Browsing by Author "Figueiredo, P"
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- Dynamics of Epileptic Activity in a Peculiar Case of Childhood Absence Epilepsy and Correlation with Thalamic Levels of GABAPublication . Leal, A; Vieira, JP; Lopes, R; Nunes, R; Gonçalves, S; Lopes da Silva, F; Figueiredo, PChildhood absence epilepsy (CAE) is a syndrome with well-defined electroclinical features but unknown pathological basis. An increased thalamic tonic GABA inhibition has recently been discovered on animal models (Cope et al., 2009), but its relevance for human CAE is unproven. METHODS: We studied an 11-year-old boy, presenting the typical clinical features of CAE, but spike-wave discharges (SWD) restricted to one hemisphere. RESULTS: High-resolution EEG failed to demonstrate independent contralateral hemisphere epileptic activity. Consistently, simultaneous EEG-fMRI revealed the typical thalamic BOLD activation, associated with caudate and default mode network deactivation, but restricted to the hemisphere with SWD. Cortical BOLD activations were localized on the ipsilateral pars transverse. Magnetic resonance spectroscopy, using MEGA-PRESS, showed that the GABA/creatine ratio was 2.6 times higher in the hemisphere with SWD than in the unaffected one, reflecting a higher GABA concentration. Similar comparisons for the patient's occipital cortex and thalamus of a healthy volunteer yielded asymmetries below 25%. SIGNIFICANCE: In a clinical case of CAE with EEG and fMRI-BOLD manifestations restricted to one hemisphere, we found an associated increase in thalamic GABA concentration consistent with a role for this abnormality in human CAE.
- Mesonephric Hyperplasia can Cause Abnormal Papanicolaou Smears: A Case ReportPublication . Pedrosa, I; Alpendre, F; Sousa, R; Raposo Dinis, S; Figueiredo, PMesonephric hyperplasia (MH) is a very rare condition. There are few cases in the literature. Mesonephric remnants (MR) or MH can be a rare source of abnormal Papanicolaou smears. The most common, often difficult, in the differential diagnosis of MH is mesonephric carcinoma that has a poor prognosis. We report a case of a 29-years-old with a routine Papanicolaou smear reported as atypical glandular cells. The patient underwent to a loop electrosurgical excision procedure and because it is a benign condition and a strong desire to preserve fertility, we opted for clinical surveillance.
- Regional White Matter Atrophy Correlates with Spike Activity in Encephalopathy Related to Status Epilepticus During Slow Sleep (ESES) After Early Thalamic LesionsPublication . Oliveira, AR; Nunes, RG; Figueiredo, P; Dias, AI; Leal, AEncephalopathy related to Status Epilepticus during slow Sleep (ESES) is an age-related, epileptic syndrome, which associates cognitive/behavioral disturbances with a peculiar pattern of spike activity. One promising line of research is the study of ESES in cases of early thalamic lesions. We studied 7 ESES patients with unilateral thalamic lesions using magnetic resonance imaging to assess regional white matter (WM) and thalamic nuclei volume differences, and long-term electroencephalogram recordings to localize the epileptogenic cortex. N170 event-related potentials were used to demonstrate the dysfunctional character of the WM abnormalities. Diffusion-weighted images in a subset of 4 patients were used to parcellate the thalamus and evaluate volume asymmetries, based on cortical connectivity. Large WM regional atrophy in the hemisphere with the thalamic lesion was associated with both cortical dysfunction and epileptic activity. A correlation was demonstrated between lesions in the pulvinar and the mediodorsal thalamic nuclei and WM atrophy of the corresponding cortical projection areas. We propose that these abnormalities are due to the widespread structural disconnection produced by the thalamic lesions associated to a yet unknown age-dependent factor. Further exploration of WM regional atrophy association with the spike activity in other etiologies could lend support to the cortical disconnection role in ESES genesis.
- Sarcoma de Kaposi Pulmonar na Infecção por VIHPublication . Teófilo, E; Figueiredo, PO aparecimento recente do sarcoma de Kaposi (SK)epidémico na prática clínica corrente da Medicina Interna veio permitir encontrar expressões clínicas raras, como a pulmonar (SKP). A radiologia tem um papel preponderante na avaliação da extensão do SKP. A grande agressividade que por vezes apresenta conduziu à investigação de novas terapêuticas em diferentes áreas (imunomodulação, hormonal e citostática). Os novos conceitos quanto à sua provável origem talvez permitam que, a curto prazo, seja mais uma profilaxia nos imunodeprimidos pelo VIH.
- Small Bowel Enteroscopy - A Joint Clinical Guideline by the Spanish and Portuguese Small-Bowel Study GroupsPublication . Pérez-Cuadrado Robles, E; Pinho, R; González-Suárez, B; Mão-de-Ferro, S; Chagas, C; Esteban Delgado, P; Carretero, C; Figueiredo, P; Rosa, B; García-Lledó, J; Nogales, O; Ponte, A; Andrade, P; Juanmartiñena-Fernández, JF; San-Juan-Acosta, M; Lopes, S; Prieto-Frías, C; Egea Valenzuela, J; Caballero, N; Valdivieso-Cortázar, E; Cardoso, H; Gálvez, C; Almeida, N; Borque Barrera, P; Gómez Rodríguez, BJ; Sánchez Ceballos, FL; Bernardes, C; Alonso-Aguirre, P; Argüelles Arias, F; Mascarenhas Saraiva, MThe present evidence-based guidelines are focused on the use of device-assisted enteroscopy in the management of small-bowel diseases. A panel of experts selected by the Spanish and Portuguese small-bowel study groups reviewed the available evidence focusing on the main indications of this technique, its role in the management algorithm of each indication, and its diagnostic and therapeutic yield. A set of recommendations was issued accordingly.