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  1. Article ; Online: Dynamics of coexisting rotating waves in unidirectional rings of bistable Duffing oscillators.

    Barba-Franco, J J / Gallegos, A / Jaimes-Reátegui, R / Muñoz-Maciel, J / Pisarchik, A N

    Chaos (Woodbury, N.Y.)

    2023  Volume 33, Issue 7

    Abstract: We study the dynamics of multistable coexisting rotating waves that propagate along a unidirectional ring consisting of coupled double-well Duffing oscillators with different numbers of oscillators. By employing time series analysis, phase portraits, ... ...

    Abstract We study the dynamics of multistable coexisting rotating waves that propagate along a unidirectional ring consisting of coupled double-well Duffing oscillators with different numbers of oscillators. By employing time series analysis, phase portraits, bifurcation diagrams, and basins of attraction, we provide evidence of multistability on the route from coexisting stable equilibria to hyperchaos via a sequence of bifurcations, including the Hopf bifurcation, torus bifurcations, and crisis bifurcations, as the coupling strength is increased. The specific bifurcation route depends on whether the ring comprises an even or odd number of oscillators. In the case of an even number of oscillators, we observe the existence of up to 32 coexisting stable fixed points at relatively weak coupling strengths, while a ring with an odd number of oscillators exhibits 20 coexisting stable equilibria. As the coupling strength increases, a hidden amplitude death attractor is born in an inverse supercritical pitchfork bifurcation in the ring with an even number of oscillators, coexisting with various homoclinic and heteroclinic orbits. Additionally, for stronger coupling, amplitude death coexists with chaos. Notably, the rotating wave speed of all coexisting limit cycles remains approximately constant and undergoes an exponential decrease as the coupling strength is increased. At the same time, the wave frequency varies among different coexisting orbits, exhibiting an almost linear growth with the coupling strength. It is worth mentioning that orbits originating from stronger coupling strengths possess higher frequencies.
    Language English
    Publishing date 2023-07-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1472677-4
    ISSN 1089-7682 ; 1054-1500
    ISSN (online) 1089-7682
    ISSN 1054-1500
    DOI 10.1063/5.0141054
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  2. Article ; Online: Results of surgery versus stereotactic body radiotherapy for lung cancer.

    Costa, R / Aires, F / Rodrigues, D / Paiva, A / Maciel, J / Fernandes, P

    Pulmonology

    2022  Volume 29, Issue 4, Page(s) 342–344

    MeSH term(s) Humans ; Radiosurgery/methods ; Lung Neoplasms/radiotherapy ; Lung Neoplasms/surgery ; Carcinoma, Non-Small-Cell Lung/radiotherapy
    Language English
    Publishing date 2022-10-19
    Publishing country Spain
    Document type Letter
    ZDB-ID 3009651-0
    ISSN 2531-0437 ; 2531-0429
    ISSN (online) 2531-0437
    ISSN 2531-0429
    DOI 10.1016/j.pulmoe.2022.10.001
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  3. Article: A Case Report of Sheehan Syndrome: A Rare Cause of Hypopituitarism.

    Vasconcelos, Ana Luís / Pinto Ribeiro, Rita / Claúdio Ferreira, Patrícia / Maciel, Joana / Araújo, Rosário

    Cureus

    2024  Volume 16, Issue 2, Page(s) e53544

    Abstract: Sheehan syndrome is a rare cause of hypopituitarism characterized by pituitary gland necrosis after postpartum hemorrhage. It is a pertinent cause of maternal morbidity and mortality in developing countries with deficient obstetrical care but is ... ...

    Abstract Sheehan syndrome is a rare cause of hypopituitarism characterized by pituitary gland necrosis after postpartum hemorrhage. It is a pertinent cause of maternal morbidity and mortality in developing countries with deficient obstetrical care but is frequently overlooked in developed countries where its occurrence is uncommon. We present the case of a 66-year-old female diagnosed with Sheehan syndrome more than 30 years after her last delivery complicated by postpartum hemorrhage. Although the patient presented several symptoms and signs of pituitary hormonal deficiencies, a diagnosis had never been established before. The complete laboratory analysis revealed a deficiency in the pituitary axis, and the cranial imaging showed an empty sella turcica. Hormonal replacement therapy resolved several impairments in terms of general energy, physical capacity, temperature regulation, skin characteristics, and sexual function. It also improved her cardiovascular and osteoporosis risk, and, most importantly, prevented a potential life-threatening adrenal crisis. This report highlights the subtle manifestations of Sheehan syndrome to help clinicians establish a prompt diagnosis. Even in developed countries such as Portugal, this condition should be regarded as a potential cause of hypopituitarism.
    Language English
    Publishing date 2024-02-04
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.53544
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  4. Article ; Online: Acute suppurative thyroiditis with Graves disease - A very rare association.

    Damásio, Inês / Maciel, Joana / Costa, Maria Manuel / Raimundo, Luisa

    Archives of endocrinology and metabolism

    2023  Volume 67, Issue 5, Page(s) e000610

    Abstract: Acute suppurative thyroiditis is an uncommon disorder caused by a bacterial infection, usually presenting with normal thyroid function. It is a serious condition that requires a prompt diagnosis and treatment with antibiotics and supportive measures. A ... ...

    Abstract Acute suppurative thyroiditis is an uncommon disorder caused by a bacterial infection, usually presenting with normal thyroid function. It is a serious condition that requires a prompt diagnosis and treatment with antibiotics and supportive measures. A 62 years-old female presented with a painful cervical induration and odynophagia a week after a fish bone had been removed from her pharynx. She was febrile, and tachycardic and, on physical examination, a painful thyroid mass was detected. High inflammatory parameters and thyrotoxicosis were confirmed: thyroid stimulating hormone (TSH) < 0.01 mIU/L (normal range [NR] 0.27-4.2); free thyroxine (FT4) 3.86 ng/dL (NR 0.9-1.7) and anti-TSH receptor antibodies (TRABs) 5.3 U/L (NR < 1.5). Thyroid scintigraphy showed a diffuse uptake of the thyroid parenchyma suggesting Graves disease. Cervical ultrasonography revealed an abscess of the left thyroid lobe of 36 × 36 mm and fine needle aspiration biopsy (FNAB) with partial drainage was performed.
    MeSH term(s) Female ; Humans ; Thyroiditis, Suppurative/complications ; Methimazole/therapeutic use ; Abscess/complications ; Graves Disease/complications ; Thyrotoxicosis/complications ; Acute Disease
    Chemical Substances Methimazole (554Z48XN5E)
    Language English
    Publishing date 2023-05-29
    Publishing country Brazil
    Document type Case Reports
    ISSN 2359-4292
    ISSN (online) 2359-4292
    DOI 10.20945/2359-3997000000610
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  5. Article: Global impact of the COVID 19 Pandemic in Portuguese Thoracic Surgery Centres.

    Rodrigues, Cristina / Maciel, João

    Revista portuguesa de cirurgia cardio-toracica e vascular : orgao oficial da Sociedade Portuguesa de Cirurgia Cardio-Toracica e Vascular

    2020  Volume 27, Issue 2, Page(s) 69–71

    MeSH term(s) Betacoronavirus ; COVID-19 ; Coronavirus Infections/epidemiology ; Humans ; Pandemics ; Pneumonia, Viral/epidemiology ; Portugal/epidemiology ; SARS-CoV-2 ; Thoracic Surgery
    Keywords covid19
    Language English
    Publishing date 2020-07-19
    Publishing country Portugal
    Document type Editorial
    ISSN 0873-7215
    ISSN 0873-7215
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  6. Article ; Online: Growth hormone deficiency and other endocrinopathies after childhood brain tumors: results from a close follow-up in a cohort of 242 patients.

    Maciel, J / Dias, D / Cavaco, D / Donato, S / Pereira, M C / Simões-Pereira, J

    Journal of endocrinological investigation

    2021  Volume 44, Issue 11, Page(s) 2367–2374

    Abstract: Purpose: Brain tumors are the most common solid tumor in children. The prevalence of survivors from these cancers has been increasing, presenting endocrine sequelae in more than 40% of the cases. Our aim was to characterize the endocrinopathies ... ...

    Abstract Purpose: Brain tumors are the most common solid tumor in children. The prevalence of survivors from these cancers has been increasing, presenting endocrine sequelae in more than 40% of the cases. Our aim was to characterize the endocrinopathies diagnosed in this population, exploring the outcomes of growth hormone treatment.
    Methods: We have performed a retrospective analysis of the survivors that were followed-up through a close protocol at our endocrine late-effects clinic.
    Results: 242 survivors, followed during 6.4 (0-23.4) years, were considered. The median age at tumor diagnosis was 6.7 (0-18) years and pilocytic astrocytoma was the most frequent neoplasm (33.5%). The prevalence of endocrinopathies was of 71.5%, with growth hormone deficiency being the most frequent (52.9%). An indirect correlation between the age at the beginning of somatropin and growth velocity in the first year of treatment was observed. Those treated with craniospinal radiotherapy presented a smaller final upper/lower segments ratio comparing with those that only received cranial radiotherapy. However, their final height was not compromised when compared to their family height target. We found pubertal delay in 12%; accelerated/precocious puberty in 13.2%; central and primary hypogonadism in 21.9% and 3.3%, respectively; primary and central hypothyroidism in 23.6% and 14.5%, respectively; thyroid nodules in 7.4%; ACTH deficiency in 10.3% and diabetes insipidus in 12%.
    Conclusion: This study reveals a higher prevalence of endocrinopathies in brain tumors survivors and explores the influence of craniospinal irradiation in the adult body proportions. It reinforces the importance of routine follow-up among survivors.
    MeSH term(s) Adolescent ; Age Factors ; Brain Neoplasms/epidemiology ; Brain Neoplasms/pathology ; Brain Neoplasms/therapy ; Cancer Survivors/statistics & numerical data ; Child ; Diabetes Insipidus/diagnosis ; Diabetes Insipidus/etiology ; Endocrine System Diseases/diagnosis ; Endocrine System Diseases/epidemiology ; Endocrine System Diseases/etiology ; Female ; Follow-Up Studies ; Growth Disorders/epidemiology ; Growth Disorders/etiology ; Growth Disorders/metabolism ; Growth Disorders/therapy ; Growth Hormone/analysis ; Growth Hormone/deficiency ; Growth Hormone/therapeutic use ; Human Growth Hormone/therapeutic use ; Humans ; Hypothyroidism/diagnosis ; Hypothyroidism/epidemiology ; Hypothyroidism/etiology ; Male ; Portugal/epidemiology ; Prevalence ; Puberty, Delayed/diagnosis ; Puberty, Delayed/epidemiology ; Puberty, Delayed/etiology ; Radiotherapy/adverse effects ; Radiotherapy/methods ; Radiotherapy/statistics & numerical data
    Chemical Substances Human Growth Hormone (12629-01-5) ; Growth Hormone (9002-72-6)
    Language English
    Publishing date 2021-03-08
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 432272-1
    ISSN 1720-8386 ; 0391-4097 ; 1121-1369
    ISSN (online) 1720-8386
    ISSN 0391-4097 ; 1121-1369
    DOI 10.1007/s40618-021-01541-4
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  7. Article ; Online: Isolated adrenal metastases of papillary thyroid carcinoma.

    Maciel, Joana / Vilar, Helena / Ferreira, Teresa C / Leite, Valeriano

    Endokrynologia Polska

    2022  Volume 73, Issue 1, Page(s) 167–168

    Abstract: Not required for Clinical Vignette. ...

    Abstract Not required for Clinical Vignette.
    MeSH term(s) Adrenal Gland Neoplasms/pathology ; Carcinoma, Papillary/pathology ; Humans ; Thyroid Cancer, Papillary/pathology ; Thyroid Neoplasms/pathology
    Language English
    Publishing date 2022-02-04
    Publishing country Poland
    Document type Journal Article
    ZDB-ID 419270-9
    ISSN 2299-8306 ; 0423-104X
    ISSN (online) 2299-8306
    ISSN 0423-104X
    DOI 10.5603/EP.a2021.0104
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  8. Article: THE DEVELOPMENT OF BRONCHOPLEURAL FISTULA.

    Costa, Rita / Maciel, João / Fernandes, Pedro / Pinho, Paulo

    Portuguese journal of cardiac thoracic and vascular surgery

    2021  Volume 28, Issue 2, Page(s) 73

    Abstract: A 66-year-old male with an aspergiloma in the upper left lobe was submitted to a wedge resection in December 2019. Pneumostasis was performed using biological glue and afterward the test of submersion in water showed no significant alveolopleural leak. ... ...

    Abstract A 66-year-old male with an aspergiloma in the upper left lobe was submitted to a wedge resection in December 2019. Pneumostasis was performed using biological glue and afterward the test of submersion in water showed no significant alveolopleural leak. In the immediate postoperative period, the patient presented an expanded lung parenchyma and moderate alveolopleural leakage that gradually decreased. A month later the patient was readmitted in intensive care unit with an acute respiratory distress after a sudden episode of coughing with abundant and purulent sputum and significant increase in alveolopleural leakage. Intraoperatively it was found that the pulmonary parenchyma covering the segmental bronchi was necrotic.
    MeSH term(s) Aged ; Bronchi ; Bronchial Fistula/diagnostic imaging ; Humans ; Male ; Pleural Diseases/diagnosis ; Pneumonectomy
    Language English
    Publishing date 2021-07-02
    Publishing country Portugal
    Document type Case Reports ; Journal Article
    ISSN 2184-9927
    ISSN 2184-9927
    DOI 10.48729/pjctvs.175
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  9. Article ; Online: Surgical treatment for a patient with immunoglobulin G4-related lung disease.

    Costa, Rita / Maciel, João / Fernandes, Pedro / Pinho, Paulo

    Interactive cardiovascular and thoracic surgery

    2021  Volume 33, Issue 5, Page(s) 824–826

    Abstract: Immunoglobulin G4-related disease (IgG4-RD) is an autoimmune fibroinflammatory disease, and isolated lung disease is a rare phenomenon. IgG4-RD frequently mimics primary pulmonary malignancy. It has been described in association with malignancies, ... ...

    Abstract Immunoglobulin G4-related disease (IgG4-RD) is an autoimmune fibroinflammatory disease, and isolated lung disease is a rare phenomenon. IgG4-RD frequently mimics primary pulmonary malignancy. It has been described in association with malignancies, including lung cancer, but it remains unclear if it increases the risk of malignancy. We report the case of a patient who had a left lower lobectomy after relapse while receiving corticotherapy. The pathological findings confirmed the diagnosis of IgG4-RD. After 2 months, the thoracic computerized tomography scan showed an important left pleural effusion that could be a consequence of the recent intervention or a relapse of IgG4-RD.
    MeSH term(s) Autoimmune Diseases ; Humans ; Immunoglobulin G ; Immunoglobulin G4-Related Disease/complications ; Immunoglobulin G4-Related Disease/drug therapy ; Lung Diseases/diagnostic imaging ; Lung Diseases/etiology ; Lung Diseases/surgery ; Neoplasm Recurrence, Local
    Chemical Substances Immunoglobulin G
    Language English
    Publishing date 2021-07-13
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 2095298-3
    ISSN 1569-9285 ; 1569-9293
    ISSN (online) 1569-9285
    ISSN 1569-9293
    DOI 10.1093/icvts/ivab162
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  10. Article ; Online: Effectiveness and safety of lenvatinib in a series of advanced well-differentiated thyroid carcinomas from a single tertiary cancer center and literature review.

    Damásio, Inês L / Figueiredo, Ana / Maciel, Joana / Horta, Mariana / Silva, Tiago N / Simões-Pereira, Joana / Donato, Sara / Leite, Valeriano

    Minerva endocrinology

    2024  

    Abstract: Background: Treatment of advanced differentiated thyroid carcinoma (DTC) remains a challenge as 25-50% of patients with locally invasive or distant metastatic disease become refractory to radioiodine (RAI) therapy. Tyrosine kinase inhibitors (TKI) are ... ...

    Abstract Background: Treatment of advanced differentiated thyroid carcinoma (DTC) remains a challenge as 25-50% of patients with locally invasive or distant metastatic disease become refractory to radioiodine (RAI) therapy. Tyrosine kinase inhibitors (TKI) are increasingly used in this setting. The SELECT trial demonstrated that lenvatinib, a multikinase inhibitor, significantly improved progression free survival (PFS) compared to placebo. Our aim was to report the effectiveness and safety of lenvatinib in our series of patients with advanced DTC.
    Methods: A total of 25 patients with advanced DTC followed at a single tertiary center from January of 2016 to January of 2022 were retrospectively reviewed.
    Results: Patients were treated with a mean daily dose of lenvatinib of 16.9 mg for a mean of 9.1 months. Median estimated PFS was 31.3 months. One patient achieved complete response. The objective response rate (ORR) was 40% and the disease control rate was 84%. The mean change in summed longest diameter of target lesions from baseline to nadir was -36.9%. Lenvatinib prolonged the tumor volume doubling time in 86.7% patients. Interestingly, we found that patients treated with a lower dose of lenvatinib (<16.9 mg daily) had a significantly higher PFS and ORR than patients treated with higher dosages (>16.9 mg). Adverse events were frequently reported.
    Conclusions: Our results confirm the effectiveness of lenvatinib in the management of patients with advanced DTC and support the need to adjust the dosage of lenvatinib to patient´s performance status and comorbidities.
    Language English
    Publishing date 2024-03-21
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 3062786-2
    ISSN 2724-6116
    ISSN (online) 2724-6116
    DOI 10.23736/S2724-6507.23.03982-9
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