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Vila Franca de Xira, Portugal

Fernandes C.,Medica Centro Hospitalar Of Setubal | Damaso C.,Servico de Pediatria Medica | Duarte R.,Servico de Cirurgia Pediatrica | Cardoso D.S.,Servico de Cirurgia Pediatrica | Casella P.,Servico de Cirurgia Pediatrica
Acta Medica Portuguesa | Year: 2011

Necrotizing fasciitis (FN) is a deep infection of the subcutaneous tissue and fascia, resulting in its progressive destruction. Usually it evolves very quickly. The authors present a case to FN abdominal wall, an extremely rare complication of acute appendicitis. A child had surgical removal of the appendix because of gangrenous acute appendicitis, which evolved into severe infection, with pain and inflammatory process of the abdominal wall. After diagnosis, he underwent a surgical debridement of the abdominal wall and drainage of intraperitoneal abscess. Antibiotic therapy, surgical debridement and successive dressings were done and at 22nd day a dermo-epidermal graft was done in a small residual lesion of the abdominal wall. Because the prognosis is closely related to time to correct diagnosis and initiation of appropriate therapy, it's extremely important that this diagnosis is considered.


Timoteo C.,Centro Hospitalar Leiria Pombal | Castanhinha S.,Servico de Pediatria Medica | Constant C.,Servico de Pediatria Medica | Robalo B.,Servico de Pediatria Medica | And 2 more authors.
Acta Medica Portuguesa | Year: 2012

Background: Type 1 Diabetes Mellitus (T1DM) is the most common endocrine-metabolic disease in children. It is associated with vascular and neuropathic complications, and may also affect growth and development. Objective: To correlate the metabolic control and disease duration with growth and puberty in patients with T1DM followed in a Pediatric Endocrinology Outpatient Clinic. Subjects and methods: Retrospective analysis. Sample obtained from patients with T1DM followed in Hospital Santa Maria Pediatric Endocrinology Outpatient Clinic (Lisbon - Portugal) since 1994 until March 2011. Inclusion criteria: patients diagnosed before the onset of puberty and who had attained their final height during the follow-up. Variables: sex, age, weight and height at diagnosis and final, parents' height, growth velocity, pubertal height gain, age at menarche and metabolic control during puberty. Results: 39 patients, 51% female, 82% diagnosed less than five years before puberty. Fifty-four percent presented an average HbA1c between 8-10%, what we considered reasonable. There seems to be a trend towards an inverse association between HbA1c and the maximum speed of growth and pubertal height gain, although not statistically significant. These patients were taller than average at diagnosis (z-score: male 0.9; female: 0.5) and lost height during puberty, yet attained final heights within normal range and matching their target heights. Conclusions: Although HbA1c seems to negatively influence maximum growth rate and pubertal height gain, there was no compromise in final height in this group of patients. © Ordem dos Médicos 2012.

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