Browsing by Issue Date, starting with "2002"
Now showing 1 - 10 of 18
Results Per Page
Sort Options
- Transferência de doentes críticos para cirurgia cardíaca urgente após colocação de balão intra-aórticoPublication . Abreu, PF; Thomas, B; Loureiro, J; Roquette, J; Ferreira, RIntrodução, material e métodos: São apresentados os resultados de um estudo retrospectivo de todos os exames hemodinâmicos realizados no nosso Centro, com o objectivo de avaliar a exequibilidade e segurança de transferência para um centro cirúrgico, de doentes coronários instáveis, nos quais foi implantado um balão intra- -aórtico. No total, foram implantados 62 BIAOs, em outros tantos doentes, dos quais 24 foram transferidos para centros cirúrgicos no centro de Lisboa, numa ambulância, acompanhados de médico, enfermeiro e pessoal paramédico. Resultados: O grupo de doentes que necessitou da implantação de BIAO, era constituído por doentes com angina instável e com uma anatomia coronária que aconselhava intervenção cirúrgica imediata, doentes com hipotensão e complicações mecânicas pós-enfarte, e ainda doentes com enfarte agudo do miocárdio que não foram submetidos a trombólise e nos quais a anatomia coronária desaconselhava intervenção percutânea. Todos os doentes chegaram vivos ao hospital, não se verificando nenhuma instabilidade hemodinâmicaa e/ou eléctrica durante o transporte. Conclusões: O transporte terrestre de doentes necessitando de cirurgia de emergência nos quais foi colocado um BIAO foi fácil e seguro, podendo a prévia colocação deste device contribuir para uma melhoria clínica neste subgrupo particularmente grave de doentes.
- Neuroblastoma quístico congénitoPublication . Aparício, S; Casella, P; França, I; Fernandes, R; Silva, S
- Triagem de Enfermagem na Urgência Geral de Adultos: uma realidade no Hospital Amadora-SintraPublication . Vieira, JO acolhimento e a triagem de doentes é um processo importante e único para cada doente, realizado por uma equipa multidisciplinar, sendo a principal preocupação a de acolher, encaminhar e estabelecer a prioridade de forma humanizada e individualizada, garantindo um atendimento rápido, pelo pessoal apropriado ná àrea clínica correcta.
- Cateterização simultânea das artérias coronárias no tratamento das oclusões crónicas totaisPublication . Abreu, PF; Loureiro, J; Thomas, B; Ferreira, RAs oclusões crónicas totais apresentam-se como um grande desafio para os cardiologistas de intervenção, sendo o seu tratamento geralmente acompanhado de um aumento das complicações. É apresentado um argumento para a utilização da cateterização simultânea das artérias coronárias para a melhoria das características da lesão e optimização dos resultados. Oito doentes com oclusões crónicas totais foram revascularizados percutaneamente utilizando esta técnica com sucesso imediato e ausência de complicações em todos eles.
- Angiografia por ressonância magnética tridimensional optimizada por contraste nas doenças da aortaPublication . Thomas, B; Roquette, J; Ferreira, RObjectivos: Avaliar a possibilidade de realizar angiografia de alta resolução com reconstrução tridimensional, com recurso a equipamento de ressonância magnética de 1 Tesla, em doentes com patologia aórtica. Métodos: Efectuaram-se trinta e um exames de ressonâncias magnética em dezassete doentes, após administração, sob a forma de bolus, de gadolinium. Foram adquiridas imagens em spin echo rápido, gradiente echo e angiografia com time-of-flight. Resultados: Todas as aquisições foram bem toleradas e conseguiu-se a opacificação do lumen aórtico, no momento apropriado, em todos os doentes. As sequências angiográficas foram obtidas com respiração suspensa que requereu cerca de 25 segundos por imagem e seis a oito minutos para conseguir uma reconstrução tridimensional. Conclusão: A angiografia aórtica por reconstrução tridimensional é possível com um equipamento de 1 Tesla, com imagens de elevada qualidade e resolução, obtidas em pouco minutos. É possível obter toda a informação facultada pela aquisição em spin echo, convencional ou acelerado, a partir da reconstrução das imagens tridimensionais, afastando assim a necessidade de aquisição, tão incómoda, das imagens spin echo, melhorar a rapidez e diminuir, portanto, o tempo de aquisição, o que se torna relevante em doentes com síndromes aórticos agudos.
- Association of anti-HBc seropositivity with undetectable or low level anti-HBs (<100) in anti-HCV positive blood donor population.Publication . Barradas, A; Barra, A; Baptista, F; Soares, F; Gaspar, R; Venâncio, B; Pereira, TIn this data we observed the association between confirmed. Anti-HCV positive and Anti-HBc positive with low level (<100) or undetectable Anti-HBs. b) ./. c) Between May 1995 to December 2001 we collected and analysed 24989 samples from volunteer blood donors. In this samples we performed the following tests Anti?HCV (Ortho), confirmed for PCR (Roche) or RIBA (Innogenetics), Anti-HBc (Dade-Behreing/Abbott, Anti-HBs (Abbott) and HCV genotype (Innogenetics). d) We found between Anti-HCV neg. population 6,94% positives Anti-HBc and 25,65% of them was Anti-HBs low level or undetectable. In the population we found 0,148% of confirmed Anti-HCV reactive donors, among them we found 51,35% of Anti-HBc positivity and between the last ones 78,9% had low level or undetectavel Anti-HBs. The ALT average level in the Anti-HCV positive donors was: Anti-HBc negative donors: 140,28 Ani-HBc positives with high level of Anti-HBs: 50,48 Anti-HBc positives with low or undetectable level of Anti-HBs: 64,11 e) The Anti-HCV confirmed donors associated to the Anti-HBc positives with low level or undetectable Anti-HBs (78,9%). Comparing with the Anti-HCV negative donors, positive for Anti?HBc and with low level or undetectable Anti-HBs (25,65%). This is statistically relevant.
- A ventral rotational skin flap to improve cosmesis and avoid chordee recurrence in epispadias repair.Publication . Pippi Salle, J; Jednak, R; Capolicchio, J; França, I; Labbie, A; Gosalbez, ROBJECTIVE: To describe a technical modification that facilitates dorsal skin closure, improves cosmesis and eliminates chordee recurrence secondary to contracture of the dorsal penile skin in the repair of epispadias. PATIENTS AND METHODS: Eleven patients with penopubic epispadias (mean age 1.8 years) had the epispadias repaired using a modified ventral penile skin flap. Four patients had isolated epispadias and seven had had a previous primary closure of bladder exstrophy. Nine patients underwent the Cantwell-Ransley technique, leaving the meatus in a glanular position. Two patients were repaired using the penile disassembly technique of Mitchell and Bägli, because they had a short urethral plate. A ventral island skin flap was fashioned, starting at the base of the penis. Dissection was carried ventrally into the scrotum to allow for adequate dorsal flap transposition. The flap was rotated laterally to shift the suture line from the midline and to cover the dorsal aspect of the penis with untouched penile shaft skin. Redundant ventral foreskin was discarded. RESULTS: All patients had an uneventful course after surgery. Dorsal penile skin was viable in every case and no patient developed recurrence of chordee or a urethrocutaneous fistula. The cosmetic result was excellent in all patients. CONCLUSIONS: Dorsal skin closure using lateral rotation of ventral penile skin flap improves cosmesis after epispadias repair and eliminates the recurrence of chordee secondary to midline dorsal scarring.
- Interictal spike EEG source analysis in hypothalamic hamartoma epilepsyPublication . Leal, A; Passão, V; Calado, E; Vieira, J; Cunha, JObjective: The epilepsy associated with the hypothalamic hamartomas constitutes a syndrome with peculiar seizures, usually refractory to medical therapy, mild cognitive delay, behavioural problems and multifocal spike activity in the scalp electroencephalogram (EEG). The cortical origin of spikes has been widely assumed but not specifically demonstrated. Methods: We present results of a source analysis of interictal spikes from 4 patients (age 2–25 years) with epilepsy and hypothalamic hamartoma, using EEG scalp recordings (32 electrodes) and realistic boundary element models constructed from volumetric magnetic resonance imaging (MRIs). Multifocal spike activity was the most common finding, distributed mainly over the frontal and temporal lobes. A spike classification based on scalp topography was done and averaging within each class performed to improve the signal to noise ratio. Single moving dipole models were used, as well as the Rap-MUSIC algorithm. Results: All spikes with good signal to noise ratio were best explained by initial deep sources in the neighbourhood of the hamartoma, with late sources located in the cortex. Not a single patient could have his spike activity explained by a combination of cortical sources. Conclusions: Overall, the results demonstrate a consistent origin of spike activity in the subcortical region in the neighbourhood of the hamartoma, with late spread to cortical areas.
- p63 expression in normal skin and usual cutaneous carcinomas.Publication . Reis-Filho, J; Torio, B; Albergaria, A; Schmitt, FBACKGROUND: p63 is a p53 homologue that is mapped to chromosome 3q27. This gene encodes six different isoforms, which have either transactivating or dominant negative effects on p53-reporter genes. It has been described that in contrast to p53, p63 seems not to be associated with tumor predisposition, as neither p63 knockout mouse models nor germline p63 mutations are related to an increased risk of tumorigenesis. It has been demonstrated that p63 is a reliable keratinocyte stem cell marker and that it is involved in the maintenance of the stem cell population. Scant data on p63 expression in normal skin, basal cell carcinomas (BCCs), keratoacanthomas and squamous cell carcinomas (SCCs) have been reported. We herein evaluated p63 expression in 16 BCCs, one keratoacanthoma and 13 SCCs. METHODS: Immunohistochemistry according to the streptavidin-biotin-peroxidase technique, using the antibody 4A4 raised against all p63 isoforms, was performed. p63 expression was evaluated in epidermal cells and skin appendages. Semi-quantitative evaluation (-, +, ++, +++) of p63 expression in BCCs, keratoacanthoma and SCCs was carried out. Only nuclear expression was considered as specific. RESULTS: p63 was expressed in the nuclei of epidermal basal and suprabasal cells, in the cells of the germinative hair matrix and the external root sheath of hair follicles, in the basal cells of the sebaceous gland and in the myoepithelial/basal cells of the sweat glands. All terminally differentiated cells were negative for p63. All BCCs showed ++ to +++ immunoreactivity. At variance, keratoacanthomas and grade I and II SCCs showed variable p63 reactivity in a basal layer-like distribution, whereas undifferentiated cells of grade III SCCs showed ++ to +++ positivity. A grade IV spindle SCC showed + immunoreactivity. The SCCs in situ showed remarkable expression of p63 in all cell layers. Terminally differentiated squamous cells were either negative or showed only focal immunoreactivity in the carcinomas. CONCLUSIONS: p63 is consistently expressed in the basal cells of epidermis and cutaneous appendages, including the basal/myoepithelial cells of sweat glands. Based on our findings, the balance of probabilities favors that p63 might play a role in the pattern of differentiation and in the oncogenesis of usual carcinomas of the skin.