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- 3 anos de gastroenterites agudas bacterianas num serviço de pediatriaPublication . Paiva-Pereira, H; Cró-Braz, M; Menezes, MF; Neto, AS
- 3 anos de gastroenterites agudas bacterianas num serviço de pediatriaPublication . Paiva-Pereira, M; Braz, MC; Menezes, MF; Neto, AS
- Accuracy of prenatal culture in predicting intrapartum group B streptococcus colonization statusPublication . Florindo, C; Damião, V; Lima, J; Nogueira, I; Rocha, I; Caetano, P; Ribeiro, L; Viegas, S; Gomes, JP; Borrego, MJOBJECTIVE: To evaluate the positive predictive value (PPV) of group B Streptococcus (GBS) cultures at 35-37 weeks of gestation relative to GBS colonization status at delivery. METHODS: Rectovaginal swabs from 221 women at labor in four Lisbon hospitals were collected for GBS screening according to the CDC guidelines. RESULTS: The PPV was 24.4%. IAP was administered to 100% of prenatally GBS positive women. There was no case of early onset GBS disease (EOD). CONCLUSIONS: Poor accuracy of prenatal cultures in identifying true candidates for IAP highlights the need for Portuguese clinical and laboratory guidelines to prevent EOD and antibiotic overtreatment of pregnant women.
- Acidente vascular cerebral perinatal: 11 casos clínicosPublication . Rodrigues, A; Lucas, M; Fonseca, S; Carvalhosa, G; Neto, ASIntrodução: Os acidentes vasculares cerebrais (AVC) são causa de epilepsia e perturbações do neurodesenvolvimento. Têm tido uma incidencia crescente atribuível em parte à melhoria das tecnicas de imagens cerebrais. Alguns diagnósticos são efectuados retrospectivamente após o periodo neonatal. O objectivo da presente serie de casos clínicos foi identificar factores comuns que possam facilitar o diagnóstico no período neonatal. Material e métodos: Estudo retrospectivo efectuado com base na consulta dos processos clinicos dos recém-nascidos, com diagnóstico de AVC entre um de Janeiro de 2003 e 31 de Dezembro de 2013. Resultados: Foram identificados onze casos de AVC perinatal, num total 28382 nados-vivos. Dois casos foram diagnosticados no periodo fetal e nove no periodo neonatal. As convulsões foram a manifestação clinica mais frequente (8 em 11 casos). A mediana da idade de diagnóstico foi um dia e variou entre um e nove dias. A ecografia transfontanelar mostrou alterações em sete casos. A ressonancia magnetica nuclear cranio-encefalica mostrou alterações em todos os casos. Cinco AVC foram arteriais isquemicos, quatro hemorragicos e dois tromboses dos seios venosos. Em seis casos foram identificadas possiveis causas. Foram observadas complicações e sequelas em quatro dos casos. Discussão: As convulsões foram a manifestação clinica mais frequentemente encontrada.Em recém-nascidos de termo com convulsões sem historia de asfixia intraparto o AVC perinatal deverá ser diagnóstico de exclusão, mesmo na ausencia de alterações na ecografia transfontanelar.
- Added value of lymphocyte subpopulations in the classification of Sjögren's syndromePublication . Barcelos, F; Brás-Geraldes, C; Martins, C; Papoila, AL; Monteiro, R; Cardigos, J; Madeira, N; Alves, N; Vaz-Patto, J; Cunha-Branco, J; Borrego, LMSjögren's Syndrome (SjS) is a chronic systemic immune-mediated inflammatory disease characterized by lymphocytic infiltration and consequent lesion of exocrine glands. SjS diagnosis and classification remains a challenge, especially at SjS onset, when patients may have milder phenotypes of the disease or uncommon presentations. New biomarkers are needed for the classification of SjS, thus, we aimed to evaluate the added-value of lymphocyte subpopulations in discriminating SjS and non-Sjögren Sicca patients. Lymphocyte subsets from 62 SjS and 63 Sicca patients were characterized by flow cytometry. The 2002 AECG and the 2016 ACR/EULAR SjS classification criteria were compared with clinical diagnosis. The added discriminative ability of joining lymphocytic populations to classification criteria was assessed by the area under the Receiver-Operating-Characteristic Curve (AUC). Considering clinical diagnosis as the gold-standard, we obtained an AUC = 0.952 (95% CI: 0.916-0.989) for AECG and an AUC = 0.921 (95% CI: 0.875-0.966) for ACR/EULAR criteria. Adding Tfh and Bm1 subsets to AECG criteria, performance increased, attaining an AUC = 0.985 (95% CI: 0.968-1.000) (p = 0.021). Th1/Breg-like CD24hiCD27+ and switched-memory B-cells maximized the AUC of ACR/EULAR criteria to 0.953 (95% CI: 0.916-0.990) (p = 0.043). Our exploratory study supports the potential use of lymphocyte subpopulations, such as unswitched memory B cells, to improve the performance of classification criteria, since their discriminative ability increases when specific subsets are added to the criteria.
- Addictive Video Game Use: An Emerging Pediatric Problem?Publication . Nogueira, M; Faria, H; Vitorino, A; Glória-Silva, F; Neto, ASINTRODUCTION: The excessive use of video games is an emerging problem that has been studied in the context of addictive behaviors. The aim of this study was to determine the prevalence of use of addictive video games in a group of children and to identify risk factors, protective factors and potential consequences of these behaviors. MATERIAL AND METHODS: Observational and cross-sectional study of children from the sixth grade using an anonymous questionnaire. Addictive video game use was defined by the presence of 5 out of 9 behavioral items adapted from the DSM-5 criteria for 'Pathological gambling'. Children who answered 'yes' to 4 items were included in the "Risk group for addictive video game use". We delivered 192 questionnaires and 152 were received and included in the study (79.2% response rate). SPSS statistical software was used. RESULTS: Half of the participants were male and the median age was 11 years old. Use of addictive video games was present in 3.9% of children and 33% fulfilled the risk group criteria. Most children played alone. We found additional factors associated with being in the risk group: greater time of use; online, action and fighting games (p < 0.001). Children with risk behaviors showed a shorter sleep duration (p < 0.001). DISCUSSION: A significant number of children of our sample met criteria for addictive video games use in an early age and a greater number may be at risk (33%). This is a problem that warrants further research and clinical attention. CONCLUSION: This exploratory study helps to understand that addiction to video games in children is an emergent problem.
- Adenoid cystic carcinoma of the palpebral lobe of the lacrimal gland – case report and literature reviewPublication . Duarte, AF; Alpuim Costa, D; Caçador, N; Boavida, AM; Afonso, AM; Vilares, M; Devoto, MartinEpithelial tumors of the lacrimal gland are rare and usually develop in the orbital lobe. We report the exceedingly rare occurrence of a primary adenoid cystic carcinoma in the palpebral lobe of the lacrimal gland. A 26-year-old female was referred for evaluation of a gradually enlarging mass in the lateral upper eyelid, previously diagnosed as a chalazion. Computed tomography revealed a heterogeneous round lesion anterior to the orbital rim. Excisional biopsy was compatible with an adenoid cystic carcinoma. After excluding distant metastasis, and as the patient refused adjuvant radiotherapy, a second surgical procedure, with wide local excision, was indicated. Follow-up showed no recurrence. This case highlights the importance of performing a thorough clinical examination when diagnosing any lateral upper eyelid mass. A high index of suspicion for malignant tumors of the lacrimal gland should always be maintained, and a complete excision with histological analysis should be preferred whenever possible.
- Allergic conjunctivitis and conjunctival provocation tests in atopic dogs.Publication . Lourenço-Martins, AM; Delgado, E; Neto, I; Peleteiro, MC; Morais-Almeida, M; Correira, JHINTRODUCTION: Canine atopic dermatitis (cAD) is a very common disease, but little is known about eye involvement. The conjunctival provocation test (CPT) is used in human to study the ocular response to allergenic stimuli and to evaluate anti-allergic therapy. To our knowledge it has not been used in dogs. OBJECTIVES: To evaluate the prevalence of ocular signs in a population of atopic dogs and relate these with clinical cAD scores; and the usefulness of CPT for dust mites in atopic dogs with itchy eyes. PROCEDURES: Sixty cAD patients were evaluated for (i) ocular signs of allergic conjunctivitis including conjunctival hyperemia, chemosis, epiphora, ocular discharge, pruritus and corneal involvement, graded 0 to 3 according to severity, and (2) cAD Extent and Severity Index (CADESI-03). Additionally, CPTs for Dermatophagoides farinae (n = 12) and Dermatophagoides pteronyssinus (n = 12) were performed in sensitized atopic dogs and 24 control dogs. RESULTS: Periocular and ocular signs of allergy were present in 60% (36/60) of cases. Conjunctival hyperemia (90%) was the most common sign. Severity of ocular signs was significantly correlated with eye pruritus (r(s) = 0.690, P = <0.001) and skin lesions score for head region (r(s) = 0.261, P = 0.04). A highly significant difference (P < 0.001, Fisher test) was found in CPTs between the test and the control groups. CONCLUSION: Allergic conjunctivitis signs associated with cAD seem under valuated so these patients would benefit from an ophthalmologic evaluation. Furthermore, we found CPT to be a reliable, easy to perform and safe test for the etiologic diagnosis of allergic conjunctivitis in the dog.
- An increase in paediatric arthroscopy in Europe: Experience of the EPOS Sport Study GroupPublication . Turati, M; Crippa, M; Nicolaou, N; Tassistro, E; Sinikumpu, J; Courvoisier, A; Mumme, M; Duart, J; Thüsing, M; Bigoni, M; Accadbled, F
- An Uncommon Cause of Recurrent Dysphagia and Chest Pain in an Adolescent BoyPublication . Craveiro Costa, R; Patena Forte, J; Correia, M; Borges, C; Faria, HAn 11-year-old boy was brought to the emergency department with a week-long history of widespread pain in his upper abdomen that worsened with deep breathing and eating, sialorrhea, food impaction sensation, and a recent fever. Ten months prior, he had similar symptoms and was diagnosed with a pharyngeal phlegmon. He was treated with antibiotics and dexamethasone. In the current episode, he presented with mild elevation of inflammatory markers, a slight deviation of the trachea on chest X-ray, and a tubular esophageal duplication was identified on a thoracic CT, with its opening observed during the endoscopic study. The patient was admitted for further treatment with fluids, analgesia, and antibiotics, and showed improvement over the next seven days with no significant incidents. Esophageal duplications are a rare congenital anomaly and their exact cause is unknown. Typically found in the posterior mediastinum and lower esophagus, they can cause symptoms such as pain, dysphagia, regurgitation, and malnutrition. Surgical or endoscopic resection can be a treatment option for these malformations.