Medicina InternaPub Date : 2024-02-20DOI: 10.36393/spmi.v37i1.822
Jecsmael Baez-Herrera
{"title":"Síndrome de Hamman","authors":"Jecsmael Baez-Herrera","doi":"10.36393/spmi.v37i1.822","DOIUrl":"https://doi.org/10.36393/spmi.v37i1.822","url":null,"abstract":"El neumomediastino espontáneo o síndrome de Hamman hace referencia a la presencia de aire en el compartimiento mediastinal en ausencia de traumatismos o procedimientos médico-quirúrgicos; de presentación poco frecuente. Está relacionado en más de la mitad de los casos a cuadros de crisis asmática como factor desencadenante. Se presenta el caso clínico de un varón de 15 años de edad, admitido en el Servivio de Emergencia por dolor torácico y disnea; y, en el examen destacaba la presencia de enfisema subcutáneo en el cuello y región supraclaviculary más sibilantes espiratorios e inspiratorios en los pulmones. La radiografía y tomografía torácica mostraron neumomediastino. Instaurada la terapia, el paciente evolucionó de manera favorable y fue dado de alta.","PeriodicalId":32856,"journal":{"name":"Medicina Interna","volume":"37 1","pages":"35-37"},"PeriodicalIF":0.0,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://revistamedicinainterna.net/index.php/spmi/article/download/822/845","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147886167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Medicina InternaPub Date : 2021-12-23DOI: 10.24950/rspmi.opiniao.4.2021
Henrique Rita
{"title":"Do Interior ao Litoral Alentejano: A Medicina Interna como Chave na Mudança do Paradigma dos Cuidados de Saúde","authors":"Henrique Rita","doi":"10.24950/rspmi.opiniao.4.2021","DOIUrl":"https://doi.org/10.24950/rspmi.opiniao.4.2021","url":null,"abstract":"","PeriodicalId":32856,"journal":{"name":"Medicina Interna","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45259198","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}
Medicina InternaPub Date : 2021-12-23DOI: 10.24950/rspmi.editorial.4.2021
J. Sá
{"title":"Serviços de Urgência e Segurança Clínica","authors":"J. Sá","doi":"10.24950/rspmi.editorial.4.2021","DOIUrl":"https://doi.org/10.24950/rspmi.editorial.4.2021","url":null,"abstract":"","PeriodicalId":32856,"journal":{"name":"Medicina Interna","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42955207","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}
Medicina InternaPub Date : 2021-12-23DOI: 10.24950/rspmi.o.224.4.2021
M. Cravo, N. Pereira, A. Vigário, T. Ferreira, R. Rêgo, Catarina Mendonça, I. Marques
{"title":"Impact of Vitamin D Supplementation in a Heart Failure Population","authors":"M. Cravo, N. Pereira, A. Vigário, T. Ferreira, R. Rêgo, Catarina Mendonça, I. Marques","doi":"10.24950/rspmi.o.224.4.2021","DOIUrl":"https://doi.org/10.24950/rspmi.o.224.4.2021","url":null,"abstract":"Introduction: Vitamin D (VD) deficiency is a major comorbidity, frequently associated to heart failure (HF). VD supplementation effects in these patients remain unknown. Therefore, this study aims to evaluate the impact of VD deficiency treatment or therapy correction in HF patients´ cohort. \u0000Material and Methods: Observational retrospective single-center study enrolling patients admitted to a HF clinic with VD deficiency. VD was prescribed to these patients with reassessment of its levels 12 months later. Study population was divided in: [VD (+) group: corrected VD deficiency] and [VD (-): maintained VD deficiency]. Variables were analysed in both groups. \u0000Results and Conclusion: Eighty-seven patients were included with no difference of baseline characteristics between the groups. Poor compliance was reported in 40% of VD (-) patients. After treatment, there were no statistically difference in variables analysed between the two groups: NYHA class I, NT-proBNP, HF hospitalizations in the previous year, Duke Activity Score Index score and 6-minute Walking Distance. VD (+) group had a statistically significant decrease of NT-proBNP level over time (1740 ± 2761 pg/mL to 851 ± 1436 pg/mL, p = 0.001). Statistically, both groups had a significant reduction of the number of HF hospitalizations, between baseline and 12 months later (1.02 ± 0.67 to 0.29 ± 0.82, p< 0.001 and 1.03 ± 1.04 to 0.40 ± 0.81, p = 0.001, for VD (+) and VD (-), respectively). Therefore, the correction of VD deficiency did not have impact in the variables analysed. The improvements reported within both groups may reflect the impact of the HF clinic optimized care.","PeriodicalId":32856,"journal":{"name":"Medicina Interna","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47331907","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}
Medicina InternaPub Date : 2021-12-23DOI: 10.24950/rspmi.o.98.4.2021
Joana C F Lima, João Pedro Aguiar, Margarida Paixão-Ferreira, Rita Calixto, Vera Cesário, Filipa Alves da Costa, José Vaz
{"title":"Estarão os Doentes com Fibrilhação Auricular Correctamente Anticoagulados? Um Retrato de um Hospital Português do Interior","authors":"Joana C F Lima, João Pedro Aguiar, Margarida Paixão-Ferreira, Rita Calixto, Vera Cesário, Filipa Alves da Costa, José Vaz","doi":"10.24950/rspmi.o.98.4.2021","DOIUrl":"https://doi.org/10.24950/rspmi.o.98.4.2021","url":null,"abstract":"Introdução: Os anticoagulantes orais (ACOs) demonstraram reduzir o risco de acidente vascular cerebral isquémico em doentes com fibrilhação auricular (FA). Contudo, a proporção de doentes que não está anticoagulada e tem indicação para estar é ainda elevada. O nosso objectivo é avaliar a proporção de doentes com FA que estão sob anticoagulação e avaliar a qualidade da prescrição de ACOs. \u0000Material e Métodos: Foi realizado um estudo observacional retrospectivo no Serviço de Medicina de um hospital do Alentejo (01-04/2019). Foram incluídos doentes com ≥18 anos, com história prévia de FA não-valvular e com CHA₂DS₂-VASc ≥ 2 (homens) ou ≥ 3 (mulheres). Extraiu-se o número de doentes que estava sob ACO e o número de doentes correctamente anticoagulado. Realizou-se análise estatística uni e bi-variada (IBM SPSS v.27.0). \u0000Resultados: Foram incluídos 203 doentes: 51,7% (n = 105) eram mulheres e a idade média foi 80,2 ± 9,4 anos. Cerca de 40% (n = 82) dos doentes não estavam sob ACO. Cinquenta e sete porcento (n = 20) dos doentes que tinham história prévia de eventos cerebrovasculares não estavam sob ACOs. Um quarto da amostra (n = 31) estava incorrectamente anticoagulada. Os doentes sob ACOs tendiam a ser mais novos e estar medicados um maior número de fármacos (p = 0,001 e p = 0,027, respectivamente). \u0000Conclusão: Os resultados sugerem que uma elevada proporção de doentes elegíveis para ACOs não estava medicada. Dos doentes medicados, um quarto estava incorrectamente anticoagulado. De forma a melhorar o padrão de prescrição, poder-se-ia considerar a optimização da formação contínua aos profissionais de saúde e o desenvolvimento de novos indicadores relativos à performance do sistema de saúde.","PeriodicalId":32856,"journal":{"name":"Medicina Interna","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43343719","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}
Medicina InternaPub Date : 2021-12-23DOI: 10.24950/rspmi.o.13.4.2021
L. Serpa Pinto, Sara Xavier Pipa, G. Carvalheiras, A. Campar, A. Marinho, F. Farinha, C. Vasconcelos, J. Araújo Correia
{"title":"Biologics Drugs in Behçet’s Disease: A Single Centre Experience","authors":"L. Serpa Pinto, Sara Xavier Pipa, G. Carvalheiras, A. Campar, A. Marinho, F. Farinha, C. Vasconcelos, J. Araújo Correia","doi":"10.24950/rspmi.o.13.4.2021","DOIUrl":"https://doi.org/10.24950/rspmi.o.13.4.2021","url":null,"abstract":"Introduction: Behçet´s disease (BD) is a systemic vasculitis of unknown cause. Several cytokines, such as tumor necrosis factor-alpha (TNF-α), appear to play a substantial role. Therefore, biologics such as anti-TNF-α agents are rising to control severe or refractory BD´s manifestations. \u0000 \u0000We aimed to describe the biological therapy´s outcomes in BD patients. \u0000 \u0000Methods: A longitudinal, prospective, unicentric cohort study with patients followed in a specialized outpatient clinic. We collected data regarding BD´s manifestations, treatments, and outcomes during follow-up. \u0000 \u0000Results: Our cohort includes 243 patients, of whom 31% were male. During follow-up, 20 patients (8%) were treated with biological drugs. Patients who received biological therapies were younger (p = 0.030), had less frequently genital aphthosis (p = 0.009), and more frequently erythema nodosum (p = 0.009), polyarthritis (p = 0.002), spondyloarthritis (p = 0.024), retinal vasculitis (p = 0.011) and gastrointestinal manifestations (p = 0.024), namely gastroduodenal ulcer (p = 0.035), digestive bleeding from ulcers (p = 0.002), and bowel perforation (p = 0.004). Anti-TNF-α agents were used in all of these patients, most frequently infliximab. Patients started biologicals after classical immunosuppressors failure, and most went into remission (93%). Three patients developed tuberculosis during treatment, regardless of regular screening tests. It was possible to stop biological therapy in five patients, so far, without recurrence, with 33 months of mean follow-up time after suspension. \u0000 \u0000Discussion: Anti-TNF-α agents are highly effective for refractory BD´s manifestations, although they are not innocuous. Little is known about the optimal duration of these therapies, regarding when and how to stop these drugs. This issue is essential not only to avoid relapses but also to reduce therapy side-effects.","PeriodicalId":32856,"journal":{"name":"Medicina Interna","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48092765","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}
Medicina InternaPub Date : 2021-12-23DOI: 10.24950/rspmi.jacorreia.4.2021
João Araújo Correia
{"title":"“A Missão de Cuidar”: O Livro Comemorativo dos 70 Anos da SPMI","authors":"João Araújo Correia","doi":"10.24950/rspmi.jacorreia.4.2021","DOIUrl":"https://doi.org/10.24950/rspmi.jacorreia.4.2021","url":null,"abstract":"","PeriodicalId":32856,"journal":{"name":"Medicina Interna","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47160431","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}
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