Browsing by Author "Moreira, T"
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- A Case of Complicated Ascaris InfectionPublication . Moreira, T; Bota, S; Carvalho, MR; Cordeiro, AI; Gouveia, C; Varandas, L
- Cytomegalovirus Infection in a Infant with Ventriculomegaly is ist Congenital or Postnatal?Publication . Moreira, T; Póvoas, M; Brito, MJ; Silva, R; Machado, R
- Intoxicação Iatrogénica por Paracetamol Endovenoso - A Propósito de um caso ClinicoPublication . Moreira, T; Campos, AP; Gouveia, C; Varandas, L; Marques, A
- Prescrição de Psicofármacos na Unidade de Desenvolvimento de um Hospital Nível IIIPublication . Moreira, T; Pangaio, N; Afonso, S; Lopes, P; Estrada, JA abordagem farmacológica na patologia do neurodesenvolvimento é complexa face à escassez de fármacos aprovados na idade pediátrica, do conhecimento limitado dos efeitos a longo prazo e da dificuldade na avaliação objetiva da eficácia. Caracterizar a população de doentes seguidos na Unidade de Desenvolvimento(UD) de um hospital de nível lIII, segundo variáveis demográficas e clínicas, e intervenção terapêutica implementada (farmacológica e não farmacológica), prescrição de psicofármacos e respetivo consumo adicional de recursos.
- Safety and Outcomes of Routine Endovascular Thrombectomy in Large Artery Occlusion Recorded in the SITS Register: An Observational StudyPublication . Ahmed, N.; Mazya, M.; Paiva Nunes, A; Moreira, T; Ollikainen, JP; Escudero‐Martinez, I; Bigliardi, G; Dorado, L; Dávalos, A; Egido, JA; Tassi, R; Strbian, D; Zini, A; Nichelli, P; Herzig, R; Jurák, L; Hurtikova, E; Tsivgoulis, G; Peeters, A; Nevšímalová, M; Brozman, M; Cavallo, R; Lees, KR; Mikulik, R; Toni, D; Holmin, SBackground and objective: We aimed to evaluate the safety and outcomes of thrombectomy in anterior circulation acute ischaemic stroke recorded in the SITS-International Stroke Thrombectomy Register (SITS-ISTR) and compare them with pooled randomized controlled trials (RCTs) and two national registry studies. Methods: We identified centres recording ≥10 consecutive patients in the SITS-ISTR with at least 70% of available modified Rankin Scale (mRS) at 3 months during 2014-2019. We defined large artery occlusion as intracranial internal carotid artery, first and second segment of middle cerebral artery and first segment of anterior cerebral artery. Outcome measures were functional independence (mRS score 0-2) and death at 3 months and symptomatic intracranial haemorrhage (SICH) per modified SITS-MOST. Results: Results are presented in the following order: SITS-ISTR, RCTs, MR CLEAN Registry and German Stroke Registry (GSR). Median age was 73, 68, 71 and 75 years; baseline NIHSS score was 16, 17, 16 and 15; prior intravenous thrombolysis was 62%, 83%, 78% and 56%; onset to reperfusion time was 289, 285, 267 and 249 min; successful recanalization (mTICI score 2b or 3) was 86%, 71%, 59% and 83%; functional independence at 3 months was 45.5% (95% CI: 44-47), 46.0% (42-50), 38% (35-41) and 37% (35-41), respectively; death was 19.2% (19-21), 15.3% (12.7-18.4), 29.2% (27-32) and 28.6% (27-31); and SICH was 3.6% (3-4), 4.4% (3.0-6.4), 5.8% (4.7-7.1) and not available. Conclusion: Thrombectomy in routine clinical use registered in the SITS-ISTR showed safety and outcomes comparable to RCTs, and better functional outcomes and lower mortality than previous national registry studies.
- Stroke Etiology and Outcomes after Endovascular Thrombectomy: Results from the SITS Registry and a Meta-AnalysisPublication . Matusevicius, M; Cooray, C; Rand, VM; Nunes, AP; Moreira, T; Tassi, R; Egido, JA; Ollikainen, J; Bigliardi, G; Holmin, S; Ahmed, NBackground and purpose: The influence of stroke etiology on outcomes after endovascular thrombectomy (EVT) is not well understood. We aimed to investigate whether stroke etiology subgrouped as large artery atherosclerosis (LAA) and cardiac embolism (CE) influences outcomes in large artery occlusion (LAO) treated by EVT. Methods: We included EVT treated LAO stroke patients registered in the Safe Implementation of Treatment in Stroke (SITS) thrombectomy register between January 1, 2014 and September 3, 2019. Primary outcome was successful reperfusion (modified Treatment in Cerebral Infarction 2b-3). Secondary outcomes were symptomatic intracranial hemorrhage (SICH), 3-month functional independence (modified Ranking Scale 0-2) and death. Multivariable logistic regression models were used for comparisons. In addition, a meta-analysis of aggregate data from the current literature was conducted (PROSPERO, ID 167447). Results: Of 7,543 patients, 1,903 (25.2%) had LAA, 3,214 (42.6%) CE, and 2,426 (32.2%) unknown, other, or multiple etiologies. LAA patients were younger (66 vs. 74, P<0.001) and had lower National Institutes of Health Stroke Scale score at baseline (15 vs. 16, P<0.001) than CE patients. Multivariable analyses showed that LAA patients had lower odds of successful reperfusion (odds ratio [OR], 0.70; 95% confidence interval [CI], 0.57 to 0.86) and functional independence (OR, 0.74; 95% CI, 0.63 to 0.85), higher risk of death (OR, 1.44; 95% CI, 1.21 to 1.71), but no difference in SICH (OR, 1.09; 95% CI, 0.71 to 1.66) compared to CE patients. The systematic review found 25 studies matching the criteria. The meta-analysis did not find any difference between etiologies. Conclusions: From the SITS thrombectomy register, we observed a lower chance of reperfusion and worse outcomes after thrombectomy in patients with LAA compared to CE etiology, despite more favorable baseline characteristics. In contrast, the meta-analysis did not find any difference between etiologies with aggregate data.