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Browsing by Author "Vieira, M"

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  • Acute Cardiovascular Manifestations in 286 Children With Multisystem Inflammatory Syndrome Associated With COVID-19 Infection in Europe
    Publication . Valverde, I; Singh, Y; Sanchez-de-Toledo, J; Theocharis, P; Chikermane, A; Di Filippo, S; Kuciñska, B; Mannarino, S; Tamariz-Martel, A; Gutierrez-Larraya, F; Soda, G; Vandekerckhove, K; Gonzalez-Barlatay, F; McMahon, C; Marcora, S; Napoleone, C; Duong, P; Tuo, G; Deri, A; Nepali, G; Ilina, M; Ciliberti, P; Miller, O; Iriart, X; Hubrechts, J; Kuipers, I; Sousa, A; Donti, A; Sharpe, A; Reinhardt, Z; Cairello, F; De Wolf, D; Vieira, M; Lazea, C; Gran, F; Medrano-Lopez, C; Ortiz-Garrido, A; Vukomanovic, V; Brent, B; Milanesi, O; Dewals, W; Manso, B; Valsangiacomo-Buchel, E; Francisco, A; Seghaye, MC; Loeckx, I; Rodriguez-Gonzalez, M; ReyGarcía, S; Ziesenitz, V; Bordin, G; Doros, G; Grangl, G; Fadl, S; Perminow, K; Centeno, F; Pinto, F; Niemelä, J; Kanthimathinathan, H; Randanne, P; Niszczota, C; Zuccotti, G; Gordillo, I; Obeyasekhara, M; Armstrong, C; Butler, K; Ciuffreda, M; Villar, AM; Pappula, N; Caorsi, R; Singh, D; Durairaj, S; McLeod, K; Calcagni, G; Quizad, Y; Gewillig, M; Kuijpers, T; Ataide, R; Fabi, M; Bharucha, T; Abbas, K; Magrass, S; Wong, J; Iacob, D; Balcells, J; GilVillanueva, N; Cuenca-Peiro, V; Cerovi, I; Sarfatt, A; Zaqout, M; Sanchez-Valderrabanos, E; Kelly-Geyer, J; Diogo, F; Cajgfinger, N; Françoise, M; Rueda-Nuñez, F; Gorenflo, M; Grison, A; Mihailov, D; Koestenberger, M; Alcalde, C; Trigo, C; Arola, A; Hanseus, K
    Background: The aim of the study was to document cardiovascular clinical findings, cardiac imaging, and laboratory markers in children presenting with the novel multisystem inflammatory syndrome associated with coronavirus disease 2019 (COVID-19) infection. Methods: This real-time internet-based survey has been endorsed by the Association for European Paediatric and Congenital Cardiologists Working Groups for Cardiac Imaging and Cardiovascular Intensive Care. Children 0 to 18 years of age admitted to a hospital between February 1 and June 6, 2020, with a diagnosis of an inflammatory syndrome and acute cardiovascular complications were included. Results: A total of 286 children from 55 centers in 17 European countries were included. The median age was 8.4 years (interquartile range, 3.8-12.4 years) and 67% were boys. The most common cardiovascular complications were shock, cardiac arrhythmias, pericardial effusion, and coronary artery dilatation. Reduced left ventricular ejection fraction was present in over half of the patients, and a vast majority of children had raised cardiac troponin when checked. The biochemical markers of inflammation were raised in most patients on admission: elevated C-reactive protein, serum ferritin, procalcitonin, N-terminal pro B-type natriuretic peptide, interleukin-6 level, and D-dimers. There was a statistically significant correlation between degree of elevation in cardiac and biochemical parameters and the need for intensive care support (P<0.05). Polymerase chain reaction for severe acute respiratory syndrome coronavirus 2 was positive in 33.6%, whereas immunoglobulin M and immunoglobulin G antibodies were positive in 15.7% cases and immunoglobulin G in 43.6% cases, respectively, when checked. One child in the study cohort died. Conclusions: Cardiac involvement is common in children with multisystem inflammatory syndrome associated with the Covid-19 pandemic. The majority of children have significantly raised levels of N-terminal pro B-type natriuretic peptide, ferritin, D-dimers, and cardiac troponin in addition to high C-reactive protein and procalcitonin levels. In comparison with adults with COVID-19, mortality in children with multisystem inflammatory syndrome associated with COVID-19 is uncommon despite multisystem involvement, very elevated inflammatory markers, and the need for intensive care support.
    2021-01Journal article Open access Show more
  • Congenital Kidney and Urinary Tract Anomalies: a Review for Nephrologists
    Publication . Vieira, M; Ferreira, A; Nolasco, F
    Kidney and urinary tract development disorder are two of the most prevalent congenital malformations and the main cause of chronic kidney disease in pediatric age patients. As such, it is very important that the neph‑ rologist understands these pathologies to improve transition and ensure a good continuity between pediatric and adult nephrological care. The purpose of this article is to present a brief review of congenital anomalies of the kidney and urinary tract (CAKUT). Kidney malformations are classified according to macroscopic and microscopic anatomic features, and are the result of the following abnormal renal developmental processes: malformations of the renal parenchyma, abnormalities of the embryonic migration of the kidneys and abnormalities of the developing urinary collecting system.
    2018Journal article Open access Show more
  • Utilização do Sugamadex: da Evidência à Prática Clínica
    Publication . Augusto, A; Torres, F; Vilela, H; Fragata, I; Ormonde, L; Vieira, M; Amorim, P; Esteves, S; Vargas, S
    O bloqueio neuromuscular (BNM) residual é um fenómeno frequente em doentes cirúrgicos após administração de relaxantes musculares. Está associado a um aumento da morbilidade e mortalidade pós-operatória devido às complicações clínicas dos eventos associados. O sugamadex é um novo fármaco para reversão do BNM induzido por rocurónio ou vecurónio. Como primeiro agente selectivo de ligação aos relaxantes musculares, é promissor em termos de eficácia e perfil de segurança. Apresenta um perfil de eficácia e segurança significativamente diferente ao verificado actualmente com as opções farmacológicas disponíveis. É expectável um valor terapêutico acrescentado significativo sobre estas mesmas opções, com importantes alterações na prática clínica anestésica e cirúrgica, com ganhos para os doentes, para os médicos e para o próprio hospital. Baseados na literatura e na experiência clínica, os autores partilham as suas reflexões relativas ao uso de sugamadex. Apresentam uma proposta para a sua utilização na prática clínica corrente, de acordo com as indicações do RCM, características dos doentes e situações clínicas específicas.
    2011Journal article Open access Show more