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Article ; Online: Hemorragia Subgaleal Neonatal

Mariana Portela / Maria Ventura Nogueira / Marta Alves / Almerinda Pereira

Gazeta Médica, Vol 1, Iss

2022 Volume 1

Keywords	Couro Cabeludo ; Hemorragia ; Recém-Nascido ; Medicine ; R ; Medicine (General) ; R5-920
Language	English
Publishing date	2022-09-01T00:00:00Z
Publisher	José de Mello Saúde
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Infeção Nosocomial Relacionada com Cateteres Centrais em Unidade de Cuidados Intensivos Neonatais

Cristiana Maximiano / Carla Cunha / Albina Silva / Almerinda Pereira

Gazeta Médica, Vol 8, Iss

Estudo Prospetivo

2021 Volume 1

Abstract: INTRODUÇÃO: Os acessos intravasculares são indispensáveis nas unidades de cuidados intensivos neonatais (UCIN) nível III. A monitorização das taxas de infeção é considerada um importante indicador dos cuidados de saúde. O objetivo deste estudo é ... ...

Abstract	INTRODUÇÃO: Os acessos intravasculares são indispensáveis nas unidades de cuidados intensivos neonatais (UCIN) nível III. A monitorização das taxas de infeção é considerada um importante indicador dos cuidados de saúde. O objetivo deste estudo é determinar a incidência atual de infeção associada ao uso de cateter central (CC), comparar os resultados com outras publicações e com um estudo prévio realizado na nossa unidade em 2011. MÉTODOS: Estudo prospetivo realizado de janeiro de 2017 a dezembro de 2019 na UCIN do Hospital de Braga. Incluídos todos os recém-nascidos (RN) com CC colocado na nossa unidade. O diagnóstico microbiológico foi efetuado através de colheita de hemocultura e cultura da ponta do CC. RESULTADOS: Foram colocados 404 CC no total, 138 cateteres umbilicais (CU) e 266 cateteres de inserção percutânea (CIP). A idade gestacional média dos RN foi 30,4 semanas (DP±3,89s), o peso ao nascer médio 1380,03 g (DP±742,68 g), com 76,03% de RN com muito baixo peso. O tempo de permanência médio dos CC foi 11,51 dias (DP±11,08 d). Obtivemos 95 culturas positivas da ponta do CC, 25 (26,32%) de CU e 70 (73,68%) de CIP. De 41 hemoculturas colhidas, 9 foram positivas (21,95%), 2 de RN com CU e 7 de RN com CIP. Os Staphylococcus coagulase-negativos foram os micro-organismos mais frequentemente identificados. A taxa de infeção associada ao uso de CC foi 0,5%. A densidade de incidência de contaminação de CC foi 20,43/1000 dias de CC. DISCUSSÃO: Comparativamente ao estudo de 2011, verifica-se uma melhoria significativa na taxa de infeção associada ao uso de CC. A taxa de infeção e os agentes patogénicos identificados são semelhantes aos de outros estudos publicados.
Keywords	Doenças dos Recém-Nascidos ; Infeções Relacionadas a Cateter ; Recém-Nascido ; Unidades de Cuidados Intensivos Neonatais ; Medicine ; R ; Medicine (General) ; R5-920
Language	English
Publishing date	2021-03-01T00:00:00Z
Publisher	José de Mello Saúde
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Facial rash in a newborn

Sílvia Mota / Carla Sá / Nicole Silva / Filipa Almeida / Ana Paula Vieira / Almerinda Pereira

Journal of Pediatric and Neonatal Individualized Medicine, Vol 11, Iss 1, Pp e110127-e

2021 Volume 110127

Abstract: A female newborn, born at 38 weeks from an uncomplicated pregnancy in a healthy 36-years-old mother, presented at birth with desquamative erythematous plaques with irregular borders, distributed bilaterally in the orbital, nasal and malar regions. ... ...

Abstract	A female newborn, born at 38 weeks from an uncomplicated pregnancy in a healthy 36-years-old mother, presented at birth with desquamative erythematous plaques with irregular borders, distributed bilaterally in the orbital, nasal and malar regions. Although there was no history of maternal autoimmune disease, neonatal lupus (NL) was suspected. Maternal and newborn screenings were positive for Sjögren syndrome type A antigen (anti-Ro/SSA) antibodies. No other alterations of NL were found in the newborn. Rheumatologic consultation on the mother showed no other alterations besides the antibodies. The newborn was discharged on day 3 of life without treatment and recommendations to avoid sun exposure. Outpatient follow-up was ensured in neonatology, dermatology and pediatric cardiology. The rash resolved during the first year of life, leaving slight local skin atrophy. NL is a rare transferred autoimmune disease with an incidence estimated as 1:20,000 live births. It occurs due to placental transfer of maternal autoantibodies. The major manifestations are cardiac and cutaneous, but hepatic, hematologic or neurologic findings may also be present. The rash usually affects the face and scalp and may be present at delivery but more often develops later, after exposure to ultraviolet light. It usually resolves within the first year of life without sequelae. NL is the leading cause of congenital heart block, but if it is not present at birth it rarely develops. Some mothers do not have a known autoimmune disease at the time of birth but may develop it later in life. Despite NL being a passively acquired autoimmune disease, the child is at increased risk of rheumatologic disease in childhood or adolescence.
Keywords	neonatal lupus ; neonatal autoimmune disease ; sjögren syndrome type a antigen antibodies ; congenital heart block ; facial rash ; skin lesions ; Medicine ; R ; Pediatrics ; RJ1-570
Subject code	610
Language	English
Publishing date	2021-12-01T00:00:00Z
Publisher	Hygeia Press di Corridori Marinella
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Vein of Galen malformation

Francisca Calheiros-Trigo / Alexandra Cadilhe / João Reis / Nicole Silva / Almerinda Pereira

Journal of Pediatric and Neonatal Individualized Medicine, Vol 9, Iss 2, Pp e090217-e

prenatal diagnosis, postnatal monitoring and treatment

2020 Volume 090217

Abstract: Vein of Galen aneurysmal malformation (VGAM) is a very rare congenital vascular malformation. Also known as the “median prosencephalic arteriovenous fistula”, VGAM is a subtype of dural arteriovenous fistula. It is believed that the development of VGAM ... ...

Abstract	Vein of Galen aneurysmal malformation (VGAM) is a very rare congenital vascular malformation. Also known as the “median prosencephalic arteriovenous fistula”, VGAM is a subtype of dural arteriovenous fistula. It is believed that the development of VGAM occurs between weeks 6 and 11 of embryo development. Prenatal diagnosis is based on fetal ultrasound, between the second and third trimesters. Despite prenatal diagnosis, this congenital malformation is associated with high morbidity and mortality. We report the case of a 38-year-old primigravida referred at 32 weeks of gestational age to our Prenatal Diagnosis Unit for a suspected VGAM. The remaining fetal assessment was normal. At 38 weeks, a male newborn weighing 3,825 g was born. The postnatal evaluation confirmed VGAM. Endovascular treatment was performed at 4 and 5 months, without complications. The patient is currently 9 months old and has a normal neurodevelopment.
Keywords	vein of galen aneurysmal malformation ; arteriovenous malformation ; congestive heart failure ; hydrocephalus ; prenatal diagnosis ; endovascular embolization ; Medicine ; R ; Pediatrics ; RJ1-570
Subject code	610
Language	English
Publishing date	2020-09-01T00:00:00Z
Publisher	Hygeia Press di Corridori Marinella
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Spontaneous depressed skull fracture in a neonate

Francisca Calheiros-Trigo / Maria João Machado / Rui Almeida / Nicole Silva / Almerinda Pereira

Journal of Pediatric and Neonatal Individualized Medicine, Vol 9, Iss 2, Pp e090216-e

2020 Volume 090216

Abstract: The most common cause of neonatal skull fracture is trauma from instruments used during an assisted birth. In the literature, there are limited reports of neonatal depressed skull fractures (DSF) in the absence of birth trauma. The diagnosis is based on ... ...

Abstract	The most common cause of neonatal skull fracture is trauma from instruments used during an assisted birth. In the literature, there are limited reports of neonatal depressed skull fractures (DSF) in the absence of birth trauma. The diagnosis is based on clinical and radiological findings. We present the case of a female neonate, born full-term after a eutocic delivery. The pregnancy was unremarkable. There was no history of trauma during pregnancy or delivery. At birth, a congenital depression in the right parietal region was noted. Head computed tomography revealed a right parietal depressed fracture, without underlying brain lesion. Surgical elevation was performed with favourable outcome. There were no complications. The patient is currently 9 months old and has a normal neurodevelopment.
Keywords	depressed skull fracture ; ping pong skull fracture ; skull fracture elevation ; labour ; neonatal ; newborn ; Medicine ; R ; Pediatrics ; RJ1-570
Language	English
Publishing date	2020-09-01T00:00:00Z
Publisher	Hygeia Press di Corridori Marinella
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Stickler syndrome

Vasco Carvalho / Diana Rita Oliveira / Marta Ribeiro Silva / Lídia Leite / Miguel Gonçalves Rocha / Liliana Pinheiro / Almerinda Pereira

Journal of Pediatric and Neonatal Individualized Medicine, Vol 11, Iss 1, Pp e110128-e

case report

2021 Volume 110128

Abstract: Introduction: Stickler syndrome is a connective tissue disorder that can include midfacial underdevelopment and cleft palate, ocular findings (myopia, cataract, and retinal detachment), hearing loss that is both conductive and sensorineural and mild ... ...

Abstract	Introduction: Stickler syndrome is a connective tissue disorder that can include midfacial underdevelopment and cleft palate, ocular findings (myopia, cataract, and retinal detachment), hearing loss that is both conductive and sensorineural and mild spondyloepiphyseal dysplasia and/or precocious arthritis. The phenotypical expression of Stickler syndrome is variable and typically associated with allelic heterogeneity. Description of case: Full-term newborn, cesarean delivery at 40 weeks. Fetal ultrasounds with orofacial malformation and mild hydronephrosis. The prenatal genetic screening test was negative. Fetal karyotype and array were normal with a male genomic profile. Fetal cerebral MRI showed brachycephalic skull configuration. At 10 minutes of life, the newborn had hypoxemia and was admitted to the Neonatal Intensive Care Unit. He had macrocephaly, but height and weight were adequate for the gestational age. At observation, he had axial hypotonia, craniofacial dysmorphia and posterior cleft palate. Mandibular hypoplasia and findings were compatible with connective tissue disease in 3D-CT. He had marked retinal choroiditis and pathological myopia and did not pass the neonatal hearing screening. Echocardiogram and capnography were normal. The hypothesis of Stickler syndrome was confirmed genetically with the COL11A1 gene mutation, variant c.2952+1G>T. Nowadays, at 13 months old, he maintains a multidisciplinary approach, with normal growth and psychomotor development. Conclusion: This case aims to illustrate a patient with a typical phenotype of a rare syndrome with posterior genetic confirmation. Multidisciplinary monitoring is essential to allow the timely diagnosis of complications associated with this syndrome (mitral valve prolapse or retinal detachment) and to assess the evolution of growth and psychomotor development.
Keywords	stickler syndrome ; case report ; retinal choroiditis ; bilateral exophthalmos ; craniofacial dysmorphia ; Medicine ; R ; Pediatrics ; RJ1-570
Subject code	610
Language	English
Publishing date	2021-12-01T00:00:00Z
Publisher	Hygeia Press di Corridori Marinella
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Thoracoscopic Lobectomy for Congenital Pulmonary Airway Malformation with Prenatal Diagnosis

Catarina Barroso / Andreia Felizes / Ana Raquel Silva / Inês Braga / Marta Gonçalves / Helena Salgado / Augusta Gonçalves / Alexandra Cadilhe / Almerinda Pereira / Maria João Santos / Jorge Correia-Pinto

Portuguese Journal of Pediatrics, Vol 52, Iss

2021 Volume 1

Abstract: INTRODUCTION: Congenital pulmonary airway malformations (CPAM) are increasingly diagnosed in the prenatal period raising concerns on the post-natal management of asymptomatic cases. Favoring early resection are the concepts of better compensatory lung ... ...

Abstract	INTRODUCTION: Congenital pulmonary airway malformations (CPAM) are increasingly diagnosed in the prenatal period raising concerns on the post-natal management of asymptomatic cases. Favoring early resection are the concepts of better compensatory lung growth, and prevention of long-term risk of infection and malignancy. Our aim was to review the results of our conduct over the years, in which we promote early thoracoscopic resection. METHODS: We have analyzed the series of patients with congenital pulmonary malformations submitted to thoracoscopic resection at our department, focusing on the infants with prenatal diagnosis of CPAM. RESULTS: From March 2012 to March 2020, we have performed 24 thoracoscopic pulmonary resections at our department for CPAM, congenital lobar emphysema, pulmonary sequestration, bronchogenic cyst and pleuropulmonary blastoma. Among these, nineteen performed thoracoscopic pulmonary lobectomy, including 14 children with prenatal diagnosis of CPAM that were operated during infancy. In our series of thoracoscopic pulmonary lobectomy, we did not have any perioperative complication. Regarding post-operative complications, we have to report two cases treated conservatively, but none in the subgroup of CPAM with prenatal diagnosis. Median length of stay was three days. In the entire series two patients report recurrent wheezing, whilst in the prenatal diagnosed CPAM subgroup all patients have a completely uneventful follow-up. CONCLUSION: Early thoracoscopic resection of prenatal diagnosed CPAM is safe and should be considered in cases with significant lung (morphological) malformation as the esthetic and clinical outcomes are excellent.
Keywords	Pediatrics ; RJ1-570 ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2021-02-01T00:00:00Z
Publisher	Sociedade Portuguesa de Pediatria
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Perinatal stroke

Joana Teixeira / Carla Sá / Henedina Antunes / Sandra Costa / Célia Barbosa / João Fernandes / Almerinda Pereira

Journal of Pediatric and Neonatal Individualized Medicine, Vol 6, Iss 2, Pp e060220-e

a six-year experience in a level-III maternity

2017 Volume 060220

Abstract: Aims: To study the incidence of perinatal stroke in a level-III maternity as well as potential risk factors, clinical presentation, neuroimaging, classification and clinical outcome of children with a minimum follow-up of 24 months. Methods: Historical ... ...

Abstract	Aims: To study the incidence of perinatal stroke in a level-III maternity as well as potential risk factors, clinical presentation, neuroimaging, classification and clinical outcome of children with a minimum follow-up of 24 months. Methods: Historical prospective follow-up of all term and late preterm newborns diagnosed with perinatal stroke from January 2008 to December 2013. Results: Fifteen perinatal strokes were diagnosed in a total of 17,056 newborns (incidence 0.9/1,000). Thirteen had potential risk factors and fourteen were symptomatic. Median age at diagnosis was two days. Seizures were the most frequent symptom (14/15), being three focal-clonic, one multifocal-clonic, two generalized-tonic, three focal-tonic and five subtle. Cerebral ultrasound was performed in eleven newborns at an early stage, suggesting the diagnosis in six. Cerebral magnetic resonance imaging (MRI) confirmed the diagnosis in fifteen. Six had an arterial ischemic stroke, eight a cerebral venous thrombosis and one a hemorrhagic stroke. An electroencephalogram was obtained in all newborns with seizures revealing epileptic activity in eight. Search for prothrombotic disorders (in newborn and both parents) showed four newborns heterozygous methylene tetrahydrofolate reductase mutation and two neonatal alloimune thrombocytopenia. No recurrence of stroke was reported. Formal development evaluation was performed in thirteen and was normal in eleven, while in two revealed delayed psychomotor development, both of which with epilepsy. On the neonatology outpatient clinic follow-up, the current median age is 3 years and 11 months. Conclusions: This study reinforces the need to maintain high level of suspicion for perinatal stroke and the importance of MRI in the classification and etiological study. Our follow-up supported a good outcome of perinatal stroke.
Keywords	brain mri ; cerebral venous thrombosis ; follow-up ; perinatal stroke ; seizures ; sequelae ; Medicine ; R ; Pediatrics ; RJ1-570
Subject code	610
Language	English
Publishing date	2017-09-01T00:00:00Z
Publisher	Hygeia Press di Corridori Marinella
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: No Limiar Da Viabilidade

Marlene Rodrigues / Clara Machado / Nicole Silva / Carla Sá / Albina Silva / Eduarda Abreu / Liliana Pinheiro / Almerinda Pereira / Miguel Costa

Portuguese Journal of Pediatrics, Vol 49, Iss

Casuística de Dez Anos Num Hospital de Apoio Perinatal Diferenciado

2018 Volume 2

Abstract: Introdução: Nas últimas décadas, os avanços na tecnologia, cuidados obstétricos e neonatais têm possibilitado a sobrevivência de recém-nascidos pré-termo com idades gestacionais cada vez menores. Aumentar a sobrevivência, sem aumentar a morbilidade e ... ...

Abstract	Introdução: Nas últimas décadas, os avanços na tecnologia, cuidados obstétricos e neonatais têm possibilitado a sobrevivência de recém-nascidos pré-termo com idades gestacionais cada vez menores. Aumentar a sobrevivência, sem aumentar a morbilidade e sequelas, é dos maiores desafios da medicina perinatal. Este trabalho pretendeu analisar a morbilidade e mortalidade nos nados-vivos nascidos entre as 23 e 25 semanas e seis dias de idade gestacional e determinar o limiar de viabilidade, num hospital de apoio perinatal diferenciado. Métodos: Estudo retrospetivo abrangendo o período de 1 de junho de 2006 e 31 de maio de 2016. Avaliaram-se dados demográficos, morbilidade, mortalidade e evolução, incluindo fatores de morbilidade major e sequelas graves do neurodesenvolvimento aos 24-30 meses. Resultados: Estudaram-se 28 recém-nascidos, seis com 23 semanas, 12 com 24 semanas e 10 com 25 semanas, com mediana de peso ao nascer de 631,5 g. A mortalidade global foi 68% e o limiar de viabilidade foi as 25 semanas. Constatou-se que a idade gestacional e o peso ao nascimento foram os únicos fatores associados a morte. Todos os recém-nascidos com peso superior 800 g sobreviveram e todos eles tinham 25 semanas de idade gestacional. Não se encontrou associação estatisticamente significativa entre as variáveis avaliadas e o desenvolvimento de sequelas graves. Todos os sobreviventes com 24 semanas apresentaram um ou mais fatores adicionais de morbilidade major e 67% apresentaram sequelas graves; com 25 semanas, 50% não apresentaram fatores adicionais de morbilidade major nem sequelas graves. Discussão: A morbilidade e mortalidade foram elevadas e o limiar de viabilidade foi as 25 semanas de idade gestacional.
Keywords	Pediatrics ; RJ1-570 ; Medicine (General) ; R5-920
Language	English
Publishing date	2018-04-01T00:00:00Z
Publisher	Sociedade Portuguesa de Pediatria
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Síndrome Cri du Chat

Sandra Costa / Joana Dias / Albina Silva / Eduarda Abreu / Almerinda Pereira

Ecos do Minho, Vol 8, Iss 1, Pp 39-

2013 Volume 40

Keywords	Medicine ; R ; Pediatrics ; RJ1-570
Language	Portuguese
Publishing date	2013-06-01T00:00:00Z
Publisher	Associação Pediátrica do Minho
Document type	Article ; Online
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