Browsing by Author "Almeida, P."
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- Arterio-arterial graft – an option for hemodialysis patients with exhaustion of venous patrimonyPublication . Castro, A.; Almeida, P.; Silva, F.; Rego, D.; Tavares, J.; Santos, J.; Silva, F.; Queirós, J.; Cabrita, A.; Almeida, R.Introduction: Vascular access (VA) for hemodialysis (HD) is the lifeline for End Stage Renal Disease (ESRD) patients. Long-term HD patients often have exhaustion of their venous patrimony for an autologous VA construction and, sometimes, even for a central venous catheter (CVC) placement. Case report: We describe the case of a 43-year-old woman with ESRD due to lupus nephritis, on maintenance HD since 2009. She also had secondary antiphospholipid syndrome and was chronically anticoagulated. Nevertheless, the patient had multiorgan thrombotic events (without sequelae) and several episodes of irreversible thrombosis of arteriovenous fistulas. Her HD course was also marked by multiple severe CVC infections, at diferente locations; a hemoperitoneum during cholecystectomy, and an immediate thrombosis of the renal artery of a kidney transplant. She was admitted to our hospital after an irreversible dysfunction of a right jugular CVC, with documentation of thrombosis of the superior and inferior vena cava. Exhaustion of the venous patrimony for HD was assumed and it was decided to make an arterio-arterial graft (AAG) of early cannulation. The first cannulation of the AAG was performed two days after surgical intervention, with no complications. The patient performed a twelve hour per week HD treatment with good efficiency. Conclusion: AAG is an alternative for HD patients who have exhausted all their venous patrimony and it can be considered prior to the placement of a CVC as their sole remaining vascular access.
- Enurese Nocturna: a Experiência de uma Consulta Especializada no CHPV/VCPublication . Almeida, P.; Monteiro, J.; Madalena, C.Introdução: A enurese nocturna (EN) é um problema comum em Pediatria. Aos 5 anos, a sua prevalência é de cerca de 15%. A maioria corresponde a EN Monossintomática (ENM). Objectivos: Caracterizar a população de crianças com EN seguidas na consulta de Enurese (CE) do Centro Hospitalar da Póvoa de Varzim/Vila do Conde (CHPV/VC). Material e métodos: Estudo observacional, analítico e retrospectivo dos doentes da CE do CHPV/VC com 1ª consulta entre Julho/2003 e Dezembro/2007. Dados recolhidos da consulta do processo clínico tratados em Microsoft Excel 2007®. Resultados: Incluídas 137 crianças (67% rapazes), entre os 5 e os 17 anos. Em 87,6% a EN era primária, em 57,7% era ENM, em 76,5% havia episódios todas as noites e em 72% havia poliúria. Todas as crianças efectuaram exame de urina tipo II. Dos 77 casos de ENM, em 3 foram instituídas inicialmente apenas medidas de reforço positivo, tendo-se verificado cura em 2; em 74 foi instituído tratamento com desmopressina, curando 42%. Em 17 casos foi associado alarme sonoro (AS) à desmopressina, curando 88,2%. Nos 53 casos de EN Não -Monossintomática (ENNM) foi instituído tratamento com oxibutinina em todos os casos, com cura em 11% (em monoterapia). Em 47 crianças foi associada desmopressina, com cura em 43%. Em 7 casos associou-se AS à desmopressina, com cura em 43%. Discussão e conclusão: Na ENM houve bons resultados associando desmopressina ao AS, quando esta não teve sucesso terapêutico isoladamente. Nos casos de ENNM verificou-se que a terapêutica isolada com oxibutinina foi pouco eficaz, recorrendo-se frequentemente à associação de 2 fármacos e/ou AS. ABSTRACT Introduction: Nocturnal enuresis (NE) is a common problem in childhood healthcare. At the age of 5 nocturnal enuresis’ prevalence is 15%. Most patients have monosymptomatic NE (MNE). Objectives: To study the children with NE followed at the Enuresis Consult at the Centro Hospitalar da Póvoa de Varzim/ Vila do Conde(CHPV/VC). Material and methods: Observational, analytic and retrospective study of the patients of the Enuresis Consult at the CHPV/VC, with the first appointment between July 2003 and December 2007. The data was collected from clinical files and coded with Microsoft Excel 2007©. Results: The study included 137 children (67% of males), aged 5 to 17 years. In 87,6%, the NE was primary, in 57,7% it was MNE; in 76,5% there was enuresis every night and in 72% there was polyuria. All the children performed a urine analysis. Of the 77 cases of MNE, in 3 children positive enforcement was instituted with cure in 2; 74 children were treated with desmopressin, curing 42%. In 17 patients the alarm was associated to desmopressin, curing 88,2%. In the 53 cases of non-monosymptomatic NE (NMNE) it was instituted treatment with oxibutinin, with a cure rate of 11%. In 47 children desmopressin was added, with a cure rate of 43%. In 7 the desmopressin was associated to the alarm, with a cure rate of 43%. Discussion and conclusion: The association of desmopressin with alarm was efficacious in the treatment of MNE. In cases of NMNE the therapy with oxybutynin alone was ineffective, often resolving with the combination of two drugs and/or alarm.
- Inquéritos de satisfação: Triagem de Manchester no Hospital de Santo AntónioPublication . Almeida, P.; Campelo, J.; Figueiredo, A.; Gonçalves, L.; Guedes, A.; Guimarães, N.; Laranjo, P.; Luís, D.; Mendes, M.; Monjardino, M.; Neto, J.; Pimenta, J.; Rebocho, M.; Soares, M.