RN&C: Ano de 2025
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- Breastfeeding for Better Health – A Community-Based InterventionPadilha, Sofia; Arantes, Pedro; Sarmento de Beires, Teresa; Ribeiro, Joana; Eiras, AndreiaIntroduction: Breastfeeding provides multiple health benefits for both mother and child. Several studies suggest that community interventions enhance breastfeeding literacy, practice and duration. The authors developed an intervention to improve parents’ knowledge of the benefits of breastfeeding in the prenatal period as a means of promoting this practice. Methods: An informative session on breastfeeding was organized for pregnant women registered at USF Rainha D. Amélia and their partners. Questionnaires were implemented before, immediately after, and one month post-session to assess knowledge at these intervals. Statistical analysis included descriptive analysis, comparison between questionnaires and analysis of the effect of several variables on knowledge progression. Results: The study included 33 participants, 78.8% of whom were women. Initial questionnaire results showed 67.3% correct answers, which increased to 91.5% immediately post-session, representing a 36% improvement (p < 0.001). Level of education was the sole predictor of higher initial knowledge (p = 0.023). Age and level of education significantly impacted knowledge progression (p = 0.034), but after adjusting for confounders, only previous attendance of a breastfeeding course predicted greater knowledge progression (p = 0.023). Discussion: The project effectively met its goals, confirming the efficacy of community interventions on breastfeeding conducted by healthcare professionals. Age, level of education, and prior breastfeeding knowledge positively influenced the decision to breastfeed. Father’s involvement and increased understanding of breastfeeding will likely enhance their ability to support the mothers. Conclusion: This community intervention positively impacted breastfeeding literacy.
- Campylobacter spp Gastroenteritis in Paediatric Patients of a Portuguese Hospital: Impact of the COVID-19 PandemicDe Beir, Joana; Caniço, Joana; Mesquita, Marta; Almeida, SílviaIntroduction: Campylobacter spp is the main cause of acute bacterial gastroenteritis. This study aims to characterise cases of Campylobacter spp acute gastroenteritis (CAG) over the past 10 years in a Portuguese hospital setting and to assess the impact of the COVID-19 pandemic on the incidence and management of these infections. Methods Observational descriptive study of CAG in a Portuguese Paediatrics Department, from 01. June.2013 to 31. December.2023. Diagnosis was established by stool culture/molecular methods. Results: Among 3391 stool samples analysed, 766 tested positive, and Campylobacter spp was isolated in 582 of them. A total of 502 CAG were diagnosed: 89% caused by C. jejuni, 63% were male, and the median age was 2 years. Co-infections were found in 12% of the cases. The incidence of CAG increased over the years, mainly after the emergence of the COVID-19 pandemic. Conclusions: Over the last 10 years, there has been an increase of CAG, mainly affecting young children and boys. After COVID-19, the incidence of campylobacteriosis increased, for reasons that remain to be clarified. Although the clinical course was mostly benign, the acute complications raised after the pandemic.
- Cyberbullying in pre-adolescence - reality of a city in northern PortugalMelo, Vanda; Pacheco, Pedro; Portela, Mariana; Costa, Sandra; Ribeiro, HelenaIntroduction: The rapid evolution of communication technologies has enabled easy and premature access for children and young people to social networks, the internet, and smartphones. The indiscriminate use of these technologies has led to the emergence of cyberbullying. The objective was to analyse the prevalence of cyberbullying and the most frequent forms involved in this age group. Methods: A cross-sectional observational study was conducted through anonymous questionnaires distributed in primary schools (2nd and 3rd cycles) in the municipality. Results: The study included 482 students, with a median age of 12 years (9-15 years), and a similar gender distribution (55% female, 45% male). Regarding the daily screen time, 20.5% reported spending less than 1 hour, 47.7% between 1 to 3 hours, while 31.1% spent more than 3 hours per day. The prevalence of cyberbullying in the studied sample was 30.9%, with 34.9% of them admitting to being victims in the last 3 months, with only 50% requesting help. The most reported type of cyberbullying was being excluded from a chat or social network. In the subsample of children who experienced cyberbullying, a statistically significant relationship was found between victimization and being female (p-value 0.046) and between victimization and being an aggressor (p-value <0.001). Conclusion: According to this study, the exposure to digital technology in this age group is practically universal, with a cyberbullying prevalence of around 31%. This alarming victimization rate occurs during a crucial phase of the child’s social and emotional development.
- Dermatologic clinical caseSantos, Raquel; Quintela, Carolina; Silva, Joana Azevedo; Peralta, Lígia; Sá, AidaPhytophotodermatosis (PPD) is a skin reaction caused by contact with furocoumarins, photosensitizing substances present in certain plants, followed by exposure to ultraviolet radiation. Herein we report a case of a 17-year-old teenager who developed a cutaneous reaction after using rue (Ruta graveolens) as a homemade treatment for acne. The condition presented with a characteristic inflammatory phase, followed by a hyperpigmentation phase. A diagnosis of PPD due to rue was established, and with rue eviction there was a full resolution. The authors aim to raise awareness about this condition which requires a high level of clinical suspicion for identifying the etiological agent. Prompt recognition and intervention are crucial in preventing the worsening and recurrence of the reaction.
- Feeding difficulties in the offspring of mothers with an eating disorder - a case reportCarvalho e Marques, Pedro; Sá, Teresa; Martins, VâniaBackground: One of the main risk factors for eating disorders (ED) in early childhood is maternal ED. Mothers with a history of ED have difficulties in their approach to feeding their children, with mealtimes being perceived as stressful, with controlling behavior and intrusiveness. Case presentation: An 11-month-old female infant was evaluated at a Child Psychiatry Consultation for feeding difficulties. Her mother had a history of Restrictive Anorexia Nervosa. Mother-child psychotherapy was performed due to a pattern of insecure attachment and an ongoing conflict over control and autonomy between the caregiver-child. After the intervention, mealtimes became more natural and less conflictual. Discussion and conclusion: The authors aim to shed light on the transgenerational transmission of ED. Feeding interactions between mothers with ED and their offspring are less harmonious, with greater conflict, controlling behaviors, negative affect and decreased emotional availability to the child. Clinicians must be aware of a potential parental history of ED when dealing with children with feeding problems.
- Lipschütz ulcer: a diagnosis to remember in acute genital ulceration in adolescentsSampaio, Margarida Camanho de; Martins, Cátia; Pereira, Patrícia; Hipólito, Elsa; Flores, Maria ManuelLipschütz ulcer (LU) is a rare cause of acute genital ulceration, usually in a mirror pattern, that mainly affects adolescents without previous sexual contact. The aetiology is unclear, but infectious and idiopathic causes have been associated with its onset. LU can cause significant pain but is self-limited and typically resolves within two to six weeks. A case report of a 12-year-old girl with LU is presented, who was initially misdiagnosed with genital herpes. After excluding other causes of genital ulceration, she was ultimately diagnosed with LU and treated with symptomatic medication for pain control and healing optimization.. The patient fully recovered after five weeks and remained asymptomatic after one year.LU is a rare cause of vaginal ulceration in non-sexually active adolescents that can be easily overlooked in the differential diagnosis. The disease is self-limited, but in some cases may require hospitalization for pain management.
- Phytophotodermatitis: a challenging diagnosis in childrenCosta, Ana Isabel; Vilarinho, Catarina; Pereira, OlgaPhytophotodermatitis, a form of plant dermatitis, is a common phototoxic reaction resulting from the interaction between photosensitising botanical substances present in several common plant families and ultraviolet radiation. We report a case of phytophotodermatitis in an 8-month-old infant who presented a progressively well-demarcated erythematous rash with blisters and subsequent erosions covering both upper limbs and feet. Additionally, asymmetric hyperpigmented streaks with bizarre configurations, were observerd in photo-exposed areas. The diagnosis of phytophotodermatitis was established based on the history of outdoor activities with sun exposure and physical examination findings. Topical treatment with antibiotic and corticosteroid cream was started. The phytophotodermatitis is a self-limiting condition, which can be challenging to diagnosis in this age group due to heterogeneity of clinical manifestations, which can mimic a range of different diseases, such as non-accidental injury in the context of child abuse, potentially delaying timely diagnosis and treatment.
- Pollen-food syndrome during pediatric age: a case seriesCunha, Francisca; Rodrigues dos Santos, Filipa; Cunha, Leonor; Falcão, HelenaIntroduction: Pollen-food syndrome (PFS) is an immunoglobulin E-mediated reaction, caused by cross-reactivity between pollen and antigens of foods such as those in fruits, vegetables, and/or nuts, in patients with pollinosis. Aims and Methods: The aim of this study was to present clinical manifestations of PFS, using a case series of six pediatric patients with PFS and pollen allergy referred to our Allergy and Clinical Immunology Department. Results: The age at diagnosis ranged between 10 and 17 years old, and three of the patients were male. All patients reported experiencing oral allergy syndrome. The main foods reported as triggers were apple, peach, pear, kiwi and banana. The allergic diagnostic workup revealed sensitisation to PR-10 and profilins, the main proteins involved in PFS. Currently, all patients remain asymptomatic after the fresh fruits’ eviction. Conclusion: We emphasize the importance of recognition of this entity to provide an adequate management.
- Purpuric rash in an adolescentMelo, Joana; Margalha Miranda, Ana; Pereira Fernandes Garcês, SóniaA previously healthy 17-year-old girl presented to the emergency department with a 14-day history of fever, sore throat, and a generalized reddish-purple pruritic rash. The rash, initially erythematous and maculopapular, worsened and became coalescent and purpuric. She had been treated with azithromycin for three days starting on the third day of illness. Physical examination revealed a good general condition, pharyngeal erythema with exudate, and a purpuric rash covering the body, including the face, palms, and soles, without other systemic signs. Serological tests confirmed a diagnosis of acute infectious mononucleosis. The patient was managed conservatively and had fully recovery at re-evaluation, 50 days after symptom onset. Acute infectious mononucleosis typically presents with fever, cervical lymphadenopathy, and tonsillitis/ pharyngitis, with spontaneous exanthema occurring in 3-15% of cases. This case highlights the importance of considering acute infectious mononucleosis in adolescents presenting with purpuric exanthema and the potential for antibiotic-associated rash including azithromycin, emphasizing the need for thorough clinical and serological evaluation.
- Right aortic arch: the value of the upper mediastinum view in fetal echocardiographyFerreira, Beatriz Sousa; Almeida, Francisca Ferreira de; Correia, Ana IsabelThe prenatal diagnosis of a right aortic arch consists of the visualization of a malposition of the aorta crossing the upper mediastinum to the right side of the trachea. The detection rate of this anatomic abnormality has improved with the introduction of the upper mediastinum views in routine fetal ultrasonographic evaluation. The following casereport demonstrates a fetus affected by an isolated right aortic arch emphasizing the importance of the five Yagel views of the fetal heart.