RN&C: Ano de 2022
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Browsing RN&C: Ano de 2022 by Subject "adolescent"
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- Between Obsessive-Compulsive Disorder and PsychosisPublication . Videira, Mafalda; Santos, Pedro; Santos, VeraIntroduction: Obsessive-compulsive disorder is an heterogeneous condition in which periods of altered perception or delusions may arise. Similarly, individuals with psychotic disorders may have obsessive-compulsive symptoms. Case report: A male adolescent presented to the Emergency Department (ED) with obsessive symptomatology with three months of evolution. Three weeks later, he returned to the ED showing symptom worsening and reporting delusions, being admitted to the inpatient unit to clarify the diagnosis. No positive symptoms were reported during hospitalization. During follow-up, the patient reported an episode of apparent delusional perception that he associated with the beginning of symptoms, again raising the question of whether a psychotic episode was present. Discussion/Conclusions: The distinction between obsessive-compulsive disorder and psychosis is not always clear, with obsessive-compulsive disorder being a significant comorbidity in patients with a first psychotic episode. Close patient assessment is required for early diagnosis and appropriate intervention.
- Persistent fever and hemoptoic sputum – clinical casePublication . Mosca, Sara; Magalhães, Adriana; Couto Guerra, Isabel; Azevedo, InêsForeign body aspiration (FBA) is a common and serious problem in children. Considering that signs and symptoms can be non-specific and subtle, it is of utmost importance to recognize vulnerable patient groups, combine an accurate history with complete physical examination, and follow a structured diagnostic approach towards correct diagnosis. In the present case, a high index of suspicion was essential to prevent a delay in FBA diagnosis, discuss the appropriate management strategy and improve patient outcomes.
- Progressive back pain due to epidural cerebrospinal fluid collection: a rare complication of lumbar puncture in adolescentsPublication . Simões, Ana Sofia; Penteado, Raquel; Carvalho, Leonor; Dias, AndreaLumbar puncture is commonly performed in Pediatrics. Common complications include headache and mild pain at the puncture site. Uncommon complications after the procedure, such as epidural cerebrospinal fluid collection, have rarely been described in children and adolescents. The authors present the clinical report of an adolescent with symptomatic epidural cerebrospinal fluid collection following a non-traumatic lumbar puncture. Diagnosis (including magnetic resonance imaging findings), treatment, clinical course, and prognosis associated with epidural cerebrospinal fluid collection are reported.
- Pulmonary clinical casePublication . Amaro, C.M.; Protasio, Pedro; Rodrigues, Carlos; Ferreira, AnaPost-extubation acute pulmonary edema (PEAPE) is an uncommon complication of tracheal extubation, occurring in 0.1% of patients undergoing general anesthesia. It has rarely been described in pediatric age, but its incidence is thought to be underestimated, as many cases of post-operative respiratory distress may be misdiagnosed or unrecognized. A formerly healthy 15-year-old male diagnosed with acute appendicitis was submitted to a laparoscopic appendectomy under general anesthesia. Immediately after extubation, he developed signs and symptoms of respiratory distress, and chest radiograph was compatible with acute pulmonary edema. Due to suspicion of PEAPE, supplementary oxygen and intravenous furosemide were administered, with favorable outcome. PEAPE is a major anesthesia-related emergency, which may worsen the prognosis of low-risk surgical procedures. A high degree of suspicion should be maintained in children and adolescents presenting with signs of respiratory distress and hypoxia after general anesthesia, as prompt diagnosis and treatment are crucial for a favorable outcome.