المؤلفون: Giovana Ennis, Gabriela Venade, Joana Silva Marques, Paulo Batista, Ana Abreu Nunes, Júlio Constantino, Luis Costa Matos

المصدر: European Journal of Case Reports in Internal Medicine (2020)

مصطلحات موضوعية: intrathoracic acute cholecystitis, diaphragmatic hernia, non-traumatic, Medicine

الوصف: The authors present the case of a 51-year-old woman with no history of surgical or traumatic injury or accident, who presented with right hypochondrium and epigastric discomfort, malaise, nausea, loss of appetite and episodes of dark urine and greenish stools. Initial laboratory work-up revealed elevated inflammatory markers including leucocytosis with left shift and C-reactive protein, and a slight elevation of gamma-glutamyltransferase and alkaline phosphatase, with no other significant alterations. Computed tomography (CT) showed intrathoracic acute cholecystitis with a large diaphragmatic hernia. A literature search revealed only one other case of acute cholecystitis complicated by intrathoracic gallbladder due to a non-traumatic diaphragmatic hernia. Symptoms are uncharacteristic and the absence of pain or fever, explained by the altered location of the gallbladder, makes the diagnosis a challenge.

وصف الملف: electronic resource

العلاقة: https://www.ejcrim.com/index.php/EJCRIM/article/view/1764Test; https://doaj.org/toc/2284-2594Test

الوصول الحر: https://doaj.org/article/1b25a86528ba49158f737e7797b484adTest

المؤلفون: Sara Mendonça Freitas, Joana Silva Marques, Ana Grilo, Rodolfo Gomes, Fernando Martos Gonçalves

المصدر: European Journal of Case Reports in Internal Medicine (2020)

مصطلحات موضوعية: cutaneous tuberculosis, behçet’s disease, venous thrombosis, Medicine

الوصف: Behçet’s disease (BD) is a systemic vasculitis characterized by recurrent orogenital ulceration and several systemic manifestations (such as gastrointestinal involvement, vascular disease or arthritis). The pathogenesis is still unknown but the trigger role of certain pathogens such as Mycobacterium tuberculosis is well documented. Furthermore, patients with BD are more susceptible to tuberculosis due to immunity defects. Here, we describe the case of a 70-year-old woman with a history of recurrent oral aphthae and inflammatory arthritis presenting with extensive thrombosis of left upper limb major veins, a positive HLA B51 genotype and colon ulceration; hence, BD diagnosis was made after excluding other causes. Simultaneously, the patient had cutaneous abscesses not associated with immunosuppressive therapy with continuous development, and after recurrent negative tuberculosis work-up, M. tuberculosis was isolated in an abscess culture.

وصف الملف: electronic resource

العلاقة: https://www.ejcrim.com/index.php/EJCRIM/article/view/1354Test; https://doaj.org/toc/2284-2594Test

الوصول الحر: https://doaj.org/article/ab457526ad934c0aa9ed9621955f42acTest

المؤلفون: Joana Silva Marques, Marta Bodro, Berta Torres, Felipe García, José Antonio Martínez, Lorna Leal

المصدر: Vaccines, Vol 9, Iss 10, p 1103 (2021)

مصطلحات موضوعية: Mycobacterium malmoense, HIV, therapeutic vaccine, Medicine

الوصف: We report a case of Mycobacterium malmoense pulmonary infection and HIV-1 chronic co-infection in a 60-year-old man while participating in an HIV-1 therapeutic vaccine clinical trial and during the analytical treatment interruption. We present clinical and therapeutic features of a complicated M. malmoense pulmonary infection along with discussion of the possible relation to the HIV-1 cure-related interventions.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2076-393X/9/10/1103Test; https://doaj.org/toc/2076-393XTest

الوصول الحر: https://doaj.org/article/eb920a4f19de47d387ebdfbd88294b8bTest

المؤلفون: Joana Silva Marques, Nuno Monteiro, Ana Nunes, João Machado, João Olivério, Ana Sofia Martins, Antonio Correia

المصدر: European Journal of Case Reports in Internal Medicine, Vol 5, Iss 4 (2018)

مصطلحات موضوعية: Hemichorea, diabetes complications, movement disorders, Medicine

الوصف: Background: Hyperkinetic disorders such as hemichorea can be caused by cerebrovascular, infectious or inflammatory diseases or by metabolic conditions such as hyperglycaemia. Hyperglycaemic hemichorea is a rare movement disorder which is frequently misdiagnosed. It is characterized by involuntary, continuous, non-patterned movements on one side of the body, basal ganglia lesions seen on head CT or MRI, and clinical improvement after blood glucose normalization. We describe the case of a female patient with uncontrolled diabetes who presented with hemichorea. Case presentation: We report the case of a 69-year-old woman with type 2 diabetes who presented with abnormal movements of the right upper limb. She had no neurological signs other than hemichorea. Her blood glucose level was 349 mg/dl and her glycosylated haemoglobin level (HbA1c) was 10.5%. Head CT and MRI showed no changes in the basal ganglia or ischaemic lesions. The patient was started on insulin and haloperidol with clinical improvement. Conclusion: Larger case series are needed to establish better understanding of the physiopathological mechanisms and diagnostic criteria of hyperglycaemic hemichorea. The most important diagnostic criterion is clinical improvement after glycaemic control.

وصف الملف: electronic resource

العلاقة: https://www.ejcrim.com/index.php/EJCRIM/article/view/807Test; https://doaj.org/toc/2284-2594Test

الوصول الحر: https://doaj.org/article/e9d70adfbf1140a7a417fbdcaa8c365cTest

المؤلفون: Luís Costa Matos, João Olivério, Mónica Teixeira, Sofia Costa Martins, Gabriela Venade, João Machado, Joana Silva Marques

المصدر: Revista da Associação Médica Brasileira, Vol 65, Iss 12, Pp 1434-1437 (2020)
Revista da Associação Médica Brasileira, Volume: 65, Issue: 12, Pages: 1434-1437, Published: 24 JAN 2020

مصطلحات موضوعية: Adult, medicine.medical_specialty, Medicine (General), endocrine system diseases, Fludrocortisone, 030204 cardiovascular system & hematology, Hypoglycemia, Gastroenterology, Doenças da glândula tireoide, 03 medical and health sciences, Poliendocrinopatias autoimunes, Rare Diseases, 0302 clinical medicine, R5-920, Addison Disease, Internal medicine, medicine, Humans, Doença de Addison, 030212 general & internal medicine, Polyendocrinopathies, Autoimmune, Autoimmune disease, Type 1 diabetes, business.industry, Type 2 Diabetes Mellitus, General Medicine, medicine.disease, Thyroid Diseases, Graves Disease, Early Diagnosis, Treatment Outcome, Diabetes Mellitus, Type 1, Diabetes mellitus tipo 1, Addison's disease, Prednisolone, Autoimmune Polyglandular Syndrome Type 2, Female, business, Addison’s Disease, medicine.drug

الوصف: SUMMARY Autoimmune polyglandular syndrome type 2 (APS 2) is defined by the presence of Addison’s disease (AD) associated with autoimmune thyroid disease and/or Type 1 diabetes mellitus (T1DM). It is a rare disease, affecting about 1.4-2 cases/100,000 inhabitants. Its less frequent clinical presentation is the combination of AD, Graves‘ disease, and T1DM. We present the case of a 42-year-old woman with a history of total thyroidectomy due to Graves’ disease, type 2 diabetes mellitus, and hypertension, who sought the ED due to asthenia, dizziness, nausea, and vomiting. She reported having stopped antihypertensive therapy due to hypotension and presented a glycemic record with frequent hypoglycemia. On physical examination, she had cutaneous hyperpigmentation. She had no leukocytosis, anemia, hypoglycemia, hyponatremia or hyperkalemia, and a negative PCR. Serum cortisol

وصف الملف: text/html

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::248afd7af3b11b47970f8e068dc8af8fTest
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302019001201434&tlng=enTest

المؤلفون: Marta Bodro, Berta Torres, José Antonio Martínez, Lorna Leal, Joana Silva Marques, Felipe García

المصدر: Vaccines, Vol 9, Iss 1103, p 1103 (2021)
Vaccines

مصطلحات موضوعية: medicine.medical_specialty, Immunology, Human immunodeficiency virus (HIV), Pulmonary infection, Case Report, medicine.disease_cause, Mycobacterium malmoense, Internal medicine, Hiv infected, Drug Discovery, medicine, Pharmacology (medical), Pharmacology, biology, business.industry, virus diseases, HIV, biology.organism_classification, Clinical trial, Infectious Diseases, Treatment interruption, Therapeutic vaccine, Medicine, therapeutic vaccine, business

الوصف: We report a case of Mycobacterium malmoense pulmonary infection and HIV-1 chronic co-infection in a 60-year-old man while participating in an HIV-1 therapeutic vaccine clinical trial and during the analytical treatment interruption. We present clinical and therapeutic features of a complicated M. malmoense pulmonary infection along with discussion of the possible relation to the HIV-1 cure-related interventions.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b53532f6c880ba9211cb0604dbb00b24Test
https://www.mdpi.com/2076-393X/9/10/1103Test

المؤلفون: Joana Silva Marques, Rui Correia, Joana F Correia, Gonçalo Ferreira, Nuno Monteiro

المصدر: Cureus

مصطلحات موضوعية: medicine.medical_specialty, Critically ill, business.industry, Point of care ultrasound, Cardiology, massive pulmonary embolism, General Engineering, medicine.disease, Pulmonary embolism, Obstructive shock, Shock (circulatory), Emergency Medicine, Internal Medicine, medicine, mcconnell sign, obstructive shock, point-of-care-ultrasound, fibrinolysis, In patient, Radiology, medicine.symptom, Differential diagnosis, business

الوصف: The ideal approach to hemodynamically unstable patients requires the quick identification of the type of shock and its etiology. This can be a challenge in critically ill patients due to the limited information, the wide number of differential diagnosis and the need for fast intervention. Point-of-care ultrasound (POCUS) is a non-invasive, low-cost, real-time and reliable tool used to rapidly and accurately assess hemodynamically unstable patients at the bedside. It can support diagnosis, tailor therapy and guide further workup, especially in patients deemed too unstable to undergo other imaging studies. The authors describe the case of a patient in obstructive shock due to pulmonary embolism, in which McConnell sign was identified by bedside echocardiography, before lab tests and pulmonary computerized tomography angiogram results were obtained.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::41aa3db1ba395f6a03b856a7a272083fTest
https://doi.org/10.7759/cureus.15819Test

المؤلفون: Rita João Soares, Joana Silva Marques, Giovana Ennis, Nuno Monteiro, Gabriela Venade, Ana Garrido Gomes

المصدر: Cureus

مصطلحات موضوعية: medicine.medical_specialty, Statin, Multivariate analysis, medicine.drug_class, 030204 cardiovascular system & hematology, statins, 03 medical and health sciences, modified rankin score, 0302 clinical medicine, Internal medicine, medicine, Internal Medicine, hemorrhagic stroke, cardiovascular diseases, Prospective cohort study, Stroke, Intracerebral hemorrhage, business.industry, General Engineering, Glasgow Coma Scale, Retrospective cohort study, Odds ratio, medicine.disease, intracerebral hemorrhage, mortality, Neurology, business, 030217 neurology & neurosurgery

الوصف: Aim The effect of statins is well established in cardiac and cerebrovascular diseases. However, its impact on intracerebral hemorrhage (ICH) is unclear. We aim to identify an association of pre-ICH statin treatment and statin use during admission for ICH with functional outcome at discharge and 30-day mortality. Material and methods A retrospective cohort study was held in patients with ICH admitted to our stroke unit over a year period. Demographic characteristics, risk factors and cardiovascular diseases, Glasgow Coma Scale (GCS), National Institutes of Health Stroke Score (NIHSS), systolic blood pressure (SBP) at admission, cholesterol levels and radiologic findings were analyzed to explore the association between pre-ICH and inpatient statin use with outcomes. The primary endpoint was functional outcome defined as modified Rankin Score (mRS) at discharge and 30-day mortality. We performed a univariate analysis and the variables with statistical significance were included in a multivariate analysis to control for confounding covariates. Results The study included 78 patients, 33 (42.31%) had previous statin intake history, of which 13 (39.39%) maintained statin intake during hospitalization. Regarding functional outcome we did not report a statistically significant difference between groups. In the “pre-ICH statin use” group a decreased 30-day mortality (6.06%, p = 0.009) was observed. In this group it was also noted higher antiplatelet medication use (33.33%, p = 0.006), higher GCS at admission (13-15: 84.38%, p = 0.018) and deep ICH (81.82%, p = 0.030). However, 30-day mortality had no impact in multivariate regression (Odds ratio (OR) 4.535, 95% Confidence Interval (CI) = 0.786-26.173, p = 0.091). In the group that maintained statin treatment during hospitalization no deaths were registered (p = 0.020) and there was no association with functional status. Multivariate regression analysis was not performed due to sample size. Conclusion The only association demonstrated in this study was lower 30-day mortality with pre-ICH statin use and continued statin treatment during admission. However, this was not confirmed by multivariate regression analysis. There were no differences between groups concerning cholesterol values, results that can be explained by the pleiotropic and immunomodulatory effect of statins. However, prospective studies are needed to prove the benefit of the statins in ICH.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f31fc631e4c6a71c6893f45017bd32fbTest
http://europepmc.org/articles/PMC8112294Test

المؤلفون: Pedro Ribeiro, Nelson Domingues, Giovana Ennis, Joana Silva Marques, Cristina Andrade

المصدر: Cureus

مصطلحات موضوعية: Pediatrics, medicine.medical_specialty, thrombocytopenia, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Aphasia, medicine, Internal Medicine, Stroke, Coma, immune thrombocytopenia purpura, business.industry, General Engineering, cerebral venous thrombosis, Hematology, medicine.disease, cerebral venous infarction, Thrombocytopenic purpura, stroke, Pulmonary embolism, Venous thrombosis, Neurology, Disease Presentation, Etiology, medicine.symptom, business, 030217 neurology & neurosurgery

الوصف: Cerebral venous thrombosis (CVT) is a serious medical condition which is difficult to diagnose because of its wide range of clinical presentations. The symptoms can vary from an isolated headache to coma. Here, we present the case of a 76-year-old female patient with a history of immune thrombocytopenic purpura, arterial hypertension, and pulmonary embolism. The diagnosis of CVT was challenging because the initial form of disease presentation mimicked a transient ischemic attack (transient aphasia and right hemiparesis). Therapeutical decisions were also a challenge because, at the time of the diagnosis, the patient was suffering from severe thrombocytopenia (29 × 109/L), which had to be taken into account. After multidisciplinary discussions, therapeutic subcutaneous enoxaparin was started, resulting in a progressive and significant neurological recovery. In presenting this case, our primary goal is to point out that CVT can be difficult to diagnose because of its wide range of clinical presentations. Headache (a symptom that was never present in this case) is the most frequent complaint, occurring in 90% of cases. Following diagnosis, an etiological study is required.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::736448d637a7d64f9246d9582fb12006Test
http://europepmc.org/articles/PMC8163355Test