Catarina Ribeiro

Herpes simplex virus esophagitis in immunocompetent children

Objectives: To review clinical, laboratory, endoscopic and histologic features, treatment and outcome of immunocompetent children with Herpes simplex virus esophagitis. Methods: Retrospective analysis of the medical records of six children (five males) referred to our unit between 1997-2001. Results: The median age at presentation was 4 years. Fever was present in all, odynophagia/dysphagia in five, retrosternal pain in four, vomiting in three, drooling in two and irritability and drowsiness in one. The median time between the onset of symptoms and the diagnosis was 6.5 days. Endoscopy, performed in all, showed friable mucosa and erosive-ulcerative involvement, with histology showing inflammation and ulcerated esophagitis. Tissue viral culture was performed in five patients and was positive in three, and polymerase chain reaction was positive in two of four tested. Serology was consistent with primary Herpes simplex virus infection in all. All received nasogastric feeding and acyclovir. The outcome was very good. Conclusions: This is an uncommon and under-recognized condition in the immunocompetent child. The most common symptoms are sometimes not diagnostic, particularly in very young children. The presence of unusual clinical signs may lead to a difficult and delayed diagnosis. Treatment with acyclovir may have hastened the resolution of symptoms, but a controlled clinical study was not performed.

Preparation of Polyelectrolyte Nanocomplexes Containing Recombinant Human Hepatocyte Growth Factor as Potential Oral Carriers for Liver Regeneration

The large number of cytokines and growth factors implicated in the regulation of liver regeneration has led to the possibility of using these molecules in therapy, namely, in the case of recombinant human hepatocyte growth factor (rhHGF). The importance and potential clinical usefulness of rhHGF has been extensively studied and documented, with results suggesting that this molecule could be a powerful tool toward increased success in hepatic regenerative therapy. However, the peptidic nature of this drug presents several challenges toward its effective administration and targeting. The possibility of encapsulating rhHGF in dextran sulfate/chitosan nanoparticles to allow its oral administration and direct liver-targeting is discussed in this manuscript. Details of a rapid and simple method for the preparation of such rhHGF-loaded nanocomplexes are presented. Beyond the practical aspects of the method, characterization techniques and main experimental features of obtained nanocarriers are also briefly analyzed and discussed.

A case report for differential diagnosis: Integrative medicine vs child abuse

The authors present the case of a ten-year-old Chinese boy who was taken to a hospital due to the presence of suspicious bruises on his body. The child was examined in the National Institute of Legal Medicine by forensic doctors and a forensic psychologist. Clinical characteristics of the case are summarized stressing that a better understanding of some kinds of integrative medicine (IM) may help to differentiate injuries resulting from those practices. This is the only and unique case diagnosed by the medico-legal services in Portugal. In fact a great range of IM practice has the potential to create confusion in the diagnosis of physical child abuse. This study focuses on the differential diagnosis of one specific kind of frequent skin injury usually seen in situations of both child abuse and IM (in this case TuiNa) - bruises. As the number of people who practice Traditional Chinese Medicine and other forms of IM increases in the Western world, the child protection community would benefit from familiarizing itselves with these practices to prevent social and/or legal conflicts that may arise from mistaken diagnoses of abuse. The objective of this case report is to emphasize the relevance of comprehensive and interdisciplinary evaluation of child abuse cases taking into account the specifics of each case, to achieve a proper diagnosis.

Interviews of Children in a Portuguese Special Judicial Procedure

Since 2007, alleged victims of child sexual abuse in Portugal have provided evidence in a mandatory Declarações para Memória Futura (DMF; English transl. Statement for future use) proceeding. In order to protect children from having to testify in court, interviews conducted at the DMF can be used later as trial evidence because the hearings are conducted by judges. The present study examined 137 interviews with 3- to 17-year-olds conducted in several Portuguese criminal courts. Detailed examination of interview transcripts showed that 69% of all questions asked were option-posing questions, 16% were directive questions, 11% were suggestive questions, and only 3% were open-ended prompts. The vast majority of details provided by children were thus obtained using the risky recognition-based prompts (i.e., option posing and suggestive questions) associated with the risks of contaminating and limiting childrens informativeness, both potential threats to the credibility of their testimony. There is an urgent need to address this issue and consider the implementation of a scientifically validated structured interview protocol in Portugal. Copyright

Preservação da privacidade em hemodiálise: perceção dos enfermeiros

Theoretical framework: In haemodialysis, nurses tend to directtheir attention towards the technical procedures, often ignoring thepatients’ feelings and priv...

Perceção de pais e enfermeiros sobre cuidados de Enfermagem em neonatologia: uma revisão integrativa

Background: The admission of a Newborn (NB) to a Neonatal Intensive Care Unit (NICU) requires specialised skills from nurses in order to not only assess th...