500 research outputs found
Pneumoperitoneum in Peritoneal Dialysis Patients
O Pneumoperitoneu no doente em diálise peritoneal é uma complicação rara, no entanto deve ser tida em atenção de forma a evitar uma laparotomia desnecessária que possa comprometer esta opção dialítica. Os autores qpresentam o cado de uma doente de 70 anos de idade com insuficiência renal crónica, em diálise peritoneal há 21 meses, sem qualquer complicação ou sinal de peritonite.
Admitida no serviço de urgência com dor epigástrica súbita. À observação, um abdómen timpanizado, sem alterações na porção externa do cateter de Tenckhoff. Analiticamente sem leucocitose. O Rx Abdominal demonstrou a existência de pneumoperitoneu. A TC abdominal confirmou uma pneumoperitoneu generalizado mas predominante no andar supramesocólico, sem extravasamento de contraste oral e com o cateter de diálise bem posicionado no quadrante inferior esquerdo. Procedeu-se à aspiração do pneumoperitoneu através de um técnica asséptica em posição de Trendlenburg, com confirmação radiológica da resolução do mesmo. Constatou-se recorrência do penumoperitoneu no dia seguinte, apesar da doente permanecer assintomática, pelo que se procedeu à remoção do cateter, sem recorrência do pneumoperitoneu.info:eu-repo/semantics/publishedVersio
Sickle cell disease
Female patient with past medical history of anaemia associated with multiple painful crises,
characterized by severe skeletal pain and fever
Left inferior vena cava with azygos continuation: association of congenital vascular anomalies in the same patient
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Association of acculturation with cardiac structure and function among Hispanics/Latinos: a cross-sectional analysis of the echocardiographic study of Latinos.
OBJECTIVE:Hispanics/Latinos, the largest immigrant population in the USA, undergo the process of acculturation and have a large burden of heart failure risk. Few studies have examined the association of acculturation on cardiac structure and function. DESIGN:Cross-sectional. SETTING:The Echocardiographic Study of Latinos. PARTICIPANTS:1818 Hispanic adult participants with baseline echocardiographic assessment and acculturation measured by the Short Acculturation Scale, nativity, age at immigration, length of US residence, generational status and language. PRIMARY AND SECONDARY OUTCOME MEASURES:Echocardiographic assessment of left atrial volume index (LAVI), left ventricular mass index (LVMI), early diastolic transmitral inflow and mitral annular velocities. RESULTS:The study population was predominantly Spanish-speaking and foreign-born with mean residence in the US of 22.7 years, mean age of 56.4 years; 50% had hypertension, 28% had diabetes and 44% had a body mass index >30 kg/m2. Multivariable analyses demonstrated higher LAVI with increasing years of US residence. Foreign-born and first-generation participants had higher E/e' but lower LAVI and e' velocities compared with the second generation. Higher acculturation and income >20K were associated with higher LVMI, LAVI and E/e' but lower e' velocities. Preferential Spanish-speakers with an income <20K had a higher E/e'. CONCLUSIONS:Acculturation was associated with abnormal cardiac structure and function, with some effect modification by socioeconomic status
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