Browsing by Author "Sousa, P"
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- Anomalous coronary origin: From suspicion to surgical revascularizationPublication . Vieira, C; Nabais, S; Salgado, A; Salomé, N; Sousa, P; Madureira, AJ; Pinho, PCongenital anomalies of the coronary arteries are uncommon and can present a diagnostic challenge. The authors present the case of a patient with recurrent chest pain during exertion admitted for acute coronary syndrome. Coronary angiography revealed no coronary lesions but showed that the right coronary artery originated from the anterolateral aortic wall, above the sinuses of Valsalva, leading to suspicion of compression by the pulmonary artery, confirmed by CT angiography. The patient underwent surgical revascularization with a good result. The authors highlight the need to consider compression of an anomalous coronary artery by the pulmonary artery in the differential diagnosis of recurrent chest pain on exertion and acute myocardial infarction without significant coronary stenosis.
- Compreender a Sintomatologia Depressiva após a Cirurgia Bariátrica: o Papel do Peso, da Alimentação e da Imagem CorporalPublication . Sousa, P; Bastos, AP; Venâncio, C; Vaz, AR; Brandão, I; Costa, JM; Machado, P; Conceição, EINTRODUCTION: Depressive symptoms have been reported as prevalent after bariatric surgery. This study aims to analyze the role of weight, eating behaviors and body image in depressive symptomatology in bariatric surgery patients assessed post-operatively. MATERIAL AND METHODS: This is a cross-sectional study including 52 bariatric surgery patients assessed post-operatively with a follow-up time ranging from 22 to 132 months. Psychological assessment included a clinical interview (Eating Disorder Examination) to assess eating disorders psychopathology, and three self-report measures: Outcome Questionnaire 45 - general distress; Beck Depression Inventory - depressive symptoms; and Body Shape Questionnaire - body image. RESULTS: Our data show that depressive symptoms after surgery are associated with loss of control over eating, increased concerns with body image, and body mass index regain. Multiple linear regressions was tested including these variables and showed that body mass index regain after surgery, loss of control over eating and concerns with body image significantly explained 50% of the variance of post-operative depressive symptoms, being the concern with body image the most significant variable: greater dissatisfaction with body image was associated with more depressive symptoms. DISCUSSION: The results of this study showed that a subgroup of patients presents a significant weight gain after bariatric surgery, which is associated with episodes of loss of control over eating, concerns with body image and depressive symptoms. CONCLUSION: These results stress the relevance of body image concerns after surgery and the importance of clinically addressing these issues to optimize psychological functioning after bariatric surgery.
- Thrombus aspiration in patients with ST-elevation myocardial infarction: results of a national registry of interventional cardiologyPublication . Pereira, H; Caldeira, D; Teles, RC; Costa, M; da Silva, PC; da Gama Ribeiro, V; Brandão, V; Martins, D; Matias, F; Pereira-Machado, F; Baptista, J; Abreu, PF; Santos, R; Drummond, A; de Carvalho, HC; Calisto, J; Silva, JC; Pipa, JL; Marques, J; Sousa, P; Fernandes, R; Ferreira, RC; Ramos, S; Oliveira, EI; de Sousa Almeida, MBACKGROUND: We aimed to evaluate the impact of thrombus aspiration (TA) during primary percutaneous coronary intervention (P-PCI) in 'real-world' settings. METHODS: We performed a retrospective study, using data from the National Registry of Interventional Cardiology (RNCI 2006-2012, Portugal) with ST-elevation myocardial infarction (STEMI) patients treated with P-PCI. The primary outcome, in-hospital mortality, was analysed through adjusted odds ratio (aOR) and 95% confidence intervals (95%CI). RESULTS: We assessed data for 9458 STEMI patients that undergone P-PCI (35% treated with TA). The risk of in-hospital mortality with TA (aOR 0.93, 95%CI:0.54-1.60) was not significantly decreased. After matching patients through the propensity score, TA reduced significantly the risk of in-hospital mortality (OR 0.58, 95%CI:0.35-0.98; 3500 patients). CONCLUSIONS: The whole cohort data does not support the routine use of TA in P-PCI, but the results of the propensity-score matched cohort suggests that the use of selective TA may improve the short-term risks of STEMI..
- Trends in coronary angioplasty in Portugal from 2002 to 2013 according to the Portuguese National Registry of Interventional CardiologyPublication . Pereira, H; Campante Teles, R; Costa, M; Canas da Silva, P; da Gama Ribeiro, V; Brandão, V; Martins, D; Matias, F; Pereira-Machado, F; Baptista, J; Farto E Abreu, P; Santos, R; Drummond, A; Cyrne de Carvalho, H; Calisto, J; Silva, JC; Pipa, JL; Marques, J; Sousa, P; Fernandes, R; Cruz Ferreira, R; Ramos, S; Oliveira, E; Almeida, MINTRODUCTION AND OBJECTIVES: The aim of the present paper was to report trends in coronary angioplasty for the treatment of ST-elevation myocardial infarction (STEMI) in Portugal. METHODS: Prospective multicenter data from the Portuguese National Registry of Interventional Cardiology (RNCI) and official data from the Directorate-General for Health (DGS) were studied to analyze percutaneous coronary intervention (PCI) procedures for STEMI from 2002 to 2013. RESULTS: In 2013, 3524 primary percutaneous coronary intervention (p-PCI) procedures were performed (25% of all procedures), an increase of 315% in comparison to 2002 (16% of all interventions). Between 2002 and 2013 the rate increased from 106 to 338 p-PCIs per million population per year. Rescue angioplasty decreased from 70.7% in 2002 to 2% in 2013. During this period, the use of drug-eluting stents grew from 9.9% to 69.5%. After 2008, the use of aspiration thrombectomy increased, reaching 46.7% in 2013. Glycoprotein IIb-IIIa inhibitor use decreased from 73.2% in 2002 to 23.6% in the last year of the study. Use of a radial approach increased steadily from 8.3% in 2008 to 54.6% in 2013. CONCLUSION: During the reporting period there was a three-fold increase in primary angioplasty rates per million population. Rescue angioplasty has been overtaken by p-PCI as the predominant procedure since 2006. New trends in the treatment of STEMI were observed, notably the use of drug-eluting stents and radial access as the predominant approach.