Susana Corujeira - Academia.edu (original) (raw)

Papers by Susana Corujeira

Trabalho organizado de acordo com as normas da revista:

Introducao: A pratica de exercicio fisico na adolescencia tem beneficios na saude e imagem corpor... more Introducao: A pratica de exercicio fisico na adolescencia tem beneficios na saude e imagem corporal. Contudo, em modalidades que implicam controlo do peso podera questionar-se se a elevada frequencia e intensidade dos treinos condicionam um compromisso do crescimento e da maturacao. Objectivo: Avaliar a influencia da ginastica de competicao no estado nutricional, composicao corporal, desenvolvimento pubertario, massa ossea, predicao estatural e presenca da triade da atleta feminina em adolescentes. Populacao e metodos : Amostra de conveniencia constituida por 27 ginastas e 15 controlos (10-18 anos) do sexo feminino. A avaliacao incluiu a caracterizacao antropometrica, da composicao corporal (impedância-bioelectrica), do estadio pubertario (Tanner), da idade ossea (Greulich-Pyle) e da densidade mineral ossea (DXA L1-L4). Foi determinada a idade da menarca e caracterizado o ciclo menstrual, foi avaliada a tensao arterial e foram calculados o indice de massa corporal (IMC), a estatura...

Introducao: Pretendeu-se identificar os niveis de stress nas maes de criancas e adolescentes com ... more Introducao: Pretendeu-se identificar os niveis de stress nas maes de criancas e adolescentes com perturbacao de hiperatividadecom defice de atencao e verificar se existe uma associacao entre o stress percecionado por estas maes e o funcionamento familiar. Metodos: Foram utilizados o indice de stress parental, versao reduzida, que caracteriza o stress parental total de acordo comtres dimensoes (dificuldade parental, interacao pais / crianca e crianca dificil), e a escala de avaliacao da adaptabilidade e coesaofamiliar, que classifica as familias em equilibradas, meio-termo ou extremas. Resultados: Participaram neste estudo 89 maes. Obtiveram-se valores medios no questionario indice de stress parental acimado percentil 85 (valor de cutoff) nas subescalas interacao disfuncional crianca-pais, crianca dificil e no valor de stress total.Verificou-se ainda que havia uma forte correlacao entre stress total e as tres subescalas, isto e, maes com niveis mais elevadosde stress tendem a ter uma...

Psicologia, Saúde & Doença, 2017

Os pais valorizam e estimulam os filhos de acordo com o que estabelecem como relevante para o seu... more Os pais valorizam e estimulam os filhos de acordo com o que estabelecem como relevante para o seu comportamento e desenvolvimento, sendo as práticas parentais de cuidados e educação determinadas pela sua cultura, crenças e valores. Perante o nascimento de uma criança prematura, os pais têm que lidar com a vulnerabilidade da criança internada na Neonatologia, um ambiente porventura facilitador da aquisição de crenças e cognições pouco adequadas. Os objetivos foram: avaliar as crenças parentais em crianças em idade pré-escolar com antecedentes de prematuridade (idade gestacional inferior a 32 semanas), identificar as práticas mais valorizadas pelas mães e relacionar as características sociodemográficas, a valorização das práticas, o grau de prematuridade e a duração do internamento com as crenças parentais. Os participantes foram as mães de crianças com antecedentes de prematuridade, com idade gestacional inferior a 32 semanas, observadas na consulta de Neurodesenvolvimento de um hospital terciário. Foram aplicados questionários sobre dados sociodemográficos e o Questionário de Crenças e Práticas Maternas sobre Cuidados com as Crianças. As mães atribuíram mais importância à dimensão "Estimulação", sendo a "Disciplina" considerada a dimensão menos importante. A "Vinculação" e a "Disciplina" associam-se negativamente com a idade cronológica. Conclui-se que que as vivências marcantes dos pais dos grandes prematuros nos primeiros tempos de vida destes acarretam preocupações quanto ao seu posterior desenvolvimento psicomotor que os levam a dar prioridade a comportamentos de estimulação e a descurar as questões sociais e a disciplina.

Journal of pediatric gastroenterology and nutrition, Jan 16, 2017

GE Portuguese Journal of Gastroenterology, 2016

Introduction: Inflammatory bowel disease may cause both intestinal and extraintestinal manifestat... more Introduction: Inflammatory bowel disease may cause both intestinal and extraintestinal manifestations. Respiratory symptoms in ulcerative colitis are rare and tracheal involvement is exceedingly rare in children. Case 1: Sixteen year-old female with a 4-week-complaint of abdominal pain, bloody diarrhea, fever and cough. The investigation was consistent with the diagnosis of concomitant ulcerative colitis/coinfection to Escherichia coli. On day 4 respiratory signs persisted so azithromycin and inhaled corticosteroids were added. By day 6 she progressed to respiratory failure and was diagnosed with necrotic tracheitis so started on intravenous steroids with fast clinical improvement. Case 2: Twelve-year-old male adolescent with ulcerative colitis and sclerosing cholangitis started dry cough and throat pain 10 days after diagnosis. Laboratory investigations showed increased inflammatory signs and normal chest X-ray. He started treatment with azithromycin without clinical improvement and on day five he presented dyspnea and fever. Laryngeal fibroscopy suggested tracheitis and so systemic steroids where added with fast clinical and analytic improvement.

GE Portuguese Journal of Gastroenterology, 2015

Introduction: Aspiration or ingestion of foreign bodies may occur during dental procedures. Diagn... more Introduction: Aspiration or ingestion of foreign bodies may occur during dental procedures. Diagnosis and management of these accidents is sometimes challenging. The authors present a small series of clinical cases: Case 1: Adolescent observed due to suspected accidental bracket ingestion, not visible on x-ray, removed by upper digestive endoscopy. Case 2: Adolescent observed after accidental ingestion of a dental file. Conflicting results in image exams and absence of object progression led to enteroscopy for extraction. Case 3: Adolescent observed due to accidental ingestion of a surgical blade, visualized on image study but not accessible by endoscopy, resulting in latter spontaneous elimination. Discussion: Image study is frequently useful when metallic object ingestion is suspected, but has some limitations. In some cases, mucosal protections must be used during removal procedures. Prevention of such accidents is the best approach, using appropriate protections to secure airway and digestive tract during dental procedures.

Paediatric Respiratory Reviews, 2013

Journal of Cystic Fibrosis, 2013

Objective: Several hundreds of CFTR variants have been reported, it is not known whether they are... more Objective: Several hundreds of CFTR variants have been reported, it is not known whether they are causing CF or not. M470 and the combined V frequency is seen the sub-Saharian Africa. In this study, we aimed to investigate the clinical importance of M470V mutation in Antiochia region (ancient commercial center and capital of Syria; an early center of Christianity) which is in the vicinity of Africa and a region with frequent consanguineous marriages due to ethnical reasons. Method: The study was designed as a case control study. The study group consisted of 79 children with mutations out of 145 children who were undergoing CF gene study because of recurrent respiratory tract infections, growth failure, chronic diarrhea and constipation. These 79 patients' clinical and labarotory features were investigated. Results: In 63 of 145 patients (43.4%), heterozygous mutation, in 16 (11%) homozygous mutation was detected. Mean age of those patients was 41.21±39.8 (min: 6 max: 192) months and 30 (38%) were girls and 49 (62%) were boys. All of them had M470V mutation. Of the patients with mutation 17 (32.7%) had a familial history of cystic fibrosis, 2 had sibling death history. In mutation group, only annual number of infections, skin dryness, loss of weight, level of IgG and IgM were significantly higher (p < 0.05). Conclusion: It was concluded that in M470V positive cases, the disease may cause clinical symptoms without affecting sweat test results, with less gastrointestinal but more respiratory symptoms, causing a more prominent loss of weight, and causing higher levels of immunoglobulin due to more frequent infections.

Journal of Cystic Fibrosis, 2013

In sports that require low body weight, it is questioned whether the high frequency and intensity... more In sports that require low body weight, it is questioned whether the high frequency and intensity of training can compromise growth and maturation. Aim was to evaluate the influence of gymnastics on nutritional status, body composition, pubertal development, bone mass, prediction of height and the occurrence of the Female Athlete Triad (FAT) in adolescents. Convenience sample consisted of 27 female gymnasts and 15 controls. The evaluation included anthropometric parameters, body composition (bioelectrical impedance; Tanita TBF 300 ®), pubertal stage, bone age, bone mineral density (DXA L1-L4; Lunar Expert XL ®) and blood pressure. Body mass index and genetic height prediction were calculated. Gymnasts practice a median of 18 hours per week of exercise, six times more than the control group. There were no significant differences between groups in genetic height, menarche, pubertal stage, nutritional status and bone mass. However, gymnasts have a lower value of total body fat. Sedentary adolescents show a higher prevalence of overweight, hypertension, osteopenia and final height prediction. In this particular group of athletes, competitive gymnastics influences body composition but does not appear to compromise nutritional status, normal progression of puberty, bone mass and genetically defined final height. These results question the concept of FAT, but more studies are needed.

GE Portuguese Journal of Gastroenterology, 2016

Introduction: The management of esophageal strictures has evolved from surgical treatment to the ... more Introduction: The management of esophageal strictures has evolved from surgical treatment to the endoscopic dilation and, more recently, esophageal stenting. Clinical case: We describe a case of a two-year-old boy with a double stenosis of the esophagus resulting from accidental ingestion of strong alkaline liquid. After several unsuccessful endoscopic dilations for three years and even topical mitomicin, it was decided to place a dynamic stent developed by the Digestive Surgery and Endoscopic Unit of the Bambino Gesù Hospital, Rome. The stent is a custom silicon device built coaxially on a nasogastric tube that is inserted after stricture dilations, by endoscopic guidance, and then fixed outside the nose. The device was removed after seven weeks with good clinical outcome (no dysphagia more than a year of follow-up). Conclusion: This case confirms that the dynamic stent is a simple device that may avoid aggressive surgical substitution in cases of refractory strictures.

Gastroenterology, Oct 1, 2017

The guidelines of the European Society of Pediatric Gastroenterology, Hepatology, and Nutrition a... more The guidelines of the European Society of Pediatric Gastroenterology, Hepatology, and Nutrition allow for diagnosis of celiac disease without biopsies in children with symptoms and levels of immunoglobulin A against tissue-transglutaminase (TGA-IgA) 10-fold or more the upper limit of normal (ULN), confirmed by detection of endomysium antibodies (EMA) and positivity for HLA-DQ2/DQ8. We performed a large, international prospective study to validate this approach. We collected data from consecutive pediatric patients (18 years or younger) on a gluten-containing diet who tested positive for TGA-IgA from November 2011 through May 2014, seen at 33 pediatric gastroenterology units in 21 countries. Local centers recorded symptoms; measurements of total IgA, TGA, and EMA; and histopathology findings from duodenal biopsies. Children were considered to have malabsorption if they had chronic diarrhea, weight loss (or insufficient gain), growth failure, or anemia. We directly compared central fi...

GE - Portuguese Journal of Gastroenterology

Mucosectomia endoscópica em criança com heterotopia gástrica do reto Palavras Chave Heterotopia m... more Mucosectomia endoscópica em criança com heterotopia gástrica do reto Palavras Chave Heterotopia mucosa gástrica • Resseção endoscópica mucosa • Reto Resumo A heterotopia da mucosa gástrica pode ocorrer em qualquer local do trato gastrointestinal, mas a localização retal é invulgar. Apresenta-se o caso clínico de uma criança de 4 anos, referenciada à consulta de Gastroenterologia Pediátrica por retorragia intermitente com cerca de 2 anos de evolução. Foi realizada ileocolonoscopia total com visualização de lesão plana de bordos elevados e bem delimitada, com cerca de 4 cm, localizada 10 cm acima da margem anal. O exame histológico revelou a presença de mucosa gástrica do tipo oxíntico. Iniciou terapêutica oral com inibidor da bomba de protões, sem resposta, pelo que se procedeu a mucosectomia endoscópica. A heterotopia da mucosa gástrica é uma causa rara de retorragias

Revista Portuguesa de Endocrinologia, Diabetes e Metabolismo, 2012

Revista Portuguesa de Endocrinologia, Diabetes e Metabolismo, 2012

Revista Portuguesa de Endocrinologia, Diabetes e Metabolismo, 2012

Trabalho organizado de acordo com as normas da revista:

Introducao: A pratica de exercicio fisico na adolescencia tem beneficios na saude e imagem corpor... more Introducao: A pratica de exercicio fisico na adolescencia tem beneficios na saude e imagem corporal. Contudo, em modalidades que implicam controlo do peso podera questionar-se se a elevada frequencia e intensidade dos treinos condicionam um compromisso do crescimento e da maturacao. Objectivo: Avaliar a influencia da ginastica de competicao no estado nutricional, composicao corporal, desenvolvimento pubertario, massa ossea, predicao estatural e presenca da triade da atleta feminina em adolescentes. Populacao e metodos : Amostra de conveniencia constituida por 27 ginastas e 15 controlos (10-18 anos) do sexo feminino. A avaliacao incluiu a caracterizacao antropometrica, da composicao corporal (impedância-bioelectrica), do estadio pubertario (Tanner), da idade ossea (Greulich-Pyle) e da densidade mineral ossea (DXA L1-L4). Foi determinada a idade da menarca e caracterizado o ciclo menstrual, foi avaliada a tensao arterial e foram calculados o indice de massa corporal (IMC), a estatura...

Introducao: Pretendeu-se identificar os niveis de stress nas maes de criancas e adolescentes com ... more Introducao: Pretendeu-se identificar os niveis de stress nas maes de criancas e adolescentes com perturbacao de hiperatividadecom defice de atencao e verificar se existe uma associacao entre o stress percecionado por estas maes e o funcionamento familiar. Metodos: Foram utilizados o indice de stress parental, versao reduzida, que caracteriza o stress parental total de acordo comtres dimensoes (dificuldade parental, interacao pais / crianca e crianca dificil), e a escala de avaliacao da adaptabilidade e coesaofamiliar, que classifica as familias em equilibradas, meio-termo ou extremas. Resultados: Participaram neste estudo 89 maes. Obtiveram-se valores medios no questionario indice de stress parental acimado percentil 85 (valor de cutoff) nas subescalas interacao disfuncional crianca-pais, crianca dificil e no valor de stress total.Verificou-se ainda que havia uma forte correlacao entre stress total e as tres subescalas, isto e, maes com niveis mais elevadosde stress tendem a ter uma...

Psicologia, Saúde & Doença, 2017

Os pais valorizam e estimulam os filhos de acordo com o que estabelecem como relevante para o seu... more Os pais valorizam e estimulam os filhos de acordo com o que estabelecem como relevante para o seu comportamento e desenvolvimento, sendo as práticas parentais de cuidados e educação determinadas pela sua cultura, crenças e valores. Perante o nascimento de uma criança prematura, os pais têm que lidar com a vulnerabilidade da criança internada na Neonatologia, um ambiente porventura facilitador da aquisição de crenças e cognições pouco adequadas. Os objetivos foram: avaliar as crenças parentais em crianças em idade pré-escolar com antecedentes de prematuridade (idade gestacional inferior a 32 semanas), identificar as práticas mais valorizadas pelas mães e relacionar as características sociodemográficas, a valorização das práticas, o grau de prematuridade e a duração do internamento com as crenças parentais. Os participantes foram as mães de crianças com antecedentes de prematuridade, com idade gestacional inferior a 32 semanas, observadas na consulta de Neurodesenvolvimento de um hospital terciário. Foram aplicados questionários sobre dados sociodemográficos e o Questionário de Crenças e Práticas Maternas sobre Cuidados com as Crianças. As mães atribuíram mais importância à dimensão "Estimulação", sendo a "Disciplina" considerada a dimensão menos importante. A "Vinculação" e a "Disciplina" associam-se negativamente com a idade cronológica. Conclui-se que que as vivências marcantes dos pais dos grandes prematuros nos primeiros tempos de vida destes acarretam preocupações quanto ao seu posterior desenvolvimento psicomotor que os levam a dar prioridade a comportamentos de estimulação e a descurar as questões sociais e a disciplina.

Journal of pediatric gastroenterology and nutrition, Jan 16, 2017

GE Portuguese Journal of Gastroenterology, 2016

Introduction: Inflammatory bowel disease may cause both intestinal and extraintestinal manifestat... more Introduction: Inflammatory bowel disease may cause both intestinal and extraintestinal manifestations. Respiratory symptoms in ulcerative colitis are rare and tracheal involvement is exceedingly rare in children. Case 1: Sixteen year-old female with a 4-week-complaint of abdominal pain, bloody diarrhea, fever and cough. The investigation was consistent with the diagnosis of concomitant ulcerative colitis/coinfection to Escherichia coli. On day 4 respiratory signs persisted so azithromycin and inhaled corticosteroids were added. By day 6 she progressed to respiratory failure and was diagnosed with necrotic tracheitis so started on intravenous steroids with fast clinical improvement. Case 2: Twelve-year-old male adolescent with ulcerative colitis and sclerosing cholangitis started dry cough and throat pain 10 days after diagnosis. Laboratory investigations showed increased inflammatory signs and normal chest X-ray. He started treatment with azithromycin without clinical improvement and on day five he presented dyspnea and fever. Laryngeal fibroscopy suggested tracheitis and so systemic steroids where added with fast clinical and analytic improvement.

GE Portuguese Journal of Gastroenterology, 2015

Introduction: Aspiration or ingestion of foreign bodies may occur during dental procedures. Diagn... more Introduction: Aspiration or ingestion of foreign bodies may occur during dental procedures. Diagnosis and management of these accidents is sometimes challenging. The authors present a small series of clinical cases: Case 1: Adolescent observed due to suspected accidental bracket ingestion, not visible on x-ray, removed by upper digestive endoscopy. Case 2: Adolescent observed after accidental ingestion of a dental file. Conflicting results in image exams and absence of object progression led to enteroscopy for extraction. Case 3: Adolescent observed due to accidental ingestion of a surgical blade, visualized on image study but not accessible by endoscopy, resulting in latter spontaneous elimination. Discussion: Image study is frequently useful when metallic object ingestion is suspected, but has some limitations. In some cases, mucosal protections must be used during removal procedures. Prevention of such accidents is the best approach, using appropriate protections to secure airway and digestive tract during dental procedures.

Paediatric Respiratory Reviews, 2013

Journal of Cystic Fibrosis, 2013

Objective: Several hundreds of CFTR variants have been reported, it is not known whether they are... more Objective: Several hundreds of CFTR variants have been reported, it is not known whether they are causing CF or not. M470 and the combined V frequency is seen the sub-Saharian Africa. In this study, we aimed to investigate the clinical importance of M470V mutation in Antiochia region (ancient commercial center and capital of Syria; an early center of Christianity) which is in the vicinity of Africa and a region with frequent consanguineous marriages due to ethnical reasons. Method: The study was designed as a case control study. The study group consisted of 79 children with mutations out of 145 children who were undergoing CF gene study because of recurrent respiratory tract infections, growth failure, chronic diarrhea and constipation. These 79 patients' clinical and labarotory features were investigated. Results: In 63 of 145 patients (43.4%), heterozygous mutation, in 16 (11%) homozygous mutation was detected. Mean age of those patients was 41.21±39.8 (min: 6 max: 192) months and 30 (38%) were girls and 49 (62%) were boys. All of them had M470V mutation. Of the patients with mutation 17 (32.7%) had a familial history of cystic fibrosis, 2 had sibling death history. In mutation group, only annual number of infections, skin dryness, loss of weight, level of IgG and IgM were significantly higher (p < 0.05). Conclusion: It was concluded that in M470V positive cases, the disease may cause clinical symptoms without affecting sweat test results, with less gastrointestinal but more respiratory symptoms, causing a more prominent loss of weight, and causing higher levels of immunoglobulin due to more frequent infections.

Journal of Cystic Fibrosis, 2013

In sports that require low body weight, it is questioned whether the high frequency and intensity... more In sports that require low body weight, it is questioned whether the high frequency and intensity of training can compromise growth and maturation. Aim was to evaluate the influence of gymnastics on nutritional status, body composition, pubertal development, bone mass, prediction of height and the occurrence of the Female Athlete Triad (FAT) in adolescents. Convenience sample consisted of 27 female gymnasts and 15 controls. The evaluation included anthropometric parameters, body composition (bioelectrical impedance; Tanita TBF 300 ®), pubertal stage, bone age, bone mineral density (DXA L1-L4; Lunar Expert XL ®) and blood pressure. Body mass index and genetic height prediction were calculated. Gymnasts practice a median of 18 hours per week of exercise, six times more than the control group. There were no significant differences between groups in genetic height, menarche, pubertal stage, nutritional status and bone mass. However, gymnasts have a lower value of total body fat. Sedentary adolescents show a higher prevalence of overweight, hypertension, osteopenia and final height prediction. In this particular group of athletes, competitive gymnastics influences body composition but does not appear to compromise nutritional status, normal progression of puberty, bone mass and genetically defined final height. These results question the concept of FAT, but more studies are needed.

GE Portuguese Journal of Gastroenterology, 2016

Introduction: The management of esophageal strictures has evolved from surgical treatment to the ... more Introduction: The management of esophageal strictures has evolved from surgical treatment to the endoscopic dilation and, more recently, esophageal stenting. Clinical case: We describe a case of a two-year-old boy with a double stenosis of the esophagus resulting from accidental ingestion of strong alkaline liquid. After several unsuccessful endoscopic dilations for three years and even topical mitomicin, it was decided to place a dynamic stent developed by the Digestive Surgery and Endoscopic Unit of the Bambino Gesù Hospital, Rome. The stent is a custom silicon device built coaxially on a nasogastric tube that is inserted after stricture dilations, by endoscopic guidance, and then fixed outside the nose. The device was removed after seven weeks with good clinical outcome (no dysphagia more than a year of follow-up). Conclusion: This case confirms that the dynamic stent is a simple device that may avoid aggressive surgical substitution in cases of refractory strictures.

Gastroenterology, Oct 1, 2017

The guidelines of the European Society of Pediatric Gastroenterology, Hepatology, and Nutrition a... more The guidelines of the European Society of Pediatric Gastroenterology, Hepatology, and Nutrition allow for diagnosis of celiac disease without biopsies in children with symptoms and levels of immunoglobulin A against tissue-transglutaminase (TGA-IgA) 10-fold or more the upper limit of normal (ULN), confirmed by detection of endomysium antibodies (EMA) and positivity for HLA-DQ2/DQ8. We performed a large, international prospective study to validate this approach. We collected data from consecutive pediatric patients (18 years or younger) on a gluten-containing diet who tested positive for TGA-IgA from November 2011 through May 2014, seen at 33 pediatric gastroenterology units in 21 countries. Local centers recorded symptoms; measurements of total IgA, TGA, and EMA; and histopathology findings from duodenal biopsies. Children were considered to have malabsorption if they had chronic diarrhea, weight loss (or insufficient gain), growth failure, or anemia. We directly compared central fi...

GE - Portuguese Journal of Gastroenterology

Mucosectomia endoscópica em criança com heterotopia gástrica do reto Palavras Chave Heterotopia m... more Mucosectomia endoscópica em criança com heterotopia gástrica do reto Palavras Chave Heterotopia mucosa gástrica • Resseção endoscópica mucosa • Reto Resumo A heterotopia da mucosa gástrica pode ocorrer em qualquer local do trato gastrointestinal, mas a localização retal é invulgar. Apresenta-se o caso clínico de uma criança de 4 anos, referenciada à consulta de Gastroenterologia Pediátrica por retorragia intermitente com cerca de 2 anos de evolução. Foi realizada ileocolonoscopia total com visualização de lesão plana de bordos elevados e bem delimitada, com cerca de 4 cm, localizada 10 cm acima da margem anal. O exame histológico revelou a presença de mucosa gástrica do tipo oxíntico. Iniciou terapêutica oral com inibidor da bomba de protões, sem resposta, pelo que se procedeu a mucosectomia endoscópica. A heterotopia da mucosa gástrica é uma causa rara de retorragias

Revista Portuguesa de Endocrinologia, Diabetes e Metabolismo, 2012

Revista Portuguesa de Endocrinologia, Diabetes e Metabolismo, 2012

Revista Portuguesa de Endocrinologia, Diabetes e Metabolismo, 2012