Browsing by Author "Almeida, S"
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- Acute Coronary Syndrome and Stress: Is There a Relationship?Publication . Santos, H; Santos, M; Paula, S; Figueiredo, M; Almeida, I; Miranda, H; Chin, J; Sá, C; Neto, M; Almeida, S; Sousa, C; Almeida, LIntroduction: Acute coronary syndrome (ACS) is the result of a complex pathophysiological process with various dynamic factors. The 10-item Perceived Stress Scale (PSS-10) is a validated instrument for estimating stress levels in clinical practice and may be useful in the assessment of ACS. Methods: We carried out a single-center prospective study engaging patients hospitalized with ACS between March 20, 2019 and March 3, 2020. The PSS-10 was completed during the hospitalization period. The ACS group was compared to a control group (the general Portuguese population), and a subanalysis in the stress group were then performed. Results: A total of 171 patients with ACS were included, of whom 36.5% presented ST-elevation myocardial infarction (STEMI), 38.1% were female and the mean PSS score was 19.5±7.1. Females in the control group scored 16.6±6.3 on the PSS-10 and control males scored 13.4±6.5. The female population with ACS scored 22.8±9.8 on the PSS-10 (p<0.001). Similarly, ACS males scored a mean of 17.4±6.4 (p<0.001). Pathological stress levels were not a predictor of major adverse cardiovascular events or severity at admission. Conclusions: ACS patients had higher perceived stress levels compared to the control group. Perceived stress level was not associated with worse prognosis in ACS patients.
- Cross-Protection to New Drifted Influenza A(H3) Viruses and Prevalence of Protective Antibodies to Seasonal Influenza, During 2014 in PortugalPublication . Guiomar, R; Pereira da Silva, S; Conde, P; Cristóvão, P; Maia, AC; Pechirra, P; Rodrigues, AP; Nunes, B; Milho, L; Coelho, AP; Fernandes, A; Caseiro, P; Rodrigues, F; Correia, L; Pereira-Vaz, J; Almeida, S; Branquinho, P; Côrte-Real, R; Viseu, R; Peres, MJ; Sanches, R; Dantas, F; Freitas, L; Andrade, G; Maurílio, M; Caldeira, F; Cabral Veloso, R; Mota-Vieira, L; Soares, M; Couto, AR; Bruges-Armas, J; Mouro Pinto, R; Sobrinho Simões, J; Costa, MR; Guimarães, JT; Martins, L; Cunha, MINTRODUCTION: Immune profile for influenza viruses is highly changeable over time. Serological studies can assess the prevalence of influenza, estimate the risk of infection, highlight asymptomatic infection rate and can also provide data on vaccine coverage. The aims of the study were to evaluate pre-existing cross-protection against influenza A(H3) drift viruses and to assess influenza immunity in the Portuguese population. MATERIALS AND METHODS: We developed a cross-sectional study based on a convenience sample of 626 sera collected during June 2014, covering all age groups, both gender and all administrative health regions of Portugal. Sera antibody titers for seasonal and new A(H3) drift influenza virus were evaluated by hemagglutination inhibition assay (HI). Seroprevalence to each seasonal influenza vaccine strain virus and to the new A(H3) drift circulating strain was estimated by age group, gender and region and compared with seasonal influenza-like illness (ILI) incidence rates before and after the study period. RESULTS: Our findings suggest that seroprevalences of influenza A(H3) (39.9%; 95% CI: 36.2-43.8) and A(H1)pdm09 (29.7%; 95% CI: 26.3-33.4) antibodies were higher than for influenza B, in line with high ILI incidence rates for A(H3) followed by A(H1)pdm09, during 2013/2014 season. Low pre-existing cross-protection against new A(H3) drift viruses were observed in A(H3) seropositive individuals (46%). Both against influenza A(H1)pdm09 and A(H3) seroprotection was highest in younger than 14-years old. Protective antibodies against influenza B were highest in those older than 65years old, especially for B/Yamagata lineage, 33.3% (95% CI: 25.7-41.9). Women showed a high seroprevalence to influenza, although without statistical significance, when compared to men. A significant decreasing trend in seroprotection from north to south regions of Portugal mainland was observed. CONCLUSIONS: Our results emphasize that low seroprotection increases the risk of influenza infection in the following winter season. Seroepidemiological studies can inform policy makers on the need for vaccination and additional preventive measures.
- Diagnóstico Retrospectivo de Infecção Congénita por Citomegalovírus numa Coorte de Crianças com Hipoacusia NeurossensorialPublication . Araújo-Martins, J; Correia, I; Monteiro, L; Santos, PB; Paixão, P; Campos, O; Vilarinho L, L; Almeida, S; Marques, TObjectivos: Determinar a prevalência da infecção congénita por Citomegalovírus (CMV) como causa de hipoacusia infantil. Métodos: Realizou-se um estudo de coorte retrospectivo através da revisão de dados nos processos clínicos. Seleccionaram-se as crianças com hipoacusia neuro-sensorial bilateral moderada ou mais grave e que não tinham diagnóstico estabelecido. Os cartões de Guthrie armazenados num laboratório de referência nacional foram analisados com uma técnica baseada em extracção de ácido desoxirribonucleico (ADN) induzida por calor, seguida de pesquisa de ADN do CMV através de amplificação por polymerase chain reactionResultados: Dos 83 cartões de Guthrie testados, 8 (9,6%) foram positivos. Na nossa coorte, 11 doentes têm infecção congénita por CMV confirmada, correspondendo a 8,1% dos casos com diagnóstico confirmado mas apenas 3,4% dos casos no global. Conclusão: A infecção congénita por CMV é uma causa significativa de hipoacusia infantil na nossa população. O diagnóstico retrospectivo é possível com recurso aos cartõesde Guthrie.
- Functional Study of DAND5 Variant in Patients with Congenital Heart Disease and Laterality DefectsPublication . Cristo, F; Inácio, JM; Almeida, S; Mendes, P; Martins, DS; Maio, J; Anjos, R; Belo, JAPerturbations on the Left-Right axis establishment lead to laterality defects, with frequently associated Congenital Heart Diseases (CHDs). Indeed, in the last decade, it has been reported that the etiology of isolated cases of CHDs or cases of laterality defects with associated CHDs is linked with variants of genes involved in the Nodal signaling pathway.
- Gastroenterite Aguda por Rotavírus em Portugal: Estudo MulticêntricoPublication . Rodrigues, F; Lopes, AI; Iturriza-Gomara, M; Nawaz, S; Cruz, A; Antunes, H; Loreto, H; Amil Dias, J; Cunha1, J; Varandas, L; Silveira, L; Costa Alves, M; Gonçalves, R; Almeida, S; Cavaco, AOs dados sobre diarreia por rotavírus em Portugal são limitados. Este estudo teve como objectivo estimar a proporção de gastroenterite aguda por este vírus em crianças observadas em serviços de urgência de vários hospitais do país e analisar as suas características clínicas e moleculares. Estudo prospectivo, multicêntrico, observacional, incluindo crianças como menos de 5 anos, com gastroenterite aguda, observadas em 10 serviços de urgência pediátricos, entre outubro de 2008 e setembro de 2009. Foram recolhidos dados demográfico e clínicos. as amostras positivas de rotavírus foram genotipadas por reacção em cadeia da polimerase. Foram incluídas 1846 crianças, 58% do sexo masculino, com idade média de 19,3 +- 14,4 meses. Foi identificado rotavírus nas fezes em 28,3% (intervalo de confiança 95%, 26,2-30,4%), com maior proporção no inverno e na primavera e em crianças com idade de 7-24 meses. Os genótipos mais frequentes foram G4P(8) (46%) e G1P(8) (37%), com variações de norte para sul. As crianças com gastroenterite por rotavírus tinham probabilidade significativamente superior (p<0,001) de ter febre, vómitos, perda de peso, desidratação e necessidade de internamento, comparativamente aos casos negativos para rotavírus. A gastroenterite aguda por rotavírus em crianças portuguesas com idade inferior a 5 anos associou-se a maior morbilidade e hospitalização do que nos casos sem identificação de rotavírus. Houve diferenças importantes na distribuição dos genótipos entre as regiões. Na era das vacinas contra o rotavírus, este conhecimento é importante para as decisões relativas à prevenção da doença e para monitorizar tendências da epidemiologia molecular do rotavírus.
- Iatrogenic Aortic Pseudoaneurysm: a Forgotten ComplicationPublication . Almeida, S; Bico, P; Almeida, AR; Laranjeira, A; Banazol, N; Fragata, J; Rabaçal, CPseudoaneurysms of the ascending aorta are a rare complication of cardiac surgery. However, the poor prognosis associated with this condition if untreated makes early diagnosis and treatment important. We present the case of a 66-year-old woman who had undergone mitral valvuloplasty 12 days previously, who was admitted with a diagnosis of new-onset atrial fibrillation. The transthoracic echocardiogram showed a clot in the right atrium and anticoagulation was initiated, followed by antibiotic therapy. After further investigation, the patient was diagnosed with a pseudoaneurysm of the ascending aorta and underwent surgical repair, followed by six weeks of antibiotic therapy. She was readmitted six months later for an abscess of the lower sternum and mediastinum. After a conservative approach with antibiotics and local drainage failed, recurrence of a large pseudoaneurysm compressing the superior vena cava was documented. A third operation was performed to debride the infected tissue and to place an aortic allograft. There were no postoperative complications.
- A Novel Autosomal Recessive GJA1 Missense Mutation Linked to Craniometaphyseal DysplasiaPublication . Hu, Y; Chen, I; Almeida, S; Tiziani, V; Amaral, C; Gowrishankar, K; Passos-Bueno, MR; Reichenberger, ECraniometaphyseal dysplasia (CMD) is a rare sclerosing skeletal disorder with progressive hyperostosis of craniofacial bones. CMD can be inherited in an autosomal dominant (AD) trait or occur after de novo mutations in the pyrophosphate transporter ANKH. Although the autosomal recessive (AR)form of CMD had been mapped to 6q21-22 the mutation has been elusive. In this study, we performed whole-exome sequencing for one subject with AR CMD and identified a novel missense mutation (c.716G>A, p.Arg239Gln) in the C-terminus of the gap junction protein alpha-1 (GJA1) coding for connexin 43 (Cx43). We confirmed this mutation in 6 individuals from 3 additional families. The homozygous mutation cosegregated only with affected family members. Connexin 43 is a major component of gap junctions in osteoblasts, osteocytes, osteoclasts and chondrocytes. Gap junctions are responsible for the diffusion of low molecular weight molecules between cells. Mutations in Cx43 cause several dominant and recessive disorders involving developmental abnormalities of bone such as dominant and recessive oculodentodigital dysplasia (ODDD; MIM #164200, 257850) and isolated syndactyly type III (MIM #186100), the characteristic digital anomaly in ODDD. However, characteristic ocular and dental features of ODDD as well as syndactyly are absent in patients with the recessive Arg239Gln Cx43 mutation. Bone remodeling mechanisms disrupted by this novel Cx43 mutation remain to be elucidated.
- Ortóteses e Outras Ajudas TécnicasPublication . Soares Branco, P; Sequeira de Medeiros, L; Tomás, R; Cláudio, S; Almeida, S; Esteves de Carvalho, T
- O Papel do Rastreio Auditivo Neonatal na Reabilitação Auditiva InfantilPublication . Araújo-Martins, J; Correia, I; Ferreira, R; Santos, PB; Gonçalves, R; Almeida, S; Nunes, L; Monteiro, LObjectivos: Determinar a influência da implementação do rastreio auditivo neonatal universal na referenciação de crianças com hipoacúsia a uma consulta de reabilitação auditiva. Métodos: Contexto – consulta de reabilitação auditiva num centro de referenciação terciário em Lisboa; Desenho do estudo – estudo de coorte retrospectivo baseado nos dados de processos clínicos de crianças com surdez. População – todos os processos de crianças nascidas a partir de 1998 (437 no total) foram analisados, resultando na selecção de 322 crianças que cumpriam os critérios de inclusão. Resultados: A idade média de referenciação à consulta tem vindo a diminuir de 55 meses (1998-2000) para 12 meses (2007-2009). Em 3/4 dos doentes o motivo de referenciação é hipoacúsia ou alterações nos programas de rastreio auditivo neonatal. Conclusão: O rastreio auditivo neonatal tem permitido iniciara reabilitação auditiva de crianças com hipoacúsia mais cedo. É importante manter este programa a funcionar para garantir a reabilitação precoce de crianças com perda auditiva.
- O Repositório e o Anuário do Centro Hospitalar de Lisboa Central: Contributos Para a Ciência AbertaPublication . Quininha, A; Barreto, D; Pereira-da-Silva, L; Almeida, SNuma unidade de saúde, a atividade científica tem reconhecidas vantagens para a assistência clínica, investigação e ensino/formação. Têm sido adoptadas diversas estratégias para obter um registo completo da produção científica do CHLC, mas também para permitir o acesso aberto da ciência aos seus colaboradores. Assim, o Centro Hospitalar de Lisboa Central (CHLC) aderiu à rede de Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) em 2011 e tem envidado esforços para registar a investigação desenvolvida na instituição na base nacional oficial, respondendo de forma rigorosa ao Inquérito ao Potencial Científico e Tecnológico Nacional (IPCTN).