Rosa Lima - Academia.edu (original) (raw)
Papers by Rosa Lima
Transvaginal ultrasonography assessment of ovarian volumes in postmenopausal women Clinic of Endo... more Transvaginal ultrasonography assessment of ovarian volumes in postmenopausal women Clinic of Endocrine Gynecology and Climacterium at the College of Me.dical Sciences of the Santa Casa of Siio Paulo- Siio Paulo, Brazil The authors evaluated ovarian volumes by transvaginal ultrasonography at different periods after menopause. Ninety-eight postmeno-pausal women with an average age of 51.9 years and a one- to eight-year postmenopausal period were studied. The control group consisted of 40 women during menacme with an average age of 31.8 years, who were also submitted to transvaginal ultrasonography to evaluate ovarian volume. There was no significant difference between right and left ovarian volumes in the study groups. There was a significant decrease in measure and standard deviations of the volumes after the first year of menopause (mean volume- 2.2:t 0.9 cm3) when compared to the control group (mean volume- 6.3:t 2.0 cm3), followed by a slow and gradual shrinking after this phase. ...
revista de pediatria do centro hospitalar do porto ano 2014, vol XXIII, n.º 2 72 artigo de revisã... more revista de pediatria do centro hospitalar do porto ano 2014, vol XXIII, n.º 2 72 artigo de revisão review articles Alergia às proteínas do leite de vaca com manifestações gastrointestinais COWS MILK PROTEIN ALLERGY WITH GASTROINTESTINAL MANIFESTATIONS ABSTRACT Cow's milk protein allergy (CMPA) is the leading cause of food allergy in children under three years of age, although its gastrointestinal manifestations may occur in all age groups. In the suspicion of CMPA based on the anamnesis and physical examination, an elimination diet should be initiated for a variable length of time according to the clinical picture, followed by an oral food challenge (OFC) confi rming or excluding the diagnosis. Complementary exams such as skin prick tests and specifi c IgE may be necessary. Treatment is based on an elimination diet and demands nutritional counselling and growth monitoring. Usually an OFC is repeated after three to 12 months of elimination diet. Tolerance is achieved at three yea...
Journal of Paediatrics and Child Health, 2021
Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva, 2021
Cameron lesions were first described 30 years ago (by Cameron and Higgins) as linear erosions or ... more Cameron lesions were first described 30 years ago (by Cameron and Higgins) as linear erosions or ulcers in hiatal hernia. They are uncommonly reported in adults evaluated for gastrointestinal bleeding, whereas in children they are only few case reports. We describe a ten-years-old boy presenting with a history of iron deficiency anemia and occasional vomiting. Esophagogastroduodenoscopy revealed a sliding hiatal hernia and a Cameron ulcer. We highlight that although a rare cause of gastrointestinal bleeding, a hiatal hernia in a child with iron deficiency anemia should raise the suspicion for Cameron lesions. In fact, the rarity of these lesions makes them a diagnostic challenge, as their identification requires knowledge and a meticulous endoscopy.
Journal of Clinical Medicine, 2021
Myosin Vb (MYO5B) is a motor protein that facilitates protein trafficking and recycling in polari... more Myosin Vb (MYO5B) is a motor protein that facilitates protein trafficking and recycling in polarized cells by RAB11- and RAB8-dependent mechanisms. Biallelic MYO5B mutations are identified in the majority of patients with microvillus inclusion disease (MVID). MVID is an intractable diarrhea of infantile onset with characteristic histopathologic findings that requires life-long parenteral nutrition or intestinal transplantation. A large number of such patients eventually develop cholestatic liver disease. Bi-allelic MYO5B mutations are also identified in a subset of patients with predominant early-onset cholestatic liver disease. We present here the compilation of 114 patients with disease-causing MYO5B genotypes, including 44 novel patients as well as 35 novel MYO5B mutations, and an analysis of MYO5B mutations with regard to functional consequences. Our data support the concept that (1) a complete lack of MYO5B protein or early MYO5B truncation causes predominant intestinal disease...
RESUMO Introducao : A encefalomielite aguda disseminada (ADEM) e uma doenca desmielinizante monof... more RESUMO Introducao : A encefalomielite aguda disseminada (ADEM) e uma doenca desmielinizante monofasica do sistema nervoso central (SNC) imunomediada. O quadro clinico inicial pode ser inespecifico, mas traduz geralmente envolvimento da substância branca em varias localizacoes do SNC, sendo a ressonância magnetica (RM) do neuroeixo o exame complementar de diagnostico de eleicao. Caso clinico : Crianca com 16 meses, internada por perda da capacidade de marcha de instalacao aguda, recusa alimentar e irritabilidade. No exame neurologico salientava -se: periodos de irritabilidade alternando com sonolencia, paraparesia flacida arreflexica, ataxia axial e retencao urinaria. O estudo do liquido cefalorraquidinano revelou pleocitose linfocitaria e foi isolado o HHV -6 por tecnica de Polymerase Chain Reaction. A RM revelou hipersinal medular na ponderacao T2, em D2 -D3 e desde D6 ate ao cone medular. Iniciou terapeutica com corticoterapia e imunoglobulina humana com melhoria progressiva. Disc...
Background: Acute disseminated encephalomyelitis (ADEM) is a monophasic immune -mediated demyelin... more Background: Acute disseminated encephalomyelitis (ADEM) is a monophasic immune -mediated demyelinating disease of the central nervous system. The initial clinical presentation may be nonspecific, but is the result of involvement of different areas in white matter tracts of CNS and brain and spinal magnetic resonance imaging (MRI) is the gold standard complementary investigation for the diagnosis. Case report: A 16 month-old child, hospitalized for loss of walking ability of acute onset, irritability and refusal to eat. The neurological examination revealed: irritability alternating with periods of drowsiness, arreflexic flaccid paraplegia and trunkal ataxia, and urinary retention. Examination of cerebrospinal fluid showed lymphocytic pleocytosis, and herpes virus 6 were isolated by Polymerase Chain Reaction technic. The MRI revealed T2-weight hyperintense diffuse signal in D2-D3 and from D6 to the medullary connus also. She started therapy with steroids and human immunoglobulin with...
Com o objectivo de avaliar a prevalencia da infeccao urinaria no pequeno lactente com febre, os a... more Com o objectivo de avaliar a prevalencia da infeccao urinaria no pequeno lactente com febre, os autores realizaram um estudo prospectivo em 51 lactentes, com idade inferior a 6 meses que recorreram ao servico de urgencia por febre. Em todos os casos foi feita colheita de urina e realizado Combur 10R e UroculturaR. O diagnostico de infeccao urinaria foi feito em 8 criancas (15,7%). O teste Combur 10R teve neste estudo uma sensibilidade de 12,5% e uma especificidade de 86%. Dada a dificuldade de deteccao de infeccao urinaria e a gravidade clinica que pode assumir nesta faixa etaria, este diagnostico devera ser sempre ponderado em todo o lactente com febre.
Cow’s milk protein allergy (CMPA) is the leading cause of food allergy in children under three ye... more Cow’s milk protein allergy (CMPA) is the leading cause of food allergy in children under three years of age, although its gastrointestinal manifestations may occur in all age groups. In the suspicion of CMPA based on the anamnesis and physical examination, an elimination diet should be initiated for a variable length of time according to the clinical picture, followed by an oral food challenge (OFC) confi rming or excluding the diagnosis. Complementary exams such as skin prick tests and specifi c IgE may be necessary. Treatment is based on an elimination diet and demands nutritional counselling and growth monitoring. Usually an OFC is repeated after three to 12 months of elimination diet. Tolerance is achieved at three years of age in more than 80% of the children. The aim of this work is to make a brief review and update on CMPA in pediatric age, proposing a management approach based on recent international recommendations.
RESUMO A tosse convulsa continua a ser uma doença potencialmente fatal, particularmente em grupos... more RESUMO A tosse convulsa continua a ser uma doença potencialmente fatal, particularmente em grupos vulneráveis, apesar da ampla cobertura vacinal em crianças. Os autores apresentam um caso dum RN do sexo feminino que iniciou acessos de tosse ...
Inflammatory Bowel Diseases, 2013
Early-onset inflammatory bowel disease starting within the first months of life could be due to a... more Early-onset inflammatory bowel disease starting within the first months of life could be due to a particular genetic defect. We set up the GENetically determined ImmUne-mediated enteropathieS (GENIUS) network and collected infants with a proven defect of the IL10 axis for accurate phenotyping of disease presentation and evolution. Design: Ten patients with early-onset inflammatory bowel disease with confirmed mutations in IL10, IL10RA, or IL10RB genes were characterized on clinical, endoscopic-histological, immunobiological, and radiological findings. Functional assays to confirm defective responses to IL10 were performed on peripheral blood mononuclear cells. Results: A functional defect in IL10 signaling was confirmed in all IL10R patients tested. Disease started with severe diarrhea within the first 12 weeks in all patients. All infants showed Crohn's disease-like ulcerations limited to the colon with marked perianal inflammation (fissures, abscess, and fistula); disease progression to the small bowel occurred in only 1 patient. Four of the 10 patients had granulomata on histology, and all patients showed Crohn's disease-like mesenteric infiltration on imaging. Disease pattern was indistinguishable between IL10R alpha or beta chain or IL10 defects; autoimmunity was not observed. Mutations in IL10 were more frequently associated with bacterial and viral infections. Patients responded partially to treatment with steroids or anti-tumor necrosis factor drugs, whereas hematopoietic stem cell transplantation proved efficacious. Conclusion: The importance of the IL10 pathway within the colonic mucosa is highlighted by the development of severe colitis within a few weeks in infants with mutations in IL10, IL10RA, or IL10RB. Immunosuppression failed to correct the defect in this pathway, which seems to be a key to controlling inflammation in the colon.
J Port Gastrenterol, 2010
Linfangiectasia Intestinal Primária (LIP) é um distúrbio linfático raro de etiologia desconhecida... more Linfangiectasia Intestinal Primária (LIP) é um distúrbio linfático raro de etiologia desconhecida. Consiste na ectasia dos vasos linfáticos digestivos, podendo provocar ruptura com enteropatia exsudativa. A apresentação clínica é variável e os sintomas ...
GE - Portuguese Journal of Gastroenterology, 2020
Nascer e Crescer, 2006
Chronic Intestinal Pseudo-Obstruction is a rare, disabling disorder characterized by signs and sy... more Chronic Intestinal Pseudo-Obstruction is a rare, disabling disorder characterized by signs and symptoms resembling a physical obstruction to luminal fl ow, without a true mechanical obstruction. Prognosis is variable, in part related to the underlying disease, if identifi ed. The authors present a case of an infant with chronic intestinal pseudoobstruction of unknown aetiology, who needed total parenteral nutrition, and showed slow but consistent improvement of symptoms after enterostomy and prokinetic medical treatment. We emphasize the rarity of the disease, the diffi culty of the diagnosis, and the absence of well defi ned and effective therapies. It is often used conservative treatment, to improve symptoms and promote intestinal motility. Nascer e Crescer 2006; 15(2): 91-96
Journal of Pediatric Gastroenterology & Nutrition
Journal of Crohn's and Colitis
Journal of Pediatric Gastroenterology and Nutrition
Transvaginal ultrasonography assessment of ovarian volumes in postmenopausal women Clinic of Endo... more Transvaginal ultrasonography assessment of ovarian volumes in postmenopausal women Clinic of Endocrine Gynecology and Climacterium at the College of Me.dical Sciences of the Santa Casa of Siio Paulo- Siio Paulo, Brazil The authors evaluated ovarian volumes by transvaginal ultrasonography at different periods after menopause. Ninety-eight postmeno-pausal women with an average age of 51.9 years and a one- to eight-year postmenopausal period were studied. The control group consisted of 40 women during menacme with an average age of 31.8 years, who were also submitted to transvaginal ultrasonography to evaluate ovarian volume. There was no significant difference between right and left ovarian volumes in the study groups. There was a significant decrease in measure and standard deviations of the volumes after the first year of menopause (mean volume- 2.2:t 0.9 cm3) when compared to the control group (mean volume- 6.3:t 2.0 cm3), followed by a slow and gradual shrinking after this phase. ...
revista de pediatria do centro hospitalar do porto ano 2014, vol XXIII, n.º 2 72 artigo de revisã... more revista de pediatria do centro hospitalar do porto ano 2014, vol XXIII, n.º 2 72 artigo de revisão review articles Alergia às proteínas do leite de vaca com manifestações gastrointestinais COWS MILK PROTEIN ALLERGY WITH GASTROINTESTINAL MANIFESTATIONS ABSTRACT Cow's milk protein allergy (CMPA) is the leading cause of food allergy in children under three years of age, although its gastrointestinal manifestations may occur in all age groups. In the suspicion of CMPA based on the anamnesis and physical examination, an elimination diet should be initiated for a variable length of time according to the clinical picture, followed by an oral food challenge (OFC) confi rming or excluding the diagnosis. Complementary exams such as skin prick tests and specifi c IgE may be necessary. Treatment is based on an elimination diet and demands nutritional counselling and growth monitoring. Usually an OFC is repeated after three to 12 months of elimination diet. Tolerance is achieved at three yea...
Journal of Paediatrics and Child Health, 2021
Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva, 2021
Cameron lesions were first described 30 years ago (by Cameron and Higgins) as linear erosions or ... more Cameron lesions were first described 30 years ago (by Cameron and Higgins) as linear erosions or ulcers in hiatal hernia. They are uncommonly reported in adults evaluated for gastrointestinal bleeding, whereas in children they are only few case reports. We describe a ten-years-old boy presenting with a history of iron deficiency anemia and occasional vomiting. Esophagogastroduodenoscopy revealed a sliding hiatal hernia and a Cameron ulcer. We highlight that although a rare cause of gastrointestinal bleeding, a hiatal hernia in a child with iron deficiency anemia should raise the suspicion for Cameron lesions. In fact, the rarity of these lesions makes them a diagnostic challenge, as their identification requires knowledge and a meticulous endoscopy.
Journal of Clinical Medicine, 2021
Myosin Vb (MYO5B) is a motor protein that facilitates protein trafficking and recycling in polari... more Myosin Vb (MYO5B) is a motor protein that facilitates protein trafficking and recycling in polarized cells by RAB11- and RAB8-dependent mechanisms. Biallelic MYO5B mutations are identified in the majority of patients with microvillus inclusion disease (MVID). MVID is an intractable diarrhea of infantile onset with characteristic histopathologic findings that requires life-long parenteral nutrition or intestinal transplantation. A large number of such patients eventually develop cholestatic liver disease. Bi-allelic MYO5B mutations are also identified in a subset of patients with predominant early-onset cholestatic liver disease. We present here the compilation of 114 patients with disease-causing MYO5B genotypes, including 44 novel patients as well as 35 novel MYO5B mutations, and an analysis of MYO5B mutations with regard to functional consequences. Our data support the concept that (1) a complete lack of MYO5B protein or early MYO5B truncation causes predominant intestinal disease...
RESUMO Introducao : A encefalomielite aguda disseminada (ADEM) e uma doenca desmielinizante monof... more RESUMO Introducao : A encefalomielite aguda disseminada (ADEM) e uma doenca desmielinizante monofasica do sistema nervoso central (SNC) imunomediada. O quadro clinico inicial pode ser inespecifico, mas traduz geralmente envolvimento da substância branca em varias localizacoes do SNC, sendo a ressonância magnetica (RM) do neuroeixo o exame complementar de diagnostico de eleicao. Caso clinico : Crianca com 16 meses, internada por perda da capacidade de marcha de instalacao aguda, recusa alimentar e irritabilidade. No exame neurologico salientava -se: periodos de irritabilidade alternando com sonolencia, paraparesia flacida arreflexica, ataxia axial e retencao urinaria. O estudo do liquido cefalorraquidinano revelou pleocitose linfocitaria e foi isolado o HHV -6 por tecnica de Polymerase Chain Reaction. A RM revelou hipersinal medular na ponderacao T2, em D2 -D3 e desde D6 ate ao cone medular. Iniciou terapeutica com corticoterapia e imunoglobulina humana com melhoria progressiva. Disc...
Background: Acute disseminated encephalomyelitis (ADEM) is a monophasic immune -mediated demyelin... more Background: Acute disseminated encephalomyelitis (ADEM) is a monophasic immune -mediated demyelinating disease of the central nervous system. The initial clinical presentation may be nonspecific, but is the result of involvement of different areas in white matter tracts of CNS and brain and spinal magnetic resonance imaging (MRI) is the gold standard complementary investigation for the diagnosis. Case report: A 16 month-old child, hospitalized for loss of walking ability of acute onset, irritability and refusal to eat. The neurological examination revealed: irritability alternating with periods of drowsiness, arreflexic flaccid paraplegia and trunkal ataxia, and urinary retention. Examination of cerebrospinal fluid showed lymphocytic pleocytosis, and herpes virus 6 were isolated by Polymerase Chain Reaction technic. The MRI revealed T2-weight hyperintense diffuse signal in D2-D3 and from D6 to the medullary connus also. She started therapy with steroids and human immunoglobulin with...
Com o objectivo de avaliar a prevalencia da infeccao urinaria no pequeno lactente com febre, os a... more Com o objectivo de avaliar a prevalencia da infeccao urinaria no pequeno lactente com febre, os autores realizaram um estudo prospectivo em 51 lactentes, com idade inferior a 6 meses que recorreram ao servico de urgencia por febre. Em todos os casos foi feita colheita de urina e realizado Combur 10R e UroculturaR. O diagnostico de infeccao urinaria foi feito em 8 criancas (15,7%). O teste Combur 10R teve neste estudo uma sensibilidade de 12,5% e uma especificidade de 86%. Dada a dificuldade de deteccao de infeccao urinaria e a gravidade clinica que pode assumir nesta faixa etaria, este diagnostico devera ser sempre ponderado em todo o lactente com febre.
Cow’s milk protein allergy (CMPA) is the leading cause of food allergy in children under three ye... more Cow’s milk protein allergy (CMPA) is the leading cause of food allergy in children under three years of age, although its gastrointestinal manifestations may occur in all age groups. In the suspicion of CMPA based on the anamnesis and physical examination, an elimination diet should be initiated for a variable length of time according to the clinical picture, followed by an oral food challenge (OFC) confi rming or excluding the diagnosis. Complementary exams such as skin prick tests and specifi c IgE may be necessary. Treatment is based on an elimination diet and demands nutritional counselling and growth monitoring. Usually an OFC is repeated after three to 12 months of elimination diet. Tolerance is achieved at three years of age in more than 80% of the children. The aim of this work is to make a brief review and update on CMPA in pediatric age, proposing a management approach based on recent international recommendations.
RESUMO A tosse convulsa continua a ser uma doença potencialmente fatal, particularmente em grupos... more RESUMO A tosse convulsa continua a ser uma doença potencialmente fatal, particularmente em grupos vulneráveis, apesar da ampla cobertura vacinal em crianças. Os autores apresentam um caso dum RN do sexo feminino que iniciou acessos de tosse ...
Inflammatory Bowel Diseases, 2013
Early-onset inflammatory bowel disease starting within the first months of life could be due to a... more Early-onset inflammatory bowel disease starting within the first months of life could be due to a particular genetic defect. We set up the GENetically determined ImmUne-mediated enteropathieS (GENIUS) network and collected infants with a proven defect of the IL10 axis for accurate phenotyping of disease presentation and evolution. Design: Ten patients with early-onset inflammatory bowel disease with confirmed mutations in IL10, IL10RA, or IL10RB genes were characterized on clinical, endoscopic-histological, immunobiological, and radiological findings. Functional assays to confirm defective responses to IL10 were performed on peripheral blood mononuclear cells. Results: A functional defect in IL10 signaling was confirmed in all IL10R patients tested. Disease started with severe diarrhea within the first 12 weeks in all patients. All infants showed Crohn's disease-like ulcerations limited to the colon with marked perianal inflammation (fissures, abscess, and fistula); disease progression to the small bowel occurred in only 1 patient. Four of the 10 patients had granulomata on histology, and all patients showed Crohn's disease-like mesenteric infiltration on imaging. Disease pattern was indistinguishable between IL10R alpha or beta chain or IL10 defects; autoimmunity was not observed. Mutations in IL10 were more frequently associated with bacterial and viral infections. Patients responded partially to treatment with steroids or anti-tumor necrosis factor drugs, whereas hematopoietic stem cell transplantation proved efficacious. Conclusion: The importance of the IL10 pathway within the colonic mucosa is highlighted by the development of severe colitis within a few weeks in infants with mutations in IL10, IL10RA, or IL10RB. Immunosuppression failed to correct the defect in this pathway, which seems to be a key to controlling inflammation in the colon.
J Port Gastrenterol, 2010
Linfangiectasia Intestinal Primária (LIP) é um distúrbio linfático raro de etiologia desconhecida... more Linfangiectasia Intestinal Primária (LIP) é um distúrbio linfático raro de etiologia desconhecida. Consiste na ectasia dos vasos linfáticos digestivos, podendo provocar ruptura com enteropatia exsudativa. A apresentação clínica é variável e os sintomas ...
GE - Portuguese Journal of Gastroenterology, 2020
Nascer e Crescer, 2006
Chronic Intestinal Pseudo-Obstruction is a rare, disabling disorder characterized by signs and sy... more Chronic Intestinal Pseudo-Obstruction is a rare, disabling disorder characterized by signs and symptoms resembling a physical obstruction to luminal fl ow, without a true mechanical obstruction. Prognosis is variable, in part related to the underlying disease, if identifi ed. The authors present a case of an infant with chronic intestinal pseudoobstruction of unknown aetiology, who needed total parenteral nutrition, and showed slow but consistent improvement of symptoms after enterostomy and prokinetic medical treatment. We emphasize the rarity of the disease, the diffi culty of the diagnosis, and the absence of well defi ned and effective therapies. It is often used conservative treatment, to improve symptoms and promote intestinal motility. Nascer e Crescer 2006; 15(2): 91-96
Journal of Pediatric Gastroenterology & Nutrition
Journal of Crohn's and Colitis
Journal of Pediatric Gastroenterology and Nutrition