Publications by authors named "Maria Miguel Gomes"

9 Publications

  • Page 1 of 1

Singular case of acanthosis nigricans.

BMJ Case Rep 2021 Feb 10;14(2). Epub 2021 Feb 10.

Paediatric, Hospital de Braga, Braga, Portugal.

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http://dx.doi.org/10.1136/bcr-2020-240143DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7878120PMC
February 2021

Follow-up of infants born to mothers with Graves' disease.

Endocrinol Diabetes Nutr 2021 Aug-Sep;68(7):472-480. Epub 2020 Dec 30.

Pediatric Endrocrinology Unit of Pediatric Department, Hospital de Braga, Braga, Portugal.

Introduction: The prevalence of neonatal hyperthyroidism (HN) due to maternal Graves Disease (GD) ranges from 0.1 to 2.7%. It may occur in pregnant women with the following: active DG, after treatment with radioactive iodine, anti-thyroid or thyroidectomy or with a previous child with hyperthyroidism. The aim of our observational study was to evaluate the follow-up of infants born to mothers with GD at a Tertiary Hospital prior to the implementation of a follow-up protocol.

Methods: This was a retrospective observational study using data from the medical records of mothers with a diagnosis of GD and their newborns from January 2013 until May 2018. Newborns were divided into two groups: high and low risk for NH according to maternal TRAb, third trimester treatment and signs of fetal hyperthyroidism.

Results: We identified 31 newborns, 58% female; 87% high risk. In none of the newborns was umbilical cord blood collected. In the high risk group, 22% had thyroid function evaluation at day-1, one patient presented with hyperthyroidism and 82% were asymptomatic. Considering the cases with an insufficient blood sample for analysis, 9 consultations would have been spared. We found a significant delay in obtaining the high-risk group results which would have spared 10 appointments. A positive correlation was found between age at outpatient clinic discharge and the number of appointments and the maternal TRAb titer.

Conclusion: The correct surveillance of pregnancy and newborns with identification of those at high risk is essential to avoid unnecessary consultations and blood analyses that increase parental anxiety and hospital costs. Consequently, a multidisciplinary protocol was created to standardize the approach.
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http://dx.doi.org/10.1016/j.endinu.2020.09.005DOI Listing
December 2020

Accuracy of endoscopic ultrasound in gastric adenocarcinoma patient selection for neoadjuvant therapy.

United European Gastroenterol J 2019 03 7;7(2):278-286. Epub 2018 Dec 7.

Department of Gastroenterology, Hospital of Braga, Braga, Portugal.

Background: Recent studies demonstrated the positive impact of neoadjuvant treatment in locally advanced gastric cancer.

Objective: To assess the accuracy of endoscopic ultrasound (EUS) in the selection of patients with gastric adenocarcinoma for neoadjuvant therapy (T ≥ 2 and/or N+).

Methods: Retrospective analysis of patients with an anatomopathological diagnosis of gastric adenocarcinoma between January 2011 and June 2017, who had EUS for staging and underwent surgery as a first therapeutic attempt. The concordance (k) and accuracy (area under the curve (AUC)) of EUS for T ≥ 2 and/or N+ were assessed using the anatomopathological staging of the resected surgical specimen as the gold standard.

Results: The final sample included 152 patients (66.4% male, 67.1 ± 12.2 years). The concordance, accuracy, sensitivity and specificity of the EUS for T ≥ 2 and/or N+ were 0.72, 0.86 ± 0.03, 88.5% and 83.1%, respectively. The results were higher in proximal (k = 0.93, AUC = 0.96 ± 0.05, sensitivity (S) = 99.0% and specificity (E) = 90.9%) compared with distal lesions (k = 0.67, AUC = 0.84 ± 0.04, S = 85.7% and E = 81.5%), and in intestinal subtype (k = 0.77, AUC = 0.88 ± 0.04, S = 92.6% and E = 84.1%) compared with diffuse (k = 0.58, AUC = 0.79 ± 0.10, S = 85.0% and E = 72.7%) or mixed-subtype tumours (k = 0.65, AUC = 0.84 ± 0.10, S = 76.9% and E = 90.0%).

Conclusion: In one of the largest series of patients, we showed that EUS has overall high agreement and accuracy in the selection of patients with gastric adenocarcinoma for neoadjuvant therapy, although the agreement and accuracy are greater for proximal and intestinal lesions.
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http://dx.doi.org/10.1177/2050640618818942DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6498790PMC
March 2019

Herpes simplex virus type 1: an atypical presentation of primary infection.

BMJ Case Rep 2018 Apr 27;2018. Epub 2018 Apr 27.

Paediatrics Department, Hospital de Braga, Braga, Portugal.

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http://dx.doi.org/10.1136/bcr-2018-224967DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5926598PMC
April 2018

Childhood Hypopigmented Mycosis Fungoides: A Rare Diagnosis.

Case Rep Pediatr 2016 29;2016:8564389. Epub 2016 Nov 29.

Pediatrics Department, Portuguese Oncology Institute of Porto Francisco Gentil, 4200-072 Porto, Portugal.

Primary cutaneous lymphomas (PCL) are rare in pediatrics. Mycosis fungoides (MF) is the most frequent PCL diagnosed in childhood. There are various clinical variants of MF, including the hypopigmented MF (HMF). We present a 5-year-old boy with an 18-month history of progressive, generalized, nonpruritic hypopigmented lesions with central lacy erythema. He had no improvement with emollients. Skin biopsy showed typical features of HMF. He was treated with topical corticosteroids and tacrolimus and narrow-band ultraviolet B (NBUVB) phototherapy, with good response. HMF may mimic multiple skin disorders. Unusual hypopigmented skin lesions should be biopsied. Though phototherapy is effective, recurrence is common.
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http://dx.doi.org/10.1155/2016/8564389DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5153468PMC
November 2016

Severe systemic type 1 pseudohypoaldosteronism: 5 years of evolution.

Endocrinol Nutr 2016 Nov 18;63(9):502-505. Epub 2016 Sep 18.

Department of Pediatrics, Hospital de Braga, Sete Fontes, São Victor, 4710-243 Braga, Portugal.

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http://dx.doi.org/10.1016/j.endonu.2016.08.002DOI Listing
November 2016

Acute Alithiasic Cholecystitis and Human Herpes Virus Type-6 Infection: First Case.

Case Rep Pediatr 2016 20;2016:9130673. Epub 2016 Apr 20.

Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, 4710-057 Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal; Department of Pediatric Surgery, Hospital de Braga, Sete Fontes, São Victor, 4710-243 Braga, Portugal.

A three-year-old male child presented with erythematous maculopapular nonpruritic generalized rash, poor feeding, vomiting, and cramping generalized abdominal pain. He was previously healthy and there was no family history of immunologic or other diseases. On examination he was afebrile, hemodynamically stable, with painful palpation of the right upper quadrant and positive Murphy's sign. Laboratory tests revealed elevated inflammatory markers, elevated aminotransferase activity, and features of cholestasis. Abdominal ultrasound showed gallbladder wall thickening of 8 mm with a positive sonographic Murphy's sign, without gallstones or pericholecystic fluid. Acute Alithiasic Cholecystitis (AAC) was diagnosed. Tests for underlying infectious causes were negative except positive blood specimen for Human Herpes Virus Type-6 (HHV-6) by polymerase chain reaction. With supportive therapy the child became progressively less symptomatic with gradual improvement. The child was discharged on the sixth day, asymptomatic and with improved analytic values. Two months later he had IgM negative and IgG positive antibodies (1/160) for HHV-6, which confirmed the diagnosis of previous infection. In a six-month follow-up period he remains asymptomatic. To the best of our knowledge, this represents the first case of AAC associated with HHV-6 infection.
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http://dx.doi.org/10.1155/2016/9130673DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4855020PMC
May 2016

Autoimmune Hemolytic Anemia and Hodgkin's Disease: An Unusual Pediatric Association.

Case Rep Pediatr 2016 19;2016:4598587. Epub 2016 Jan 19.

Department of Pediatrics, Portuguese Oncology Institute of Porto Francisco Gentil, 4200-072 Porto, Portugal.

Autoimmune hemolytic anemia (AIHA) is a recognized complication of lymphoproliferative disorders. AIHA associated with Hodgkin's disease (HD) is uncommon especially in the pediatric population. The diagnosis of AIHA is usually associated with HD at the time of initial presentation or during the course of disease, but it could precede it by years to months. In adults the association of AIHA and HD is more frequent in advanced stages and in the nodular sclerosis and mixed cellularity type HD. Warm immune hemolytic anemia is mainly controlled with steroids and chemotherapy. We report a case of a pediatric patient with direct antiglobulin positive test at the diagnosis of a late relapse of stage III B mixed cellularity type HD.
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http://dx.doi.org/10.1155/2016/4598587DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4745911PMC
February 2016
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