Browsing by Author "Macedo, Filipe"
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- Acute total occlusion of the unprotected left main coronary artery: Patient characteristics and outcomesPublication . Calvão, João; Braga, Marta; Brandão, Mariana; Campinas, Andreia; Alexandre, André; Amador, Ana; Costa, Catarina; Silva, João C.; Silva, Marisa; Brochado, Bruno; Freitas, João; Macedo, FilipeIntroduction and objectives: Acute total occlusion of the unprotected left main coronary artery (LMCA) is a dramatic event. There are limited data regarding this population. We aimed to describe the clinical presentation and outcomes of patients and to determine predictors of in-hospital mortality. Methods: This retrospective study included patients presenting with acute (<12 h) myocardial infarction due to total occlusion of the LMCA (TIMI flow 0) between January 2008 and December 2020 in three tertiary hospitals. Results: During this period, 11036 emergent coronary angiographies were performed, 59 (0.5%) of which revealed acute total occlusion of the LMCA. Patients' mean age was 61.2 (SD±12.2) years and 73% were male. No patients had left dominance. At presentation, 73% were in cardiogenic shock, aborted cardiac arrest occurred in 27% and 97% underwent myocardial revascularization. Primary percutaneous coronary intervention was performed in 90% of cases and angiographic success was achieved in 56% of procedures, while 7% of patients underwent surgical revascularization. In-hospital mortality was 58%. Among survivors, 92% and 67% were alive after one and five years, respectively. After multivariate analysis, only cardiogenic shock and angiographic success were independent predictors of in-hospital mortality. Use of mechanical circulatory support and presence of well-developed collateral circulation were not predictive of short-term prognosis. Conclusion: Acute total occlusion of the LMCA is associated with a dismal prognosis. Cardiogenic shock and angiographic success play a major role in predicting the prognosis of these patients. The effect of mechanical circulatory support on patient prognosis remains to be determined.
- Caso radiológicoPublication . Macedo, FilipeApresenta-se o caso de um rapaz de 17 anos com dor persistente na vertente anterior do joelho sem traumatismo agudo. Realizou radiografia e tomografia computorizada que revelou um quadro de doença de Osgood-Schlatter. A doença de Osgood-Shlatter é uma causa frequente de dor em adolescentes e ocorre por traumatismo repetido na inserção tibial do tendão rotuliano, com dor e tumefação localizadas. O tratamento conservador é geralmente suficiente para aliviar a dor e permitir o regresso à atividade.
- Caso radiológico: Avulsão aguda da espinha ilíaca antero-inferior esquerdaPublication . Macedo, FilipeWe present a case of a 15-year-old boy with sudden onset of left hip pain while playing football. The x-ray revealed an avulsion injury of the anterior inferior iliac spine. The anterior inferior iliac spine is one of the places in the pelvis where avulsion injuries can occur and is due to forceful contractions of the rectus femoris muscle
- Caso radiológico: Imagem artefactual causada pela sobreposição dos cabelos compridos.Publication . Macedo, FilipeWe present a case of a 14-year-old girl with fever and cough in whom the chest x-ray revealed a bizarre density over the upper two thirds of the left lung. It was due to the superimposed long hair hanging on her back. Artefacts images must systematically be suspected specially when being of strange shapes.