Browsing by Author "Abreu, P"
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- Amiloidose secundária e lúpus eritematoso sistémicoPublication . Monteiro, P; Abreu, P; Salvador, MJ; Malcata, ABThe authors report a clinical case of a 57 years old woman with systemic lupus erythematosus diagnosed 25 years before and secondary amyloidosis. Secondary amyloidosis can be associated with inflammatory or infectious chronic diseases, however the association with systemic lupus erythematosus is rare. We discuss the association between the two entities.
- Artrose de localização atípicaPublication . Saavedra, MJ; Oliveira, MA; Garcia, J; Abreu, P; Malcata, AB
- Consensus Recommendations of the Multiple Sclerosis Study Group and Portuguese Neuroradiological Society for the Use of the Magnetic Resonance Imaging in Multiple Sclerosis in Clinical Practice: Part 1Publication . Abreu, P; Pedrosa, R; Sá, MJ; Cerqueira, J; Sousa, L; Da Silva, AM; Pinheiro, J; De Sá, J; Batista, S; Simões, RM; Pereira, DJ; Vilela, P; Vale, JINTRODUCTION: Magnetic resonance imaging is established as a recognizable tool in the diagnosis and monitoring of multiple sclerosis patients. In the present, among multiple sclerosis centers, there are different magnetic resonance imaging sequences and protocols used to study multiple sclerosis that may hamper the optimal use of magnetic resonance imaging in multiple sclerosis. In this context, the Group of Studies of Multiple Sclerosis and the Portuguese Society of Neuroradiology, after a joint discussion, appointed a committee of experts to create recommendations adapted to the national reality on the use of magnetic resonance imaging in multiple sclerosis. The purpose of this document is to publish the first Portuguese consensus recommendations on the use of magnetic resonance imaging in multiple sclerosis in clinical practice. MATERIAL AND METHODS: The Group of Studies of Multiple Sclerosis and the Portuguese Society of Neuroradiology, after discussion of the topic in national meetings and after a working group meeting held in Figueira da Foz on May 2017, have appointed a committee of experts that have developed by consensus several standard protocols on the use of magnetic resonance imaging in the diagnosis and follow-up of multiple sclerosis. The document obtained was based on the best scientific evidence and expert opinion. Subsequently, the majority of Portuguese multiple sclerosis consultants and departments of neuroradiology scrutinized and reviewed the consensus paper; comments and suggestions were considered. Technical magnetic resonance imaging protocols regarding diagnostic, monitoring and the recommended information to be included in the magnetic resonance imaging report will be published in a separate paper. RESULTS: We provide some practical guidelines to promote standardized strategies to be applied in the clinical practice setting of Portuguese healthcare professionals regarding the use of magnetic resonance imaging in multiple sclerosis. CONCLUSION: We hope that these first Portuguese magnetic resonance imaging guidelines, based in the best available clinical evidence and practices, will serve to optimize multiple sclerosis management and improve multiple sclerosis patient care across Portugal.
- Health-related quality of life in portuguese SLE patients: an outcome measure independent of disease activity and cumulative damagePublication . Duarte, C; Abreu, P; Couto, M; Vaz, C; Malcata, A; Inês, LPURPOSE: To evaluate quality of life in Portuguese patients with Systemic Lupus Erithematosus (SLE) and its correlation with disease activity and cumulative damage. METHODS: We included consecutive SLE patients, fulfilling the 1997 ACR Classification Criteria for SLE and followed at the Rheumatology Department of the University Hospital of Coimbra, Portugal at time of visit to the outpatient clinic. Quality of life was evaluated using the patient self-assessment questionnaire Medical Outcomes Survey Short Form-36 (SF-36) (validated Portuguese version). The consulting rheumatologist fulfilled the SLE associated indexes for cumulative damage (Systemic Lupus International Collaborating Clinics- Damage Index: SLICC/ACR-DI) and disease activity (Systemic Lupus Erythematosus Disease Activity Index: SLEDAI 2000). Correlation between SLEDAI and SLICC and SF-36 was tested with the Spearman Coefficient. Significant level considered was 0.05. RESULTS: The study included 133 SLE patients (90.2% female, mean age - 40.7 years, mean disease duration - 8.7 years). Most patients presented low disease activity (mean SLEDAI = 4.23) and limited cumulative damage (mean SLICC = 0.76). Despite that, SF-36 mean scores were below 70% in all eight domains of the index. Physical function domains showed lower scores than mental function domains. The QoL in this group of patients is significantly impaired when compared with the reference Portuguese population (p<0.05 in all domains). There was no correlation between clinical activity or cumulative damage and quality of life. CONCLUSION: QoL is significantly compromised in this group of SLE patients, but not related with disease activity or damage. These findings suggest that disease activity, cumulative damage and QoL are independent outcome measures and should all be used to assess the full impact of disease in SLE patients.
- Linfedema na artrite idiopática juvenil: uma manifestação extra-articular raraPublication . Ambrósio, C; Abreu, P; Alexandre, M; Malcata, ABExtraarticular features are usually found in rheumatological diseases sometimes with no correlation with the disease's activity in that moment. Lymphoedema is one of these manifestations and it's defined as a tissue fluid accumulation with gradual onset of swelling of a limb. Because it is an unusual finding, the physiopatological explanation of this feature is still difficult to understand. We describe a case report of lymphoedema on left upper arm, in a patient with systemic juvenile arthritis, with no identified cause and with no associated systemic signs or symptoms.
- Paraneoplastic sclerodermiform syndrome--case report.Publication . Rovisco, J; Serra, S; Abreu, P; Coutinho, M; Santiago, T; Inês, L; Pereira da Silva, JAOccasionally, auto-immune diseases may emerge as paraneoplastic syndromes. This is especially recognized in the case of polymyositis/dermatomyostis, but it is an extremely rare event in systemic sclerosis (SSc). The authors report the case of a sixty-year-old woman who presented with Raynaud's phenomenon and rapidly progressing skin thickness of the forearms, hands and lower limbs. Patient evaluation revealed a colorectal carcinoma. The patient was referred to the oncology department. This concomitance of cancer and SSc with rapid progression of the latter, suggests that the scleroderma might have a paraneoplastic origin. Such an hypothesis deserves consideration in every case as early diagnosis may be decisive to control the progression of either disease.
- Síndrome de Sjögren ou esclerose múltipla? Um dilema na prática clínicaPublication . Duarte, C; Teotónio, R; Abreu, P; Matias, FThe authors present a clinical case of a male, 53-years old with a multiple sclerosis like syndrome, progressive, with 3 years of evolution. The patient also referred dry eye and inflammatory arthralgias, the complementary workup was according with Sjögren's Syndrome. The central nervous system involvement of Sjögren's Syndrome and the difficulty of differential diagnosis with neurological diseases such as Multiple sclerosis is discussed