Rehabilitation of peripheral facial palsy associated with COVID-19 in a child: A case report.

COVID-19 has been associated with multiple neurological manifestations. Coronaviruses are known to have a neurotropic propensity, possibly leading to various neurological complications, including peripheral facial paralysis (PFP). However, the pathogenic mechanisms underlying neurological symptoms in COVID-19 are not completely understood. This report presents the first published case of facial palsy in an otherwise healthy child secondary to infection with the novel coronavirus SARS-Cov-2, with reflections on the natural course and the role of physical and rehabilitation medicine in this form of PFP. Thus, PFP may also be a manifestation of COVID-19 and in the current epidemiological context, physicians evaluating patients with facial palsy should exclude infection with SARS-Cov-2 to prevent diagnostic delays and further transmission of the disease. These patients may have a slower recovery and worse prognosis as compared with those with Bell's palsy. Thus, rehabilitation needs to be initiated promptly, and close follow-up must be assured to identify and address early complications.

[PRAdA intervention: effects on weight of dietary intervention among treated hypertensive Portuguese natives and African immigrants]. / Intervenção PRAdA: efeitos no peso induzidos por proposta de alteração de comportamento alimentar em hipertensos medicados nativos Portugueses e imigrantes de origem Africana.

INTRODUCTION: Blood pressure is significantly improved with weight loss. Behavioral interventions for weight loss seem to be less successful in African immigrants. Our main aims were to assess the effect of a dietary and lifestyle intervention on weight among hypertensive Portuguese natives and immigrants and to identify success factors for weight loss, and also to evaluate changes in knowledge and compliance with food recommendations. MATERIAL AND METHODS: Hypertensive medicated patients followed in primary care setting were randomly enrolled in a two phase study, observational (15-months) and behavioral intervention (six months). Participants were divided in two groups: immigrants from African Countries of Portuguese Official Language and Portuguese natives. Participants were given dietary and life styles recommendations in individual face-to-face and telephone sessions. RESULTS: Of 110 participants with a mean BMI of 31.6 ± 3.7 Kg/m(2), 60 were immigrants. The number of dietary recommendations known and followed at the end was significantly greater than at baseline; however natives performed a greater number of recommendations. Weight loss during intervention was in average 1.4 ± 2.7% in natives and 0.8 ± 3.6% in immigrants and was greater than in the observational period. Being male and consuming more than 2 servings of low-fat dairy products/day was associated with higher weight loss, independently of age and ethnicity. DISCUSSION: In general the proposed intervention was efficacious especially in Portuguese natives, confirming other studies. CONCLUSION: The intervention increased knowledge and adherence to recommendations, highlighting the relevance of nutrition education, culturally adapted in primary care.

Introdução: Perdas de peso melhoram o controlo da tensão arterial em indivíduos hipertensos. As intervenções comportamentais para a perda de peso parecem ser menos eficazes nos imigrantes de origem africana (IOA). Os principais objetivos foram avaliar os efeitos no peso de uma intervenção alimentar em hipertensos nativos de origem portugueses (NOP) e IOA; identificar fatores de sucesso na perda de peso; avaliar a evolução dos conhecimentos e adesão às recomendações alimentares. Material e Métodos: Foram selecionados aleatoriamente hipertensos medicados seguidos nos cuidados de saúde primários para um estudo de duas fases, observacional (15 meses) e de intervenção comportamental (seis meses). Os participantes foram divididos em dois grupos: IOA e NOP. Foram dadas recomendações alimentares e de estilos de vida em sessões individuais presenciais e telefónicas. Resultados: Dos 110 participantes, com IMC médio de 31,6 ± 3,7 kg/m2 e idade média 61,3 ± 10,0 anos, 60 eram imigrantes. Durante a intervenção os NOP perderam 1,4 ± 2,7% do peso e os IOA 0,8 ± 3,6%, sendo a perda superior comparativamente com a fase observacional. Ser do sexo masculino e consumir pelo menos duas porções de lacticínios magros por dia associou-se a maior perda de peso durante a intervenção, independentemente da idade e origem. Houve um aumento significativo no número de recomendações dietéticas conhecidas e cumpridas, com os NOP a cumprirem em média mais recomendações. Discussão: A intervenção foi bem sucedida relativamente à perda de peso, especialmente no grupo dos NOP, confirmando outros estudos. Conclusão: A intervenção aumentou os conhecimentos e adesão às recomendações, realçando a pertinência da educação alimentar, culturalmente adaptada, nos cuidados de saúde primários.