Browsing by Author "Ferreira, AM"
Now showing 1 - 4 of 4
Results Per Page
Sort Options
- Case 136: intraductal papillary mucinous tumor (main duct type) of the pancreasPublication . Ferreira, AM; Vaz, A; Viana, M; Gil-Agostinho, P; Caseiro-Alves, F
- Narcolepsia – a propósito de um caso clínicoPublication . Cabral, AS; Madeira, N; Ferreira, AMA Narcolepsia é uma doença crónica cuja causa exacta continua ainda por esclarecer. Caracteriza-se por sintomas cardinais como sonolência diurna excessiva e cataplexia, reveste-se de algumas especificidades a nível poligráfico e pode estar associada a determinados marcadores imunogenéticos. Determina habitualmente importantes consequências no funcionamento global e na adaptação psicossocial do indivíduo, afectando significativamente a sua qualidade de vida. Neste trabalho os autores expõem o caso de um doente do sexo masculino, de 18 anos, referenciado à Consulta de Distúrbios do Sono do Serviço de Psiquiatra dos Hospitais da Universidade de Coimbra, por uma pneumologista do Laboratório de Sono da mesma instituição, por apresentar uma sonolência diurna excessiva grave, tendo já efectuado diversos exames cujos resultados não eram suficientes para explicar a gravidade da queixa. O doente foi posteriormente internado no Serviço de Psiquiatria dos HUC, com a suspeita de se tratar dum síndrome de Kleine Levin. Após avaliação clínica e estudo orgânico aprofundado concluiu-se que o doente apresentava um quadro compatível com Narcolepsia. Partindo do caso descrito, é feita uma breve revisão teórica desta patologia.
- NOD2 gene mutations in ulcerative colitis: useless or misunderstood?Publication . Freire, P; Cardoso, R; Figueiredo, P; Donato, MM; Ferreira, M; Mendes, S; Ferreira, AM; Vasconcelos, H; Portela, F; Sofia, CPURPOSE: NOD2 mutations have been linked to an increased risk of Crohn's disease and to some of its phenotypes. The association between NOD2 mutations and susceptibility to ulcerative colitis (UC) remains somewhat controversial and potential correlations between these mutations and UC phenotype have not been studied. AIM: To assess whether NOD2 mutations are a risk factor for UC in Portugal and if there are any genotype-phenotype correlations in these patients. METHODS: The three main NOD2 mutations were searched in 200 patients with UC and in 202 healthy controls. RESULTS: NOD2 mutations were present in 28 patients with UC (14.0 %) and in 27 controls (13.4 %) (p = 0.853). Mutation carriers were more likely to receive steroids during the first year of disease than non-carriers (54.2 % vs. 29.6 %, p = 0.018) and among these patients the need for intravenous administration was more frequent in those with the R702W polymorphism (90.0 % vs. 45.5 %, p = 0.014). In patients with severe colitis admitted for intravenous steroids, a greater proportion of mutation carriers was considered intravenous-steroid refractory and required salvage therapy (90.0 % vs. 38.1 %, p = 0.004). Patients with NOD2 mutation were submitted to colectomy more frequently than non-carriers (17.9 % vs. 4.1 %. p = 0.015). No correlation with the need for immunosuppressants/immunomodulators was found. CONCLUSIONS: In the Portuguese population, NOD2 mutations do not increase the risk of UC but are associated with a more aggressive course including greater need of steroids in the first year, increased incidence of intravenous-steroid refractoriness and a higher colectomy rate.
- Snoring in Portuguese primary school childrenPublication . Ferreira, AM; Clemente, V; Gozal, D; Gomes, A; Pissarra, C; César, H; Coelho, I; Silva, CF; Azevedo, MHOBJECTIVE: To determine the prevalence of snoring and its potential associations with sleep problems, such as daytime symptoms, medical conditions, school performance, and behavioral disturbances in Portuguese children attending primary school. METHODS: A previously validated questionnaire was sent to the parents of 1381 children attending primary schools in a parish of Coimbra, Portugal. To assess behavioral disturbances, the Portuguese version of Rutter's Children's Behavior Questionnaire for completion by teachers was used. RESULTS: Of the 988 questionnaires returned (71.5%), complete information concerning snoring was obtained for 976 children (496 girls and 480 boys; mean age: 8.1 +/- 1.5 years). Loud snoring during sleep was reported as frequent or constantly present (LSn) in 84 children (8.6%), as occasionally present in 299 children (30.6%), and as never present (NSn) by 593 children (60.8%). The LSn and NSn groups did not differ with respect to age, gender, sleep duration, time to fall asleep, frequency of night wakings, bedwetting, daytime tiredness, and school achievement. However, LSn was significantly associated with increased bedtime problems (fears and struggles), increased need for comforting activities to fall asleep, behaviors suggestive of parasomnias (sleep talking, teeth grinding, and night terrors), increased daytime sleepiness and irritability, and behavioral disturbances. Children in the LSn group were also more likely to report recurrent medical problems particularly those involving infections of the respiratory tract. CONCLUSIONS: Snoring is a common symptom in Portuguese children that is associated with behavioral daytime and sleep time disturbances. Children with loud snoring may benefit from early evaluation and intervention.