Browsing by Author "Relvas, R"
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- Complexo Demencial Relacionado com SIDAPublication . Relvas, R; Gonçalves, M; Viana, JPO complexo demencial relacionado com SIDA, ou mais recentemente classificado como demência associada ao VIH, manifesta-se clinicamente como uma demência subcortical. Surge em estadios avançados da infecção pelo VIH, evoluindo num período de tempo que pode variar entre semanas a meses. Os autores revêem a fisiopatologia, quadro clínico, diagnóstico diferencial e abordagem terapêutica desta situação.
- Meningites CrónicasPublication . Relvas, R; Gonçalves, MAs meningites crónicas são processos inflamatórios das meninges, com uma evolução superior a 4 semanas, englobando etiologias infecciosas e não infecciosas. A sua frequência, embora inferior à das meningites agudas, tem aumentado nos últimos anos, sobretudo na população de doentes imunodeprimidos. Os autores abordam as características clínicas, bem como o diagnóstico diferencial destas situações.
- Miastenia Gravis e Síndromes MiasténicosPublication . Relvas, R; Gonçalves, M; Viana, JPOs autores abordam a anatomia e neuroquímica da placa neuromuscular, a classificação das diferentes entidades, bem como as patologias mais frequentemente encontradas na clínica de adultos. São revistos a fisiopatologia, quadro clínico, diagnóstico diferencial e abordagem terapêutica da miastenia gravis, considerada o paradigma das doenças de envolvimento da placa neuromuscular, da síndroma miasténica de Eaton-Lambert e do botulismo.
- Miosite Orbitária IdiopáticaPublication . Relvas, R; Cruz, P; Gonçalves, M; Almeida, R; Saraiva, P; Viana, P; Beirão, CA miosite orbitária idiopática é uma doença inflamatória de etiologia desconhecida, que deve constituir sempre um diagnóstico de exclusão, cujo conhecimento tem evoluído com as novas técnicas de imagem. Os autores descrevem o caso clínico de um doente do sexo masculino, 69 anos, que inicia subitamente um quadro clínico caracterizado por dor peri-orbitária à direita e diplopia, ao que se seguiu, passado uma semana, diminuição da acuidade visual homolateral. À observação, era de realçar marcada diminuição da acuidade visual, oftalmoplegia, proptose e hipostesia álgica no território do V par do mesmo lado. Faz-se referência aos aspectos tomodensitométricos e à resposta à corticoterapia, devido à sua importância no diagnóstico desta patologia.
- Raising Awareness and Early Detection of Atrial Fibrillation, an Experience Resorting to Mobile Technology Centred on Informed IndividualsPublication . Cunha, S; Antunes, E; Antoniou, S; Tiago, S; Relvas, R; Fernandez-Llimós, F; Alves da Costa, FBackground: Atrial fibrillation (AF) is a cardiac arrhythmia responsible for one third of ischemic strokes. Early detection of AF plays an important role in preventing embolic stroke. Objectives: This study aimed to test the feasibility of an awareness event including opportunistic screening for atrial fibrillation; and to test the reliability of the innovative portable electrocardiogram (ECG) device used. Methods: An awareness campaign was held during two weeks, where individuals consenting to participate in a pharmacist-led detection event, received a manual pulse check, were clinically evaluated and subject to a single-lead electrocardiogram using AliveCor Kardia® mobile. ECGs highlighted as possible AF were confirmed by the cardiologist and those signalled with abnormalities in cardiac rhythm were referred to their physician. Data were collected in a password protected application and analyzed using SPSS, v.24. The Kardia® mobile's sensitivity and specificity was tested against the standard 12-lead ECG. Results: The awareness event involved 223 individuals, among which 205 were screened. Mean age was 66 years (SD = 15) and hypertension was the most frequently reported (n = 107; 52.2%). Mean CHAD2DS2- VASc score was 3 (SD = 1.8). Cardiac irregularities were identified in 45 individuals, 14 confirmed to be new cases of AF (6.8%) by the cardiologist. The sensitivity and specificity were 90.9% and 97.4%. Conclusion: Data suggests this device to be potentially useful for opportunistic early detection of AF, provided interprofessional collaboration is guaranteed so that suspect cases are adequately managed and in a timely way. Fourteen new cases of AF were identified in the population studied, suggesting the pharmacist working in a multiprofessional context, may have had an important role in preventing potential ischemic-related strokes with this initiative. All healthcare professionals involved in the patient pathway should play a more active role in contributing to better health outcomes, particularly within primary care.
- Workplace Violence in Healthcare: a Single-Center Study on Causes, Consequences and Prevention StrategiesPublication . Antão, HS; Sacadura-Leite, E; Manzano, MJ; Pinote, S; Relvas, R; Serranheira, F; Sousa-Uva, AIntroduction: Workplace violence is one of the main risk factors in the professional world. Healthcare workers are at higher risk when compared to other sectors. Our study aimed to characterize physical and verbal violence in a public hospital and to define occupational health prevention and surveillance strategies. Material and Methods: Single center observational cross-sectional study, carried amongst healthcare workers in a public hospital in Lisbon. A qualitative survey was carried out through six in-depth interviews. A quantitative survey was carried through questionnaires delivered to 32 workers. A significance level of 5% was accepted in the assessment of statistical differences. The Mann-Whitney test and the Fisher’s exact test were used to calculate p values. Results: The main results are: (1) 41 violence incidents were reported in the quantitative phase; (2) 5/21 [23.81%] victims notified the incident to the occupational health department; (3) 18/21 [85.71%] victims reported a permanent state of hypervigilance; (4) 22/28 [78.57%] participants self-reported poor or no familiarity with internal reporting procedures; (5) 24/28 [85.71%] participants believed it is possible to minimize workplace violence. Discussion: Workplace violence is favored by unrestricted access to working areas, absence of security guards and police officers or scarce intervention. The low notification rate contributes to organizational lack of action. The state of hypervigilance reported in our study reflects the negative effects of threatening occupational stressors on mental health. Conclusion: Our results show that workplace violence is a relevant risk factor that significantly impacts workers’ health in a noxious manner, deserving a tailored occupational health approach whose priority areas and strategies have been determined.