RN&C: Ano de 2020
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Browsing RN&C: Ano de 2020 by Subject "adolescent"
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- 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.
- 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.
- Dating violence – knowledge and attitudes of adolescents and evaluation of the effectiveness of a brief intervention in high school studentsPublication . Simões Ferreira, Sofia; Oliveira, Mafalda; Aguiar, Benedita; Ferreira, Márcia; Guedes, Raquel; Correia, Márcia; Tavares, HugoTeen’s inexperience and willingness to please others make them especially susceptible to violent behaviour in relationships, which they accept as natural and as manifestations of love. This study determines the prevalence of dating violence (DV) in a sample of adolescents from a high school in the northern region of Portugal, 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 of the six groups were subject to an intervention about DV. CADRI (Conflict in Adolescent Dating Relationships Inventory) and ADV (Attitudes Toward Dating Violence) surveys were filled out, of which the latter was repeated in the intervention group. 138 adolescents from regular and professional education were included. 75.5% of these adolescents resorted to abusive conflict resolution strategies, 33% to severe violence and 40.6% were victims of severe violence. Males revealed higher legitimization of emotional, physical and sexual violence perpetrated by both males (EVM, PVM, SVM) and females (EVF, PVF, SVF). 69 adolescents participated in the intervention, whereby girls had a non-significant decrease in the legitimacy of SVF, whereas boys showed a non-significant decrease in the legitimacy of EVM. A high percentage of adolescents used abusive conflict resolution and severe violence strategies. Despite the active participation of adolescents during the intervention, its impact was lower than expected.
- Pancreatite e cetoacidose diabética numa adolescente tratada com sertralinaPublication . Ferreira, Ana Maria; Caldeira Santos, Joana; Ferreira, Sofia; Leite, Ana Luísa; Campos, Rosa ArméniaAcute pancreatitis (AP) is a rare entity in pediatric age. Reports of AP in the context of diabetic ketoacidosis (DKA) have established the role of transient hyperlipemia as a consequent factor. Pharmacological etiology is responsible for 0.3−1.4% of AP cases, with no case reports of an association with the use of sertraline in the pediatric population to date. Herein is described the case of a 15-year-old girl with poorly controlled type 1 diabetes, taking sertraline for a depressive disorder, who developed AP associated with DKA. With this report, the authors intend to emphasize the importance of diagnosing AP in DKA setting. In addition, since the patient had normal serum triglyceride levels and no other risk factors for AP, it is hypothesized that sertraline may have been a triggering event in this context.
- 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.
- The boy to whom things happen: case report of a condition once named “hysteria”Publication . Rodrigues, Ana Rita; Queirós, OtíliaIntroduction: Although banished from current mental disorders classifications, the condition formerly known as hysteria has clinical manifestations still puzzling to clinicians. Herein is briefly revised the historical concept of hysteria, as well as, psychological mechanisms underlying some of its current derivatives: conversive and dissociative disorders. Case report: A previously healthy 17-year-old boy presented with sudden onset of total strength loss in the lower limbs. After neurological assessment, the boy was diagnosed with conversion disorder. Two months later he developed trance and possession states requiring hospitalization, and later, dissociative amnesia. Despite psychological distress underlying patient’s symptoms, la belle indifference was also a meaningful issue. Discussion: This study presents a critical reflection about conversion and dissociative disorders and diagnostic challenges arising from their inconsistent and variable clinical features. Conclusion: With this case report, the authors intend to raise awareness to the risk of recurring care demand for care that can elicit iatrogenic harm and delayed proper treatment.