Showing papers by "Ana Maria Oliveira Brett published in 2021"
TL;DR: A doenca de Kawasaki (DK) is a principal causa de cardiopatia adquirida em idade pediatrica nos paises desenvolvidos as discussed by the authors.
Abstract: Resumo Fundamento A doenca de Kawasaki (DK) e a principal causa de cardiopatia adquirida em idade pediatrica nos paises desenvolvidos. Objetivos Identificar fatores preditores de resistencia a imunoglobulina intravenosa (IGIV), calcular a eficacia dos modelos preditores japoneses e caracterizar as complicacoes cardiacas. Metodos Analise retrospectiva dos casos de DK entre janeiro de 2006 e julho de 2018 em um hospital pediatrico portugues. Foram construidas curvas ROC para encontrar fatores preditores de resistencia e utilizada regressao logistica multivariada para elaborar o modelo preditor. O nivel de significância utilizado foi de 5%. Resultados Foram incluidos 48 pacientes com mediana de idade de 36 meses. Verificou-se resistencia a IGIV em 21%. Ocorreram alteracoes ecocardiograficas em 46%, com envolvimento coronario em 25%. Como variaveis preditoras de resistencia, a proteina C-reativa (PC-R) apresentou uma AUC ROC = 0,789, ponto de corte = 15,1 mg/dL, sensibilidade (S) = 77,8% e especificidade (E) = 78,9%. A velocidade de sedimentacao (VS) apresentou uma AUC ROC = 0,781, ponto de corte = 90,5 mm/h, S = 66,7% e E = 85,7%. O modelo com as duas variaveis apresentou valor p = 0,042 e AUC ROC = 0,790. O modelo Kobayashi apresentou S = 63,6% e E = 77,3%; Egami, S = 66,7% e E = 73,1%; e Sano, S = 28,6% e E = 94,1%. Conclusao A PC-R e a VS sao variaveis independentes que mostraram tendencia preditora de resistencia a IGIV com pontos de corte otimos de 15,1 mg/dL e 90,5 mm/h, respectivamente. Cerca de metade dos pacientes teve algum tipo de envolvimento cardiaco. Os modelos japoneses nao tem utilidade nessa populacao. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)
7 citations
TL;DR: A 9-year-old boy presented to the emergency department of a paediatric hospital with non-painful lesions on his lips and inside his mouth, associated with lip swelling as mentioned in this paper.
Abstract: A 9-year-old boy presented to the emergency department of a paediatric hospital with non-painful lesions on his lips and inside his mouth, associated with lip swelling. On examination, his oral mucosa and lips showed numerous blisters with yellowish serofibrinous content and lip oedema. An eye examination revealed bilateral conjunctival injection. Genitalia was unaffected and no other skin lesions were found. He was on day 4 of clarithromycin prescribed for atypical pneumonia caused by Mycoplasma pneumoniae The patient was diagnosed with M. pneumoniae-associated mucositis and was started on topical treatment with fusidic acid and betamethasone, with gradual improvement of the oral lesions.
TL;DR: The first known outbreak in infants of human parechovirus type 3 in Portugal was reported in 2016 as discussed by the authors, where the mean duration of admission was 5.6 days and the median age was 23 days.
Abstract: Introduction: Human parechovirus type 3 has been recognized as a cause of pediatric infection, occasionally associated with serious illness, including sepsis and meningitis, particularly among young infants. The aim of this study is to report the first known human parechovirus type 3 outbreak in Portugal. Material and Methods: Descriptive study of an outbreak that occurred between the 8th June to the 12th August 2016. Laboratory diagnosis was made by reverse transcription - polymerase chain reaction in the cerebrospinal fluid and/or in stools. Genotyping was made by reverse transcription - polymerase chain reaction and sequencing in stool samples from infants and family members. Results: Human parechovirus type 3 infection was detected in seven infants, of which six were male. Median age was 23 days (5 - 52). One had seizures, with a magnetic resonance imaging scan showing white matter diffusion restriction. The mean duration of admission was 5.6 days (3 - 11), with favourable outcome in all. In three cases there were symptomatic close family members. Human parechovirus type 3 was identified in the stools of three mothers. Discussion: Even though human parechovirus type 3 infection has been well described in the presented age group, most Portuguese hospitals do not have this laboratory diagnosis. Our results are comparable to those obtained in other countries. Besides detection of the virus in the cerebrospinal fluid, there were no raised local or systemic inflammatory markers. Conclusion: This study reports the first known outbreak, in infants, of human parechovirus type 3 in Portugal. Although there is no specific treatment, this diagnosis can avoid unnecessary empirical antibiotic treatment and prolonged admissions.