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Browsing by Author "Dutschmann, R"

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  • Abordagem multidisciplinar de lesão esplénica: um desafio diagnóstico
    Publication . Gomes, F; Schmitt, W; Branco, J; Aparício, D; Ferreira, M; Dutschmann, R
    2015Conference object Restricted access Show more
  • Análise dos reinternamentos precoces num serviço de medicina
    Publication . Gomes, F; Faustino, A; Dutschmann, R; Louro, F
    2012Conference object Restricted access Show more
  • Iatrogenia rara ao alopurinol
    Publication . Branco, J; Gomes, AF; Dutschmann, R; Dutschmann, L
    Existem raríssimos casos citados de granulomas da medula óssea por iatrogenia ao alopurinol. Os granulomas são um achado raro nas biópsias da medula óssea e podem ter várias etiologias, nomeadamente infeciosas, neoplásicas, autoimunes, iatrogénicas ou sarcoidose. Na ausência de características patognomónicas, recorre-se à integração de dados clínicos, laboratoriais, imagiológicos e histológicos para estabelecer o diagnóstico. Descrevemos o caso de um caucasiano, 59 anos, referenciado à consulta de Medicina por gota úrica, tendo sido medicado com alopurinol e colchicina. Ao longo do seguimento surgiram anemia e trombocitopenia. Do estudo por mielograma e biópsia osteomedular salientavam-se “numerosos granulomas de tipo epitelióide, sem células multinucleadas, sem identifica- ção de microrganismos PAS pós diástase ou Ziehl-Neelsen, sem neoplasia, compatível com mielite granulomatosa”. A etiologia estabelecida foi a de reação de hipersensibilidade ao alopurinol pelo que foi descontinuado. Repetido o exame um ano depois, não se observaram granulomas, facto que reforçou a hipótese diagnóstica.
    2015Journal article Open access Show more
  • Secular Trends in the Mortality by Cerebrovascular Diseases in Portugal: 1902-2012
    Publication . Ramalheira, C; Gonçalves, A; Gomes, F; Dutschmann, R; Gusmão, R
    Introduction: Cerebrovascular diseases (CVD) are one of the main causes of death in Portugal. Research on the epidemiologic history might help to understand the phenomenon and guide intervention strategies. Objectives: (1) Describe historic trends in mortality. (2) Estimate the impact of demographic variations on the registered number of cases. Methods: (1) We calculated rates, specific and standardized, for deaths registered as CVD (ICD-10: I60-I69, G45; ICD8/9: 430-438; ICD-6/7: 330-334) by sex (1902-2012) and by sex and age groups (1913-2012). We used Join point analysis to identify statistically significant changes in standardized death rates, and multivariate regression models, Poisson and negative binomial, controlling for demographic dynamics and time trend, from 1913 to 2012. (2) We calculated the contribution of demographic variations using the application RiskDiff. (3) We evaluated if changes in coding rules might have been a source of bias. Data source: National Institute of Statistics. Results: (1) We gathered the longest and most discriminated mortality series from CVD in Portugal with data since the beginning of nationwide collection. Mortality increases exponentially with age and is higher in men. (2) We observed significant variations in age-standardized time trends (1913-1933: APC 2.0%; 1933-1955: APC -0.9%; 1955-1974: 2.9%; 1974- 1996: -2.4%; 1996-2012: -6.5%). (3) Population ageing exerted a significant pressure to increase the number of deaths, particularly in the second half of the twentieth century. However, this effect was counterweighted by protective factors. Conclusion: CVD mortality in Portugal is particularly expressive when compared to other European countries, although significant gains have been observed in the last decades. Population ageing combined with a transition between the morbid and mortality dimensions changed the public health paradigm.
    2020Journal article Open access Show more
  • 2014Conference object Open access Show more