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Browsing by Author "Andrade, R"

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  • Association Between Glycated Albumin, Fructosamine, and HbA1c with Neonatal Outcomes in a Prospective Cohort of Women with Gestational Diabetes Mellitus
    Publication . Mendes, N; Alves, M; Andrade, R; Ribeiro, R; Papoila, AL; Serrano, F
    Objective: To investigate whether glycated albumin, fructosamine, and hemoglobin A1c (HbA1c) are associated with neonatal complications in newborns of pregnant women with gestational diabetes mellitus (GDM). Methods: Between November 2016 and September 2017, women with a singleton pregnancy and GDM were enrolled in a prospective study in an obstetric Portuguese referral center. Glycemic markers were compared between mothers of newborns with and without complications. Multivariable logistic regression models and corresponding areas under the receiver operating characteristic curve (AUC) were used. Results: A total of 85 women participated in the study. Raised levels of glycated albumin and fructosamine were associated with at least one neonatal complication (OR- [odds ratio] estimate: 1.33, P=0.015; OR: 1.24, P=0.027, respectively) and with respiratory disorders at birth (OR 1.41, P=0.004; OR 1.26, P=0.014, respectively). HbA1c was not associated with these outcomes. All biomarkers were associated with large-for-gestational age (LGA) status (OR 1.61, P<0.001; OR 1.45, P<0.001; OR 3.62, P=0.032 for glycated albumin, fructosamine, and HbA1c, respectively). All had similar AUC for at least one neonatal complication (0.82; 0.81; 0.79, respectively). For newborn respiratory disorders, AUCs were 0.83, 0.81, and 0.76, respectively, and for LGA status were 0.81, 0.79, and 0.71, respectively. Conclusion: Raised values of glycated albumin and fructosamine were associated with particular perinatal complications in newborns of mothers with GDM, better discriminating mothers of newborns with and without complications than HbA1c.
    2019Journal article Open access Show more
  • Colocação de Catéter Epidural pelo Neurocirurgião às 2h de Instrumentação Lombar sob Bloqueio Sub-Aracnoideu
    Publication . Duarte, C; Andrade, R; Botas, C
    Doente 69 anos, sexo masculino com patologia respiratória restritiva e com o diagnóstico de hérnia discal lombar L3-L4 recidivada submetido a laminectomia bilateral de L3, foraminectomia bilateral de L3-L4, discectomia L3-L4 e artrodese com sistema transpedicular de barras e parafusos, sob bloqueio subaracnoideu ao nível de L2-L3 com 10 mg de levobupivacaína e sedação com midazolam e propofol em bólus (grau 4/5 de Ramsay). Ao fim de 2:15 h de bloqueio subaracnoideu e de conseguida a artrodese, o neurocirurgião colocou um cateter no espaço epidural a nível lombar sob visão directa, por intermédio do qual foram administrados 7 ml de levobupivacaína a 0,25%, acrescido de outros 7 ml passados 35 min. A analgesia foi complementada com tramadol 100 mg iv e parecoxib 40 mg iv. Não houve complicações anestésico-cirúrgicas. Esta abordagem anestésica, raramente utilizada, visou acima de tudo, minimizar o impacto da anestesia numa doença concomitante – doença pulmonar restritiva, e foi bem sucedida.
    2010Journal article Open access Show more
  • Instabilidade Subtalar: uma Entidade Subdiagnosticada?
    Publication . Machado, M; Barreira, M; Pereira, B; Andrade, R; Espregueira-Mendes, J
    A instabilidade subtalar continua a ser um tópico controverso e a sua causa está ainda por conhecer. O mecanismo de lesão e os sintomas clínicos da instabilidade do tornozelo e da instabilidade subtalar sobrepõem-se, resultando muitas vezes em casos de instabilidade subtalar, isolada ou combinada, que não são corretamente diagnosticados. Negligenciar a instabilidade subtalar associada à instabilidade do tornozelo pode levar à falência do tratamento conservador e à evolução para instabilidade crónica com necessidade de tratamento cirúrgico. A compreensão da anatomia e da biomecânica da articulação subtalar é crucial para o diagnóstico correto desta patologia e posterior escolha do tratamento mais adequado. Esta revisão narrativa pretende percorrer à literatura mais recente, de forma a tornar percetível o estado de arte sobre esta entidade, desde a sua anatomia e biomecânica, aos métodos de diagnóstico e, finalmente, aos tipos de tratamentos existentes ao dia de hoje.
    2022Journal article Open access Show more
  • Medial Collateral Ligament Release During Knee Arthroscopy: Key Concepts
    Publication . Silva Campos, V; Guerra Pinto, F; Constantino, D; Andrade, R; Espregueira-Mendes, J
    Complete access to the posterior medial compartment of the knee may represent a technical challenge during arthroscopy in patients with a tight tibiofemoral joint space.Medial collateral release reduces direct iatrogenic cartilage damage in the medial compartment of the knee through manipulation with instruments.We recommend performing medial collateral release in surgeries that access the posteromedial compartment (e.g. partial meniscectomy for ruptures of the posterior horn of medial meniscus or posterior root repairs) when the patient has a tight tibiofemoral joint space.There are two main techniques to perform medial collateral release: inside-out and outside-in. Regardless of the technique used, releasing medial ligament structures is a safe and effective method to be used in the diagnosis and treatment of injuries to the medial compartment.
    2021-08Journal article Open access Show more