Três médicos e uma mãe / Three doctors and a mother / Tres médicos y una madre

A papilomatose laríngea, doença rara potencialmente fatal, carateriza-se pela proliferação de papilomas no trato respiratório, múltiplos, recorrentes, cuja etiologia é a infeção por papilomavírus humano (HPV). Menina, 21 meses, filha de mãe com serologia positiva para vírus da imunodeficiência humana (VIH) e HPV. Em acompanhamento nas consultas de Pediatria do Desenvolvimento do Hospital, Pediatra Particular e Médico de Família (MF). Aos 18 meses, na consulta de acompanhamento do MF, a mãe preocupada salienta a fala sussurrada e choro rouco da filha com diagnóstico frequente de laringite aguda no Pediatra e MF nos últimos 3 meses, motivando a referenciação à Otorrinolaringologia e posterior diagnóstico de papilomatose laríngea. A abordagem da disfonia na criança evita o uso inapropriado de corticoides, inibidores da bomba de prótons e antibioticoterapia. Neste relato sobressai a desvantagem associada ao seguimento por múltiplos médicos, sendo o MF fundamental para reunir e integrar a informação clínica, permitindo a continuidade de cuidados.

Laryngeal papillomatosis is a rare and potentially fatal disease characterized by the proliferation of recurrent respiratory papillomas, whose etiology is human papillomavirus (HPV) infection. We report a clinical case of a 21-month girl, whose mother is sero-positive to human immunodeficiency virus (HIV) infection and HPV. This girl attended multiple medical consultations: Development Pediatrics (at the hospital), private Pediatrician and General Practitioner (GP). At 18 months, in the GP surveillance consultation, the concerned mother referred whispered talking, hoarse crying and frequent diagnosis of acute laryngitis at the Pediatrician in the last 3 months. She was referenced to otorhinolaryngology with subsequent diagnosis of laryngeal papillomatosis. The approach to childhood dysphonia avoids inappropriate use of corticosteroids, proton pump inhibitors and antibiotics. This report highlights the disadvantage of the surveillance by multiple doctors and the key role of the GP in gathering and integrating clinical information, allowing the continuity of care.

La papilomatosis laríngea, una enfermedad rara y potencialmente mortal, se caracteriza por la proliferación de papilomas respiratorios recurrentes, cuya etiología es la infección por el virus del papiloma humano (VPH). Se relata el caso de una niña de 21 meses, hija de una madre seropositiva al virus de la inmunodeficiencia humana (VIH) y VPH. Vigilada en las consultas de Pediatría de Desarrollo del Hospital, Pediatría Privada y Médico de la Familia (MF). A los 18 meses, en la consulta de vigilancia del MF, la madre preocupada destaca habla susurrada, llanto ronco y diagnóstico frecuente de la laringitis aguda en la pediatra en los últimos 3 meses. Se referenció a otorrinolaringología con posterior diagnóstico de papilomatosis laríngea. El enfoque de la disfonía infantil evita el uso inapropiado de los corticosteroides, inhibidores de la bomba de protones y antibioterapia. En este informe se destaca la desventaja asociada al seguimiento por parte de varios médicos, y el papel clave del MF para reunir e integrar la información clínica, lo que permite la continuidad de la atención.

[High blood pressure prevalence in Oporto sedentary and regular exercise practicing people]. / Prevalência do diagnóstico de hipertensão arterial em pessoas sedentárias e em praticantes de exercício físico, na cidade do Porto.

INTRODUCTION: The association between the lack of exercise and prevalence of high blood pressure (HBP) is a well known fact. The non-pharmacological treatment for HBP includes regular aerobic exercise practicing. METHODS: A total of 900 individuals, aged above 40, resident in Oporto, representing the 15 parishes of the city, were approached to answer a questionnaire about exercise habits and diagnosis of HBP. The exercise practitioner was defined as the one who practices aerobic exercise for a minimal period of 30 minutes at least 3 times a week. For data analysis non-parametric tests (Pearson's Chi-Square) were used through the Statistical Package for the Social Sciences (SPSS) software. RESULTS: The HBP prevalence in the sample was 39.67% (Confidence Interval (IC) 95%, 36,46% to 42,87%). The HBP prevalence in the exercise practitioners was inferior to the one of the non-practitioners (13,78% vs 25,89%, p < 0,001). This result is valid to the male 33,5% vs 51,6%, p < 0,001) and female population (27,1% vs 51,9%, p < 0,001), as well as to the population without the most frequent HBP-related comorbidities (21,8% vs 44,6%, p < 0,001). CONCLUSIONS: The HBP prevalence in the population resident in Oporto city is higher in the non-practitioners of regular exercise. The HBP prevalence, in both sexes, is higher in the non-practitioners of exercise. Finally, we can also conclude that the studied comorbidities don't bias the obtained results because the group of individuals who don't have them the HBP prevalence is still higher in the group of sedentary.