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Browsing by Author "Alves, M"

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  • Crescimento discordante precoce numa gravidez gemelar monocoriónica
    Publication . Sousa, S; Passarinho, R; Alves, M; Taborda, A; Santos-Silva, I
    Introduction: Abnormal growth, including discordant growth and intrauterine growth restriction (IUGR), occurs frequently in twin pregnancies and has been associated with increased risk of perinatal morbidity and mortality. Typically this occurs in the second or third trimester. Discordant growth in monochorionic twin pregnancies is probably related with the complications of a shared placenta. It is not clear whether there is increased risk of perinatal morbidity in both discordant twins or only in those with low birth weight. Case report: A 21 year old primigravida with a spontaneous monochorionic twin pregnancy was seen to have a crown-rump length discordance at 8 weeks of gestation (one fetus with 6mm and the other with 12 mm). All routine tests were normal. No major congenital or karyotype abnormalities or evidence of twin to twin transfusion syndrome (TTTS) were detected during follow up examinations. This discrepancy persisted until birth: fetus A was in the 25th percentile while fetus B below the 5th percentile. Umbilical artery flow in both twins remained normal. At 34 weeks, preeclampsia developed and labor induction was performed. The twins had a birth weight of 2195 g and 1415 g (35,5% discrepancy), and an Apgar score of 7 and 10 at 5th minute, respectively. They remain in the neonatal intensive care unit for 29 days, with the larger twin having more complications: transient tachypnea of the newborn, pneumothorax and hyperbilirubinemia. At two years old, they both had a normal development. Discussion: In monochorionic twins with a normal karyotype and no evidence of TTTS, the causes of discordant growth are not always clear. In this case, the occurrence of discordant growth and IUGR did not lead to more complications in the smaller twin.
    2012Journal article Open access Show more
  • Evaluation protocol for amusia: portuguese sample
    Publication . Peixoto, MC; Martins, J; Teixeira, P; Alves, M; Bastos, J; Ribeiro, JC
    Amusia is a disorder that affects the processing of music. Part of this processing happens in the primary auditory cortex. The study of this condition allows us to evaluate the central auditory pathways. OBJECTIVE: To explore the diagnostic evaluation tests of amusia. METHOD: The authors propose an evaluation protocol for patients with suspected amusia (after brain injury or complaints of poor musical perception), in parallel with the assessment of central auditory processing, already implemented in the department. The Montreal Evaluation of Battery of amusia was the basis for the selection of the tests. From this comprehensive battery of tests we selected some of the musical examples to evaluate different musical aspects, including memory and perception of music, ability concerning musical recognition and discrimination. In terms of memory there is a test for assessing delayed memory, adapted to the Portuguese culture. Prospective study. RESULTS AND CONCLUSIONS: Although still experimental, with the possibility of adjustments in the assessment, we believe that this assessment, combined with the study of central auditory processing, will allow us to understand some central lesions, congenital or acquired hearing perception limitations.
    2012Journal article Open access Show more