From Prone to Prepared: Airway Management in a Patient With Penetrating Thoracic Trauma.

Perioperative and critical care management following penetrating thoracic trauma represents a complex challenge. Those who survive the early trauma approach and reach the hospital alive often remain in critical condition, with cardiocirculatory complications and major pulmonary injuries. Additional difficulty arises from the presence of a weapon , particularly in a dorsal location, which limits patient positioning, and the safe manipulation of both the weapon and the patient.

Improving the compromise between accuracy, interpretability and personalization of rule-based machine learning in medical problems.

One of the key challenges when developing a predictive model is the capability to describe the domain knowledge and the cause-effect relationships in a simple way. Decision rules are a useful and important methodology in this context, justifying their application in several areas, particularly in clinical practice. Several machine-learning classifiers have exploited the advantageous properties of decision rules to build intelligent prediction models, namely decision trees and ensembles of trees (ETs).

Prenatal Diagnosis of Aberrant Right Subclavian Artery: Association with Genetic Abnormalities.

Objective:  The objective of the present study was to determine the frequency of malformations and chromosomal abnormalities in a population of fetuses with an aberrant right subclavian artery (ARSA).

Methods:  This is a 6-year retrospective study of fetuses with a prenatal diagnosis of ARSA conducted during the period between September 2013 and June 2019 at a fetal medicine unit. Data were collected from ultrasound, fetal echocardiograms, genetic studies, and neonatal records.

A new approach for interpretability and reliability in clinical risk prediction: Acute coronary syndrome scenario.

Introduction: The risk prediction of the occurrence of a clinical event is often based on conventional statistical procedures, through the implementation of risk score models. Recently, approaches based on more complex machine learning (ML) methods have been developed. Despite the latter usually have a better predictive performance, they obtain little approval from the physicians, as they lack interpretability and, therefore, clinical confidence.

Prenatal diagnosis of frontal encephalocele.

Encephalocele is a rare congenital form of neural tube defect characterized by a protrusion of the meninges and cerebral tissue through a skull defect. These defects are classified according to their location: frontal, parietal and occipital, the last one being the most common form of presentation. The prognosis is related to the anatomical site, the volume of the neural contents and the presence of coexisting abnormalities.

Prenatal diagnosis of isolated frontonasal dysplasia: A case report.

We report a case of mild frontonasal dysplasia, a complex and rare malformation affecting the central portion of the face, especially the eyes, nose, and forehead, which was diagnosed at 20 weeks of gestation. The diagnosis was made by two- and four-dimensional ultrasound and confirmed at autopsy after pregnancy termination. A review of the literature is presented.

Quality of Sleep among Portuguese Anaesthesiologists: A Cross-Sectional Study.

Introduction: Sleeping is essential to maintain proper relationships with others, keep alertness, and execute responsibilities, among many other functions. In the medical profession, there are several studies linking sleep deprivation with a decrease in responsiveness, cognition and attention. With this study we intended to characterize the sleep pattern of Portuguese anaesthesiologists and identify independent factors associated with sleep quality in this population.

Mourning and Takotsubo cardiomyopathy: neuroendocrine implications and nutritional management.

This article aims to make reference to some recent mourning aspects considered risk factors for cardiovascular disease, specifically the Takotsubo cardiomyopathy. The objective was to describe the stress from the death of a loved one combining it to the possibility of occurrence of Takotsubo cardiomyopathy through the perception of a traumatic event by the cortex, which triggers the subcortical brain circuit affecting the endocrine response. Given the growing acknowledgement of this cardiomyopathy, it is possible to contextualize the nutritional behaviours and decisions surrounding it, whose benefits must exceed the condition of temporary cardiac dysfunction and extend to food choices that have some influence in the limbic system.

Chorionic bump in a pregnant patient with a history of infertility.

Chorionic bump is a rare condition in the first trimester of pregnancy. It appears as a bulge from the choriodecidual surface into the gestational sac. So far, there have been no ultrasound or clinical markers that can predict a difference in outcomeWe report a case of a pregnant woman with history of infertility, diagnosed in the first trimester with a chorionic bump.

Two-Dimensional Identification of Fetal Tooth Germs.

Objective: To demonstrate the efficiency and applicability of two-dimensional ultrasonography in the identification of tooth germs and in the assessment of potential pathology.

Design: Observational, descriptive, cross-sectional study.

Setting: Prenatal Diagnosis Unit of Centro Hospitalar de Vila Nova de Gaia / Espinho-Empresa Pública in Portugal.

Prenatal ultrasound and postmortem histologic evaluation of tooth germs: an observational, transversal study.

Introduction: Hypodontia is the most frequent developmental anomaly of the orofacial complex, and its detection in prenatal ultrasound may indicate the presence of congenital malformations, genetic syndromes and chromosomal abnormalities. To date, only a few studies have evaluated the histological relationship of human tooth germs identified by two-dimensional (2D) ultrasonography. In order to analyze whether two-dimensional ultrasonography of tooth germs may be successfully used for identifying genetic syndromes, prenatal ultrasound images of fetal tooth germs obtained from a Portuguese population sample were compared with histological images obtained from fetal autopsies.

Minimally invasive approach of tubo-ovarian abscesses.

Purpose: To evaluate the treatment outcome of tubo-ovarian abscesses managed by transvaginal ultrasound-guided aspiration.

Methods: Descriptive analysis of all patients with tubo-ovarian abscesses treated with a minimally invasive procedure, ultrasound-guided drainage, at the Department of Gynecology, Centro Hospitalar Vila Nova de Gaia/Espinho, during a period of 5 years (from June 2009 to June 2014).

Results: Twenty-six cases were included in the study.

Successful pregnancy in a woman with arthrogryposis multiplex congenita.

Arthrogryposis multiplex congenita refers to a clinical condition or syndrome characterised by multiple congenital contractures that affect two or more different areas of the body. Of the cases reported so far, an important percentage had to be terminated before pregnancy term, predominantly by caesarean section. We describe a 36 year-old woman who wanted to conceive.

[Multiple sclerosis: social and economic implications].

Multiple Sclerosis (MS) is the most common demyelinating disease of the Central Nervous System. It is more frequently diagnosed in young individuals between 20 and 40 years old. MS is the leading non-traumatic cause for disability in young adults in western countries.