Browsing by Issue Date, starting with "2014-03"
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- Gradenigo syndrome: an unexpected otitis complicationPublication . Mendes, Catarina; Garrido, Cristina; Guedes, Margarida; Marques, LauraIntroduction: Gradenigo syndrome (also known as apical petrositis) is a clinical triad of otitis media, trigeminal neuralgia and ipsilateral abducens nerve palsy. In the era of antibiotic therapy, it is an exceptional but potentially life threatening complication of acute otitis media, requiring prompt diagnosis and treatment. Case report: A seven-year-old girl with previous history of otitis, presented with left ear pain, headache, diplopia and fever. Diagnosis of Gradenigo syndrome was established and she was treated with systemic broad-spectrum antibiotics and myringotomy with timpanostomy tube placement. Clinical outcome was favourable. Conclusion: This case documents therapeutic success and total recovery with a conservative approach in an immunocompetent child with Gradenigo syndrome.
- Uso de BAHA em crianças: Indicações, resultados e complicaçõesPublication . Reis, C.; Coutinho, M.; Gameiro-Santos, J.; Almeida-Sousa, C.O BAHA (Bone Anchored Hearing Aid - prótese auditiva ancorada no osso) é utilizado em malformações do ouvido externo e médio, otorreia crónica, doença ossicular inoperável e como alternativa à prótese auditiva convencional por inadaptação/ impossibilidade. Este artigo descreve a experiência de colocação de BAHA no Hospital Maria Pia – Centro Hospitalar do Porto na última década, por estudo retrospectivo de 47 pacientes. O ganho audiométrico médio foi de 33,9 dB em relação aos valores base e de 14,4 dB em relação ao uso de próteses auditivas convencionais, com limiar auditivo médio com BAHA de 17,8 dB. Não houve qualquer complicação intra-operatória. No pós-operatório, quatro casos exigiram cirurgia para revisão da pele, em dois casos não houve integração óssea do implante e em três casos houve extrusão do implante por traumatismo directo. Este estudo conclui que os BAHA são um método eficaz e seguro de aparelhamento auditivo em crianças.
- Causa moderna de uma dermatose antiga – Eritema ab ignePublication . Ferreira, Sara; Mota, Lourdes; Tellechea, Óscar; Figueiredo, Nuno; Mascarenhas, Rosaermatosis, caused by prolonged and repeated exposure to heat. Multiple heat sources have been reported to cause this condition, as fire or stove in proximity with the skin. Case report: We report a case of a diabetic teenager with erythema ab igne induced by a laptop computer. Conclusions: Laptop induced erythema ab igne is an underdiagnosed clinical entity. In the future maybe it will be more frequent due to the improper use of these devices. The possible irreversibility of skin lesions and the potential severe complications reinforce the need to be aware for this disease.
- Transfusão feto-fetal – sobrevivente policitémicoPublication . Dias, Joana; Fraga, José; Branco, Susana; Monteiro, Tânia; Carvalho, Carmen; Alexandrino, Ana MargaridaIntroduction: Twin-twin transfusion syndrome (TTTS) is associated with the death of one or both foetuses, particularly if diagnosed before 28 weeks’ gestation. Sudden deteriorations can occur, leading to death of the cotwin and neurological handicap in the survivor. Case Report: We report a case of polycythemia in the recipient twin of a pregnancy with TTTS. Laser photocoagulation of placental anastomoses was performed successfully at 18 weeks. Follow-up showed resolution of signs of TTTS on ultrasound examination. Caesarean section at 33 weeks due to foetal death of donor twin, the recipient twin demonstrated symptomatic polycythemia (hematocrit 70%). Partial exchange transfusion (PET) was performed twice in the first 12 hours. Normal hematocrit levels were achieved without complication. Perinatal outcome was good. Conclusion: Despite the prognosis improvement after laser photocoagulation of placental anastomoses, perinatal mortality and morbidity remains height.
- Caso endoscópico: esofagite pépticaPublication . Pereira, FernandoWe present the case of a 18-year-old female patient with dyspeptic complaints lasting for three months, that relieved with inhibition of gastric acid secretion. She had a past history (two years before) of laparoscopic gastric banding for morbid obesity with therapeutic success two years before. Upper endoscopy showed mild distal esophagitis and proximal displacement of the gastric band.
- Caso radiológico: Imagem artefactual causada pela sobreposição dos cabelos compridos.Publication . Macedo, FilipeWe present a case of a 14-year-old girl with fever and cough in whom the chest x-ray revealed a bizarre density over the upper two thirds of the left lung. It was due to the superimposed long hair hanging on her back. Artefacts images must systematically be suspected specially when being of strange shapes.
- Parotidite recorrente idiopática na criançaPublication . Vicente, Inês Nunes; Oliva, MónicaIntroduction: Recurrent idiopathic parotitis (RIP) is a frequent etiology of repeated inflammatory episodes of the parotid gland, in childhood. Objectives: To review current literature on the etiology, clinical presentation, diagnosis and treatment of RIP. Development: RIP is characterized by repeated episodes of swelling and pain in the parotid gland, usually accompanied by fever and malaise. Aetiology is multifactorial and, to date, unclear. Diagnosis is essentially clinical. Despite its benign character, recurrent parotitis can be a signal of other diseases, particularly in case of delayed onset of symptoms (from six-year-old) and bilateral involvement. The use of complementary tests should be individualized. Ultrasound is the diagnostic tool of choice and shows non-obstructive dilatation of glandular ducts (sialectasis). Treatment is mainly symptomatic. Prognosis is good with tendency to remission at puberty. Conclusions: RIP is a benign and self-limited condition. However, recurrent parotitis episodes should prompt investigation for underlying diseases, particularly in cases of late onset of symptoms (after age six years) and bilateral involvement.
- Nonsteroidal anti-inflammatory drug (NSAID)-induced colopathy with diaphragm-like stricturesPublication . Küttner-Magalhães, R.; Ferreira, J.; Pedroto, I.
- Angioedema recorrente – caso clínicoPublication . Martins, Sandrina; Salgado, Miguel; Raposo, Filipa; Pinto, Diana; Martinho, Isabel; Araújo, RitaIntroduction: Hereditary angioedema (HA) is a rare cause of recurrent angioedema caused by a default in the gene that encodes the C1 esterase inhibitor (C1-INH). The oedema involves predominantly the face, limbs and genital and gastrointestinal tract. The involvement of the larynx, although less frequent, is the most severe clinical expression of HA and is potentially fatal. Case report: Clinical report of an eight-year-old female with multiple episodes of angioedema. The laboratory study confirmed the diagnosis of HA. Discussion: HA diagnosis is established based on the clinical history, family history and complements testing. Its documentation is extremely important because it is potentially fatal and needs specific therapy.
- Recém-nascido no Serviço de Urgência – casuística do ano 2011 de um Centro HospitalarPublication . Ratola, Ana; Machado, Marta; Almeida, Ângela; Pio, Daniela; Almeida, SílviaIntrodução: O nascimento de um filho é um desafio para os pais. Assim, no período neonatal, surgem frequentemente dúvidas que motivam a ida ao Serviço de Urgência (SU), muitas vezes sem justificação clínica. Objetivos: Caracterizar as admissões de recém-nascidos (RN) no SU num período de 12 meses e avaliar a justificação do atendimento pediátrico urgente. Material e métodos: Análise retrospetiva dos episódios de urgência dos RN que recorreram ao nosso hospital entre Janeiro e Dezembro de 2011. Resultados: No período em estudo, recorreram 394 RN (20% foram observados em mais do que uma ocasião), representando 1,3% das admissões no SU Pediátrico; 20% referenciados por profissionais de saúde. Os principais motivos de recurso foram queixas gastrointestinais (31%), lesões cutâneo-mucosas (18%), icterícia (17%) e queixas respiratórias (15%). Foram realizados exames complementares em 44% das admissões, sendo os mais frequentes, bilirrubina transcutânea e análise de urina. Instituiu-se terapêutica em 18% dos casos. Os diagnósticos mais frequentes corresponderam a patologia neonatal benigna e problemas de puericultura em 57% dos casos (n=283). A maioria dos RN (75,6%) teve alta para o domicílio. A mediana da idade materna foi de 30 anos e 58,6% eram primíparas. Metade das mães cuja escolaridade foi conhecida tinham concluído o nono ano. Conclusões: A maioria dos recursos ao SU hospitalar no período neonatal corresponde a situações não urgentes que poderiam ser resolvidos nos Cuidados Primários de Saúde. Salienta-se a importância do esclarecimento das mães durante a gravidez e período neonatal. Por outro lado, a inespecificidade de sintomas nesta faixa etária exige um maior nível de alerta para as situações potencialmente graves.