Browsing by Issue Date, starting with "2024-09-30"
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- Pediatric hospitalizations for respiratory infections: Before and after SARS-CoV-2Monteiro, Sara; Salazar, Luís; Oliveira, João; Souto, Mariana; Morais, Lurdes; Ramos, Ana; Ferreira-Magalhães, ManuelIntroduction: With the emergence of the COVID-19 pandemic, several non-pharmacological measures were adopted to prevent and control the transmission of SARS-CoV-2. Objective: To compare pediatric hospitalizations for acute respiratory infections (ARIs) before and after the emergence of SARS-CoV-2. Materials and Methods: This was a retrospective, observational study of admissions for ARIs in the pediatric ward of a tertiary hospital between April 2018 and March 2021. Inclusion criteria comprised: hospitalization of pediatric patients ([0-17[ years); length of stay >24 hours; and a respiratory infection diagnosis code from ICD-10. Data were collected using electronic clinical records. The first two years were considered ‘non-COVID-19 years’ (year[Y]1 and Y2), while the period between April 2020 and March 2021 was considered the ‘COVID-19 year’ (Y3). Results: A total of 783 hospitalizations were included in the analysis. There was a significant decrease in ARIs admissions in Y3 compared to Y1 and 2 (-67% from Y2 to Y3; p<0.001), with a decrease in the proportion of bronchiolitis cases (-42% from Y2 to Y3; p<0.001) and an increase in pneumonia cases (+124% from Y2 to Y3; p<0.001). There was a significant decrease in the incidence of respiratory viruses from Y2 to Y3 (76.6% vs. 56.4%; p<0.001), mainly driven by a decrease in respiratory syncytial virus (RSV; 46.8% in Y2 vs. 2.0% in Y3; p<0.001). Conversely, there was a significant increase in the incidence of rhinovirus from Y2 to Y3 (15.3% vs. 22.8%; p<0.001), and SARS-CoV-2 was identified in 31.7% of cases in Y3. More chest computed tomography scans were performed (5.6% vs. 10.9%; p<0.001) and more systemic steroids were used (26.3% vs. 40.6%; p=0.023) from Y2 to Y3. Conclusions: Population-based non-pharmacological measures implemented during the COVID-19 pandemic were associated with a reduction in pediatric hospitalizations for ARIs. The decrease in ARIs due to RSV is particularly noteworthy in this pandemic context.
- Miliary tuberculosis – A challenging diagnosisSilva, Catarina Pinto; de Sousa, Beatriz; Lima, Joana; Vasconcelos, Sofia; Rebelo, Alícia; Lobo, Ana Luísa; Fernandes, AlexandreTuberculosis is a challenging diagnosis with marked clinical heterogeneity that can lead to diagnostic delay and serious and potentially life-threatening problems. The most prevalent form of the disease is pulmonary tuberculosis. The present case has unique features as in that it describes a case of miliary tuberculosis in an immunocompetent adolescent vaccinated with the Bacillus Calmette-Guerin vaccine and raises awareness of the occurrence of normal radiograph and early in the course of pulmonary tuberculosis, and normal head tomography even in the presence of tuberculous meningitis, highlighting the need for a high index of suspicion. It also shows that tuberculosis should be included in the differential diagnosis of fever of unknown origin with weight loss, even when no epidemiologic link has been established
- Snakebite poisoning: A neglected diseaseDe Matos, Bárbara Barroso; Gaspar, Nélio Santos; Ferreira, SaraSnakebite is a rare but potentially fatal cause of poisoning in children worldwide. It is a neglected public health issue in Europe, mainly affecting farmers and children, the latter suffering more severe consequences due to their small body mass. If poisoning is suspected, hospitalization of these patients is mandatory for clinical monitoring and early initiation of therapy. Snakebite can be a medical emergency. However, unlike many other serious health conditions, there is a highly effective treatment – anti-ophidian serum. It is crucial to invest in more effective and safer serums and to make them easily accessible in the event of a snakebite. The case of an adolescent affected by viper bite, its treatment and clinical course is reported.