Acta Medica Port
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Although previous studies show that physicians generally agree that nutrition knowledge is important for their daily clinical practice, several other studies report their poor knowledge of the subject. One of the strongest reasons given for this is the non-incorporation of Nutrition as a compulsory subject for the medical sciences degree. Dietary counselling and assessment of the patients' nutritional status don't seem to be systematic. ⋯ About 95% stated they provided written or verbal nutritional guidance, and most of the physicians had already sought the assistance of a nutritionist. This study shows that the clinical body of the CHVR/PR is aware of the importance nutrition knowledge has in their daily practice. It must be noted, though, that although almost one third of the physicians rate their nutrition knowledge poor, most of them provide nutritional guidance to their patients.
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Neuroepithelial cysts, heterogeneous group of lesions, are fluid collections similar to CSF, lined by epithelial cells, frequently found in the lateral ventricles and choroidal fissure; intraparenchymal cysts are relatively uncommon. We report CT and MRI imaging findings of four intraparenchymal neuroepithelial cysts, two of which have histological confirmation of the diagnosis.
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Paraneoplastic neurological syndromes (PNS) are remote effects of cancer, which are not caused by invasion of the tumour or its metastasis, but presumably immunologic mediated. They developed in less than 1% of patients with systemic cancers, most Limbic encephalitis (LE) is the most common clinical paraneoplastic syndrome attainting the CNS (Central Nervous System), and it is characterized by involvement of hippocampus and amygdala; LE is also the only one with clearly defined imaging features. We report a 64 year old man, former smoker, which presented multiple paraneoplastic syndromes, namely LE, opsoclonus-myoclonus, subacute cerebellar degeneration, brainstem encephalitis, sensory-motor neuropathy and inappropriate antidiuretic hormone secretion syndrome (SIADH); these syndromes were identifiable in the clinical and imaging examination, confirmed by the neuro-pathological study. ⋯ A mediastinal adenopathy depicted a metastasis from low differentiated neoplasm cells, with some signs of neuroendocrine differentiation. With this case we provide a comprehensive illustration of the PNS, from a clinical, imaging and pathological point of view. This report also emphasises the importance of a diagnosis based on early clinical and imaging findings, given that, in most cases the cancer is not apparent.
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For elective surgeries over ordering of blood is a common practice. The goal of the Maximum Surgical Blood Order Schedule (MSBOS) is to promote efficient use of blood. ⋯ As in other Blood Banks, the differences are more evident in the situations in which the need for blood is very small, the so called Type and Screen. MSBOS should be re-evaluated regularly because of operative environment such as surgeons, operative methods, haemostatic drugs and preoperative conditions of patients can change.
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Prostate cancer is a significant cause of morbidity and mortality. In Portugal alone, according to a study published in 2003, the rate of new prostate cancer cases were 53 per 100,000 men (in 2000), with an age-standardized mortality rate of about 28 per 100,000 (in 1995). Multiple bone metastases are one of the major complications of advanced prostate cancer. Samarium-EDTMP showed to be a safe and effective alternative for palliative treatment of bone metastases. The goal of this economic study is to assess the cost-effectiveness of Samarium-153-EDTMP for the treatment of pain due to multiple bone metastases in hormone-refractory prostate cancer versus conventional pain therapy, in Portugal. ⋯ Samarium-153-EDTMP was not only a very effective therapeutic option but also an option with less cost than the conventional pain therapy, in patients with pain due to multiple bone metastases, in Portugal.