[Intima-media thickness and hypertensive disorders of pregnancy: a prospective study].

Purpose: To evaluate intima-media thickness (IMT) in hypertensive pregnant women and to ascertain if an increased IMTcorrelates with the development of preeclampsia.

Methods: A controlled, descriptive and prospective study was conducted in the Maternal-Fetal Medicine Unit (MFMU) of a level II hospital with perinatal assistance. Throughout six months randomly selected pregnant women were allocated in three branches (A - control group, n = 17; B - gestational hypertension group, n = 17; C - pregestational hypertension group, n = 14(.

[Postpartum portal venous system thrombosis in a patient with antiphospholipid syndrome].

Introduction: Antiphospholipid Syndrome (APS) is an immune thrombophylia of unknown etiology which leads to vascular thrombosis and gestational complications.

Clinical Report: A 27-year old woman who had been diagnosed APS four years before was admitted in the Emergency Room five days after a spontaneous delivery due to [corrected] pain in the upper right abdominal quadrant. Blood analysis revealed AST and ALT rise and thrombocytopenia.

Depression, anxiety and alcohol abuse in a gastroenterology intensive care unit: prevalence and detection.

Objectives: To assess depression, anxiety, and alcohol abuse in a Gastroenterology ICU, and the level of its detection by the staff.

Method: All patients consecutively admitted to the ICU during a six-month period, 18 or above, and staying ≥ 24 hours, were assessed with the Hospital Anxiety and Depression Scale (HADS) and the CAGE. Doctors and nurses assessed the type and severity of patients' morbidity.

ICD defibrillation failure solved in an unusual fashion.

An implantable cardioverter defibrillator (ICD) is designed to sense life-threatening ventricular arrhythmias and terminate them, either by rapid pacing or by delivering an electrical shock. Nowadays it is a proven therapy for both primary and secondary prevention of sudden cardiac death. The typical configuration of an ICD consists of a right ventricular sensing/defibrillator lead with two coils (one distal, located in the right ventricle, and one proximal, located at the superior vena cava-right atrium junction) and an active can, the so-called "ventricular triad".

Nephrolithiasis is associated with an increased prevalence of cardiovascular disease.

Background: Nephrolithiasis has been associated with hypertension, obesity and diabetes mellitus. The prevalence of adverse cardiovascular outcomes among kidney stone formers (KSF) is unknown.

Methods: We examined the IV Portuguese National Health Survey for documenting possible associations between nephrolithiasis, cardiovascular diseases, diabetes and obesity in the Portuguese adult population.

[Non invasive ventilation in a pediatric intensive care unit].

Background: Non-invasive ventilation (NIV) is being increasingly used in children with acute respiratory failure, preventing complications associated with conventional mecánical ventilation.

Aims: To determinate the efficacy of NIV in children with acute respiratory failure or chronic respiratory failure.

Methods: Prospective study of all patients who underwent NIV (November 2005 to April 2008).

Ethnic and clinical characteristics of a Portuguese psychiatric inpatient population.

The present study examined the association between ethnicity and clinical characteristics of patients admitted to a psychiatric inpatient unit in Portugal. The only ethnicity-related terms routinely recorded in the medical records were "Black" (mainly from the African Portuguese-speaking countries of Cape Verde, Angola, Guinea, Sao Tome and Mozambique) and "White." Black immigrants appeared to be over-represented, comprising 19.

Familial C4B deficiency and immune complex glomerulonephritis.

Homozygous complement C4B deficiency is described in a Southern European young female patient with Membranoproliferative Glomerulonephritis (MPGN) type III characterized by renal biopsies with strong complement C4 and IgG deposits. Low C4 levels were independent of clinical evolution or type of immunosuppression and were found in three other family members without renal disease or infections. HLA typing revealed that the patient has homozygous A*02, Cw*06, B*50 at the class I region, and DRB1*08 and DQB1*03 at the class II region.

Cystatin C as a marker of acute kidney injury in the emergency department.

Background And Objectives: The diagnosis of acute kidney injury (AKI) is usually based on changes in serum creatinine, which is a poor marker of early renal dysfunction. The discriminative and predictive abilities of serum and urinary cystatin C were examined for the prediction of AKI.

Design, Setting, Participants, & Measurements: In this prospective cohort study, serum and urinary cystatin C were serially measured in a heterogeneous group of patients (n = 616) presenting to a tertiary care emergency department.

[Acute liver failure].

Acute liver failure refers to the rapid development of severe acute liver injury with impaired synthetic function in a patient who previously had a normal liver or a well compensated liver disease. Its aetiology is diversified and it provides one of the best indicators of prognosis thus being crucial its quick identification. Because it can progress to multiple organ failure syndrome these patients should be managed in an Intensive Care Unit.

[Immigrant children in a pediatric department: what social problems?].

Background: Hospital Fernando Fonseca is located in a suburban area that houses a great number of immigrants from developing countries.

Aims: To characterize and compare the immigrant and portuguese pediatric populations which have been admitted and referred to Social Service department.

Material And Methods: Prospective study, from November 2004 to March 2005; demographic and socioeconomic data, diagnosis and social problems were analysed.

Familial haemophagocytic lymphohistiocytosis: two case reports.

Haemophagocytic lymphohistiocytosis (HLH) is a life threatening inflammatory syndrome, which presents a highly stimulated but ineffective immune response with severe hypercytokinaemia. HLH, primary or secondary, is characterised by prolonged fever and hepatosplenomegaly associated with pancytopenia, hypertriglyceridaemia and hypofibrinogenaemia. However, the hallmark of HLH is impaired or absent function of natural killer cells and cytotoxic T lymphocytes.

[Iodinated contrast agents].

The use of contrast agents is common in clinical practice and physicians should be familiar with their use. We review the types of contrast agents, their characteristics, clinical indications and adverse reactions.

[Non-traumatic spontaneous intramural hematoma of the small bowel: an infrequent complication of anticoagulation therapy].

Intramural hematoma of the small bowel is an infrequent complication of the use of oral anticoagulants. Diagnosis can only be performed when these symptoms are associated with a history of oral anticoagulant use and radiological tests. We report the case of a patient admitted for epigastric pain associated with oral anticoagulation therapy with warfarin and a 48-h history of retention vomiting.

Caloric intake and weight gain in a neonatal intensive care unit.

The aim of this paper was to study the weight gain in very-low-birthweight (VLBW) infants by adopting earlier and higher intake of proteins and earlier intake of lipids. We studied 28 VLBW infants admitted to Neonatal Intensive Care Unit during the year 2004 (group 1) and 18 during the first semester of 2006 (group 2). Dietary intakes for group 1 were: 1 g kg(-1) day(-1) of proteins started at postnatal day 2 (P2) and 0.

[The use of opium in Roman society and the dependence of Princeps Marcus Aurelius].

Opium was known and frequently used in Roman society. Medical practice recognized its usefulness as an analgesic, soporific, anti-tussic or anti-diarrheic agent, as well as other currently unsupported uses with quasi-magical properties. It was additionally used as an ingredient in antidotes, panaceas and poisons.

Is Manchester (MTS) more than a triage system? A study of its association with mortality and admission to a large Portuguese hospital.

Background: The Manchester Triage System (MTS) is a 5-point triage scale used to triage patients presenting to the emergency department. It was introduced in the UK in 1996 and is now widespread, especially in Europe, and has been in use in our hospital since 2000 via a computerised protocol. A study was undertaken to determine whether the subgroups created by the application of MTS have different propensities for indirect triage outcomes such as death in the A&E department or being admitted to hospital.

Ebstein's anomaly: a case with an unexpected evolution.

Ebstein's anomaly of the tricuspid valve is a rare and complex congenital heart defect. Its etiology is unknown and in the majority of cases it is multifactorial. Mortality in the neonatal period is high.

[Gastrointestinal stromal tumors - a retrospective study of 43 cases].

Background: gastrointestinal stromal tumors (GISTs) are rare (10 to 20/million). They exist in the whole digestive system and its surroundings, and are most common in the stomach (70%), followed by the small intestine (20-25%), colon and rectum (5%), and esophagus ( < 5%). Their clinical presentation varies from small, incidentally found nodules to large and aggressive tumors.

Congenital laryngomucocoele: a rare cause for CHAOS.

Congenital high airway obstruction syndrome (CHAOS) is a rare but life-threatening condition that results from the obstruction of the upper airways.We describe a female newborn, from a Grávida II, Para 0, 36-year-old woman, with a routine ultrasound at 30 weeks' gestation that showed polyhydramnios. She delivered a live-born female baby at 36 weeks without any dismorphic features but with respiratory distress.

[Overweight and obesity - prevention in the school].

Introduction: The prevalence of the childhood obesity through the last decades is increasing, with significant comorbidities and major health consequences. Children's food habits are influenced by family, friends, school and the media. Successful interventions for preventing childhood obesity must include nutrition education, physical activity, school-based programs, family participation and counseling.

A short neuropsychologic and cognitive evaluation of frontotemporal dementia.

Objective: To elaborate a brief but efficient neuropsychological assessment of frontotemporal dementia (FTD), selecting the most specific and sensitive cognitive and behavioural items for distinguish between AD and FTD in the earlier dementia stages.

Methods: Retrospective study with three groups, 35 patients with FTD, 46 with AD and 36 normal subjects, were administered the MMSE, FAB, Tower of London and Stoop's test along with a 98 items behavioural and cognitive questionnaire. The most sensitive items were selected and validated internally for diagnosis by lineal discriminant analysis.

Combined myocardial infarction: two case reports.

Combined myocardial infarction is defined as a current of injury on the electrocardiogram in both inferior and anterior leads. From a pathophysiological standpoint, this indicates simultaneous acute transmural ischemia of contralateral vascular territories. The authors present the cases of two patients admitted with this rare type of infarction, followed by a discussion of the relationship between electrocardiographic and angiographic findings and their value for assessing prognosis in this clinical entity.

Nutritive sucking pattern--from very low birth weight preterm to term newborn.

Unlabelled: The contribution of maturation and stimulation to the development of oral feeding was investigated, with two main objectives: (1) to analyze the nutritive sucking pattern of very-low-birth-weight newborns from their first oral feeding to the acquisition of independent oral feeding, and (2) to compare the nutritive sucking patterns of these babies, after feeding autonomy, with healthy term newborns.

Methods: Two groups were considered for analysis. Group 1: N=15 Very-Low-Birth-Weight (VLBW), gestacional age (GA)=28.