Percorrer por autor "Marinho, Joana"
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- Epidemiological and clinical aspects of Cutaneous and Mucosal Leishmaniases in Portugal: retrospective analysis of cases diagnosed in public hospitals and reported in the literature between 2010 and 2020Publication . Rocha, Rafael; Conceição, Cláudia; Gonçalves, Luzia; Carvalho, Ana Cláudia; Maia, André; Martins, André; Carujo, António; Maio, António; Forra, Catarina; Melita, Catarina; Couto, Daniela; Fernandes, Diana; Pereira, Dulce; Leal, Ema; Sarmento, Helena; Sousa, Inês; Gonçalves, Jean-Pierre; Marinho, Joana; Vasconcelos, Joana; Cunha, João; Rodrigues, João; Silva, José Miguel; Caley, Lídia; Malheiro, Luís; Santos, Luís; Garcia, Margarida; Cunha, Maria; Lima, Maria; Andrade, Maria Margarida; Marques, Marta; Alpalhão, Miguel; Silva, Mónica; Ferraz, Rita; Soares, Rui; Fernandes, Salomão; Llobet, Samuel; Cruz, Sofia; Guimarães, Teresa; Branco, Tiago; Nunes, Tomás Robalo; Almeida, Vasco; Maia, CarlaLeishmania infantum, a zoonotic vector-born parasite, is endemic in the Mediterranean region, presenting mostly as visceral (VL), but also as cutaneous (CL) and mucosal leishmaniasis (ML). This study aimed to describe the epidemiological and clinical aspects of the CL and ML cases diagnosed in mainland Portugal between 2010 and 2020. Collaboration was requested from every hospital of the Portuguese National Health System. Cases were screened through a search of diagnostic discharge codes or positive laboratory results for Leishmania infection. Simultaneously, a comprehensive literature search was performed. Descriptive statistics and hypothesis testing were performed using IBM (R) SPSS (R) Statistics. A total of 43 CL and 7 ML cases were identified, with a predominance of autochthonous cases (86%). In CL, immunosuppressed individuals constituted a significant proportion of patients (48%), and in this group, disseminated CL (22%) and simultaneous VL (54%) were common. In autochthonous cases, lesions, mostly papules/nodules (62%), were frequently observed on the head (48%). The approach to treatment was very heterogeneous. ML cases were all autochthonous, were diagnosed primarily in older immunosuppressed individuals, and were generally treated with liposomal amphotericin B. The findings suggest a need for enhanced surveillance and reporting, clinical awareness, and diagnostic capacity of these forms of leishmaniasis to mitigate underdiagnosis and improve patient outcomes. A holistic One Health approach is advocated to address the multifaceted challenges posed by leishmaniases in Portugal and beyond.
- Retrospective study of cisplatin plus radiotherapy toxicities in locally advanced squamous cell carcinoma of the head and neck – ReCisTT studyPublication . Gomes, Ana; Castro, Gilberto; Oliveira, Thiago Bueno de; Colmenero, Ana Medina; Ribeiro, Leonor; Psyrri, Amanda; Magné, Nicolas; Serrahima, Maria Plana; Marinho, Joana; Giglio, Raul; Rey, Leticia Iglesias; Angel, Martín; Macedo, AnaIntroduction Squamous cell carcinoma of the head and neck (SCCHN) is a multifactorial disease involving genetic and environmental factors representing one of the most frequent cancer-related deaths worldwide. Tobacco and alcohol use account for most SCCHN, while a growing subset of oropharyngeal cancers is causally associated with human papillomavirus (HPV) infection. Despite improvements in overall survival, patients with HPV-negative locally advanced (LA) SCCHN continue to have a poor prognosis. For these patients, the standard of care is radiotherapy with concurrent chemotherapy (RCT).Methods This retrospective, multicenter, and observational study analyzed the treatment compliance of 326 patients with LA-SCCHN who underwent RCT between January 1st, 2014, and June 30th, 2017. This study also evaluated the potential factors associated with treatment compliance, the compliance impact on clinical response, and the main toxicities experienced by patients.Results A total of 274 (84%) patients were compliant and received the planned dose of cisplatin. Overall, 957 adverse events were reported in 98.2% of patients during the study. The overall response rate was 80.2%, with 60.4% of patients achieving a complete response.Discussion Despite the high treatment compliance, 62.6% of adverse events reported were related to cisplatin. Identifying risk factors associated with non-compliance could enable physicians to identify ineligible patients for cisplatin-based RCT and prevent patients from receiving inadequate treatment leading to severe adverse events.