Browsing by Issue Date, starting with "2000"
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- Left ventricular reduction surgeryPublication . Thomas, B; Batista, RWhen medical therapy is unsuccessful in improving the functional class in patients with heart failure, surgical options must be considered. Although transplantation may be considered the gold standard, numerous factors limit the number of patients who can benefit from it. Therefore, other surgical methods have been devised as alternatives to transplantation. Left ventricular reduction by surgical resection of a piece of myocardium was introduced in Brazil a few years ago, and enthusiasm for the procedure is increasing because encouraging results have been published by various groups. It is hoped that this procedure will form part of the treatment for congestive heart failure in the future.
- Utilização do "cell-block" na citologia aspirativa: experiência do Serviço de Anatomia Patológica do Hospital Fernando Fonseca (Amadora/Sintra)Publication . Fernandes, R; Martins, L; Bernardo, H; Nina, P; Silva, S
- 0 papel do LBA na identificação de Pneumonia a Pneumocystis cariniiPublication . Pardal, C; Rosa, P; Fernandes, L; Longo, C; Sustelo, Arminda
- Diagnostico de uma massa cardiaca- a proposito de um casoPublication . Galrinho, A; Ferreira, D; Loureiro, J; Terras, F; Silva, S; Ferreira, RThe authors describe a case of a recidivant pericardial effusion associated to a mass with an unusual, filamentous aspect that involved the upper part of right atrium and surrounded the upper vena cava. Despite the diagnostic techniques employed--transesophageal echocardiography and magnetic resonance imaging, the etiologic diagnosis could not be done, so a biopsy of the mass was made by percutaneous approach using transesophageal echocardiography to control the procedure. The histopathological result was an angiosarcoma of the right atrium. The authors make a brief review of the literature about this rare condition.
- Coriocarcinoma da trompaPublication . Aparício, S; Fernandes, R; Oliveira, M; Milheiro, A; Higgs, H; Miranda, I; Silva, S
- European Consultation-Liaison Psychiatric Services: the ECLW Collaborative StudyPublication . Huyse, F; Herzog, T; Lobo, A; Malt, U; Opmeer, B; Stein, B; Creed, F; Crespo, MD; Cardoso, G; Guimarães-Lopes, R; Mayou, R; van Moffaert, M; Rigatelli, M; Sakkas, P; Tienari, POBJECTIVE: To describe the patterns of organization of consultation-liaison (C-L) services in 11 European countries in relation to hospital characteristics and national approaches to C-L psychiatry. METHOD: Cross-sectional survey. RESULTS: Services can best be described in terms of their size and seniority of their staff and whether or not they are multidisciplinary. Single-discipline services are based upon the standard medical consultant model, whereas those with multidisciplinary teams work in a way that is comparable with community mental health teams. German psychosomatic C-L services belonged to either model. National differences were found. CONCLUSION: This first international study provides empirical evidence for the wide variation in the organization of C-L services. In view of the increasing numbers of patients with psychiatric disorder who are being treated in general hospitals and the changing patterns of medical care there are important implications for clarification and improvement of the role of C-L services.
- Tiotropium improves FEV1 in patients with COPD irrespective of smoking statusPublication . Moita, J; Bárbara, C; Cardoso, J; Costa, R; Sousa, M; Ruiz, J; Santos, MLThis study evaluated whether the effect of tiotropium on the change in trough forced expiratory volume in 1s (FEV1), vs. placebo, is affected by smoking status. In a 3-month, double-blind study in 31 centres in Portugal, 311 (289 completed) patients were randomised to tiotropium 18 microg once daily or placebo. Baseline mean (standard deviation (SD)) FEV1 was 1.11 (0.39) l in the tiotropium group and 1.13 (0.39) l in the placebo group. Patients had an average smoking history of 55 (25.7) pack-years; 80 (26%) were smokers and 224 (74%) were ex-smokers. The primary end-point was change in morning pre-dose (i.e. trough) FEV1 after 12 weeks. Trough FEV1 at 12 weeks was significantly improved with tiotropium vs. placebo: the difference in means was 102 ml, P=0.0011, 95% confidence interval (CI) (41, 164). The difference in means in smokers was 138 ml, P=0.0105, CI (32, 244); in ex-smokers it was 66 ml, P=0.0375, CI (3, 129). The difference between smokers and ex-smokers was not statistically significant (P=0.6982) and may be due to greater variability and differences in disease severity. The significant improvement in lung function in patients treated with tiotropium vs. placebo in both smokers and ex-smokers suggests that tiotropium is an effective and well-tolerated therapy in chronic obstructive pulmonary disease (COPD), regardless of smoking status.
- European consultation-liaison services and their user populations: the European Consultation-Liaison Workgroup Collaborative StudyPublication . Huyse, F; Herzog, T; Lobo, A; Malt, U; Opmeer, B; Stein, B; Cardoso, GThe authors identified variations in the characteristics of patients referred to 56 consultation-liaison (C-L) services in 11 European countries. The authors found differences in the types of patients referred to the services, and there were significant differences between countries. The first difference lays in whether services saw patients for deliberate self-harm and for substance abuse. German psychosomatic C-L services saw virtually no such patients, although in other C-L services these patients constituted one-quarter to one-third of the patients referred. The second difference lays in the remaining group of referred patients. This group is best characterized by two dimensions. One describes the severity of psychopathology -- ranging from organic mental conditions to somatization. The other describes the clarity of the physical diagnosis -- ranging from patients referred by surgical wards to those referred by general medicine and neurology wards.