Percorrer por autor "Vasconcelos, Tiago"
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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.
- Hemorrhagic transformation in patients with ischemic stroke and atrial fibrillation: to anticoagulate or not, that is the questionPublication . Vasconcelos, Tiago; Emidio, Fábio Caleça; Silva, Frederico; Nascimento, Joana; Duarte, MartaThe management of anticoagulation in patients with ischemic stroke and atrial fibrillation (AF) poses a critical dilemma due to the inherent risk of hemorrhagic transformation. This article presents the case of an 89-year-old male with AF and recurrent ischemic strokes, highlighting the complex challenge of deciding whether to initiate or withhold anticoagulation. After the initial ischemic stroke event, the patient started a direct oral anticoagulant. Subsequent imaging revealed hemorrhagic transformation, leading to the cessation of anticoagulation. Despite multiple hemorrhagic recurrences, balancing thrombotic and bleeding risks remained challenging. Mechanical thrombectomy was performed for a subsequent ischemic stroke due to an absolute contraindication for thrombolysis. The patient's intricate clinical course involved a multidisciplinary approach, resulting in a decision to cautiously resume low-dose anticoagulation combined with left atrial appendage closure. This decision was made after careful consideration of persistent thrombotic risk despite recurrent hemorrhages. The case underscores the complex management dilemma of anticoagulation in elderly patients with AF and recurrent strokes, emphasizing the need for a multidisciplinary approach and individualized decision-making in such challenging scenarios. Further research and guidelines are warranted to establish optimal strategies for (re)initiating anticoagulation in patients with recurrent hemorrhagic transformation.
- 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.
- Transforming chronic disease data into actionable knowledge: a comprehensive systematic review for data science models in healthcare knowledge managementPublication . Baptista, Márcia; Vasconcelos, José Braga; Rocha, Álvaro; Silva, Rita; Gouveia, Maria do Carmo Lemos Vieira; Vasconcelos, TiagoThe increasing prevalence of chronic disease, responsible for high mortality and disability, is of considerable concern to healthcare. The ongoing care and management requirements contribute to extreme health costs which affect economies worldwide. Chronic diseases patients require understanding of the existing care models to address their complex and involved health needs. Centers for Disease Control and Prevention shows that providing data to guide, prioritize, deliver and monitor population health is a vital domain to improve Chronic Disease Management. The twenty-first century led to a new age of Data Science and Analytics. Big Data has become a core technology for providing innovative solutions in numerical applications and healthcare services. Embedded in Big Data is valuable information and knowledge. That’s when Data Science becomes an important tool to transform actionable data into knowledge, a requirement to make better decisions, solve complicated problems and optimize health processes. This aims for a Data Science Model as a Healthcare Knowledge Management System tool, which emerges as an important paradigm for innovating healthcare that depends on developing more adaptive, intelligent and user-centric systems that can effectively manage the increasingly dense healthcare knowledge ecosystem. Under this context, there is also a critical need to develop Healthcare Intelligent Systems based on Data Science. This article provides a comprehensive overview of these systems, synthesizing current research and highlighting the critical role of these systems in modern healthcare. It also proposes a model for Healthcare Knowledge Management System based on integrated data science tools transforming healthcare data into actionable knowledge.