Browsing by Author "Lopes, AI"
Now showing 1 - 4 of 4
Results Per Page
Sort Options
- Gastroenterite Aguda por Rotavírus em Portugal: Estudo MulticêntricoPublication . Rodrigues, F; Lopes, AI; Iturriza-Gomara, M; Nawaz, S; Cruz, A; Antunes, H; Loreto, H; Amil Dias, J; Cunha1, J; Varandas, L; Silveira, L; Costa Alves, M; Gonçalves, R; Almeida, S; Cavaco, AOs dados sobre diarreia por rotavírus em Portugal são limitados. Este estudo teve como objectivo estimar a proporção de gastroenterite aguda por este vírus em crianças observadas em serviços de urgência de vários hospitais do país e analisar as suas características clínicas e moleculares. Estudo prospectivo, multicêntrico, observacional, incluindo crianças como menos de 5 anos, com gastroenterite aguda, observadas em 10 serviços de urgência pediátricos, entre outubro de 2008 e setembro de 2009. Foram recolhidos dados demográfico e clínicos. as amostras positivas de rotavírus foram genotipadas por reacção em cadeia da polimerase. Foram incluídas 1846 crianças, 58% do sexo masculino, com idade média de 19,3 +- 14,4 meses. Foi identificado rotavírus nas fezes em 28,3% (intervalo de confiança 95%, 26,2-30,4%), com maior proporção no inverno e na primavera e em crianças com idade de 7-24 meses. Os genótipos mais frequentes foram G4P(8) (46%) e G1P(8) (37%), com variações de norte para sul. As crianças com gastroenterite por rotavírus tinham probabilidade significativamente superior (p<0,001) de ter febre, vómitos, perda de peso, desidratação e necessidade de internamento, comparativamente aos casos negativos para rotavírus. A gastroenterite aguda por rotavírus em crianças portuguesas com idade inferior a 5 anos associou-se a maior morbilidade e hospitalização do que nos casos sem identificação de rotavírus. Houve diferenças importantes na distribuição dos genótipos entre as regiões. Na era das vacinas contra o rotavírus, este conhecimento é importante para as decisões relativas à prevenção da doença e para monitorizar tendências da epidemiologia molecular do rotavírus.
- Helicobacter Pylori Infection in Pediatric Patients Living in Europe: Results of the EuroPedHP Registry 2013 to 2016Publication . Kori, M; Le Thi, TG; Werkstetter, K; Sustmann, A; Bontems, P; Lopes, AI; Oleastro, M; Iwanczak, B; Kalach, N; Misak, Z; Cabral, J; Homan, M; Cilleruelo Pascual, ML; Pehlivanoglu, E; Casswall, T; Urruzuno, P; Martinez Gomez, MJ; Papadopoulou, A; Roma, E; Dolinsek, J; Rogalidou, M; Urbonas, V; Chong, S; Kindermann, A; Miele, E; Rea, F; Cseh, A; Koletzko, SObjectives: The aim of the study was to assess clinical presentation, endoscopic findings, antibiotic susceptibility and treatment success of Helicobacter pylori (H. pylori) infected pediatric patients. Methods: Between 2013 and 2016, 23 pediatric hospitals from 17 countries prospectively submitted data on consecutive H. pylori-infected (culture positive) patients to the EuroPedHP-Registry. Results: Of 1333 patients recruited (55.1% girls, median age 12.6 years), 1168 (87.6%) were therapy naïve (group A) and 165 (12.4%) had failed treatment (group B). Patients resided in North/Western (29.6%), Southern (34.1%) and Eastern Europe (23.0%), or Israel/Turkey (13.4%). Main indications for endoscopy were abdominal pain or dyspepsia (81.2%, 1078/1328). Antral nodularity was reported in 77.8% (1031/1326) of patients, gastric or duodenal ulcers and erosions in 5.1% and 12.8%, respectively. Primary resistance to clarithromycin (CLA) and metronidazole (MET) occurred in 25% and 21%, respectively, and increased after failed therapy. Bacterial strains were fully susceptible in 60.5% of group A, but in only 27.4% of group B. Primary CLA resistance was higher in Southern and Eastern Europe (adjusted odds ratio [ORadj] = 3.44, 95% confidence interval [CI] 2.22-5.32, P < 0.001 and 2.62, 95% CI: 1.63-4.22, P < 0.001, respectively) compared with Northern/Western Europe. Children born outside Europe showed higher primary MET resistance (ORadj = 3.81, 95% CI: 2.25-6.45, P < 0.001). Treatment success in group A reached only 79.8% (568/712) with 7 to 14 days triple therapy tailored to antibiotic susceptibility. Conclusions: Peptic ulcers are rare in dyspeptic H. pylori-infected children. Primary resistance to CLA and MET is markedly dependent on geographical regions of birth and residence. The ongoing survey will show whether implementation of the updated ESPGHAN/NASPGHAN guidelines will improve the eradication success.
- Portuguese Consensus on Diagnosis, Treatment, and Management of Anemia in Pediatric Inflammatory Bowel DiseasePublication . Lopes, AI; Azevedo, S; Cabral, J; Ferreira, MG; Sande-Lemos, P; Ferreira, R; Trindade, E; Lima, R; Antunes, HAnemia is a common extraintestinal manifestation of inflammatory bowel disease (IBD), both in pediatric and in adult patients. Iron deficiency is the main cause of anemia in patients with IBD. Anemia is a clinically relevant comorbidity, with impact on patients' quality of life and it should be timely diagnosed and adequately treated. Currently, an active treatment approach is the recommended strategy, with evidence showing efficacy and safety of intravenous iron formulations. However, evidence in pediatric age remains scarce and no clinical recommendations exist for the diagnosis and treatment of this particular age group. The present document represents the first national consensus on the management of anemia in pediatric IBD and is therefore particularly relevant. The authors anticipate that the proposed recommendations will be useful in daily clinical practice for diagnosing and managing iron deficiency and iron-deficiency anemia in the pediatric population with IBD.
- Portuguese Prevalence of Pediatric Chronic Intestinal FailurePublication . Antunes, H; Nóbrega, S; Correia, M; Campos, AP; Silva, R; Guerra, P; Mourato, P; Lopes, AI; Mansilha, H; Tavares, M