Papers by Miguel Ângelo Costa
Cureus
Pyomyositis is a rare bacterial infection of the skeletal muscle that often presents with insidio... more Pyomyositis is a rare bacterial infection of the skeletal muscle that often presents with insidious symptoms, thus making the diagnosis challenging. It is categorized into primary and secondary (usually traumatic) variants, mainly occurring in tropical regions and occasionally in temperate climates, with predisposing factors including immunosuppression. Staphylococcus aureus is the most common pathogen. A 39-year-old woman with a history of breast cancer underwent a mastectomy followed by chemotherapy. After her second chemotherapy cycle, she developed fever, odynophagia, vomiting, and right hip pain (considered to be related to muscle tension due to functional exercises). Fever and hip pain progressively worsened and the other symptoms resolved. On the 12th day after chemotherapy, she received intramuscular diclofenac injections due to severe hip pain. Physical examination revealed tenderness in her right hip and signs of inflammation on her thigh and buttock. Laboratory tests showed elevation of inflammatory markers and mild kidney and liver dysfunction. A CT scan revealed an intramuscular collection in her right gluteal region (~45 x 70 mm), with adjacent fat densification. Attempts to drain the collection initially failed, but a later ultrasound-guided procedure was successful and pus was collected for bacterial culture, which identified methicillin-susceptible Staphylococcus aureus (MSSA). Antibiotic treatment was adjusted to target SA with flucloxacillin and the patient's condition improved. Subsequent imaging showed a resolving collection (<10 mm). The patient continued antibiotic treatment for six weeks, maintaining clinical improvement, normal inflammatory parameters, and apyrexia. Adjuvant chemotherapy was discontinued due to the risk of infection recurrence associated with the multiloculated collection caused by SA. The patient remained asymptomatic four months after hospitalization. An MRI then showed only a residual T2 hyperintensity in the deeper region of the right buttock, with no visible collections. The nadir period refers to the time after each chemotherapy cycle when the risk of neutropenia and subsequent infection is the highest, typically occurring between 7 and 14 days after each cycle. In this case, the intramuscular injection occurred 12 days after the second cycle of chemotherapy. It is most likely that this served as the entry point for the pyomyositis agent (MSSA) during a period of transient neutropenia.
Revista Argentina de Urología, 1999
our Service performed 115 nephrectomies on patients with renal cell carcinomas, seven ofwhich pre... more our Service performed 115 nephrectomies on patients with renal cell carcinomas, seven ofwhich presented sarcomatoid variant. ln six ofthem, the tumor had exceeded the renal capsule. In the other one, the tumor was confined to the renal parenchyma, being this one in which progressión ofthe disease wasn 't noticed after the surgery. The cases were studied through cellular morphology in H-E stained slides, cellular ploidy with flow cytometry comparing, in retrospective style, the clinical evolution of this type of tumor. The utility ofthe applied methods as prognostic factors of disease was evaluated.
Mestrado em Biomedicina FarmacêuticaA detecção de recidivas antes da manifestação dos primeiros s... more Mestrado em Biomedicina FarmacêuticaA detecção de recidivas antes da manifestação dos primeiros sintomas é essencial para atingir bons resultados na gestão de doenças neoplásicas. O antigénio carcinoembrionário é o marcador tumoral bioquímico para cancro colorectal mais usado desde há já muitos anos mas a sua variabilidade na detecção de recidivas é elevada. Este trabalho propôs-se a identificar parâmetros que, associados a antigénio carcinoembrionário, melhorem a detecção de recidivas de cancro colorectal entre dados bioquímicos, clínicos e clinico-patológicos de pacientes submetidos a cirurgias de intenção curativa para essa mesma patologia, utilizando registos retrospectivos clínicos diários dos serviços de Cirurgia Geral e Oncologia do Hospital Infante D. Pedro E.P.E em Aveiro. Recorrendo a análise estatística descritiva tradicional e multivariada, a glucose sérica e o antigénio carcinoembrionário sérico foram identificados como factores de prognóstico de recidivas colorectais. ...
The present project work, Designing US, is placed between the scientific areas of medicine and te... more The present project work, Designing US, is placed between the scientific areas of medicine and technology, where it seeks the synthetization of aspects inherent to the quality of life of an amputee, in the form of a multiarticulated myoelectric transradial prosthesis. This project work is divided into 4 parts, “O QUOTIDIANO DE UM AMPUTADO” (daily life on an amputee), “PRÓTESES” (prosthesis), “O PAPEL DO DESIGNER” (Designer’s role), e “PROJETO” (project). The first 3 chapters are based on the direct and indirect conditioning factors that influence the life on an amputated person. They are thus intended to provide a framework to the project’s chapter, highlighting the imperative aspects, to the projection of a comfortable, desirable, safe and meaningful prosthesis. “PROJETO”, is therefore, the conclusive subject of this investigation, which focus in 4 parts, “Dispositivo terminal” (terminal device), “Interface protética” (prosthetic interface), “Estética” (aesthetics) and “Processo de...
We consider the effect of strong external electromagnetic fields on thermodynamic observables in ... more We consider the effect of strong external electromagnetic fields on thermodynamic observables in QCD, through lattice simulations with 1+1+1 flavors of staggered quarks at physical quark masses. Continuum extrapolated results are presented for the light quark condensates and for their tensor polarizations, as functions of the temperature and the magnetic field. We find the light condensates to undergo inverse magnetic catalysis in the transition region, in a manner that the transition temperature decreases with growing magnetic field. We also compare the results to other approaches and lattice simulations. Furthermore, we relate the tensor polarization to the spin part of the magnetic susceptibility of the QCD vacuum, and show that this contribution is diamagnetic. © Copyright owned by the author(s).
Revista Brasileira de Ortopedia, 2021
Resumo Objetivo Estudar a anatomia do ligamento coracoclavicular medial e avaliar a contribuição ... more Resumo Objetivo Estudar a anatomia do ligamento coracoclavicular medial e avaliar a contribuição do ligamento acromioclavicular, coracoclaviculares e coracoclavicular medial na estabilidade da articulação acromioclavicular. Métodos Foram dissecados 26 ombros de 16 cadáveres frescos, posicionados em decúbito dorso-horizontal, com um coxim de 15 cm de altura entre as escápulas. Realizou-se uma via deltopeitoral estendida proximal e medialmente. Realizou-se dissecção por planos e identificação dos ligamentos. Realizou a medida da distância acromio-clavicular e coracoclavicular usando pontos previamente demarcados com paquímetro milimetrado. Em seis dessas amostras foi realizado estudo biomecânico. Seccionando, nesta ordem, o ligamento acromioclavicular, os coracoclaviculares e o ligamento coracoclavicular medial com uma força cefálica de 20N foi aplicada na clavícula lateral. Foi medida a distância acromio-clavicular e coracoclavicular em cada uma das etapas de secção dos ligamentos. R...
A actividade fisica, desportiva ou ludica, e essencial para umestilo de vida saudavel. Como os ha... more A actividade fisica, desportiva ou ludica, e essencial para umestilo de vida saudavel. Como os habitos de vida se instalam numa fase precoce da vida, e importante que a pratica desportiva faca parte» desde cedo, do quotidiano da crianca, para que os efeitos desta prevencao primaria se facam sentir mais tarde na idade adulta.Actualmente as novas terapeuticas permitindo um melhor controlo da asma, tomam possivel uma adequada integracao da crianca asmatica nas actividades desportivas. Objectivo: Conhecer os habitos desportivos e factores associados da populacao infantil com asma que frequenta a consulta de patologia respiratoria infantil do Hospital de S. Miguel (Oliveira deAzemeis). Material e Metodos: Foi efectuado um inquerito aos pais e as criancas com idade superior a 5 anos, durante os meses de Outubro e Novembro de 2002. Resultados: Das 90 criancas (32F: 58M), com idades com preendidas entre 5 e 16 anos, verificou-se que 73% praticavam actividade fisica integrada no plano educat...
The accurate detection of recurrences, prior to the onset of the first clinical symptoms, is esse... more The accurate detection of recurrences, prior to the onset of the first clinical symptoms, is essential for achieving favorable results in the management of neoplastic diseases. Carcinoembryonic antigen has been a long-standing biochemical tumor marker for colorectal cancer and is the most widely used in this disease. However, it presents great variability in the detection of recurrences. Henceforth, the identification of additional parameters is of great importance. This work proposed to retrospectively analyze clinical, clinicopathological and biochemical data of patients that had undergone surgical resection of primary colorectal cancer, collected during the daily practice of the Surgery and Oncology Services of the Infante D. Pedro E.P.E Hospital in Aveiro, to identify parameters that, associated with carcinoembryonic antigen, improve the detection of colorectal cancer recurrences By means of traditional descriptive and multivariant statistical analysis, serum glucose and carcino...
Diabetes, 2018
The primary objective of this study was to assess whether the topical administration of two neuro... more The primary objective of this study was to assess whether the topical administration of two neuroprotective drugs (brimonidine and somatostatin) could prevent or arrest retinal neurodysfunction in patients with type 2 diabetes. For this purpose, adults aged between 45 and 75 years with a diabetes duration ≥5 years and an Early Treatment of Diabetic Retinopathy Study (ETDRS) level of ≤35 were randomly assigned to one of three arms: placebo, somatostatin, or brimonidine. The primary outcome was the change in implicit time (IT) assessed by multifocal electroretinography between baseline and at the end of follow-up (96 weeks). There were 449 eligible patients allocated to brimonidine (n = 152), somatostatin (n = 145), or placebo (n = 152). When the primary end point was evaluated in the whole population, we did not find any neuroprotective effect of brimonidine or somatostatin. However, in the subset of patients (34.7%) with preexisting retinal neurodysfunction, IT worsened in the place...
Proceedings of Xth Quark Confinement and the Hadron Spectrum — PoS(Confinement X), 2013
We consider the effect of strong external electromagnetic fields on thermodynamic observables in ... more We consider the effect of strong external electromagnetic fields on thermodynamic observables in QCD, through lattice simulations with 1 + 1 + 1 flavors of staggered quarks at physical quark masses. Continuum extrapolated results are presented for the light quark condensates and for their tensor polarizations, as functions of the temperature and the magnetic field. We find the light condensates to undergo inverse magnetic catalysis in the transition region, in a manner that the transition temperature decreases with growing magnetic field. We also compare the results to other approaches and lattice simulations. Furthermore, we relate the tensor polarization to the spin part of the magnetic susceptibility of the QCD vacuum, and show that this contribution is diamagnetic.
Diabetes, Jun 29, 2017
Cross-sectional study evaluating the relationship between: a) functional and structural measureme... more Cross-sectional study evaluating the relationship between: a) functional and structural measurements of neurodegeneration in initial stages of diabetic retinopathy (DR); and b) presence of neurodegeneration and early microvascular impairment. We analyzed baseline data of patients with type 2 diabetes (n=449) enrolled in the EUROCONDOR study (NCT01726075). Functional studies by multifocal ERG (mfERG) evaluated neurodysfunction and structural measurements using spectral domain optical-coherence tomography (SD-OCT) evaluated neurodegeneration. The mfERG P1 amplitude was more sensitive than the P1 implicit time (IT), and was lower in patients with ETDRS 20-35 than in patients with ETDRS <20 (p=0.005). In 58% of cases, mfERG abnormalities were present in the absence of visible retinopathy. Correspondence between SD-OCT thinning and mfERG abnormalities was shown in 67% of the eyes with ETDRS <20 and in 83% of the eyes with ETDRS 20-35. Notably, 32% of patients with ETDRS 20-35 prese...
British Journal of Ophthalmology, 2016
Purpose To analyse and compare the classification of eyes with diabetic retinopathy using fluores... more Purpose To analyse and compare the classification of eyes with diabetic retinopathy using fluorescein angiography (FA) and optical coherence tomography angiography (OCTA) performed either with AngioPlex or AngioVue. Methods This was an observational cross-sectional study of 50 eyes from 26 diabetic subjects. Two independent graders classified the FA angiograms, to assess the presence and severity of several characteristics according to the ETDRS Report 11, and a similar evaluation was performed for each 3×3 mm OCTA image from the superficial retinal layer and for the full retina slab. Results Percentages of non-gradable images for the outline of foveal avascular zone (FAZ) in the central subfield (CSF) were 29.0% for FA, 12.0% for AngioVue and 3.0% for AngioPlex. For capillary loss, percentages of non-gradable images in the CSF were 25.0% for FA, 11% for AngioVue and 0.0% for AngioPlex. For the inner ring (IR), percentages of non-gradable images were 12.5% for FA, 11.5% for AngioVue and 0.5% for AngioPlex. Agreement between graders was substantial for outline of FAZ. For capillary loss, the agreement was fair for the CSF, and moderate for the IR. Conclusions The OCTA allows better discrimination of the CSF and parafoveal macular microvasculature than FA, especially for FAZ disruption and capillary dropout, without the need of an intravenous injection of fluorescein. In addition, FA had also a higher number of non-gradable images. The OCTA can replace with advantage the FA, as a non-invasive and more sensitive procedure for detailed morphological evaluation of central macular vascular changes. Trial registration number NCT02391558, Pre-results.
Revista Brasileira de Ortopedia, 2017
Síndrome de colisão do ombro Tenotomia Tenodese Bainha rotadora Dor de ombro r e s u m o As lesõe... more Síndrome de colisão do ombro Tenotomia Tenodese Bainha rotadora Dor de ombro r e s u m o As lesões da cabec ¸a longa do tendão bicipital (CLB) são comuns na prática clínica e podem ter causas degenerativas, inflamatórias, instabilidades (subluxac ¸ão ou luxac ¸ão) ou traumáticas. Geralmente, elas estão associadas a outras doenc ¸as do ombro, principalmente a lesões do manguito rotador. Atualmente, existem controvérsias quanto às indicac ¸ões dos tratamentos cirúrgicos e à escolha da melhor técnica para cada caso, devido à possibilidade de deformidade estética, perda da forc ¸a muscular e dor residual. O objetivo deste estudo foi identificar as indicac ¸ões do tratamento cirúrgico, a melhor técnica cirúrgica e as vantagens e desvantagens de cada técnica descritas na literatura médica ortopédica no tratamento das lesões da CLB. Foi realizada revisão da literatura médica ortopédica disponível na base de dados da Biblioteca Regional de Medicina (BIREME), Medline, PubMed, Cochrane Library e Google Scholar, incluindo artigos publicados no período de 1991 a 2015.
Costa, JMRC (2002) The role of the leaf in growth dynamics and rooting of leafy stem cuttings of ... more Costa, JMRC (2002) The role of the leaf in growth dynamics and rooting of leafy stem cuttings of rose, PhD thesis, Plant Sciences Group, The Netherlands. With English, Dutch, Portuguese and Spanish summaries. The present study aims at better understanding the relation between photosynthesis of the original leaf, carbohydrates, rooting and growth of single node leafy stem cuttings of rose. This knowledge can be used to improve success and efficiency in propagation and improving the uniformity of the planting material of cut roses derived form cuttings. The effects of the original leaf area on the growth of cuttings of Rosa hybrida Madelon® were investigated during the first 10 weeks after severance. Total plant dry weight, and dry weight of the roots in particular, were proportionally related with the original leaf area of cuttings. When leaf area was modified, leaf area duration was linearly related to the rooting and growth of cuttings during the first 21 days of propagation. The presence of the leaf during the first week of propagation was critical for survival and its removal caused stem rot. This was caused by low carbohydrate concentrations. Cuttings remained photosyntheticaly active after severance. Photosynthetic rates decreased immediately after severance, but recovered up to 70% of the rates measured on leaves on mother plants and remained constant during propagation. The PSII efficiency decreased during propagation with a simultaneous increase in its heterogeneity across the leaflets (patchiness) which may be attributed to decreased sink activity rather then to water stress. The root and shoot tissues accounted for about 70% of the increase in total fresh weight after 21 days of propagation, whereas the remaining 30% increase was due to dry weight accumulation in the leaf and stem. About 55% of the dry weight accumulated consisted of carbohydrates, in particular starch, which accumulated mainly in the first 14 days in leaves and stem tissues (pith and medullar rays). This accumulation may be explained by reduced meristematic sink activity following severance. In fact, the newly formed roots and primary shoot after 21 days of propagation only represented 10% of the total dry weight of cuttings. Reduced light integrals and low CO2 concentrations resulted in reduced rooting and growth of cuttings and decreased carbohydrate levels. Number of roots, and particularly, dry weight of roots, were linearly related with total dry weight accumulation during the 21 days of propagation showing that photosynthetic activity of cuttings during propagation influences both root initiation and growth. The effects of low light, low C0 2 concentration, and leaf area reduction on rooting and growth of cuttings were similar indicating that these effects could be explained to a great extent by photosynthesis. Growth in general depended on the length of the period cuttings were photosynthetically active during propagation. An exception was the growth of the axillary primary shoot, which was more negatively affected by reduced photosynthetic activity in the first 11 days of propagation. Root initiation was also more negatively affected by low photosynthetic activity in the first 11 days of propagation whereas root growth responded to the integral of photosynthesis. Cuttings were able to efficiently use reserves for growth. Optimal rooting and further growth of cuttings rely on the synthesis of new photosynthates because storage is limited in single node stem cuttings.
III International Symposium on Rose Research and Cultivation, 2001
Leaves are essential in the propagation of roses by cuttings. However, about the underlying princ... more Leaves are essential in the propagation of roses by cuttings. However, about the underlying principles, there is no unequivocal opinion in the literature. We investigated the hypothesis that current photosynthesis would represent the dominating factor. To validate this hypothesis variations in photosynthesis were created by reducing leaf area, covering of leaves and by reducing CO 2 air concentration. The consequences in terms of survival percentage, root formation, and carbohydrate concentrations were followed throughout the first 3 weeks of propagation. Moreover, the known promoting effect of auxins was studied in a comparative experiment to investigate potential auxin deficiencies created by the leaf treatments. Leaf removal, leaf covering or CO 2 depletion had a quantitative negative effect on survival and growth of cuttings. Auxins did not promote rooting when leaves were covered or removed. Dry matter distributed uniformly by the leaf and stem of cuttings after 21 days of propagation. Unexpected, and perhaps contradictory, was that, although current leaf photosynthesis seemed the limiting factor for propagation, the majority of photosynthates was stored as starch. This apparent ineffective use of photosynthates could be explained in terms of competition within different sinks. The weak sink of starch accumulating organelles becomes the major sink relatively to the modest sink activity of the new roots and new shoots. In fact, the new formed organs accounted for less than 15% of the total dry weight of cuttings. It is concluded that photosynthetic capacity of cuttings is to be considered an important determinant for quality in rose propagation. Further research should confirm the relationship between photosynthesis and its value as criterion for quality in rose propagation. 1.
Revista Brasileira de Ortopedia, 2015
Objetivo: Estabelecer uma zona de seguranc ¸a neurovascular no acesso cirúrgico do terc ¸o médio ... more Objetivo: Estabelecer uma zona de seguranc ¸a neurovascular no acesso cirúrgico do terc ¸o médio da clavícula por dissecc ¸ão em cadáveres. Métodos: Foram dissecados 20 ombros de 10 cadáveres, foi feita a dissecc ¸ão profunda do terc ¸o médio da clavícula e identificaram-se as seguintes estruturas: veia subclávia, tronco superior do plexo braquial (divisão anterior e posterior) e nervo supraescapular. Essas estruturas foram demarcadas para mensurac ¸ão de suas distâncias até os pontos mais próximos do terc ¸o médio da clavícula. Resultados: A distância média do terc ¸o médio da clavícula ao nervo supraescapular, à veia subclávia, ao tronco superior, à divisão anterior do tronco superior e à divisão posterior do
IFIP International Federation for Information Processing, 2007
Manufacturing leanness and agility are requirements o.ftoday•s manufacturing systems. Leanness ca... more Manufacturing leanness and agility are requirements o.ftoday•s manufacturing systems. Leanness callfor a best/it oJthe manufacturing systems to products. therefore requiring product oriented manufacturing systems (POMSj. Manufacturing agility can be achieved through easy systems reconfiguration to ./it changing manufacturing requirements. which may mean dynamical(v configuring POM5. For this a suitable design system is required Due to complexity of this design, and to the need Jar using suitable design methods, which may not be available local()', distributed sources of design services can be used This paper presents and describes a prototype ofa Distributed Design system Jar POMS based on a POMS design methodology and distributed suppliers of design services.
Revista Brasileira de Ortopedia, 2015
Objetivo: Avaliar a evoluc ¸ão do resultado funcional da hemiartroplastia CTA ® no tratamento cir... more Objetivo: Avaliar a evoluc ¸ão do resultado funcional da hemiartroplastia CTA ® no tratamento cirúrgico da artropatia degenerativa do manguito rotador com um seguimento médio de 5,4 anos. : Foram reavaliados 18 pacientes submetidos à artroplastia parcial CTA ® para o tratamento da artropatia degenerativa do manguito rotador entre abril de 2007 e junho de 2009, com seguimento mínimo e médio de 4,6 anos e 5,4 anos, respectivamente. Foram usados parâmetros pré e pós-operatórios de funcionalidade e satisfac ¸ão dos pacientes (escala funcional da Universidade da Califórnia em Los Angeles [UCLA]). Todos os pacientes fizeram tratamento conservador prévio por seis meses e foram submetidos ao tratamento cirúrgico na ausência de resultado satisfatório. Foram excluídos pacientes com cirurgia prévia no ombro, pseudoparalisia, insuficiência do arco coracoacromial (tipo 2 B da classificac ¸ão de Seebauer), lesão neurológica ou insuficiência do músculo deltoide e do músculo subescapular. Resultados: Com um seguimento médio de 5,4 anos, 14 pacientes se consideravam satisfeitos com a cirurgia (78%). A amplitude de movimento articular melhorou na elevac ¸ão ativa média e variou de 55,8 • no pré-operatório para 82 • no pós-operatório. A rotac ¸ão externa média melhorou de em média 18,9 • no pré-operatório para 27,3 • no pós-operatório. A média da rotac ¸ão medial manteve-se no nível da terceira vértebra lombar. O escore UCLA médio, após seguimento médio de 5,4 anos, foi de 23,94 e melhorou em comparac ¸ão com as médias pré-operatória e do primeiro ano pós-operatório. Conclusão: Os resultados funcionais da hemiartroplastia CTA ® no tratamento da artropatia do manguito rotador em pacientes selecionados mantiveram-se satisfatórios após um seguimento médio de 5,4 anos.
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Papers by Miguel Ângelo Costa