Browsing by Author "Oliveira, R"
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- Assimetria pulmonar na telerradiografia do tóraxPublication . Oliveira, R; Martins, JD; Marques, H; Santos, O; Freitas, I; Pinto, FFThe unilateral absence of one pulmonary artery is a rare congenital abnormality. The authors report a clinical case of a two-year-old boy with no previous medical history who was referred for evaluation after the detection of pulmonary asymmetry on the chest X-ray with a right mediastinal shift. The CT scan and pulmonary perfusion scintigraphy pointed to an absent right pulmonary artery, which was confirmed by right heart catheterization and cardiac magnetic resonance imaging. This is an important pathology because early diagnosis and timely correction can prevent future complications. Since at this time the patient is asymptomatic, the authors opted for careful clinical vigilance.
- Candida clinical species identification: molecular and biochemical methodsPublication . Costa, AR; Silva, F; Henriques, M; Azeredo, J; Oliveira, R; Faustino, AIn the last decade, the number and diversity of nosocomial Candida infections has increased significantly, resulting in an emergent need for rapid and accurate methods for Candida identification. Therefore, the aim of this study was to evaluate the performance of three biochemical systems (Auxacolor, ID32C, and Vitek 2 YST) for the identification of Candida species, comparing them with molecular identification (polymerase chain reaction and gel agarose electrophoresis). These methods were used to assess Candida spp. (229 clinical isolates) prevalence and distribution among clinical specimens. The biochemical methods with higher percentages of correct identification were Vitek 2 YST (79.6%) and Auxacolor (78.6%). However, overall the biochemical methods assayed differed from the molecular identification. Thus, due to their rapid and precise identification, molecular methods are promising techniques for Candida species identification in clinical laboratories. Candida albicans and Non Candida albicans Candida species had a similar prevalence (50.4 and 49.6%, respectively), corroborating the epidemiological shift observed for these pathogens in the recent years.
- Late-onset Lennox-Gastaut syndrome as a phenotype of 15q11.1q13.3 duplicationPublication . Rocha, J; Guerra, C; Oliveira, R; Dória, S; Rego, R; Rosas, MJThe clinical symptoms associated with chromosome 15q duplication syndrome manifest through a heterogeneous group of symptoms characterised by hypotonia, delay in motor skills and language development, cognitive and learning disabilities, autism spectrum disorder and refractory epilepsy. The late development of Lennox-Gastaut syndrome in patients with 15q11q13 duplication is a possibility that physicians should be aware of. We report the case of a 27-year-old man with a neurodevelopmental syndrome due to a 15q duplication, with intellectual disability, psychiatric disturbances, and an epileptic phenotype diagnosed as late-onset Lennox-Gastaut syndrome.
- The Manchester Triage System in acute coronary syndromesPublication . Matias, C; Oliveira, R; Duarte, R; Bico, P; Mendonça, C; Nuno, L; Almeida, A; Rabaçal, C; Afonso, SINTRODUCTION: A growing number of hospitals have implemented the Manchester Triage System (MTS) in their Emergency Department (ED), so as to better prioritize the evaluation of those attending these departments. OBJECTIVES: To assess whether the MTS was used effectively in patients admitted to the hospital with a diagnosis of acute coronary syndrome (ACS). METHODS: We evaluated 114 consecutive patients admitted to the Cardiology Department with a diagnosis of ACS. We recorded the color assigned in the MTS, mean time from arrival in the ED to MTS, mean time from MTS to first medical assessment (1-MA) and mean time from 1-MA to admission. We also analyzed the correlation between the type of ACS and clinical presentation and its relation with MTS. RESULTS: Of the 114 patients, one was coded red (0.9%), 71 orange (62.3%), 12 green (11%), and two were not assigned a color code according to MTS because they were admitted via a Medical Emergency and Resuscitation Vehicle. Mean time from arrival in the ED to MTS was 5.2 +/- 0.6 min and from MTS to MA was 20 +/- 2.5 min. In patients triaged as orange the time from MTS to MA was 15.1 +/- 1.5 min, as yellow 36.2 +/- 7 min, and as green 35.2 +/- 20.6 min (p = 0.003). Mean time from 1-MA to admission was 144.4 +/- 17 min, with no differences according to triage code or ACS type. Clinical presentation influenced triage and the speed of 1-MA and admission, patients with typical presentation being evaluated and admitted more quickly. CONCLUSIONS: Most patients admitted for ACS are initially triaged as orange or yellow, an indication for prompt assessment in the ED; this has a positive effect on time to first medical assessment, but has no effect on time to hospital admission.