Endometrial stromal tumors: immunohistochemical and molecular analysis of potential targets of tyrosine kinase inhibitors.

Background: The systemic treatment of malignant endometrial stromal tumors (EST) is not well established. A few reports describe objective responses to imatinib, which suggest a novel therapeutic strategy for these tumors. Due to these facts, we aimed to perform a retrospective analysis of possible molecular targets of tyrosine kinase inhibitors (TKI) in EST: KIT, PDGFRA and EGFR.

Images in pediatrics: the thymic sail sign and thymic wave sign.

The authors present a radiographic image portraying the "thymic sail sign" and the "thymic wave sign," both normal findings in infant radiographs and present a short description of these signs. These are distinguished from pathologic findings such as the "spinnaker-sail sign" in pneumomediastinum.

ESMO Consensus Guidelines for management of patients with colon and rectal cancer. a personalized approach to clinical decision making.

Colorectal cancer (CRC) is the most common tumour type in both sexes combined in Western countries. Although screening programmes including the implementation of faecal occult blood test and colonoscopy might be able to reduce mortality by removing precursor lesions and by making diagnosis at an earlier stage, the burden of disease and mortality is still high. Improvement of diagnostic and treatment options increased staging accuracy, functional outcome for early stages as well as survival.

[Carcinoid heart - case report].

We describe the case of a 76-year-old woman, diagnosed with a neuroendocrine tumor of the cecum in 2004, with liver metastases and carcinoid syndrome since September 2010. The patient had been treated intermittently with chemotherapy cycles, and remained symptomatic, with worsening secondary lesions. In June 2011 she began to present signs and symptoms of right heart failure and was hospitalized in September 2011.

[Prevalence of inappropriate urinary catheterization: a preventable risk factor].

Healthcare-associated infection is an issue with major socio-economic implications worldwide. Urinary Tract Infection is a Healthcare-Associated infection with a high influence on morbidity and personal impact for patients and their families, also has a great economic impact on institutions. The financial cost of each infection is difficult to estimate.

SU-E-T-390: Monitorization of the Dynamic Multi-Leaf Collimator Performance Using Log Files - a Quality Assurance Tool for Intensity Modulated Radiotherapy.

Purpose: Commission baseline values of the multi-leaf collimator (MLC) using Varian's dynalog file viewer software (DFV) and establish tolerance levels to use as a periodic quality assurance tool in intensity modulated radiotherapy (IMRT).

Methods: A sliding window test was created to have all leafs moving at a constant high speed of 2.5cm/s.

[Contrast-induced nephropathy].

Contrast-induced nephropathy (CIN) is an iatrogenic disorder, resulting from procedures requiring the intravascular administration of iodinated contrast media. It has an association with increased morbidity and mortality, increased costs and it remains the third most common cause of hospital-acquired kidney failure. CIN is usually defined as an increase in serum creatinine by either at least 0.

[Right atrial thrombus: a rare presentation of plasminogen activator inhibitor deficiency].

Free-floating right atrial thrombi are rare but associated with high mortality. Although advances in echocardiography have improved diagnosis, their management is still the subject of debate. A 24-year-old woman with a history of smoking, obesity and oral contraceptive use presented to the emergency department with dyspnea, cough and hemoptysis.

Non-cardiac comorbidities in the very elderly with acute myocardial infarction: prevalence and influence on management and in-hospital mortality.

Introduction: Acute myocardial infarction (AMI) in the very elderly is common and is associated with increased mortality. Despite this, the majority of such patients do not receive the most effective cardiovascular therapies. The presence of non-cardiac comorbidities constitutes an additional challenge to the management of AMI in very elderly patients.

A newborn with neck mass.

Congenital goiter is a rare cause of neonatal neck mass and may result from a fetal defectin synthesis of thyroxine, or administration of antithyroid drugs or iodides during pregnancy. The thyroid dysfunction often accompanies it. This report describes a case of a male term newborn with congenital goiter and primary hypothyroidism.

Complicated meningitis caused by a rare serotype of Haemophilus influenzae in Portugal.

We report a case of meningitis due to Haemophilus influenzae serotype d strain in an infant. As far as we know, this is the first report of a serotype d strain, responsible for childhood invasive disease in Europe, demonstrating an emerging of H. influenzae non-b serotype, in the post-vaccination era.

Transient idiopathic dystonia in infancy.

Aim: Review of transient idiopathic dystonia cases to improve knowledge on this entity, in relation to frequency, characterization and evolution.

Methods: Retrospective review and characterization of clinical cases seen in paediatric neurology consultation, diagnosed with transient idiopathic dystonia, between February 2001 and June 2009, using clinical files complemented with photographic records and updated information through the physician.

Results: Thirteen infants were referred to the paediatric neurology consultation over a period of 8 years, for asymmetric tone, posture and movements of the upper limb with onset before 6 months, with spontaneous favourable evolution and disappearance without sequelae, although the reason for referral was, in most cases, the suspicion of a hemiplegic cerebral palsy.

[Pheocromocytoma with negative MIBG].

Pheochomocytomas are catecholamine-releasing tumors derived from chromaffin cells. These kind of tumors occur in less than 1% of the patients evaluated for hypertension. The authors present a case of pheochomocytoma difficult to localize because MIBG scintigraphy was negative and elaborate a review about that subject.

Intraventricular gradients and acute coronary syndromes: a case report.

Left ventricular outflow tract obstruction (LVOTO) has traditionally been associated with hypertrophic obstructive cardiomyopathy, but can occur in other clinical scenarios such as acute myocardial infarction (AMI). In some patients, LVOTO is absent at rest, being detectable only with provocation tests such as stress echocardiography. Timely diagnosis of this phenomenon is very important, as it has therapeutic implications, and relies on clinical suspicion and on recognizing substrates in which LVOTO can occur.

The role of antidiuretic hormone in the pathophysiology and treatment of heart failure.

Heart failure (HF) is still one of the most important causes of morbidity and mortality worldwide. Neurohormonal changes appear to play an important role in the development and continuation of HF. Among the mediators responsible for these changes, antidiuretic hormone (ADH) is probably the least known.

[Biosimilars in oncology].

The development of biotechnology drugs represents one of the great advances in medical therapy and it was observed an exponential growth in its use. The resource to these drugs in Oncology and Hematology is no exception and it soon became an essential element of an integrated and directed therapy strategy. The expiry of the first biotechnology drugs patents has opened the door for the development and marketing of biosimilars, which entry in the Portuguese market was recently approved.

Therapeutic implications of transesophageal echocardiography after transthoracic echocardiography on acute stroke patients.

Background: The role of transesophageal echocardiography (TEE) in the evaluation of acute stroke patients is still ill-defined. We conducted a prospective observational study to find the prevalence of TEE findings that indicate anticoagulation as beneficial, in acute ischemic stroke patients without indication for anticoagulation based on clinical, electrocardiographic and transthoracic echocardiography (TTE) findings.

Methods: We prospectively studied all patients referred to our laboratory for TTE and TEE.

[Guidelines for prevention of febrile neutropenia].

Neutropenia and febrile neutropenia are common consequences of some cytotoxic chemotherapy regimens. This situation leads to modifications of the therapeutic regimen, conducting to either dose reduction or cycle delays. Granulocyte colony stimulating factors are commonly used to minimize chemotherapy cytotoxic effect on the granulocytic series.

[Stroke in HIV-infected patients].

The spectrum of human immunodeficiency virus infection (HIV) is changing. New drug treatments have reduced morbidity and mortality of this disease, therefore it is necessary to start treating the HIV infection as a chronical disease. The association of the stroke with the HIV infection was inicially thought to be a result of other opportunistic infeccions and tumors.