Percorrer por autor "Barros, A"
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- "Death by a thread" - Peritonitis due to visceral perforation by a guide wire, during proximal femur osteosynthesis with DHS: A fatal case and legal implications.Publication . Durão, C; Barros, A; Guerreiro, R; Pedrosa, FIatrogenic intestinal perforations in orthopaedic surgery are very rare. Reports of iatrogenic lesions caused by a guide wire during femur fracture osteosynthesis are even scarcer. There are no similar reports in recent literature. As opposed to what is normally described the lesion documented in this case report was not identified on time resulting in death by peritonitis. The forensic autopsy allowed the identification of an intestinal perforation with faecal leakage to peritoneal space in association with a vesical perforation enabling the reproduction of the guide wire path. In view of the increasing number of osteosynthesis it is essential for the surgeon to be aware of possible complications due to guide wire perforations. Cases like this go unnoticed if the forensic pathologist is not familiarized with the surgical technique which may explain the rarity of such descriptions in literature.
- Estratificação dos acidentes de trabalho no Serviço de Urgência – Experiência do nosso HospitalPublication . Campos, P; Rosa, B; Barros, A; Karmali, S; Durão, C
- Fractura da tíbia bilateral por projéctil de arma de arma de fogoPublication . Rosa, B; Barros, A; Lopes, A; Alves da Silva, J; Durão, C
- Lombalgia e acidentes de trabalho: a incidência no Serviço de UrgênciaPublication . Barros, A; Rosa, B; Campos, P; Alves da Silva, J; Durão, C
- Primary Total Elbow Arthroplasty in the Treatment of Complex Elbow Fracture: A Case ReportPublication . Campos, PM; Rosa, B; Barros, A; Durão, C; Magalhães, G; Júlio, C; Quinaz-Neto, PIntroduction: Some elbow fractures are very complex with inadequate bone stock, so it is not possible to perform a stable fixation. However, loss of basic elbow function can severely affect daily living activities. There are few alternatives to internal fixation, but arthroplasty can be a reasonable option. The aim of this case report is to evaluate the role of primary total elbow arthroplasty in the treatment of complex elbow fractures. Case study: A 54-year-old male patient presented at our emergency department in the sequence of a motorcycle accident, which caused an open fracture of the left elbow, classified as type IIIB of Gustilo and Anderson. The X-ray showed comminuted fractures of distal humerus and proximal ulna with bone loss from both epiphysis. He started antibiotherapy and was submitted to immediate surgical debridement, provisional fixation with an external fixator and skin closure. The external fixator was removed 2 months after, when the patient presented with great elbow instability. The X-ray and the Computed Tomography showed signals of malunion and bone loss, which prevented any kind of fixation. Therefore, 3 months after, the patient was submitted to elbow joint replacement. A posterior approach was used, in which the triceps was reflected and was applied a linked arthroplasty - Coonrad-Morrey total elbow arthroplasty. On the second week after surgery, passive motion was started and by the fourth week, progressed to active motion. Six months after, he presented without significant pain and with a range of motion of 0° to 135º. Conclusions: Although rarely used, total elbow arthroplasty may be the choice in selected patients with elbow fractures with loss of bone. As shown in this case, this treatment can lead to a satisfactory functional recovery. Despite having some complications, more recent studies encourage its use in the future.
- Primary Total Elbow Arthroplasty in the Treatment of Complex Elbow Fracture: A Case ReportPublication . Campos, PM; Rosa, B; Barros, A; Durão, C; Magalhães, G; Júlio, C; Quinaz-Neto, PIntroduction: Some elbow fractures are very complex with inadequate bone stock, so it is not possible to perform a stable fixation. However, loss of basic elbow function can severely affect daily living activities. There are few alternatives to internal fixation, but arthroplasty can be a reasonable option. The aim of this case report is to evaluate the role of primary total elbow arthroplasty in the treatment of complex elbow fractures. Case study: A 54-year-old male patient presented at our emergency department in the sequence of a motorcycle accident, which caused an open fracture of the left elbow, classified as type IIIB of Gustilo and Anderson. The X-ray showed comminuted fractures of distal humerus and proximal ulna with bone loss from both epiphysis. He started antibiotherapy and was submitted to immediate surgical debridement, provisional fixation with an external fixator and skin closure. The external fixator was removed 2 months after, when the patient presented with great elbow instability. The X-ray and the Computed Tomography showed signals of malunion and bone loss, which prevented any kind of fixation. Therefore, 3 months after, the patient was submitted to elbow joint replacement. A posterior approach was used, in which the triceps was reflected and was applied a linked arthroplasty - Coonrad-Morrey total elbow arthroplasty. On the second week after surgery, passive motion was started and by the fourth week, progressed to active motion. Six months after, he presented without significant pain and with a range of motion of 0° to 135º. Conclusions: Although rarely used, total elbow arthroplasty may be the choice in selected patients with elbow fractures with loss of bone. As shown in this case, this treatment can lead to a satisfactory functional recovery. Despite having some complications, more recent studies encourage its use in the future.
- A rare case of digital myiasisPublication . Durão, C; Barros, A; Campos, PCutaneous myiasis is the infestation of the skin or mucous membranes by larvae of the order Diptera. Wound myiasis affect the skin with a previous lesion, and it may consume both dead and living tissue. Finger infestation is rarely a cause of death, but it may provoke considerable morbidity. Prompt wound exploration and careful total larvae removal is essential to achieve healing. In the reported case, the patient was presented in an advanced stage of the infestation, with a large area of finger necrosis and amputation, associated with cellulitis extending from the finger's base to the hand. This diagnosis helped uncover a familiar history of severe abuse and neglect. The accurate understanding and management of such injuries are important not only for the orthopaedic treatment but also for the acknowledgment of their social and forensic implications.
- Solitary bone plasmacytoma of the pelvis: a rare tumorPublication . Karmali, S; Barros, A; Rosa, B; Campos, P; Gonçalves, R; Sá da Costa, D; López-Presa, DSolitary bone plasmacytomas are part of a wide range of monoclonal neoplasms that share a common progenitor in the B lymphocyte lineage. In their particular case, a single bone lesion is found, most frequently on the axial skeleton, having evidence of no other osteolytic lesions or systemic involvement. Diagnosis can sometimes prove to be difficult as they are rare tumors, occurring in 3 to 5% (up to 10% in some series) of patients with plasma cell neoplasms, with important considerations regarding the differential diagnosis. We report a case of a solitary bone plasmacytoma, found on the ala of the left ilium of a patient during a routine consult due to hip pain.
- Spectrum of CFTR gene sequence variants in a northern Portugal populationPublication . Grangeia, A.; Alves, S.; Gonçalves, L; Gregório, I; Santos, AC; Barros, H; Barros, A; Carvalho, F; Moura, CIn Portugal, the spectrum of Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene variants is not known. The main objective of this work was to determine the type and frequency of CFTR variants in a sample from northern Portugal by the complete analysis of the CFTR coding sequencing performed in 512 Portuguese children. A total of 30 different CFTR sequence variants, already reported as cystic fibrosis (CF) or CFTR related disorders variants, were detected. Ninety-two children (18.0%; 95%CI: 14.7-21.6) were found to be carriers of one sequence variant and 8 (1.6%; 95%CI: 0.7-3.1) had two sequence variants. Taking into consideration only variants that may cause CF when combined with a pathogenic CF variant, the CF pathogenic variant carrier frequency was 3.3% (95%CI: 1.9-5.3). One (0.2%; 95%CI: 0.01-0.7) child presented two CF pathogenic variants. CONCLUSIONS: The majority of CFTR variants detected have been associated with a less severe CF phenotype. A wide spectrum of CFTR variants was identified, confirming the highest CFTR allelic heterogeneity previously reported in Mediterranean country. Additionally, better knowledge about the CFTR sequence variation spectrum may contribute to more efficient genetic testing in the Portuguese population.
- Spinous Process Osteochondroma as a Rare Cause of Lumbar PainPublication . Rosa, B; Campos, P; Barros, A; Karmali, S; Ussene, E; Durão, C; Alves da Silva, J; Coutinho, NWe present a case of a 5th Lumbar Vertebra (L5) spinous process osteochondroma as a rare cause of lumbar pain in an old patient. A 70-year-old male presented with progressive and disabling lower lumbar pain. Tenderness over the central and left paraspinal area of the lower lumbar region and a palpable mass were evident. CT scan showed a mass arising from the spinous process of L5. Marginal resection of the tumor was performed through a posterior approach. The histological study revealed an osteochondroma. After surgery, pain was completely relieved. After one year there was no evidence of local recurrence or symptoms. Osteochondromas rarely involve the spine, but when they do symptoms like pain, radiculopathy/myelopathy, or cosmetic deformity may occur. The imagiologic exam of election for diagnosis is CT scan. When symptomatic the treatment of choice is surgical resection. The most concerning complication of osteochondromas is malignant transformation, a rare event.