Browsing by Author "Alves, MJ"
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- Abcesso Renal na GravidezPublication . Santos, L; Borges, A; Serrano, F; Alves, MJ; Campos, AApesar das infecções urinárias serem relativamente frequentes durante a gravidez, a ocorrência de um abcesso renal é muito raro. A patogénese do abcesso renal tem mudado ao longo dos anos. Actualmente, mais de 75% dos casos têm origem numa infecção do aparelho urinário. Os autores apresentam o caso clínico de uma grávida de 35 anos, internada às 38 semanas e cinco dias de gestação por febre, náuseas, vómitos e dor lombar à direita. Os dados clínicos e os exames complementares realizados levaram ao diagnóstico de abcesso renal. É feita uma revisão da literatura acerca do tema.
- Burkitt’s Lymphoma Related to Epstein–Barr Virus Infection During PregnancyPublication . Cordeiro, A; Machado, AI; Borges, A; Alves, MJ; Frade, MJSetting: Burkitt’s lymphoma is a rare form of cancer and is an extremely rare diagnosis during pregnancy. This form of lymphoma is a very fast growing B cell neoplasm and chemotherapy is the treatment of choice for the disease in all its stages. Case report: The authors describe the case of a Caucasian 40-year-old nulliparous woman, with previous known Epstein–Barr virus infection, that presents at 28 weeks gestation with supraclavicular adenopathy and multiple bilateral breast nodules, in which biopsy showed non-Hodgkin lymphoma, Burkitt’s type. Discussion: There are few described cases of Burkitt’s lymphoma during pregnancy and in general the outcomes have been poor. In most of the cases, the patients were not treated by current standards or instead had a late diagnosis. This neoplasia is the most rapidly progressive human tumor, and any delay in initiating therapy can adversely aVect patient’s prognosis. The authors discuss treatment options in pregnancy and its perinatal implications.
- Contraceptive Choices Pre and Post Pregnancy in AdolescencePublication . Correia, L; Martins, I; Oliveira, N; Antunes, I; Palma, F; Alves, MJSTUDY OBJECTIVE: The main aim of this study is to evaluate the impact of adolescent pregnancy in the future contraceptive choices. A secondary aim is to verify whether these choices differ from those made after an abortion. DESIGN: Retrospective study. SETTING:Adolescent Unit of a tertiary care center. PARTICIPANTS:212 pregnant teenagers. INTERVENTIONS: Medical records review. MAIN OUTCOME MEASURES:Intended pregnancy rate and contraceptive methods used before and after pregnancy. For contraceptive choices after pregnancy we considered: Group 1 - teenagers who continued their pregnancy to delivery (n = 106) and Group 2 - the same number of adolescents who chose to terminate their pregnancy. RESULTS: The intended pregnancy rate was 14.2%. Prior to a pregnancy continued to delivery, the most widely used contraceptive method was the male condom (50.9%), followed by oral combined contraceptives (28.3%); 18.9% of adolescents were not using any contraceptive method. After pregnancy, contraceptive implant was chosen by 70.8% of subjects (P < .001) and the oral combined contraceptives remained the second most frequent option (17.9%, P = .058). Comparing these results with Group 2, we found that the outcome of the pregnancy was the main factor in the choices that were made. Thus, after a pregnancy continued to delivery, adolescents prefer the use of LARC [78.4% vs 40.5%, OR: 5,958 - 95% (2.914-12.181), P < .001)], especially contraceptive implants [70.8% vs 38.7%, OR: 4.371 - 95% (2.224-8.591), P < .001], to oral combined contraceptives [17.9% vs 57.5%, OR: 0.118 - 95% CI (0.054-0.258), P < .001]. CONCLUSION:Adolescent pregnancy and its outcome constitute a factor of change in future contraceptive choice.
- João Dória Nóbrega (1934-2021), um Homem SingularPublication . Campos, A; Soares, C; Serrano, F; Alves, MJ
- João Dória Nóbrega (1934-2021): A Unique ManPublication . Campos, A; Soares, C; Serrano, F; Alves, MJ
- As Novas PílulasPublication . Vicente, L; Vicente, L; Alves, MJDurante os últimos anos foram introduzidas no mercado português novas formulações de contraceptivos orais, que vieram alargar as escolhas possíveis. Entre elas, novas dosagens e novas substâncias. É importante conhecer as suas características para melhor perceber o papel que estas novas “pílulas” podem desempenhar no universo da contracepção. Acima de tudo, para que mais mulheres possam dispor de contracepção eficaz, segura e com a qual se sintam confortáveis. É com este objectivo que os autores apresentam esta revisão.
- Pregnancy and EpilepsyPublication . Aguilar, S; Alves, MJ; Serrano, FEpilepsy is common among women of childbearing age. Maternal-fetal risk is slightly superior to general population, resulting from antiepileptic drugs' teratogenicity and seizures. Optimized disease control and screening for medication's adverse effects are crucial parts of prenatal care. Most pregnant women require chronic therapy to prevent seizures; definition of an effective and least teratogenic regime should be performed preconceptionally. Sodium valproate is the most teratogenic drug; teratogenicity also increases with polytherapy and medication dosage. Labour should take place in a qualified obstetrical and neonatal centre. Usually breastfeeding is safe. Regarding contraception, consider interactions between enzyme-inducing antiepileptics drugs and hormonal contraceptives
- Primary Biliary Cholangitis: a Rare Diagnosis During PregnancyPublication . Inês Felizardo Lopes, I; Dos Reis, CP; Alves, MJ; Calinas, F; Borges, MAPrimary biliary cholangitis is an autoimmune disease that mostly affects women. It is uncommon in women of childbearing age and the diagnosis during pregnancy is rare and can be challenging. Described here is a case of primary biliary cholangitis first manifesting during pregnancy, with the onset of pruritus, jaundice, biochemical liver abnormalities and positive antimitochondrial antibodies. Although treatment with ursodeoxycholic acid was started at the time of diagnosis, there was a progressive worsening of cholestatic biochemical markers throughout pregnancy. In addition, fasting hyperglycemia with polyhydramnios was diagnosed, consistent with gestational diabetes. She had a spontaneous preterm delivery at 31 weeks of gestation, of a newborn who was admitted to the neonatal intensive care unit but who subsequently had no long-term sequelae of preterm delivery. A maternal postpartum flare occurred. Treatment with ursodeoxycholic acid was well tolerated during pregnancy and lactation.
- Recurrent Acute Pancreatitis in PregnancyPublication . Charepe, N; Rodrigues, AS; Massa, AC; Alves, MJIntroduction: During pregnancy pancreatitis is a rare and diagnosis is difficult. Cholelithiasis is the most frequent risk factor. Case report: A 26-year-old pregnant woman with abdominal pain, vomiting and low-grade fever. Hyperamylasemia and cholelithiasis was found and pancreatitis diagnosis was made. A second episode of acute pancreatitis was observed and treated with medical therapy. There was no foetal or neonatal complications. In puerperium a third pancreatitis occurred, a laparoscopic cholecystectomy was performed. Discussion: Diagnosis of acute pancreatitis in pregnancy is challenging and it may have serious maternal-fetal implications. Recurrent pattern should be taken into account when choosing the best treatment.
- Saúde Sexual e Reprodutiva das Adolescentes - a Nossa RealidadePublication . Oliveira Marques, C; Gomes, G; Correia, L; Palma, F; Martins, I; Alves, MJOverview and Aims: Several behavioral and biological factors can make adolescents particularly vulnerable to unwanted pregnancies and sexually transmitted diseases. The aim of this study was to evaluate sexual behavior and contraceptive use patterns of a population of adolescents. Study Design: Retrospective study. Population: 163 female adolescents attending an Adolescence Unit for the first time, during 2010. Methods: Analysis of clinical charts and assessment of demographic data, smoking and drinking habits, drug use, gynecologic and obstetric history, sexual behavior and contraceptive use. Results: The mean age was 16.04 years (±1.32). 71.7% were students (of these, 70% had failed one or more years and were behind in their studies), 2.5% were working and 23.9% were neither studying or working. 95.1% had already had sexual intercourse and the mean age of first coitus was 14.53 years (±1.24). There was a history of at least one previous pregnancy in 77.3% of the cases. Before the first appointment at the AU, the contraceptive methods used were: the pill (33.2%, but 41.3% of these reported inconsistent use), and the condom (23.9%, with inconsistent use in 28.3% of these cases). 19.6% did not use any contraceptive method.. After counseling at the AU, 54% of the teenagers chose the contraceptive implant and 35% preferred the pill. Adolescents who had already been pregnant preferred a long acting method (namely, the contraceptive implant)in 61.9% of cases; those who had never been pregnant decided to use an oral contraceptive in 67.6% of cases (p<0.001). Conclusions: After counseling the number of teenagers using contraception increased. In this population there were a high number of adolescents with a previous pregnancy. This factor seems to have influenced the choice of the contraceptive method, with most of these adolescents choosing a long-acting method.