SESARAM - Serviço de Saúde da Região Autónoma da Madeira, EPERAM
Permanent URI for this community
O Serviço de Saúde da Região Autónoma da Madeira, E.P.E, designado por SESARAM, é uma unidade integrada de prestação de cuidados de saúde, com sede no Funchal. Visa alcançar uma elevada promoção e protecção da saúde das pessoas e populações bem como desenvolver actividades na área da investigação e formação, tanto nos seus serviços como em unidades específicas. Dele fazem parte: Hospital Dr. Nélio Mendonça, Hospital dos Marmeleiros, Unidade João de Almada e Unidade Atalaia e Agrupamento dos Centros de Saúde. A criação do repositório institucional do SESARAM permite que a actividade científica realizada na instituição seja contemplada como um todo e divulgada de uma forma una e organizada, em formato digital, levando a que esse conhecimento tenha uma disseminação global. Excelente ferramenta para a centralização de dados e devido arquivamento, funcionará como um ponto basilar no conhecimento da história da instituição.
https://www.sesaram.pt/Browse
Browsing SESARAM - Serviço de Saúde da Região Autónoma da Madeira, EPERAM by Title
Now showing 1 - 10 of 392
Results Per Page
Sort Options
- 0 Serviço Social lntegrado na Consulta de terapêutica de dorPublication . Roberts, MónicaAs atuais políticas de inserção obedecem a uma lógica de discriminação positiva, defendendo grupos específicos e desenvolvendo estratégias concretas para todos aqueles que sofrem de um "défice" de interação. Neste sentido o integração dos incapacitados" (doentes oncológicos, portadores de deficiência doentes crónicos e idosos) só será efetivamente,conquistada ajudando a sociedade a assumir, em conjunto com eles a responsabilidade de equacionar os seus problemas, encontrando alternativas e recursos respondendo às suas necessidades básicas Tendo por base estes pressupostos e atendendo ao elevado número de solicitações, o Serviço Social, efetuou um trabalho de recolha da legislação reguladora dos direitos e recursos sociais "incapacitado", referente às várias áreas, nomeadamente nos regimes do Segurança Social, Ação Social, Aposentação e Reforma, Saúde,Emprego e Formação Profissional, Finanças, habitação e Transportes Próprios.
- A 2018 overview of diuretic resistance in heart failurePublication . Jardim, S; Ramos dos Santos, L; Araújo, I; Marques, F; Branco, P; Gaspar, A; Fonseca, CAbstract Heart failure is a disease with high direct and indirect costs. Current treatment includes drugs that alter disease progression and drugs that to improve symptoms. Loop diuretics are the cornerstone of congestion relief for acute management, as well as for chronic stabilization. In heart failure patients, maximal diuretic response is reduced by many individual factors. Diuretic resistance is defined as failure to achieve effective congestion relief despite appropriate or escalating diuretic doses. Its causes include impaired delivery of the diuretic to its luminal site of action, neurohormonal activation, tubular compensatory adaptation and drug interactions. Several strategies can be employed to aid decongestion of patients with impaired diuretic response. These include salt restriction, a higher effective single dose or higher dose frequency of loop diuretics, continuous infusion of diuretics and/or sequential nephron blockade through a synergistic combination of two or more diuretics from different classes. Ultrafiltration has also been found to be another effective and safe therapeutic option and should be considered in patients with refractory diuretic resistance. Overall, there is a lack of high-quality clinical data to guide the choice of treatment strategy and therapy should be tailored on a case-by-case basis.
- Abordagem ao consumo de álcool em consultaPublication . Mendonça, Carlota
- Acute Pancreatitis and Posterior Reversible Encephalopathy Syndrome: A Case ReportPublication . Pereira, Vítor Magno; Correia, Luís Marote; Rodrigues, Tiago; Faria, Gorete SerrãoThe posterior reversible encephalopathy syndrome is a neurological syndrome characterized by headache, confusion, visual disturbances and seizures associated with identifiable areas of cerebral edema on imaging studies. The authors report the case of a man, 33 years-old, leukodermic with a history of chronic alcohol and tobacco consumption, who is admitted to the emergency department for epigastric pain radiating to the back and vomiting with about six hours of evolution and an intense holocranial headache for two hours. His physical examination was remarkable for a blood pressure of 190/100 mmHg and tenderness in epigastrium. His analytical results revealed emphasis on amylase 193 U/L and lipase 934 U/L. During the observation in the emergency department, he presented a generalized tonic-clonic seizure. Abdominal ultrasonography was performed and suggestive of pancreatitis without gallstones signals. Head computed tomography showed subarachnoid haemorrhage and a small right frontal cortical haemorrhage. The brain magnetic resonance imaging done one week after admission showed areas of a bilateral and symmetrical T2 / FLAIR hyperintensities in the subcortical white matter of the parietal and superior frontal regions, suggesting a diagnosis of posterior reversible encephalopathy syndrome. Abdominal computed tomography (10 days after admission) demonstrated a thickened pancreas in connection with inflammation and two small hypodense foci in the anterior part of the pancreas body, translating small foci of necrosis. The investigation of a thrombophilic defect revealed a heterozygous G20210A prothrombin gene mutation. The patient was discharged without neurological sequelae and asymptomatic. The follow-up brain magnetic resonance imaging confirmed the reversal of the lesions, confirming the diagnosis.
- Acute Pancreatitis in the Context of Abdominal Attack of Hereditary AngioedemaPublication . Lourenço, T; Fernandes, M; Lopes, A; Pereira Barbosa, M
- Acute Pyelonephritis Associated with Ruptured Abdominal Aortic Aneurysm: An Unusual PresentationPublication . Nascimento, Rafael Ferreira; Morna, Carolina; Bilreiro, Mariana; Correia, InesWe describe a rare presentation of acute pyelonephritis associated with a ruptured abdominal aortic aneurysm. A 68-year-old female presented to the emergency department with a 3 day history of cystitis. General examination revealed the acute onset of pain in the left flank accompanied by fever and chills. Blood tests revealed leucocytosis 25,400×109/L and C-reactive protein 495 mg/L (<6.1), while urinary sediment analysis revealed many leucocytes and gram-negative bacteria. The patient was admitted with acute piyelonephritis. On the third day of admission, the urine culture isolated Escherichia coli sensitive to the antibiotic prescribed; however, the patient clinically deteriorated. A computed tomography scan revealed a ruptured abdominal aortic aneurysm involving the left renal artery. The patient underwent an exploratory laparotomy but uncontrollable haemorrhage led to a fatal outcome. This case highlights a rare case of acute pyelonephritis associated with a ruptured abdominal aortic aneurysm. A computed tomography scan or abdominal ultrasound should be considered whenever a patient has acute pyelonephritis with a C-reactive protein >400 mg/L in order to exclude complications and other potentially fatal pathologies.
- Additional value of a combined genetic risk score to standard cardiovascular stratificationPublication . Pereira, Andreia; Mendonca, Maria Isabel; Borges, Sofia; Sousa, Ana Célia; Freitas, Sónia; Henriques, Eva; Rodrigues, Mariana; Freitas, Ana Isabel; Guerra, Graça; Freitas, Carolina; Pereira, Décio; Brehm, António; Palma dos Reis, RobertoThe utility of genetic risk scores (GRS) as independent risk predictors remains inconclusive. Here, we evaluate the additive value of a multi-locus GRS to the Framingham risk score (FRS) in coronary artery disease (CAD) risk prediction. A total of 2888 individuals (1566 coronary patients and 1322 controls) were divided into three subgroups according to FRS. Multiplicative GRS was determined for 32 genetic variants associated to CAD. Logistic Regression and Area Under the Curve (AUC) were determined first, using the TRF for each FRS subgroup, and secondly, adding GRS. Different models (TRF, TRF+GRS) were used to classify the subjects into risk categories for the FRS 10-year predicted risk. The improvement offered by GRS was expressed as Net Reclassification Index and Integrated Discrimination Improvement. Multivariate analysis showed that GRS was an independent predictor for CAD (OR = 1.87; p<0.0001). Diabetes, arterial hypertension, dyslipidemia and smoking status were also independent CAD predictors (p<0.05). GRS added predictive value to TRF across all risk subgroups. NRI showed a significant improvement in all categories. In conclusion, GRS provided a better incremental value in intermediate subgroup. In this subgroup, inclusion of genotyping may be considered to better stratify cardiovascular risk.
- Adherence to the Mediterranean diet in Portuguese university studentsPublication . Ferreira-Pêgo, Cíntia; Rodrigues, Joana; Costa, Adriana; Sousa, BrunoAbstract Mediterranean diet (MedDiet) is one of the most recognized healthy dietary patterns. Despite the beneficial effects of healthy eating habits on academic performance, university students make unhealthy food choices. Cross sectional information regarding MedDiet adherence was collected in 305 students from the Universidade Lusófona de Humanidades e Tecnologias, from different academic courses, related or not with health sciences. To assess the MedDiet adherence, the participants completed a validated 14-point questionnaire. Approximately 29% of the total population presented poor (< 5 points) MedDiet adherence, meanwhile 59% presented an average (between 6 and 9 points) adherence and only 12.50% presented a high (> 10 points) MedDiet adherence. Nutrition students presented the highest MedDiet adherence of all the students analyzed. Pharmaceutical students, although being health professionals, showed poor adherence to the MedDiet, similar to students from courses not related to health sciences
- Administração e Gestão em Saúde - Coletânea de textos - Cuidados de Saúde Primários na Região Autónoma da Madeira: compromissos com o clientePublication . Pinto, Cisaltina Sousa; Andrade, Maria Gorete; Jardim, António Gonçalo; Gouveia, Pedro; Machado, Soraya Coelho Gonçalves
- Age-related expression of TGF beta family receptors in human cumulus oophorus cellsPublication . Ribeiro, A.; Freitas, C.; Matos, L.; Gouveia, A.; Gomes, F.; Silva Carvalho, J. L.; Almeida, H.During ovarian follicle growth, local cellular interactions are essential for oocyte quality acquisition and successful fertilization. While cumulus cells (CCs) nurture oocytes, they also deliver oocyte-secreted factors (OSFs) that activate receptors on CCs. We hypothesized that disturbance of those interactions contributes to age-related lower reproductive success in women submitted to assisted reproductive technology treatments.