Browsing by Author "Ribeiro, L"
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- Abcesso do Espaço de Parona com Origem em Foco Sético Oral: Abordagem MultidisciplinarPublication . Fonseca, L; Ribeiro, L; Pinheiro, J; Silva Guerra, AA infeção do espaço de Parona é uma patologia rara do antebraço. Reportamos um caso de um homem de 55 anos, com dor e impotência funcional na porção distal do antebraço, sem história de trauma, com uma semana de evolução. Associadamente, apresentava história de infeção odontogénica, síncrona com o início das queixas do antebraço, mas com resolução espontânea. A ecografia do punho documentou um abcesso, que foi prontamente drenado e o exame microbiológico demonstrou infeção por Streptococcus constellatus. A avaliação estomatológica revelou agudização sintomática de periodontite crónica no dente 2.7. O doente realizou a eliminação de focos séticos orais durante o internamento e teve alta com evolução favorável. As manifestações do quadro clínico e o agente isolado confirmam a origem odontogénica. Do que pudemos apurar, este é o primeiro caso publicado de um abcesso antebraquial odontogénico e demonstra a importância da eliminação sistemática de focos séticos orais na população geral.
- Cistadenocarcinoma do Ovário. A Propósito de um Caso ClínicoPublication . Ribeiro, L; Barros, I; Lourenço, C; Oliveira, M; Pinto, E; Santos, T; Barros Veloso, AJOs autores apresentam o caso clínico de uma doente de 49 anos, internada por poliadenopatias e sintomatologia respiratória, cujo diagnóstico definitivo de cistadenocarcinoma seroso do ovário, foi efectuado através do exame necrópsico. O quadro clínico era dominado por extensa invasão linfática predominantemente supradiafragmática, apresentação não habitual deste tipo de neoplasia.
- Doenças Hepáticas num Serviço de Medicina InternaPublication . Colaço, MI; Melo, M; Coelho, M; Ribeiro, L; Barros Veloso, AJAs doenças hepáticas constituem uma das causas frequentes de internamentos em serviços de Medicina Interna. Os autores fizeram um trabalho de revisão de cinco anos dos internamentos num Serviço de Medicina Interna cujos diagnósticos foram de doença hepática crónica, hepatite aguda e carcinoma hepatocelular. Concluíram que houve uma diminuição de internamentos por doença hepática crónica ao longo dos anos e um crescente aumento de hepatites agudas, a maioria delas associada a doentes toxicodependentes e com SIDA.
- Um Hospital, um Serviço para CriançasPublication . Carvalho, J; Ferreira, P; Morais, A; Moura, S; Ribeiro, L; Rodrigues, AP
- Internamentos num Serviço de Medicina Interna. As Diferenças com um Intervalo de 10 Anos (1984-1994)Publication . Nogueira, A; Coelho, M; Ribeiro, L; Mateus, E; Jacquet, J; Barros Veloso, AJ
- Mesotelioma Peritoneal Maligno. Dificuldades Diagnósticas e TerapêuticasPublication . Cunha, P; Luz, Z; Seves, I; Sousa, C; Skiappa; Ribeiro, L; Marques, C; Oliveira, MO Mesotelioma Peritoneal Maligno (MPM) é um tumor raro, de apresentação clínica inespecífica, colocando dificuldades diagnósticas particularmente na diferenciação com carcinomatose peritoneal. O diagnóstico tardio e a ineficácia da terapêutica convencional – cirurgia, radioterapia, quimioterapia – conferem-lhe um mau prognóstico com sobrevida média de 6-12 meses. Os autores descrevem um caso de MPM diagnosticado durante investigação de ascite inaugural, através de biópsia peritoneal laparoscópica. Submetido a quimioterapia sistémica, o doente encontra-se em remissão parcial aos 42 meses.
- Necrotizing Fasciitis Caused by Photobacterium damselae: The First Case in PortugalPublication . Guimarães, D; Ribeiro, L; Vieira, L; Coelho, RNecrotizing fasciitis is a severe soft tissue infection with a high mortality rate and therefore requires emergent surgical treatment. Several microorganisms can cause this infection, Photobacterium damselae being one of them, with only eight cases previously published in the literature. We report the first ever case of necrotizing fasciitis, caused by this microorganism, in Portugal. In this case report the patient survived after several debridement procedures and reconstruction of the upper limb with acellular dermal matrix and skin graft. A brief review of the Photobacterium damselae soft tissue infection reports as well as the clinical presentation, diagnosis, pathophysiology and treatment of necrotizing fasciitis can also be found in this paper.
- Predicting Incomplete Basal Cell Carcinoma Excisions - a Large Multidisciplinary Retrospective Analysis in a Tertiary CenterPublication . Duarte, B; Vieira, L; Pessoa e Costa, T; Ribeiro, L; João, A; Cabete, J; Varanda Pereira, AIntroduction: Surgical treatment of basal cell carcinomas is often performed by physicians with different surgical backgrounds. Collecting data from different surgical departments would better reflect their real-life surgical management.Objectives: To identify the rate, recurrence risk, and predictive factors accordingly to their relative contribution for an incomplete basal cell carcinoma excision in a large multidisciplinary real-life settingMethods: Retrospective cohort study of 2305 surgically treated lesions in different departments of a tertiary center.Results: There was a rate of incomplete excisions (15%) and a recurrence rate (35.5% vs. 6.8% in incomplete vs. complete excisions (p < .001)). A third of incompletely excised basal cell carcinoma (BCC) will recur over time. Stratified by relevancy, high-risk histological subtypes (micronodular (OR 5.10 - p < .001) and morpheaform (OR 5.42 - p < .001), smaller specimen sizes ( <0.5 cm or 0.5-1 cm, OR 3.99 and 2.49, respectively, p < .001) high-risk locations (OR 3.06 on the nose, OR 2.77 on the eyelids, p < .001), and recurrent BCCs (OR 1.72, p < .001). are the best predictors of an incomplete excision.Conclusions: Acknowledging the rate, recurrence risk and predictive factors for incomplete excisions may be beneficial for optimal preoperative planning and to prevent unwarranted re-interventions, morbidity, and healthcare costs.
- Real-World Outcomes of Anti-VEGF Treatment for Retinal Vein Occlusion in PortugalPublication . Vaz-Pereira, S; Marques, IP; Matias, J; Mira, F; Ribeiro, L; Flores, RPurpose: Retinal vein occlusion (RVO) is an important cause of visual disability in the modern world. We aim to evaluate the real-world outcomes of patients with RVO treated with anti-vascular endothelial growth factor (VEGF) in Portugal. Methods: We performed a retrospective, observational, multicenter study including 8 centers across Portugal and 200 patients treated with either ranibizumab or bevacizumab. Data were collected at 3 time points: time of diagnosis (0 time point) and 6 and 12 months after initiating treatment. Demographic and clinical data were collected. Results: Median visual acuity (VA) and central macular thickness (CMT) improved in the branch RVO (BRVO), central RVO (CRVO), bevacizumab, and ranibizumab groups at 6 and 12 months compared to baseline, with CMT improving further only in the CRVO and ranibizumab groups between 6 and 12 months (p = 0.002 and p = 0.001, respectively). The CMT was lower in the ranibizumab group compared to the bevacizumab group both at 6 and 12 months (p<0.02). Median CMT improved in both the good and poor baseline VA groups at 6 and 12 months compared to baseline (p<0.001). Median VA only improved for the group with poor baseline VA at 6 and 12 months of follow-up (p<0.001). Regression analysis identified several baseline variables as predictors of visual outcomes at 6 and 12 months, with different results depending on the analyzed group. Conclusions: Both treatments were effective, although less effective than results reported in clinical trials. The morphologic response was better with ranibizumab compared to bevacizumab, although functionally there were no differences.