4940 research outputs found
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Una Causa Rara de Proteinuria Nefrótica en la Enfermedad de Sjögren
No full textinfo:eu-repo/semantics/publishedVersio
Síndrome Coronária Aguda e o Stress: Há de Facto uma Associação?
No full textIntroduction: Acute coronary syndrome (ACS) is the result of a complex pathophysiological process with various dynamic factors. The 10-item Perceived Stress Scale (PSS-10) is a validated instrument for estimating stress levels in clinical practice and may be useful in the assessment of ACS.
Methods: We carried out a single-center prospective study engaging patients hospitalized with ACS between March 20, 2019 and March 3, 2020. The PSS-10 was completed during the hospitalization period. The ACS group was compared to a control group (the general Portuguese population), and a subanalysis in the stress group were then performed.
Results: A total of 171 patients with ACS were included, of whom 36.5% presented ST-elevation myocardial infarction (STEMI), 38.1% were female and the mean PSS score was 19.5±7.1. Females in the control group scored 16.6±6.3 on the PSS-10 and control males scored 13.4±6.5. The female population with ACS scored 22.8±9.8 on the PSS-10 (p<0.001). Similarly, ACS males scored a mean of 17.4±6.4 (p<0.001). Pathological stress levels were not a predictor of major adverse cardiovascular events or severity at admission.
Conclusions: ACS patients had higher perceived stress levels compared to the control group. Perceived stress level was not associated with worse prognosis in ACS patients.info:eu-repo/semantics/publishedVersio
Consulta de Voz do Hospital Dona Estefânia: Casuística Pré e Pós Videolaringoscopia de Chip Distal
No full textObjetivos: Descrever a casuística da consulta de Voz do Hospital Dona Estefânia. Avaliar os diagnósticos
realizados utilizando videolaringoscopia fexível de fbra óptica e de chip distal.
Desenho do Estudo: Estudo retrospetivo observacional.
Material e Métodos: Análise dos processos clínicos dos doentes avaliados em primeira consulta de
setembro de 2018 a dezembro de 2021.
Resultados: Foi realizada laringoscopia em 78.1% das 73 crianças estudadas. Obtiveram-se os diagnósticos de nódulos das cordas vocais (42.5%), refuxo faringolaríngeo (12.3%), disfonia por tensão muscular (9.6%), cordite (2.7%), quisto (2.7%) e pólipo (1.4%) das cordas vocais. A videolaringoscopia de chip distal não alterou de forma signifcativa os diagnósticos realizados, mas identifcouse uma redução na proporção de diagnósticos
de nódulos e de laringoscopias normais e um aumento na proporção de diagnósticos de refuxo faringolaríngeo (p = 0.479).
Conclusão: A videolaringoscopia de chip distal não alterou de forma signifcativa os diagnósticos realizados em crianças com disfonia crónica.info:eu-repo/semantics/publishedVersio
Blunt Trauma and Right Diaphragmatic Rupture: Unveiling the Impact
No full textTraumatic diaphragmatic ruptures are rare, yet blunt injuries tend to be more easily overlooked compared to penetrating trauma. The minimal evidence of external injuries makes a high index of suspicion key for diagnosis. We report the case of a right-sided thoracoabdominal blunt trauma that resulted in a diaphragmatic rupture and fractured rib. Although often approached through a midline laparotomy, a definitive right thoracotomy repair was exceptionally performed since the adjacent peritoneum remained uninjured.info:eu-repo/semantics/publishedVersio
Ventricular Septal Rupture—The Resurgence of a Post-Myocardial Infarction Dreadful Complication During COVID-19 Pandemic
No full textIn the midst of the coronavirus disease-2019 (COVID-19) pandemic, an 84-year-old female patient was admitted due to non-exertional syncope preceded by retrosternal pain. She had experienced a prolonged episode of oppressive chest pain 6 days before her presentation, but due to the concern of contracting COVID-19, she did not present for medical care. Upon admission to the emergency department, the patient was in circulatory shock, with her physical examination being remarkable for the presence of a holosystolic murmur. Admission electrocardiogram revealed an inferior ST-segment elevation with Q waves with extension to the posterior wall, consistent with subacute infarct in the right coronary artery (RCA) territory, and the patient was transferred for primary percutaneous coronary intervention. Upon arrival to the catheterization laboratory, a summary transthoracic echocardiogram was performed, which revealed inferior wall and infero-septal akinesia with an 18 mm ventricular septal rupture. Coronary angiography documented occlusion of the proximal segment of a dominant RCA. Due to a high perioperative risk, the patient underwent successful retrograde percutaneous closure with a 24 mm MemoPart™ device, with mild to moderate residual shunt. Despite an immediate clinical improvement, the patient died 12 hours after the procedure due to refractory cardiogenic shock.info:eu-repo/semantics/publishedVersio
Editor's Choice – European Society for Vascular Surgery (ESVS) 2023 Clinical Practice Guidelines on the Management of Atherosclerotic Carotid and Vertebral Artery Disease
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Risk Factors for Delayed Discharge Due to Social Factors: A Retrospective Study
No full textIntroduction: The hospital setting faces a rate of bed occupation by patients whose discharge is limited by other factors apart from clinical needs. This urges the need for an early identification of the patients at risk of delayed discharge due to social factors in order to reduce expenses and to add value that converts itself into the patient health. The aim of this study was to identify the demographic and clinical factors that may be associated with delayed discharge.
Material and methods: Demographic and clinical comorbidity data on 582 patients of an internal medicine ward from a tertiary hospital center during the years 2018 and 2019 was analyzed. A binomial logistic regression model was used, adjusted for sex, age, and length of clinical stay, in order to identify potential risk factors associated with delayed discharge.
Results: A total of 473 patients admitted in the internal medicine ward throughout the two years of study were included. Ninety-four (19%) of these patients had their discharge delayed beyond their clinical needs; sixty-four (68%) of these were females. The most representative age was between 75 - 89 years old (45.7%). The characteristics that significantly differed between both non-delayed and delayed discharge were female sex (OR 2.84, 95% CI 1.65 - 4.90, p-value < 0.05), prolonged clinical stay (OR 2.64, 95% CI 1.60 - 4.937, p-value < 0.05) and diabetes mellitus (OR 1.87, 95% CI 1.08 - 3.23, p-value < 0.05). Besides these, the presence of heart failure (OR 0.52, 95% CI 0.27 - 0.99, p-value < 0.05) and chronic kidney disease (OR 0.34, 95% CI 0.14 - 0.86, p-value < 0.05) were associated with a lower risk of delayed discharge.
Conclusion: Female sex, a prolonged clinical stay and diabetes mellitus were associated with a higher risk of delayed discharge, while heart failure and chronic kidney disease were associated with a reduced risk. These findings create a basis for a possible future multicentre study aimed at creating a clinical prediction rule to stratify the risk of delayed hospital discharge in the Portuguese population.info:eu-repo/semantics/publishedVersio
Intoxicação do Sistema Nervoso Central Durante a Implantação de um Cardioversor Desfibrilhador Implantável -- Um Caso Clínico e Revisão da Literatura
No full textLidocaine, a local anesthetic, is commonly used in various medical procedures. Despite its widespread use, most physicians are not familiar with the life threatening presentation of lidocaine toxicity and its treatment. Our case demonstrates successful management of local lidocaine-induced systemic toxicity in a 53-year-old female during insertion of an implantable cardioverter defibrillator. Our goal was to raise awareness of the risks and symptoms of local anesthetic toxicity, educate regarding the site of administration and dose of anesthetic delivery as independent risk factors for systemic toxicity and highlight the use of intravenous lipid emulsion as an antidote.A lidocaína é um anestético local vulgarmente usado em vários procedimentos médicos. Apesar do seu uso abrangente, a maioria dos clínicos não está familiarizada com os sinais e sintomas de toxicidade e o seu tratamento. O nosso caso demonstra o tratamento bem-sucedido de uma intoxicação sistémica de lidocaína numa mulher de 53 anos durante a implantação de um cardioversor desfibrilhador implantável (CDI). O nosso objetivo é consciencializar para os riscos, sinais e sintomas da intoxicação de anestésicos locais, informar sobre o local e dose de administração como fatores de risco independentes para a toxicidade sistémica e enfatizar ouso de emulsão lipídica como antídoto.info:eu-repo/semantics/publishedVersio
Investigator-Led Clinical Research in Portugal: Problem Identification and Proposals for Improvement
No full textinfo:eu-repo/semantics/publishedVersio