Browsing by Author "Rodrigues, P"
Now showing 1 - 6 of 6
Results Per Page
Sort Options
- Doença pneumocóccica invasiva na era vacinalPublication . Neves, JF; Rodrigues, P; Peres, A; Constantino, C; Cunha, F
- Gastropatia hipertrófica exsudativa na criança: uma doença rara?Publication . Rodrigues, P; Peres, A; Simões, AS; Cunha, F
- Infective endarteritis complicating clinically silent patent ductus arteriosusPublication . Ferreira, PS; Rodrigues, P; Peres, A; Roque do Vale, P; Casimiro, A; Cunha, FInfective Endocarditis is caused by bacteria or fungi involving the heart or the great vessels (Endarteritis). It is a rare and potentially ominous disease, with increasing incidence. Despite technological advances it remains difficult to diagnose and treat, particularly in children below two years. Congenital heart disease is the main risk factor for Infective Endocarditis in children. A patent ductus arteriosus clinically silent is infrequently implied. Over two-month-old Streptococci spp and Staphylococcus aureus are the main agents, responsible for 62-77% of cases. Gram negative rods count for 4-6%, being Klebsiella pneumoniae a rare pathogen. The authors report a case of a previously healthy four-months-old infant, admitted for bronchiolitis. He developed a Klebsiella pneumoniae persistent bacteremia related to Endarteritis of a silent patent ductus arteriosus. After prolonged and successful antibiotic therapy, the ductus arteriosus was surgically closed. He suffered no complication during the disease process and recovered uneventfully.
- Non-coronary sinus of Valsalva aneurysm diagnosed after a road traffic accidentPublication . Ribeiro, A; Fernandes, F; Costeira, A; Simões, A; Rodrigues, PA 38 year old man with a huge unruptured sinus of Valsalva aneurysm, complicated with severe valvar aortic regurgitation, is described. The aneurysm was detected by echocardiography in the asymptomatic patient who presented with an intense precordial diastolic rumble after a road traffic accident. The patient had successful surgery for the aneurysm and aortic valve replacement. Possible aetiologies for the aneurysm and a brief revision of clinical aspects and treatment are discussed.
- Poster - Casuistica dos doentes com esclerose multipla da consulta de doenças desmielinizantes do serviço de Neurologia do Hospital Dr. Nélio MendonçaPublication . Rodrigues, P; Aguiar, S; Morganho, A; Vieira, JA Esclerose Múltipla (EM) é uma doença inflamatória, caracterizada pela desmielinização e neurodegeneração no Sistema Nervoso Central1. Estima-se que em todo o mundo existam cerca de 2,5 milhões de pessoas com EM e em Portugal Continental estima-se que esta patologia atinja cerca de 6500 pessoas. Surge frequentemente entre os 20 e os 40 anos de idade e afeta mais mulheres do que homens (3 para 1). É em muitos países, a principal causa de incapacidade neurológica não traumática em adultos jovens1. As manifestações clínicas da EM variam desde alterações motoras, da sensibilidade, visuais, cognitivas, entre outras. A terapêutica utilizada para o tratamento desta doença tem como principal objetivo controlar a atividade da doença no sentido de atrasar a progressão da incapacidade dos doentes, a prevenção dos surtos e controlo dos sintomas. Neste trabalho temos como objetivo realizar uma análise retrospetiva de dados sociodemográficos (idade e sexo) e respetivo tratamento dos doentes Hospital Dr. Nélio Mendonça.
- Risk and clinical-outcome indicators of delirium in an emergency department intermediate care unit (EDIMCU): an observational prospective studyPublication . Mariz, J; Santos, NC; Afonso, H; Rodrigues, P; Faria, A; Sousa, N; Teixeira, JBACKGROUND: Identification of delirium in emergency departments (ED) is often underestimated; within EDs, studies on delirium assessment and relation with patient outcome in Intermediate Care Units (IMCU) appear missing in European hospital settings. Here we aimed to determine delirium prevalence in an EDIMCU (Hospital de Braga, Braga, Portugal) and assessed routine biochemical parameters that might be delirium indicators. METHODS: The study was prospective and observational. Sedation level was assessed via the Richmond Agitation-Sedation Scale and delirium status by the Confusion Assessment Method for the ICU. Information collected included age and gender, admission type, Charlson Comorbidity Index combined condition score (Charlson score), systemic inflammatory response syndrome criteria (SIRS), biochemical parameters (blood concentration of urea nitrogen, creatinine, hemoglobin, sodium and potassium, arterial blood gases, and other parameters as needed depending on clinical diagnosis) and EDIMCU length of stay (LOS). Statistical analyses were performed as appropriate to determine if baseline features differed between the 'Delirium' and 'No Delirium' groups. Multivariate logistic regression was performed to assess the effect of delirium on the 1-month outcome. RESULTS: Inclusion and exclusion criteria were met in 283 patients; 238 were evaluated at 1-month for outcome follow-up after EDIMCU discharge ("good" recovery without complications requiring hospitalization or institutionalization; "poor" institutionalization in permanent care-units/assisted-living or death). Delirium was diagnosed in 20.1% patients and was significantly associated with longer EDIMCU LOS. At admission, Delirium patients were significantly older and had significantly higher blood urea, creatinine and osmolarity levels and significantly lower hemoglobin levels, when compared with No Delirium patients. Delirium was an independent predictor of increased EDIMCU LOS (odds ratio 3.65, 95% CI 1.97-6.75) and poor outcome at 1-month after discharge (odds ratio 3.51, CI 1.84-6.70), adjusted for age, gender, admission type, presence of SIRS criteria, Charlson score and osmolarity at admission. CONCLUSIONS: In an EDIMCU setting, delirium was associated with longer LOS and poor outcome at 1-month post-discharge. Altogether, findings support the need for delirium screening and management in emergency settings.