Browsing by Author "Morais, C"
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- Os dias iniciais da infecção pelo vírus da gripe pandémica (H1N1) 2009 na região centro de PortugalPublication . Duque, V; Cordeiro, E; Mota, V; Morais, C; Rodrigues, F; Coelho, F; Saraiva da Cunha, JG; Meliço-Silvestre, ABACKGROUND: The first case of pandemic (H1N1) 2009 virus infection was diagnosed in the central region of Portugal on June 16, 2009, in a woman infected in Canada. METHODS: The aim of our study was, first to characterize the clinical and epidemiologic aspects of all the patients with clinical manifestations included in the definition of case for investigation with samples submitted to diagnosis of the pandemic (H1N1) 2009 virus infection, in the central region of Portugal; second to assess the precision of the case definition of case for investigation considered in the study according to the presence or the absence of fever at the moment of clinical observation. We reviewed the medical records of all the patients presenting with Influenza like-illness classified as case for investigation and the first cases of patients infected with the new pandemic (H1N1) 2009 virus, diagnosed in the central region of Portugal during the pandemic period between June and August, 2009, were analyzed. Real-time reverse-transcriptase polymerase-chain-reaction (RT-PCR) testing was used to confirm the pandemic (H1N1) 2009 virus infection. Data collection was performed on a standardized paper format in agreement with the General Health Directorate. Results and discussion: Pandemic (H1N1) 2009 virus infection was confirmed in 255 patients. Overall, median age was 23 years and 42.7 % were included in the category of 20 to 29 years. Confirmed infection in patients with less than 2 years or greater than 50 years was a rare event. The first cases were imported from Europe, namely France, Spain and England. On a second phase, pandemic (H1N1) 2009 virus infection was acquired in the south of Portugal (Algarve), before de diagnosis of the first domestic case. The incidence rate for pandemic (H1N1) 2009 virus infection was 10.7 per 100,000 persons and was different according to the district. It was higher in the district of Coimbra and Guarda were the main roads connecting to Europe are. The median calculated incubation period for the for pandemic (H1N1) 2009 virus infection was 2 days. The length of the clinical manifestations until the patients look for medical observation had a median time of 2 days. All the cases were of mild to moderate severity. No deaths were observed. CONCLUSIONS: The early days of pandemic (H1N1) 2009 virus infection was mild in our region. Most affected patients were young adults, with the extreme categories ages of life being spared. Early detection and diagnosis, combined with stringent isolation and treatment procedures could have slowed the spread of the infection in our region.
- História natural da dilatação pielocalicial pré-natalPublication . Franco, S; Carvalho, G; Antunes, A; Brito, M; Morais, C; Barros, JSINTRODUCTION: It is estimated that genitourinary anomalies comprise 20% of all antenatally detected fetal anomalies, and pyelocaliectasia is the most common one. Detection of antenatal dilatation of the urinary tract does not always indicate postnatal urinary tract obstruction or even a significant genitourinary anomaly. Most cases will improve spontaneously, representing a temporary physiologic impedence and do not require surgery. MATERIALS AND METHODS: In a two-year period we studied 197 newborns, with prenatal pyelocaliectasia, without concomitant anomaly, delivered at Maternidade Dr. Daniel de Matos. In the postnatal follow-up period, the infants were followed at Pediatrics Department, at our Center. RESULTS: A male predilection was found. Ultrasonic follow-up of the 197 infants showed that pyelocaliectasia resolved in 97%, while 3% still presented it in the postnatal ultrasound. Complementary renal evaluation, with voiding cystourethrography and radionuclide imaging, was realised in 29 (15%) infants to further characterize the abnormality detected in postnatal ultrasound. Surgery was performed in four (2%) children. CONCLUSION: Prenatally diagnosed pyelocaliectasia may be safely observed, and surgical correction should be performed only if renal compromise occurs.