Browsing by Author "Sousa, P."
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- Avaliação da exposição à Radiação Ionizante de pacientes submetidos a procedimentos de CPRE com recurso a fluoroscopiaPublication . Granadas, Marisa; Ribeiro, Luís; Abrantes, António; Sousa, P.; Almeida, Rui; Rodrigues, S.; Lesyuk, OksanaObjetivo: Avaliar as doses de exposição a radiação ionizante de pacientes submetidos a procedimentos de CPRE. Metodologia: Recolha de uma amostra de dados em duas instituições num total de 267 pacientes, 198 numa instituição pública (A) e 69 numa instituição privada (B). Resultados: A mediana dos tempos de fluoroscopia é semelhante entre as duas instituições em estudo, 4 minutos e 17 segundos na instituição A e 4 minutos e 21 segundos na instituição B, porém verifica-se uma diferença na mediana do DAP com valores de 3,60 Gy.cm2 e 13,21 Gy.cm2. A dose efetiva mediana estimada foi, respetivamente, de 0,94 mSv e 3,43 mSv. Conclusão: As doses de exposição encontram-se dentro do intervalo de valores praticados na literatura, sendo a avaliação do risco de desenvolvimento de cancro, como consequência da exposição a procedimentos de CPRE, na Instituição A de 0,006% e na Instituição B de 0,025%.
- Serum neutrophil biomarkers to predict crohn's disease progression and infliximab treatment outcomesPublication . Magalhaes, D.; Santiago, M.; Patita, M.; Arroja, B.; Lago, P.; Rosa, I.; Sousa, Helena Tavares; Ministro, P.; Mocanu, I.; Vieira, A.; Castela, J.; Moleiro, J.; Roseira, J.; Eugenia, C.; Sousa, P.; Portela, F.; Correia, L.; Dias, S.; Afonso, J.; Danese, S.; Peyrin‐Biroulet, L.; Dias, C. C.; Magro, F.Background and aims: Predicting the treatment outcomes of biological therapies is an unmet need in Crohn's Disease. In this study, we explored the potential of serum neutrophil-related biomarkers to predict infliximab therapeutic results and disease progression in Crohn's Disease patients, over a 2-year period, in a real-world setting. Methods: The study included 100 asymptomatic Crohn's Disease patients in the IFX maintenance phase from the prospective, observational, multicenter DIRECT study. Patients were categorized according to a composite outcome reflecting progression that included surgery, hospitalizations, new fistulae, abscess or stricture, and drug treatment escalation. Serum neutrophil elastase, lipocalin-2, lactoferrin, and resistin (non-neutrophil control) were analyzed via multiplex magnetic bead assays at multiple touchpoints. Fecal calprotectin was assessed by ELISA. Results: Over up to 2 years of follow-up, serum biomarkers did not differentiate between the composite outcome groups, whereas fecal calprotectin was significantly higher in patients with worse outcomes. During the infliximab maintenance phase, there was a significant, sustained reduction of neutrophil elastase (p < 0.001), lipocalin-2 (p < 0.001), and lactoferrin (p < 0.001), but not of resistin, despite stable neutrophil levels. Correlations between NE and NGAL levels were strong (Pearson correlations 0.75-0.85); all other correlations were of small magnitude. Conclusion: Our real-world data do not support using serum neutrophil elastase, lipocalin-2, or lactoferrin concentrations as predictors of treatment outcomes or disease evolution in infliximab -treated Crohn's Disease patients. On the other hand, the sustained decrease in biomarkers over time suggests that neutrophil stabilization might be an additional infliximab mechanism of action.