Browsing by Author "Alba, Diana"
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- Involuntary movements in an adolescentMoreira, Mafalda; Alba, Diana; Ferreira, Inês Paiva; Monteiro, CláudiaExtrapyramidal symptoms (EPS), such as dystonia, akathisia, and parkinsonism, are movement disorders that have been described as a side effect of antipsychotic medications in adults. In children, their use has expanded, as have this type of symptoms, especially those caused by first-generation antipsychotics. Paliperidone is a second-generation drug approved for schizophrenia in adolescents. The authors describe the case of a 12-year-old boy with a chronic disruptive behavior disorder who was admitted to the Emergency Department with tongue protrusion, inability to speak, eye rolling, and body tremors since that day. He was treated with paliperidone, the dose of which had been doubled in the previous month. Examination revealed dystonia of the eyes, mouth, and tongue, and increased neck tone. Biperiden was administered with complete resolution of symptoms after five minutes, and paliperidone was discontinued. This case suggests that caution should be exercised when prescribing antipsychotics (even second-generation agents). As the use of antipsychotics in children is increasing, pediatricians should be familiar with the acute presentation of side effects of these drugs.
- Pruritic rash in a child – Clinical caseAlba, Diana; Pimenta, Sofia; Machado, Ângela; Ferreira, Jorge AbreuUrticaria multiforme (UM) is an allergic hypersensitivity reaction characterized by the acute onset of polycyclic and annular wheals with ecchymotic centers. It is more common in children under 4 years of age, who typically present with a pruritic rash and nontoxic appearance. The diagnosis is clinical. The condition usually has a favorable response to antihistamines and self-limited course. UM is probably underdiagnosed as it is often confused with erythema multiforme and serum sickness-like reaction. Herein is reported a case of UM in a four-year-old boy, followed by a review of the literature on the subject.
- Sleep habits and screen use in an adolescent population during the COVID-19 pandemicVieira, Paula Manuel; Cascais, Inês; Alba, Diana; Bernardo, Ana; Faria, João; Feio, Ana; Coelho, Margarida Paiva; Ribeiro, Maria do Céu; Gomes, Lúcia; Fonseca, Paula; Rios, MartaIntroduction: Screen use among adolescents has increased, with excessive screen time associated with poor sleep. Isolation due to the COVID-19 pandemic may have exacerbated these problems. This study aimed to characterize adolescents’ sleep and screen use behaviors during the COVID-19 pandemic lockdown.Methods: This was a multicenter, cross-sectional, descriptive study of adolescents aged 10 to 18 years evaluated in an Adolescent Medicine outpatient visit of four hospitals in northern Portugal between January and March 2021. Adolescents completed a survey with questions about screen use and sleep and the Pediatric Daytime Sleepiness Scale (Portuguese version).Results: A total of 131 adolescents (66.4% female; median age 15 years) were enrolled during the study period. Participants reported a median sleep duration of nine hours on weekdays and 10 hours on weekends, with 25.9% sleeping less than eight hours on weekdays. Approximately 80% reported good or very good sleep quality. Onset insomnia was identified in 39.7% and excessive daytime sleepiness (EDS) in 13.7%. Most adolescents (74.0%) reported screen time of ≥6 hours/day. Screens were mainly used for attending classes and talking to friends. Smartphones were available in the bedroom at night for 83.2%, while 61.1% had televisions, 57.3% had computers, and 16.0% had gaming consoles in their bedrooms. Fifty-five percent used screens within an hour of bedtime every day. Screen time ≥6 hours/day and having a computer or smartphone in the bedroom at night were associated with shorter sleep duration on weekdays and EDS. Screen use within an hour of bedtime ≥4 times/week was associated with sleep-onset insomnia, shorter weekday sleep duration, and EDS. Discussion: Online classes during the COVID-19 lockdown may explain the use of devices ≥6 hours/day. Although most adolescents reported normal median sleep time and subjective good or very good sleep quality, screen use ≥6 hours/day and within one hour before bedtime was associated with sleep deprivation on weekdays and EDS.Conclusions: Excessive screen time during the pandemic appears to have had a negative impact on adolescents’ sleep. These findings underscore the importance of identifying and intervening in these issues when addressing adolescent global health.