Browsing by Author "Miranda, AM"
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- Febre, cardiopatia congénita e muitas surpresasPublication . Coelho, R; Miranda, AM; Brito, MJ; Correia, P
- Overweight in youth and sleep quality: is there a link?Publication . Pacheco SR1, SR; Miranda, AM; Coelho, R; Monteiro, AC; Bragança, GOBJECTIVE: Overweight seems to be related to a higher prevalence of sleep disturbances. Decreased sleep duration and altered sleep quality are risk factors for obesity. Our aim was to compare the sleep pattern of overweight children with that of a matched control group and assess the relationship between sleep quality and obesity. MATERIALS AND METHODS: Retrospective cohort study comparing 41 overweight children with a normal-weight control group, both submitted to polysomnography. The samples were matched for age, sex, and apnea-hypopnea index. Body mass index (BMI) z-scores were calculated using World Health Organization (WHO) growth charts. Insulin resistance in the study group was determined using the homeostatic model assessment for insulin resistance (HOMA-IR). Sleep patterns were compared. The statistical analysis was performed using SPSS® version 21. RESULTS: The mean age (± standard deviation) of the population was 10 ± 3.4 years (min. 5 years; max. 17 years). Fifty-six percent of the participants in both groups were girls. N3% was lower in the study group (18.95 ± 6.18%) compared with the control group (21.61 ± 7.39%; t (40) = 2.156, p = 0.037). We found a correlation in the study group between HOMA-IR and N3% (Rs = -0.434, p = 0.008). CONCLUSION: The present study suggests a link between overweight/obesity and altered sleep quality due to compromised non-rapid eye movement sleep, an indirect marker of sleep quality. There was also a link between slow-wave sleep duration and insulin resistance. We must find a strategy to provide adequate slow-wave sleep duration to reduce the obesity epidemic at young ages. Further research is needed.
- Urinary tract infections under 24 months old: Is it possible to predict the risk of renal scarring?Publication . Miranda, AM; Garcia, C; Bento, V; Pinto, SBackground: Urinary tract infection is one of the most common bacterial infections in the first two years of life and it can lead to irreversible renal scarring. Renal scintigraphy is the gold standard method for detection of renal scars. The aim of our work was to revise the cases of pyelonephritis, detect the possible predictors for renal scarring and compare those results we would have obtained if we had followed current NICE guidelines. Methods: Retrospective analysis of all patients aged under 24 months evaluated in the paediatric department and diag- nosed with pyelonephritis during a three -year period. We excluded the cases in which no renal scintigraphy was performed. Results: Of the 59 children analysed, 50.8% were boys and 86.4% were under one -year old. Escherichia coli was the predominant bacteria. Renal ultrasonography showed abnormal findings in 23 patients (39%). The incidence of renal scarring was 15.3%. Age, atypical urinary tract infection and abnormal renal ultrasonography seem to be correlated with risk of renal scarring, although the results were not statistically significant. C -reactive protein level is significantly correlated with renal scarring risk (p=0.047). Working outside the NICE guidelines allowed us to catch 7 further renal scars. Conclusions: It’s arguable if renal scintigraphy must be performed in all cases of pyelonephritis diagnosed in the first 24 months of life or only when there are other risk factors for renal scarring. Age, atypical urinary tract infection, C -reactive protein level and renal ultrasonography results must be taken into account in the decision to perform renal scintigraphy in a child. More prospective studies with larger cohorts are needed.