Browsing by Author "Dias, P"
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- Ácido úrico e doença cardiovascularPublication . Guimarães, J; Devesa, N; Dias, P; Parente, F; Alexandrino, MB; Moura, JA
- Apolipoprotein E epsilon-4 polymorphism is associated with younger age at referral to a lipidology clinic and a poorer response to lipid-lowering therapyPublication . Baptista, R; Rebelo, M; Decq-Mota, J; Dias, P; Monteiro, P; Providência, LA; Silva, JMThe risk of coronary heart disease (CHD) is related to environmental factors and genetic variants. Apolipoprotein E (apoE) polymorphisms are heritable determinants of total and low-density lipoprotein cholesterol, with some authors suggesting an association between the ε4 allele and CHD. We investigated the relationship between apoE genotype and age at referral to a specialized lipid clinic by the primary care physician and whether the benefits of treatment with statin differed between genotypes. METHODS: We assessed individual apoE genotypes and lipid blood profile in a total of 463 patients followed at a specialized lipid clinic due to dyslipidemia, with a 3-year median follow-up time. The primary care physician at the time of the referral had no access to the apoE genotyping results. Carriers of apoE ε4/ε2 genotype were excluded. RESULTS: The frequencies of ε2, ε3 and ε4 alleles were 7.8, 78.9 and 13.3%, respectively. There were no significant differences between genders. Although with similar lipid profiles and antidyslipidemic drug usage at baseline, ε4-carriers were referred to the clinic at a younger age (44.2 ± 14.7 years) compared with non-ε4 carriers (50.6 ± 13.8 years) (p < 0.001), with a substantially younger age of referral for homozygous E4/4 and for all genotypes with at least one copy of the ε4 allele (p < 0.001 for trend). Although both ε4 and non-ε4 carriers achieved significant reductions in total cholesterol during follow-up (p < 0.001 vs. baseline), the mean relative decrease in total cholesterol levels was higher in non-ε4 carriers (-19.9 ± 2.3%) compared with ε4 carriers (-11.8 ± 2.3%), p = 0.003. CONCLUSION: Our findings support the concept that there is a reduced response to anti-dyslipidemic treatment in ε4 carriers; this can be a contributing factor for the earlier referral of these patients to our specialized lipid clinic and reinforces the usefulness of apoE genotyping in predicting patients response to lipid lowering therapies.
- Avaliação do percurso intra-hospitalar após a alta de um serviço de Medicina InternaPublication . Dias, P; Parente, F; Gaspar, E; Carrola, P; Alexandrino, MB; Alves-Moura, JJ
- Biópsia hepática: evolução numa casuística recentePublication . Devesa, N; Guimarães, J; Carrola, P; Reis, R; Dias, P; Parente, F; Lourenço, A; Alexandrino, MB; Alves-Moura, JJ
- Doença de deposição de cadeias leves com atingimento hepático predominantePublication . Costa, S; Dias, P; Gaspar, E; Cipriano, MA; Parente, F; Lourenço, A; Alexandrino, MB; Moura, JA
- Estatinas e microalbuminúriaPublication . Dias, P; Silva, JM; Silva, N; Alexandrino, MB; Alves-Moura, JJ
- Evolução do peso numa consulta de dislipidemiasPublication . Dias, P; Reis, R; Parente, F; Silva, JM; Moura, JA
- Processo clínico informatizado: uma opiniãoPublication . Parente, F; Silva, N; Dias, P
- Próteses totais primárias da anca com um recuo superior a 15 anos a propósito de 12 casos clínicosPublication . Corte-Real, C; Ferreira, I; Mendes, J; Dias, P; Mendonça, A; Cura-Mariano, J; Lucas, F; Judas, FO Ortopedista dispõe, atualmente, de um leque alargado de endopróteses articulares primárias da anca para o tratamento da artropatia degenerativa ou inflamatória e, bem assim para a cirurgia reconstrutiva da anca traumática, que incluem implantes cimentados, não cimentados, híbridos, revestidos ou não com biocerâmicos, com diversas cúpulas de fricção articular. A implantação de uma prótese total da anca representa uma das intervenções de maior sucesso clínico em Ortopedia, quiçá em Medicina, proporcionando o alívio/supressão da dor e o restabelecimento precoce da função articular a milhões de doentes em todo o mundo. Apesar de ser assim, a artroplastia total da anca não é uma solução definitiva, a médio ou a longo prazo assiste-se a uma falência mecânica originada, na maioria das situações, pela osteólise periprotética provocada pelas partículas de degaste dos biomateriais que constituem a cúpula de fricção articular, processo biológico que o melhor cirurgião não consegue evitar. Pode-se aceitar que o tempo médio de duração de uma prótese total da anca situa-se, nas melhores casuístas, acima dos 15 anos. O objetivo central deste trabalho é mostrar os resultados clínicos e radiológicos do tratamento de uma série de 12 diferentes situações clínicas em que foram implantadas próteses totais primárias da anca, com um recuo clínico superior a 15 anos.
- Thyroid dysfunction and amiodaronePublication . Lima, J; Carvalho, P; Molina, MA; Rebelo, M; Dias, P; Vieira, JD; Nascimento-Costa, JMAlthough most patients remain clinically euthyroid, some develop amiodarone-induced hyperthyroidism (HPEAI) or hypothyroidism (HPOAI). The authors present a retrospective analysis of ten patients with amiodarone-induced thyroid dysfunction. Six patients were female and mean amiodarone intake was 17.7 months. HPOIA was more common (six patients). From all the patients with HPEAI, two had type 2, one had type 1, and one had type 3 hyperthyroidism. Symptoms suggestive of thyroid dysfunction occurred in five patients, most of them with HPOAI. In HPEAI, the most frequent symptom was exacerbation of arrhythmia (three patients). Discontinuation of amiodarone and treatment with levothyroxine was chosen in 83.3% of the HPOAI cases, while thyonamide treatment with corticosteroids and without amiodarone was the option in 75% of the HPEAI cases. There were three deaths, all in patients with HPEAI. HPEAI is potentially fatal. The clinical picture may be vague, so the thyroid monitoring is mandatory.