Percorrer por autor "Roque, D"
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- Enfarte agudo do miocárdio no YouTube – Is it all fake news?Publication . Fialho, I; Beringuilho, M; Madeira, D; Ferreira, JB; Faria, D; Ferreira, H; Roque, D; Santos, MB.; Morais, C; Gil, V; Augusto, JB.Introduction and objectives: The Internet is a fundamental aspect of health information. However, the absence of quality control encourages misinformation. We aim to assess the relevance and quality of acute myocardial infarction videos shared on YouTube (www.youtube.com) in Portuguese. Methods: We analyzed 1,000 videos corresponding to the first 100 search results on YouTube using the following terms (in Portuguese): "cardiac + arrest"; "heart + attack"; "heart + thrombosis"; "coronary + thrombosis"; "infarction - brain", "myocardial + infarction" and "acute + myocardial + infarction". Irrelevant (n=316), duplicated (n=345), without audio (n=24) or non-Portuguese (n=106) videos were excluded. Included videos were assessed according to source, topic, target audience and scientific inaccuracies. Quality of information was assessed using The Health on the Net Code (HONCode from 0 to 8) and DISCERN (from 0 to 5) scores - the higher the score, the better the quality. Results: 242 videos were included. The majority were from independent instructors (n=95, 39.0%) and were addressed to the general population (n=202, 83.5%). One third of the videos (n=79) contained inaccuracies while scientific society and governmental/health institution videos had no inaccuracies. The mean video quality was poor or moderate; only one video was good quality without any inaccuracies. Governmental/health institutions were the source with the best quality videos (HONCode 4±1, DISCERN 2±1). Conclusions: One third of the videos had irrelevant information and one third of the relevant ones contained inaccuracies. The average video quality was poor; therefore it is important to define strategies to improve the quality of online health information.
- Lumbar paraspinal intramuscular myxoma: A case reportPublication . Hipólito-Reis, J; Roque, D; Teixeira, JCBackground: With an estimated incidence of about 1 case/million patients, paravertebral intramuscular myxomas represent a rare cause of lumbar pain. Rather, they typically occur in the heart and in bone tissues. Case description: A 64-year-old female presented with a protracted course of nocturnal lumbar pain that radiated to the anterior aspect of the right thigh accompanied by numbness. She reported a slow-growing right paramedian lumbar mass in the previous months. The magnetic resonance (MR) showed a right lumbar paravertebral intramuscular mass at the L3 level (i.e., 70 × 50 mm) that had well-defined margins, and markedly enhanced with gadolinium. Following gross total "en bloc" tumor resection, the patient fully recovered. Pathologically, the myofibroblastic lesion proved to be an intramuscular myxoma without malignant changes. Conclusion: A 64-year-old female presented with a slow-growing MR-documented right paramedian lumbar L3 mass responsible for proximal right-thigh numbness. Following "en bloc" gross total removal of the benign intramuscular myxoma, the patient was asymptomatic.
- Understanding a woman's heart: Lessons from 14 177 women with acute coronary syndromePublication . Roque, D; Ferreira, J; Monteiro, S; Costa, M; Gil, VINTRODUCTION: Coronary artery disease is becoming the leading cause of death in women in Western society. However, the available data shows that women are still underdiagnosed and undertreated with guideline-recommended secondary prevention therapy, leading to a significantly higher rate of in-hospital complications and in-hospital mortality. OBJECTIVE: The main objective of this work is to assess the approach to acute coronary syndrome (ACS) in Portugal, including form of presentation, in-hospital treatment and in-hospital complications, according to gender and in three different periods. METHODS: We performed an observational study with retrospective analysis of all patients included between 2002 and 2019 in the Portuguese Registry of Acute Coronary Syndromes (ProACS), a voluntary, observational, prospective, continuous registry of the Portuguese Society of Cardiology and the National Center for Data Collection in Cardiology. RESULTS: A total of 49 113 patients (34 936 men and 14 177 women) were included. Obesity, hypertension, diabetes (p<0.001 for all) and dyslipidemia (p=0.022) were all more prevalent in women, who were more frequently admitted for non-ST segment elevation ACS (p<0.001), and more frequently presented with atypical symptoms. Women had more time until needle and until reperfusion, which is less accessible to this gender (p<0.001). During hospitalization, women had a significantly higher risk of in-hospital mortality (OR 1.94 [1.78-2.12], p<0.001), major bleeding (OR 1.53 [1.30-1.80], p<0.001), heart failure (OR 1.87 [1.78-1.97], p<0.001), atrial fibrillation (OR 1.55 [1.36-1.77], p<0.001), mechanical complications (OR 2.12 [1.78-2.53], p<0.001), cardiogenic shock (OR 1.71 [1.57-1.87], p<0.001) and stroke (OR 2.15 [1.76-2.62], p<0.001). Women were more likely to have a normal coronary angiogram or coronary lesions with <50% luminal stenosis (p<0.001 for both), and thus a final diagnosis other than ACS. Both during hospitalization and at hospital discharge, women were less likely to receive guideline-recommended secondary prevention therapy. CONCLUSION: In women admitted for ACS, revascularization strategies are still underused, as is guideline-recommended secondary prevention therapy, which may explain their higher incidence of in-hospital complications and higher unadjusted mortality.