Browsing by Author "Ferreira, Joana"
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- Biochemical clinical casePublication . Silva, Joana Vanessa; Ferreira, Joana; Silva, Mariana; Costa, MiguelBisalbuminemia is a qualitative albumin variation defined by coexistence of two types of serum albumin with different electrophoretic mobilities in the same individual. It can be of two different types: hereditary (or permanent) and acquired (or transient). Herein is described a rare case of hereditary bisalbuminemia in a healthy infant, incidentally found during elevated aminotransferase study. Despite not having pathological significance, acknowledgement of this analytical alteration is key for adequate management of these patients.
- Language regression as a manifestation of epilepsyPublication . Ferreira, Joana; Lopes, Sofia; Carmona Lopes, José; Ferreira, Cristina; Magalhães, CatarinaIntroduction: Childhood epileptic encephalopathies are age-dependent brain disorders in which ictal and interictal epileptogenic activity is the apparent cause of progressive cognitive and neuro-psychological impairment. Case report: A previously healthy four-year-old boy presented to the Emergency Department with a history of receptive and expressive language regression with four days of evolution, associated with seizure onset. Clinical features and electroencephalographic findings led to diagnosis of Landau-Kleffner syndrome. The boy was treated with valproate, clobazam, and prednisolone, with language improvement. Discussion/Conclusion: Landau-Kleffner syndrome is a rare epileptic encephalopathy with pathognomonic sudden aphasia, epilepsy, and paroxysmal electroencephalographic abnormalities. The condition should be suspected in children with normal development who show a deterioration of established language skills. Early diagnosis and treatment are important to improve outcome.
- Preconceptional immunity and congenital cytomegalovirus infection – A serologic pitfallPublication . Ferreira, Joana; Fonseca, José Luís; Vieira, Maria JoãoCongenital cytomegalovirus infections are the most prevalent intrauterine infections worldwide and result from maternal primary or non-primary infections. Diagnosis of primary cytomegalovirus infection during pregnancy is considered reliable and mainly relies on maternal serology. However, diagnosis of non-primary cytomegalovirus infection is more questionable. Herein is reported the case of a 34-week-old male newborn with congenital cytomegalovirus infection of a mother with preconceptional immunity. The organism was identified in urine by polymerase chain reaction in the first week of life. Maternal peripartum serology was the same as prior to conception. This case highlights the pitfalls of cytomegalovirus serology interpretation in non-primary infection during pregnancy. Clinicians should be aware of this and consider congenital cytomegalovirus infection, particularly when suggestive signs are present.
- Provas de provocação oral a fármacos em Pediatria - casuística 2015Publication . Costeira, Mónica André; Sousa, Dinis; Ferreira, Joana; Ferreira, Carla; Silva, Armandina; Santalha, Marta; Alendouro, Paula; Matos, Águeda; Costa, AlbertoIntrodução: A suspeita de alergia a fármacos em idade pediátrica é um motivo frequente de consulta, que contudo raramente se confirma. Desta forma, a prova de provocação oral (PPO) assume um papel significativo na abordagem diagnóstica. Objetivos: Caracterizar a população pediátrica da consulta de um hospital de nível II, que realizou PPO a fármacos, avaliar os fármacos implicados e analisar os casos cujas PPO foram positivas. Material e métodos: Análise retrospetiva dos processos clínicos dos doentes com idade inferior a 18 anos que realizaram PPO a fármacos no período compreendido entre 1 de janeiro e 31 de dezembro de 2015. Resultados: A amostra incluiu 58 doentes, 53,4% do sexo masculino, sendo a mediana de idades cinco anos. A maioria foi referenciada a partir do serviço de urgência (39,7%) e da consulta externa (36,2%). A amoxicilina foi o fármaco suspeito em 46,6 %, associada com ácido clavulânico em 34,5%. Cerca de 93,1% apresentaram manifestações mucocutâneas, 5,2% gastrointestinais e mucocutâneas e 1,7% respiratórias e mucocutâneas. Em 20,7 % dos casos as manifestações surgiram nas primeiras 24h. As PPO foram positivas em três doentes e os fármacos responsáveis foram a amoxicilina (dois casos) e o ibuprofeno (um caso). Conclusões: Sendo a alergia a fármacos rara em crianças e tendo em conta a sua repercussão na decisão terapêutica em casos de situações infeciosas, é de extrema relevância a referenciação para esclarecimento diagnóstico.
- Screen time use in children less than five years oldPublication . Ferreira, Joana; Prucha, Bárbara; Pinto, Odete; Souto, Raquel; Peixoto Lima, Ricardo; Morna, CarlaIntroduction: While the limited use of high-quality and appropriate media may have a positive influence, excessive exposure carries health risks for young children and their families. Research suggests that increased screen time in young children is linked to negative health outcomes, including obesity, decreased cognitive and language development and reduced academic success. In this study we aimed to characterize the screen-time habits in a healthy population of children, aged between six months and five years, of two Family Healthcare Units of an urban area in northern Portugal, and to review the current literature on children’s screen time and health-related issues. Methods: This is a cross-sectional, observational and analytic study. We selected a convenience sample of children aged between six months and five years who were assessed at a scheduled surveillance visit and a questionnaire was applied to the caregivers between February and July 2018. Results: One hundred sixty-six children were included. The mean age was 30 months; 53% were males. Television dominated total screen time. About 85% of children under two years-old and 80% of infants six to 12-months-old were exposed to screens daily, with 79% of them spending up to one hour per day in front of screens. The majority of parents of children aged two years and older were present and set limits on their children’s screen use. Overall, only 39% of parents affirmed to be aware of current guidelines for screen time. In our study, children’s screen time habits were not related with parents’ socioeconomic or academic status. Parents’ knowledge about current guidelines also did not minimize children’s screen use (p=0,094). Discussion/Conclusion: Young children are exceeding screen time recommendations. Given that parents play a key role in the development of their children’s behaviors and that there is no evidence to support introducing screens at an early age, interventions to reduce children’s screen-time in the current media environment are needed.