Browsing by Author "Carvalho, M"
Now showing 1 - 6 of 6
Results Per Page
Sort Options
- A 3-month-old baby with H1N1 and Guillain-Barré syndromePublication . Vasconcelos, A; Abecasis, F; Monteiro, R; Camilo, C; Vieira, M; Carvalho, M; Correia, MMajority of children with pandemic influenza A (H1N1)pdm09 experience mild illness with full recovery without treatment. A previously healthy two and a half month-old girl was admitted to our paediatric intensive care unit because of severe respiratory failure with A (H1N1)pdm09 infection. Despite initial clinical improvement all attempts to extubate to non-invasive ventilation were unsuccessful and 2 to 3 weeks after symptom onset she started periods of cardiovascular instability and a progressive neurological deterioration with distal symmetrical progressive motor weakness and areflexia. All investigations were normal except elevated liver enzymes and cerebrospinal fluid examination that revealed elevated protein without pleocytosis. A possible diagnosis of Guillain-Barré syndrome (GBS) was considered and electromyogram was compatible with axonal form of GBS. To our knowledge this is the youngest case of GBS acquired postnatally and the first in children associated with H1N1 virus.
- Epilepsia e comorbilidades psiquiátricasPublication . Araújo, A; Carvalho, MIntrodução: A epilepsia é uma doença neu- rológica crónica prevalente. Devido a fatores biológicos, psicológicos e sociais, os afetados pela doença apresentam maior susceptibili- dade de desenvolvimento de morbilidades psi- quiátricas. Objetivos: Revisão crítica da associação entre epilepsia e patologia psiquiátrica, permitindo aos clínicos uma abordagem mais consciente e informada. Métodos: Os artigos incluídos foram selec- cionados através da base de dados Pubmed com a query “((“Epilepsy”[Mesh]) AND “Mental Disorders”[Mesh]) AND “Comor- bidity”[Mesh]”. Adicionalmente foram con- sultados relatórios oficiais da Internacional League Against Epilepsy e World Health Or- ganization. Resultados e Conclusões: Cerca de 15% a 70% dos doentes com epilepsia apresentam patologia psiquiátrica, que pode ser classifi- cada em peri-ictal ou inter-ictal. A depressão é a patologia mais frequente, podendo ter uma prevalência de 70%, seguida das pertur- bações de ansiedade. A relação entre epilepsia e psicose poderá dever-se ao papel etiológico comum da patologia cerebral subjacente. As crises não epiléticas psicogénicas configuram um desafio diagnóstico e terapêutico, tendo uma apresentação clínica sugestiva de cri- ses epiléticas mas sem as alterações eletro- fisiológicas correspondentes, podendo surgir em doentes com e sem epilepsia. Apesar da sua heterogeneidade, os diferentes estudos globalmente evidenciam uma prevalência aumentada de patologia psiquiátrica em doentes com epilepsia. A natureza da relação entre estas patologias ainda não está inequi- vocamente esclarecida, revelando a insufi- ciência de conhecimento sobre esta temática. O presente trabalho reforça a necessidade da intervenção multidisciplinar por parte da neurologia, psiquiatria e psicologia, em indi- víduos com epilepsia e patologia psiquiátrica concomitante.
- Hemorragia pós-partoPublication . Carvalho, M; Rodrigues, M
- Mutations of the GLA gene in young patients with stroke: the PORTYSTROKE study-screening genetic conditions in Portuguese young stroke patientsPublication . Baptista, V; Ferreira, S; Pinho-e-Melo, T; Carvalho, M; Cruz, V; Carmona, C; Silva, F; Tuna, A; Rodrigues, M; Ferreira, C; Pinto, A; Leitão, A; Gabriel, J; Calado, S; Oliveira, J; Ferro, JBACKGROUND AND PURPOSE: Fabry disease is an X-linked monogenic disorder caused by mutations in the GLA gene. Recent data suggest that stroke in young adults may be associated with Fabry disease. We aimed to ascertain the prevalence of this disorder among young adult patients with stroke in Portugal by GLA genotyping. METHODS: During 1 year, all patients aged 18 to 55 years with first-ever stroke, who were admitted into any of 12 neurology hospital departments in Portugal, were prospectively enrolled (n=625). Ischemic stroke was classified according to Trial of Org 10172 in Acute Stroke Treatment criteria. Alpha-galactosidase activity was further assayed in all patients with GLA mutations. RESULTS: Four hundred ninety-three patients (mean age, 45.4 years; 61% male) underwent genetic analyses: 364 with ischemic stroke, 89 with intracerebral hemorrhage, 26 with subarachnoid hemorrhage, and 14 with cerebral venous thrombosis. Twelve patients had missense GLA mutations: 9 with ischemic stroke (p.R118C: n=4; p.D313Y: n=5), including 5 patients with an identified cause of stroke (cardiac embolism: n=2; small vessel disease: n=2; other cause: n=1), 2 with intracerebral hemorrhage (p.R118C: n=1; p.D313Y: n=1), and one with cerebral venous thrombosis (p.R118C: n=1). Leukocyte alpha-galactosidase activity was subnormal in the hemizygous males and subnormal or low-normal in the heterozygous females. Estimated prevalence of missense GLA mutations was 2.4% (95% CI, 1.3% to 4.1%). CONCLUSIONS: Despite a low diagnostic yield, screening for GLA mutations should probably be considered in different types of stroke. Restricting investigation to patients with cryptogenic stroke may underestimate the true prevalence of Fabry disease in young patients with stroke.
- Normal Ultrasound Anatomy and Common Anatomical Variants of the Thyroid Gland Plus Adjacent Structures - A Pictorial ReviewPublication . Germano, A; Schmitt, W; Carvalho, M; Marques, RHigh-resolution ultrasound is considered the best imaging technique for evaluating the thyroid gland, as it is accessible, non-invasive, and highly sensitive concerning the detection and characterization of thyroid nodules. However, a background knowledge of the normal ultrasound anatomy of the thyroid gland, adjacent structures, and its anatomical variants is crucial to avoid misdiagnosis in daily practice. Through this pictorial review, we intend to.
- Strong nocebo effect in amyotrophic lateral sclerosis trials might mask conclusions.Publication . Rato, M; Duarte, G; Mestre, T; Carvalho, M; Ferreira, J