Browsing by Issue Date, starting with "2024-04"
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- Perceptions of Cardiology, Professional Preferences and Impact on Career Choices Among Portuguese Cardiologists: Results From the Portuguese Society of Cardiology's Women and Cardiology Task Force SurveyPublication . Timóteo, AT; Ribeiras, R; Gavina, C; Cabral, S; Almeida, A; António, N; Calé, R; Moura, B; Franco, F; Ilhão Moreira, R; Gonçalves, LIntroduction and objectives: Cardiology has not been seen as an attractive specialty, and women have avoided it for many years. Some surveys have been performed in other countries, but in Portugal, the situation is largely unknown. Methods: An online survey on perceptions of cardiology and professional preferences was sent to 1371 members of the Portuguese Society of Cardiology, of whom 18.2% completed the survey. Results: We included 219 cardiologists or cardiology trainees, of whom 50.2% were female, with decreasing proportions from younger to older age groups, in which males still predominate. Women are less often married and more frequently childless, particularly those working in an invasive subspecialty, where they represent only 16% of all respondents working in these areas. Men's perception is that women do not choose these areas due to family reasons, radiation concerns and difficult working conditions, but from the female perspective, male dominance, lack of female role models and restricted access are the main barriers. Women consider it is difficult for them to obtain a leadership role, but men do not think the same (75.5% vs. 27.5%). Conclusion: In Portugal, females predominate in younger age groups, suggesting a paradigm change. Women are less frequently married and more frequently childless, particularly women working in invasive subspecialties. Women consider that it is more difficult for them to obtain a leadership role. Moreover, the barriers reported by women are substantially different from men regarding the reasons for not choosing an invasive subspecialty.
- An Insight into the Burden of Drug-Resistant Tuberculosis in ChildrenPublication . Dias, Joana Valente; Varandas, Luís; Gonçalves, Luzia; Kagina, Benjamin M
- Pachydysostosis of the Fibula in a Case of Familial Adenomatous Polyposis.Publication . Oliveira, Daniela; Maia, Sofia; Balacó, Inês; Coelho, Paulo; Almeida, Susana; Venâncio, Margarida; Saraiva, Jorge; Nishimura, Gen; Sousa, Sérgio BBackground: Familial Adenomatous Polyposis (FAP) is a colorectal cancer (CRC) predisposition syndrome caused by germline APC mutations and characterised by an increased risk of CRC and colonic polyps and, in certain forms, of specific prominent extraintestinal manifestations, namely osteomas, soft tissue tumours and dental anomalies. Pachydysostosis of the fibula is a rare clinical entity defined by unilateral bowing of the distal portion of the fibula and elongation of the entire bone, without affectation of the tibia. Clinical report: We report a 17-year-old male, who presented with a non-progressive bowing of the right leg detected at 18 months of age caused by a fibula malformation (later characterized as pachydysostosis) and a large exophytic osteoma of the left radius, noticed at the age of 15 years, without gastrointestinal symptoms. There was no relevant family history. Detailed characterisation revealed multiple osteomas, skin lesions and dental abnormalities, raising the hypothesis of FAP. This diagnosis was confirmed by genetic testing [c.4406_4409dup p.(Ala1471Serfs*17) de novo mutation in the APC gene] and endoscopic investigation (multiple adenomas throughout the colon, ileum and stomach). Discussion: This case report draws attention to the phenotypic spectrum of skeletal manifestations of FAP: this patient has a congenital fibula malformation, not previously associated with this syndrome, but which is likely to have been its first manifestation in this patient. This clinical case also illustrates the challenges in the early diagnosis of FAP, especially without family history, and highlights the importance of a multidisciplinary approach and the adequate study of rare skeletal abnormalities.
- Intracranial Complications of Sinogenic and Otogenic Infections in Children: an ESPN Survey on their Occurrence in the Pre-COVID and Post-COVID Era.Publication . Massimi, L; Cinalli, G; Frassanito, P; Arcangeli, V; Auer, C; Baro, V; Bartoli, A; Bianchi, F; Dietvorst, S; Di Rocco, F; Gallo, P; Giordano, F; Hinojosa, J; Iglesias, S; Jecko, V; Kahilogullari, G; Knerlich-Lukoschus, F; Laera, R; Locatelli, D; Luglietto, D; Luzi, M; Messing-Jünger, M; Mura, R; Ragazzi, P; Riffaud, L; Roth, J; Sagarribay, A; Pinheiro, M Santos; Spazzapan, P; Spennato, P; Syrmos, N; Talamonti, G; Valentini, L; Van Veelen, M L; Zucchelli, M; Tamburrini, GBackground: COVID-19 pandemic is thought to have changed the epidemiology of some pediatric neurosurgical disease: among them are the intracranial complications of sinusitis and otitis (ICSO). According to some studies on a limited number of cases, both streptococci-related sinusitis and ICSO would have increased immediately after the pandemic, although the reason is not clear yet (seasonal changes versus pandemic-related effects). The goal of the present survey of the European Society for Pediatric Neurosurgery (ESPN) was to collect a large number of cases from different European countries encompassing the pre-COVID (2017-2019), COVID (2020-2021), and post-COVID period (2022-June 2023) looking for possible epidemiological and/or clinical changes. Material and methods: An English language questionnaire was sent to ESPN members about year of the event, patient's age and gender, presence of immune-deficit or other favoring risk factors, COVID infection, signs and symptoms at onset, site of primary infection, type of intracranial complication, identified germ, type and number of surgical operations, type and duration of medical treatment, clinical and radiological outcome, duration of the follow-up. Results: Two hundred fifty-four cases were collected by 30 centers coming from 14 different European countries. There was a statistically significant difference between the post-COVID period (129 children, 86 cases/year, 50.7% of the whole series) and the COVID (40 children, 20 cases/year, 15.7%) or the pre-COVID period (85 children, 28.3 cases/year, 33.5%). Other significant differences concerned the presence of predisposing factors/concurrent diseases (higher in the pre-COVID period) and previous COVID infection (higher in the post-COVID period). No relevant differences occurred as far as demographic, microbiological, clinical, radiological, outcome, morbidity, and mortality data were concerned. Paranasal sinuses and middle ear/mastoid were the most involved primary site of infection (71% and 27%, respectively), while extradural or subdural empyema and brain abscess were the most common ICSO (73% and 17%, respectively). Surgery was required in 95% of cases (neurosurgical and ENT procedure in 71% and 62% of cases, respectively) while antibiotics in 99% of cases. After a 12.4-month follow-up, a full clinical and radiological recovery was obtained in 85% and 84% of cases, respectively. The mortality rate was 2.7%. Conclusions: These results suggest that the occurrence of ICSO was significantly increased after the pandemic. Such an increase seems to be related to the indirect effects of the pandemic (e.g., immunity debt) rather than to a direct effect of COVID infection or to seasonal fluctuations. ICSO remain challenging diseases but the pandemic did not affect the management strategies nor their prognosis. The epidemiological change of sinusitis/otitis and ICSO should alert about the appropriate follow-up of children with sinusitis/otitis.
- Eltrombopag Use in Children with Persistent and Chronic Primary Immune Thrombocytopenia in a Portuguese Pediatric Center.Publication . Lopes, Caroline; Castro, Ana; Maia, Raquel; Batalha, Sara; Kjöllerström, Paula