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HVFX - PED - Artigos

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  • 2009Journal article Open access Show more
  • Acalásia na adolescência – dois casos
    Publication . Vaz-Silva, I; Belo-Morais, R; Ferreira, P; Cunha, F
    2015Journal article Open access Show more
  • Acanthosis nigricans as a clinical marker of insulin resistance among overweight adolescents
    Publication . Videira-Silva, A; Albuquerque, C; Fonseca, H
    PURPOSE: Acanthosis nigricans (AN) is a hyperpigmented dermatosis associated with obesity and insulin resistance (IR). There is no consensus whether AN extension scoring offers added value to the clinical estimation of IR. In this study we aimed to assess and score AN using both a short and an extended version of the scale proposed by Burke et al. and analyze the relationships of both versions with hyperinsulinemia and IR. METHODS: We analyzed data from 139 overweight adolescents (body mass index ≥85th percentile) aged 12-18 with (n=67) or without (n=72) AN who were followed at a pediatric obesity clinic. RESULTS: Adolescents with AN had higher levels of insulin (d=0.56, P=0.003) and HOMA-IR (d=0.55, P=0.003) compared to those without. Neither the short nor the extended versions of AN scores explained either hyperinsulinemia (β=1.10, P=0.316; β=1.15, P=0.251) or IR (β=1.07, P=0.422; β=1.10, P=0.374). The presence of AN alone predicted hyperinsulinemia and the presence of IR in 7.3% (β=2.68, P=0.008) and 7.1% (β=2.59, P=0.009) of adolescents, respectively. CONCLUSION: Screening for AN at the neck and axilla is a noninvasive and cost-effective way to identify asymptomatic overweight adolescents with or at risk of developing IR.
    2019-06Journal article Open access Show more
  • Acidentes em Crianças e Jovens, Que Contexto e Que Abordagem? Experiência de Nove Meses no Serviço de Urgência num Hospital de Nível II
    Publication . Batalha, S; Salva, I; Santos, J; Albuquerque, C; Cunha, F; Sousa, H
    Introdução: Os acidentes constituem uma importante causa de morbimortalidade infantil e de recurso ao serviço de urgência pediátrica. A nível nacional conhecem-se apenas alguns dados epidemiológicos. Métodos: Estudo observacional transversal com análise da coorte das crianças observadas no serviço de urgência pediátrica de um hospital nível II por motivo de acidente, durante um período de nove meses, com dados obtidos através de um inquérito e submetidos a análise estatística. Resultados: Das 22502 admissões de crianças até aos 14 anos registadas, 1746 (7,8%) foram por acidentes. A maioria era do sexo masculino e tinha mais de 5 anos. Os acidentes ocorreram maioritariamente no exterior da escola (29,1%) e interior de casa (25%), predominando a queda como tipo de acidente (55,5%) e a contusão como mecanismo de lesão (54,2%). A maioria das crianças (77,3%) foi submetida a exames complementares de diagnóstico destacando-se os radiológicos. Os diagnósticos mais frequentes foram os traumatismos superficiais (47,9%) e os ferimentos (24,8%). Em 6,6% (115) dos casos os acidentes foram considerados graves. Estas admissões por acidentes associaram-se a uma despesa imediata estimada de 124 mil euros. Discussão: A frequência elevada e o local de ocorrência dos acidentes coincidiram com a literatura. Apesar do predomínio das lesões minor superficiais (47,9%) verificou-se um número significativo de crianças com necessidade de cuidados hospitalares. Não foram registados óbitos. Os autores concluem que os acidentes em crianças foram um motivo frequente de ida ao serviço de urgência pediátrica com importante consumo de recursos. A sensibilização dos cuidadores é essencial na prevenção dos acidentes.
    2016Journal article Open access Show more
  • Análise das Serologias para Infeções do Grupo TORCH e do Rastreio para Streptococcus do Grupo B na População de Grávidas de uma Maternidade
    Publication . Lito, D; Francisco, T; Salva, I; Tavares, M; Rodrigues, R; Neto, MT
    INTRODUCTION: Systematic screening for TORCH infections and group B Streptococcus (GBS) during pregnancy has been an important factor in the improvement of perinatal care. AIM: To evaluate TORCH serology and GBS carriers state in the population of a maternity, to assess variability with age and nationality and to search for congenital infections. MATERIAL AND METHODS: Non-probabilistic prevalence study. RESULTS: 9508 TORCH and 2639 GBS results were registered. Immunity rate for rubella was 93.3%, higher for Portuguese women; for toxoplasmosis it was 25.7%, higher among the oldest and foreign women; IgG for CMV was positive in 62.4%, no influence of age was found. VDRL was reactive in 0.5%; HBsAg was found to be positive in 2.3%, higher in foreign women. Antibodies for hepatitis C virus and HIV were found respectively in 1.4% and 0.7%. No congenital infections were diagnosed. GBS carrier state was found in 13.9%. DISCUSSION: A high rate of positive IgG was found for rubella reflecting vaccines policy. For toxoplasmosis the low rate of positives means that a high number of pregnant women have to repeat serology during pregnancy with inherent costs. Like in the general population, a high rate of CMV positive mothers was found. For some infections we found that foreign women had different conditions. CONCLUSION: Knowledge on TORCH and GBS state helps to better draw guidelines concerning screening policies during pregnancy
    2013Journal article Open access Show more
  • Artrite meningocócica primária na criança
    Publication . Machado, R; Gouveia, C; Ramos, S; Tavares, D
    A artrite é uma complicação conhecida da doença meningocócica. Contudo, a artrite meningocócica primária (AMP), na ausência de meningite ou manifestações de meningococemia aguda, é rara. Descreve-se o caso de uma criança do sexo masculino, 17 meses, saudável, com quadro de febre, recusa da marcha e limitação dos movimentos da anca esquerda. Sem instabilidade hemodinâmica, exantema ou sinais meníngeos. Analiticamente tinha elevação dos parâmetros inflamatórios. Foi isolada Neisseria meningitidis serotipo B no líquido articular e foi medicado com ceftriaxone, seguido de amoxicilina oral, com boa evolução clínica e analítica. Apresentamos este caso raro, salientando a importância do diagnóstico etiológico de artrite séptica na criança.
    2016Journal article Open access Show more
  • Autoimmune hepatitis: trust in transaminases
    Publication . Brissos, J; Carrusca, C; Correia, M; Cabral, J
    A rational and appropriate evaluation of liver biochemical tests is essential, given the increased number of abnormal laboratory results in asymptomatic patients. Critical judgement allows early diagnosis in the absence of typical clinical signs. Autoimmune hepatitis is a rare disease with high clinical variability. We present a child investigated for unexplained increase in aminotransferases, discovered accidentally 2 months earlier in a standard laboratory panel approach. She was asymptomatic and no physical signs of chronic or acute liver disease were found. Laboratory investigation showed hypergammaglobulinaemia with selective elevation of IgG and a positive anti-liver cytosol type 1. Severe interface hepatitis was found on liver biopsy and treatment was initiated with steroids and azathioprine with good response. This case highlights the importance of trusting in any serum aminotransferase abnormality, even in asymptomatic children and emphasises the value of clinical suspicion and specific immunosuppressive therapy in prognosis.
    2014Journal article Open access Show more
  • Benign acute childhood myositis: an alarming condition with an excellent prognosis!
    Publication . Almeida Santos, J; Albuquerque, C; Lito, D; Cunha, F
    2014Journal article Open access Show more
  • Complex Congenital Heart Disease: The Influence of Prenatal Diagnosis
    Publication . Correia, M; Fortunato, F; Martins, D; Teixeira, A; Nogueira, G; Menezes, I; Anjos, R
    INTRODUCTION: Complex congenital heart disease is a group of severe conditions. Prenatal diagnosis has implications on morbidity and mortality for most severe conditions. The purpose of this work was to evaluate the influence of prenatal diagnosis and distance of residence and birth place to a reference center, on immediate morbidity and early mortality of complex congenital heart disease. MATERIAL AND METHODS: Retrospective study of complex congenital heart disease patients of our Hospital, born between 2007 and 2012. RESULTS: There were 126 patients born with complex congenital heart disease. In 95%, pregnancy was followed since the first trimester, with prenatal diagnosis in 42%. There was a statistically significant relation between birth place and prenatal diagnosis. Transposition of great arteries was the most frequent complex congenital heart disease (45.2%), followed by pulmonary atresia with ventricular septal defect (17.5%) and hypoplastic left ventricle (9.5%). Eighty-two patients (65.1%) had prostaglandin infusion and 38 (30.2%)were ventilated before an intervention. Surgery took place in the neonatal period in 73%. Actuarial survival rate at 30 days, 12 and 24 months was 85%, 80% and 75%, respectively. There was no statistically significant relation between prenatal diagnosis and mortality. DISCUSSION: Most patients with complex congenital heart disease did not have prenatal diagnosis. All cases with prenatal diagnosis were born in a tertiary center. Prenatal diagnosis did not influence significantly neonatal mortality, as already described in other studies with heterogeneous complex heart disease. CONCLUSION: prenatal diagnosis of complex congenital heart disease allowed an adequate referral. Most patients with complex congenital heart disease were not diagnosed prenatally. This data should be considered when planning prenatal diagnosis of congenital heart disease.
    2015Journal article Open access Show more
  • Cutaneous hyperpigmentation and cobalamin deficiency
    Publication . Machado, R; Furtado, F; Kjöllerström, P; Cunha, F
    2016-09Journal article Open access Show more