Browsing by Author "Meireles, Carla"
Now showing 1 - 3 of 3
Results Per Page
Sort Options
- Acute abdominal pain in a 13-year-old female adolescentPublication . Monteiro Cunha, Sara; Leite, Sara; Vasconcelos, Sofia; Meireles, Carla; Gonzaga, Luís; São Simão, TeresaIntroduction: Ovarian torsion can occur at any pediatric age, mainly between the ages of 9 and 14 years. Diagnosis is challenging, as symptoms are nonspecific, misleading to other more common diagnoses, as genitourinary and gastrointestinal disorders. In children, ovarian lesions leading to torsion are typically benign and cystic. Surgical approach is safe, as most cases of early torsed ovary untwisting exhibit later normal ovarian function. Case report: A 13-year-old female adolescent was referred to the Emergency Department for vomiting, left low back pain, and diffuse abdominal pain with irradiation to the hypogastric area, associated with urinary symptoms. Abdomen was tender in the right iliac fossa and hypogastric area. Analytical study revealed increased inflammatory parameters, urinary test strip was negative, and pelvic computed tomography showed a cystic lesion of ovarian origin. Due to suspicion of cyst torsion, laparoscopic surgery was performed, revealing a necrotic adnexal torsion requiring adnexectomy. Discussion: Although often suspected, adnexal torsion is rarely confirmed. Although ovarian torsion accounts for a small number of all gynecological emergencies, it represents a common diagnostic challenge in the emergency setting. Conclusion: As ovary viability depends on early diagnosis, a high index of suspicion is required. This clinical case raises awareness of this entity in the differential diagnosis of lower abdominal pain in female children and adolescents.
- Quality of life of adolescents with type 1 diabetes mellitusPublication . Vasconcelos, Sofia; Monteiro Cunha, Sara; Rebelo, Alícia; Ferreira, Carla; Meireles, Carla; Dias, ÂngelaIntroduction: Type 1 diabetes mellitus is one of the most common endocrine-metabolic disorders of childhood and adolescence and requires a continuous and rigorous therapeutic approach, with recognized impact on children and adolescents’ quality of life. The purpose of this study was to evaluate the quality of life of adolescents with type 1 diabetes mellitus and its relationship with clinical and laboratory aspects and lifestyle. Material and Methods: DQOL questionnaire was applied to type 1 diabetes mellitus adolescents managed at the Pediatric Diabetology consultation of a level II hospital for more than one year. Questionnaire has a global score between 36 and 180, with higher scores reflecting worse quality of life. Statistical analysis was performed in SPSS®. Results: Seventy-one percent (n=36) of adolescents responded to the survey, 55.6% of which male, with a median age of 15 years. Median DQOL global score was 66. Adolescents with good metabolic control had a median global score of 49, compared with 71 in adolescents with poor metabolic control (p=0.007). The median global score of self-perception of better health was 51 compared to 73 for self-perception of poorer health (p=0.007). Discussion: In general, adolescents in this study revealed a satisfactory quality of life. Adolescents with better metabolic control have a higher satisfaction and better quality of life. Adolescents with better self-perceived health have a better quality of life. Conclusion: Recognizing factors that affect quality of life of adolescents with type 1 diabetes mellitus is crucial to devise therapeutic strategies that meet their expectations, promoting treatment adherence and better metabolic control.
- Síndrome do Ovário Poliquístico na adolescênciaPublication . Baptista, Diana; Vieira, Maria João; Meireles, CarlaIntrodução:A Síndrome do Ovário Poliquístico é a endocrinopatia mais frequente nas mulheres em idade reprodutiva. As manifestações começam habitualmente durante a adolescência; porém o diagnóstico nesta faixa etária é dificultado pela sobreposição das características da síndrome e os achados fisiológicos observados durante a progressão normal da puberdade. Objetivos:Rever a abordagem diagnóstica e terapêutica da Síndrome do Ovário Poliquístico na adolescência. Desenvolvimento:Não existem critérios de diagnóstico ou orientações terapêuticas consensuais para a Síndrome do Ovário Poliquístico na população pediátrica. Por outro lado, algumas das manifestações da síndrome, como a acne, irregularidades menstruais e hiperinsulinemia, são achados normais durante a puberdade. A maioria dos autores sugere um diagnóstico baseado na evidência clínica e/ou laboratorial de hiperandrogenismo associada a disfunção ovárica, não explicada por outras etiologias. O doseamento sérico da testosterona livre é o método mais sensível e fiável para a documentação do hiperandrogenismo bioquímico. Já a visualização ecográfica dos ovários poliquísticos, não estabelece o diagnóstico, pois trata-se de um achado frequente em adolescentes saudáveis. A abordagem terapêutica assenta essencialmente na mudança do estilo de vida e no tratamento do hirsutismo/irregularidades menstruais. Conclusões: A identificação das adolescentes em risco para o desenvolvimento da Síndrome do Ovário Poliquístico é fundamental. Para além de uma abordagem terapêutica adequada, é primordial prevenir as co morbilidades associadas à síndrome, entre elas a obesidade, insulinorresistência, dislipidemia e infertilidade.