Browsing by Author "Ferreira, C"
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- 12-Year-Old Female with Mucocutaneous LesionsPublication . Marujo, F; Conde, M; Ferreira, C; Cunha, I; Gouveia, C
- Análise dos Factores de Risco dos Carcinomas da Mama U.P.M.Publication . Ferreira, C; Nazaré, MA; Jerónimo, AROs autores fizeram a análise dos factores de risco universalmente aceites na população de neoplasia maligna da mama diagnosticada na Unidade de Patologia Mamária do Serviço de Ginecologia da MAC, de Janeiro de 1990 a Junho de 1993. Pretendeu-se apenas verificar, nos 147 casos diagnosticados, a distribuição desses factores e não definir o risco relativo da nossa população, que será estabelecido posteriormente, em presença de série maior e grupo de controlo adequado.
- Análise Estrutural do Segmento Anterior por Tomografia de Coerência Ótica no Glaucoma Congénito PrimárioPublication . Vieira, L; Sá Cardoso, M; Anjos, R; Ferreira, C; Xavier, A; Maduro, V; Brito, CObjectivo: Analisar a morfologia do segmento anterior por tomografia de coerência ótica de segmento anterior (OCT-SA) em crianças com glaucoma congénito primário (GCP). Material e métodos: Realizou-se um estudo caso-controlo, prospetivo, em crianças com GCP e em crianças sem glaucoma (grupo controlo), seguidas em Consulta de Oftalmologia Pediátrica do Hospital Dona Estefânia, Centro Hospitalar de Lisboa Central. Efectuou-se avaliação oftalmológica completa e OCT-SA utilizando o protocolo A C biometry. Resultados: O estudo incluiu 27 olhos (17 crianças com OCP) e 22 olhos (11 crianças sem glaucoma). Detetaram-se valores significativamente superiores de profundidade central e largura da câmara anterior (CA) (p<0,001) e maiores distâncias de abertura do ângulo a 500 CP<0,001) e 750µm (p=0,00 l), áreas de espaço irido-trabecular a 500 e 750µm (p<0,001) e áreas do recesso do ângulo a 500 (p<0,00l) e 750µm (p=0,001), no grupo GCP. A espessura da íris foi significativamente mais fina a 500µm do ângulo (p=0,011), no centro da íris (p<0,001) e na região mais espessa da mesma (p=0,001) no grupo GCP, assim como o comprimento da íris foi superior (p<0,001). A largura de CA e a acuidade visual (logMAR) apresentam correlação positiva (r=0,688; p<0,001). Outros achados morfológicos: anteriorização e hipoplasia da íris, alteração da morfologia do ângulo no local de intervenção cirúrgica (goniotomia, trabeculotornia, trabeculectomia, válvula de Ahmed). Conclusão: Este primeiro estudo em crianças com GCP sugere que a OCT-SA é de aquisição relativamente fácil, poderá ajudar no seguimento clínico e cirúrgico e ser útil como fator prognóstico destes doentes.
- Anti-Phospholipase A2 Receptor Antibodies in the Diagnosis of Idiopathic Membranous NephropathyPublication . Meneses, G; Viana, H; Santos, MC; Ferreira, C; Calado, J; Carvalho, F; Remédio, F; Nolasco, FCirculating anti-phospholipase A2 receptor antibodies (anti-PLA2R) have been described in 70% to 80% of the patients with idiopathic membranous nephropathy (iMN), but not in patients with secondary membranous nephropathy or other glomerular diseases. The goal of this study was to evaluate the sensitivity and specificity of the assay for anti-PLA2R in the diagnosis of iMN. Anti-PLA2R IgG, Elisa and immunofluorescence tests were used to detect circulating anti-PLA2R. These tests were applied in 53 patients who had a kidney biopsy. Of these, 38 had histological diagnosis of membranous nephropathy (MN) and the remaining had other glomerular diseases. The MN was classified as idiopathic in 33 patients after clinical exclusion of secondary causes. Anti-PLA2R were positive in 57.6% of the patients with iMN. All patients with secondary membranous nephropathy or other glomerular diseases did not show circulating anti-PLA2R. The sensitivity was 57.6% (CI 39.2-74.5) and specificity 100% (CI 47.8-100), AUC 0.788; p < 0.0001 for the detection of iMN. 71.4% of the iMN patients that tested negative for anti-PLA2R were in partial or complete remission. The detection of anti-PLA2R in the studied population had a specificity of 100% for the iMN diagnosis. Prior treatments seem to make the test negative and contribute to a lower sensitivity.
- Atheroembolic Renal Disease As a Cause of Allograft Primary Non-FunctionPublication . Viana, H; Ferreira, C; Carvalho, F; Santos, AR; Galvão, MJ; Remédio, F; Nolasco, FAtheroembolic renal disease, also referred to as cholesterol crystal embolization, is a rare cause of renal failure, secondary to occlusion of renal arteries, renal arterioles and glomerular capillaries with cholesterol crystals, originating from atheromatous plaques of the aorta and other major arteries. This disease can occur very rarely in kidney allografts in an early or a late clinical form. Renal biopsy seems to be a reliable diagnostic test and cholesterol clefts are the pathognomonic finding. However, the renal biopsy has some limitations as the typical lesion is focal and can be easily missed in a biopsy fragment. The clinical course of these patients varies from complete recovery of the renal function to permanent graft loss. Statins, acetylsalicyclic acid, and corticosteroids have been used to improve the prognosis. We report a case of primary allograft dysfunction caused by an early and massive atheroembolic renal disease. Distinctive histology is presented in several consecutive biopsies. We evaluated all the cases of our Unit and briefly reviewed the literature. Atheroembolic renal disease is a rare cause of allograft primary non -function but may become more prevalent as acceptance of aged donors and recipients for transplantation has become more frequent.
- CAT-SCRATCH Disease: Still a ChallengePublication . Bota, S; Jacinto, S; Ferreira, C; Santos, AS; Varandas, L; Gouveia, C
- Cirurgia Laparoscópica dos Quistos Dermóides do OvárioPublication . Ferreira, C; Machado, P; Fraga, T; Catarino TavaresApresentamos uma série de 72 quistos dermoides do ovário, diagnosticados em 63 doentes (taxa de bilateralidade de 14,3%) e tratados por cirurgia laparoscópica no Serviço de Ginecologia da M.A.C. durante 5 anos (Jan. 88 a Fev. 93). O diagnóstico ecográfico foi muito fiável, concordante em 95% dos casos. Realizaram-se 70 quistectomias e 2 anexectomias intraperitoneais, não tendo havido complicações per ou pós operatórias imediatas. Apenas se registou um caso de D.I.P. aguda, ao 5º dia de convalescença. O tempo médio de internamento pós operatório foi de 8 horas. O follow-up ecográfico efectuado somente em 53 casos, por abandono dos restantes, evidenciou uma taxa de cura de 90,5%.
- Corrimento Mamilar CirúrgicoPublication . Ferreira, C; Aires Gonçalves, M; Jerónimo, AROs autores fizeram a avaliação dos corrimentos mamilares cirúrgicos, diagnosticados durante 3.5 anos de funcionamento da Unidade de Patologia Mamária da MAC (Janeiro de 1990 a Junho de 1993).
- Fístula Vesicovaginal Associada a Ruptura UterinaPublication . Reis Correia, A; Ferreira, C; Bernardo, MJVesicovaginal fistula (VVF) is an obstetric complication rarely reported in developed countries. The occurrence of uterine rupture is a potentially catastrophic event, and its incidence is estimated in 1/1146 (0.07%) pregnancies.The main risk factorsfor its occurrence are: congenital uterine changes, multiparity, history of previous cesarean or myomectomy,fetal macrosomia and induced labor. Association between uterine rupture and bladder lesions has been rarely reported. The authors describe a case of a VVF associated with uterine rupture
- Hyperprolinemia as a Clue in the Diagnosis of a Patient with Psychiatric ManifestationsPublication . Duarte, M; Afonso, J; Moreira, A; Antunes, D; Ferreira, C; Correia, H; Marques, M; Sequeira, SLately, microdeletions of the 22q region, responsible for DiGeorge syndrome or velocardiofacial syndrome, have been increasingly related to neuropsychiatric disorders including schizophrenia and bipolar disorder. These manifestations seem to be related to certain genes located in the hemideleted region such as the proline dehydrogenase (PRODH) and the catechol-o-methyltransferase (COMT) genes. We describe a teenager who started his adolescent psychiatric care presenting cognitive impairment, irritable mood and aggressive behaviour with schizophrenia-like symptoms that scored 153 in the Positive and Negative Symptoms Scale (PANSS) assessment. Worsening of symptoms when the patient was treated with valproic acid, and plasma aminoacids showing an increase in alanine and proline, suggested a mitochondrial involvement of the proline metabolic pathway. Mild dysmorphic features also suggested a possible 22q11 deletion syndrome that was confirmed. A mutation for Hyperprolinemia type I was also detected. Knowledge of the correct diagnosis was crucial for an adequate treatment.