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Traditional and alternative metrics: The full story of impact.

Donato, H
Fonte: Centro Hospitalar e Universitário de Coimbra Publicador: Centro Hospitalar e Universitário de Coimbra
Tipo: Artigo de Revista Científica
Publicado em //2014 Português

Nuclear medicine training and practice in Portugal

Vieira, R; Costa, G
Fonte: Springer Publicador: Springer
Tipo: Artigo de Revista Científica
Publicado em //2013 Português
Nuclear medicine in Portugal has been an autonomous speciality since 1984. In order to obtain the title of Nuclear Medicine Specialist, 5 years of training are necessary. The curriculum is very similar to the one approved under the auspices of the European Union of Medical Specialists, namely concerning the minimum recommended number of diagnostic and therapeutic procedures. There is a final assessment, and during the training the resident is in an approved continuing education programme. Departments are accredited by the Medical College in order to verify their capacity to host nuclear medicine residencies.

Clinical correlates of early repolarization and J wave patterns...are they proarrhythmic on their own?

Barra, SN; Providência, R; Nascimento, J
Fonte: Elsevier Publicador: Elsevier
Tipo: Artigo de Revista Científica
Publicado em //2013 Português

Traumatic middle cerebral artery aneurysm secondary to a gunshot wound.

Santos, G; Lima, T; Pereira, S; Macahdo, E
Fonte: Wiley Publicador: Wiley
Tipo: Artigo de Revista Científica
Publicado em //2013 Português
Traumatic intracranial aneurysms are rare lesions, accounting for less than 1% of all intracranial aneurysms. Formation of these lesions after a penetrating missile wound is very unusual, and diagnosis can be difficult due to the presence of associated lesions. In this article, we report a case of a woman who developed a middle cerebral artery aneurysm after a gunshot wound, and discuss potential pitfalls found during diagnostic work-up.

De novo tacrolimus – associated hemolytic uremic syndrome after renal transplantation - Case report

Neto, P; Lopes, K; Macário, F; Alves, R; Mota, A; Campos, M
Fonte: Centro Hospitalar e Universitário de Coimbra Publicador: Centro Hospitalar e Universitário de Coimbra
Tipo: Artigo de Revista Científica
Publicado em //2013 Português

Congenital pancreas malformations: a clinical case report

Bento, A; Baptista, H; Oliveira, FJ
Fonte: Centro Hospitalar e Universitário de Coimbra Publicador: Centro Hospitalar e Universitário de Coimbra
Tipo: Artigo de Revista Científica
Publicado em //2013 Português
OBJECTIVE: This study aimed to review the congenital malformation known as agenesis of the dorsal pancreas (ADP) and other pancreatic birth defects, based on a rare and exemplary clinical case of pancreatic malformations. The intent was to review the latest information published in the national and international literature on pancreatic birth defects, and to investigate the diversity of clinical presentations of ADP and other congenital pancreas abnormalities. The purpose was to identify which situations have therapeutic indication, the most appropriate time to institute treatment, and the currently available medical or surgical treatment of pancreatic congenital malformations. RESULTS: ADP is a very rare malformation that occurs during organogenesis. In the last decades, a large volume of embryological and genetic information has been obtained, helping to understand the causes of pancreatic malformations, which must be studied and understood as a whole. CONCLUSION: Pancreatic malformations are infrequently studied causes of acute and chronic pancreatic in adults. The possibility of pancreatic malformations should always be considered in patients with acute or chronic pancreatitis with no evident cause.

Pulmonary hypertension in Portugal: first data from a nationwide registry

Baptista, A; Meireles, J; Agapito, A; Castro, G; Silva, AM; Shiang, T; Gonçalves, F; Robalo-Martins, S; Nunes-Diogo, A; Reis, A
Fonte: Centro Hospitalar e Universitário de Coimbra Publicador: Centro Hospitalar e Universitário de Coimbra
Tipo: Artigo de Revista Científica
Publicado em //2013 Português
INTRODUCTION: Pulmonary arterial hypertension (PAH) is a rare disease that must be managed in specialized centers; therefore, the availability of epidemiological national data is critical. METHODS: We conducted a prospective, observational, and multicenter registry with a joint collaboration from five centers from Portugal and included adult incident patients with PAH or chronic thromboembolic pulmonary hypertension (CTEPH). RESULTS: Of the 79 patients enrolled in this study, 46 (58.2%) were classified as PAH and 33 patients (41.8%) as CTEPH. PAH patients had a mean age of 43.4 ± 16.4 years. Idiopathic PAH was the most common etiology (37%). At presentation, PAH patients had elevated right atrial pressure (RAP) (7.7 ± 5.9 mmHg) and mean pulmonary vascular resistance (11.4 ± 6.5 Wood units), with a low cardiac index (2.7 ± 1.1 L·min(-1)·m(-2)); no patient was under selective pulmonary vasodilators; however, at follow-up, most patients were on single (50%), double (28%), or triple (9%) combination vasodilator therapy. One-year survival was 93.5%, similar to CTEPH patients (93.9%), that were older (60.0 ± 12.5 years) and had higher RAP (11.0 ± 5.2 mmHg, P = 0.015). CONCLUSIONS: We describe for the first time nationwide data on the diagnosis...

Risk stratification of patients with early repolarization…still an unresolved matter!

Barra, SN; Providência, R
Fonte: Wiley Publicador: Wiley
Tipo: Artigo de Revista Científica
Publicado em //2013 Português

When to implant an ICD following a myocardial infarction?

Barra, SN; Agarwal, S; Providência, R
Fonte: Elsevier Publicador: Elsevier
Tipo: Artigo de Revista Científica
Publicado em //2013 Português

Fracturas periprotéticas do fémur com PTJ tratadas com osteossíntese e aloenxerto. Avaliação da consolidação

Dias, R; Carvalhais, P; Fonseca, F; Judas, F
Fonte: Centro Hospitalar e Universitário de Coimbra Publicador: Centro Hospitalar e Universitário de Coimbra
Tipo: Artigo de Revista Científica
Publicado em //2009 Português
O aumento da longevidade e o número crescente de artroplastias primárias e de revisão do joelho, induzem um aumento das fracturas periprotéticas. A complexidade destas fracturas e os defeitos ósseos apresentados implicam a osteossíntese e/ou revisão dos sistemas de artroplastia e a aplicação de aloenxertos ósseos, sendo necessário procedimentos definidos. Entre Janeiro de 2000 e Dezembro de 2006 foram aplicadas 1028 PTJ primárias e 76 de revisão. Foram diagnosticadas 20 fracturas periprotéticas primárias de PTJ (1,94%) e 12 fracturas periprotésicas de revisão (15,7%). Foi utilizada a classificação de AAOS. A maioria das fracturas periprotéticas foi do tipo I e 2. Foram operadas 29 fracturas periprotéticas (90,6%). 5 casos foram tratadas com artroplastia de revisão e os restantes 24 casos foram tratados com osteossíntese com placa AO (8) ou cavilha (16). Em 20 casos foi aplicado aloenxerto. Nos 20 casos de aloenxertos aplicados não foram confirmados casos de infecção, reações imonulógicas nem qualquer caso de transmissão de doenças víricas associada ao aloenxerto. A consolidação óssea foi conseguida entre as 2 e os 12 meses. Não há registo de pseudoartrose.

Information and Communication Technologies in Long-term and Palliative Care

Reis, A; Araújo Pedrosa, A; Dourado, M; Reis, C
Fonte: Centro Hospitalar e Universitário de Coimbra Publicador: Centro Hospitalar e Universitário de Coimbra
Tipo: Artigo de Revista Científica
Publicado em //2013 Português

An 11-year-old boy with pharyngitis and cough: Lemierre syndrome

Mação, P; Cancelinha, C; Lopes, P; Rodrigues, F
Fonte: BMJ Publicador: BMJ
Tipo: Artigo de Revista Científica
Publicado em //2013 Português
The authors present the case of an 11-year-old boy with pharyngitis, treated with amoxicillin, that worsened on day 7, with cough, high fever and refusal to eat. Lethargy and respiratory distress were noted. Based on radiographic findings of bilateral infiltrates he was diagnosed with pneumonia and started on intravenous ampicillin and erythromycin. Two days later he complained of right-sided neck pain and a palpable mass was identified. An ultrasound showed partial thrombosis of the right internal jugular vein and a lung CT scan revealed multiple septic embolic lesions. Lemierre syndrome was diagnosed, antibiotic treatment adjusted and anticoagulation started. A neck CT-scan showed a large parapharyngeal abscess. His clinical condition improved gradually and after 3 weeks of intravenous antibiotics he was discharged home on oral treatment. This case illustrates the importance of diagnosing Lemierre syndrome in the presence of pharyngitis with localised neck pain and respiratory distress, to prevent potentially fatal complications.

Pulmonary Hypertension in Mitral Stenosis: An Optical Coherence Tomography Study

Jorge, E; Calisto, J; Faria, H
Fonte: Centro Hospitalar e Universitário de Coimbra Publicador: Centro Hospitalar e Universitário de Coimbra
Tipo: Artigo de Revista Científica
Publicado em //2014 Português

Eosinophilic cistitis. A rare cause of dysuria

Piedade, C; Ramos, M; Heitor, F; Castro, L; Ochoa de Castro, A
Fonte: Centro Hospitalar e Universitário de Coimbra Publicador: Centro Hospitalar e Universitário de Coimbra
Tipo: Artigo de Revista Científica
Publicado em //2014 Português

Molecular and cytogenetic characterization of expanded B-cell clones from multiclonal versus monoclonal B-cell chronic lymphoproliferative disorders.

Henriques, A; Rodriguez-Caballero, A; Criado, I; Langerak, AW; Nieto, WG; Lecrevisse, Q; Gonzáles, M; Cortesão, E; Paiva, A; Almeida, J; Orfão, A
Fonte: European Hematology Association Publicador: European Hematology Association
Tipo: Artigo de Revista Científica
Publicado em //2014 Português
Chronic antigen-stimulation has been recurrently involved in the earlier stages of monoclonal B-cell lymphocytosis, chronic lymphocytic leukemia and other B-cell chronic lymphoproliferative disorders. Among these individuals, expansion of ≥2 B-cell clones has been frequently reported; potentially, such coexisting clones have a greater probability of interaction with common immunological determinants. Here, we comparatively analyzed the B-cell receptor repertoire and the molecular profile, as well as the phenotypic, cytogenetic and hematological features of 228 chronic lymphocytic leukemia-like and non-chronic lymphocytic leukemia-like clones between multiclonal (n=85 clones from 41 cases) versus monoclonal (n=143 clones) monoclonal B-cell lymphocytosis, chronic lymphocytic leukemia and other B-cell chronic lymphoproliferative disorders. The B-cell receptor of B-cell clones from multiclonal cases showed a slightly higher degree of HCDR3 homology than B-cell clones from monoclonal cases, in association with unique hematological (e.g. lower B-lymphocyte counts) and cytogenetic (e.g. lower frequency of cytogenetically altered clones) features usually related to earlier stages of the disease. Moreover, a subgroup of coexisting B-cell clones from individual multiclonal cases which were found to be phylogenetically related...

Uso de antídotos en un servicio de urgencias pediátricas

Martínez Sánchez, L; Almario Hernández, AF; Escuredo Argullós, L; Mação, P; Trenchs Sainz de la Maza, V; Luaces Cubells, C
Fonte: Centro Hospitalar e Universitário de Coimbra Publicador: Centro Hospitalar e Universitário de Coimbra
Tipo: Artigo de Revista Científica
Publicado em //2014 Português
INTRODUCTION: Poisoning is an infrequent cause of consultation in a pediatric emergency department (PED), but it can be potentially serious. Pediatricians should know how to use the available antidotes properly. OBJECTIVES: To analyze the use of antidotes in a PED and to assess the suitability of their indications. MATERIALS AND METHODS: A retrospective review of antidote use in a PED between January 2008 and June 2012. Inclusion criteria were age younger than 18 years and consultation for suspicious poisoning by a substance that could be treated with an antidote. The adequacy of antidote indication was based on the recommendations of the Spanish Society of Pediatric Emergencies (SSPE). RESULTS: A total of 1728 consultations for suspicious poisoning (0.4% of the total visits in the PED) were recorded. In 353 cases (20.4%) the involved poison could be treated with an antidote. Sixty-seven patients received an antidote (3.9% of consultations for suspicious poisoning), and a total of 69 administrations of an antidote were made: 100% oxygen (46), N-acetylcysteine (10), flumazenil (4), naloxone (3), deferoxamine (2), vitamin K (2), bicarbonate (1), and carnitine (1). In 3 cases there was no indication for administration: flumazenil without respiratory depression...

Can cardiac computed tomography predict cardiovascular events in asymptomatic type-2 diabetics?: results of a long term follow-up

Faustino, A; Providência, R; Mota, P; Barra, S; Silva, J; Fernandes, A; Catarino, R; Basso, S; Costa, M; Leitão-Marques, A
Fonte: BMC Publicador: BMC
Tipo: Artigo de Revista Científica
Publicado em //2014 Português
BACKGROUND: Doubts remain about atherosclerotic disease and risk stratification of asymptomatic type-2 diabetic patients (T2DP). This study aims to evaluate the usefulness of calcium score (CS) and coronary computed tomography (CT) angiography (CTA) to predict fatal and non fatal cardiovascular events (CVEV) in T2DP. METHODS: Eighty-five consecutive T2DP undergoing CT (Phillips Brilliance, 16-slice) with CS and CTA were prospectively enrolled in a transversal case-control study. Patients were followed for 48 months (range 18 - 68) to assess CVEV: cardiovascular death, acute coronary syndrome, revascularisation and stroke. Potential predictors of CVEV were identified. Predictive models based on clinical features, CTA and CS were created and compared. RESULTS: Performing CT impacted T2DP treatment. Cardiovascular risk was lowered during follow-up but metabolic control remained suboptimal. CVEV occurred in 11.8% T2DP (3.1%/year). CS ≥86.6 was predictor of CVEV over time, with a high negative predictive value, an 80% sensitivity and 74.7% specificity. Although its prognostic value was not independent of the presence/absence of obstructive CAD, adding CS and CTA data to clinical parameters improved the prediction of CVEV: the combined model had the highest AUC (0.888...

Reflexões sobre a Publicação Científica

Donato, H
Fonte: Associação de Docentes e Orientadores de Medicina Geral e Familiar Publicador: Associação de Docentes e Orientadores de Medicina Geral e Familiar
Tipo: Artigo de Revista Científica
Publicado em //2013 Português

Think Tank: Relatório Estratégico sobre Publicação Científica Biomédica em Portugal

Tato Marinho, R; Donato, H; Fernandez-Llimos, F; Massano, J; Silva, JM; Almeida, M; Carvalho, JC; Villanueva, T; Fonseca, JE
Fonte: Centro Hospitalar e Universitário de Coimbra Publicador: Centro Hospitalar e Universitário de Coimbra
Tipo: Artigo de Revista Científica
Publicado em //2014 Português

Cianose no pequeno lactente – desafio diagnóstico

Amaral, ME; Silva, PV; Marinho, J; Francisco, A; Andrade, H; Martins, P; Santos, I; Rodrigues, D; Sousa, G; Pires, A; Marinho, A; Castela, E
Fonte: Centro Hospitalar e Universitário de Coimbra Publicador: Centro Hospitalar e Universitário de Coimbra
Tipo: Conferência ou Objeto de Conferência
Publicado em //2013 Português