Browsing by Author "Ferreira, E."
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- Gastroenterite por Salmonella em recém-nascidoPublication . Ferreira, E.; João, A.; Ferraz, L.A Salmonella é um agente implicado na gastroenterite aguda em todo o Mundo. A frequência das infecções depende da localização geográfica, condições sanitárias, idade do doente, estado imunitário etc. É um agente comum nas infecções do lactente. No recém-nascido a infecção surge geralmente após a 1ª semana de vida. Os autores descrevem o caso clínico de um recém-nascido, fruto de uma gestação de 40 semanas, complicada por uma gastroenterite materna 24 horas antes do parto, que apresentou fezes mucosanguinolentas nas 1ªs horas de vida. Na coprocultura da mãe e do RN foi isolada uma Salmonella enteritidis. Os autores chamam a atenção para a necessidade de um diagnóstico precoce a fim de evitar as complicações bacteriémicas e a contaminação de outros recém nascidos na enfermaria. ABSTRACT Salmonella infection is a common worldwide agent of acute gastroenteritis. The frequence of occurrence depends mainly on geographic localization, sanitary conditions, age of the child and his immunity stage. Salmonella is a frequent agent in infancy. In the newborn, the infection starts usually after the first week of life. The authors describe the case of a term newborn whose mother was affected by gastroenteritis 24 hours before delivery, who developed bloody and mucous stools in the first hours of life. The stool culture revealed Salmonella enteritidis in both the mother and the newborn. The prompt diagnosis is important to prevent bacteraemia and eventual contamination of other newborns host in the nursery.
- Hemangioma da pálpebra em recém-nascido pré-termoPublication . Martins, C.; Caldeira, T.; Ferreira, E.; Varandas, R.; Pinto, R.Os hemangiomas são os tumores benignos mais frequentes na infância e em especial nos recém-nascidos de pré-termo. Habitualmente aparecem nas primeiras semanas de vida e a fase proliferativa pode ser rápida. Geralmente regridem espontaneamente, mas dependendo da localização e do volume pode ser necessário o tratamento farmacológico e/ou cirúrgico. Os autores apresentam o caso clínico de um recém-nascido de pré-termo (28 semanas gestacionais) a quem ao oitavo dia de vida aparece um hemangioma plano da pálpebra superior direita. Ao longo do internamento assistiu-se a um rápido crescimento do mesmo com ptose total do olho. O risco de ambliopia levou à necessidade de intervenção terapêutica com corticoterapia sistémica e intra-lesional, tendo sido a resposta clínica favorável. Actualmente, aos 7 meses, a lactente apresenta um exame oftalmológico normal. O tratamento atempado foi essencial para a redução do hemangioma e do risco de ambliopia. ABSTRACT Haemangioma is the most frequent benign tumour in infancy, especially in premature neonates. It usually appears in the first weeks of life and may proliferate quickly. Normally it diminishes spontaneously but, depending on the location and the volume, pharmacological treatment or surgery may be necessary. The authors report a case of a premature neonate (28 gestational weeks) aged 8 days, presenting a plan haemangioma located in the superior right eyelid. During the hospital stay, we verified a rapid growth of the haemangioma with total ptosis. The risk of ambliopy imposed therapeutic intervention associated with systemic and intra-lesional corticotherapy, with good clinic response. At the aged of seven months, the infant has a normal ophthalmologic exam. The precocity of the treatment was essential to the reduction of the haemangioma and the risk of ambliopy.
- Pseudoxantoma elástico - caso clínicoPublication . Martins, C.; Silva, V.; Leite, I.; Ferreira, E.; Romariz, J.Pseudoxantoma elástico é uma doença genética rara que se caracteriza pela progressiva calcificação e fragmentação das fibras elásticas da pele, retina e sistema cardiovascular. Os pacientes apresentam lesões cutâneas típicas e as manifestações extracutâneas aparecem posteriormente. O diagnóstico baseia-se na clínica, histologia e genética. Os autores apresentam o caso de um rapaz de 8 anos que refere aparecimento de pápulas alaranjadas, confluindo em placas de consistência elástica, de limites imprecisos, inicialmente limitadas à região cervical e estendendo-se posteriormente às regiões axilares. Realizou biopsia de pele que confirmou a suspeita clínica de pseudoxantoma elástico. Efectuou estudo analítico, electrocardiograma, ecocardiograma, eco-Doppler das carótidas e aorto-ilíacas, retinograma e potenciais evocados visuais que foram normais. Houve expansão das lesões para as regiões inguinais, não apresentando quaisquer queixas sistémicas. A raridade desta doença leva ao diagnóstico tardio. Sendo as complicações frequentes, é importante o diagnóstico atempado para instituir medidas profiláticas, evitando sequelas. ABSTRACT Pseudoxhantoma elasticum is a rare inherited disorder, characterised by a progressive mineralization and fragmentation of elastic fibres of the skin, retina and cardiovascular system. The skin exhibits distinctive lesions and extra-dermal manifestations appear in advanced age. The diagnosis relies on clinical manifestations, histology and genetic analysis. The authors present a case report of an eight year old boy complaining of orange papules in the lateral cervical regions and axilae, becoming later into elastic consistence plaques with irregular limits. The skin biopsy demonstrated pseudoxhantoma elasticum. Analytic study, electrocardiogram, echocardiogram, carotid and aortal-iliac eco-doppler, retinogram and evocated visual potentials were normal. There was expansion of cutaneous lesions to inguinal regions. The low prevalence of this disease may be the cause of a late diagnosis. The authors emphasize the importance of an early diagnosis to minimize the complications, which are common in these cases.
- Update on Atopic DermatitisPublication . Torres, T.; Ferreira, E.; Gonçalo, M.; Mendes-Bastos, P.; Selores, M.; Filipe, P.With an increasing prevalence during the past decades, atopic dermatitis has become a global health issue. A literature search following a targeted approach was undertaken to perform this non-systematic review, which intends to provide an overview of the epidemiology, pathophysiology, clinical features, comorbidities, and current therapies for the treatment of atopic dermatitis. In sum, this is a heterogeneous skin disorder associated with variable morphology, distribution, and disease course. Although not completely understood, its pathogenesis is complex and seems to result from a combination of genetic and environmental factors that induce skin barrier dysfunction, cutaneous and systemic immune dysregulation, skin microbiota dysbiosis, and a strong genetic influence. Diagnosis is based on specific criteria that consider patient and family history and clinical manifestations. Overall disease severity must be determined by evaluating both objective signs and subjective symptoms. Therapeutic goals require a multistep approach, focusing on reducing pruritus and establishing disease control. Patients should be advised on basic skin care and avoidance of triggers. Topical anti-inflammatory agents should be considered in disease flares or chronic/recurrent lesions. In case of inadequate response, phototherapy, systemic immunosuppressants and, more recently, dupilumab, should be added. Nevertheless, the treatment of moderate-to-severe atopic dermatitis remains challenging and novel, efficacious, safe and targeted treatments are urgently needed. In conclusion, although the last few years have seen important improvement in the understanding of the disease, future research in atopic dermatitis will continue exploring gene-environment interactions and how it affects pathophysiology, disease severity, and treatment outcomes.