Browsing by Author "Aguiar, I."
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- Pneumonia Necrotizante A Propósito de Um Caso ClínicoPublication . Prazeres, T.; Dias, A.; Moura, R.; Fernandes, A.; Aguiar, I.; Lobo, A.ABSTRACT Introduction. Necrotizing Pneumonia (NP) is a serious complication of Community Acquired Pneumonia, whose incidence has been increasing in recent years. The authors present a case report of a child with NP and make a comprehensive review of the subject. Case report. A 22 months old girl, without history of relevant diseases, presented in Hospital because of high fever lasting six days. She appeared ill and septic, with severe respiratory distress, pallor, increased capillary refi lling time and defense to abdominal palpation. Serum analysis showed anaemia, neutrofi lia and elevated Reactive-C-Protein (393 mg/L). The thoraco-abdominal CT scan showed evidence of a large parenquimal consolidation involving the upper and lower lobes of the right lung. Due to unfavourable evolution after four days of antibiotics, she underwent thoracic CT scan that showed necrotizing phenomena of the right upper lobe associated with liquid collections, and therefore, intravenous clindamycin was associated to the treatment. She completed four weeks of antibiotherapy with a favourable outcome. Comments. Typically, children with NP appear ill and present with high fever, respiratory distress and hypoxemia; the diagnosis must be considered in all children with pneumonia presenting an unfavourable evolution. The CT scan is the gold-standard exam for the diagnosis. Antibiotic regimen should be long (normally four weeks), being vancomycin and clindamycin the preferred antibiotics. Conservative treatment appears to have good results and surgery is reserved for selected cases. Although it may be a severe disease in the acute stage, pediatric NP has a good outcome with clinical resolution in two months’ and minimal sequelae.
- [Readmission to an Adolescent Psychiatry Inpatient Unit: Readmission Rates and Risk Factors]Publication . Mendes, P.; Fonseca, M.; Aguiar, I.; Pangaio, N.; Confraria, L.; Queirós, O.; Saraiva, J.; Monteiro, P.; Guerra, J.INTRODUCTION: Most mental disorders have a chronic evolution and therefore a certain amount of psychiatric readmissions are inevitable. Several studies indicate that over 25% of child and adolescent inpatients were readmitted within one year of discharge. Several risk factors for psychiatric readmissions have been reported in the literature, but the history of repeated readmissions is the most consistent risk factor. Our aim is to calculate the readmission rates at 30 days and 12 months after discharge and to identify associated risk factors. MATERIAL AND METHODS: The authors consulted the clinical files of patients admitted to the Inpatient Unit between 2010 and 2013, in order to calculate the readmission rates at 30 days and at 12 months. The demographic and clinical characteristics of the readmitted patients were analyzed and compared with a second group of patients with no hospital readmissions, in order to investigate possible predictors of readmission. RESULTS: A total of 445 patients were admitted to our inpatient unit between 2010 and 2013. Six adolescents were readmitted in a 30 days period (1.3%) and 52 were readmitted in a 12 month period after discharge (11.5%). Duration of the hospitalization and the previous number of mental health admissions were significant predictors of future hospital readmissions (p = 0.04 and p = 0.014). DISCUSSION: The low readmission rates may reflect the positive clinical and sociofamilial support being provided after discharge. CONCLUSION: Rehospitalisation is considered a fundamental target for intervention concerning prevention and intervention in mental healthcare. Thus, knowledge regarding their minimisation is crucial.