Publications by authors named "Eduardo Portela"

4 Publications

  • Page 1 of 1

Is This Contrast? Is This Blood? An Agreement Study on Post-thrombectomy Computed Tomography Scans.

Front Neurol 2020 22;11:593098. Epub 2020 Dec 22.

Ottawa Stroke Program, Department of Medicine (Neurology), University of Ottawa, Ottawa, ON, Canada.

Hemorrhagic transformation after acute ischemic stroke is a dreaded and severe complication of thrombolysis and thrombectomy. However, its detection on post-thrombectomy conventional non-contrast computed tomography (CT) scan can be complicated by the frequent (and sometimes concomitant) presence of contrast, resulting in changes in management. Our objective was to assess the inter- and intra-rater reliability for the detection of blood and/or contrast on day-1 post-thrombectomy CT scans. A total of 18 raters across 3 different specialties independently examined 30 post-thrombectomy CT scans selected from the Aspiration vs. STEnt-Retriever (ASTER) trial. They were asked to judge the presence of blood and contrast. Thirty days later, the same 18 raters again independently judged the 30 scans, in randomized order. Agreement was measured with Fleiss' and Cohen's statistics. Overall agreement on blood and/ or contrast presence was only fair, = 0.291 (95% CI = 0.273-0.309). There were 0 scans with consensus among the 18 readers on the presence of blood and/or contrast. However, intra-rater global agreement across all 18 physicians was relatively high, with a median kappa value of 0.675. This intra-rater consistency was seen across all specialties, regardless of level of training. Physician judgment for the presence of blood and/or contrast on day-1 post-thrombectomy non-contrast CT scan shows limited inter-observer reliability. Advanced imaging modalities may then be warranted for challenging clinical cases.
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http://dx.doi.org/10.3389/fneur.2020.593098DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7783397PMC
December 2020

Is This Contrast? Is This Blood? An Agreement Study on Post-thrombectomy Computed Tomography Scans.

Front Neurol 2020 22;11:593098. Epub 2020 Dec 22.

Ottawa Stroke Program, Department of Medicine (Neurology), University of Ottawa, Ottawa, ON, Canada.

Hemorrhagic transformation after acute ischemic stroke is a dreaded and severe complication of thrombolysis and thrombectomy. However, its detection on post-thrombectomy conventional non-contrast computed tomography (CT) scan can be complicated by the frequent (and sometimes concomitant) presence of contrast, resulting in changes in management. Our objective was to assess the inter- and intra-rater reliability for the detection of blood and/or contrast on day-1 post-thrombectomy CT scans. A total of 18 raters across 3 different specialties independently examined 30 post-thrombectomy CT scans selected from the Aspiration vs. STEnt-Retriever (ASTER) trial. They were asked to judge the presence of blood and contrast. Thirty days later, the same 18 raters again independently judged the 30 scans, in randomized order. Agreement was measured with Fleiss' and Cohen's statistics. Overall agreement on blood and/ or contrast presence was only fair, = 0.291 (95% CI = 0.273-0.309). There were 0 scans with consensus among the 18 readers on the presence of blood and/or contrast. However, intra-rater global agreement across all 18 physicians was relatively high, with a median kappa value of 0.675. This intra-rater consistency was seen across all specialties, regardless of level of training. Physician judgment for the presence of blood and/or contrast on day-1 post-thrombectomy non-contrast CT scan shows limited inter-observer reliability. Advanced imaging modalities may then be warranted for challenging clinical cases.
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http://dx.doi.org/10.3389/fneur.2020.593098DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7783397PMC
December 2020

Brazilian version of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E).

Epilepsy Behav 2010 Nov 21;19(3):328-31. Epub 2010 Aug 21.

Neuropsychiatric Unit, Neurology Division, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.

Objective: The purpose of this research was to evaluate the Brazilian-Portuguese version of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) and to assess its psychometric properties.

Methods: This study involved 98 outpatients who underwent psychopathological evaluation with the Mini International Neuropsychiatric Interview-Plus Version, Hamilton Depression Scale (HAM-D), and a Portuguese version of the NDDI-E.

Results: The NDDI-E was easily understood and quickly administered to most of the patients. At a cutoff score >15, NDDI-E had a sensitivity of 81.5%, a specificity of 83.1%, and a negative predictive value of 92.2% for diagnosis of major depression. Internal consistency reliability of the NDDI-E was 0.79, and there was also a positive correlation between the NDDI-E and the HAM-D (P<0.001).

Conclusion: The Brazilian-Portuguese version of NDDI-E can be used as a practical screening tool to improve recognition of depression in Brazilian people with epilepsy.
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http://dx.doi.org/10.1016/j.yebeh.2010.07.013DOI Listing
November 2010

Psychiatric disorders in temporal lobe epilepsy: an overview from a tertiary service in Brazil.

Seizure 2010 Oct 13;19(8):479-84. Epub 2010 Aug 13.

Neuropsychiatric Unit, Neurology Division, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.

Purpose: To evaluate the frequency and intensity of psychiatric disorders in a group of temporal lobe epilepsy (TLE) patients from a tertiary-care center.

Methods: Clinical and sociodemographic data of 73 patients were collected and a neuropsychiatric evaluation was performed with the following instruments: Mini-Mental State Examination (MMSE), structured clinical interview (MINI-PLUS), Hamilton Anxiety Scale (HAM-A), Hamilton Depression Scale (HAM-D), Brief Psychiatric Rating Scale (BPRS).

Results: Patients with TLE showed a high frequency of lifetime psychiatric disorders (70%), the most frequent being mood disorders (49.3%). At assessment, 27.4% of the patients were depressed and 9.6% met criteria for bipolar disorder. Nevertheless, depression had not been properly diagnosed nor treated. Anxiety disorders were also frequent (42.5%), mainly generalized anxiety disorder (GAD) (21.9%). Obsessive compulsive disorder (OCD) was present in 11.0% and psychotic disorders in 5.5% of the sample. Patients with left mesial temporal sclerosis (LMTS) exhibited more psychopathologic features, mainly anxiety disorders (p=0.006), and scored higher on HAM-A and HAM-D (p<0.05 in both).

Conclusion: TLE is related to a high frequency of psychiatric disorders, such as anxiety and depression, which are usually underdiagnosed and undertreated. Damage to the left mesial temporal lobe, seen in LMTS, seems to be an important pathogenic lesion linked to a broad range of psychopathological features in TLE, mainly anxiety disorders. The present study prompts discussion on the recognition of the common psychiatric disorders in TLE, especially on the Brazilian setting.
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http://dx.doi.org/10.1016/j.seizure.2010.07.004DOI Listing
October 2010