Browsing by Author "Santos, G"
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- An insulinoma presenting with hypochondriac delusions and food refusalPublication . Renca, S; Santos, G; Cerejeira, JABSTRACT The authors report a case of a 68-year-old man with an unrecognized insulinoma manifesting with neuropsychiatric symptoms. For two years, he presented with unspecified behavior changes, autonomic and neuroglycopenic symptoms, which led him to be misdiagnosed with a neurologic and psychiatric disorder before the insulinoma was recognized. Following neurological alterations in context of hypoglycemia, subsequent to longstanding food refusal, he was admitted in the psychiatric ward. Despite good global response and normal food intake, hypoglycemic episodes were still occurring and led to a careful evaluation which permitted the definitive diagnostic. This case highlights the diagnostic difficulties of medical disorders presenting with clinical features overlapping neurological and psychiatric syndromes. It also reflects the diagnostic difficulties in rare clinical entities, particularly in patients previously followed in psychiatry and underlines the need for a constant dialogue and updating of clinicians.
- Estudo clínico, multicêntrico, aberto para avaliar a eficácia e a tolerância do sildenafil no tratamento de doentes com disfunção eréctilPublication . Palha, AP; Gomes, A; Martins, AS; Pimenta, A; Neves, J; Gonçalves, R; Ramos, L; Abrantes, P; Canhão, A; Santos, G; Carvalho, LF; Soares, J; Lima, E; Rosa, GErectile dysfunction (ED), defined by the Impotence-NIH Consensus Conference as the "persistent inability to achieve and/or maintain erection sufficient for satisfactory sexual activity" affect more than 100 million men worldwide, at particular severity levels. The global prevalence of ED is estimated to affect about 10%, but has been found to increase significantly with age (39% in men 40 years of age and 67% at 70 years of age). In men aged 40 to 70 years, the severe ED prevalence increased of three folds, 5 to 15%. In order to evaluate the efficacy and tolerance of sildenafil, it was conducted a national open, multicentre study on a portuguese population affected by ED. Subjects under ambulatory treatment were recruited in Psychiatry/Sexology Clinical units and Urology/Andrology. The results of the study carried out on a group of 62 men with ED, demonstrate that sildenafil was effective in the recovering of erectile function, increasing the number of attempts to sexual activity and improving their success rates (mainly in severe dysfunction). Fifty one patients treated with sildenafil, at the end of the study referred a global improvement in their erections (92.2%). Doses of 50 mg and 100 mg sildenafil were used and were well tolerated and also effective in the treatment of this pathology (70% and 69% respectively). Being this study a flexible dose one and taking into consideration that the final dose used was found the more suitable to the patients, can be concluded that 43.1% of the patients elected dose of 50 mg whereas 56.9% elected the maximum prescribed dose of 100 mg. Over and above global efficacy experimented by patients, a significant improvement in the sexual activity with partners was occurred. These results make possible a final conclusion--in the studied patients group affected by Erectile Dysfunction, aside from associated somatic pathology, sildenafil use provided a remarkable clinical profit, in what concerns global efficacy, by erectile function mechanisms improvement, concerning patients sensitivity of improvement, occurring in the major part of them, being these of high importance to the lifting up of their self-esteem
- Estudo de aneurismas cerebrais: por angio-tomografia computorizada cerebralPublication . Pereira, S; Santos, G; Marques, C; Machado, E; Brito, O
- Melanoma brain metastases presenting as delirium: a case reportPublication . Morais, S; Cabral, A; Santos, G; Madeira, N
- Melanoma brain metastases presenting as delirium: a case reportPublication . Morais, S; Cabral, A; Santos, G; Madeira, N
- Multiple Dural Arteriovenous Fistulas Presenting as Rapidly Progressive DementiaPublication . Mendonça, N; Santos, G; Duro, D; Machado, E; Goulão, A; Santana, IINTRODUCTION:Dural arteriovenous fistulas (DAVFs) are important causes of neurological dysfunction and are many times misdiagnosed. Particularly in older populations, DAVFs may present with a selective cognitive dysfunction. CASE REPORT: The authors describe a 70-year-old woman presenting with a rapidly progressive dementia, very similar in presentation to prion disease. Neuroimaging showed multifocal DAVFs associated with venous thrombosis and white matter changes, suggesting that impaired cerebral circulation due to venous hypertensive encephalopathy caused the patient's dementia. Prompt treatment of some of the abnormal shunts with endovascular embolization resulted in a clinically relevant improvement. Subsequent clinical improvement was achieved with anticoagulation, although no cause or predisposing factor was documented that could have led to the development of the venous thrombosis. CONCLUSIONS:Neurologists should maintain a high degree of suspicion to avoid missing the diagnosis of DAVFs that are potentially treatable lesions.
- Novos marcadores do prognóstico do acidente vascular agudo: outro olhar sobre a avaliação da perfusão cerebral por tomografia computorizadaPublication . Cordeiro, M; Nunes, C; Santos, G; Pereira, S; Moura, C
- Traumatic middle cerebral artery aneurysm secondary to a gunshot wound.Publication . Santos, G; Lima, T; Pereira, S; Macahdo, ETraumatic intracranial aneurysms are rare lesions, accounting for less than 1% of all intracranial aneurysms. Formation of these lesions after a penetrating missile wound is very unusual, and diagnosis can be difficult due to the presence of associated lesions. In this article, we report a case of a woman who developed a middle cerebral artery aneurysm after a gunshot wound, and discuss potential pitfalls found during diagnostic work-up.