Browsing by Author "Martins, I"
Now showing 1 - 10 of 15
Results Per Page
Sort Options
- Angiossarcoma do BaçoPublication . Sousa, C; Martins, I; Gonçalves, M; Cocco Martins, C; Carvalho, ROs tumores primitivos do baço são extremamente raros. Descrevemos o 1° caso dos Hospitais Civis de Lisboa, em S. José, numa mulher de 70 anos que apresentava espleno egália. Havia história anterior de irradiação pélvica. A ressonância magnética esclareceu a presença de massa tumoral e a angiografia caracterizou-a como vascular. A doente está bem um ano após esplenectomia. Encontrámos na literatura a descrição de 61 casos deste tumor de etiopatogenia não esclarecida. A esplenectomia precoce deve ser a primeira abordagem terapêutica pelo risco de ruptura. Esta foi a forma de apresentação em 34° o dos casos da série de Autry et al. Por se tratar de um tumor tão raro, não há estudos sobre a eficácia da quimioterapia, mas nas formas disseminadas podem utilizar-se esquemas de tratamentos citostáticos activos em sarcomas de partes moles.
- Auditory Neuropathy Spectrum Disorder - 2 Different But Successfull Pediatric CasesPublication . Martins, I; Rodrigues, M; Santos, N; Lavra, T; Sousa, HAuditory Neuropathy Spectrum Disorder ( is a disorder characterized by disruption of the temporal coding of acoustic signals in auditory fibers with consequent impairment of auditory perceptions dependent on temporal cues ANSD is a rare condition, associated with several risk factors and its diagnosis and management are challenging Objective To compare 2 pediatric cases of ANSD and analyze its rehabilitation Materials and Methods Analysis of behavioral and electrophysiological test results
- 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.
- Current Trends and Perceptions of the Portuguese Gynecology Experts on Hormonal Intrauterine Contraception: The DIOGIN StudyPublication . Brito, M; Costa, AR; Pacheco, A; Rebelo, C; Castro, MG; Martins, I; Palma, FOverview and Aims: Intrauterine systems (IUS) are one of the most effective forms of long acting reversible birth control, with low failure rates and high continuity and satisfaction rates. Still, they account for a small proportion of contraception use, which may be due to several myths and misperceptions. With this study, we aimed to assess Portuguese experts’ perceptions on potential benefits and fears that may limit women’s contraception choice and to identify current trends in clinical practice. Methods and Population: We performed an observational, descriptive and analytical study in which gynecologists/obstetricians were invited to answer an anonymous questionnaire by call or email made of multiple-choice questions on IUS use. Results: A total of 482 Portuguese Gynecologists answered the survey, of which 97.1% revealed that the insertion of IUS is a common procedure in their current clinical practice. More than 95% considered the insertion of IUS an easy procedure and a safe contraceptive method. Cost-efficacy and the fact that this method doesn’t rely on womens action to be effective were the top benefits for IUS users, perceived by the physicians. On the other hand, concern about having a foreign object inside the body and fear of insertion pain were perceived by the physicians as the top barriers to IUS use. Female gynecologists perceived a higher degree of pain associated with IUS insertion (p=0.021). Overall, gynecology experts’ opinions were conservative regarding IUS recommendations to women. Conclusions: The results of this study provide a general insight towards Portuguese gynecologists’ perceptions, opinions and attitudes on the use of IUS. Most of the experts consider IUS a safe contraception method but, on the other hand, there is still concern about its use in particular female conditions which may in part contribute to the low rate of IUS use in Portuguese women.
- Hérnia Diafragmática Congénita: Revisão de 12 CasosPublication . Martins, I; Amador, A; Martins, AT; Cohen, A; Machado, AI; Ferreira, A; Correia, JÉ apresentada uma revisão teórica sobre Hérnia Diafragmática Congénita (HDC). Os autores realizam um estudo retrospectivo de 12 casos de HDC referenciados ou diagnosticados na Unidade de Ecografia da Maternidade Dr. Alfredo da Costa (MAC) entre os anos de 1996 a 1999. Após avaliação o aconselhamento foi efectuado, caso a caso, sendo proposta Interrupção Médica da Gravidez ou cirurgia pós-natal.
- Implant Site Nexplanon Reaction?Publication . Pedroso, C; Martins, I; Palma, F; Machado, AINexplanon (Schering-Plough Limited/Merck Sharp & Dohme Limited (MSD)) is a long active reversible contraceptive method that provides effective contraception for 3 years. It consists of a single, flexible, rod-shaped implant, containing 68 mg etonogestrel. It is 4 cm long, consists of an ethylene vinyl acetate copolymer, a non-absorbable material, and also contains 15 mg of barium sulfate, which makes it visible by X-ray. We describe a case of a 39-year-old woman who experienced a local reaction to the barium sulfate in Nexplanon. She was given medical treatment, but only the removal of the implant resolved the symptoms. After removal there was gradual improvement and 72 h later the patient was asymptomatic. Allergic reaction to barium sulfate is extremely rare: until now, there have only been two cases associated with Nexplanon described in the literature.
- A Informação Clínica no Doente OncológicoPublication . Martins, CC; Martins, I
- Meningite por Vírus Varicela Zoster em Doente ImunocompetentePublication . Martins, I; Milheiro Silva, T; Brito, MJIntrodução: O herpes-zóster (HZ) é uma erupção cutânea, vesicular, dolorosa com distribuição restrita aos dermátomos resultante da reativação do vírus varicela-zóster (VVZ) nos gânglios da raiz dorsal. Pode também apresentar uma distribuição central causando meningite, uma entidade rara, com incidência de 0,5% Relato de Caso: Adolescente, sexo masculino, 12 anos, previamente saudável, com cefaleia occipital de agravamento progressivo, após dois dias com exantema vesicular de distribuição linear no quarto dermátomo da região toracodorsal direita e posteriormente vómitos e febre. Medicado para ambulatório com valaciclovir e omeprazol, foi reavaliado por agravamento da cefaleia. Não havia sinais meníngeos, mas referia dor de localização occipital na manobra de flexão da cabeça. Realizou punção lombar com pleocitose (257/μL) predomínio de linfócitos, proteínas 76mg/dL, glucose 54mg/dL. A PCR VVZ foi positiva e o exame cultural negativo. A pesquisa dos restantes vírus neurotrópicos, serologias infeciosas e estudo de imunossupressão foram negativos. Foi medicado com aciclovir 1500mg/m2 ev durante 10 dias, com melhoria progressiva. Em D4 surge reação eritematosa no local de administração do aciclovir que resolveu com alteração da marca. Comentários: As complicações neurológicas do HZ são raras na idade pediátrica, representando um desafio diagnóstico. Dado que os anticorpos VVZ se mantêm inalterados ou aumentam com a idade, a meningite por HZ ocorre sobretudo em imunocomprometidos (terapêutica imunossupressora, transplante de medula óssea, infecção VIH, défice de CD 16) pelo que devem ser sempre excluídos déficits da imunidade celular. Este caso alerta ainda para a ocorrência desta complicação neurológica mesmo em doentes imunocompetentes.
- Newborn Hearing Screening: 5 Years´ ResultsPublication . Martins, I; Rodrigues, M; Sousa, HIn an average of 1000 healthy babies, up to 3 have sensorineural hearing loss ( but this incidence increases 20 to 40 babies if we take into account the newborns’ high risk factors. Newborn hearing screening is essential to detect the total of babies with hearing loss 35 dB If hearing loss is present, it will allow an early detection (before 2 months of age) and an adequate intervention re(h) abilitation before 3 months of age. Hearing screening is performed with Otoacoustic Emissions OAE) and Automated Auditory Brainstem Response aABR.
- Ovarian Ectopic Pregnancy in AdolescencePublication . Gonçalves Andrade, A; Rocha, S; Marques, C; Simões, M; Martins, I; Biscaia, I; Barros, COvarian pregnancy is one of the rarest types of extrauterine pregnancy. Its preoperative diagnosis remains a challenge since it presents quite similarly to tubal pregnancy and complicated ovarian cysts. Although in most cases, histology is necessary to confirm the diagnosis, we present an ovarian pregnancy in a teenager, correctly diagnosed during ultrasound examination.