Hipotireoidismo na infância: Um relato de caso / Childhood hypothyroidism: A case report

O hipotireoidismo é um dos distúrbios hormonais mais frequentes em pediatria. É classificado em primário e secundário, sendo a causa primária a mais comum. O hipotireoidismo primário pode ser causado pela disormonogênese, deficiência de iodo ou por uma etiologia autoimune (tireoidite crônica linfocítica). Este estudo apresenta o relato de uma criança que buscou atendimento médico queixando-se de sintomas inespecíficos como baixa estatura, prurido ocular, dificuldade para enxergar, vômitos matutinos e constipação. No exame físico foi verificada bradicardia, idade aparente inferior à idade referida, pele edemaciada e seca, acantose nigricans, estatura abaixo do percentil 3 e índice de massa corpórea (IMC) acima do percentil 97. Exames laboratoriais e de imagem confirmaram a suspeita de tireoidite de Hashimoto, causa mais comum de hipotireoidismo na infância em localidades não deficientes em iodo. Dois meses e meio após instituição da terapia com levotiroxina, a criança evoluiu com melhora da sintomatologia, diminuição do peso e aumento da estatura

Exame clínico pediátrico: aquisição de habilidades na disciplina Pediatria Preventiva Social, FAMEB - UFBa.

This study analyzes the main difficulties and the acquired skilles of the medical students  in the ambulatorial practice of Social Preventive Pediatrics Discipline, from the College of Medicine of Bahia - Federal University of Bahia - in their first contact with the pediatric clinic.  The students were inquired about their main difficulties at the begining and at the end of the discipline, through a questionnaire, with the objective of identifying the acquired skills and the most hardly surpassed difficulties. This practical activity is characterized by the ambulatorial primary attendance, in which the pediatric consultation is performed,  emphasizing a detailed interview and a complete physical examination, besides the peculiarities of each pediatric age group. As to the interview, the students  demonstrated to be less secure on  the analysis of  growth and  neuropsychomotor development; whereas on  physical examination, a reduced self-confidence has been noted on abdominal and genital examination. A clear acquisition of skills was noted in the performance of the interview as well as of the physical examination, although in  some  variables  this evolution was more evident.O estudo analisa as principais dificuldades referidas e as habilidades adquiridas pelos estudantes de Medicina na prática ambulatorial da disciplina Pediatria Preventiva Social, da Faculdade de Medicina da Universidade Federal da Bahia, em seu primeiro contato com a clínica pediátrica. Através de um questionário, os estudantes foram inquiridos, em dois momentos distintos (início e término da disciplina) acerca dos aspectos com maior dificuldade de superação e progressos obtidos no contato com as crianças. Essa atividade prática se caracteriza pelo atendimento primário ambulatorial, na qual se exercita a consulta pediátrica, enfatizando anamnese detalhada e o exame físico completo, além das peculiaridades das diversas faixas etárias pediátricas. Com relação à anamnese, os estudantes demonstraram ter menor segurança na análise do crescimento e do desenvolvimento neuropsicomotor, enquanto que, no exame físico, relataram redução no grau de segurança no exame do abdômen (palpação de órgãos) e dos órgãos genitais. No geral, houve aquisição de habilidades tanto na realização da anamnese quanto do exame físico, sendo que, para algumas variáveis, essa evolução foi mais evidente

Relationship Among Mothers' Glycemic Level, Periodontitis, and Birth Weight

BARRETO, Mauricio Lima. “Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta à informação no documento”.Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2018-03-01T13:32:01Z No. of bitstreams: 1 Gomes IS Relationship Between Mothers’ Glycemic Level....pdf: 493798 bytes, checksum: 5ed09e3e3cc0524ca2269cb0870303ad (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2018-03-01T16:19:05Z (GMT) No. of bitstreams: 1 Gomes IS Relationship Between Mothers’ Glycemic Level....pdf: 493798 bytes, checksum: 5ed09e3e3cc0524ca2269cb0870303ad (MD5)Made available in DSpace on 2018-03-01T16:19:05Z (GMT). No. of bitstreams: 1 Gomes IS Relationship Between Mothers’ Glycemic Level....pdf: 493798 bytes, checksum: 5ed09e3e3cc0524ca2269cb0870303ad (MD5) Previous issue date: 2016Foundation of the State of Bahia, National Council for Scientific and Technological Development, and Feira de Santana State UniversityFeira de Santana State University. Department of Health. Salvador, BA, BrazilFeira de Santana State University. Department of Health. Salvador, BA, BrazilFeira de Santana State University. Department of Health. Salvador, BA, Brazil / Federal University of Recôncavo of Bahia. Santo Antonio de Jesus, BA, BrasilFederal University of Bahia. Department of Medicine. Salvador, BA, BrasilFederal University of Bahia. Department of Preventive Dentistry. Salvador, BA, BrasilFeira de Santana State University. Department of Health. Salvador, BA, Brasil / Federal University of Bahia. Department of Preventive Dentistry. Salvador, BA, BrasilFeira de Santana State University. Department of Health. Salvador, BA, BrazilFederal University of Bahia. Department of Pharmacy. Salvador, BA, BrazilFeira de Santana State University. Department of Health. Salvador, BA, BrazilFeira de Santana State University. Department of Health. Salvador, BA, BrazilFederal University of Maranhão. Department of Dentistry. São Luís, MA, BrazilFederal University of Bahia. Department of Public Health. Salvador, BA, BrazilUniversity of Otago. Sir John Walsh Research Institute. Dunedin, New ZealandThe aim of this study is to determine the influence of glycemic level on the relationship between periodontitis and low birth weight (LBW). Methods: A case-control study was conducted with 372 females divided into cases (109 mothers of newborns with birth weight <2,500 g) and controls (263 mothers of newborns with birth weight ‡2,500 g). The birth weight of children was obtained from medical records, whereas information on sociodemographic, lifestyle, and health characteristics of the participants was obtained through an interview. Glycated hemoglobin (HbA1c) levels were measured, and probing depth, clinical attachment levels, and bleeding on probing were used to determine the periodontal status. Results were analyzed using logistic regression. Results: The likelihood of having children with LBW among the mothers with periodontitis was six times greater than that observed among mothers without periodontitis (adjusted odds ratio [ORadjusted] = 6.02, 95% confidence interval [CI] = 2.47 to 15.17), even after adjustment. There was also a strong, statistically significant relationship between periodontitis and LBW in both the normal glycemic–level group (HbA1c levels <5.6%, unadjusted odds ratio [ORunadjusted] = 8.30, 95% CI = 3.56 to 19.35) and the high glycemic–level group (HbA1c levels ‡5.6% and <6.5%, ORunadjusted = 5.73, 95% CI = 1.75 to 18.70). After adjustment for confounders, the magnitude of the association continued to be strong in the normal glycemic–level group (ORadjusted = 7.59, 95% CI = 2.7 to 24.28), an increase of 25% when compared to the main association measurement. In those with high glycemic levels (ORadjusted = 4.03, 95% CI = 0.81 to 19.96), the OR decreased almost 50%, and the association lost statistical significance. Conclusion: Periodontitis and glycemic levels appeared to have opposing influences on birth weight, with periodontitis being associated with LBW and the magnitude of the association being altered depending on maternal blood glucose level