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- Anomalia Congénita Coclear: Tentativa de Relação Embriológica e Anátomo-FuncionalPublication . Maurício, JC; Biscoito, L; Branco, GIn this review of cochlear malformations, 17 cases were studied by CT scan (high resolution-target program) including 10 males and 7 females. The anomaly was bilateral in 12 cases and unilateral in 7 (the latter included 2 Mondini type aplasias and one Michel). The cochlear malformation (whose most frequent expression was the cochlear hypoplasia with 1 or 1 1/2 spires-65% of the cases) was associated to semicircular canals and/or vestibular aqueduct anomaly in 82% of the patients; it was exclusively of the anterior labyrinth in 18% of the cases. A middle ear malformation coexisted in 29%: in 3 cases with malleoincudal dysmorphy only and with tympanic aplasia in 2 others. These cochlear anomalies with CT expression were discussed considering the embryology, in view of a possible gestational dating, moreover relating to the hipocusia type: perceptive or combined.
- An alternative explanation of the origin of the signal in diffusion-weighted MRIPublication . Branco, GI formulated an alternative explanation for the origin of the signal in diffusion-weighted MRI (DWI) and tested it in a simple experimental model using gelatin. My findings indicate that the signal in DWI is influenced by the passage of water from the sol to the gel state, independently of the presence of cell structures or membrane-dependent diffusion.
- Patologia naso-sinusalPublication . Paço, J; Branco, C; Ruah, C; Marco, E; Barros, E; Ruah, S; Loureiro, C; Caroça, C; Almeida, E; Branco, G; Cardoso, S; Vilhena de Mendonça, F
- Rinosinusites na prática clínica: guia de diagnóstico e tratamentoPublication . Paço, J; Branco, C; Ruah, C; Caroça, C; Barros, E; Branco, G; Ruah, S; Vilhena de Mendonça, F
- Otites na prática clínica: guia de diagnóstico e tratamentoPublication . Paço, J; Branco, C; Caroça, C; Vieira de Almeida, J; Caçador, M; Vilhena de Mendonça, F
- Schwannoma, a rare tumor of the seminal vesiclePublication . Furtado, AM; Carrasquinho, E; Ferreira, M; Afonso, A; Ferrito, FWe present a rare case of a schwannoma of the seminal vesicle that occurred in a 43-year-old male with symptoms of the lower urinary tract. Ultrasonography and magnetic resonance imaging documented a solid mass in the patient's left seminal vesicle. A transvesical approach with a transtrigonal midline incision was successfully performed. The microscopic aspect was compatible with schwannoma.
- Patologia da cavidade bucal, faringe e laringe na prática clínica: guia de diagnóstico e tratamentoPublication . Paço, J; Vilhena de Mendonça, F
- Endoscopic stenting for hilar cholangiocarcinoma: efficacy of unilateral and bilateral placement of plastic and metal stents in a retrospective review of 480 patientsPublication . Liberato, MJ; Canena, JMBACKGROUND: Endoscopic biliary drainage of hilar cholangiocarcinoma is controversial with respect to the optimal types of stents and the extent of drainage. This study evaluated endoscopic palliation in patients with hilar cholangiocarcinoma using self-expandable metallic stents (SEMS) and plastic stents (PS).We also compared unilateral and bilateral stent placement according to the Bismuth classification. METHODS: Data on 480 patients receiving endoscopic biliary drainage for hilar cholangiocarcinoma between September 1995 and December 2010 were retrospectively reviewed to evaluate the following outcome parameters: technical success (TS), functional success (FS), early and late complications, stent patency and survival. Patients were followed from stent insertion until death or stent occlusion. Patients were divided into 3 groups according to the Bismuth classification (Group 1, type I; Group 2, type II; Group 3, type ≥ III). RESULTS: The initial stent insertion was successful in 450 (93.8%) patients. TS was achieved in 204 (88.3%) patients treated with PS and in 246 (98.8%) patients palliated with SEMS (p < 0.001). In the intention-to-treat (ITT) analysis, the FS in patients treated with SEMS (97.9%) was significantly higher than in patients treated with PS (84.8%) (p < 0.001). Late complications occurred in 115 (56.4%) patients treated with PS and 60 (24.4%) patients treated with SEMS (p < 0.001). The median duration of stent patency in weeks (w) were as follows: 20 w in patients palliated with PS and 27 w in patients treated with SEMS (p < 0.0001). In Group 2, the median duration of PS patency was 17 w and 18 w for unilateral and bilateral placement, respectively (p = 0.0004); the median duration of SEMS patency was 24 w and 29 w for unilateral and bilateral placement, respectively (p < 0.0001). Multivariate analysis using the Poisson regression showed that SEMS placement (B = 0.48; P < 0.01) and bilateral deployment (B = 0.24; P < 0.01) were the only independent prognostic factors associated with stent patency. CONCLUSIONS: SEMS insertion for the palliation of hilar cholangiocarcinoma offers higher technical and clinical success rates in the ITT analysis as well as lower complication rates and a superior cumulative stent patency when compared with PS placement in all Bismuth classifications. The cumulative patency of bilateral SEMS or PS stents was significantly higher than that of unilateral SEMS or PS stents, with lower occlusion rates in Bismuth II patients.
- Prevalence and classification of rhinitis in the elderly: a nationwide survey in PortugalPublication . Morais-Almeida, M; Pite, H; Pereira, AM; Todo-Bom, A; Nunes, C; Bousquet, J; Fonseca, JABACKGROUND: Nationwide epidemiologic data on rhinitis in the elderly do not exist. This study aimed to estimate the prevalence of rhinitis in the population aged 65 years or above in mainland Portugal and to characterize and classify rhinitis in this age group. METHODS: Cross-sectional, nationwide, population-based survey of citizens aged 65 years or above, living in mainland Portugal. Current rhinitis (CR) was defined as the presence of at least two symptoms: 'repeated sneezing and itchy nose', 'blocked nose for more than one whole hour', or 'runny nose when not having a cold or flu', either usually or in the last 12 months. Rhinitis severity was assessed using a visual analogue scale; rhinitis was classified according to ARIA. RESULTS: Data were obtained from 3678 responders (92.5% response rate). The prevalence of CR was 29.8% (95% confidence interval (CI): 28.4%-31.3%): 49.1% had mild intermittent, 7.0% mild persistent, 27.5% moderate-severe intermittent, and 16.4% moderate-severe persistent rhinitis. Only 38.6% of patients with CR had been physician diagnosed and 38.7% were under treatment for this disease in the previous year. Allergic conjunctivitis symptoms were referred by 68.6% of subjects with CR (rhinoconjunctivitis population prevalence, 20.5% (95% CI: 19.2%-21.8%)). CONCLUSIONS: Rhinitis and rhinoconjunctivitis are common but underdiagnosed and undertreated diseases in the geriatric population. This was the first nationwide epidemiological survey classifying rhinitis according to ARIA guidelines in this age group. More than 40% of old-age patients presented moderate-severe disease.
- The influence of muscles activation on the dynamical behaviour of the tympano-ossicular system of the middle earPublication . Gentil, F; Parente, M; Martins, P; Garbe, C; Paço, J; Ferreira, AJ; Tavares, JM; Jorge, RNThe human ear is a complex biomechanical system and is divided into three parts: outer, middle and inner ear. The middle ear is formed by ossicles (malleus, incus and stapes), ligaments, muscles and tendons, which transfers sound vibrations from the eardrum to the inner ear, linking with mastoid and Eustachian tube. In this work, a finite element modelling of the tympano-ossicular system of the middle ear was developed. A dynamic study based on a structural response to harmonic vibrations, for a sound pressure level (SPL) of 110, 120 and 130 dB SPL applied in the eardrum, is presented. The connection between the ossicles is made using a contact formulation. The model includes the different ligaments considering its hyperelastic behaviour. The activation of the muscles is based on the constitutive model proposed by previous work. The harmonic responses of displacement and pressure obtained on the stapes footplate, for a frequency range between 100 Hz and 10 kHz, are obtained simulating the muscle activation. The results are compared considering the passive and active states. The results are discussed and they are in accordance with audiological data published with reference to the effects of the middle ear muscles contraction.