Publications by authors named "Fábia Carvalho"

7 Publications

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Follow-up of infants born to mothers with Graves' disease.

Endocrinol Diabetes Nutr 2021 Aug-Sep;68(7):472-480. Epub 2020 Dec 30.

Pediatric Endrocrinology Unit of Pediatric Department, Hospital de Braga, Braga, Portugal.

Introduction: The prevalence of neonatal hyperthyroidism (HN) due to maternal Graves Disease (GD) ranges from 0.1 to 2.7%. It may occur in pregnant women with the following: active DG, after treatment with radioactive iodine, anti-thyroid or thyroidectomy or with a previous child with hyperthyroidism. The aim of our observational study was to evaluate the follow-up of infants born to mothers with GD at a Tertiary Hospital prior to the implementation of a follow-up protocol.

Methods: This was a retrospective observational study using data from the medical records of mothers with a diagnosis of GD and their newborns from January 2013 until May 2018. Newborns were divided into two groups: high and low risk for NH according to maternal TRAb, third trimester treatment and signs of fetal hyperthyroidism.

Results: We identified 31 newborns, 58% female; 87% high risk. In none of the newborns was umbilical cord blood collected. In the high risk group, 22% had thyroid function evaluation at day-1, one patient presented with hyperthyroidism and 82% were asymptomatic. Considering the cases with an insufficient blood sample for analysis, 9 consultations would have been spared. We found a significant delay in obtaining the high-risk group results which would have spared 10 appointments. A positive correlation was found between age at outpatient clinic discharge and the number of appointments and the maternal TRAb titer.

Conclusion: The correct surveillance of pregnancy and newborns with identification of those at high risk is essential to avoid unnecessary consultations and blood analyses that increase parental anxiety and hospital costs. Consequently, a multidisciplinary protocol was created to standardize the approach.
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http://dx.doi.org/10.1016/j.endinu.2020.09.005DOI Listing
December 2020

Sleep quality and bullying - prevalence in a cohort of Portuguese students.

Int J Adolesc Med Health 2020 Jun 6. Epub 2020 Jun 6.

Unit of Adolescent Medicine in Pediatrics, Department of Hospital de Braga, Braga, Portugal.

Objectives The involvement of adolescents in violent behaviors is becoming an important public health problem that is concerning physicians as it is associated with a decrease in adult life quality. In this context, bullying is a type of aggressive behavior that occurs repeatedly in interpersonal relationship where power imbalance exists increasing the risk of physical and psychosocial problems in all its intervenient. Prevalence of bullying in Portuguese adolescents is estimated to be ranging from 16.2 to 27.5%. Sleep disorders are a well-known problem related to bullying situations, either as a consequence or a risk factor; estimated prevalence in adolescence is 25% worldwide. In the present study we aimed to investigate the association between sleep quality and the involvement in school bullying in Portuguese adolescents in two high schools. Methods Data collected from a cross-sectional survey addressing questions on bullying behaviors and sleep quality was analyzed using SPSS 22.0. A two-tailed p-value of less than 0.05 was considered significant for all tests. Results We have included 171 adolescents, mean age of 14.39 ± 1.149 years, 59.6% were boys; prevalence of bullying behaviors was 28.1%. Among the students 15.2% were identified as "pure victims", 8.8% as "pure bullies", 4.1% as "bully-victims" and 71.9% as "neutrals". "Pure bullies" and "bully-victims" present higher Athens Insomina Scale (AIS) scores (p = 0.004) and higher prevalence of insomnia (p = 0.004). The prevalence of insomnia was significantly higher in the group involved in bullying behaviors comparing with the neutrals (58.3% vs 30%, p = 0.001). We verified that 65.4% of the reported bullying situations took place inside the school and 8.8% of those teachers did nothing to help the victim and in 17.5% school staff took the same attitude. Conclusions We found a prevalence of bullying behaviors higher than the one reported in previous studies and a prevalence of insomnia of 38.0%, proving that bullying and sleep disturbances are two major problems in adolescence which may increase future risk for psychiatric symptoms, involvement in criminal activities, hyperactive, and inattentive behaviors. We verified a strong relation between insomnia and involvement in bullying situations with those who are involved reporting difficulties in sleep induction. The group of "bully-victims" was identified as potentially being the one with the most troubled adolescents since they combine characteristics of both bullies and victims. The authors conclude that there should be an investment in school-based interventions that help recognize and reduce school bullying and change lifestyle behaviors that may negatively influence adolescents' development.
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http://dx.doi.org/10.1515/ijamh-2020-0018DOI Listing
June 2020

ATLANTIC EPIPHYTES: a data set of vascular and non-vascular epiphyte plants and lichens from the Atlantic Forest.

Ecology 2019 02;100(2):e02541

Centro de Ensino Superior em Juiz de Fora (CESJF), Campus Arnaldo Janssen, Luz Interior, 345, Santa Luzia, Juiz de Fora, Minas Gerais, 36030-776, Brazil.

Epiphytes are hyper-diverse and one of the frequently undervalued life forms in plant surveys and biodiversity inventories. Epiphytes of the Atlantic Forest, one of the most endangered ecosystems in the world, have high endemism and radiated recently in the Pliocene. We aimed to (1) compile an extensive Atlantic Forest data set on vascular, non-vascular plants (including hemiepiphytes), and lichen epiphyte species occurrence and abundance; (2) describe the epiphyte distribution in the Atlantic Forest, in order to indicate future sampling efforts. Our work presents the first epiphyte data set with information on abundance and occurrence of epiphyte phorophyte species. All data compiled here come from three main sources provided by the authors: published sources (comprising peer-reviewed articles, books, and theses), unpublished data, and herbarium data. We compiled a data set composed of 2,095 species, from 89,270 holo/hemiepiphyte records, in the Atlantic Forest of Brazil, Argentina, Paraguay, and Uruguay, recorded from 1824 to early 2018. Most of the records were from qualitative data (occurrence only, 88%), well distributed throughout the Atlantic Forest. For quantitative records, the most common sampling method was individual trees (71%), followed by plot sampling (19%), and transect sampling (10%). Angiosperms (81%) were the most frequently registered group, and Bromeliaceae and Orchidaceae were the families with the greatest number of records (27,272 and 21,945, respectively). Ferns and Lycophytes presented fewer records than Angiosperms, and Polypodiaceae were the most recorded family, and more concentrated in the Southern and Southeastern regions. Data on non-vascular plants and lichens were scarce, with a few disjunct records concentrated in the Northeastern region of the Atlantic Forest. For all non-vascular plant records, Lejeuneaceae, a family of liverworts, was the most recorded family. We hope that our effort to organize scattered epiphyte data help advance the knowledge of epiphyte ecology, as well as our understanding of macroecological and biogeographical patterns in the Atlantic Forest. No copyright restrictions are associated with the data set. Please cite this Ecology Data Paper if the data are used in publication and teaching events.
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http://dx.doi.org/10.1002/ecy.2541DOI Listing
February 2019

Risk behaviors in adolescence - a study in a Portuguese health unit.

Int J Adolesc Med Health 2018 Oct 24;33(1). Epub 2018 Oct 24.

Health Unit, ACES Cávado I, Braga, Portugal.

Introduction: Adolescence is a time of social and self-affirmation, search of autonomy and pleasure. An early sexual debut and substance use are still public health problems.

Objectives: To assess the prevalence of illicit drug use and sexual behavior of adolescents, ages 15- 17, followed in a Portuguese Family Health Unit.

Material And Methods: This was a cross sectional descriptive study of a random convenience sample. Data were obtained from an anonymous and confidential questionnaire, given to patients at adolescent consultation, between the months of May and July 2016. Statistical significance p < 0.05.

Results: This study involved a sample of 134 adolescents, 54.5% girls. It was revealed that 73.1% of adolescents have tried alcohol, from which 18.7% experienced intoxication at least once. Regarding tobacco, 35.1% have tried it, 23.4% are regular users. Regarding cannabinoids, 7.5% of adolescents stated to have tried them once, or to consume them regularly. Adolescents start to experiment with tobacco earlier than with alcohol (9 years old vs. 11 years old), with a mean age of 15 years old. Regarding sexual behavior, 23.8% are sexually active, from which 9.4% do not use any form of contraception. Smoking behavior was a predictor of the consumption of illicit drugs, and it was found a significantly statistic association between sexual activity and substance use, p = 0.04.

Discussion: By descending order, the alcohol, tobacco and illicit drugs consumption are still worrisome and can affect the life of adolescents. Primarily health care and pediatric consultation should provide strategies for prevention and promotion of a healthy lifestyle for adolescents.
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http://dx.doi.org/10.1515/ijamh-2018-0040DOI Listing
October 2018

Odynophagia and neck pain after exercise.

BMJ Case Rep 2018 Apr 11;2018. Epub 2018 Apr 11.

Pediatric Department, Hospital de Braga, Braga, Portugal.

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http://dx.doi.org/10.1136/bcr-2018-224581DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5898280PMC
April 2018

Teenage pregnancy - a study in São Tomé and Príncipe.

Int J Adolesc Med Health 2017 Aug 22;32(1). Epub 2017 Aug 22.

Unit of Adolescent Medicine, Pediatrics Department of Hospital de Braga, Braga, Portugal.

Introduction The increasing number of pregnant teenagers in São Tomé and Príncipe (STP) represents a serious public health issue. The aim of this study was to characterize the population of pregnant adolescents followed in a health facility dedicated to maternal health in STP. Methods A cross-sectional survey was conducted among pregnant teenagers that attended the Mother and Child Protection Center during the first quarter of 2017. The survey contained questions on sociodemographic characteristics, sexual and risk behaviors, family, partners and health support. Results The mean age of the 51 pregnant teenagers included was 16.37 ± 0.8 years. Eight girls reported that they had planned to fall pregnant. Teenagers whose pregnancy was unplanned usually present with a previous family history of adolescent pregnancy. About 59% of girls engaged in sexual activity before 16 years of age with a mean number of sexual partners of 1.84 ± 0.88. In this study, 51% of the girls do not use any contraceptive method, usually because their partner refuses to do so. The preferred contraceptive method are condoms. Information on contraception is given mainly at school. Pregnant girls' first medical consultation was at a mean gestational age of 6 weeks. Abortion was considered by 51% of girls after pregnancy was confirmed. Conclusion Teenage pregnancy imposes health problems for the mother and child and contributes to educational and socioeconomic disadvantages. The collaboration of healthcare providers, teachers and parents is needed to enhance sexual health education. This is the first study in STP on teenage pregnancy; although the sample is small, the authors believe that the results are representative of the general population.
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http://dx.doi.org/10.1515/ijamh-2017-0088DOI Listing
August 2017

Prevalence of iron deficiency anemia and iron deficiency in a pediatric population with inflammatory bowel disease.

Scand J Gastroenterol 2017 Oct 23;52(10):1099-1103. Epub 2017 Jun 23.

a Gastroenterology, Hepatology and Nutrition Unit, Pediatrics Department , Hospital de Braga , Braga , Portugal.

Objectives: Iron deficiency is the most common cause of anemia in children with inflammatory bowel disease, although the real prevalence is unknown. Intravenous iron is suggested as the first line treatment. This study aims to determine the prevalence of iron deficiency anemia in children with inflammatory bowel disease followed in a Pediatric Gastroenterology Unit of a tertiary center and to evaluate this unit's experience with intravenous iron.

Materials And Methods: A retrospective cohort study was designed involving children with inflammatory bowel disease followed in that unit between January 2001 and April 2016. Laboratory results were collected at the moment of diagnosis, after one-year follow-up and prior each IV iron administration performed during the study period. Anemia was defined according to World Health Organization criteria and the iron deficiency was defined using recent guidelines.

Results: Were studied 69 patients 71% had CD and 29% UC. 50.7% were female. Mean patient age at diagnosis was 13.3 years (range 1--17 years). Prevalence of ID and IDA at diagnosis was 76.8% and 43.5%, respectively. After one year follow-up, those values decreased to 68.1% (p = .182) and 21.7% (p = .002), respectively. Hemoglobin significantly increased (p < .001). Intravenous iron was administered to 92.8% of patients. No adverse reactions were reported.

Conclusions: Intravenous iron is the first line in the treatment of Iron deficiency anemia in Inflammatory Bowel disease and it is safe and effective. Persistent anemia and iron deficiency are common.
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http://dx.doi.org/10.1080/00365521.2017.1342137DOI Listing
October 2017
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