Browsing by Author "Almeida, J"
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- Anatomia cirúrgica do osso temporalPublication . Domingues, J; Mendonça, F; Almeida, J; Pereira, S; Sousa, MT, rev.
- Direct application of the INNO-LiPA Rif.TB line-probe assay for rapid identification of Mycobacterium tuberculosis complex strains and detection of rifampin resistance in 360 Mycobacterium tuberculosis complex strains and detection of rifampin resistance in 360 smear-positive respiratory specimens from an area of high incidence of multidrug-resistant tuberculosisPublication . Viveiros, M; Leandro, C; Rodrigues, L; Almeida, J; Bettencourt, R; Couto, I; Carrilho, L; Diogo, J; Fonseca, A; Lito, L; Lopes, J; Pacheco, T; Pessanha, M; Quirim, J; Sancho, L; Salfinger, M; Amaral, LThe INNO-LiPA Rif.TB assay for the identification of Mycobacterium tuberculosis complex strains and the detection of rifampin (RIF) resistance has been evaluated with 360 smear-positive respiratory specimens from an area of high incidence of multidrug-resistant tuberculosis (MDR-TB). The sensitivity when compared to conventional identification/culture methods was 82.2%, and the specificity was 66.7%; the sensitivity and specificity were 100.0% and 96.9%, respectively, for the detection of RIF resistance. This assay has the potential to provide rapid information that is essential for the effective management of MDR-TB.
- Effective treatment with clozapine and valproate for refractory schizophrenia-like psychosis after cerebellar hemorrhagePublication . Almeida, J; Serrão, E; Almeida, A; Afonso, JBackground: The cerebellum has traditionally been regarded as an organ of motor coordination. However, the importance of the cerebellum in psychiatric disorders, behavior, and cognition is increasingly being recognized. There is no consensus concerning treatment of schizophrenia-like psychosis after cerebellar pathology. Reports describe the use of several antipsychotics, either alone or in combination with antidepressants or lithium. Clozapine is used for the treatment of refractory schizophrenia, but there are no reports of its use in the abovementioned situation. Case Presentation: We report the case of a 20-year-old woman who developed a schizophrenia-like psychosis after rupture of arteriovenous malformation at 13 years of age. The psychotic symptoms proved to be resistant to treatment, and several psychopharmacological schemas were tried. The clinical picture only showed consistent improvement with the combined use of clozapine and valproate. Conclusions: The relationship between chronic psychosis and cerebellar pathology remains poorly understood. Cases like the present one suggest that clozapine and valproate may be used safely and effectively in refractory schizophrenia-like psychosis associated with cerebellar pathology.
- Fisiologia de atletas de trampolins de alta competição portugueses ou a fibra que promove campeõesPublication . Longo, C; Costa, R; Chilumbo, A; Pardal, C; Almeida, JOs resultados desportivos excelentes a nível internacional dos atletas de trampolins levaram-nos a proceder a um estudo de modo a avaliar quais as suas características principais a nível fisiológico para o sucesso nesta modalidade. O que diferencia os atletas de elite (europeu e mundial) de trampolim dos atletas de nível distrital da mesma modalidade. Com esses objectivos estudámos 17 atletas de trampolins de alta competição (AC) e comparámo-los com 10 atletas de modalidades gímnicas mas de nível distrital (grupo de controlo). Estudámos o metabolismo aeróbico e anaeróbico (láctico e aláctico ). Realizamos para o efeito prova de esforço máxima em ciclo ergómetro com carga inicial de 1 watt/kg de peso e incrementos todos os 2 minutos. Calculámos a potência aeróbica máxima (PAM) através da fórmula proposta por VAGO. Retirámos sangue para lactatos no final do esforço (LM) e aos 3 minutos de recuperação (LR). Para avaliação do metabolismo anaeróbico aláctico utilizámos o teste de impulsão vertical e seguidamente através da fórmula de Lewis calculámos a potência anaeróbica aláctica (P Alact). Fizemos análise de variância e estudo de coeficientes parciais de correlação através de regressão linear múltipla. Os atletas de alta competição (AC) tinham idades médias de 18,7 +/- 2.54 anos e o grupo de controlo de 16,7 +/- 2.06. No AC 7 atletas eram do sexo feminino (F) e 10 do sexo masculino (M); o grupo de controlo eram 4 do sexo feminino e 6 do sexo masculino.Trampolim AC Controlo P VO2max (l) 3,2 +/- 0.62 3,07 +/- 0.66 NS PAM (W) 236,09 +/- 49.24 225,52 +/- 52.58 NS LM (mmol/l) 8,75 +/- 1.75 6,64 +/- 2.35 <0.05 LR (mmol/l) 8,32 +/- 1.72 5,83 +/- 1.89 <0.05 PAlact (W) 106,66 +/- 22.58 90,81 +/- 13.84 <0.05 Conclusão: Encontrámos diferenças com significado estatístico nos 2 componentes do metabolismo anaeróbico entre os 2 grupos estudados. Os atletas de trampolins de alta competição têm uma taxa mais elevada de metabolismo anaeróbico láctico o que certamente terá a ver com prestação desportiva de alto nível.
- Hepatite C em toxicodependentes: acompanhamento e acesso à terapêuticaPublication . Castro, R; Valente, C; Ramos, J; Almeida, J; Marinho, R; Branco, T; Andrade, S; Macedo, AA hepatite C constitui, actualmente, um grave problema de saúde pública. Estima-se que existam, em todo o mundo, 180 milhões de pessoas com infecção crónica por vírus da hepatite C (VHC) e que a sua prevalência na população portuguesa varie entre 1 e 1,5%. Em Portugal, não existem normas de orientação actualizadas de tratamento, nem recomendações para o diagnóstico e acompanhamento dos doentes com VHC e, em particular, para os UDEVs. O presente artigo reúne informação de consenso relativa à de prática clínica e propõe algumas orientações para o acompanhamento e acessibilidade ao tratamento dos doentes toxicodependentes com infecção crónica por VHC, em Portugal.
- Non-AIDS-related comorbidities in people living with HIV-1 aged 50 years and older: The AGING POSITIVE study.Publication . Serrão, R; Piñero, C; Velez, J; Coutinho, D; Maltez, F; Lino, S; Sarmento, E; Castro, R; Tavares, AP; Pacheco, P; Lopes, MJ; Mansinho, K; Miranda, AC; Neves, I; Abreu, R; Almeida, J; Pássaro, LOBJECTIVE: To characterize the profile of non-AIDS-related comorbidities (NARC) in the older HIV-1-infected population and to explore the factors associated with multiple NARC. METHODS: This was a multicentre, cross-sectional study including HIV-1-infected patients aged ≥50 years, who were virologically suppressed and had been on a stable antiretroviral therapy (ART) regimen for at least 6 months. A multiple regression model explored the association between demographic and clinical variables and the number of NARC. RESULTS: Overall, 401 patients were enrolled. The mean age of the patients was 59.3 years and 72.6% were male. The mean duration of HIV-1 infection was 12.0 years and the median exposure to ART was 10.0 years. The mean number of NARC was 2.1, and 34.7% of patients had three or more NARC. Hypercholesterolemia was the most frequent NARC (60.8%), followed by arterial hypertension (39.7%) and chronic depression/anxiety (23.9%). Arterial hypertension and diabetes mellitus were the most frequently treated NARC (95.6% and 92.6% of cases, respectively). The linear regression analysis showed a positive relationship between age and NARC (B=0.032, 95% confidence interval 0.015-0.049; p=0.0003) and between the duration of HIV-1 infection and NARC (B=0.039, 95% confidence interval 0.017-0.059; p=0.0005). CONCLUSIONS: A high prevalence of NARC was found, the most common being metabolic, cardiovascular, and psychological conditions. NARC rates were similar to those reported for the general population, suggesting a larger societal problem beyond HIV infection. A multidisciplinary approach is essential to reduce the burden of complex multi-morbid conditions in the HIV-1-infected population.