Browsing by Author "Roque, R"
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- Apolipoprotein E Polymorphism Interacts with Cigarette Smoking in Progression of Multiple SclerosisPublication . Sena, A; Couderc, R; Ferret-Sena, V; Pedrosa, R; Andrade, ML; Araujo, C; Roque, R; Cascais, MJ; Morais, MGBACKGROUND AND PURPOSE: The influence of apolipoprotein E (ApoE) polymorphism on clinical severity of multiple sclerosis (MS) is still controversial. Cigarette smoking has been suggested to influence the progression of disability in these patients. In this study, we aimed to investigate whether an interaction of smoking with the ApoE polymorphism influences the progression of disability in MS patients. METHODS: Smoking history from 205 female patients with MS was obtained. Clinical data collected include age at onset, disease duration, annual relapse rate, the Expanded Disability Status Scale (EDSS) and the Multiple Sclerosis Severity Score (MSSS). ApoE polymorphism was examined in all patients and stratified according to smoking status and associations with the clinical data investigated. RESULTS: There were no significant associations between cigarette smoking and any of the clinical characteristics in the whole group of patients. In women carrying the ApoE E4 isoform, smokers had a lower EDSS (P = 0.033) and MSSS (P = 0.023) in comparison with non-smokers. CONCLUSION: Our data suggest that in women with MS carrying the ApoE E4 isoform, cigarette smoking may have a protective influence on disease progression and accumulation of disability. These findings need to be confirmed by future large longitudinal studies.
- A Case of Trigeminal Malignant Melanotic Nerve Sheath Tumor in the Wide Spectrum of Melanotic and Nerve Sheath TumorsPublication . Rachão, A; Ferro, M; Roque, R; Rainha Campos, A; Pimentel, J
- Doente com Tiróide de Hashimoto e EncefalopatiaPublication . Roque, R; Dias, M; Pena, J; Almeida, M; Pedrosa, R
- Predicting Outcome after Cardiopulmonary Arrest in Therapeutic Hypothermia Patients: Clinical, Electrophysiological and Imaging PrognosticatorsPublication . Maia, B; Roque, R; Amaral-Silva, A; Lourenço, S; Bento, L; Alcântara, JINTRODUCTION: Predicting outcome in comatose survivors of cardiac arrest is based on data validated by guidelines that were established before the era of therapeutic hypothermia. We sought to evaluate the predictive value of clinical, electrophysiological and imaging data on patients submitted to therapeutic hypothermia. MATERIALS AND METHODS: A retrospective analysis of consecutive patients receiving therapeutic hypothermia during years 2010 and 2011 was made. Neurological examination, somatosensory evoked potentials, auditory evoked potentials, electroencephalography and brain magnetic resonance imaging were obtained during the first 72 hours. Glasgow Outcome Scale at 6 months, dichotomized into bad outcome (grades 1 and 2) and good outcome (grades 3, 4 and 5), was defined as the primary outcome. RESULTS: A total of 26 patients were studied. Absent pupillary light reflex, absent corneal and oculocephalic reflexes, absent N20 responses on evoked potentials and myoclonic status epilepticus showed no false-positives in predicting bad outcome. A malignant electroencephalographic pattern was also associated with a bad outcome (p = 0.05), with no false-positives. Two patients with a good outcome showed motor responses no better than extension (false-positive rate of 25%, p = 0.008) within 72 hours, both of them requiring prolonged sedation. Imaging findings of brain ischemia did not correlate with outcome. DISCUSSION: Absent pupillary, corneal and oculocephalic reflexes, absent N20 responses and a malignant electroencephalographic pattern all remain accurate predictors of poor outcome in cardiac arrest patients submitted to therapeutic hypothermia. CONCLUSION: Prolonged sedation beyond the hypothermia period may confound prediction strength of motor responses.
- Quisto do Mesentério: Achado IncidentalPublication . Menezes, C; Morgado, C; Andrade, D; Roque, R; Santa Rita, COs quistos do mesentério são tumores intra-abdominais benignos raros. Podem manifestar-se em qualquer faixa etária, no entanto, cerca de 33% manifestam-se em crianças com menos de 15 anos. Na maioria dos casos são assintomáticos e o seu diagnóstico, frequentemente, é um achado incidental. Embora a etiologia dos quistos seja desconhecida, várias são as teorias propostas para explicar a sua formação. O tratamento é cirúrgico e consiste na excisão completa do quisto. O prognóstico é bom e a taxa de recidiva é baixa. Os autores reportam o caso de um doente portador de um quisto do mesentério ressecado por laparotomia.