Search PubMed⌕ Search

Biomedical subjects

F Godinho

Publications and source records attributed to F Godinho.

24 records · Page 2Linked to original sources
PubMedDate not supplied

[Predictive factors of hospital and 6-month morbidity and mortality in hospitalized elderly patients].

This article presents the results of a prospective multivariable study of elderly patients aged over 70 years, hospitalized in an Internal Medicine Department of a Central Lisbon Hospital. The study aimed to identify, at the beginning of hospital admission (HA), predictive factors of hospital mortality (HM) and mortality at 6 months, of duration of HA, of admission to a nursing home at the time of discharge and during a period of 6 months thereafter and of hospital readmission during the 6 months following discharge. The study included 158 patients with a mean hospital stay of 15 days and a hospital mortality of 12%. The main pathologies responsible for hospital admission were cerebrovascular accident (22%), heart failure (20%) and pneumonia (16%). Mortality at 6 months was 29% and hospital readmission in the 6 months thereafter was 24%. When the patient was cared for by the spouse there was a statistically significant correlation with a shorter duration of admission (p = 0.006). Mean hospital stay was not significantly associated with any other variable. A subjective medical evaluation (SME) at the start of HA (p = 0.001), a low Barthel score prior to and at the time of HA, low serum albumin (p = 0.001) and a high leucocyte count (p = 0.005) were correlated with a higher HM. Nursing home admission was only positively correlated with cerebrovascular pathology. Mortality at 6 months was significantly correlated with the SME (p = 0.001), a low Barthel score prior to admission (p < 0.008) and at the time of HA (p < 0.001), nursing home residency (p < 0.005) and a low mental test score (p < 0.01). Hospital readmission at 6 months was influenced by the SME (p < 0.04) and by the reduction in the Barthel score caused by the illness and HA (p = 0.004). These correlations enabled the development of mathematical models that predict HM and mortality at 6 months and admission to a nursing home at the time of discharge and during a period of 6 months thereafter. They could be important in identifying elderly patients' needs early in the hospital admission and in the improvement of the strategy necessary for a successful and dignified hospital discharge.

Aged↗
PubMedDate not supplied

Safety of leflunomide plus infliximab combination therapy in rheumatoid arthritis.

OBJECTIVE: To analyse the safety of leflunomide plus infliximab combination therapy, in adult rheumatoid arthritis (RA) patients. PATIENTS: A retrospective study of 17 adult patients with active RA (DAS 28 = 5.94 +/- 0.88 at baseline) who were treated with a combination of leflunomide plus infliximab after failure of treatment with other DMARDs. 13 patients were treated for a minimum of 3 months with leflunomide without toxicity before beginning infliximab. Treatment was begun simultaneously with both drugs in 4 patients. Side effects (clinical and biological) and efficacy (DAS 28) were evaluated at each infliximab infusion (3 mg/kg at week 0, 2, 6 and then every 8 weeks). RESULTS: Thirteen patients experienced 20 types of side effects and 8 of them stopped the combination therapy. The causes of discontinuation were congestive heart failure (1 case), hypertension with thoracic pain (2 cases), eczematous skin patches (2 cases) and neutropenia (3 cases). No death was registered. Nine RA patients continuted the therapy with a median follow-up of 22 weeks. Only 4 of them experienced no side effects. Eight patients were positive for antinuclear antibodies (ANA) and 1 for double-stranded DNA (dsDNA) antibodies at study entry. After treatment, 13 and 5 patients tested positive respectively for ANAs and dsDNA antibodies. There was no relationship between discontinuation and ANA/dsDNA positivity. CONCLUSION: In this cohort, adverse events were not very different from those seen in patients on either treatment alone and the combination of leflunomide plus infliximab did not appear to be as badly tolerated as described in a previous study.

Adjuvants, Immunologic↗
PubMedDate not supplied

[A comparative study of gallbladder function using echography and HIDA-CCK].

This paper compares two methods of evaluating gall-bladder function after stimulation with cholecystokinin (CCK); One, the echographic method, permits the gall-bladder contraction study by determining variations in face area of the organ. The other, the scintigraphic method (HIDA-CCK test), studies of the gall-bladder emptying registering the decreases of activity by external counts. Out of 20 studies performed: 8 cases presented a contractile response and normal emptying; 7 had an abnormality late initial response (Ti) and contraction and emptying (defined by T1/2) slower than normal. In the 5 patients the gall-bladder traced with HIDA did not respond to CCK. Within this group, one patient had an incomplete painful contraction, evaluation by echography. The onset of pain or sub-costal discomfort was a variable finding within the different study groups. The linear coefficient correlation for the normal group and for the patients with late response was 0.8255 (x = 2.216 gamma-4.59). Based on these data and taking into account cheaper cost, patient comfort, and greater availability of equipment, the echographic method for studying gall-bladder contraction after administration of CCK, can be used instead of the HIDA-CCK procedure.

Adolescent↗