Browsing by Issue Date, starting with "2020-06-15"
Now showing 1 - 10 of 12
Results Per Page
Sort Options
- Eating disorder - a diagnosis of exclusionPublication . Fonseca, Margarida Silva; Santos, Helena; Guedes, Raquel; Tavares, Hugo BragaIn adolescents with weight loss, diagnoses other than eating disorders should be considered, namely neurological diseases. A 16-year-old girl with an intellectual development disorder was referred to the Adolescent Medicine outpatient clinic from Child Psychiatry with a diagnosis of eating disorder and persistent anemia. Her body mass index was consistently below the fifth percentile and long-lasting eating difficulties were reported since the age of 15. The girl had no other gastrointestinal, articular, or respiratory complaints, neither polyuria, polydipsia, or recurrent fever. Parental divorce and domestic violence were reported. The patient complained of excessive daytime sleepiness, asthenia, intermittent myalgia, and muscular weakness episodes. Phenotypic characteristics and personal medical history led to clinical suspicion of a neuromuscular disease and genetic study confirmed myotonic dystrophy type 1. This case highlights the importance of considering other diagnoses besides eating disorders in adolescents with eating problems. An exhaustive evaluation of personal and family medical history, patient complaints, and detailed physical examination is mandatory.
- Dating violence - knowledge and attitudes of adolescents and evaluation of the effectiveness of a brief intervention in high school studentsPublication . Ferreira, Sofia Simões; Oliveira, Mafalda; Aguiar, Benedita; Ferreira, Márcia; Guedes, Raquel; Cordeiro, Márcia; Tavares, Hugo BragaTeen’s inexperience and willingness to please others make them especially susceptible to violent behavior in relationships, which they accept as natural and as displays of affection. The present study determined the prevalence of dating violence (DV) in a sample of adolescents from a high school in the northern region of Portugal and their knowledge and attitudes about DV, as well as the effectiveness of a brief intervention to empower adolescents to deal with DV. This longitudinal, interventional study randomly selected adolescents from a high school and divided them into six groups. Three were subject to an intervention focusing DV. Conflict in Adolescent Dating Relationships Inventory (CADRI) and Attitudes Toward Dating Violence (ADV) surveys were filled out prior to the intervention. ADV survey was repeated by the intervention group after the intervention. A total of 138 adolescents from regular and professional education were included. Of these, 75.5% resorted to abusive conflict resolution strategies, 33% to severe violence, and 40.6% were victims of severe violence. Males revealed higher emotional, physical, and sexual violence legitimization perpetrated by both genders. Sixty-nine adolescents participated in the intervention, with girls showing a non-significant decrease in sexual violence legitimacy perpetrated by females and boys showing a non-significant decrease in emotional violence legitimacy perpetrated by males. A high percentage of adolescents used abusive conflict resolution and severe violence strategies. Despite adolescents active participation during the intervention, its impact in decreasing legitimization of DV was lower than expected.
- Prevention of sexual abuse in preschoolers - teacher’s knowledge and attitudesPublication . Cascais, Mafalda; Passadouro, Rui; Mendes, Odete; Zarcos, Maria ManuelIntroduction: Child sexual abuse (CSA) is a global public health problem across different culture and socioeconomic strata. Teachers have a privileged role in prevention programs and the approach is feasible and effective in preschoolers. The aim of this study was to characterize preschool teachers’ knowledge, attitudes, and training about CSA prevention. Methods: A non-experimental, exploratory, cross-sectional study was conducted in Leiria, Portugal, comprising 47 preschool teachers. Data was retrieved through a questionnaire developed by study authors. Results: Most preschool teachers had no CSA prevention training. About half of inquired teachers considered their knowledge about CSA prevention as reasonable. However, 12.8% classified it as poor, mainly teachers with less practice years (50% vs 69.6% of teachers with ≥30 practice years who classified their knowledge as reasonable, p=0.03). Most participants agreed that CSA prevention should be part of preschool curriculum, particularly older teachers (92% vs 77%, p=0.03). Most respondents considered adjusting these concepts to preschoolers challenging for implementation of prevention programs, 72.4% considered that some topics were not suitable for discussion with preschool children, and 82.9% considered that their approach was not well accepted by parents or caregivers. Discussion: Study results evidenced several difficulties and limited training of preschool teachers in CSA prevention. Encouragingly, most teachers showed a positive attitude towards participating in CSA training education and including this topic in preschool curriculum. This study emphasizes the importance of teachers’ education in this subject through implementation of training programs.
- Growing in the shadows of suicidePublication . Costa, Ana Vera; Mendes, Sandra; Pires, Ana Sofia; Melo, Sara; Borges, Sandra; Jorge, Joana; Mendes, GraçaIntroduction: Children/adolescents mourning the death of a primary caregiver face several challenges, including bond breaking and family restructuring due to loss. The negative connotation associated with suicide loss is enhanced by stigma, increasing acceptance difficulties and feelings of isolation, abandonment, shame, and guilt in face of what happened. Objective: The aim of this study was to retrieve data on childhood bereavement due to primary caregiver suicide and explore psychopathological and psycho-affective developmental consequences of this type of grief. Methods: Literature review of articles published on PubMed database about the subject. Results and Discussion: Bereavement of a suicidal parent is associated with multiple psychopathological conditions: mood disorders, post-traumatic stress disorder, substance abuse, self-injurious behavior, suicidal behavior. Suicide and depressive disorder risk is higher when parental death occurred early in life course, with maternal suicide having greater impact. Antidepressants are more commonly used in cases of early parental death from suicide and are associated with increased hospitalizations for Major Depression and Bipolar Affective Disorder in adulthood. Consequences of parental death by suicide may be explained by several factors, as genetics, biological reactions, psychological factors originated from loss of an attachment figure, or social and environmental changes. Conclusions: Parental suicide can be impactful for children’s developmental trajectory and later functioning level. The authors alert to the need for prevention and early intervention strategies associated with this process.
- Hidden by the hair - a precocious puberty case reportPublication . Ferreira, Filipa A.; Costa, Sara T.; Pereira, Carla; Robalo, Brígida; Sampaio, LurdesMcCune-Albright syndrome (MAS) is one of the conditions causing precocious gonadotropin-independent puberty. It is a rare disease, characterized by two of the three following features: precocious puberty, polyostotic fibrous dysplasia (PFD), and café au lait (CAL) skin spots. Herein is presented the case of a girl with pubarche, acne, and transient thelarche since the age of three and menarche since the age of six years old. Besides transitory follicular cysts and advanced bone age, no other changes were found. Diagnosis was only established after brain magnetic resonance imaging showed fibrous dysplasia involving left craniofacial bones. The girl’s parents later mentioned that she had multiple café au lait skin spots on the scalp since birth, disclosing how the key diagnostic sign had been covered by the child’s hair. MAS is a rare disorder and diagnosis depends on a high index of suspicion. CAL skin spots are generally the first manifestation, but can easily go unnoticed. Additionally, PFD may only affect some bones, like craniofacial.
- Behçet’s syndrome in pediatric agePublication . Mendes, Ana Raquel; Braga, Sandrina; Vilarinho, Catarina; Costa, Maria Antónia; Ferreira, Cristina; Simão, Teresa SãoIntroduction: Behçet´s syndrome is a systemic vasculitis characterized by recurrent oral and/or genital ulcers, and several systemic manifestations. The authors describe the case of a pediatric-onset Behçet´s syndrome. Case report: An 11-year-old boy was referred to the Pediatric consultation after two episodes of great saphenous vein thrombophlebitis. He had experienced daily oral aphthae for the past three years, and various episodes of folliculitis with pustule formation. Laboratory study was normal. The boy showed no signs of uveitis. The diagnosis of Behçet´s syndrome diagnosis was established according to the international criteria, with positive HLA- B51 testing. Colchicine was initiated, with favourable response. Conclusions: Due to clinical feature overlap with other conditions, Behçet’s syndrome diagnosis remains challenging. Consensus pediatric classification criteria developed in 2016 enabled greater sensitivity and earlier diagnosis.
- Coarse face, hypotonia, and neurodevelopmental regressionPublication . Miranda, Ana Margalha; Ezequiel, Marta; Luís, Catarina; Dupont, Juliette; Gaspar, Paulo; Vilarinho, Laura; Janeiro, Patrícia; Gaspar, AnaInborn errors of metabolism are a heterogeneous class of multisystemic diseases which, although individually rare, are collectively quite common. Central nervous system is usually affected. The authors report the case of a five-month-old girl, daughter of non-consanguineous parents, born after an unremarkable full-term pregnancy and delivery. Hypotonia and neurodevelopmental regression were noted from the age of five months, along with progressive onset of facial dysmorphism, hepatomegaly, seizures, and dilated cardiomyopathy. Gangliosidosis type 1 diagnosis was confirmed by biochemical, enzymatic, and genetic findings. This report enhances the relevance of multidisciplinary approach and follow-up.
- A very rare cause of infantile spasmsPublication . Fonseca, Margarida Silva; Vieira, Clara; Chorão, Rui; Bandeira, Anabela; Carrilho, InêsPsychomotor development regression or delay associated with epilepsy represent a diagnostic challenge. The diagnostic approach should take into account age group, epileptic syndrome, physical and neurological data, and organ and/or system involvement. Herein is reported the case of a toddler for whom hair development, epileptic seizure evolution, and electroencephalographic findings were key for Menkes kinky hair disease diagnosis. The typical electroclinical evolution in this syndrome has rarely been previously reported. A 22-month-old boy, born at 35 weeks, was admitted to the hospital by the age of two months due to epileptic seizures. Physical examination revealed dysmorphic facial features, pectus excavatum, and inguinal hernias. Antiepileptic drugs were initiated and one month later the patient was readmitted with recurrent epileptic seizures. Transfer to a hospital with Pediatric Neurology support was required, where light-toned and pleated skin, sparse hair, failure to thrive, and axial hypotonia were remarked. Initial investigation with general metabolic, neuroimaging, ophthalmological, and microarray study revealed no changes. Electroencephalograms were markedly abnormal, initially with focal changes and later with hypsarrhythmia. Considering the patient’s phenotype, copper serum level was analysed, with null value. Molecular study confirmed Menkes kinky hair disease and copper histidine therapy was initiated. Menkes kinky hair disease should be considered in infants with global developmental delay, severe hypotonia, refractory epilepsy, and typical hair and skin changes occurring early in life. However, neonatal diagnosis is hampered by age-unspecific signs and symptoms. Despite being a rare and fatal entity, timely diagnosis allowing early therapy institution and avoiding unnecessary additional tests and prompt genetic counseling are of utmost importance.
- Cardiovascular care in cancer patientsPublication . Álvares, Sílvia
- Genes, Children and PediatriciansPublication . Coelho, Margarida Paiva; Soares, Ana Rita; Magalhães, Catarina; Martins, Esmeralda