Browsing by Author "Carvalho, D."
Now showing 1 - 3 of 3
Results Per Page
Sort Options
- Descrição, factores, preditores e prognóstico dos derrames parapneumónicosPublication . Ferreira, J.; Maia, J.; Mendonça, C.; Carvalho, D.; Paiva, P.; Correia, J.Resumo Introdução: A infecção pleural é um problema comum na prática clínica. Uma porção significativa das infecções no espaço pleural representa um processo progressivo que leva à transformação de um derrame simples em complicado. A maioria dos autores sugere que a decisão terapêutica depende do estadio de evolução da doença. Objectivos: Descrever e caracterizar os derrames parapneumónicos quanto à forma de apresentação, características, terapêutica instituída e evolução. Métodos: Estudo observacional, retrospectivo e longitudinal com base na análise dos processos clínicos dos doentes com o diagnóstico de derrame parapneumónico, entre Janeiro de 2005 e Junho de 2011. Trinta e quatro casos cumpriram critérios de inclusão. Resultados: A evolução do quadro clínico parece ser independente do tipo de dreno/catéter usado (p=0,608). Os empiemas associam-se com significado estatístico a não resolução inicial do quadro (p=0,024). A presença de derrames loculados aumentou o tempo de internamento médio em aproximadamente 10 dias (p=0,071) e acarretou um prolongamento no tempo médio de antibioterapia de 13 dias (p=0,049). Conclusões: O derrame parapneumónico com significado clínico parece ter baixa incidência, contudo é uma patologia que acarreta prolongamento no tempo de internamento e potenciais complicações. Deve preferir-se a utilização de catéteres de pequeno diâmetro (10-14F). Os parâmetros que pioram significativamente o prognóstico são a presença de empiema ou de derrames loculados.
- Endocrinology in Portugal - Census 2016. Board of the Portuguese College of Endocrinology and Nutrition of the Portuguese Medical AssociationPublication . Guimarães, J.; Afonso, A.; Carvalho, D.; Marques, A.; Martins, T.; Mascarenhas, M.; Pereira, C.; Rodrigues, D.; Saraiva, C.; Cardoso, H.INTRODUCTION: On September 2016, the Board of the College of Endocrinology and Nutrition of the Portuguese Medical Association carried out a national survey, about all Endocrinology, Diabetes and Metabolism Departments of the public hospitals included in the Portuguese National Health Service and a simplified version of this survey was sent to all endocrinologists working in Portugal and registered with the Portuguese Medical Association. MATERIAL AND METHODS: Data related to organizational and human resources were collected, reporting the situation by the end of year 2015. The census registered 107 individuals and 27 Departments. RESULTS: The ratio of endocrinologists-population was 1.4, much lower than in the other European countries (varies between 2 to 4), resulting in alarming shortages of services in some areas of Portugal and in worse quality indicators. DISCUSSION: These data suggest that actions should be taken to increase the number of endocrinologists and departments in the country. CONCLUSION: In recent years, the number of residents has significantly increased, which will make it possible to correct this situation
- Stability of blood gases when refrigeratedPublication . Ferreira, J.; Silva, S.; Rodrigues, P.; Abreu, M.; Maia, J.; Carvalho, D.; Carvalho, L.Background: Blood gas analysis is a widely used procedure. In clinical practice, the physicians may not always have a blood gas analyzer in their proximity. Not infrequently, blood gas samples are stored in a fridge or on ice and read retrospectively. Continued anaerobic and aerobic metabolism in the blood may alter blood gases in the interval between drawing arterial blood and its analysis, which may cause a fall in the PaO2 and pH and a rise in the PaCO2. Methods: Two sets of arterial blood samples were obtained from hospitalized patients. After the initial analysis, one sample from each patient was put in raw ice within a specimen bag (0 to +1 oC) and the other in the fridge (+4 to +8 oC). These samples were submitted to serial analysis at 30 minutes, 1 hour and 2 hours after the initial analysis. Results: Two hundred arterial blood gas results from 25 patients were analysed. The mean values of PaO2, PaCO2, HCO3-, Na+, K+, Ca2+ and lactate at 0 minutes, 30 minutes, 1 hour and 2 hours were not signifi cantly different between the two alternatives of storage. However, within each group, signifi cant changes were found over time for PaO2, K+, Na+, Ca2+ and lactate. Conclusions: When using plastic syringes, arterial blood gas analysis should be processed shortly after collecting the sample. Despite the fact that low temperatures can slow down the metabolism, neither the ice nor the fridge preserved all the sample parameters.