Gazeta MedicaPub Date : 2022-03-24DOI: 10.29315/gm.v9i2.552
D. Marques, Catarina Gomes, Rosa Vilares Santos
{"title":"Protein and Multivitamin Supplementation in Managing Sarcopenia/Sarcopenic Obesity in the Elderly: A Narrative Review of Literature","authors":"D. Marques, Catarina Gomes, Rosa Vilares Santos","doi":"10.29315/gm.v9i2.552","DOIUrl":"https://doi.org/10.29315/gm.v9i2.552","url":null,"abstract":"Sarcopenia may be described as a muscular disease associated with unfavourable outcomes. Sarcopenic obesity refers to the concomitant presence of sarcopenia and obesity. The best approach to these pathologies is still not determined. Our goal was to review the current knowledge regarding nutrition as a therapeutic option in the treatment of these conditions. From a total of 1024 articles obtained from medical databases, nine were included in the narrative review. Supplementation of vitamin D alone was not associated with significant differences. Protein supplements, especially those rich in leucine, have been commonly used in the included studies, with potential benefit in some muscle parameters such as muscle mass. Benefits of supplementation in sarcopenic obesity are less clear. There was significant heterogeneity between the included studies in many parameters. Therefore, clear and valid conclusions are still not possible, however leucine enriched protein supplements might be an interesting option. Further research is needed.","PeriodicalId":32321,"journal":{"name":"Gazeta Medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45564443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gazeta MedicaPub Date : 2022-03-15DOI: 10.29315/gm.v9i2.554
Cristina Aguiar, Nuno Medeiros, Leandro Ribeiro, A. Condé
{"title":"Just a Tongue Anomaly or Something More?","authors":"Cristina Aguiar, Nuno Medeiros, Leandro Ribeiro, A. Condé","doi":"10.29315/gm.v9i2.554","DOIUrl":"https://doi.org/10.29315/gm.v9i2.554","url":null,"abstract":"A 54-year-old woman with a past history of breast and uterine cancer, appeared at the Emergency Room with a six-month history of fatigue, weight loss (> 12 kg), lower limbs swelling and dysphagia due to progressive tongue enlargement. ENT examination demonstrated macroglossia (Fig. 1-A), that was confirmed by computed tomography (CT) scan (Fig. 1-B). Laboratory tests complemented with image findings showed the presence of a restrictive cardiomyopathy and a nephrotic syndrome. The abdominal fat biopsy with immunofixation electrophoresis was positive for light-chain amyloidosis. The patient began chemotherapy treatment with bortezomib, dexamethasone and cyclophosphamide, completing four cycles of treatment with frank tongue reduction. The patient died 5 months after the diagnosis.[...]","PeriodicalId":32321,"journal":{"name":"Gazeta Medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41689021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gazeta MedicaPub Date : 2022-03-15DOI: 10.29315/gm.v1i1.513
Patrícia Borges, Daniela Lopes
{"title":"Síndrome das Pernas Inquietas: Abordagem nos Cuidados de Saúde Primários","authors":"Patrícia Borges, Daniela Lopes","doi":"10.29315/gm.v1i1.513","DOIUrl":"https://doi.org/10.29315/gm.v1i1.513","url":null,"abstract":"A síndrome das pernas inquietas é uma patologia com um impacto negativo na qualidade de vida dos doentes, nomeadamente por estar associada a uma disrupção do sono. Felizmente, após o diagnóstico, a maior parte dos doentes apresenta uma boa resposta à terapêutica. O objetivo deste artigo é sistematizar o diagnóstico e a terapêutica desta patologia, focando-se particularmente na sua abordagem nos cuidados de saúde primários. A terapêutica da síndrome das pernas inquietas passa pela implementação de medidas comportamentais e pela correção da ferropénia, se existente. Em alguns casos é necessária a utilização contínua ou intermitente de fármacos, consoante a gravidade dos sintomas. O correto acompanhamento destes doentes, nos quais muitas vezes coexistem alterações do padrão do sono, ansiedade e depressão, é de extrema importância.","PeriodicalId":32321,"journal":{"name":"Gazeta Medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44213406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gazeta MedicaPub Date : 2022-03-11DOI: 10.29315/gm.v1i1.414
Bela Machado, Luís Marote Correia, Lino Nóbrega, P. Freitas, Rafael Freitas
{"title":"Evolução da função renal em doentes com acidente vascular cerebral submetidos a terapia endovascular","authors":"Bela Machado, Luís Marote Correia, Lino Nóbrega, P. Freitas, Rafael Freitas","doi":"10.29315/gm.v1i1.414","DOIUrl":"https://doi.org/10.29315/gm.v1i1.414","url":null,"abstract":"INTRODUÇÃO: No acidente vascular cerebral isquémico agudo, a terapia endovascular indicada na oclusão de grande vaso cerebral suscita preocupações quanto à exposição adicional a radiocontraste. Procuramos caracterizar a evolução renal visando identificar nefropatia induzida por contraste e estudar o impacto da doença renal preexistente.MATERIAL E MÉTODOS: Estudámos retrospetivamente admissões na Unidade de Doenças Cerebrovasculares do Hospital Central do Funchal entre março 2017 e fevereiro 2020 com necessidade de terapia endovascular neste contexto. Obtivemos características demográficas e semiológicas. Registámos creatinina plasmática em três momentos. Apurámos como desfechos: nefropatia induzida por contraste, índices neurofuncionais e óbito intra-hospitalar. Comparamos aqueles com taxa de filtração glomerular estimada (TFGe) < 60 mL/min/1,73 m2 com os restantes.RESULTADOS: Na amostra de 62 casos (32 homens [51,6%], idade 69,6 ± 10,9 [média ± desvio-padrão] anos, National Institutes of Health Stroke Scale [NIHSS] à admissão 15,0 ± 5,9), descrevemos a creatinina plasmática: admissão 0,98 ± 0,23; 48 horas 0,86 ± 0,21; 5º-7º dia 0,87 ± 0,22 mg/dL. Nenhum cumpriu critérios de nefropatia induzida por contraste. Aqueles com TFGe < 60 mL/min/1,73 m2 (16 casos, 25,8%) não diferiram na evolução nefrológica (variação da creatinina plasmática às 48 horas: -0,17 ± 0,13 versus -0,11 ± 0,11 p=0,067) ou neurológica (modified Rankin Scale ? 2: 31,3% versus 23,9% p=0,563; ? NIHSS: -0,94 ± 9,6 versus -2,9 ± 9,0 p=0,479; óbito: 18,8% versus 19,6% p=0,943).CONCLUSÃO: Nesta amostra, não se detetaram casos de nefropatia induzida por contraste. Aqueles com TFGe < 60 mL/min/1,73 m2 pré-procedimento, também não demonstraram pior desfecho.","PeriodicalId":32321,"journal":{"name":"Gazeta Medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43935268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gazeta MedicaPub Date : 2022-03-11DOI: 10.29315/gm.v9i2.547
Catarina Janicas, Francelina Fernandes
{"title":"Estenose do Eixo Iliocava: Uma Sequela de Trombose Subaguda Extensa","authors":"Catarina Janicas, Francelina Fernandes","doi":"10.29315/gm.v9i2.547","DOIUrl":"https://doi.org/10.29315/gm.v9i2.547","url":null,"abstract":"Doente do sexo feminino, com 67 anos de idade, recorre ao Serviço de Urgência por lombalgia bilateral com irradiação abdominal, anorexia e edema dos membros inferiores.O quadro tem início no mês anterior, após internamento por desidratação secundária a diarreia crónica iatrogénica. [...]","PeriodicalId":32321,"journal":{"name":"Gazeta Medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47738481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gazeta MedicaPub Date : 2022-03-11DOI: 10.29315/gm.v1i1.493
Francisco Maio Matos, Mafalda Ramos Martins, G. Norte
{"title":"Portuguese National Pedagogical Plan for Anesthesiology Residents’ Evaluation: The Participants’ Rating","authors":"Francisco Maio Matos, Mafalda Ramos Martins, G. Norte","doi":"10.29315/gm.v1i1.493","DOIUrl":"https://doi.org/10.29315/gm.v1i1.493","url":null,"abstract":"INTRODUCTION: Simulation in anesthesiology has been considered a crucial complementary training for residents of this medical specialty. A National Pedagogical Plan of the Biomedical Simulation Center from Centro Hospitalar e Universitário de Coimbra was designed according to the curricular objectives defined by the Portuguese Board of Anesthesiology. The objective of this study is to analyze the evaluation of the programmatic contents included in the simulation courses from the participants’ point of view.METHODS: Post-course confidential questionnaires were answered by all the anesthesiology residents that attended the different modules. All the questions were answered on a 0-10 scale. This study was conducted at the Biomedical Simulation Center from Centro Hospitalar e Universitário de Coimbra, Portugal, from February 2011 to March 2018.RESULTS: A total of 344 questionnaires were answered. The students considered that all the topics included in the simulation courses are important for the training during residency, being basic pharmacology in anesthesiology (Year I) the less important one being classified with 5.03 (IC 95% 4.83-5.22). All the programmatic contents included in the simulation module of the year IV were classified by the residents with importance higher than 8. This last year was the one where the importance of the topics is all numerically higher than in the other years.CONCLUSION: Given the importance attributed by the residents to the programmatic content included in the simulation courses, we can conclude that the design of the courses was appropriate to the needs and the goals of the anesthesiology residents, as a complement of their internship.","PeriodicalId":32321,"journal":{"name":"Gazeta Medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46955302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gazeta MedicaPub Date : 2022-02-25DOI: 10.29315/gm.v1i1.543
M. Bilreiro, Luís Marote Correia
{"title":"Ertapenem-Induced Delirium","authors":"M. Bilreiro, Luís Marote Correia","doi":"10.29315/gm.v1i1.543","DOIUrl":"https://doi.org/10.29315/gm.v1i1.543","url":null,"abstract":"Neurotoxicity is an unusual iatrogenic effect associated with carbapenems, typically manifested as seizures or hyperactive delirium. We present an 89-year-old female patient with a medical history of hypertension and chronic kidney disease who was admitted for acute tracheobronchitis and anemia related to diverticular disease. As a complication, she developed acute cystitis caused by extended spectrum ß-lactamases producing Klebsiella pneumoniae, so intravenous ertapenem was started. On the second day of antibiotic therapy, the patient manifested visual hallucinations followed by an inattentive and lethargic state suggestive of a hypoactive delirium. An ertapenem-induced neurotoxicity was suspected. Upon substitution by meropenem, the patient improved, and symptom reversal occurred after 72 hours. We present a review of ertapenem-induced hallucinations and address pharmacokinetics aspects namely renal dysfunction and hypoalbuminemia that could potentiate encephalopathy. Although rare, clinicians should be aware of non-seizure ertapenem related neurotoxicity. Ready recognition can lead to rapid improvement and prevent dire outcomes.","PeriodicalId":32321,"journal":{"name":"Gazeta Medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42383162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gazeta MedicaPub Date : 2022-02-17DOI: 10.29315/gm.v1i1.512
Filipe Emanuel Oliveira Cabral, F. Franco-Pego, P. Barata, Bernardo Sousa Pinto, J. Bernardes
{"title":"The Impact of Lockdown during COVID-19 Pandemic on Physical Activity: a Web-based Cross-sectional Survey","authors":"Filipe Emanuel Oliveira Cabral, F. Franco-Pego, P. Barata, Bernardo Sousa Pinto, J. Bernardes","doi":"10.29315/gm.v1i1.512","DOIUrl":"https://doi.org/10.29315/gm.v1i1.512","url":null,"abstract":"INTRODUCTION: Home lockdown enforced during COVID-19 pandemic may have affected individuals’ lifestyles and, possibly, their physical activity (PA) levels. In this study, we aimed to assess changes in Portuguese PA levels during lockdown.METHODS: We conducted an online survey based on the Special eurobarometer public opinion survey on sports and physical activity in April 2020 in order to collect data about the Portuguese PA levels before and during the home confinement period. PA was assessed by three outcome variables: (i) compliance with World Health Organization (WHO) aerobic PA recommendations, (ii) daily sitting time, (iii) and weekly walking time, with pre- lockdown and during lockdown levels being compared for each. Multinomial regression models were used to identify variables that were associated to changes in PA levels.RESULTS: We obtained 1281 responses (36.4% males). Most participants had high academic levels (73%) and were employed (76.3%). Lockdown was associated with significant decreases in aerobic PA levels (50.0% participants met WHO recommendations for aerobic PA levels before lockdown versus 38.8% during that period; p<0.001) and average weekly walking time (97.2 versus 72.4 minutes; p<0.001), as well as with increases in daily sitting time (p<0.001). We did not identify variables consistently associated with increasing or decreasing PA during lockdown.CONCLUSION: Home lockdown during COVID-19 pandemic is associated with a decrease in PA levels. In the likely event of another waves, when confinement may again be implemented, these data can be used to better prepare and to promote PA during that period.","PeriodicalId":32321,"journal":{"name":"Gazeta Medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43363031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Psychiatric Hospitalizations in Times of a Pandemic: A Portuguese Experience","authors":"Tânia Patrícia Vasques Alves, António José Cardoso Carvalho, Melissa Alfafar Marques","doi":"10.29315/gm.v9i2.568","DOIUrl":"https://doi.org/10.29315/gm.v9i2.568","url":null,"abstract":"Studies have shown that patients with psychiatric pathology exacerbated their symptoms during the COVID-19 pandemic, which, together with the decrease in programmed medical activity, could lead to a greater influx of patients to psychiatric acute care units. [...]","PeriodicalId":32321,"journal":{"name":"Gazeta Medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42801062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gazeta MedicaPub Date : 2022-02-15DOI: 10.29315/gm.v1i1.500
M. Rosa, A. Roque, P. Ferreira
{"title":"Closed-Loop Obstruction Caused by Double Intussusception in an Adult","authors":"M. Rosa, A. Roque, P. Ferreira","doi":"10.29315/gm.v1i1.500","DOIUrl":"https://doi.org/10.29315/gm.v1i1.500","url":null,"abstract":"A 73-year-old male presented to the emergency department with diffuse abdominal pain. Physical and analytical evaluation revealed abdominal distension, meteorism and elevated C-reactive protein. Contrast-enhanced computed tomography (CECT) was performed revealing dilated bowel-loops with air fluid levels found in between two points of transition: proximally,a jejunum-jejunal intussusception adjacent to a jejunal lipoma; distally, an ileo-ileal intussusception with enlarged lymph nodes in its mesenteric fold. [...]","PeriodicalId":32321,"journal":{"name":"Gazeta Medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41488785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}