Caso 2/19: “Uma doença destruidora da face”  / Case 2/19: “A face-destroying disease”

Caso relatado na Reunião de Discussão de Casos Clínicos do Hospital Universitário Prof. Polydoro Ernani de São Thiago, iniciada pelos Profs. Jorge Dias de Matos, Marisa Helena César Coral e Rosemeri Maurici da Silva, em julho de 2017. No dia 13 de junho de 2019, no bloco do curso de medicina, realizou-se a apresentação e discussão do caso cujo registro é apresentado a seguir: um paciente de 38 anos é acompanhado no ambulatório de reumatologia, com uma doença destrutiva das vias aéreas superiores, pansinusopatia, ANCA e anti-proteinase 3 positivos. É usuário crônico de cocaína inalável e de corticosteróides. Um dia, dá entrada na emergência com cefaleia aguda e meningismo. Qual é o diagnóstico?Case reported at the Clinical Cases Discussion Meeting of the University Hospital “Polydoro Ernani of São Thiago”, initiated by Profs. Jorge Dias de Matos, Marisa Helena César Coral and Rosemeri Maurici da Silva, July 2017. On June 13, 2019, in the medical school block, the case was presented and discussed: A 38-year-old male patient is followed at the rheumatology outpatient clinic with a destructive upper airway disease, pansinusopathy, positive ANCA and anti-proteinase 3. He is a chronic user of inhaled cocaine and corticosteroids. One day, he comes to the emergency room with acute headache and meningism. What is the diagnosis?

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The second step in the construction of a stigma scale of epilepsy

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2005000300005 ◽

2005 ◽

Vol 63 (2b) ◽

pp. 395-398 ◽

Cited By ~ 17

Author(s):

Priscila C.B. Salgado ◽

Paula T. Fernandes ◽

Ana Lúcia A. Noronha ◽

Fernanda D. Barbosa ◽

Elisabete A.P. Souza ◽

...

Keyword(s):

Social Relationships ◽

Outpatient Clinic ◽

Psychosocial Problems ◽

University Hospital ◽

Second Step ◽

Stigma Scale ◽

Know How ◽

The University ◽

Brazilian Culture ◽

Recreation Activities

RATIONALE: The issue of stigmatization is one of the most common psychosocial problems faced by people with epilepsy. PURPOSE: A second step towards the development of a scale to measure epilepsy stigma. METHOD: We applied a closed questionnaire to 12 patients and 32 relatives from the Epilepsy Outpatient Clinic at the University Hospital of Campinas. RESULTS: The results are grouped in three main domains: medical, social and personal areas. Medical: the subjects did not know exactly what epilepsy is or how it is caused; nonetheless they know how to treat it. Social: the most important areas that people with epilepsy are discriminated are at work and social relationships. Patients also complained about their lack of freedom and limits on recreation activities. Personal Area: subjects apparently have the same feelings and thoughts about epilepsy and seizures. CONCLUSION: This study analyzed the most common aspects presented in the questionnaire to assess epilepsy stigma for the Brazilian culture which are the base to the elaboration of a stigma scale of epilepsy.

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Impacto de la ecografía volumétrica portátil en el sondaje vesical por retención urinaria en una unidad de medicina interna

Enfermería Global ◽

10.6018/eglobal.19.1.347591 ◽

2019 ◽

Vol 19 (1) ◽

pp. 42-62

Author(s):

David Guadarrama Ortega ◽

Raquel Díaz Díaz ◽

María Aránzazu Martín Hernández ◽

María Teresa Peces Hernández ◽

Jonatan Vallejo Paredes ◽

...

Keyword(s):

Internal Medicine ◽

Urinary Retention ◽

Medical Record ◽

Electronic Medical Record ◽

University Hospital ◽

Urinary Catheterization ◽

Short Term ◽

The University ◽

The Impact ◽

De Medicina

Objetivo: Estimar el impacto que el uso de ecógrafo vesical tiene en los sondajes vesicales por sospecha de retención urinaria de una unidad de Medicina interna.Metodología: Estudio de cohortes retrospectivas, comparando la cohorte expuesta a la disponibilidad del ecógrafo vesical, con la no expuesta el año previo. Se analizan todos los registros en la Historia Clínica Electrónica (HCE) de sondajes vesicales permanentes de corta duración en pacientes adultos que ingresaron en la unidad de hospitalización de Medicina Interna del Hospital Universitario Fundación Alcorcón (HUFA) durante los años 2015 y 2016. Se estima la frecuencia de retención urinaria como causa del sondaje después de la incorporación del dispositivo en la unidad y se compara con la frecuencia en sondajes durante el mismo periodo del año anterior en la misma unidad. Se estima el impacto que disponer de este dispositivo tiene en la frecuencia de retención urinaria como motivo del sondaje.Resultados: Se incluyen 134 sondajes en 113 pacientes, 62 en el grupo sin ecógrafo y 72 en el grupo con ecógrafo. La frecuencia de sondajes por retención se reduce del 47.5% al 21.4% después de introducir el ecógrafo en la unidad. Esto supone una reducción del 50% (RR ajustado= 0.48; IC95%:0.27-0.84, p=0.01) en la frecuencia de sondaje vesical por sospecha de retención urinaria. Aim: To estimate the impact of the use of portable bladder volumetric ultrasound on bladder catheterization due to suspicion of urinary retention in an internal medicine unit. Methodology: Study of retrospective cohorts, comparing the cohort exposed to the availability of bladder ultrasound, with the not exposed the previous year. All records in the Electronic Medical Record (EHR) of short-term permanent bladder catheters in adult patients admitted to the Internal Medicine hospitalization unit of the University Hospital Fundación Alcorcón (HUFA) during the years 2015 and 2016 were analyzed. The urinary retention frequency is estimated as the cause of the catheterization after the device has been incorporated into the unit and compared with the frequency of catheterization during the same period of the previous year in the same unit. It is estimated that the impact of having this device on the urinary retention frequency is the reason for the catheterization. Results: 134 catheters are included in 113 patients, 62 in the group without ultrasound and 72 in the group with ultrasound. The frequency of catheterizations due to retention is reduced from 47.5% to 21.4% after introducing the ultrasound unit into the unit. This represents a 50% reduction (adjusted RR=0.48; CI95%:0.27-0.84, p=0.01) in the frequency of urinary catheterization for suspected urinary retention.

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Medically Unexplained Oropharyngeal Dysphagia at the University Hospital ENT Outpatient Clinic for Dysphagia: A Cross-Sectional Cohort Study

Dysphagia ◽

10.1007/s00455-018-9912-9 ◽

2018 ◽

Vol 34 (1) ◽

pp. 43-51 ◽

Cited By ~ 1

Author(s):

Rob J.C.G. Verdonschot ◽

Laura W.J. Baijens ◽

Sophie Vanbelle ◽

Michelle Florie ◽

Remco Dijkman ◽

...

Keyword(s):

Cohort Study ◽

Outpatient Clinic ◽

Oropharyngeal Dysphagia ◽

University Hospital ◽

Cross Sectional ◽

Medically Unexplained ◽

The University

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Retrospective Analysis And Description Of A Cohort Of Non-cystic Fibrosis Bronchiectatic Patients From An Outpatient Clinic In The University Hospital Gasthuisberg, Leuven, Belgium

10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a3190 ◽

2010 ◽

Author(s):

Pieter Goeminne ◽

Julie Soens ◽

Walter De Wever ◽

Pascal Van Bleyenbergh ◽

Lieven J. Dupont

Keyword(s):

Cystic Fibrosis ◽

Retrospective Analysis ◽

Outpatient Clinic ◽

University Hospital ◽

The University

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Abstract #216: Knowledge About Inpatient Diabetes Management: Impact of an Educational Intervention in Nurses at the University Hospital of Puerto Rico

Endocrine Practice ◽

10.1016/s1530-891x(20)42522-4 ◽

2015 ◽

Vol 21 ◽

pp. 30-31

Author(s):

Anette Garces-Dominguez ◽

Loida Gonzalez-Rodriguez ◽

Monica Vega ◽

Myriam Allende-Vigo

Keyword(s):

Puerto Rico ◽

Educational Intervention ◽

Diabetes Management ◽

University Hospital ◽

Inpatient Diabetes ◽

Inpatient Diabetes Management ◽

The University

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Symptomatic vascular complications after vascular closure device use following diagnostic and interventional catheterisation

VASA ◽

10.1024/0301-1526.33.2.78 ◽

2004 ◽

Vol 33 (2) ◽

pp. 78-81 ◽

Cited By ~ 21

Author(s):

Thalhammer ◽

Aschwanden ◽

Jeanneret ◽

Labs ◽

Jäger

Keyword(s):

Current Literature ◽

Vascular Complications ◽

University Hospital ◽

Closure Device ◽

Ultrasound Guided ◽

Vascular Closure Device ◽

Device Use ◽

Arterial Stenoses ◽

The University ◽

Stenotic Lesions

Background: Haemostatic puncture closure devices for rapid and effective hemostasis after arterial catheterisation are a comfortable alternative to manual compression. Implanting a collagen plug against the vessel wall may become responsible for other kind of vascular injuries i.e. thrombotic or stenotic lesions and peripheral embolisation. The aim of this paper is to report our clinically relevant vascular complications after Angio-Seal® and to discuss the results in the light of the current literature. Patients and methods: We report the symptomatic vascular complications in 17 of 7376 patients undergoing diagnostic or therapeutic catheterisation between May 2000 and March 2003 at the University Hospital Basel. Results: Most patients presented with ischaemic symptoms, arterial stenoses or occlusions and thrombotic lesions (n = 14), whereas pseudoaneurysms were extremely rare (n = 3). Most patients with ischaemic lesions underwent vascular surgery and all patients with a pseudoaneurysm were successfully treated by ultrasound-guided compression. Conclusions: Severe vascular complications after Angio-Seal® are rare, consistent with the current literature. There may be a shift from pseudoaneurysms to ischaemic lesions.

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User Evaluation of an Integrated Medical Workstation for Clinical Data Analysis

Methods of Information in Medicine ◽

10.1055/s-0038-1634954 ◽

1993 ◽

Vol 32 (05) ◽

pp. 365-372 ◽

Cited By ~ 2

Author(s):

T. Timmeis ◽

J. H. van Bemmel ◽

E. M. van Mulligen

Keyword(s):

Data Analysis ◽

Clinical Research ◽

Clinical Data ◽

University Hospital ◽

User Evaluation ◽

Scientific Staff ◽

Medical Institutions ◽

Clinical Data Analysis ◽

Research Problems ◽

The University

AbstractResults are presented of the user evaluation of an integrated medical workstation for support of clinical research. Twenty-seven users were recruited from medical and scientific staff of the University Hospital Dijkzigt, the Faculty of Medicine of the Erasmus University Rotterdam, and from other Dutch medical institutions; and all were given a written, self-contained tutorial. Subsequently, an experiment was done in which six clinical data analysis problems had to be solved and an evaluation form was filled out. The aim of this user evaluation was to obtain insight in the benefits of integration for support of clinical data analysis for clinicians and biomedical researchers. The problems were divided into two sets, with gradually more complex problems. In the first set users were guided in a stepwise fashion to solve the problems. In the second set each stepwise problem had an open counterpart. During the evaluation, the workstation continuously recorded the user’s actions. From these results significant differences became apparent between clinicians and non-clinicians for the correctness (means 54% and 81%, respectively, p = 0.04), completeness (means 64% and 88%, respectively, p = 0.01), and number of problems solved (means 67% and 90%, respectively, p = 0.02). These differences were absent for the stepwise problems. Physicians tend to skip more problems than biomedical researchers. No statistically significant differences were found between users with and without clinical data analysis experience, for correctness (means 74% and 72%, respectively, p = 0.95), and completeness (means 82% and 79%, respectively, p = 0.40). It appeared that various clinical research problems can be solved easily with support of the workstation; the results of this experiment can be used as guidance for the development of the successor of this prototype workstation and serve as a reference for the assessment of next versions.

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Sharing of Worldwide Spread Knowledge Using Hypermedia Facilities & Fast Communication Protocols (Mosaic and World Wide Web): The Example of ExPASy

Methods of Information in Medicine ◽

10.1055/s-0038-1634588 ◽

1995 ◽

Vol 34 (01/02) ◽

pp. 75-78 ◽

Cited By ~ 5

Author(s):

R. D. Appel ◽

O. Golaz ◽

Ch. Pasquali ◽

J.-C. Sanchez ◽

A. Bairoch ◽

...

Keyword(s):

World Wide Web ◽

World Wide ◽

Relevant Literature ◽

Communication Protocols ◽

Laboratory Data ◽

Central Element ◽

University Hospital ◽

New Information ◽

The University ◽

Link Information

Abstract:The sharing of knowledge worldwide using hypermedia facilities and fast communication protocols (i.e., Mosaic and World Wide Web) provides a growth capacity with tremendous versatility and efficacy. The example of ExPASy, a molecular biology server developed at the University Hospital of Geneva, is striking. ExPASy provides hypermedia facilities to browse through several up-to-date biological and medical databases around the world and to link information from protein maps to genome information and diseases. Its extensive access is open through World Wide Web. Its concept could be extended to patient data including texts, laboratory data, relevant literature findings, sounds, images and movies. A new hypermedia culture is spreading very rapidly where the international fast transmission of documents is the central element. It is part of the emerging new “information society”.

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