy.

Methods: Virtual Navigation (VN) results from a technology that uses software generated realistic images to replicate the immersive feeling of a real environment.

Conclusion: This report aims to demonstrate VN in a Chiari II malformation case, obtained from 3DUS and MRI files, comparing this with the fetal endoscopic surgery for MMC.
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http://dx.doi.org/10.1007/s00381-020-04961-4DOI Listing
March 2021

Squamous cell carcinoma in a pregnant woman with recessive dystrophic epidermolysis bullosa.

Oxf Med Case Reports 2020 Aug 10;2020(8):omaa059. Epub 2020 Aug 10.

Department of Dermatology, Vila Nova de Gaia/ Espinho Hospital Center, Vila Nova de Gaia, Portugal.

We report the case of a pregnant woman with recessive dystrophic epidermolysis bullosa. During pregnancy, she presents with a large, rapidly growing, tumor on her right forearm, whose biopsy revealed an invasive squamous cell carcinoma. Amputation by the middle third of the forearm was performed at 21 weeks of pregnancy, without intra- or post-operative complications. The remainder of pregnancy was unremarkable and, at 36 weeks, she gave birth to a healthy baby. One month after delivery, a large lymph node conglomerate was detected in the right axilla, highly suggestive of metastatic disease and complete lymph node dissection was then performed. Despite the prompt institution of chemotherapy, the patient died a few months later due to metastatic disease.
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http://dx.doi.org/10.1093/omcr/omaa059DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7416828PMC
August 2020

An esthetic removable inclined plane.

J Clin Orthod 2020 May;52(5):275-276

Department of Orthodontics, Faculty of Dental Medicine IMED-Porto Alegre, Porto Alegre, Brazil.

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May 2020

Factors influencing patient and parents' satisfaction on pediatric dermatologic surgery.

Int J Dermatol 2020 Sep 2;59(9):e340-e341. Epub 2020 Jul 2.

Department of Dermatology, Centro Hospitalar Vila Nova de Gaia/ Espinho, Vila Nova de Gaia, Portugal.

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http://dx.doi.org/10.1111/ijd.15044DOI Listing
September 2020

NF1 microdeletion syndrome: a phenotypical characterization of a rare case of neurofibromatosis type 1.

Acta Dermatovenerol Alp Pannonica Adriat 2020 Jun;29(2):85-87

Department of Dermatology, Vila Nova de Gaia / Espinho Hospital Center, Vila Nova de Gaia, Portugal.

Neurofibromatosis type 1 (NF1) is one of the most common neurocutaneous disorders, resulting from a wide spectrum of mutations in the NF1 gene. The NF1 microdeletion syndrome is characterized by a more severe clinical presentation than the majority of NF1 patients, with facial dysmorphic features, cognitive impairment, developmental delay, early-onset neurofibromas, and an increased risk of malignant tumors. This report provides the phenotypical characterization of a young boy diagnosed with this syndrome.
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June 2020

Sister Mary Joseph's nodule.

Oxf Med Case Reports 2020 Apr 23;2020(4):omaa022. Epub 2020 May 23.

Department of Dermatology, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.

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http://dx.doi.org/10.1093/omcr/omaa022DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7243714PMC
April 2020

Diclofenac shifts the role of root glutamine synthetase and glutamate dehydrogenase for maintaining nitrogen assimilation and proline production at the expense of shoot carbon reserves in Solanum lycopersicum L.

Environ Sci Pollut Res Int 2020 Aug 19;27(23):29130-29142. Epub 2020 May 19.

GreenUPorto - Sustainable Agrifood Production Research Centre, Biology Department, Faculty of Sciences, University of Porto, Rua do Campo Alegre s/n, 4169-007, Porto, Portugal.

The continuous increase of the human population worldwide has led to an increase of pharmaceuticals' consumption, such as diclofenac (DCF), a widely used non-steroidal anti-inflammatory drug (NSAID), that is not removed by wastewater treatment processes. Although there is some research regarding the effects of DCF on animals and aquatic invertebrates, information concerning its influence on plants' metabolism is still scarce. Through an integrated approach, using combined biochemical and molecular biology techniques, this work aimed to evaluate the phytotoxicity of DCF in Solanum lycopersicum L., focusing on the primary plant processes: nitrogen (N) assimilation and photosynthesis. The exposure of tomato plants to increasing concentrations of DCF (0, 0.5, and 5 mg L) revealed that glutamine synthetase (GS) was differentially affected, in an organ-dependent manner, by this contaminant at the gene expression, protein, and activity levels, with an increased activity of 0.2-fold in shoots of plants treated with the lowest concentration of DCF although a general decrease was registered for the SlGS gene family expression, revealing that post-translational regulation was in order, since GS2 polypeptide content did not change. Glutamate dehydrogenase (GDH) activity was generally enhanced, accompanied by increases of 0.4- to 1.9-fold in proline levels, revealing GDH as an important compensatory route for both N assimilation and proline production under stressful conditions. No alterations in most photosynthetic endpoints were noticed after DCF treatments, but small decreases of 0.1- to 0.8-fold in the accumulation of RuBisCO-encoding transcripts were observed, along with a reduction in starch content. Some alterations in the soluble polypeptide profile were also detected in response to DCF, evidencing the participation of some stress-related proteins in the plant's response to DCF.
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http://dx.doi.org/10.1007/s11356-020-09136-xDOI Listing
August 2020

Coronavirus and pregnancy: How can three-dimensional printing laboratories help?

J Matern Fetal Neonatal Med 2020 May 19:1-2. Epub 2020 May 19.

Medical course, Municipal University of São Caetano do Sul (USCS), São Paulo-SP, Brazil.

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http://dx.doi.org/10.1080/14767058.2020.1763950DOI Listing
May 2020

Hypnosis for the treatment of chronic refractory pruritus.

Int J Dermatol 2020 Aug 2;59(8):e300-e301. Epub 2020 May 2.

Department of Dermatology, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.

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http://dx.doi.org/10.1111/ijd.14908DOI Listing
August 2020

Extensive Refractory Perineal Pyoderma Gangrenosum Treated with Infliximab, Fecal Diversion, and Negative-Pressure Wound Therapy.

GE Port J Gastroenterol 2020 Feb 25;27(2):128-131. Epub 2019 Sep 25.

Gastroenterology Department, Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal.

Background: Pyoderma gangrenosum (PG) is a rare and difficult-to-diagnose disease that often associates with inflammatory bowel disease.

Case: We present a case of a 57-year-old female with ulcerative colitis receiving 5-ASA who presented with rapidly progressive ulcers in the right foot and on the inside of the thigh, extending from the left large vaginal lip to the perianal area, compatible with PG. She was initially treated with corticosteroids with no response. After multidisciplinary consultation, it was decided to initiate in-fliximab 5 mg/kg, and to perform ileostomy for fecal diversion and negative-pressure wound therapy. The patient presented with marked improvement of the lesions, being discharged after 2 months and demonstrating almost complete resolution of the lesions within 4 months.

Conclusion: Due to the rarity of PG, there is no evidence of the optimal management. The role of surgery is controversial as PG lesions can demonstrate pathergy and theoretically could worsen with surgical intervention. In this case it was decided based on the extent of the lesions and the experience in other septic/ulcerative perianal conditions.
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http://dx.doi.org/10.1159/000502982DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7113590PMC
February 2020

Response of Solanum lycopersicum L. to diclofenac - Impacts on the plant's antioxidant mechanisms.

Environ Pollut 2020 Mar 9;258:113762. Epub 2019 Dec 9.

GreenUPorto - Sustainable Agrifood Production Research Centre, Departamento de Biologia, Faculdade de Ciências, Universidade do Porto, Rua do Campo Alegre 687, 4169-007, Porto, Portugal.

One emerging problem that recently has become a vastly acknowledged topic of concern is the environmental contamination by pharmaceuticals. Diclofenac (DCF) is one of the most common pharmaceuticals found, due to its high utilization and low removal rate in wastewater treatment processes. In this work, Solanum lycopersicum L. was used as a model to unravel how DCF contamination can affect crops, focusing on the internal mechanisms triggered by this exposure. For this purpose, plants were exposed to two different DCF concentrations (0.5 mg L and 5 mg L). Results obtained here point towards a loss of shoot performance when plants were exposed to very high concentrations of DCF, but no delay or loss of yield in the flowering and fruit stages were ascribed to DCF contamination. Our data shows that a state of oxidative stress due to high reactive oxygen species accumulation was associated with this contamination, with very high DCF levels leading to a rise of lipid peroxidation, possibly accentuated by the inhibition of ROS-scavenging enzymes and unable to be counteracted by the visible upregulation of proline and the thiol-based redox network. Overall, these results allow to infer that in the current environmental context, no noticeable negative effects should be associated with the presence of DCF in soils where this crop is cultivated. However, the oxidative stress and lower biomass associated with the highest concentration are alarming, since DCF levels in the environment are continuously increasing and further measures are necessary to assess this problematic.
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http://dx.doi.org/10.1016/j.envpol.2019.113762DOI Listing
March 2020

Adult vulvar Langerhans cell histiocytosis: a rare presentation.

Int J Dermatol 2020 Feb 11;59(2):e40-e41. Epub 2019 Oct 11.

Dermatology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova De Gaia, Portugal.

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http://dx.doi.org/10.1111/ijd.14679DOI Listing
February 2020

Autosomal recessive hyper-IgE syndrome successfully treated with hematopoietic stem cell transplantation.

Pediatr Dermatol 2019 Sep 24;36(5):693-696. Epub 2019 Jul 24.

Department of Dermatology, Vila Nova de Gaia/Espinho Hospital Center, Vila Nova de Gaia, Portugal.

Autosomal recessive hyper-IgE syndrome is a primary immunodeficiency that results from a mutation in the DOCK8 gene. We report a case of a patient presenting with severe eczema, atopy, and recurrent skin infections since the first months of life. The diagnosis of autosomal recessive hyper-IgE syndrome was made at the age of 7 by a positive DOCK8 genetic test. The patient underwent hematopoietic stem cell transplantation, with complete remission of the various manifestations.
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http://dx.doi.org/10.1111/pde.13919DOI Listing
September 2019

Three-dimensional virtual traveling navigation and three-dimensional printing models of a normal fetal heart using ultrasonography data.

Prenat Diagn 2019 02 4;39(3):175-177. Epub 2019 Feb 4.

Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil.

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http://dx.doi.org/10.1002/pd.5417DOI Listing
February 2019

An interactive experiment combining ultrasound, magnetic resonance imaging, and force feedback technology to physically feel the fetus during pregnancy.

Eur J Radiol 2019 01 20;110:128-129. Epub 2018 Nov 20.

Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil; Medicine course, Municipal University of São Caetano do Sul (USCS), São Paulo, SP, Brazil. Electronic address:

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http://dx.doi.org/10.1016/j.ejrad.2018.11.020DOI Listing
January 2019

3D Virtual Broncoscopy before FETO Procedure in a Fetus with Severe, Isolated Left Congenital Diaphragmatic Hernia.

Fetal Pediatr Pathol 2018 Apr 2;37(2):134-139. Epub 2018 Apr 2.

f Clínica de Diagnóstico por Imagem (CDPI), Radiology , Rio de Janeiro , Brazil.

Introduction: Congenital diaphragmatic hernia (CDH) is a life-threatening event in severe forms and fetuses affected may benefit from in utero treatment by fetoscopic endotracheal occlusion (FETO).

Materials And Methods: Application of 3D virtual bronchoscopy in a case of severe, isolated, left CDH before performing FETO procedure at 27 week's gestation is reported.

Results: The 3D virtual imaging of the fetal trachea was technically useful in planning the real FETO procedure. FETO successfully promoted fetal lung growth by decreasing the herniation of abdominal organs into the thorax and decreasing the risk of pulmonary hypoplasia. Ultrasound calculation of lung to head ratio (LHR) and fetal-MRI were used to assess lung development following FETO procedure.

Conclusion: 3D virtual fetal reality enabled the fetal surgeon to review and navigate on demand inside the upper airway, reducing the risk of unexpected intervention complications.
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http://dx.doi.org/10.1080/15513815.2018.1445148DOI Listing
April 2018

Prenatal diagnosis of Apert syndrome using ultrasound, magnetic resonance imaging, and three-dimensional virtual/physical models: three case series and literature review.

Childs Nerv Syst 2018 08 13;34(8):1563-1571. Epub 2018 Feb 13.

Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), Rua Belchior de Azevedo, 156 apto. 111 Torre Vitoria, São Paulo, SP, CEP 05089-030, Brazil.

Objective: This aimed to describe the prenatal diagnosis of three cases of Apert syndrome using two-dimensional (2D) and three-dimensional (3D) ultrasound, magnetic resonance imaging (MRI), and 3D virtual/physical models.

Methods: We retrospectively analyzed three cases of Apert syndrome at our service. The prenatal diagnostic methods used were 2D ultrasound, 3D ultrasound in conventional and HDlive rendering modes, T2-weighted MRI sequences, and 3D virtual/physical models from MRI or 3D ultrasound scan data. All imaging methods were performed by one observer. All prenatal diagnoses were confirmed by autopsy in cases of termination of pregnancy or genetic assessment during the postnatal period.

Results: Mean ± standard deviation of maternal and gestational age at the time of diagnosis was 36.5 ± 3.5 years and 32 ± 4.2 weeks, respectively. Main 2D/3D ultrasound and MRI findings were craniosynostosis, hypertelorism, low ear implantation, increased kidneys dimensions, and syndactyly of hands and feet. 3D virtual/physical models allowed 3D view of fetal head and extremity abnormalities. Termination of pregnancy occurred in two cases.

Conclusion: Prenatal 3D ultrasound and MRI enabled the identification of all Apert syndrome phenotypes. 3D virtual/physical models provided both the parents and the medical team a better understanding of fetal abnormalities.
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http://dx.doi.org/10.1007/s00381-018-3740-yDOI Listing
August 2018

3-D Virtual Reconstruction of a Large Amniocele With Protrusion of Legs and Umbilical Cord Following Asymptomatic Uterine Rupture.

J Obstet Gynaecol Can 2018 Jan 29;40(1):75-77. Epub 2017 Jul 29.

Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil. Electronic address:

Background: Complete uterine rupture is a rare and severe intrapartum complication with high rates of maternal and fetal mortality. Asymptomatic uterine rupture is a very rare condition with one unique previous case described in the literature. Three-dimensional virtual models allow an immersive virtual reality of maternal-fetal structures with better understanding by the parents and the medical team.

Case: We demonstrate a case of asymptomatic rupture uterine with a large amniocele and protruded legs and umbilical cord at 28 weeks of gestation by using a 3-D virtual model from ultrasound scan data.

Conclusion: 3-D virtual models may be applied to the assessment of obstetric complications, thereby allowing a novel 3-D spatial view of maternal-fetal structures.
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http://dx.doi.org/10.1016/j.jogc.2017.05.025DOI Listing
January 2018

First-trimester intrauterine Zika virus infection and brain pathology: prenatal and postnatal neuroimaging findings.

Prenat Diagn 2016 Aug 21;36(8):785-9. Epub 2016 Jul 21.

Department of Obstetrics, Paulista School of Medicine Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil.

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http://dx.doi.org/10.1002/pd.4860DOI Listing
August 2016

Prenatal diagnosis and physical model reconstruction of agnathia-otocephaly with limb deformities (absent ulna, fibula and digits) following maternal exposure to oxymetazoline in the first trimester.

J Obstet Gynaecol Res 2016 Aug 17;42(8):1016-20. Epub 2016 Apr 17.

Radiology, Clincial Diagnostic Imaging (CDPI), Rio de Janeiro, Brazil.

Agnathia-otocephaly or agnathia-sinotia-microstomy syndrome is the most severe malformation affecting the first branchial arch. It is a rare congenital anomaly characterized by absence of the lower jaw and abnormal ear positioning. Prenatal diagnosis is possible on conventional 2-D ultrasound in the second trimester. Three-dimensional ultrasound enhances detection of abnormal facial phenotype, especially in surface rendering mode. In addition, 3-D volume datasets are used to produce a physical model of the anomaly. We present a case of second trimester ultrasound diagnosis of agnathia-otocephaly associated with limb deformities. A physical model produced using 3-D ultrasound volume datasets facilitated better understanding of this congenital malformation, and improvement of parental counselling and management by the multispecialist team.
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http://dx.doi.org/10.1111/jog.13014DOI Listing
August 2016

Innate immunity and hepatocarcinoma: Can toll-like receptors open the door to oncogenesis?

World J Hepatol 2016 Jan;8(3):162-82

Jorge André Gomes Lopes, Marta Borges-Canha, Pedro Pimentel-Nunes, Department of Physiology and Cardiothoracic Surgery, Cardiovascular Research and Development Unit, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.

Hepatocarcinoma (HCC) is a highly prevalent cancer worldwide and its inflammatory background was established long ago. Recent studies have shown that innate immunity is closely related to the HCC carcinogenesis. An effective innate immunity response relies on the toll-like receptors (TLR) found in several different liver cells which, through different ligands and many signaling pathways can elicit, not only a pro-inflammatory but also an oncogenic or anti-oncogenic response. Our aim was to study the role of TLRs in the liver oncogenesis and as a consequence their value as potential therapeutic targets. We performed a systematic review of PubMed searching for original articles studying the relationship between HCC and TLRs until March 2015. TLR2 appears to be a fundamental stress-sensor as its absence reveals an augmented tendency to accumulate DNA-damages and to cell survival. However, pathways are still not fully understood as TLR2 up-regulation was also associated to enhanced tumorigenesis. TLR3 has a well-known protective role influencing crucial processes like angiogenesis, cell growth or proliferation. TLR4 works as an interesting epithelial-mesenchymal transition's inducer and a promoter of cell survival probably inducing HCC carcinogenesis even though an anti-cancer role has already been observed. TLR9's influence on carcinogenesis is also controversial and despite a potential anti-cancer capacity, a pro-tumorigenic role is more likely. Genetic polymorphisms in some TLRs have been found and its influence on the risk of HCC has been reported. As therapeutic targets, TLRs are already in use and have a great potential. In conclusion, TLRs have been shown to be an interesting influence on the HCC's microenvironment, with TLR3 clearly determining an anti-tumour influence. TLR4 and TLR9 are considered to have a positive relationship with tumour development even though, in each of them anti-tumorigenic signals have been described. TLR2 presents a more ambiguous role, possibly depending on the stage of the inflammation-HCC axis.
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http://dx.doi.org/10.4254/wjh.v8.i3.162DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4724579PMC
January 2016
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