Browsing by Author "Castro, S"
Now showing 1 - 5 of 5
Results Per Page
Sort Options
- Do GnRH Agonists Really Increase Body Weight Gain? Evaluation of a Multicentric Portuguese Cohort of Patients With Central Precocious PubertyPublication . Leite, AL; Galo, E; Antunes, A; Robalo, B; Amaral, D; Espada, F; Castro, S; Simões Dias, S; Limbert, CIntroduction: There are several concerns associated with gonadotropin-releasing hormone agonist (GnRHa) treatment for central precocious puberty (CPP), such as obesity and changes in body mass index (BMI). We aimed to investigate whether any anthropometric differences exist and if they persist over time. Methods: We conducted an observational study of Portuguese children (both sexes) diagnosed with CPP between January 2000 and December 2017, using a digital platform, in order to analyze the influence of GnRHa treatment on BMI-SD score (BMI-SDS). Results: Of the 241 patients diagnosed with CPP, we assessed 92 patients (8% boys) in this study. At baseline, 39% of the patients were overweight. BMI-SDS increased with treatment for girls but then diminished 1 year after stopping GnRHa therapy (p = 0.018). BMI-SDS variation at the end of treatment was negatively correlated with BMI-SDS at baseline (p < 0.001). Boys grew taller and faster during treatment than did girls (p < 0.001), and therefore, their BMI-SDS trajectory might be different. Conclusions: This study showed an increase of body weight gain during GnRHa treatment only in girls, which reversed just 1 year after stopping treatment. The overall gain in BMI-SDS with treatment is associated with baseline BMI-SDS.
- Função Tiroideia em Doentes com Trissomia 21 – Casuística de Duas Consultas num Hospital Pediátrico CentralPublication . Castro, S; Amaral, D; Pinto, M; Pina, R; Lopes, L; Fonseca, GEm crianças e adolescentes com síndrome de trissomia 21 observa-se uma prevalência aumentada de alterações da função tiroideia. A mais frequentemente encontrada é o hipotiroidismo subclínico, seguida do hipotiroidismo clínico e, mais raramente, doença de Graves. O diagnóstico de hipotiroidismo é, por vezes, tardio pois os sintomas são confundidos com as manifestações características da trissomia 21, sendo portanto fundamental rastrear sistematicamente a função tiroideia nestas crianças. A velocidade de crescimento é um elemento clínico que pode contribuir quer para a valorização do diagnóstico quer da terapêutica apesar de esta não ser totalmente consensual. Descreve-se a casuística de um Hospital Central Pediátrico em foram seguidas quarenta e cinco crianças e adolescentes com trissomia 21, entre Janeiro de 2000 e Maio de 2008. Neste grupo de crianças, foram detectadas alterações da função tiroideia em dezanove; a alteração mais frequente foi o hipotiroidismo subclínico (treze) seguida do hipotiroidismo clínico (cinco); houve apenas um caso de hipertiroidismo. As alterações da função tiroideia aumentaram com a idade dos doentes, foram mais frequentes no sexo feminino e tiveram uma clínica inespecífica.
- Height Benefit of GnRH Agonists After Age 8 in a Portuguese Cohort of Central Precocious PubertyPublication . Castro, C; Espada, F; Leite, AL; Antunes, A; Robalo, B; Amaral, D; Galo, E; Castro, S; Ferreira, S; Limbert, CObjective: Idiopathic central precocious puberty (iCPP) is common in paediatric endocrinology. Gonadotropin-releasing hormone agonists (GnRHa) are safe, but the effect on final height and the ideal timing for treatment remains controversial. This study aims to assess the effectiveness of GnRHa on growth outcomes in girls with iCPP treated before and after the age of 8 years old. Design and patients: This retrospective longitudinal study evaluated data from Portuguese girls with iCPP who completed treatment between 2010 and 2021. Measurements: Auxological and clinical characteristics were compared according to age at treatment onset. Results: A cohort of 134 girls with iCPP, was divided into early treatment (ET) (<8 years, n = 48) and later treatment (LT) groups (≥8 years, n = 86). In both groups, most children presented with Tanner II and III. Tanner IV was more frequent in LT group (p = .003). At the end of treatment, predicted adult height increased in both groups (ET p = .032; LT p = .04) and bone age significantly slowed down in all participants (p = .008, p = .034). The height gain was greater in the ET group, but without significant differences (p = .065). Conclusions: Treatment with GnRHa improved final height in all girls with iCPP, even when initiated after 8 years. To achieve better outcomes, treatment should be provided promptly after diagnosis
- Insulin pump therapy in children with type 1 diabetes: analysis of data from the SWEET registryPublication . Szypowska, A; Schwandt, A; Svensson, J; Shalitin, S; Cardona-Hernandez, R; Forsander, G; Sundberg, F; De Beaufort, C; Maahs, D; Maffeis, C; O'Riordan, S; Krisane, ID; Scharf, M; Castro, S; Konstantinova, M; Obermannova, B; Casteels, K; Gökşen, D; Galhardo, J; Kanaka-Gantenbein, C; Rami-Merhar, B; Madacsy, LIntensified insulin delivery using multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII) is recommended in children with type 1 diabetes (T1D) to achieve good metabolic control.
- Liver Depurative Techniques: A Single Liver Transplantation Center ExperiencePublication . Rodrigues, J; Castro, S; Moya, B; Fortuna, P; Martins, A; Pereira, JP; Bento, L; Perdigoto, R; Barroso, E; Marcelino, PIn a liver transplant (LT) center, treatments with Prometheus were evaluated. The main outcome considered was 1 and 6 months survival. Methods. During the study period, 74 patients underwent treatment with Prometheus; 64 were enrolled,with a mean age of 51 13 years; 47men underwent 212 treatments (mean, 3.02 per patient). The parameters evaluated were age, sex, laboratorial (liver enzymes, ammonia) and clinical (model for end-stage liver disease and Child-Turcotte-Pugh score) data. Results. Death was verified in 23 patients (35.9%) during the hospitalization period, 20 patients (31.3%) were submitted to liver transplantation, and 21 were discharged. LT was performed in 4 patients with acute liver failure (ALF, 23.7%), in 7 patients with acute on chronic liver failure (AoCLF, 43.7%), and in 6 patients with liver disease after LT (30%). Seven patients who underwent LT died (35%). In the multivariate analysis, older age (P ¼ .015), higher international normalized ratio (INR) (P ¼ .019), and acute liver failure (P ¼ .039) were independently associated with an adverse 1-month clinical outcome. On the other hand, older age (P ¼ .011) and acute kidney injury (P ¼ .031) at presentation were both related to worse 6-month outcome. For patients with ALF and AoCLF we did not observe the same differences. Conclusions. In this cohort, older age was the most important parameter defining 1- and 6-month survival, although higher INR and presence of ALF were important for 1-month survival and AKI for 6-month survival. No difference was observed between patients who underwent LT or did not have LT.