Acta Medica Port
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Comment Letter
[Excessive Alcohol Use in Women: An Underdiagnosed Problem?]
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Observational Study
Therapeutic Plasmapheresis: Seven Year Experience of an Intensive Care Unit in Portugal.
Therapeutic plasmapheresis is a therapeutic procedure in which the patient's blood is passed through a medical device which separates out plasma from other components of blood. The plasma is removed and replaced with a replacement solution. Studies on the use of plasmapheresis in critically ill patients are scarce. The aim of this study was to review all therapeutic plasmapheresis sessions carried out in the Hospital Beatriz Ângelo intensive care unit. ⋯ Therapeutic plasmapheresis is a complex technique that requires specific training. The indications are diverse, and some are not consensual. Complications were frequent, but they did not increase morbidity.
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In Portugal, a colorectal cancer screening program based on faecal immunochemical test followed by colonoscopy was shown to be cost-effective for individuals between 50 and 74 years old. We report the first findings of the implementation of a population-based program In Northern Portugal. ⋯ A centralized invitation system based on direct mailing was feasible and both colonoscopy quality and diagnostic yield were adequate antecipating the success of the programme.
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Sibutramine is a serotonin-norepinephrine-dopamine reuptake inhibitor, initially developed as a potential antidepressant and later approved for the management of obesity. Sibutramine use is also associated with psychiatric symptoms, namely mania, panic attacks, and, less frequently, psychosis. ⋯ The symptoms remitted completely after discontinuation of sibutramine and a brief period of antipsychotic medication. The aim of this manuscript is to highlight the importance of the recognition of sibutramine-associated psychosis, to discuss the possible pathophysiology and the proper clinical and therapeutic management.
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Sarcoid granulomas can be found in a wide range of diseases and differentiating sarcoidosis from a sarcoid-like reaction may be a challenge. We present a woman with erythematoviolaceous papulonodular lesions located on the ears where piercings were placed. A skin biopsy showing an infiltrate of sarcoid and focal tuberculoid granulomas did not exclude sarcoidosis. ⋯ Epicutaneous tests performed revealed a strong positive reaction to palladium and nickel, supporting the diagnosis of granulomatous contact dermatitis. There are only a few reports of granulomatous contact dermatitis to palladium with piercings as the source of sensitization. The formation of sarcoid granulomas can represent either a sarcoid-like reaction or a form of cutaneous sarcoidosis, and patch tests are essential in order to establish the diagnosis.