Browsing by Author "Ferreira, Sofia"
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- Deliberate self-harm in adolescence: a cross-sectional studyMendes, Joana; Martins, Miguel Vieira; Azevedo, Isabel; Patrício, Pedro; Ferreira, SofiaIntroduction: The high prevalence of deliberate self-harm (DSH) and its strong association with suicide make the condition a natural target for intervention to prevent harmful consequences for adolescents. The aim of this study was to determine the prevalence of DSH and to characterize DSH patterns and associated risk factors in a sample of adolescents. Methods: A cross-sectional study was conducted by applying a questionnaire based on the “Lifestyle and Coping Questionnaire” adapted to the Portuguese language. Adolescents aged between 12 and 17 years attending the outpatient clinic of a secondary-care hospital were invited to participate. Data were analyzed by descriptive, bivariate, and regression analysis using SPSS v.25 software. Results: A total of 159 eligible responses were obtained from adolescents with a mean age of 15 years. Of the 25.8% who reported having engaged in DSH, the majority (61%) did so more than once, and the same percentage did not seek help. A statistically significant association was found between DSH and befriending less easily, having a history of bullying, and seeking online information on how to self-harm. A significantly higher risk of self-harm was found among adolescents who had experienced a variety of negative life events (adjusted odds ratio [aOR] 1.47, confidence interval [CI] 1.231-1.1763; p<0.01), whereas having no health problems (aOR 0.356, CI 0.13-0.969; p=0.04) and not using drugs (aOR 0.087, CI 0.012-0.633; p=0.016) were protective factors. Conclusions: DSH is a common but often overshadowed problem in adolescents. The findings of this study highlight the need for careful assessment of adolescents with better screening for DSH and associated risk factors.
- Liver Transplantation for Acute Hepatic Failure Following Intentional Iron OverdosePublication . Eça, Rosário; Ferreira, Sofia; Gandara, Judit; Pessegueiro Miranda, Helena; Daniel, JorgeThe majority of acute iron toxicity cases occur in young children from accidental ingestion. In adults, iron poisoning is rare and mostly due to intentional ingestion. Physicians, particularly those who do not routinely treat pediatric patients, are often unfamiliar with the clinical manifestation of iron poisoning, its management, and its potential for multiple organ failure, especially liver damage. Severe acute hepatotoxicity treated with liver transplantation is rare in adults, with very limited published literature. We report a case of a severe iron tablet overdose with suicidal intent that progressed to fulminant hepatic failure despite medical treatment, ultimately treated with liver transplantation.
- 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.
- Severe Acute Liver Injury Related to Heat StrokePublication . Ribeiro, Fani; Bibi, Mário; Pereira, Marta; Ferreira, Sofia; Pessegueiro Miranda, Helena; Araújo, RuiHeat stroke (HS) is a life-threatening condition characterized by hyperthermia and multiple organ failure. Mild to moderate hepatocellular injury is a well-documented complication but severe liver injury and acute liver failure are rare. There are neither established criteria nor optimal timing for liver transplantation and conservative management seems to be the cornerstone treatment. The authors report a case of a patient with severe liver injury related to HS who recovered completely under conservative treatment. Learning points: Hyperthermia, neurologic dysfunction and recent exposure to hot weather or physical exertion should raise the suspicion of heat stroke (HS).Fast and effective cooling is the cornerstone of treatment, along with support of organ dysfunction. Antipyretics have no role in HS management.Conservative treatment has been described as being successful in the management of patients with HS that manifest severe acute liver injury (ALI) and acute liver failure (ALF). However, early referral to a liver transplantation centre is essential to guide treatment.
- Uncommon Movement Disorders in Chronic Hepatic Disease with Response to RifaximinPublication . Sousa, Ana L; Salgado, Paula; Alves, José E; Silva, Sara; Ferreira, Sofia; Magalhães, MarinaBackground: Chronic hepatic disease can present with extrapyramidal symptoms. We describe two cases that presented with highly unusual movement disorders: ballism and gait freezing. Case report: Patient 1 is a 42-year-old man with previous episodes of hepatic encephalopathy (HE) who presented with upper limb dystonia and generalized chorea that progressed to ballism. Patient 2 is a 55-year-old woman who presented with pronounced gait freezing. In both patients, features of HE and acquired hepatocerebral degeneration coexisted. They improved markedly, though transiently, with rifaximin. Discussion: Ammonia-reducing treatments should be considered in patients presenting with movement disorders due to chronic liver disease.