Rita Franca

Pediatric knowledge about acute viral hepatitis

Knowledge about hepatotropic viruses is crucial for pediatricians because of the high prevalence of viral hepatitis during childhood. The multiplicity of hepatotropic viruses, the spectrum of acute and chronic infections, and the sequels of viral hepatitis result in a need for physicians to better understand the clinical and epidemiological context of patients with viral hepatitis, as well as the importance of prevention measures for hepatitis. A descriptive cross-sectional study was made of pediatricians knowledge about viral hepatitis, through questionnaires to 574 pediatricians, with no obligation of identification. The pediatricians were recruited among those who attended a national Congress of Pediatrics in Brasília, Brazil. Among these pediatricians, 50.1% frequently treated cases of hepatitis, and 74.7% indicated that they had knowledge of the existence of five hepatotropic viruses; 14.5% knew about at least four types of hepatitis complications, while only 7.7% and 4.3% were able to correctly diagnose viral hepatitis A and B, respectively. Many (28.4%) did not know how to treat the patients adequately. Only 37.5% had already recommended vaccination against hepatitis B. Only 50.2% of the pediatricians had been vaccinated against hepatitis B. We concluded that it is crucial to make pediatricians more knowledgeable about viral hepatitis, through continued education programs, especially emphasizing prevention procedures.

Aspectos anatomoclínicos da esclerose hepatoportal em crianças

Introducao: A Esclerose Hepatoportal e caracterizada pela presenca de hipertensao portal com preservacao da arquitetura e funcao hepatica na ausencia de obstrucao extra-hepatica da veia porta. Objetivo: enumerar as principais caracteristicas anatomo-clinicas dos pacientes portadores de esclerose hepatoportal, acompanhados no servico de Gastroenterologia Pediatrica. Metodologia: estudo descritivo de uma serie de casos, no qual foram coletadas informacoes dos prontuarios dos pacientes portadores de esclerose hepatoportal acompanhados no ambulatorio de hepatologia pediatrica do Hospital Universitario Professor Edgard Santos – UFBA. Resultados: Foram selecionados cinco pacientes que preenchem os criterios para esclerose hepatoportal. Dentre os sintomas, todos apresentaram aumento de volume abdominal, dois hepatomegalia, dois esplenomegalia e um com hepatoesplenomegalia. Sinais de hepatopatia cronica foram encontrados em tres pacientes. As provas de funcao hepatica nao se mostraram alteradas. Foram visualizadas varizes esofagicas em quatro pacientes, sendo feita escleroterapia em apenas um dos casos. Dentre os aspectos vistos na biopsia hepatica, quatro pacientes apresentaram fibrose portal e septal, dois com espacos-porta alargados por fibrose, dois com areas de dilatacao e congestao de sinusoides, quatro com nodulos no parenquima e todos com vasos telangiectasicos. Conclusao: a Esclerose Hepatoportal ainda e uma doenca muito pouco estudada na populacao pediatrica, sao necessarios mais estudos para caracterizar melhor a evolucao tanto clinica como anatomopatologica nessa faixa etaria.