Browsing by Author "Ramos, J"
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- Evolução da intervenção coronária percutânea entre 2004‐2013. Atividade em Portugal segundo o Registo Nacional de Cardiologia de IntervençãoPublication . Pereira, H; Teles, R; Costa, M; Silva, P; Ferreira, R; Ribeiro, V; Santos, R; Abreu, PF; Carvalho, H; Marques, J; Fernandes, R; Brandão, V; Martins, D; Drummond, A; Pipa, J; Seca, L; Calisto, J; Baptista, J; Matias, F; Ramos, J; Pereira-Machado, F; Silva, J; Almeida, M; Registo Nacional de Cardiologia de IntervençãoINTRODUCTION AND OBJECTIVES: The aim of the present paper is to report trends in Portuguese interventional cardiology from 2004 to 2013 and to compare them with other European countries. METHODS: Based on the Portuguese National Registry of Interventional Cardiology and on official data from the Directorate-General of Health, we give an overview of developments in coronary interventions from 2004 to 2013. RESULTS: In 2013, 36 810 diagnostic catheterization procedures were performed, representing an increase of 34% compared to 2007 and a rate of 3529 coronary angiograms per million population. Coronary interventions increased by 65% in the decade from 2004 to 2013, with a total of 13 897 procedures and a rate of 1333 coronary interventions per million population in 2013. Primary percutaneous coronary intervention (PCI) increased by 265% from 2004 to 2013 (1328 vs. 3524), an adjusted rate of 338 primary PCIs per million, representing 25% of total angioplasties. Stents were the most frequently used devices, drug-eluting stents being used in 73% in 2013. Radial access increased from 4.1% in 2004 to 57.9% in 2013. CONCLUSION: Interventional cardiology in Portugal has been expanding since 2004. We would emphasize the fact that in 2013 all Portuguese interventional cardiology centers were participating in the National Registry of Interventional Cardiology, as well as the growth in primary PCI and increased use of radial access.
- Feocromocitoma: a propósito de 3 casos clínicosPublication . Carvalho, R; Branquinho, F; Ramos, J; Carrasquinho, J; Manso, RT; Calado, J; Ferrito, F; Carmona, C
- Folie à deux: um caso de folie imposée numa díade mãe/filhoPublication . Nascimento, M; Ramos, J; Dindo, V; Ribeiro, RIntrodução: Embora a paternidade do conceito de delírio partilhado não seja consensual, a designação de folie à deux foi introduzida em 1877 por dois investigadores franceses – Lasègue e Falret. Segundo o conceito original, um indivíduo (indutor), cognitivamente dominante, desenvolve uma ideia delirante que progressivamente impõe a um segundo elemento (induzido), com quem mantém uma relação próxima. Os quatro subtipos psicopatológicos conhecidos – folie imposée, folie simultanée, folie communiquée e folie induite foram sendo descritos ao longo do final do séc. XIX, mas a sua classificação e respetiva conceptualização foi atribuída ao investigador americano Gralnick (1942). Objetivos, material e métodos: Pretende‑se com a apresentação de um caso clínico e respetiva revisão não sistemática da literatura, salientar algumas particularidades da entidade, perturbação delirante partilhada, relativamente à sua clínica, aspetos epidemiológicos e psicopatogénicos e abordagem terapêutica.Resultados: Reportou‑se um caso de delírio partilhado do tipo folie imposée numa díade mãe/filho. O elemento indutor (filho), afeto de perturbação bipolar e síndrome de Asperger, partilha com a mãe, sua cuidadora e elemento induzido, um delírio de conteúdo persecutório. Conclusões: Realça‑se a importância do isolamento social e do contacto próximo entre os dois elementos na génese da doença; discute‑se a questão da dominância cognitiva entre indutor e induzido e as implicações da separação da díade mãe/filho enquanto principal ação terapêutica preconizada.
- 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.
- Hérnia do desportista: avaliação dos resultados de 3 anos de experiênciaPublication . Ramos, J; Calado, J; Pinheiro, N
- Kraepelinian systematic paraphrenia as a recognizable disorderPublication . Borja-Santos, N; Trancas, B; Ferreira, B; Parente, J; Gamito, A; Almeida, S; Vieira, C; Luengo, A; Xavier, S; Klut, C; Graça, J; Ramos, J; Martins, M; Ribeiro, J; Neto, A; Palma, M; Luis, A; Cardoso, GObjectives: To demonstrate that systematic paraphrenia as defined by Kraepelin (the most consistent prototypic paraphrenia subtype) can be recognized and diagnosed. Subjects and methods: All patients admitted to a Portuguese psychiatric inpatient unit between September 2006 and October 2011, meeting the criteria for systematic paraphrenia based on Kraepelin’s definition, Munro’s operational criteria and the authors’ criteria, were evaluated by two senior psychiatrists. Results: Out of 27 evaluated patients, 16 (10 women and 6 men) were confirmed as having systematic paraphrenia, accounting for 0.83% of the total number of inpatients (1921). The mean age of onset was 34.3 years (SD = 8.9) and the mean duration of illness at observation was 19.5 years (SD = 12.3). Most (n = 13) had no family psychiatric history, were married (n = 11) before the onset of the disorder and none had previous sensorial deficit. Six were born outside of Portugal. Their academic achievements were only slightly inferior to the general population. Conclusions: Systematic paraphrenia can be recognized and diagnosed. Contrary to Kraepelin, the disorder seems to be more frequent in women. It does not seem to be associated with old age or heredity. This syndrome is internally consistent and its only similarity with schizophrenia is the positive symptoms’ dimension. It should also be distinguished from late paraphrenia.
- Neoplasias do intestino delgado: 10 anos de experiência num serviço de cirurgia geralPublication . Leichsenring, C; Ramos, J; Rocha, F; Sanchez, P; Geraldes, V; Calado, J; Pinheiro, N
- Pathways to Care for First Psychiatric Admissions in LisbonPublication . Ramos, J; Santos, J; Jorge, S; Maia, T; Cardoso, GOBJECTIVES:This report characterizes pathways to first psychiatric admission and describes their relationship to patients' sociodemographic and clinical features. METHODS: Eighty-four patients consecutively admitted for the first time in 2009-2010 to a Lisbon district psychiatric department were interviewed. Associations between pathways and clinical and sociodemographic variables were explored through univariate and multivariate analysis. RESULTS: Most patients (N=49, 58%) went directly to the psychiatric emergency department and were admitted, without contacting any other care providers. This pathway was significantly associated with male gender, involuntary admission, referral by a family member, fewer people per room in the household, and lower probability of previous contact with mental health services. CONCLUSIONS: The most striking feature was the high prevalence of direct access to the psychiatric emergency department with subsequent admission. Use of this direct pathway suggests that these patients were bypassing care filters, with negative consequences. Specific sociodemographic variables, but not diagnosis, were associated with filter bypass.
- Perturbações do espectro do autismo no adulto e suas comorbilidades psiquiátricasPublication . Ramos, J; Xavier, S; Morins, MAs perturbações do espectro do autismo (PEA) no adulto, ao contrário do que tem vindo a acontecer na população infantil, não têm sido tão extensamente estudadas, o que se reflecte em dificuldades no diagnóstico e tratamento de doentes nesta faixa etária, principalmente na presença de comorbilidade psiquiátrica. Os autores fazem uma revisão selectiva da literatura, debruçando‑se com maior detalhe sobre aspectos da definição das PEA, sua epidemiologia, diagnóstico e factores que determinam o outcome no adulto. Abordar‑se‑ão posteriormente as principais comorbilidades psiquiátricas no adulto e a forma como a patologia de base modula a sua apresentação clínica. Apesar da tendência para uma melhoria global da sintomatologia na idade adulta, estas patologias acompanham o indivíduo ao longo do seu ciclo de vida. Para além disso, estima‑se que afectem uma proporção considerável de doentes, o que torna ainda mais premente a necessidade de conhecer estas patologias de forma mais aprofundada.
- Phenotype-genotype profiles in Crohn's disease predicted by genetic markers in autophagy-related genes (GOIA study II).Publication . Durães, C; Machado, J; Portela, F; Rodrigues, S; Lago, P; Cravo, M; Ministro, P; Marques, M; Cremers, I; Freitas, J; Cotter, J; Tavares, L; Matos, L; Medeiros, I; Sousa, R; Ramos, J; Deus, JR, et al.BACKGROUND: About 70 loci are associated with susceptibility to Crohn's disease (CD), particularly in pathways of innate immunity, autophagy, and pathogen recognition. Phenotype-genotype associations are inconsistent. METHODS: CD susceptibility polymorphisms ATG16L1 rs2241880, ICAM1 rs5498, IL4 rs2070874, IL17F rs763780, IRGM rs13361189, ITLN1 rs2274910, LRRK2 rs11175593, and TLR4 rs4986790 were genotyped in a Portuguese population (511 CD patients, 626 controls) and assessed for association with CD clinical characteristics. RESULTS: There is a significant association of CD with the single nucleotide polymorphisms (SNPs) in ATG16L1 (odds ratio [OR] 1.36 [1.15-1.60], P = 2.7 × 10(-6) for allele G), IRGM (OR 1.56 [1.21-1.93], P = 3.9 × 10(-4) for allele C), and ITLN1 (OR 1.55 [1.28-1.88], P = 4.9 × 10(-4) for allele C). These SNPs are associated with ileal location (OR, respectively, 1.49, 1.52, and 1.70), ileocolonic location (OR, respectively, 1.31, 1.57, and 1.68), and involvement of the upper digestive tract (OR, respectively for ATG16L1 and IRGM, 1.96 and 1.95). The risk genotype GG in ATG16L1 is associated with patients who respond to steroids (OR 1.89), respond to immunosuppressants (OR 1.77), and to biologic therapy (OR 1.89). The SNPs in ITLN1 and IRGM are both associated with a positive response to biologic therapy. The risk for ileal, ileocolonic, and upper digestive tract locations increases with the number of risk alleles (OR for three alleles, respectively, 7.10, 3.54, and 12.07); the OR for positive response to biologic therapy is 3.66. CONCLUSIONS: A multilocus approach using autophagy-related genes provides insight into CD phenotype-genotype associations and genetic markers for predicting therapeutic responses.