Rita Mendes - Academia.edu (original) (raw)

Papers by Rita Mendes

International Journal of Medical Reviews and Case Reports

The May–Thurner Syndrome (MTS) is a rare anatomical condition in which the compression of the lef... more The May–Thurner Syndrome (MTS) is a rare anatomical condition in which the compression of the left common iliac vein by the right common iliac artery causes an outflow obstruction, presenting frequently as chronic venous insufficiency or deep venous thrombosis (DVT). This variant is rarely considered when investigating DVT, especially in patients with other risk factors. MTS requires careful workup and management to avoid complications such as chronic venous insufficiency, post-thrombotic syndrome, and primary lymphedema. The authors present a 63-year-old woman admitted to the emergency department with a 24-hour history of left lower limb pain and edema. Initial assessment, with computed tomography of the lower left limb and pelvis, showed compression of the left common iliac vein with an extensive thrombus of the left common iliac and external iliac veins, as well as femoral and popliteal left veins, consistent with MTS. Therapeutic enoxaparin initially implemented, was then switch...

European Journal of Internal Medicine, 2009

Background: Aortoenteric fistula(AEF) is a rare and deadly vascular complication usually secondar... more Background: Aortoenteric fistula(AEF) is a rare and deadly vascular complication usually secondary to aortic aneurysmal graft repair causing massive bleeding. Recurrent AEF, years after the initial repair, is an even rarer occurrence. Case presentation: We present a case of a 58 year old male with history of abdominal aortic aneurysm, who was brought to the emergency department (ED) after being found unresponsive with a visual approximation by EMT of 500ml of bright red blood per rectum. Unlike many previous case reports our patient's recurrent fistula occurred years after second repair in 2012. Conclusions: Although rare, abdominal aortic aneurysm (AAA) repair can form enteric fistula causing massive bleeding which is a medical emergency. Patient can present with hemodynamic instability. Urgent vascular imaging and repair is necessary for the management.

International Journal of Medical Reviews and Case Reports, 2023

European Journal of Case Reports in Internal Medicine, 2017

Background: Human intestinal spirochetosis is a condition defined by the presence of spirochetes ... more Background: Human intestinal spirochetosis is a condition defined by the presence of spirochetes attached to the colonic epithelium. Brachyspira aalborgi and Brachyspira pilosicoli may cause the disease in humans. Case report: We describe the case of a 58-year-old patient who presented with epigastric abdominal pain and diarrhoea. He was thought to be having a myocardial infarction and underwent an angiogram with subsequent stenting of the circumflex coronary artery. However, the pain and diarrhoea were still present after the procedure and the patient now had sepsis. An exploratory laparotomy was inconclusive. The patient improved on intravenous antibiotics and was discharged, but returned to the emergency department 2 days later with the same complaints. He was then admitted to an internal medicine ward where the diagnosis of intestinal spirochetosis was made. The patient was started on metronidazol and completed a 10-day antibiotic course with full recovery of his symptoms. Conclusion: This case highlights the importance of an internist-based approach that could have prevented two invasive procedures and the accompanying risks. LEARNING POINTS • Uncommon causes of diarrhoea are a diagnostic challenge. • Errors of clinical judgement can lead to invasive and potentially harmful procedures. • An internist-based approach can prevent diagnostic mistakes and be in the patient's best interests.

European Journal of Case Reports in Internal Medicine, 2017

Patients who survive a traumatic brain injury (TBI) can sometimes experience symptoms of excessiv... more Patients who survive a traumatic brain injury (TBI) can sometimes experience symptoms of excessive sympathetic discharge. Despite being known about for more than 60 years, the diagnostic criteria for this condition have only recently been defined under the name "paroxysmal sympathetic hyperactivity". Failure to recognize this syndrome leads to excessive costs, prolonged hospital stays and delayed recovery for TBI patients. This case report describes a patient whose specific rehabilitation program was affected by a failure to identify this entity, even though he presented with many of the characteristics of this condition.

European Journal of Case Reports in Internal Medicine, 2017

Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) is a common cause of euvolemic h... more Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) is a common cause of euvolemic hyponatremia which has many possible etiologies such as tumors (mainly lung cancers). We present a case of a 79-year old women hospitalized due to microcytic anemia with transfusion need and hyponatremia due to SIADH. Three primary tumors without known metastasis were discovered. The case shows the importance of studying causes of hyponatremia. LEARNING POINTS • Hyponatremia is a common electrolytic disorder during hospitalization and is associated with greater mortality. • Correction of hyponatremia, cause can be devastating unless the underlying causes are investigated as it can be caused by severe diseases. • Cancer must be excluded in the absence of an obvious etiology of SIADH (drugs, pulmonary and nervous system disorders).

We describe the clinical case of a 32-year-old woman with a previous diagnosis of thyroiditis, me... more We describe the clinical case of a 32-year-old woman with a previous diagnosis of thyroiditis, medicated with levothyroxin, and with a family history of hypothyroidism (sister). During the first term of pregnancy, a clinical state of worsening asthenia began, with inability to gain weight (3Kg throughout the pregnancy), alopecia, and hyperpigmentation of the skin and mucosal surfaces. These symptoms persisted

Resumo Descreve-se o caso de uma doente de 32 anos com o diagnóstico prévio de tiroidite, medicad... more Resumo Descreve-se o caso de uma doente de 32 anos com o diagnóstico prévio de tiroidite, medicada com levotiroxina e história familiar de hipotiroidismo (irmã). Durante o primeiro trimestre de gravidez iniciou quadro de agravamento progressivo de astenia marcada, incapacidade de ganho ponderal (3kg no total de tempo de gravidez), alopécia e hiperpigmentação generalizada da pele e mucosas. Manteve a