Browsing by Author "Moutinho, Joana"
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- Chilaiditi syndrome: a rare case and clinical insights for diagnosis and managementPublication . Silva, Frederico S.; Moutinho, Joana; Vasconcelos, Tiago; Simões, Inês G.Chilaiditi syndrome is a rare medical condition characterized by the interposition of a hollow organ, usually the colon, between the liver and diaphragm, leading to abdominal pain, discomfort, bloating, constipation, or nausea; in more severe instances, respiratory symptoms may manifest due to pressure on the diaphragm. The exact cause remains unclear but is thought to present along with various factors such as anatomical anomalies (hepato-diaphragmatic interposition and intestinal malrotation) and chronic conditions (cirrhosis or chronic obstructive pulmonary disease). This case report presents a 78-year-old male with rapid deterioration, confusion, and mild abdominal discomfort. Clinical and radiological examinations confirmed Chilaiditi syndrome, highlighting the challenges in diagnosis. Management strategies range from conservative approaches to surgical interventions, emphasizing the need for increased clinical awareness among physicians to ensure accurate and timely interventions. This case report underscores the importance of recognizing this rare condition.
- Perirenal hematoma: a rare complication of anticoagulant therapyPublication . Silva, Frederico; Moutinho, Joana; Nascimento, Joana; Vasconcelos, Tiago; Simões, Inês G.Hemorrhagic complications arising from anticoagulant use are a well-recognized concern in clinical practice. This case study presents an 84-year-old woman with multiple cardiovascular risk factors, including atrial fibrillation, who developed a perirenal hematoma after just five doses of enoxaparin, prescribed for stroke prevention. The patient exhibited altered mental status and abdominal pain, prompting imaging studies revealing the hematoma. This case highlights the importance of vigilance in patients at risk for bleeding complications, especially in the initial days of anticoagulant therapy. Diagnostic imaging, particularly CT scans or ultrasound, is crucial for early detection. Management strategies range from discontinuing anticoagulants to potential interventions like anticoagulation reversal, angiography, or surgery. The decision to resume anticoagulation presents a challenge and requires a personalized approach based on patient factors. This case underscores the need for continued vigilance, early diagnosis, and evidence-based decisions in managing patients on anticoagulants, emphasizing the necessity for further research to establish clear guidelines in such complex clinical scenarios.
- Reflections on central nervous system LupusPublication . Moutinho, Joana; Isenberg, David A.Neuropsychiatric (NP) disorders are important in the morbidity (even mortality) in systemic lupus erythematosus (SLE). Aspects of central nervous system (CNS) lupus remain unsatisfactory, notably what constitutes this element of SLE. The American College of Rheumatology (ACR) (in 1971/1982) recognized ‘seizures and psychosis’ without other causes being identified, such as drugs or metabolic derangements [1]. An ACR working party (1999), however, proposed 19 different clinical features (12 central, seven peripheral) [2].