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Urgent tracheostomy： four-year experience in a tertiary hospital

World Journal of Emergency Medicine 2016年第3期7卷 227-230页

作者： Liliana Costa Ricardo Matos Sara Julio Fernando Vales margarida santos Otorhinolaryngology Sao Joao Hospital Center Porto 4200-319 Portugal

BACKGROUND: Urgent airway management is one of the most important responsibilities of otolaryngologists, often requiring a multidisciplinary approach. Urgent surgical airway intervention is indicated when an acute airway obstruction occurs or there are intubation difficulties. In these situations, surgical tracheostomy becomes extremely ***: We retrospectively studied the patients who underwent surgical tracheostomy from 2011 to 2014 by an otolaryngologist team at the operating theater of the emergency department of a tertiary hospital. Indications, complications and clinical evolution of the patients were ***: The study included 56 patients(44 men and 12 women) with a median age of 55 years. The procedure was performed under local anesthesia in 21.4% of the patients. Two(3.6%) patients were subjected to conversion from cricothyrostomy to tracheostomy. Head and neck neoplasm was indicated in 44.6% of the patients, deep neck infection in 19.6%, and bilateral vocal fold paralysis in 10.7%. Stridor was the most frequent signal(51.8%). Of the 56 patients, 15 were transferred to another hospital. Among the other 41 patients, 21 were decannulated(average time: 4 months), and none of them were cancer patients. Complications occurred in 5(12.2%) patients: hemorrhage in 3, surgical wound infection in 1, and cervico-thoracic subcutaneous emphysema in 1. No death was related to the ***: Urgent tracheostomy is a life-saving procedure for patients with acute airway obstruction or with diffi cult intubation. It is a safe and effective procedure, with a low complication rate, and should be performed before the patient's clinical status turns into a surgical emergency situation.

关键词： Tracheostomy Cricothryrostomy Stridor Airway obstruction

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Dexamethasone intravitreal implant(Ozurdex) in diabetic macular edema: real-world data versus clinical trials outcomes

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International Journal of Ophthalmology(English edition) 2021年第10期14卷 1571-1580页

作者： Pedro Neves Mário Ornelas Inês Matias João Rodrigues margarida santos Marco DutraMedeiros David Martins Department of Ophthalmology Centro Hospitalar de SetúbalSetúbal 2910-549Portugal Department of Ophthalmology Hospital BeatrizÂngeloLoures 2674-514Portugal Department of Ophthalmology Hospital da Luz SetúbalSetúbal 2900-722Portugal Department of Ophthalmology Centro Hospitalar Lisboa CentralFaculdade de Ciências MédicasNOVA University of LisbonLisbon 1990-237Portugal

AIM: To investigate the safety and efficacy of intravitreal dexamethasone implants(Ozurdex?/DEX) in patients with diabetic macular edema(DME) either na?ve or nonna?ve to anti-VEGF therapies who switched to DEX implant independent of response to anti-vascular endothelial growth factors(anti-VEGFs).METHODS: This was an audit retrospective review of medical records of patients with DME who switched to the DEX intravitreal implant. Patients were divided into 2 groups: patients na?ve to antiangiogenic therapy and patients who were previously treated with anti-VEGFs. Data regarding demographics, changes in mean best-corrected visual acuity(BCVA), central macular thickness(CMT), and intraocular pressure(IOP) was collected over 6 mo. The demographic data mean changes in BCVA, CMT, and IOP were compared. Six-month follow-up data of 47 patients(57 eyes), who either switched to DEX implant irrespective of response to previous treatments or were treatment na?ve before receiving DEX implant, was ***: Improvement in mean BCVA was observed from 1-4 mo after injection with a decreased effect at month 6 as expected, with better outcomes in na?ve compared to non-na?ve patients. A statistically relevant decrease in mean CMT was observed during the follow-up period. An increase in mean IOP was observed in the first 2 mo after DEX therapy. The mean number of injections of the overall population during the 6 mo was 1.3. A subgroup analysis showed no relevant difference between phakic versus pseudophakic patients relative to measured outcomes. There was no cataract progression during the follow-up period and no adverse events ***: This real-life setting study shows that intravitreal DEX implant is effective and safe. The timings of greater therapeutic impact are concordant with previous studies and suggest that earlier treatment with corticosteroids may have an additional benefit in na?ve patients.

关键词： anti-VEGF therapy diabetic macular edema dexamethasone intravitreal implant na?ve eyes steroids

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Polymorphism in cardiovascular diseases(CVD)susceptibility loci in the azores islands(Portugal)

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Open Journal of Genetics 2011年第3期1卷 48-53页

作者： Mafalda Raposo Paul Sousa Stefan Nemeth Ana Rita Couto margarida Rodrigues santos Joao Paulo Pinheiro Maria Joao Peixoto Christian Oberkanins Nadiya Kazachkova Teresa Cymbron Manuela Lima Jacome Bruges-Armas Center of Research in Natural Resources(CIRN)and Department of Biology University of the AzoresPonta DelgadaPortugal Specialized Service of Epidemiology and Molecular Biology(SEEBMO) Hospital of Santo EspiritoAngra do HeroismoPortugal Institute for Molecular and Cell Biology(IBMC) University of PortoPortoPortugal ViennaLab Diagnostics GmbH ViennaAustria

Background: Atherosclerosis and thrombosis are the major manifestations underlying cardiovascular diseases (CVD), which are the leading cause of mortality and morbidity worldwide. Both result from an interaction between genetic and environmental risk factors. The goal of our study was to evaluate several polymorphisms identified as predisposing factors to atherosclerosis and thrombosis. Material and Methods: A series of 155 healthy unrelated individuals of Azorean origin were analyzed using the CVD StripAssay (ViennaLab Diagnostics, Austria) for the most established polymorphisms involved in blood coagulation (F2, F5, F13A1, FGB), fibrinolitic system (SERPINE1), platelet adhesion (ITGB3), homocysteine metabolism (MTHFR), reninangio-tensin system (ACE) and lipid metabolism (APOE). Results: No significant differences were observed in allelic frequencies when comparing our data to mainland Portugal. Group stratification according to the number of “increased” risk alleles, demonstrated that 116/155 (75%) individuals belong to the moderate risk group (5 - 10 risk alleles). Conclusions: Although acknowledging the fact that the allelic states at the analysed loci lack predictive value, the fact that a high frequency of individuals presents at least 5 risk alleles (124/155;80%) is important for the establishment of the appropriate preventive measures in the Azorean population.

关键词： Atherosclerosis Thrombosis Cardiovascular Diseases Susceptibility Genes Genetic Risk Poly-morphism

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Capsule enteroscopy is useful for the therapeutic management of Crohn's disease

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World Journal of Gastroenterology 2015年第44期21卷 12660-12666页

作者： Joao santos-Antunes Hélder Cardoso Susana Lopes margarida Marques Amadeu CR Nunes Guilherme Macedo Gastroenterology Department Faculty of Medicine Hospital de Sao Joao Department of Biochemistry (U38-FCT) Faculty of Medicine University of Porto

AIM: To analyze therapeutic changes in Crohn's disease(CD) patients following video capsule endoscopy(VCE) and to assess the usefulness of Lewis score and the Patency ***: Patency Capsule was performed in every patient that had indication for VCE, and those with negative patency did not undergo VCE. Patients with established CD that underwent VCE between January 2011 and February 2014 were selected for this study; those with suspected CD were excluded, independent of VCE results, since our purpose was to address differences in therapeutic regimen in CD patients before and after VCE. Patients with inconclusive VCE were also excluded. Patients had to be free of non-steroidal anti-inflammatories for at least 1 mo. Those patients who met these criteria were allocated into one of three groups: Staging group(asymptomatic CD patients that underwent VCE for staging of CD), Flare group(patients with active CD), or Post-op group(CD patients evaluated for post-operative recurrence). Lewis score was calculated for every VCE procedure. Statisticalanalysis was performed to address the impact of VCE findings on the therapeutic management of CD patients and to evaluate the utility of the Lewis ***: From a total of 542 VCEs, 135 were performed in patients with CD. Patency capsule excluded nearly 25% of the patients who were supposed to undergo VCE. No videocapsule retention during VCE was reported. From these 135 patients, 29 were excluded because CD diagnosis was not established at the time of VCE. Therefore, a total of 106 patients were included in the final analysis. From these, the majority were in the Staging group(n = 73, 69%), and the remaining were in the Flare(n = 23, 22%) or Post-op(n = 10, 9%) group. Median time between diagnosis and VCE was 5.5 years. Overall, VCE determined changes in the treatment of 40% of patients: only 21% remained free of immunosuppressors after VCE compared to 44% before VCE(P < 0.001). The differences in therapy before and a

关键词： Capsule enteroscopy Crohn's disease Treatment modification Patency capsule Lewis score

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Individual factors related to chronic condition in Portuguese adolescents: Highlights from the HBSC/WHO study

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Health 2013年第11期5卷 25-34页

作者： Teresa santos margarida Gaspar de Matos Maria Celeste Simoes Helena Fonseca Maria do Ceu Machado Faculdade de Motricidade Humana(“Social Adventure”Team) Universidade de LisboaLisboaPortugal Centro de Malaria e Doencas Tropicais/IHMT Universidade Nova de LisboaLisboaPortugal Departamento de Pediatria do Hospital de Santa Maria

Background: Adolescence includes a period (10 to 19 years) of profound biopsychosocial changes, constituting potentially difficult challenges, which may become more pronounced in the presence of a chronic condition and its limitations. Responses are not homogeneous and can be quite variable, depending on various specific individual factors. Research comparing adolescents with or without chronic illness, or comparing across different conditions, has been contradictory, not confirming a direct relationship between the degree of suffering and the chronic condition. Objective: To characterize and assess the impact of 1) having a chronic condition (CC) and 2) how CC affects school participation;and its association with life satisfaction and perception of wellness, controlling for demographic factors: age, gender and family socioeconomic status (SES). Methods: 5050 Portuguese adolescents with an average age of 14 years participated in the Health Behaviour in School-aged Children/WHO (HBSC). Results: The majority of the adolescents with CC reported that their conditions did not affect school participation. Adolescents with CC who indicated that CC affected school participation felt more frequently unwell and presented lower life satisfaction. Being a boy, younger and having high family socio economic status (SES) were identified as predictors of higher life satisfaction;on the other hand, being a girl, older, having lower SES, living with CC and feeling that CC affects school participation are predictors for feeling more frequently unwell. Conclusions: These adolescents showed an increased vulnerability, presenting internalized symptoms and lower life satisfaction. Furthermore, when there was simultaneous occurrence of living with CC and that CC affected school participation, the impact was even higher. Thus, it is crucial that future interventions should include the identified predictors, combined with “listen to the voice” of adolescents, throughout the adaptation proces

关键词： Adolescent Health Chronic Condition Health Promotion and Prevention Quality of Life

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Assessment of Natural Radioactivity in Rivers Sediment and Soil from the Copper Belt Artisanal Mining Region, Democratic Republic of the Congo

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Journal of Geoscience and Environment Protection 2021年第7期9卷 1-20页

作者： Emmanuel K. Atibu João M. Oliveira margarida Malta Marta santos Crispin K. Mulaji Pius T. Mpiana Fernando P. Carvalho University of Kinshasa (UNIKIN) Faculty of Sciences Department of Chemistry Kinshasa Democratic Republic of the Congo Laboratório de Protecç ã o e Seguranç a Radiologica Instituto Superior Técnico/Campus Tecnológico Nuclear Universidadede Lisboa Bobadela Portugal

The concentrations and distribution of naturally occurring radionuclides (238U, 235U, 234U, 230Th, 226Ra, 210Pb, 232Th, 228Ra, and 40K) were determined by alpha and gamma spectrometry in soil and sediments collected from Luilu and Dilala rivers located in the mining district of Kolwezi (Lualaba Province) of the Democratic Republic of the Congo. The average concentrations of 238U and 226Ra in the analyzed samples were 5 - 10 times higher than the world average values for soil provided by the United Nations Scientific Committee on the Effects of Atomic Radiation. However, the average concentrations of 232Th were found similar to the world average. In both river basins, artisanal mining activities and mineral washing sites displayed the higher concentration values of radionuclides. The mean values of health risk indices calculated for those sites were found significantly higher compared to world average levels. Radiation protection measures seem needed to ensure the radiation safety of local populations. Gra

关键词： Natural Radioactivity Gamma-Ray Spectrometry Alpha-Particle Spectrometry Artisanal Mining Activity Radiological Hazard

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Neurocognitive Disorders in Patients with HIV Infection with Virologic Suppression for More than 10 Years

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World Journal of AIDS 2017年第1期7卷 59-66页

作者： André Filipe dos santos-Silva Joana margarida Almeida Alves Isabel Ramos Maria del Cármen Piñ eiro-Calvo Cláudia Sousa Maria do Rosário Serrã o António Carlos Eugénio Megre Sarmento Infectious Diseases Department S&atilde o Joã o Hospital Centre Oporto Portugal Faculty of Medicine of the University of Oporto Oporto Portugal Psychiatry and Mental Health Department S&atilde o Joã o Hospital Centre Oporto Portugal Neurology Department S&atilde o Joã o Hospital Centre Oporto Portugal

Background: HIV-associated neurocognitive disorder (HAND) may appear in patients with viral and immunological response to treatment and remain unnoticed during the initial stage of the infection. The goal of this study is to evaluate the development and/or progression of HAND in patients with undetectable viral load for more than ten years. Methods: We included adult HIV-infected patients who were under antiretroviral treatment and had undetectable plasma viral load for more than ten years (blips were included). These patients had already been subjected to neurocognitive evaluation five years previously. Demographic, clinical and analytical data were analysed. For the neurocognitive evaluation, the WAIS-III subtests (digit symbol coding and symbol search), trail making test (TMT) A and B, Stroop test and categorical verbal fluency (animals) tests were used. SPSS??version 22.0 for Windows was used for statistical analysis. Results: In this re-evaluation, performed 4.76 (±1.82) years after the first one, 9 (36%) patients showed deficits in processing speed (WAIS-III and TMT A), 8 (32%) executive function (TMT B and Stroop) and 12 (48%) verbal fluency. There were significant statistical differences between the past and current executive function tests (p = 0.029 and p = 0.01), highlighting worsening of deficits. No differences were found for the other tests. No association was found between deficit progression and the studied variables. Conclusions: Although not generally noticed on regular appointments, in this small population, worsening of executive function deficits (mental flexibility and divided attention) was found. Classical risk factors for HAND did not appear to interfere in its progression. Speed of information processing and categorical verbal fluency remained stable.

关键词： HIV HAND Dementia Impairment

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