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ABSTRACT Objective: To assess predictive factors for improved diagnostic accuracy with the use of radial-probe EBUS (RP-EBUS). Methods: This was a retrospective review of consecutive patients undergoing RP-EBUS between February of 2012 and January of 2020. Parameters including the presence of a bronchus sign on CT scans, the position of the radial EBUS probe, lesion size, lesion location, and lesion type were analyzed in relation to two defined outcomes (final diagnosis or no diagnosis). Univariate analysis was used in order to explore the individual effects of each parameter on diagnostic accuracy. Multivariate logistic regression was performed to identify significant predictors of diagnostic accuracy. Results: RP-EBUS was used for diagnostic purposes in 101 patients. The lesion was < 3 cm in size in 59 patients (58.4%) and predominantly solid in 60.3%. There was a positive correlation between radial EBUS probe position and diagnostic accuracy (p = 0.036), with 80.9% of the patients showing a bronchus sign on CT scans. Furthermore, 89% of the patients showed a bronchus sign on CT scans and a correlation with diagnostic accuracy (p = 0.030), with 65.8% of the lesions being located in the left/right upper lobe (p = 0.046). When the radial EBUS probe was within the target lesion, the diagnostic yield was = 80.8%. When the probe was adjacent to the lesion, the diagnostic yield was = 19.2%. A bronchus sign on CT scans was the only parameter that independently influenced diagnostic accuracy (adjusted OR, 3.20; 95% CI, 1.081-9.770; p = 0.036). Conclusions: A bronchus sign on CT scans is a powerful predictor of successful diagnosis by RP-EBUS.

Resumén Las amiloidosis son un grupo poco común de enfermedades que resultan de la deposición extracelular de amiloide, un material fibrilar derivado de varias proteínas precursoras que se autoensamblan con una conformación de hoja β cruzada anormal altamente ordenada. Los autores presentan el caso de una mujer de 76 años con anemia y deterioro de la función renal, que desarrolla lesiones nodulares intermitentes en la lengua y lesiones hemorrágicas en la mucosa oral. El estudio etiológico permitió el diagnóstico de amiloidosis de cadenas ligeras. Abstract The amyloidoses are a rare group of diseases that result from extracellular deposition of amyloid, a fibrillar material derived from various precursor proteins that self-assemble with highly ordered abnormal cross β-sheet conformation. The authors present the case of a 76-year-old woman with anemia and worsening of renal function, who develops intermittent nodular lesions on the tongue and hemorrhagic lesions on the oral mucosa. The etiological study allowed the diagnosis of light chain amyloidosis.

Resumén Los quistes ováricos son una condición muy común en mujeres, alrededor del 7% de las mujeres reportan tener un quiste ovárico en algún momento de su vida.1 Presentamos el caso de una mujer de 78 años, referida a nuestra consulta para el estudio de la ascitis. La TC abdominopélvica reveló un tumor quístico ovárico masivo, que fue sometido a cirugía y drenaje de aproximadamente 30L (40Kg). Abstract Ovarian cysts are a very commonly encountered condition in females, about 7% of women are reported to have an ovarian cyst at any point in their life.1 We present the case of a 78-year-old woman, referred to our consult for the study of ascites. The Abdominal-pelvic CT revealed a massive ovarian cystic tumor, that was submitted to surgery and drainage of approximately 30L (40Kg).

Weber-Christian disease is a skin condition that features recurring inflammation in the subcutaneous fat layer and systemic symptoms. The disease is a diagnosis of exclusion characterized by a lobular panniculitis without vasculitis in histopathology. The authors report a 80-year-old man with constitutional symptoms and relapsing nonsuppurative nodular panniculitis. The purpose of the case described is to emphasize that rare diseases may occur, therefore their diagnosis can only be made with previous medical knowledge and the delay, or even the absence, in the diagnosis of these pathologies could interfere with the quality of life of patients.

Os cuidados de saúde apresentam uma complexidade crescente. Face à diversidade de novas tecnologias e fármacos disponíveis, é essencial uma abordagem por uma equipa multidisciplinar para que esses cuidados possam ser optimizados e os riscos possam ser minimizados.

Spondylodiskitis is a rare condition in adults but with high index of morbidity and mortality due to difficult diagnosis. The insidious evolution and the unspecificity of symptoms interfere with prompt treatment, being the diagnosis based primarily on a high index of suspicion. There are two major groups of spondylodiskitis: pyogenic, being Staphylococcus aureus the most frequent etiological pathogen, and granulomatous, caused mainly by Mycobacterium tuberculosis and Brucella melitensis, both endemic in Portugal. The authors describe two clinical cases of spondylodiskitis, where the etiological investigation proved a challenge. In both cases the combination of clinical and imagiological data contributed to the appropriate empirical treatment, with a favorable clinical outcome.

A presente reunião de reflexão teve como objectivo debater aspectos referentes à realidade portuguesa no âmbito do diagnóstico e tratamento de doentes com sarcomas. Durante a reunião foram apresentados dados relativos à doença, foram identificadas potenciais vantagens e riscos do tratamento farmacológico e foram debatidos vários aspectos relativos à abordagem dos sarcomas em Portugal. Todos os intervenientes participaram activamente na reunião com apresentações formais pré-concebidas para o efeito ou contribuindo com a sua opinião. Este documento foi objecto de parecer por parte dos participantes na reunião, sendo a sua redacção final resultado de um extenso processo de consulta com o objectivo de obter um texto no qual todos os participantes se revissem.