Long COVID in Children and Adolescents: A Retrospective Study in a Pediatric Cohort.

Studies on long coronavirus disease (COVID) in children are scarce. We aimed to describe persistent symptoms and identify risk factors for its development. In our study population, 17.6% presented with long COVID, with respiratory symptoms more frequent in the first weeks and neuropsychiatric symptoms over time. Chronic conditions and obesity were risk factors, and adolescents were at a greater risk for long COVID.

Should first blood pressure measurement be performed in the newborn? / Deveremos avaliar a pressão arterial no recém­nascido?

Dilated cardiomyopathy is the most common form of cardiomyopathy and the main cause of cardiac transplantation in children and in adults. Infants and children have a wider spectrum of etiologies, hampering their identification. The most frequent initial manifestation of dilated cardiomyopathy is symptomatic heart failure during exercise or at rest (although many patients are asymptomatic). Some causes are potentially reversible, therefore the investigation should be carefully planned and immediately performed after diagnosis. In most children no cause is identified, which limits the targeted therapeutic approach and therefore the effectiveness of the treatment. The authors present a case of dilated cardiomyopathy secondary to renovascular hypertension diagnosed in an infant with 3.5 month-old, highlighting the etiological investigation, treatment and evolution. The authors present this case emphasising the fact that the arterial hypertension diagnose in infants is not always easy, questioning the current recommendations relating to an initial evaluation on blood pressure. We postulate that the assessment of blood pressure in newborns can detect early renovascular hypertension (and even other cardiovascular diseases) and help prevent the development of deleterious effects, including fatal episodes.

Relationship between the mothers' nutritional status with that of a child population from São Tomé Principe, "Africa" / Avaliação entre o estado nutricional materno e o de uma população infantil de São Tomé e Príncipe "África"

Abstract Objectives: analyse the relation between the nutritional status of children with 0 to 60 months in São Tome and Principe (STP) and their mothers. Methods: characterization of the nutritional status of 1,169 children for the weight / length ratio (W/L) (≤24months) and Body Mass Index (BMI) for age (>24months) and their mothers. The Chi Square or Fisher tests were used for the study on the relation between the nutritional status of the mother and children, as appropriate. Results: fifty-five percent (55%) of the children are female (median = 21 months). There was a high percentage of global acute malnutrition in the children aged0≤24months (30.2%) and 24≤60months (22%) as well as global chronic malnutrition (32% and 41.1% respectively). We observed a high percentage of overweight /obese mothers (31.6%), with 16.5% of them being of a low height. We observed a significantly higher percentage of children with global acute malnutrition 47.5%) when compared with that which was reported for children of normal mothers (27.9%) or overweight /obese (22%) (p<0,001) mothers. Conclusions: It was observed a high prevalence of acute and chronic global malnutrition in the children studied and a high prevalence of overweight /obese mothers. We observed a statistically significant association between maternal and acute global malnutrition of the children.

Resumo Objetivos: analisar a relação entre o estado de nutrição materno e o de crianças dos 0 aos 60 meses em São Tomé e Príncipe (STP). Métodos: caracterizou-se o estado de nutrição de 1.169 crianças pelo Índice Peso/Comprimento (P/C) (≤24meses) e Índice de Massa Corporal (IMC) para a idade (>24meses) e o estado de nutrição das mães (IMC) A associação entre o estado de nutrição materno e o das crianças foi testada pelo teste do qui-quadrado ou exato de Fisher, conforme apropriado. Resultados: do total da amostra analisada, a maior parte é representada por crianças do sexo feminino (55%). Observa-se média de idade de 25,2±18 meses (mediana 21 meses). Observou-se uma elevada percentagem de desnutrição aguda global nas crianças de 0≤24meses (30,2%) e de 24 ≤60 meses (22,0%), bem como de desnutrição crônica global (32,0% e 41,1% respetivamente). Entre as mães, observou-se elevado percentual de sobrepeso/obesidade (31,6%) e de baixa estatura (16,5%). Das crianças estudadas, 47,5% têm desnutrição aguda global, comparativamente à prevalência em crianças de mães eutróficas (27,9%) ou de mães com sobrepeso/obesidade (22%) (p<0,001). Conclusões: Observou-se elevada prevalência de desnutrição global aguda e crônica nas crianças estudadas e elevada prevalência de sobrepeso/obesidade maternas. A desnutrição global aguda dos filhos esteve associada à desnutrição materna.

Aleitamento materno e caracterização dos hábitos alimentares na primeira infância: experiência de São Tomé e Príncipe / Maternal breastfeeding and the characterization of feeding habits in early infancy: the experience of São Tomé e Príncipe

Avaliação da amamentação, da diversificação e frequência alimentar, em crianças de São Tomé e Príncipe (STP). Métodos: trata-se de uma amostra constituída por 1285 crianças. O protocolo incluiu a prevalência do aleitamento materno exclusivo (AME) e Total (AMT), início da diversificação alimentar (DA) e um questionário de frequência alimentar. O tratamento estatístico foi efetuado no SPSS®. Os resultados foram apresentados de acordo com o total da amostra. Resultados: 45,5 por cento são do sexo feminino e a média de idades 26±18 meses. 46,6 por cento fez AME até aos 6 meses (média 5±2). A média de AMT foi 12±7 meses e o início da DA aos 6±3 meses (mediana=6), sendo as farinhas e a canja de peixe os primeiros alimentos oferecidos. 42 por cento das crianças são incluídas na dieta familiar aos 7±3 meses (mediana=6). Elevada porcentagem de crianças nunca ingere: leite de vaca (74 por cento) ou iogurte (40 por cento), contrariamente ao elevado consumo de óleo alimentar (34 por cento) e açúcar (33 por cento). A idade média de iniciação da cerveja é aos 18±12 meses e vinho de palma 13±10 meses. Conclusões: observa-se uma elevada prevalência de AME e uma precoce introdução da DA. Embora existam recursos alimentares disponíveis, não há informação/ formação adequada para elaborar um plano alimentar saudável durante a infância...

To evaluate breastfeeding and the frequency and diversification of feeding, in children in São Tomé e Príncipe (STP). Methods: the sample comprised 1,285 children. The protocol included the prevalence of exclusive (EMB) and total (TMB) maternal breastfeeding, the onset of nutritional diversification (ND) and a questionnaire on the frequency of feeding. The statistics were processed using SPSS®. The results were presented in terms of the total sample. Results: 45.5 percent of the babies were female and the mean age 26±18 months. 46.6 percent were given EMB up to the age of six months (mean 5±2). The mean for TMB was 12±7 months and the onset of ND at 6±3 months (median=6), with corn flour and fish soup being the first solid foods offered. 42 percent ate the same as the rest of the family at 7±3 months (median=6). High percentages of children never ingested cow's milk (74 percent) or yogurt (40 percent), in contrast to the high consumption of cooking oil (34 percent) and sugar (33 percent). The mean age for beginning to drink beer was 18±12 months and for beginning to drink palm wine 13±10 months. Conclusions: There was a high prevalence of EMB and early introduction of ND. Although nutritional resources are available, there is no adequate information or training on how to draw up a healthy eating plan for infants...

Diagnosis of first case of Balamuthia amoebic encephalitis in Portugal by immunofluorescence and PCR.

We report here the first Portuguese case of acute fatal granulomatous encephalitis attributed to Balamuthia mandrillaris, initially thought to be a brain tumor, which had a progressive and fatal outcome. Balamuthia mandrillaris is a free-living amoeba recognized as an uncommon agent of granulomatous encephalitis. Infections have been identified in immunocompromised hosts and in immunocompetent pediatric patients. Balamuthia infections are very rare, with only two reported cases in Europe. The case presented here occurred in a previously healthy boy who died 5 weeks after the onset of the symptoms. No evidence of immunological deficiency was noted, and testing for human immunodeficiency virus antibodies was negative. The symptoms were initially thought to be the result of a tumor, but histopathologic examination showed evidence of amoebic infection. Immunofluorescence staining of brain tissue identified B. mandrillaris as the infectious agent. The diagnosis was confirmed with PCR by detecting Balamuthia DNA in formalin-fixed brain tissue sections. Despite initiation of empirical antimicrobial therapy for balamuthiasis, the patient died 3 weeks after being admitted to the hospital. No source of infection was readily apparent.

Systemic lupus erythematosus (SLE) presenting with nephrotic syndrome and membranous glomerulopathy in a 10-year-old girl.

UNLABELLED: The authors report the case of a 10-y-old girl with clinical diagnosis of systemic lupus erythematosus (SLE), made at the age of 6 y, based upon arthritis, serositis, haematological disorder and positive antinuclear antibody. The first manifestation of disease--Raynaud's phenomenon--appeared at the age of 4 y. Seven months after the diagnosis, she developed nephrotic proteinuria with haematuria. Percutaneous renal biopsy showed membranous glomerulonephritis, the least common form of lupus nephritis. CONCLUSION: Intravenous cyclophosphamide therapy associated with oral prednisolone proved effective in inducing complete remission of nephrotic syndrome.