Browsing by Author "Fonseca, Paula"
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- Dermatology clinical casePublication . Vilela Oliveira, Raquel; Bordalo, Diana; Carvalho, Sónia; Fonseca, PaulaA previously healthy 15-year-old girl was sent to the Pediatric Emergency Department by the general practitioner due to suspicion of a hematological condition. The girl presented with ecchymotic lesions on the anterior region of the thorax and antero-proximal region of the upper limbs, which had apparently worsened in the last 24 hours. She denied trauma or impact sports, fever or recent infections, and blood loss or other symptoms. Laboratory evaluation showed no alterations and urine toxicology screening was negative. When confronted with normal laboratory evaluation, the girl confessed intentional self-inflicted injuries following a discussion with her mother. Parents were made aware of the situation, and a pediatric psychiatry consultation was recommended. After discharge, follow-up in the girl’s home country was assured. With this report, the author intend to raise awareness of the importance of maintaining a high index of suspicion to non-suicidal self-injury, identifying alarm signs and establishing early preventive strategies.
- Dor abdominal em adolescentePublication . Almeida, Filipa; Melo, Cláudia; Santos, Susana Vilar; Cunha, Diogo; Fonseca, PaulaDoente do sexo feminino de 16 anos de idade, recorreu ao serviço de urgência por dor abdominal com duas semanas de evolução localizada à fossa ilíaca esquerda (FIE) associada a obstipação. Negava atividade sexual, referindo último cataménio três semanas antes. Apresentava palpação abdominal dolo- rosa na FIE, sem defesa ou sinais de irritação peritoneal. Estudo analítico inicial e exame sumário de urina normais. Ecografia abdomino-pélvica revelou quisto complexo na região anexial esquerda e ascite de médio volume. Foi doseada a hormona gonadotrofina coriónica sérica que foi positiva (2608 mUI/mL). A ecografia transvaginal revelou quisto simples com área adjacente de aspeto reticular, não evidenciando qualquer imagem de saco gestacional intrauterino. Foi submetida a laparotomia exploradora, constatando-se hemoperitoneu e gravidez ectópica tubar esquerda e efetuada salpingectomia esquerda. Os autores pretendem alertar para uma causa rara de dor abdominal na adolescência, que deverá ser considerada de for- ma a evitar um desfecho potencialmente fatal.
- 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.
- The Anatomic Pathology laboratory adjustments in the era of COVID-19 pandemic: The experience of a laboratory in a Portuguese central hospitalPublication . Lamas, Nuno Jorge; Esteves, Sara; Alves, Joana Raposo; Costa, Francisca Emanuel; Tente, David; Fonseca, Paula; Vizcaíno, JoséThe coronavirus disease 2019 (COVID-19) pandemic has dramatically changed the world over the past weeks, with already 8,25 million infections and 445,000 deaths worldwide, leading to an unprecedented international global effort to contain the virus and prevent its spread. The emergence of novel respiratory viruses such as the SARS-CoV-2 creates dramatic challenges to the healthcare services, including surgical pathology laboratories, despite their extensive daily experience in dealing with biological and chemical hazards. Here, we cover important aspects on the knowledge on COVID-19 gathered during the first six months of the pandemic and address relevant issues on human biological sample handling in the Anatomic Pathology laboratory in the context of COVID-19 global threat. In addition, we detail our strategy to minimize the risk of contamination upon exposure to the different biological products received in the laboratory, which can be of general interest to other laboratories worldwide. Our approach has enabled a safe work environment for laboratory staff, while ensuring the maintenance of high quality standards of the work performed. In times of uncertainty and given the lack of specific guidelines directed at Anatomic Pathology services to better deal with the global COVID-19 public-health emergency, it is essential to share with the community rigorous methodologies that will enable us to better cope with probable novel waves of COVID-19 infection and other viruses that will possibly arise in the near future.
- Unintentional injuries and associated factors among adolescentsPublication . Bordalo, Diana; Fonseca, Paula; Lopes, Tânia; Rolim, Sara; Figueirinha, Joana; Almeida, Filipa; Melo, Cláudia; Neves, Sérgio; Palha, Francisca; Araújo e Sá, Gabriela; Fonseca, HelenaIntroduction: Unintentional injuries are an important cause of death in adolescents, as well as a major cause of ill health. This age group is prone to unintentional injuries due to their specific biological, psychological, and social characteristics. To prevent these injuries, it is crucial to understand their prevalence and associated factors. The aim of this study was to identify and characterize unintentional injuries in adolescents and their potential impact on health and life. Material and Methods: Prospective, observational, two-center study over one year based on a survey of adolescents admitted to the Emergency Department due to unintentional injuries. Results: The study included 1054 adolescents (840 from Center A and 214 from Center B), mostly male (58.2%), 51.6% of which in early adolescence (10 to 13 years old) and only 11.2% in late adolescence (17 to 18 years old). Alchool or drug use were reported by 2.3% of participants. Main reported injuries included traumatic injuries (mainly during sports), accidental falls (mainly at school), and road traffic accidents (being run over by a car as the most frequent). Acidental falls and traumatic injuries were more common in early adolescence, whereas burns, road traffic accidents, and intoxications were more frequent in middle adolescence. Low frequency of personal protection equipment use (31.3%) was reported by bycicle riders. School absence was reported in 31% of cases, mainly associated with traumatic injuries (49.8%) and falls (40.1%). Conclusion: Most reported unintentional injuries had preventable causes and their prevalence was developmental stage-dependent. These results provide additional data for implementation of preventive measures according to developmental adolescence stages.