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Article ; Online: Subacute Neurotoxicity as an Adverse Reaction to Ceftazidime: A Case Report.

Pinheiro, Filipe Oliveira / Duarte, Delfim / Rodrigues, Pedro / Nogueira-Silva, Luís / Martins, José Carlos / Almeida, Jorge

The Kurume medical journal

2024 Volume 69, Issue 3.4, Page(s) 261–263

Abstract: Neurotoxicity associated with cephalosporins is an increasingly recognized complication, although among cephalosporins, ceftazidime is rarely reported for such an adverse reaction. Moreover, subacute, rather than acute, presentation of neurotoxicity ... ...

Abstract	Neurotoxicity associated with cephalosporins is an increasingly recognized complication, although among cephalosporins, ceftazidime is rarely reported for such an adverse reaction. Moreover, subacute, rather than acute, presentation of neurotoxicity associated with cephalosporins is rare. A 77-year-old female patient with stage 4 chronic renal disease was admitted due to cellulitis in her right lower limb, multiorgan dysfunction complicated by oliguric acute kidney injury, and a need for hemodialysis via a central venous catheter. On the 13th day after admission, she became febrile, and bacteremia associated with a central venous catheter was identified, which prompted the initiation of empirical antibiotic therapy with vancomycin and ceftazidime. After 13 days of antibiotic therapy with vancomycin and ceftazidime, the patient became confused, with temporal-spatial disorientation and myoclonus, especially in the upper limbs, with worsening renal function. Ceftazidime was discontinued, and the patient's condition improved with complete remission of symptoms on the 8th day after symptom onset. Neurotoxicity associated with ceftazidime is a rare but probably underdiagnosed adverse reaction. It is more frequent in elderly patients with previous neurological dysfunction and end-stage kidney disease and/or acute kidney injury, and it usually manifests soon after starting treatment. Early identification and monitoring of risk factors and symptoms should lead the physician to a rapid withdrawal of the offending drug.
MeSH term(s)	Humans ; Aged ; Female ; Ceftazidime/adverse effects ; Ceftazidime/therapeutic use ; Anti-Bacterial Agents/adverse effects ; Neurotoxicity Syndromes/etiology ; Neurotoxicity Syndromes/diagnosis ; Vancomycin/adverse effects ; Renal Dialysis ; Treatment Outcome ; Acute Kidney Injury/chemically induced
Language	English
Publishing date	2024-01-16
Publishing country	Japan
Document type	Case Reports ; Journal Article
ZDB-ID	603905-4
ISSN	1881-2090 ; 0023-5679
ISSN (online)	1881-2090
ISSN	0023-5679
DOI	10.2739/kurumemedj.MS6934009
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Article: Flash Pulmonary Edema: A Rare Presentation of Graves' Disease.

Rocha, Maria Helena / Conde, André / Nogueira-Silva, Luis / Nogueira, Fernando / Almeida, Jorge S

Cureus

2022 Volume 14, Issue 6, Page(s) e25833

Abstract: Graves' disease is the most common cause of hyperthyroidism. It has an autoimmune basis with the activating thyrotropin-receptor antibodies inducing thyroid hormone overproduction. The most common manifestations of hyperthyroidism are weight loss, ... ...

Abstract	Graves' disease is the most common cause of hyperthyroidism. It has an autoimmune basis with the activating thyrotropin-receptor antibodies inducing thyroid hormone overproduction. The most common manifestations of hyperthyroidism are weight loss, fatigue, heat intolerance, tremor, and palpitations, but there are several other symptoms and signs associated with this condition. We report a case of a young woman who presented in the emergency room with acute onset of cough with mild hemoptysis and dyspnea at rest. She reported one month of insomnia, palpitations, and anxiety. The diagnostic investigation leads to the diagnosis of Graves' disease in thyrotoxic crisis presenting with flash pulmonary edema. Therapy with propranolol and methimazole was instituted with remarkable clinical improvement.
Language	English
Publishing date	2022-06-10
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.25833
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Article: Neurolisteriosis: The Importance of a Prompt Diagnosis.

Silva, Clara / Ferrão, Diana / Almeida, Mariana / Nogueira-Silva, Luis / Almeida, Jorge S

Cureus

2021 Volume 13, Issue 7, Page(s) e16662

Abstract: Immune thrombocytopenia (ITP) is a prevalent disease that may need immunosuppressant treatment, which increases the risk of an opportunistic infection. We present the case of a woman with corticosteroid-resistant ITP who was electively admitted to the ... ...

Abstract	Immune thrombocytopenia (ITP) is a prevalent disease that may need immunosuppressant treatment, which increases the risk of an opportunistic infection. We present the case of a woman with corticosteroid-resistant ITP who was electively admitted to the hospital to initiate second-line treatment. On the second day, she presented with a high fever and altered mental status, with no lesions on the cerebral tomography and inconclusive cerebrospinal fluid analysis. Nonetheless, she was promptly started on empiric antibiotics for meningitis which were then adjusted for
Language	English
Publishing date	2021-07-27
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.16662
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Article ; Online: Cochrane Corner: Antihypertensive efficacy of beta-1 selective beta blockers for primary hypertension.

Nogueira-Silva, Luís / Marques, Pedro Sousa / Lima, Maria João

Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology

2017 Volume 36, Issue 5, Page(s) 385–388

Abstract: Beta blockers are commonly used to treat hypertension. This Cochrane systematic review assessed the effect of beta-1 selective beta blockers on blood pressure (BP), pulse pressure (PP), heart rate (HR) and withdrawal due to adverse effects in patients ... ...

Title translation	Cochrane Corner: eficácia anti‐hipertensora dos betabloqueadores seletivos beta‐1 na hipertensão essencial.
Abstract	Beta blockers are commonly used to treat hypertension. This Cochrane systematic review assessed the effect of beta-1 selective beta blockers on blood pressure (BP), pulse pressure (PP), heart rate (HR) and withdrawal due to adverse effects in patients with primary hypertension. Fifty-six randomized placebo-controlled trials were included, with a total of 7812 patients. These drugs reduced systolic/diastolic BP by 10/8 mmHg, PP by 2 mmHg and HR by 11 bpm; no difference was found between treatment and placebo regarding withdrawal due to adverse effects. Differences in efficacy were observed between the various beta-1 selective beta blockers, which may be due to methodological differences in the trials. The choice of an antihypertensive drug should take into account not only its efficacy in reducing BP but also its tolerability, its efficacy in preventing cardiovascular events, and other factors such as undesirable metabolic effects.
Language	Portuguese
Publishing date	2017-05
Publishing country	Portugal
Document type	Journal Article
ZDB-ID	632718-7
ISSN	2174-2030 ; 0870-2551 ; 0304-4750
ISSN (online)	2174-2030
ISSN	0870-2551 ; 0304-4750
DOI	10.1016/j.repc.2016.09.012
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Article ; Online: Encefalomielite Aguda Disseminada Após Imunização Contra o Vírus do Papiloma Humano.

Ferreira, Daniel / Almeida, Mariana / Nogueira-Silva, Luís / Araújo, Rui / Abreu, Pedro

Acta medica portuguesa

2020 Volume 33, Issue 11, Page(s) 780–781

Title translation	Acute Disseminated Encephalomyelitis Following Human Papillomavirus Vaccination.
MeSH term(s)	Alphapapillomavirus ; Encephalomyelitis, Acute Disseminated/chemically induced ; Humans ; Papillomavirus Infections/prevention & control ; Papillomavirus Vaccines/administration & dosage ; Papillomavirus Vaccines/adverse effects ; Vaccination
Chemical Substances	Papillomavirus Vaccines
Language	Portuguese
Publishing date	2020-11-02
Publishing country	Portugal
Document type	Letter
ZDB-ID	603078-6
ISSN	1646-0758 ; 0870-399X
ISSN (online)	1646-0758
ISSN	0870-399X
DOI	10.20344/amp.14769
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Article ; Online: Surviving Extreme Anaemia.

Esteves, Joana M / Fernandes, Joana / Oliveira Monteiro, Pedro / Almeida, Mariana / Nogueira-Silva, Luis / Almeida, Jorge

European journal of case reports in internal medicine

2021 Volume 8, Issue 3, Page(s) 2357

Abstract: Before the development of transfusion medicine, severe anaemia was an important cause of morbidity and mortality. The discovery of haematopoietic mechanisms and essential nutrients made it possible to easily treat and prevent this condition. Nevertheless, ...

Abstract	Before the development of transfusion medicine, severe anaemia was an important cause of morbidity and mortality. The discovery of haematopoietic mechanisms and essential nutrients made it possible to easily treat and prevent this condition. Nevertheless, it is often fatal in patients presenting with extreme anaemia (haemoglobin levels <2 g/dl). We report the rare case of a 54-year-old woman who presented with profound megaloblastic anaemia (haemoglobin of 1.7 g/dl) due to vitamin B12 deficiency, and was successfully treated. Learning points: The discovery of vitamin B12 in the 20th century led to the successful and easy treatment of thousands of patients with anaemia.Focus on patient adherence to treatment and medical advice is essential in order to manage chronic conditions such as post-gastrectomy nutritional deficiencies.Extreme anaemia is very rare and associated with high mortality; treatment should be tailored to acute or chronic anaemia and in cases where haemodynamic stability is guaranteed, a restrictive blood transfusion strategy should be considered to reduce the risk of complications.
Language	English
Publishing date	2021-03-05
Publishing country	Italy
Document type	Journal Article
ISSN	2284-2594
ISSN (online)	2284-2594
DOI	10.12890/2021_002357
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Article ; Online: Análise da Revisão Cochrane: Inibidores da Enzima de Conversão da Angiotensina Versus Antagonistas do Receptor da Angiotensina como Prevenção Cardiovascular na Hipertensão Essencial. Cochrane Database Syst Rev. 2014,8: CD009096.

Nogueira-Silva, Luís / Fonseca, João A

Acta medica portuguesa

2015 Volume 28, Issue 3, Page(s) 283–285

Abstract: Angiotensin converting enzyme inhibitors and angiotensin receptor blockers are first line drugs in the treatment of hypertension. The aim of this review was to assess if there are differences between these drug classes regarding the prevention of total ... ...

Title translation	Analysis of the Cochrane Review: Angiotensin Converging Enzyme Inhibitors Versus Angiotensin Receptor Blockers for Primary Hypertension. Cochrane Database Syst Rev. 2014,8: CD009096.
Abstract	Angiotensin converting enzyme inhibitors and angiotensin receptor blockers are first line drugs in the treatment of hypertension. The aim of this review was to assess if there are differences between these drug classes regarding the prevention of total mortality, occurrence of cardiovascular events and of adverse effects. A systematic review and metanalysis was performed, searching for studies that compare angiotensin converting enzyme inhibitors and angiotensin receptor blockers face-to-face, in several databases until July 2014. The study selection and data extraction were performed by 2 independent researchers. Nine studies were included, with a total of 10 963 participants, 9 398 of which participated in the same study and had high cardiovascular risk. No differences were observed regarding total mortality, cardiovascular mortality or total cardiovascular events. A slightly smaller risk was observed with angiotensin receptor blockers regarding withdrawal due to adverse effects (55 people were needed to be treated with angiotensin receptor blockers for 4.1 years to avoid one withdrawal due to adverse effect), mainly due to the occurrence of dry cough with angiotensin converting enzyme inhibitors. Thus, no differences were observed between angiotensin converting enzyme inhibitors and angiotensin receptor blockers in the prevention of total mortality and cardiovascular events, and angiotensin receptor blockers were better tolerated. Given the large proportion of participants with a high cardiovascular risk, the generalization of these results to other populations is limited.
MeSH term(s)	Angiotensin Receptor Antagonists ; Angiotensins ; Cardiovascular Diseases/epidemiology ; Humans ; Hypertension ; Risk Factors
Chemical Substances	Angiotensin Receptor Antagonists ; Angiotensins
Language	Portuguese
Publishing date	2015-05
Publishing country	Portugal
Document type	Comment ; English Abstract ; Journal Article
ZDB-ID	603078-6
ISSN	1646-0758 ; 0870-399X
ISSN (online)	1646-0758
ISSN	0870-399X
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Article ; Online: Oncology Referral Concerning Paediatric Neurosurgery? Analysis of the Situation between 2008-2013 in the North of Portugal.

Batista, Ana / Nogueira-Silva, Luís / Vaz, Rui / Oliveira, Joana

Acta medica portuguesa

2016 Volume 29, Issue 1, Page(s) 15–23

Abstract: Introduction: Primary central nervous system tumours represent the second most frequent neoplasm and are the leading cause of death from solid tumours in children. Our study aimed to provide the most up-to-date epidemiological analysis of primary ... ...

Abstract	Introduction: Primary central nervous system tumours represent the second most frequent neoplasm and are the leading cause of death from solid tumours in children. Our study aimed to provide the most up-to-date epidemiological analysis of primary central nervous system tumours in children living in the north of Portugal and to explore a possible effect of the centralisation of care on outcomes. Material and methods: This population-based study included all newly diagnosed and histologically confirmed primary central nervous system tumours in people below 18 years old, living in the north of Portugal, from January 2008 to December 2013. Data were collected through access to clinical files. We described children and tumour characteristics, and analysed patient: paediatric neurosurgeon and histological tumour type: paediatric neurosurgeon ratios. Results: A total of 147 cases was recorded. Mean age at diagnosis of primary central nervous system tumours was 8.0 ± 5.2 years. Astrocytomas were the most common histological type (34%). We found that World Health Organization Tumour Grade was the only variable of statistically significant influence in mortality (p = 0.001). 1-, 3- and 5-year survivals related to 2008-2013 period were statistically higher than 2005 - 2007. Astrocytomas have the highest survival rate, with statistically significant difference from other tumours (p = 0.015). We estimated a mean of 12.25 treated cases per year by each paediatric neurosurgeon at our institution. Discussion: Our results are globally consistent with those published all over the world, but we reported the highest survival rates. The number of cases treated per year by each neurosurgeon is accordant to the recommended. Conclusion: We showed an improvement when comparing to data previous to 2008 and better results than those from previous studies, namely higher survival at 1-, 3- and 5-years from the diagnosis, with low complication and relapsing rates. Therefore, the referral of primary central nervous system tumours cases to centres with larger experience can be invaluable for the achievement of the best outcomes.
Language	English
Publishing date	2016-01
Publishing country	Portugal
Document type	Journal Article
ZDB-ID	603078-6
ISSN	1646-0758 ; 0870-399X
ISSN (online)	1646-0758
ISSN	0870-399X
DOI	10.20344/amp.6432
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Article ; Online: Impact of Chronic Nitrate Therapy in Patients With Ischemic Heart Failure.

Moreira-Silva, Sofia / Urbano, Joana / Nogueira-Silva, Luís / Bettencourt, Paulo / Pimenta, Joana

Journal of cardiovascular pharmacology and therapeutics

2016 Volume 21, Issue 5, Page(s) 466–470

Abstract: Purpose: There is a lack of knowledge on the effects of nitrates alone in heart failure (HF). We aimed to assess the impact of nitrates use in the occurrence of ischemic events in patients with ischemic HF attending an HF clinic.: Methods: We ... ...

Abstract	Purpose: There is a lack of knowledge on the effects of nitrates alone in heart failure (HF). We aimed to assess the impact of nitrates use in the occurrence of ischemic events in patients with ischemic HF attending an HF clinic. Methods: We performed a retrospective analysis of a cohort of 632 patients managed in an HF clinic between January 2000 and December 2011. Patients with ischemic etiology were selected (n = 290). Patients were classified according to chronic nitrates use (n = 83 nitrates users vs n = 194) and followed up for 5 years for the occurrence of fatal or nonfatal myocardial infarction or stroke. Results: Nitrates users had more frequently diabetes, dyslipidemia, and higher body mass index but were less frequently treated with statins. Thirty adverse events were recorded (n = 16 in nitrates group). Variables significantly associated with the occurrence of the end point in univariate analysis were arterial hypertension, diabetes, and nitrates use. Male gender, beta-blockers, statin, and clopidogrel use had a protective effect on the occurrence of the end point. In multivariate analysis, nitrates use remained an independent predictor of adverse outcome when adjusted for each of the variables: arterial hypertension, gender, diabetes, beta-blocker, and clopidogrel use; however, when adjusted for statin use, nitrates were no longer associated with the outcome. Conclusion: Long-term nitrates use in patients with ischemic HF was associated with higher occurrence of ischemic events, defined as fatal or nonfatal myocardial infarction or stroke. Our results, although from a retrospective analysis, do not support a role for chronic nitrate use in HF.
MeSH term(s)	Aged ; Chi-Square Distribution ; Drug Administration Schedule ; Female ; Heart Failure/diagnosis ; Heart Failure/drug therapy ; Heart Failure/mortality ; Heart Failure/physiopathology ; Humans ; Kaplan-Meier Estimate ; Male ; Multivariate Analysis ; Myocardial Infarction/mortality ; Myocardial Ischemia/diagnosis ; Myocardial Ischemia/drug therapy ; Myocardial Ischemia/mortality ; Myocardial Ischemia/physiopathology ; Nitrates/administration & dosage ; Nitrates/adverse effects ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Stroke/mortality ; Time Factors ; Treatment Outcome ; Vasodilator Agents/administration & dosage ; Vasodilator Agents/adverse effects
Chemical Substances	Nitrates ; Vasodilator Agents
Language	English
Publishing date	2016-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	1329372-2
ISSN	1940-4034 ; 1074-2484
ISSN (online)	1940-4034
ISSN	1074-2484
DOI	10.1177/1074248416634464
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Article ; Online: Translation and cultural adaptation of the Hill-Bone Compliance to High Blood Pressure Therapy Scale to Portuguese.

Nogueira-Silva, Luís / Sá-Sousa, Ana / Lima, Maria João / Monteiro, Agostinho / Dennison-Himmelfarb, Cheryl / Fonseca, João A

Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology

2016 Volume 35, Issue 2, Page(s) 93–97

Abstract: Introduction: Hypertension is an extremely prevalent disease worldwide and hypertension control rates remain low. Lack of adherence contributes to poor control and to cardiovascular events. No questionnaire in Portuguese is readily available for the ... ...

Abstract	Introduction: Hypertension is an extremely prevalent disease worldwide and hypertension control rates remain low. Lack of adherence contributes to poor control and to cardiovascular events. No questionnaire in Portuguese is readily available for the assessment of adherence to antihypertensive drugs. We aimed to perform a translation and cultural adaptation to Portuguese of the Hill-Bone Compliance to High Blood Pressure Therapy Scale, a validated instrument to measure adherence in hypertensive patients. Methods: A formal process was employed, consisting of a forward translation by two independent translators and a back translation by a third translator. Discrepancies were resolved after each step. Hypertensive patients were involved to identify and resolve phrasing and wording difficulties and misunderstandings. Results: The forward and back translation did not produce significant discrepancies. However, important issues were identified when the questionnaire was presented to patients, which led to changes in the wording of the questions and in the format of the questionnaire. Conclusion: Questionnaires are important instruments to assess adherence to therapy, particularly in hypertension. A formal translation and cultural adaptation process ensures that the new version maintains the same concepts as the original. After translation, several changes were necessary to ensure that the questionnaire was understandable by elderly, low literacy patients, such as the majority of hypertensive patients. We propose a Portuguese version of the Hill-Bone Compliance Scale, which will require validation in further studies.
MeSH term(s)	Antihypertensive Agents/therapeutic use ; Humans ; Hypertension/drug therapy ; Literacy ; Medication Adherence ; Patient Compliance ; Portugal ; Surveys and Questionnaires ; Translations
Chemical Substances	Antihypertensive Agents
Language	English
Publishing date	2016-02
Publishing country	Portugal
Document type	Journal Article
ZDB-ID	632718-7
ISSN	2174-2030 ; 0870-2551 ; 0304-4750
ISSN (online)	2174-2030
ISSN	0870-2551 ; 0304-4750
DOI	10.1016/j.repc.2015.07.013
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