Browsing by Issue Date, starting with "2004"
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- Miocardite fulminante como manifestação de doença mitocondrialPublication . Abadesso, C; Aparício, S; Almeida, HI; Machado, MCOs autores apresentam o caso clínico de um lactente de 9 meses, previamente saudável, que se apresenta com um quadro de cardiomiopatia aguda fulminante rapidamente progressiva e fatal. O quadro de insuficiência cardíaca grave surge no contexto de uma doença febril e é acompanhado de hipoglicémia grave. O exame histológico post-mortem de músculo cardíaco não é consistente com a hipótese inicial de miocardite aguda. Na microscopia electrónica identificam-se mitocôndrias gigantes e formações anormais das cristas mitocondriais. As doenças mitocondriais e defeitos do metabolismo energético cardíaco são causas cada vez mais reconhecidas de cardiomiopatias. Chama-se a atenção para a necessidade de realizar um screening metabólico e preservar amostras de tecidos na cardiomiopatia aguda em crianças.
- A brief diagnostic screening instrument for mental disturbances in general medical wardsPublication . Fink, P; Ørnbøl, E; Huyse, F; Jonge, P; Lobo, A; Herzog, T; Slaets, J; Arolt, V; Cardoso, G; Rigatelli, M; Hansen, MOBJECTIVE: Mental illness is prevalent among general hospital ward patients but often goes unrecognised. The aim of this study was to validate the SCL-8d as a brief questionnaire for mental disturbances for use in general hospitals. METHODS: The study included 2040 patients, 18 years or older, consecutively admitted to 11 general internal medicine wards in seven European countries. All patients were screened on admission by means of the SCL-8d questionnaire. The psychometric performance (i.e., the internal validity) of the SCL-8d scale was tested using modern item response theory (IRT) in the form of the Rasch model. RESULTS: Differences between sample characteristics were considerable. Even so, the SCL-8d scale showed a remarkable, statistically significant fit in terms of internal homogeneity (P>.01) in all individual settings, except in Spain and Germany where the item "Everything is an effort" had to be excluded to obtain a fit. When pooling data from all centres, an excellent statistical significance of fit (P>.05) was obtained by exclusion of the "Effort" item. The scale was homogeneous as to gender (P>.05), but not age as it performed better among young patients than among patients older than 60 years (P<.01). In these two patient groups both internal and external homogeneity (gender, median age) was achieved. The SCL-8d sum score showed a marked correlation with current and previous treatment for mental illness. CONCLUSION: Apart from the "Effort" item ranking differently on the latent severity dimension as to age, the SCL-8d seems very robust from a psychometric point of view. Besides being short, the SCL-8d scale contains only emotional symptoms. It would therefore seem to be an excellent diagnostic tool for use in medical settings.
- Mycoplasma pneumoniae causing nervous system lesion and SIADH in the absence of pneumoniaPublication . Coelho, M; Leite, A; Revés, A; Miranda, C; Serra, I; Brandão, T; Albuquerque, L; Freitas, PTA patient was admitted for fever and acute respiratory failure (ARF), rapidly progressive tetraparesis, delirium, behavioral abnormalities, and diplopia. Leukocytosis and a rise in C-reactive protein were present. A syndrome of inappropriate anti-diuretic hormone secretion (SIADH) was also diagnosed. Lumbar puncture yielded colorless CFS with mononuclear pleocytosis and protein rise. Electrodiagnosis revealed demyelinating polyneuropathy and axonal degeneration. Serum IgG and IgM for mycoplasma pneumoniae (MP) was consistent with acute infection, and erythromycin was started with rapid resolution of symptoms. Contrarily to most reports, an associated respiratory disease was not present and SIADH in association with MP has been reported only once, in a patient without direct central nervous system (CNS) involvement. Differential diagnosis and possible pathogenic mechanisms are discussed.
- Crescer com paralisia cerebralPublication . Alves, A; Cadete, A; Figueiredo, H; Gabriel, C; Jacobsohn, L; Oliveira, A; Patinha, D; Valério, P
- Qualidade de vida no tratamento conservador da laringe: métodos de avaliaçãoPublication . Caçador, M; Adónis, C; Pacheco, R; Estibeiro, H; Olias, JO objectivo da teropêufica oncológica, nos nossos dias, visa assegurar a cura/controle da doença com a mínima morbilidade física e psíquica. O conceito de quolìdade de vida só muito recentemente passou a ser ponderado nas decìsões terapêuticas, quer pela ausência de sensibilidade dos cirurgiões oncológicos, quer pela dificuldade em quontifìcar parametros tão subjectivos. A avaliação científica e objectiva dos parametros envolvidos na qualidade de vida exige a elaboração de questionários e a sua aplicação segundo regras muito específicas. A sua ulilização junto a populações com língua e culturas diferentes implica igual rigor para que os seus resultados possam ser consideroados válidos. Os autores apresentam a adaptação de um questionário de avaliação da quualidade de vida aplicando-o em doentes com tumores da laringe submetidos ao protocolo de preservação de orgão (Quimioteropia+Rodìoteropìa) do Instituto Português de Oncologia de Francisco Gentil de Lisboa.
- Current and lifetime psychiatric illness in women with Turner syndromePublication . Cardoso, G; Daly, R; Haq, N; Hanton, L; Rubinow, D; Bondy, C; Schmidt, PAbnormalities in quality of life and cognitive measures have been observed in women with Turner syndrome (TS), and a relationship between these phenomena and chromosomal constitution has been suggested. In contrast, few studies have systematically evaluated the presence of mood and behavioral syndromes in these women. In this study, 100 TS women were administered the Structured Clinical Interview for DSM IV after a two-week period during which their hormone replacement had been discontinued. The majority of women who met criteria for a psychiatric condition had a mood or anxiety disorder. Overall, 52 (52%) of the TS women met criteria for a current or a past depressive or anxiety disorder. Eighteen of the women with TS met criteria for a current Axis I psychiatric disorder [Depression--major (n = 5), minor (n = 5), dysthymia (n = 1); Anxiety (n = 9)]. Forty-six of the women with TS met criteria for a past Axis I psychiatric illness [Depression: unipolar (n = 41), bipolar (n = 3); Anxiety (n= 7); eating disorder (n =6); substance dependence (n = 3)]. Five women with TS met criteria for an Axis II personality disorder. Women with TS reported a higher rate of lifetime depression compared with rates observed in community-based studies but similar to those obtained from gynecologic clinic samples.
- Gravidez ectópica abdominal avançada: a propósito de um caso clínicoPublication . Fernandes, R; Manso, RT; Matos, F; Pires, F; Silva, S; Laurini, R
- Misoprostol e parto pré-termoPublication . Escumalha, M; Gouveia, C; Cunha, M; Machado, MC
- Acquired immunodeficiency syndrome and the risk of strokePublication . Cole, J; Pinto, A; Hebel, J; Buchholz, D; Earley, C; Johnson, C; Macko, R; Price, T; Sloan, M; Stern, B; Wityk, R; Wozniak, M; Kittner, SBACKGROUND AND PURPOSE: Although acquired immunodeficiency syndrome (AIDS) is thought to increase the risk of stroke, few data exist to quantify this risk. This is the first population-based study to quantify the AIDS-associated risk of stroke. METHODS: We identified all incident ischemic stroke (IS) and intracerebral hemorrhage (ICH) cases among young adults 15 to 44 years of age in central Maryland and Washington, DC, who were discharged from any of the 46 hospitals in the study area in 1988 and 1991. Using data from the medical records, 2 neurologists reviewed each case to confirm the diagnosis. Cases of AIDS among these patients with stroke were defined using Centers for Disease Control and Prevention criteria (1987). The number of cases of AIDS in the central Maryland and Washington population during 1988 and 1991 was determined from regional health departments working with the Centers for Disease Control and Prevention. Poisson regression was used to estimate the age-, race-, and sex-adjusted relative risk of stroke associated with AIDS. RESULTS: There were 385 IS cases (6 with AIDS) and 171 ICH cases (6 with AIDS). The incidences of IS and ICH among persons with AIDS were both 0.2% per year. AIDS conferred an adjusted relative risk of 13.7 (95% confidence interval [CI], 6.1 to 30.8) for IS and 25.5 (95% CI, 11.2 to 58.0) for ICH. After exclusion of 5 cases of stroke in AIDS patients in whom other potential causes were identified, AIDS patients continued to have an increased risk of stroke with an adjusted relative risk of 9.1 (95% CI, 3.4 to 24.6) for IS and 12.7 (95% CI, 4.0 to 40.0) for ICH. CONCLUSIONS: This population-based study found that AIDS is strongly associated with both IS and ICH.
- Estudo de utilização de albumina humana 20% no Hospital Fernando FonsecaPublication . Afonso, R; Costa, C; Elias, C; Fernandes, J; Ferreira, A; Jesus, S; Oliveira, C; Oliveira, I; Oliveira, MJ; Prata, A; Almeida, P