Browsing by Author "Costa, C"
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- An Adult with Episodic Abnormal Limb PosturingPublication . Santos, M; Rebordão, L; Leitão, L; Costa, C; Lobo, P
- Breve história da transfusão: transfusão de concentrado eritrocitário no doente críticoPublication . Costa, CA anemia é um problema comum no doente internado numa UCI. Surge nos primeiros dias e pode manter-se ou agravar-se durante o internamento. A sua etiologia é multifactorial e o tratamento mais utilizado é a transfusão de concentrado de eritrócitos. Cerca de 40 a 50% 1 de todos os doentes internados em UCI recebem, pelo menos uma unidade de concentrado eritrocitário e em média perto de 5 unidades durante o seu internamento. Estima-se que um terço de todos os doentes admitidos em UCI é transfundido com o objectivo principal, na maioria dos casos, de melhorar o transporte de oxigénio. A transfusão de componentes sanguíneos acarreta riscos 1,2,3,4 e há pouca evidência que a transfusão habitual de CE seja benéfica para o doente crítico com anemia hemodinâmicamente estável 3 . Foi feita uma revisão de alguma literatura existente sobre este tema dos últimos 15 anos com o objectivo de obter guidelines simples e práticos para uma melhor prática transfusional, adequada à nossa prática clínica, tentando assim ser mais racional no uso de componentes sanguíneos e evitando a exposição do doente aos efeitos adversos da transfusão, como o risco de infecção e de imunomodelação. A pesquisa foi realizada através da internet: Medline, PubMed, Medsacape, eMedicine através da Univadis, com as palavras-chave: transfusão, eritrócitos, anemia, doente crítico, trauma e guidlines. Foi feita também consulta em livros de texto. A revisão bibliográfica demonstra, entre outros resultados, que não há benefícios numa estratégia “liberal” de transfusão (Hb <10g/dl) em doentes críticos sob ventilação mecânica, em comparação com uma estratégia “restritiva” transfusional (Hb <7g/dl) 2. A estratégia “restritiva” transfusional é tão eficaz quanto a estratégia “liberal” num doente crítico anémico hemodinâmicamente estável, à excepção, possivelmente, do doente com isquémia do miocárdio. A revisão bibliográfica também refere o uso de várias alternativas à transfusão de CE, já utilizadas actualmente, como a eritropoietina e outras ainda em estudo.
- Carta ao Editor. Urticária em Serviço de Urgência: Recomendações para Abordagem Diagnóstica e TerapêuticaPublication . Costa, C; Gonçalo, M; GPEU – Grupo Português de Estudos de Urticária; Sokolova, A, et al.
- A case of Birt-Hogg-Dubé syndromePublication . Martins, L; Caixeiro, M; Costa, C; Feijó, S; Bárbara, C
- Casuistic of related blood donations incidents in HPFF Blood DepartmentPublication . Barra, A; Barradas, A; Gil, A; Costa, C; Silva, I; Rebelo, S; Simões, A; Rodrigues, T; Moura, H; Santos, L; Soares, FBackground Related blood donations incidents (RBDI) have to be reported to the Portuguese Haemovigilance Blood Group since de last year. In our department we have a manual system of incidents registration since 2006. We understand how is important the analysis of this data to prevent future incidents. Aims We want in some way to share our results aimed a better prevention of this incidents. Methods Data of RBDI between March of 2006 and December of 2009. This register include date, ID, age, sex, weight, time of incidents in relation to donation, donation status (first-time vs. repeat), type of incidents, the time window between last meal and donation. Measures to ease RBDI, past donor history and haemoglobin value before donation (g/dl). Results Between March of 2006 and December of 2009 we have registered 122 (0.60%) RDBI, in a total of 20067 allogeneic donations, 68.58% donations from men and 31.42% from women. RBDI were 70 in men (0.50% of male donations) and 52 in women (0.82% of female donations). The age of studied donors ranged between 19 and 62 ears old with an average of 32.21 ears (19-30 - 34.43%; 31-40 - 25,4%; 41-50 - 16,4%; 50-62 - 13,1%) . The average of weight was 70.1 Kilos. We found 96.2% of early RBDI (< 1h) and 3.8% were late (> 1h). RBDI was verified in 20 first time donors, 61 in donors who have donated less than 5 times and 41 in donors with more than 5 donations. What concern to past donor history 18 (14.75%) of blood donors that had RBDI tell us that they already have at least one BDI in past blood donations. We had to interrupted blood donation in 4 (3.27%) occasions. Hb average was 14.29 g/dl. In the first 6 months of the year RBDI are about half of those in the second semester. In most cases the RBDI happened within 10 minutes after initiation of blood donation and the last food intake occurred on average 1.5 hours prior to donation. Signs and symptoms. Most RBDI reversed with simple procedures (Trendelemburg donor position, drinking a sweet juice or water and heating of some biscuits). We didn’t find severe RDBI. Summary/conclusions In conclusion we can say that in our study most frequent RBDI were non-severe (vasovagal reaction), RBDI are few (~1/200 donations). RBDI were more frequent in young people. Early RBDI are more frequent than late. It seems that women are more likely to have BDI. We have not found a direct relationship between the level of Hb and RBDI. We found a relationship between the donations and the seasons, and in the warmer seasons there is a greater tendency to be RDBI. Probably in future we have to take steps to prevent RDBI.
- Crosstalk between genetics, gene expression and biochemical markers supports systemic iron homeostasis dysregulation in alzheimer diseasePublication . Crespo, A; Silva, B; Ferreira, C; Marquesa, L; Marcelino, E; Maruta, C; Costa, S; Timóteo, A; Vilares, A; Couto, F; Faustino, P; Correia, AP; Verdelho, A; Porto, G; Guerreiro, M; Herrero Valverde, A; Costa, C; Mendonça, A; Costa, L; Martins, M
- Cytomegalovirus (CMV) and transfusion therapy: prevalence of cmv seropositivity in a portuguese blood donor population (2007-2014)Publication . Cardoso, E; Lichtner, A; Barra, A; Costa, C; Plácido, C; Nunes, C; Ferreira, M; Rebelo, S; Santos, C; Mota, MBackground: Cytomegalovirus (CMV or human herpesvisrus-5) is a common infection and not clinically significant in immunocompetent individuals. It’s the most important herpesvirus with reference to transfusion and, as all human herpesvirus, has the capability to lie dormant in tissues after an acute infection. The risk of CMV infectivity is still a major problem in immunocompromised patients requiring transfusion therapy, and should be minimized in CMV-negative pregnant women, fetuses, premature infants and neonats, transplant recipients and other severely immunosuppressed patients. The residual risk of transfusion-transmitted CMV infection is between 2.3% and 3% for leucocyte-reduced blood components, and the additional use of anti-CMV screened blood components decreases this risk to less than 1%, which, in our point of view, justifies the non-abandonment of CMV-seronegative blood bank inventories, especially in high prevalent populations. There is substantial variation in the donor rates of CMV seropositivity described in the literature (20-95%) and it seems to be inversely related to improved hygiene and living conditions. The same principle applies to the seroconversion rate per year. Aims: To determine the prevalence of CMV seropositivity and CMV seroconversion rate per year in a Portuguese blood donor population over an eight-year period of time (2007-2014), and compare it to those mentioned in other studies. Methods: Blood samples from donors were analyzed during the period 2007-2014 (8 years), and tested for detection of anti-CMV antibodies (‘total’ anti-CMV ELISA-based assays, capable of detecting both IgG and IgM class antibodies- Siemens Enzygnost® Anti-CMV/IgG+IgM), as they belonged to a first-time or to a previously tested CMV-seronegative donor. The prevalence of CMV seropositivity and the seroconversion rate per year were retrospectively determined among this blood donors population. Results: A total of 42.286 blood collections were analyzed. The prevalence of CMV infection was determined for each year: 2007 – 86.4%; 2008 – 87,2%; 2009 – 86.5%; 2010 – 88.9%; 2011 – 90.2%; 2012 – 89.7%; 2013 – 91,3%; 2014 – 89,4%. The CMV seroconversion rate per year was 1.43% (average age of seroconversion 36.4 years old; 81.8% men and 18,2% women). Summary/Conclusions: All blood components transfused in Portugal are leucocyte-reduced. We try to provide CMV seronegative blood components to all patients in high risk CMV infection, even in a high prevalent population as ours. The existence of CMV-seronegative blood bank inventories does not reflect practice countrywide, but is still important for some high-risk groups of patients, and allows us to respond to the needs of our hospital and other institutions (whenever possible).
- Decrease in APP and CP mRNA expression supports impairment of iron export in Alzheimer's disease patientsPublication . Guerreiro, C; Silva, B; Crespo, A; Marques, L; Costa, S; Timóteo, A; Marcelino, E; Maruta, C; Vilares, A; Matos, M; Couto, F; Faustino, P; Verdelho, A; Guerreiro, M; Herrero Valverde, A; Costa, C; Mendonça, A; Martins, M; Costa, LAlzheimer's disease (AD) is a neurodegenerative disorder of still unknown etiology and the leading cause of dementia worldwide. Besides its main neuropathological hallmarks, a dysfunctional homeostasis of transition metals has been reported to play a pivotal role in the pathogenesis of this disease. Dysregulation of iron (Fe) metabolism in AD has been suggested, particularly at the level of cellular iron efflux. Herein, we intended to further clarify the molecular mechanisms underlying Fe homeostasis in AD. In order to achieve this goal, the expression of specific Fe metabolism-related genes directly involved in Fe regulation and export was assessed in peripheral blood mononuclear cells (PBMCs) from 73AD patients and 74 controls by quantitative PCR. The results obtained showed a significant decrease in the expression of aconitase 1 (ACO1; P=0.007); ceruloplasmin (CP; P<0.001) and amyloid-beta precursor protein (APP; P=0.006) genes in AD patients compared with healthy volunteers. These observations point out to a significant downregulation in the expression of genes associated with ferroportin-mediated cellular Fe export in PBMCs from AD patients, when compared to controls. Taken together, these findings support previous studies suggesting impairment of Fe homeostasis in AD, which may lead to cellular Fe retention and oxidative stress, a typical feature of this disease.
- O enfermeiro e a laqueação de varizes esofágicasPublication . Pereira, A; Coelho, AP; Rodrigues, C; Costa, C; Carreteiro, MO conceito de enfermeiro endoscopista ainda é recente, estando ligado em grande parte ao desenvolvimento das técnicas de diagnóstico e terapêutica em Gastroenterologia. A sua diversificação e complexidade tem vindo a reforçar o contributo do enfermeiro nesta área. Nesse sentido é da maior importância que se acompanhe esta evolução através da actualização de conhecimentos teóricos e práticos que se traduzam num desempenho eficaz e de qualidade.
- Estudo de utilização de albumina humana 20% no Hospital Fernando FonsecaPublication . Afonso, R; Costa, C; Elias, C; Fernandes, J; Ferreira, A; Jesus, S; Oliveira, C; Oliveira, I; Oliveira, MJ; Prata, A; Almeida, P