Browsing by Author "Mendes, R."
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- Organization of rehabilitation care in Portuguese intensive care unitsPublication . Mendes, R.; Nunes, M.; Pinho, J.; Gonçalves, R.Objective: To describe the different rehabilitation care models in practice in Portuguese adult intensive care units. Methods: A simple observational (cross-sectional) study was conducted through an online survey sent to the head nurses or individuals responsible for the 58 adult intensive care units that are part of the database of the Sociedade Portuguesa de Cuidados Intensivos. Results: We identified three models of organization of rehabilitation care: care provided by the staff of the intensive care unit (22.9%), care provided by specialized external teams (25.0%), and a mixture of the previous models, combining the two situations (52.1%). In the first model, the care was provided mainly by nurses with specialization in rehabilitation and, in the second model, the care was provided by physiotherapists. No significant differences were found between the models regarding the availability of care, in hours/day or days/week (p = 0.268 and 0.994, respectively), or results such as length of hospital stay in intensive care, ventilation time, or mortality rate in the unit (p = 0.418, 0.923, and 0.240, respectively). Conclusion: The organization of rehabilitation care in Portuguese intensive care units is unique and heterogeneous. Despite different care organization models, the availability of hours of care is similar, as are the overall results observed in patients.
- Quisto Porencefálico após Hemorragia Intracraniana: Evolução Imagiológica pré e pós-natalPublication . Cunha, A.; Mendes, M.; Ramos, C.; Nogueira, R.; Martins, M.; Veloso, P.; Mendes, R.RESUMO A infecção por Citomegalovírus (CMV) é a infecçâo congénita mais frequente. As manifestações clínicas são variáveis e multisistémicas. Do envolvimento do sistema nervoso central (SNC) podem resultar microcefalia, calcificações e, mais raramente, hidranencefalia e porencefalia por destruição do tecido cerebral. Estes achados são geralmente de diagnóstico tardio em Diagnóstico Pré Natal (DPN) com manifestações ecográficas muitas vezes inespecíficas. Os autores descrevem os aspectos imagiológicos ultrasonográficos no período fetal, neonatal, e tomográfico pósnatal num caso de hemorragia parenquimatosa cerebral com evolução para quisto porencefálico por provável infecção por citomegalovirus. Este caso mostra que achados ecográficos inespecíficos pré-natais numa paciente de alto risco têm um valor preditivo alto para infecção fetal por citomegalovirus e também podem ter significado prognóstico. ABSTRACT CMV is the most common congenital infection. Clinical manifestations can be multiple and affect different organs. Microcephaly, intracranial calcifications and less frequently hydranencephaly and porencephaly can be a consequence of cerebral involvement. These anomalies are generally diagnosed late in pregnancy after prenatal sonographic signs of little sensitivity. In this report, we describe the prenatal and neonatal images of cerebral hemorrhage and porencephaly, presumed secondary to intrauterine cytomegalovirus infection.This case shows that subtle ultrasound findings in a high risk pregnant woman may be predictive of sequelae in infected fetuses.