Browsing by Author "Vaz, C"
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- Um caso invulgar de dor generalizada: paramiloidose simulando fibromialgiaPublication . Vaz, C; Couto, M; Duarte, C; Salvador, MJ; Inês, LThe authors report a case of a 52-year old female previously followed at the Outpatient Rheumatology Clinic with the diagnosis of Fibromyalgia (FM). Approximately 2 years after this diagnosis, she presents with a 2nd degree burn in a hand, as a result of thermal hypoesthesia. The patient described hipostesia of the distal upper and lower limbs, incontinence of the anal sphincter and chronic diarrhoea with progressive worsening. The electromiography showed sensory-motor axonal polyneuropathy, chronic, moderate to severe. The muscle and nerve biopsy showed deposition of amyloid substance. The search for TTR Met 30 was positive, confirming the diagnosis of familial amyloidotic polyneuropathy. This is the first reported case of familial amyloidotic polyneuropathy as part of the differential diagnosis of fibromyalgia.
- Diástase congénita da sínfise púbicaPublication . Vaz, C; Salvador, MJ; Malcata, AB
- Health-related quality of life in portuguese SLE patients: an outcome measure independent of disease activity and cumulative damagePublication . Duarte, C; Abreu, P; Couto, M; Vaz, C; Malcata, A; Inês, LPURPOSE: To evaluate quality of life in Portuguese patients with Systemic Lupus Erithematosus (SLE) and its correlation with disease activity and cumulative damage. METHODS: We included consecutive SLE patients, fulfilling the 1997 ACR Classification Criteria for SLE and followed at the Rheumatology Department of the University Hospital of Coimbra, Portugal at time of visit to the outpatient clinic. Quality of life was evaluated using the patient self-assessment questionnaire Medical Outcomes Survey Short Form-36 (SF-36) (validated Portuguese version). The consulting rheumatologist fulfilled the SLE associated indexes for cumulative damage (Systemic Lupus International Collaborating Clinics- Damage Index: SLICC/ACR-DI) and disease activity (Systemic Lupus Erythematosus Disease Activity Index: SLEDAI 2000). Correlation between SLEDAI and SLICC and SF-36 was tested with the Spearman Coefficient. Significant level considered was 0.05. RESULTS: The study included 133 SLE patients (90.2% female, mean age - 40.7 years, mean disease duration - 8.7 years). Most patients presented low disease activity (mean SLEDAI = 4.23) and limited cumulative damage (mean SLICC = 0.76). Despite that, SF-36 mean scores were below 70% in all eight domains of the index. Physical function domains showed lower scores than mental function domains. The QoL in this group of patients is significantly impaired when compared with the reference Portuguese population (p<0.05 in all domains). There was no correlation between clinical activity or cumulative damage and quality of life. CONCLUSION: QoL is significantly compromised in this group of SLE patients, but not related with disease activity or damage. These findings suggest that disease activity, cumulative damage and QoL are independent outcome measures and should all be used to assess the full impact of disease in SLE patients.
- Perfil de risco cardiovascular numa população portuguesa de doentes com LESPublication . Duarte, C; Couto, M; Vaz, C; Inês, L; Malcata, ABSystemic Lupus Erythematosus is associated with an increased risk of atherosclerosis and cardiovascular events, as compared to the general population. Objective: To evaluate the prevalence of «traditional» cardiovascular risk factors in Portuguese SLE patients and to estimate the associated risk of cardiovascular events. To evaluate the needs for optimization of prophylactic measures to prevent cardiovascular events in these patients. Material and Methods: Consecutive SLE patients followed in the Coimbra Lupus Cohort were included. Traditional cardiovascular risk factors were evaluated and risk factors associated to the disease (renal disease, anti-phospholipid antibodies, therapy) were evaluated. The 10-year cardiovascular risk was estimated using the Framingham model. Institution or optimization of therapeutic measures to control cardiovascular risk factors was evaluated according to published preliminary guidelines. Results: 102 SLE patients were included (female: 89.2%, mean age= 39.7 years old, mean disease duration=8.9 years). 40.5% are overweighted, obesity in 9.9%. 72.5% have sedentary lifestyle and 11.8% are currently smokers. 40.2% have arterial hypertension, 32% have dyslipidaemia. Metabolic syndrome was identified in 21% of patients. Of these patients, 79.05% present one or more cardiovascular classical risk factors. Were receiving more than 10 mg/day of prednisone, 23.6% of the patients. Estimated 10-year cardiovascular risk is higher than 1% in 24.7% patients. We estimate that 55.8% of patients might benefit from dietary changes, 79.4% from increase in physical activity, 55.9% could be on anti-hypertensive medication, 52,9% on lipid lowering therapy and 76.5% on low dose aspirin anti-platelet aggregation. Conclusion: Similar to findings in other academic centers, the majority of our patients have at least one modifiable, traditional cardiovascular risk factor which had not been treated adequately by standard guidelines and possibly even detected. These measures could greatly improve the long-term prognosis of SLE patients.