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Browsing by Author "Ribeiro, A"

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  • Caracterização e intervenção na fase prodrómica da psicose
    Publication . Ribeiro, A; Borges, G
    As autoras fazem uma revisão da caracterização e intervenção na fase prodómica da psicose de acordo com alguns grupos de trabalho empenhados no estudo dos modelos de intervenção precoce na psicose e sua aplicação. As autoras salientam a importância do estabelecimento de critérios operacionais da população em risco de desenvolver um primeiro surto psicótico, no sentido da minimização dos custos da psicose e melhoria do prognóstico.
    2005Journal article Open access Show more
  • [Diabetes Screening in Patients with Macrovascular Coronary Disease: Are the New European Guidelines a Step Backwards?]
    Publication . Ribeiro, A; Baptista, SB; Faustino, M; Alves, P; Abreu, PF; Gil, V; Morais, C
    BACKGROUND: The new European guidelines on diabetes mellitus and cardiovascular diseases propose that the FINnish Diabetes RIsk SCore should be used to evaluate the risk of diabetes mellitus and that diabetes mellitus screening in coronary artery disease patients should be based on fasting glucose and HbA1c. The 2 hour oral glucose tolerance test, recommended for all pts in the previous guidelines, is now only recommended for 'inconclusive' cases. We aimed to evaluate this new strategy. MATERIAL AND METHODS: Fasting glucose, HbA1c and glucose tolerance test (75 g, 2h) were prospectively evaluated in a consecutive group of pts with coronary artery disease. ADA criteria (both glucose tolerance test and HbA1c) were used to define diabetes mellitus and pre-diabetes mellitus. Diabetes mellitus risk was evaluated according to the FINnish Diabetes RIsk SCore. RESULTS: A total of 135 patients were included (mean age 62.3 +/- 13.1 years, 99 males). Glucose tolerance test and HbA1c together diagnosed 18 (13.3%) new cases of diabetes mellitus and 77 (57.0%) patients with pre-diabetes mellitus. Fasting glucose + HbA1c (guidelines strategy) identified 12/18 patients with diabetes mellitus (Sens 66.7%; negative predictive value 95.1%; Kappa 0.78; p < 0.0001) and 83/95 patients with glucose anomalies (pre- diabetes mellitus + diabetes mellitus) (Sens 87.4%; negative predictive value 76.9%). Performing glucose tolerance test in the 29 patients with an elevated FINnish Diabetes RIsk SCore would allow identifying 15/18 patients with diabetes mellitus (Sens 83.3%; negative predictive value 97.5%; Kappa 0.85; p < 0.0001) and 86/95 patients with glucose anomalies (Sens 90.5%; negative predictive value 81.6%). DISCUSSION: Although this strategy improved the screening accuracy, one in each six patients with diabetes mellitus would still remain undiagnosed, as compared to measuring HbA1c and performing an glucose tolerance test in all patients. CONCLUSION: Using the FINnish Diabetes RIsk SCore to select candidates to additional glucose tolerance test improves the accuracy for identifying diabetic patients, as compared with fasting glucose + HbA1c alone. However, 1/6 patients diabetes mellitus is still left undiagnosed with this strategy proposed by the current guidelines.
    2017Journal article Open access Show more
  • Psicose pós-ictal: a importância do controlo da epilepsia
    Publication . Ribeiro, A; von Dessauer, O
    A existência de sintomatologia psiquiátrica so-brevém, com bastante frequência, na epilepsia e é um importante factor de prognóstico da qualidade de vida dos doentes portadores deste quadro neurológico. Na epilepsia, as perturbações psiquiátricas psi-cóticas são classificadas de acordo com a sua relação cronológica com as crises. As psicoses peri-ictais ocorrem antes (pré-ictais), durante (ictais) ou após (pós-ictais) o surgimento de uma crise epiléptica. Por sua vez, as psicoses inter-ictais ocorrem independentemente das crises. Os episódios de psicose pós-ictal (PP) são caracteristicamente de curta duração. Deste modo, para que haja um melhor co-nhecimento do quadro clínico global e, consequentemente, um tratamento mais eficaz, torna-se necessário o reconhecimento destes sintomas psiquiátricos. Neste artigo descrevemos o caso clínico de um doente com epilepsia pós-traumática e sintomatologia psicótica pós-ictal, em acompanha-mento por Psiquiatria e por Neurologia.
    2014Journal article Open access Show more