18 results on '"Inês Ramalho"'
Search Results
2. Abnormal Uterine Bleeding in Adolescents: A Multidisciplinary Approach
- Author
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Inês Ramalho, Helena Leite, and Fernanda Águas
- Subjects
Adolescent ,Blood Coagulation Disorders ,Menorrhagia ,Metrorrhagia ,Uterine Hemorrhage ,Medicine ,Medicine (General) ,R5-920 - Abstract
Abnormal uterine bleeding is the most common complaint that motivates female adolescents to seek medical advice. Abnormal uterine bleeding has a significant impact on quality of life, promoting school absenteeism and limitations in social life. Moreover, episodes can vary from mild to life threatening events if not recognized and treated promptly. Healthcare providers should be able to distinguish between a normal and abnormal menstrual pattern, as this may provide early diagnosis of a potential health concern. The PALM-COEIN classification system should be used in the evaluation. Anovulation is the most frequent cause, frequently due to immaturity of the hypothalamic-pituitary-ovarian axis. A careful history and physical examination are crucial in the differential diagnosis. Management is based on both the underlying cause and the severity of bleeding. Most patients improve with pharmacological treatment, frequently requiring a multidisciplinary approach. First line treatment consists of hormonal therapy. Surgery is rarely needed. Although the prevalence of abnormal uterine bleeding is higher in adolescents compared to adults, most recommendations are not specific for this age, which makes the diagnosis and management challenging. The literature reveals lack of standardized care for adolescents and regimens vary widely. Future studies on efficacy and safety of treatments specifically in adolescents are needed.
- Published
- 2021
- Full Text
- View/download PDF
3. Breech Presentation: Vaginal Versus Cesarean Delivery, Which Intervention Leads to the Best Outcomes?
- Author
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Andreia Fonseca, Rita Silva, Inês Rato, Ana Raquel Neves, Carla Peixoto, Zita Ferraz, Inês Ramalho, Ana Carocha, Nisa Félix, Sandra Valdoleiros, Ana Galvão, Daniela Gonçalves, Joana Curado, Maria João Palma, Isabel Lobo Antunes, Nuno Clode, and Luís Mendes Graça
- Subjects
Breech Presentation ,Cesarean Section ,Delivery, Obstetric ,Medicine ,Medicine (General) ,R5-920 - Abstract
Introduction: The best route of delivery for the term breech fetus is still controversial. We aim to compare maternal and neonatal outcomes between vaginal and cesarean term breech deliveries. Material and Methods: Multicentric retrospective cohort study of singleton term breech fetuses delivered vaginally or by elective cesarean section from January 2012 - October 2014. Primary outcomes were maternal and neonatal morbidity or mortality. Results: Sixty five breech fetuses delivered vaginally were compared to 1262 delivered by elective cesarean. Nulliparous women were more common in the elective cesarean group (69.3% vs 24.6%; p < 0.0001). Gestational age at birth was significantly lower in the vaginal delivery group (38 ± 1 weeks vs 39 ± 0.8 weeks; p = 0.0029) as was birth weight (2928 ± 48.4 g vs 3168 ± 11.3 g; p < 0.0001). Apgar scores below seven on the first and fifth minutes were more likely in the vaginal delivery group (1st minute: 18.5% vs 5.9%; p = 0.0006; OR 3.6 [1.9 - 7.0]; 5th minute: 3.1% vs 0.2%; p = 0.0133; OR 20.0 [2.8 - 144.4]), as was fetal trauma (3.1% vs 0.3%: p = 0.031; OR 9.9 [1.8-55.6]). Neither group had cases of fetal acidemia. Admission to the Neonatal Intensive Care Unit, maternal postpartum hemorrhage and the incidence of other obstetric complications were similar between groups. Discussion: Although vaginal breech delivery was associated with lower Apgar scores and higher incidence of fetal trauma, overall rates of such events were low. Admission to the neonatal intensive care unit and maternal outcomes were similar. Conclusion: Both delivery routes seem equally valid, neither posing high maternal or neonatal complications’ incidence.
- Published
- 2017
- Full Text
- View/download PDF
4. A Scary Onset of a Rare and Aggressive Type of Primary Breast Sarcoma: A Case Report
- Author
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Inês Ramalho, Sara Campos, Teresa Rebelo, and Margarida Figueiredo Dias
- Subjects
Primary breast sarcoma ,Malignant phyllodes tumor ,Breast cancer ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Primary breast sarcoma, arising from connective tissue within the breast, is extremely rare, accounting for less than 1% of all primary breast malignancies and no more than 5% of all sarcomas. The rarity of this pathology limits most studies to case reports and small retrospective studies, which has led to a lack of consensus on the clinical management. We report a clinical case of a 52-year-old woman, perimenopausal, previously healthy, with regular breast surveillance, who presented with a large (>20 cm) and rapidly expanding hypervascularized tumor of the left breast developed over 10 days, with a very thin preulcerative skin over the last 4 days. There was no systemic dissemination. The patient was submitted to total mastectomy and excision of axillary adenopathy. The tumor was diagnosed histologically as malignant phyllodes tumor associated with areas of high-grade sarcoma. Due to rapid growth and aggressive histological characteristics, adjuvant chemotherapy and radiotherapy were performed. There is a lot of evidence that tumors larger than 5 cm are associated with a poor prognosis. Despite the poor prognosis associated with this aggressive entity, the patient had no recurrence during 5 years of follow-up. We review the relevant literature about primary breast sarcomas.
- Published
- 2016
- Full Text
- View/download PDF
5. Live birth after treatment of a spontaneous ovarian heterotopic pregnancy: A case report
- Author
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Inês Ramalho, Iolanda Ferreira, João Paulo Marques, Maria João Carvalho, António Lobo, Teresa Rebelo, José Paulo Moura, and Fernanda Águas
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Surgery ,RD1-811 ,Gynecology and obstetrics ,RG1-991 - Abstract
Spontaneous heterotopic pregnancies occur in about 1/30000 pregnancies, with the ovarian subtype comprising 2.3% of the total.We report the case of a healthy 32-year-old woman, gravida 4, para 3, who presented to the emergency room with severe abdominal pain. Two weeks earlier, pelvic ultrasound had revealed a 6-week intrauterine pregnancy. She was hemodynamically stable, but had rebound tenderness on the right iliac fossa. Transvaginal ultrasound revealed an evolutive intrauterine pregnancy with a gestational age (GA) of 8 weeks, with a synchronous evolutive adnexal pregnancy of the same GA and some free fluid in the pouch of Douglas. She underwent an urgent laparoscopy which showed an intact gestational sac containing an embryo on the right ovary associated with mild hemoperitoneum. An ovarian wedge resection was performed to preserve ovarian tissue. The intrauterine pregnancy had no complications and the patient delivered vaginally at term.Heterotopic pregnancy is potentially life-threatening. Despite being extremely rare after natural conception, and even more so in the absence of major risk factors, it should be considered in any pregnant woman with abdominal pain. A high index of suspicion is important for a prompt diagnosis, selection of the appropriate surgical treatment and successful obstetric outcomes. Keywords: Heterotopic pregnancy, Ovarian pregnancy, Laparoscopic management
- Published
- 2019
- Full Text
- View/download PDF
6. Ser artista a tempo inteiro, e o estudo de coletivos artísticos na cidade do Porto
- Author
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Faria, Inês Ramalho Pinto de and Faria, Nuno Filipe Moreira Ribeiro de
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Artista ,Humanidades::Artes [Domínio/Área Científica] ,Gestão/Ação ,Coletivo ,Profissionalização - Abstract
Esta dissertação procura compreender o lugar do artista, a sua forma de trabalho e organização em grupo, com abordagem às formas e processos de profissionalização no campo artístico. Ao identificar os ofícios que o artista assume, à parte da sua prática, em possíveis ações em alguns planos culturais, compreende-se a dificuldade constante de criar um modo de subsistência no meio artístico, devido aos existentes entraves institucionais. Esclarecendo o conceito de profissionalização, segue-se o enquadramento do tecido artístico explorado e as características da indústria criativa no contexto da cidade do Porto, em particular, de coletivos artísticos. Através do estudo deste modo de organização, comum na cidade, pretende-se compreender a sua forma de gestão e ação, delineando as redes de contacto criadas, o seu alcance de públicos e os modos de obtenção de apoios e fundos. Assim, esta investigação é como um convite a um diferente olhar do papel do artista, com uma melhor compreensão e apreciação das dinâmicas particulares dos coletivos artísticos como formas organizacionais e redes relacionais, tanto culturais como profissionais, em particular no meio artístico portuense. Pretende-se alcançar uma melhor leitura da posição do artista, de uma perspetiva profissional, estimado e respeitado pela sociedade e com uma maior ligação com a comunidade.
- Published
- 2022
7. Abnormal Uterine Bleeding in Adolescents: A Multidisciplinary Approach
- Author
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Fernanda Águas, Inês Ramalho, and Helena Leite
- Subjects
Adult ,medicine.medical_specialty ,Medicine (General) ,Physical examination ,uterine hemorrhage ,Quality of life (healthcare) ,R5-920 ,Multidisciplinary approach ,Medical advice ,menorrhagia ,medicine ,Humans ,Intensive care medicine ,Uterine Diseases ,medicine.diagnostic_test ,business.industry ,Uterine Hemorrhage ,Metrorrhagia ,General Medicine ,adolescent ,Quality of Life ,Hormonal therapy ,Medicine ,Female ,blood coagulation disorders ,Differential diagnosis ,medicine.symptom ,business ,metrorrhagia - Abstract
Abnormal uterine bleeding is the most common complaint that motivates female adolescents to seek medical advice. Abnormal uterine bleeding has a significant impact on quality of life, promoting school absenteeism and limitations in social life. Moreover, episodes can vary from mild to life threatening events if not recognized and treated promptly. Healthcare providers should be able to distinguish between a normal and abnormal menstrual pattern, as this may provide early diagnosis of a potential health concern. The PALM-COEIN classification system should be used in the evaluation. Anovulation is the most frequent cause, frequently due to immaturity of the hypothalamic-pituitary-ovarian axis. A careful history and physical examination are crucial in the differential diagnosis. Management is based on both the underlying cause and the severity of bleeding. Most patients improve with pharmacological treatment, frequently requiring a multidisciplinary approach. First line treatment consists of hormonal therapy. Surgery is rarely needed. Although the prevalence of abnormal uterine bleeding is higher in adolescents compared to adults, most recommendations are not specific for this age, which makes the diagnosis and management challenging. The literature reveals lack of standardized care for adolescents and regimens vary widely. Future studies on efficacy and safety of treatments specifically in adolescents are needed.A hemorragia uterina anormal constitui a queixa que mais frequentemente leva as adolescentes a procurar cuidados de saúde. Esta situação tem um impacto significativo na qualidade de vida, levando a absentismo escolar e limitações na vida social. Os episódios podem variar de ligeiros a potencialmente fatais, se não reconhecidos e tratados rapidamente. Os prestadores de cuidados de saúde devem ser capazes de distinguir um padrão menstrual anormal, uma vez que isto poderá permitir o diagnóstico precoce de um grave problema de saúde. A classificação de PALM-COEIN deve ser usada na avaliação. A causa mais frequente é a anovulação, frequentemente associada a imaturidade do eixo hipotálamo-hipófise-ovário. A história clínica e um exame objetivo cuidado são cruciais no diagnóstico diferencial. A abordagem terapêutica deve ser baseada na etiologia subjacente e gravidade da hemorragia, sendo frequentemente necessária uma intervenção multidisciplinar. A maioria das doentes melhora com tratamento farmacológico, cuja primeira linha é constituída pela terapêutica hormonal. O tratamento cirúrgico é raramente necessário. Apesar da prevalência ser superior em adolescentes, a maioria das recomendações não são específicas desta idade, o que dificulta o diagnóstico e abordagem. A literatura revela falta de uniformização de condutas em adolescentes e os esquemas posológicos são muito variáveis. Por este motivo, é fundamental a realização de estudos sobre a eficácia e segurança dos tratamentos nesta faixa etária.
- Published
- 2021
8. 'Prisoners within themselves': sociological study of aphasia and care practices
- Author
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Carvalho, Inês Ramalho and Costa, Daniel Neves da
- Subjects
Barreiras ,Facilitators ,Isolamento ,Afasia ,Loneliness ,Cuidado ,Aphasia ,Facilitadores ,Care ,Barriers - Abstract
Dissertação de Mestrado em Sociologia apresentada à Faculdade de Economia O presente trabalho procura fazer uma análise sociológica da afasia, um problema de origem biológica normalmente visto como dizendo apenas respeito à pessoa afetada, com o objetivo de assim o compreender enquanto uma questão social e pública. Este trabalho começa por fazer uma discussão da afasia com base na literatura especializada da saúde e das ciências sociais de modo a fazer a sua problematização de acordo com os modelos médico, biopsicossocial e social. A afasia é uma perturbação da linguagem com origem num AVC, que afeta a comunicação do indivíduo, e coloca em causa a sua autonomia e participação na sociedade. Este trabalho procura identificar e discutir as várias barreiras que existem à participação social, aceitação e inclusão das PcA. São identificadas e discutidas barreiras estruturais, atitudinais, de informação e ambientais. Estas barreiras são responsáveis pela discriminação, opressão e exclusão social das PcA, mas igualmente das suas famílias. Na verdade, estas barreiras funcionam como muros, que escondem não só a opressão social e o isolamento, mas também as pessoas com afasia e os seus cuidadores informais. O isolamento associado à afasia é um aspeto que ressalta deste trabalho. O envolvimento das famílias no acompanhamento e cuidado das PcA, cujo grau de dependência é grande, é marcado pela necessidade de desenvolver um conjunto de estratégias para facilitar a comunicação com a PcA e promover uma maior participação social. Este trabalho procurou igualmente tornar visível e discutir a realidade do cuidado na afasia. Para isso discute o papel dos cuidadores formais e informais de PcA, reflete sobre as suas experiências e opiniões, os desafios e dificuldades desta realidade.O cuidado informal é enaltecido durante o trabalho, pois esta é uma luta diária de todo o agregado familiar que se vê, também, isolado e dentro das barreiras impostas pela sociedade. Da análise das entrevistas sobressai a frustração de quem é cuidado (pessoa com afasia) e a angústia de quem cuida. Este trabalho procura tornar visível e discutir as barreiras que são colocadas às famílias, as desigualdades e formas de opressão social que são criadas pela sociedade, com a intenção de contribuir para uma mudança de paradigma, para a eliminação das barreiras à participação social das pessoas com afasia. A única barreira que deveria existir é uma barreira à opressão social. The present work seeks to make a sociological analysis of aphasia, a problem of biological origin usually seen as referring only to the affected person, with the aim of understanding it as a social and public issue. This work begins with a discussion of aphasia based on the specialized literature in health and social sciences to discuss it according to medical, biopsychosocial and social models. Aphasia is a language disorder originating from a stroke, which affects the individual's communication, and undermines their autonomy and participation in society.This work seeks to identify and discuss the many barriers that exist to social participation, acceptance, and inclusion of PwA. Structural, attitudinal, information and environmental barriers are identified and discussed. These barriers are responsible for discrimination, oppression, and social exclusion of the PwA, but also of their families. In fact, these barriers act as walls, hiding not only social oppression and isolation, but also people with aphasia and their informal caregivers. The isolation associated with aphasia is an aspect that stands out from this work.The involvement of families in the monitoring and care of PwA, whose degree of dependence is high, is marked by the need to develop a set of strategies to facilitate communication with the PwA and promote greater social participation. This work also sought to make visible and discuss the reality of care in aphasia. For this, it discusses the role of formal and informal caregivers of PwA, reflects on their experiences and opinions, the challenges, and difficulties of this reality.Informal care is highlighted during work, as this is a daily struggle for the entire household, which is also isolated and within the barriers imposed by society. From the analysis of the interviews, the frustration of those who are cared for (person with aphasia) and the anguish of those who are caring stand out. This work seeks to make visible and discuss the barriers that are placed on families, the inequalities and forms of social oppression that are created by society, with the intention of contributing to a paradigm shift, to the elimination of barriers to the social participation of people with aphasia. The only barrier that should exist is a barrier to social oppression.
- Published
- 2021
9. Submarine landslide tsunamis in SW Iberia Margin: Sensitivity of tsunamigenic potential and hazard extent to physical properties of marine sediments
- Author
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Aldina Piedade, Luís J.L. Lemos, José Grazina, Inês Ramalho, Davide Gamboa, and Rachid Omira
- Subjects
Margin (machine learning) ,Sensitivity (control systems) ,Geomorphology ,Hazard ,Geology ,Submarine landslide - Abstract
Slope instability is probably the most effective process shaping the seafloor of continental margins. This process often leads to the occurrence of submarine mass failures that, if large enough, can cause potential tsunamis. Yet, the dynamics of the landslide evacuated material and their induced tsunamigenic potential remain largely uncharacterized in most continental margins. This applies to the SW Iberia Margin, where large underwater landslide episodes have been evidenced.In this work, we investigate the sensitivity of landslide-generated tsunami to the physical properties of marine sediments involved in the slope failures in the SW Iberia Margin. This includes the landslide dynamics, the tsunamigenic potential and the tsunami hazard extent. Based upon the MAGICLAND (Marine Geo-hazards Induced by Underwater Landslides in the SW Iberian Margin) project database, we select promising sizable submarine landslide scenarios. We then use an in-house developed two-layer numerical code (based on a Bingham visco-plastic model for the landslide and a non-linear shallow water model for the tsunami) to simulate both the landslide dynamics and the induced tsunami generation and propagation.In a first stage, the numerical simulations are done considering uncertain sediments properties deduced from the literature. Next, we perform numerical simulations of the selected landslide scenarios using accurate geotechnical properties (mainly the in-situ shear strength obtained from undisturbed samples) determined by laboratory tests conducted on from the analysis of available marine gravity cores in the SW Iberian Margin. Results show that the geotechnical parameters significatively influence the simulation results of both the landslide dynamics and induced tsunami. Particularly, we noticed major effects on the landslide downslope deformation, failure speed, deposited thickness and run-out, which considerably control the momentum transferred to the generated tsunami wave. This demonstrates that the use of inappropriate material properties leads to a misquantification of landslide tsunamigenesis and hazard extent.This work was financed by national funds through FCT—Portuguese Foundation for Science and Technology, I.P., under the framework of the project MAGICLAND – Marine Geo-hazards Induced by Underwater Landslides in the SW Iberian Margin (PTDC/ CTA-GEO/30381/2017).
- Published
- 2021
10. A avaliação subjetiva de estímulos emocionais e a relação com a cognição na Lesão Cerebral Adquirida
- Author
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Azevedo, Maria Inês Ramalho de and MONTEIRO, LUÍS MANUEL COELHO
- Subjects
Ativação ,Lesão cerebral adquirida ,Funcionamento cognitivo ,Valência ,Funcionamento executivo - Abstract
A lesão cerebral adquirida (LCA) conduz frequentemente a sequelas incapacitantes nos domínios emocional e cognitivo, que possuem implicações no posterior ajustamento pessoal, social e vocacional desta população. No que respeita à experiência emocional subjetiva na LCA, a investigação não é consensual e possui um foco predominante no afeto facial. Com efeito, este estudo pretendeu, como objetivo primário, averiguar se a LCA conduz a um comprometimento na capacidade de avaliar subjetivamente imagens evocativas complexas que representam aspetos da vida real e quotidiana. Por outro lado, não é totalmente clara a relação entre o processamento emocional desta população e as alterações cognitivas que frequentemente exibem. Deste modo, procurou-se compreender esta relação num segundo objetivo deste estudo. Métodos: Doze imagens de conteúdo agradável, neutro e desagradável, selecionadas a partir do International Affective Picture System (IAPS), foram apresentadas a 52 participantes com LCA e 33 indivíduos saudáveis do grupo de controlo que as avaliaram nas escalas de valência e de ativação do Self-Assessment Manikin (SAM). Foram ainda administrados o Montreal Cognitive Assessment (MoCA) e o INECO Frontal Screening (IFS) ao grupo com LCA, visando avaliar o desempenho cognitivo geral e o funcionamento executivo destes indivíduos, respetivamente. Resultados: Os grupos apresentaram diferenças significativas na avaliação subjetiva dos estímulos. Mais especificamente, os pacientes com LCA avaliaram as imagens agradáveis como mais agradáveis e as desagradáveis como mais desagradáveis em comparação ao grupo de controlo. Além disso, os indivíduos com LCA avaliaram as imagens agradáveis e neutras como mais ativadoras relativamente aos controlos. O grupo com LCA evidenciou ainda défices no desempenho cognitivo geral e no funcionamento executivo em particular. Contudo, não foi encontrada nenhuma relação significativa entre estes défices e as diferenças na sua resposta subjetiva aos estímulos. Conclusão: Os nossos resultados evidenciam que os indivíduos com LCA apresentam um comprometimento na capacidade de avaliação dos estímulos emocionais em termos de valência e ativação. Salientam também a importância de considerar as alterações no processamento emocional como um objetivo de intervenção nos programas de reabilitação neuropsicológica. Os resultados reforçam ainda a necessidade da continuidade da investigação neste âmbito e da clarificação da interação entre o processamento emocional e o funcionamento cognitivo nesta população. Acquired brain injury (ABI) frequently results in disabling consequences in the emotional and cognitive domains, which in turn has implications for the subsequent personal, social and vocational adjustment of this population. Regarding self-reported emotional experience in ABI, research is still not consensual and focuses predominantly on facial affect. Therefore, the primary goal of this study was to examine whether ABI leads to an impairment in the ability to subjectively rate emotionally evocative pictures that represent real and everyday life aspects. On the other hand, the relationship between the emotional processing and the cognitive deficits that ABI individuals frequently present is not totally clear. Thus, we also aimed to better understand this relationship as a second goal of this study. Methods: Twelve pictures with pleasant, neutral and unpleasant content selected from the International Affective Picture System (IAPS) were presented to 52 patients with ABI and 33 control participants and subjects rated them on the valence and arousal scales from the Self-Assessment Manikin (SAM). In the ABI group, the Montreal Cognitive Assessment (MoCA) and the INECO Frontal Screening (IFS) were also administered in order to assess the general cognitive performance and executive functioning of these individuals, respectively. Results: Subjective ratings differed significatively between groups. More specifically, ABI patients rated the pleasant pictures as more pleasant and the unpleasant pictures as more unpleasant than controls. Furthermore, the ABI group rated the pleasant and neutral pictures as more arousing than control participants. In addition, patients showed deficits in general cognitive performance and executive functioning in particular. However, no significant association was found between these deficits and the aforementioned differences in their subjective ratings. Conclusion: Our results indicate that ABI individuals show an impaired ability to rate emotional stimuli according to valence and arousal. Moreover, the results highlight the importance of addressing the emotional processing impairments within neuropsychological rehabilitation programs and the need for more research in this field, as well as further clarification of the interaction between emotional processing and cognitive functioning in the ABI population.
- Published
- 2021
11. Metabolic modulation in paused-like pluripotency
- Author
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Sousa, Maria Inês Ramalho de Almeida e and Santos, João Ramalho de Sousa
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Pluripotency ,Metabolismo ,Metabolism ,Diapausa ,Pluripotência ,Proliferation ,mTOR ,Ciências Naturais::Ciências Biológicas [Domínio/Área Científica] ,Diapause ,Proliferação - Published
- 2020
12. Geotechnical properties of marine sediments in the SW Iberia Margin – Implications to marine geohazards
- Author
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Aldina Piedade, Mário Quinta-Ferreira, Nicole Santos, Luís J.L. Lemos, Cristina Roque, Rachid Omira, and Inês Ramalho
- Subjects
Margin (machine learning) ,Geochemistry ,Geology - Abstract
Submarine mass-failures are recognized worldwide as a potential source of marine geo-hazards. They can compromise the safety and integrity of seafloor and subsurface infrastructures through destroying offshore installations or triggering potential tsunamis. This applies to the SW Iberia Margin, where the occurrence of damaging and tsunamigenic underwater landslides were evidenced in various research works.This work assesses the geotechnical properties of the marine sediments forming the slopes of the SW Iberia Margin and provides implications to the marine geohazard in the region. Taking advantage of the availability of the cores from previous projects and expeditions (i.e. CONDRIBER, and IODP Expedition-339), we perform conventional Triaxial laboratory tests. These tests allow determining the in-situ shear strength and stress deformation properties, pre-and post-rupture of the undisturbed sediments.Furthermore, we present, through a landslide case-study in the SW Iberia Margin, a sensitivity analysis of the marine geohazards (sliding mass drag forces and tsunamigenesis) to the geotechnical properties of the marine sediments. We demonstrate that the geotechnical analysis is crucial for an accurate modelling of the submarine mass movements, their impact on offshore installations, and their induced tsunamis.This work was financed by national funds through FCT—Portuguese Foundation for Science and Technology, I.P., under the framework of the project MAGICLAND – Marine Geo-hazards Induced by Underwater Landslides in the SW Iberian Margin (PTDC/ CTA-GEO/30381/2017).
- Published
- 2020
13. Breech Presentation: Vaginal Versus Cesarean Delivery, Which Intervention Leads to the Best Outcomes?
- Author
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Joana Curado, Rita de Cássia Ribeiro Silva, Ana Galvão, Sandra Valdoleiros, Luís M. Graça, Ana Carocha, Ana Raquel Neves, Nisa Felix, Daniela C. Gonçalves, Carla Peixoto, Inês Ramalho, A. M. M. Fonseca, Maria João Palma, Nuno Clode, Inês Rato, Isabel Antunes, and Zita Ferraz
- Subjects
Adult ,medicine.medical_specialty ,Neonatal intensive care unit ,Birth weight ,lcsh:Medicine ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Breech presentation ,Pregnancy ,Medicine ,Humans ,Breech Presentation ,Cesarean Section ,Delivery, Obstetric ,030212 general & internal medicine ,reproductive and urinary physiology ,Retrospective Studies ,Gynecology ,lcsh:R5-920 ,030219 obstetrics & reproductive medicine ,Breech Presentation/therapy ,business.industry ,Vaginal delivery ,Apresentação Pélvica ,Cesariana ,Parto Obstétrico ,lcsh:R ,Infant, Newborn ,Pregnancy Outcome ,Gestational age ,Retrospective cohort study ,Obstetric ,General Medicine ,medicine.disease ,female genital diseases and pregnancy complications ,Female ,MAC OBS ,business ,lcsh:Medicine (General) ,Delivery ,Cohort study - Abstract
The best route of delivery for the term breech fetus is still controversial. We aim to compare maternal and neonatal outcomes between vaginal and cesarean term breech deliveries.Multicentric retrospective cohort study of singleton term breech fetuses delivered vaginally or by elective cesarean section from January 2012 - October 2014. Primary outcomes were maternal and neonatal morbidity or mortality.Sixty five breech fetuses delivered vaginally were compared to 1262 delivered by elective cesarean. Nulliparous women were more common in the elective cesarean group (69.3% vs 24.6%; p0.0001). Gestational age at birth was significantly lower in the vaginal delivery group (38 ± 1 weeks vs 39 ± 0.8 weeks; p = 0.0029) as was birth weight (2928 ± 48.4 g vs 3168 ± 11.3 g; p0.0001). Apgar scores below seven on the first and fifth minutes were more likely in the vaginal delivery group (1st minute: 18.5% vs 5.9%; p = 0.0006; OR 3.6 [1.9 - 7.0]; 5th minute: 3.1% vs 0.2%; p = 0.0133; OR 20.0 [2.8 - 144.4]), as was fetal trauma (3.1% vs 0.3%: p = 0.031; OR 9.9 [1.8-55.6]). Neither group had cases of fetal acidemia. Admission to the Neonatal Intensive Care Unit, maternal postpartum hemorrhage and the incidence of other obstetric complications were similar between groups.Although vaginal breech delivery was associated with lower Apgar scores and higher incidence of fetal trauma, overall rates of such events were low. Admission to the neonatal intensive care unit and maternal outcomes were similar.Both delivery routes seem equally valid, neither posing high maternal or neonatal complications' incidence.Introdução: A melhor via de parto do feto pélvico de termo ainda é controversa. Pretendemos comparar desfechos maternos e neonatais entre partos vaginais e cesarianas de fetos pélvicos de termo. Material e Métodos: Estudo de coorte, multicêntrico e retrospetivo, incluindo gestações de feto único de termo, em apresentação pélvica, que terminaram em parto vaginal ou cesariana eletiva entre janeiro de 2012 e outubro de 2014. Os desfechos primários foram a morbilidade e mortalidade maternas e neonatais. Resultados: Sessenta e cinco partos vaginais foram comparados com 1262 cesarianas eletivas. As nulíparas foram mais frequentes no grupo das cesarianas (69,3% vs 24,6%; p0,0001). A idade gestacional foi inferior nos partos vaginais (38 ± 1 semanas vs 39 ± 0,8 semanas; p = 0,0029), verificando-se o mesmo para o peso ao nascer (2928 ± 48,4 g vs 3168 ± 11,3 g; p0,0001). Índices de Apgar7 foram mais frequentes nos partos vaginais (1º minuto: 18,5% vs 5,9%; p = 0,0006; OR 3,6 [1,9 - 7,0]; 5º minuto: 3,1% vs 0,2%; p = 0,0133; OR 20,0 [2,8 - 144,4]). Verificou-se também uma maior incidência de traumatismo fetal neste grupo (3,1% vs 0,3%; p = 0,031; OR 9,9 [1,8 - 55,6]). Nenhum grupo teve casos de acidemia fetal. As taxas de internamento na unidade de cuidados intensivos neonatais, de hemorragia materna pós-parto ou de outras complicações obstétricas foram idênticas. Discussão: O parto vaginal associou-se a índices de Apgar inferiores e a uma maior incidência de traumatismo fetal, com taxas globalmente baixas. Não se verificaram diferenças nas taxas de internamento neonatal nem nos desfechos maternos. Conclusão: Ambas as vias de parto parecem adequadas, nenhuma condicionando incidências elevadas de complicações maternas ou neonatais.
- Published
- 2017
14. Live birth after treatment of a spontaneous ovarian heterotopic pregnancy: A case report
- Author
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Fernanda Águas, Iolanda Ferreira, Inês Ramalho, José Paulo Moura, Teresa Rebelo, António Lobo, João Paulo Marques, and Maria João Carvalho
- Subjects
medicine.medical_specialty ,Abdominal pain ,Gestational sac ,Iliac fossa ,lcsh:Surgery ,Ovarian pregnancy ,lcsh:Gynecology and obstetrics ,Article ,03 medical and health sciences ,0302 clinical medicine ,medicine ,030212 general & internal medicine ,Hemoperitoneum ,lcsh:RG1-991 ,Pregnancy ,030219 obstetrics & reproductive medicine ,Heterotopic pregnancy ,business.industry ,Obstetrics ,Laparoscopic management ,Obstetrics and Gynecology ,Gestational age ,lcsh:RD1-811 ,medicine.disease ,medicine.anatomical_structure ,medicine.symptom ,business - Abstract
Highlights • Spontaneous heterotopic pregnancy occurs in 1/30000 pregnancies, with an allocation to the ovary on solely 2.3% of cases. • Heterotopic pregnancy diagnosis requires a high index of suspicion and systematic gynecological ultrasound examination. • Correct diagnosis is extremely important to provide the best care while preserving the intrauterine pregnancy., Spontaneous heterotopic pregnancies occur in about 1/30000 pregnancies, with the ovarian subtype comprising 2.3% of the total. We report the case of a healthy 32-year-old woman, gravida 4, para 3, who presented to the emergency room with severe abdominal pain. Two weeks earlier, pelvic ultrasound had revealed a 6-week intrauterine pregnancy. She was hemodynamically stable, but had rebound tenderness on the right iliac fossa. Transvaginal ultrasound revealed an evolutive intrauterine pregnancy with a gestational age (GA) of 8 weeks, with a synchronous evolutive adnexal pregnancy of the same GA and some free fluid in the pouch of Douglas. She underwent an urgent laparoscopy which showed an intact gestational sac containing an embryo on the right ovary associated with mild hemoperitoneum. An ovarian wedge resection was performed to preserve ovarian tissue. The intrauterine pregnancy had no complications and the patient delivered vaginally at term. Heterotopic pregnancy is potentially life-threatening. Despite being extremely rare after natural conception, and even more so in the absence of major risk factors, it should be considered in any pregnant woman with abdominal pain. A high index of suspicion is important for a prompt diagnosis, selection of the appropriate surgical treatment and successful obstetric outcomes.
- Published
- 2019
15. Deep-water seamounts, a potential source of tsunami generated by landslides? The Hirondelle Seamount, NE Atlantic
- Author
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Rachid Omira, Inês Ramalho, Nevio Zitellini, Pedro Terrinha, Maria Ana Baptista, and Luis Batista
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geography ,geography.geographical_feature_category ,Deep-water seamount ,010504 meteorology & atmospheric sciences ,Seamount ,Submarine mass-failures ,Submarine ,Geology ,Landslide ,010502 geochemistry & geophysics ,Oceanography ,01 natural sciences ,Deep water ,Tsunamigenic potential ,Geochemistry and Petrology ,Bathymetry ,Potential source ,Submarine pipeline ,NE Atlantic ,Seismology ,0105 earth and related environmental sciences ,Submarine landslide - Abstract
Submarine mass failures represent one of the most significant marine geo-hazards. Their importance as a major contributor to tsunami generation and hazard has been recognized over the last 20–30 years. This study investigates a newly mapped submarine landslide, the South Hirondelle Landslide (SHL), and its potential to generate a tsunami and to threat the surrounding coasts. The SHL is located 150 km offshore South West Iberia, along the southern flank of the Hirondelle Seamount. Here, available swath bathymetry and one multichannel seismic profile show the presence of large, geometrically well constrained, deep-water landslide deposit of about 500 km 3 and its associated scar. The failure likely occurred in one single event and according to a detailed numerical modelling of the landslide dynamics and of the resulting water propagation the mass failure generated a mega-tsunami, with significant impact along the surrounding coastal areas of Iberia and Morocco. This result strongly supports the inclusion of tsunami induced by deep-water submarine landslides in the marine geo-hazard assessment of the North East Atlantic region.
- Published
- 2016
16. Tsunami-induced morphological change – A model-based impact assessment of the 1755 tsunami in NE Atlantic from the Morocco coast
- Author
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Maria Ana Baptista, Rachid Omira, Mohamed Najib Zaghloul, Inês Ramalho, and S. El Moussaoui
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010504 meteorology & atmospheric sciences ,Tsunami ,Sediment ,Shoaling and schooling ,010502 geochemistry & geophysics ,01 natural sciences ,Deposition (geology) ,Oceanography ,Breakwater ,Erosion ,Geomorphological changes ,Submarine pipeline ,Alteração Geomorfológica ,Sediment transport ,Bay ,Geology ,0105 earth and related environmental sciences ,Earth-Surface Processes - Abstract
Tsunamis can be responsible for coastal geomorphic crises. Extensively inundated coasts can suffer widespread and dramatic changes in their morphology due to sediment erosion, transport, and deposition processes. In this paper, we investigate the tsunami-induced morphological changes on coasts prone to inundation and how sediment transport is controlled by both tsunami and sediment characteristics. We focus on a tsunami-prone coast in the NE Atlantic, Tangier-Morocco, that experienced the 1755 Lisbon tsunami. We use a coupled hydrodynamic and morphodynamic numerical model, together with high-resolution digital elevation and sedimentary models, to simulate the impact of tsunamis on the morphology and sediment distribution of Tangier Bay. Due to the uncertainty on the source and effects of the 1755 event, we consider two 1755-like tsunamigenic scenarios that have the potential to cause different levels of inundation. Results show that the coastal zone of Tangier can undergo substantial changes in morphology and sediment distribution following the tsunami impact. For the selected scenarios, the volume of sediments mobilized, at both the offshore and onshore zones of the Tangier site, ranges from 30,000 to 200,000 m3. Moreover, the presence of mobile sediments and conditions favoring tsunami shoaling lead to an increase in wave impact on the coastal configuration. Conversely, the presence of the breakwaters helps to protect the Tangier coast by limiting the extent of the affected area. The results of this study suggest that the assessment of tsunami-induced coastal impact should include the effect on morphology.
- Published
- 2018
17. Projeto : Meu Porto Seguro
- Author
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Catarino, Inês Ramalho Ortigão and Vieira, Isabel Maria Paula Amado de Freitas
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Comunidade ,Human dignity ,Dementia ,Dignidade humana ,Cuidar ,Community ,Care ,Ciências Sociais::Outras Ciências Sociais [Domínio/Área Científica] ,Innovation ,Empreendedorismo social e inovação ,Social entrepreneurship ,Demência - Abstract
Submitted by Maria Helena Ribeiro (helena.ribeiro@lisboa.ucp.pt) on 2020-01-28T12:26:50Z No. of bitstreams: 1 Dissertação Ines catarino.pdf: 4667470 bytes, checksum: e9b526494e3f8e875d7bdfc5f5d8da3e (MD5) Approved for entry into archive by Maria Helena Ribeiro (helena.ribeiro@lisboa.ucp.pt) on 2020-01-28T12:27:02Z (GMT) No. of bitstreams: 1 Dissertação Ines catarino.pdf: 4667470 bytes, checksum: e9b526494e3f8e875d7bdfc5f5d8da3e (MD5) Made available in DSpace on 2020-01-28T12:27:02Z (GMT). No. of bitstreams: 1 Dissertação Ines catarino.pdf: 4667470 bytes, checksum: e9b526494e3f8e875d7bdfc5f5d8da3e (MD5) Previous issue date: 2018-03-09
- Published
- 2017
18. The Tsunami Effects of a Collapse of a Volcanic Island on a Semienclosed Basin
- Author
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Maria Ana Baptista, Neil C. Mitchell, Inês Ramalho, Rachid Omira, and Rui Quartau
- Subjects
010504 meteorology & atmospheric sciences ,Volcanic island ,Tsunami hazard ,Collapse (topology) ,Numerical modeling ,Structural basin ,010502 geochemistry & geophysics ,01 natural sciences ,Seismology ,Geology ,0105 earth and related environmental sciences - Published
- 2016
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