Browsing by Author "Morgado, S"
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- Dor após cirurgia lombar: imagens e reflexosPublication . Gaspar, AT; Morgado, S; Antunes, FAim: To characterize one population with persistent or recurrent pain after lumbar spinal surgery and evaluate the functional impact of this pathological condition. Methods: The sample consisted of patients with a history of back surgery that kept the pain level and whom had performed imaging examination of the lumbar spine after surgery. The authors made the demographic characterization of the population and the characterization of pain using the DN-4 survey. It was considered the findings in neurological examination and the results of imaging studies. The assessment of quality of life was objectified using the SF-36 survey. Results: The study included 28 patients, mostly female and working age. Most patients had neuropathic pain, changes in neurological examination and for 27 of the 28 patients were found in imaging compression of neurvous structures, mainly by recurrence of initial pathology and scarring. The results obtained in the survey SF- 36 clearly showed the negative impact on patients quality of life. Conclusion: In this sample, most patients presents with documented anatomical lesion that may justify pain complaints. The negative impact on quality of life makes this clinical picture a true challenge for Physical Medicine and Rehabilitation.
- Fraqueza Muscular Adquirida nos Cuidados Intensivos: Sub ou Sobrediagnosticada?Publication . Morgado, S; Moura, SIntensive care unit-acquired weakness (ICU-AW) is recognized as an important and common clinical problem, associated with an increased morbidity in critical ill patients. This muscle weakness has been described in a wide range of clinical settings and therefore, has many different terminologies such as “critical illness myopathy – CIM”, “critical illness polyneuropathy - CIP”, “acute quadriplegic myopathy”, among others. Nowadays, these designations are considered somewhat restrictive, therefore most authors adopt the more wide range designation of “ICU-Acquired Weakness”.Generally, these patients have a flacid tetraparesis without cranial nerve palsy, normal or diminished osteotendinous reflexes and no sensitive alterations unless on the cases traditionally classified as polyneuropathy. The diagnosis of ICU-AW is often difficult, and should be suspected whenever a critical ill patient has unexplained weakness. Traditionally, the diagnosis of neuromuscular diseases is based in nerve conduction studies and electromyography. Muscle biopsy can be used to confirm or exclude myopathy, but is not a routine exam. Since there is a significant percentage of critical patients that develop muscle weakness it is important to screen all patients in the ICU, avoid potential toxic re-exposures on the identified patients and begin early rehabilitation. However, two questions arise from this screening: if the screening is only clinical are we underestimating these patients? If electrophysiological are we overestimating ICU-AW? There are no specific therapies for ICU-AW. The criterious use of some drugs is one of the possible measures to be taken. On the other hand, the early inclusion of these patients in a rehabilitation program seems to be helpful for a speedy functional recovery. There are few studies regarding ICU-AW, and systematic studies with longer follow-ups and bigger samples are necessary to determine the most effective rehabilitation approach for these patients.
- Síndrome de Escápula CrepitantePublication . Morgado, S; Antunes, FSnapping Scapula Syndrome is a rare disorder that consists mainly in an audible and/or palpable crepitus of the scapula with movements on the scapulo-thoracic plane. This crepitus is often associated with shoulder or cervicodorsal pain. Patients generally seek medical help for pain relief. This syndrome can have many causes, originating from the various anatomical structures involved in the scapulothoracic movement (bone, muscle, bursa…). The diagnosis is clinical, although imaging studies can be helpful in the identification of the underlying cause. Most patients with Snapping Scapula Syndrome are treated conservatively, with a rehabilitation program and analgesic medication. Surgical approach can be beneficial in patients that do not respond to the nonoperative treatment, although its execution is still not consensual. The authors present the case of a patient with Snapping Scapula Syndrome, its diagnostic and therapeutic approach and a revision of the literature on this pathological entity.