Browsing by Issue Date, starting with "2021-04"
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- Corneal Biomechanical Assessment with Ultra-High-Speed Scheimpflug Imaging During Non-Contact Tonometry: A Prospective ReviewPublication . Baptista, Pedro Manuel; Ambrósio Jr, Renato; OLIVEIRA, LUIS; Menéres, Pedro; Beirão, JoãoBackground: In recent years, increasing interest has arisen in the application of data from corneal biomechanics in many areas of ophthalmology, particularly to assist in the detection of early corneal ectasia or ectasia susceptibility, to predict corneal response to surgical or therapeutic interventions and in glaucoma management. Technology has evolved and, recently, the Scheimpflug principle was associated with a non-contact air-puff tonometer, allowing a thorough analysis of corneal biomechanics and a biomechanically corrected intraocular pressure assessment, opening up new perspectives both in ophthalmology and in other medical areas. Data from corneal biomechanics assessment are being integrated in artificial intelligence models in order to increase its value in clinical practice. Objective: To review the state of the art in the field of corneal biomechanics assessment with special emphasis to the technology based on ultra-high-speed Scheimpflug imaging during non-contact tonometry. Summary: A meticulous literature review was performed until the present day. We used 136 published manuscripts as our references. Both information from healthy individuals and descriptions of possible associations with systemic diseases are described. Additionally, it exposed information regarding several fields of ocular pathology, from cornea and ocular surface through areas of refractive surgery and glaucoma until vascular and structural diseases of the chorioretinal unit.
- Recurrent neck swelling after iodinated contrast media administrationPublication . Cunha, Inês Machado; Maganinho, Pedro; Marques, Maria Luís; Amorim, João Pinheiro; Gomes, EvaA 74-year-old male with an abdominal aortic aneurism reported 2 episodes of neck swelling 16 hours after an abdominal CT with iodinated contrast media that reappeared in a subsequent CT, although the use of pre-medication. The tests used to exclude the hypersensitivity hypothesis where negative and once a new CT where needed we decided to do it with close monitoring. We performed a facial picture and cervical ultrasound exam before and 24 hours after the exam. The neck swelling and the ultrasound findings 24 hours after the CT made the diagnosis of contrast induced sialoadenitis possible. Contrast induced sialadentis is an uncommon adverse reaction to iodinated contrast media. As it presents with neck swelling it is important to exclude a hypersensitivity reaction because it's further limitations and make a differential diagnosis.
- A Rare Cause of Abdominal Pain: Intestinal AngioedemaPublication . Ferreira, Tania Araujo; Alves, Marta Rebocho; Oliveira, Ana Maria Pinheiro; Silva, Filipa; Pereira, ClaudiaAngioedema with evidence of mucosal swelling is a rare condition that can be caused by angiotensin-converting enzyme inhibitors. The authors describe a case of a 28-year-old woman medicated with lisinopril 2 months before, with abdominal pain associated with nausea, vomiting and a onetime watery stool. A small volume of ascites was found in the abdominal ultrasound and the parietal thickening of the middle ileum in the abdominal computed tomography (CT). The complementary study was negative. The symptoms stopped after drug withdrawal. The authors intend to warn to this diagnosis, which has non-specific symptoms and if not suspected, can lead to a great morbidity for patients. The authors also intend to identify various signs that can be clues for its correct diagnosis.
- Therapeutic respiratory and functional rehabilitation protocol for intensive care unit patients affected by COVID-19: a structured summary of a study protocol for a randomised controlled trialPublication . Carvalho, Ana Cristina; Moreira, Jorge; Cubelo, Pedro; Cantista, Pedro; Branco, Catarina Aguiar; Guimarães, Bruno
- Self-Care in Heart Failure Inpatients: What Is the Role of Gender and Pathophysiological Characteristics? A Cross-Sectional Multicentre StudyPublication . Delgado, Bruno; Lopes, Ivo; Mendes, Tânia; Lopes, Patrícia; Sousa, Luís; López-Espuela, Fidel; Preto, Leonel; Mendes, Eugénia; Gomes, Bárbara; Novo, AndréHeart failure is often characterised by low exercise capacity and a great impairment of performance in the activities of daily living. The correct management of the disease can prevent the worsening of symptoms and promote a better quality of life. The aims of this study are to understand the relationship of gender and pathophysiological characteristics with self-care behaviour and to evaluate the self-care behaviour in a sample of Portuguese heart failure inpatients, using the Self-Care of Heart Failure Index (SCHFI). A cross-sectional multicentre study enrolling 225 heart failure inpatients from eight hospitals from Portugal was performed. At admission, each patient's functional capacity was evaluated as well as their self-care behaviour, using the SCHFI Portuguese v6.2. A comparison between self-care behaviour with gender was performed. The patients' mean age was 68.4 ± 10.7 years old, 68% were male and 82.3% had reduced ejection fraction. A mean value of 47.9, 35.6 and 38.8 points was found in the SCHFI score of the sections self-care maintenance, self-care management and self-care confidence, respectively. Heart failure inpatients present inadequate levels of self-care behaviour. The results do not suggest a relationship between gender and pathophysiological characteristics with self-care behaviour.
- Pyrocarbon Humeral Head in a Shoulder Hemiarthroplasty: Preliminary Results at 3 Years Follow-Up and Review of the Current LiteraturePublication . Campos-Pereira, Eva; Henrique Barros, Luís; Claro, RuiShoulder hemiarthroplasty is a viable option in young patients with an intact rotator cuff in order to preserve the native glenoid. To avoid the dreaded and expected wear of the glenoid in very active shoulders, implants with humeral head coated with a high resistant and elastic material-pyrolytic carbon-are now an option. The authors present the first pyrocarbon coated hemishoulder arthroplasty performed at our Orthopedic Department in a patient with osteonecrosis of the humeral head. At three years of follow-up, the patient is pain free and without limitations in his daily work. The Constant score was applied pre- and postoperatively, and an improvement of 32 points was reported. Larger cohorts with long-term follow-up are required to confirm our promising results.
- Another Twist in the Tale: Intrafamilial Phenotypic Heterogeneity in ANO3‐Related DystoniaPublication . Carvalho, Vanessa; Martins, Joana; Correia, Filipe; Costa, Manuela; Massano, João; Temudo, Teresa
- Defining tetrahydrobiopterin responsiveness in phenylketonuria: Survey results from 38 countriesPublication . Evers, R.A.F.; van Wegberg, A.M.J.; Ahring, K.; Beblo, S.; Bélanger-Quintana, A.; Bosch, A.M.; Burlina, A.; Campistol, J.; Coskun, T.; Feillet, F.; Giżewska, M.; Huijbregts, S.C.J.; Kearney, S.; Langeveld, M.; Leuzzi, V.; Maillot, F.; Muntau, A.C.; Rocha, J.C.; Romani, C.; Trefz, F.K.; MacDonald, A.; van Spronsen, F.J.Background: A subset of patients with phenylketonuria benefit from treatment with tetrahydrobiopterin (BH4), although there is no consensus on the definition of BH4 responsiveness. The aim of this study therefore was to gain insight into the definitions of long-term BH4 responsiveness being used around the world. Methods: We performed a web-based survey targeting healthcare professionals involved in the treatment of PKU patients. Data were analysed according to geographical region (Europe, USA/Canada, other). Results: We analysed 166 responses. Long-term BH4 responsiveness was commonly defined using natural protein tolerance (95.6%), improvement of metabolic control (73.5%) and increase in quality of life (48.2%). When a specific value for a reduction in phenylalanine concentrations was reported (n = 89), 30% and 20% were most frequently used as cut-off values (76% and 19% of respondents, respectively). When a specific relative increase in natural protein tolerance was used to define long-term BH4 responsiveness (n = 71), respondents most commonly reported cut-off values of 30% and 100% (28% of respondents in both cases). Respondents from USA/Canada (n = 50) generally used less strict cut-off values compared to Europe (n = 96). Furthermore, respondents working within the same center answered differently. Conclusion: The results of this study suggest a very heterogeneous situation on the topic of defining long-term BH4 responsiveness, not only at a worldwide level but also within centers. Developing a strong evidence- and consensus-based definition would improve the quality of BH4 treatment.