Browsing by Issue Date, starting with "2017-11"
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- Type 2 Autoimmune Pancreatitis: A Challenge in the Differential Diagnosis of a Pancreatic MassPublication . Martins, C.; Lago, P.; Sousa, P.; Araújo, T.; Davide, J.; Castro-Poças, F.; Pedroto, I.Autoimmune pancreatitis is a rare entity of unknown etiology that can mimic pancreatic cancer and whose diagnosis involves clinical, serological, imagiological, and histological findings. There are two types of autoimmune pancreatitis: type 1, in which the pancreas is involved as one part of a systemic immunoglobulin G4-related disease, and type 2, generally without immunoglobulin G4-positive cells and without systemic involvement.
- A importância da Comissão de Proteção Contra as Radiações Ionizantes no contexto da qualidade do Centro Hospitalar do PortoPublication . Monteiro, A.; MAchado, C.; Oliveira, F.A Estratégia Nacional para a Qualidade na Saúde 2015 -2020 visa assegurar que as funções de governação, coordenação e ação local, centradas no doente, estão devidamente alinhadas pelo mesmo diapasão, com respeito pelas dimensões da efetividade, eficiência, acesso, segurança, equidade, adequação, oportunidade, continuidade e respeito pelo cidadão. A pesquisa da qualidade nos serviços de saúde deixou de ser um ato isolado e tornou-se hoje um dado adquirido e categórico. A Sociedade está cada vez mais exigente, no que se refere à qualidade dos serviços prestados, fundamentalmente nas instituições públicas. Esta exigência desenvolveu uma necessidade de criar normas e mecanismos de avaliação e controlo da qualidade nos serviços de saúde. Na última década os meios complementares de diagnóstico e terapêutica transformaram-se em ferramentas essenciais para todos os ramos e especialidades da medicina. O recurso a procedimentos radiológicos para diagnóstico e terapêutica tem determinado um aumento da dose de radiação nos pacientes, tornando-se numa preocupação constante dos utilizadores. Contudo, a sua quantificação e monitorização permite assegurar a segurança dos pacientes, assim como contribuir para a manutenção de serviços de qualidade no SNS. Este trabalho tem como objetivo apresentar a importância da Comissão de Proteção contra Radiações (CPCR), no contexto do Centro Hospitalar do Porto, na manutenção da qualidade e segurança de todos os pacientes e profissionais envolvidos em procedimentos radiológicos.
- Estrogen Metabolism-Associated CYP2D6 and IL6-174G/C Polymorphisms in Schistosoma haematobium InfectionPublication . Cardoso, R.; Lacerda, P.; Costa, P.; Machado, A.; Carvalho, A.; Bordalo, A.; Fernandes, R.; Soares, R.; Richter, J.; Alves, H.; Botelho, M.Schistosoma haematobium is a human blood fluke causing a chronic infection called urogenital schistosomiasis. Squamous cell carcinoma of the urinary bladder (SCC) constitutes chronic sequelae of this infection, and S. haematobium infection is accounted as a risk factor for this type of cancer. This infection is considered a neglected tropical disease and is endemic in numerous countries in Africa and the Middle East. Schistosome eggs produce catechol-estrogens. These estrogenic molecules are metabolized to active quinones that induce modifications in DNA. The cytochrome P450 (CYP) enzymes are a superfamily of mono-oxygenases involved in estrogen biosynthesis and metabolism, the generation of DNA damaging procarcinogens, and the response to anti-estrogen therapies. IL6 Interleukin-6 (IL-6) is a pleiotropic cytokine expressed in various tissues. This cytokine is largely expressed in the female urogenital tract as well as reproductive organs. Very high or very low levels of IL-6 are associated with estrogen metabolism imbalance. In the present study, we investigated the polymorphic variants in the CYP2D6 gene and the C-174G promoter polymorphism of the IL-6 gene on S. haematobium-infected children patients from Guine Bissau. CYP2D6 inactivated alleles (28.5%) and IL6G-174C (13.3%) variants were frequent in S. haematobium-infected patients when compared to previously studied healthy populations (4.5% and 0.05%, respectively). Here we discuss our recent findings on these polymorphisms and whether they can be predictive markers of schistosome infection and/or represent potential biomarkers for urogenital schistosomiasis associated bladder cancer and infertility.
- [Readmission to an Adolescent Psychiatry Inpatient Unit: Readmission Rates and Risk Factors]Publication . Mendes, P.; Fonseca, M.; Aguiar, I.; Pangaio, N.; Confraria, L.; Queirós, O.; Saraiva, J.; Monteiro, P.; Guerra, J.INTRODUCTION: Most mental disorders have a chronic evolution and therefore a certain amount of psychiatric readmissions are inevitable. Several studies indicate that over 25% of child and adolescent inpatients were readmitted within one year of discharge. Several risk factors for psychiatric readmissions have been reported in the literature, but the history of repeated readmissions is the most consistent risk factor. Our aim is to calculate the readmission rates at 30 days and 12 months after discharge and to identify associated risk factors. MATERIAL AND METHODS: The authors consulted the clinical files of patients admitted to the Inpatient Unit between 2010 and 2013, in order to calculate the readmission rates at 30 days and at 12 months. The demographic and clinical characteristics of the readmitted patients were analyzed and compared with a second group of patients with no hospital readmissions, in order to investigate possible predictors of readmission. RESULTS: A total of 445 patients were admitted to our inpatient unit between 2010 and 2013. Six adolescents were readmitted in a 30 days period (1.3%) and 52 were readmitted in a 12 month period after discharge (11.5%). Duration of the hospitalization and the previous number of mental health admissions were significant predictors of future hospital readmissions (p = 0.04 and p = 0.014). DISCUSSION: The low readmission rates may reflect the positive clinical and sociofamilial support being provided after discharge. CONCLUSION: Rehospitalisation is considered a fundamental target for intervention concerning prevention and intervention in mental healthcare. Thus, knowledge regarding their minimisation is crucial.