Abstract：
INTRODUCTION:Respiratory tract infections represent the most frequent conditions in pediatric clinical practice that motivate antibiotic prescribing. The objective was to identify the frequency and pattern of antibacterial prescribing in respiratory diseases. MATERIAL AND METHODS:Over a period of two years (divided by the presentation of the clinical guideline standards) data was collected from clinical records of children with respiratory disease. Chi-square tests or Fisher's exact test were used to test associations between variables, statistical significance p < 0.05. RESULTS:There were 547 visits (mean age 6 years ± 5.3, 55% male gender). Analysis for Group A Streptococcus of the oropharynx was most frequently requested by pediatric residents (p = 0.005). Chest x-rays were more frequently requested by the Family Physician (p = 0.033). An antibiotic was prescribed in 87% of pneumonias, 84% acute otitis media, 68% acute tonsillitis, 25% laryngitis, 17% upper respiratory infections, 16% acute bronchiolitis. The Family Physician prescribed antibiotics more often than the Pediatrics resident in acute tonsillitis (p = 0.003) and in acute otitis media (p = 0.013). The most frequently prescribed antibiotic was amoxicillin (61%). There were no significant differences between the two periods studied regarding the number of prescriptions and antibiotic choice of the conditions studied. DISCUSSION:Antibiotic prescribing in pediatric acute respiratory infections was high and the choice of antibiotic therapy could be adjusted. We found no difference in antibiotic prescribing after the presentation of the clinical guideline standards. CONCLUSION:An improvement in the antibiotic prescription in children and adolescents in the outpatient clinic is considered necessary. :Introdução: As infeções do trato respiratório são das patologias que mais frequentemente motivam a prescrição antibiótica em idade pediátrica. Os objetivos deste estudo foram identificar a frequência e padrão de prescrição de antibacterianos na patologia respiratória. Material e Métodos: Durante dois anos (divididos pela apresentação das normas de orientação clínica), os dados foram obtidos através da consulta de processos clínicos de crianças com patologia respiratória. Utilizaram-se os testes qui-quadrado ou teste exato de Fisher para testar associações entre variáveis, assumindo-se significado estatístico quando p < 0,05. Resultados: Realizaram-se 547 consultas (idade média de seis anos ± 5,3, 55% do género masculino). A pesquisa do antigénio do Streptococcus do grupo A na orofaringe foi realizada mais frequentemente por internos de Pediatria (p = 0,005). A radiografia de tórax foi mais pedida pelo especialista de Medicina Geral e Familiar (p = 0,033). Prescreveu-se antibiótico em 87% pneumonias, 84% otites médias agudas, 68% amigdalites, 25% laringites, 17% infeções respiratórias superiores e 16% bronquiolites agudas. O especialista de Medicina Geral e Familiar prescreveu mais antibiótico que o interno de Pediatria na amigdalite aguda (p = 0,003) e na otite média aguda (p = 0,013). O antibiótico mais prescrito foi amoxicilina (61%). Não houve diferenças entre os dois períodos estudados quanto ao número de prescrições e escolha de antibiótico das patologias estudadas. Discussão: A prescrição de antibióticos foi elevada e numa proporção significativa a antibioterapia poderia ser ajustada. Realça-se que não houve diferenças na prescrição após a apresentação das normas de orientação clínica. Conclusão: Considera-se necessária uma melhoria da prescrição antibiótica pediátrica no ambulatório.
journal_name
Acta Med Portjournal_title
Acta medica portuguesaauthors
Andrade JV,Vasconcelos P,Campos J,Camurça Tdoi
10.20344/amp.11111subject
Has Abstractpub_date
2019-02-28 00:00:00pages
101-110issue
2eissn
0870-399Xissn
1646-0758journal_volume
32pub_type
杂志文章abstract：:Chorioangioma is the most frequent nontrophoblastic tumour of the placenta, with a reported incidence ranging from 0.01% to 1.3%. The authors describe three cases of placental chorioangiomas, two of these diagnosed prenatally by ultrasound, and the clinical implications for both mother and fetus. Premature delivery an...
journal_title：Acta medica portuguesa
pub_type： 杂志文章
doi：
更新日期：1997-10-01 00:00:00
abstract：:Appropriate nutritional support is crucial in the therapeutic approach of multiple conditions, which justifies the frequent and increasing use of specific access routes for enteral and parenteral nutrition. This article reviews the relevant literature concerning indications, procedures, effectiveness and complications...
journal_title：Acta medica portuguesa
pub_type： 杂志文章,评审
doi：
更新日期：2014-09-01 00:00:00
abstract：INTRODUCTION:The surgical management of complete ureteral duplication anomalies is not consensual. OBJECTIVE:To characterize the pediatric population who underwent surgery for complete ureteral duplication and assess the outcomes of different approaches. MATERIAL AND METHODS:Clinical records from patients treated bet...
journal_title：Acta medica portuguesa
pub_type： 杂志文章
doi：10.20344/amp.6329
更新日期：2016-04-01 00:00:00
abstract：:The authors, using the Cancer Registry data of S. Antonio General Hospital in Oporto, selected the cancer cases from 1981 to 1993. Distribution according to age, sex, topography and morphology is presented. Seven point nine percent of the 12,124 cases mentioned in the Registry were skin cancers (n = 883). They were mo...
journal_title：Acta medica portuguesa
pub_type： 杂志文章
doi：
更新日期：1998-06-01 00:00:00
abstract：INTRODUCTION:Diabetes is a major public health problem and it is related to socioeconomic factors. The aim of this study is to describe socioeconomic inequalities in the distribution of diabetes in the population with 25 years or more, resident in Portugal in 2014. MATERIAL AND METHODS:Data from the Health National Su...
journal_title：Acta medica portuguesa
pub_type： 杂志文章
doi：10.20344/amp.8235
更新日期：2017-08-31 00:00:00
abstract：INTRODUCTION:Accurate recognition of omental infarction has resulted in increasing supporters of non-operative approach. In order to assess the efficacy and safety of conservative management, we surveyed the cases of omental infarction treated at a single institution. MATERIAL AND METHODS:Primary omental infarction tr...
journal_title：Acta medica portuguesa
pub_type： 杂志文章
doi：10.20344/amp.4996
更新日期：2014-07-01 00:00:00
abstract：:Considering the geographical asymmetric distribution of viral hepatitis A, B and E, having a much higher prevalence in the less developed world, travellers from developed countries are exposed to a considerable and often underestimated risk of hepatitis infection. In fact a significant percentage of viral hepatitis oc...
journal_title：Acta medica portuguesa
pub_type： 杂志文章,评审
doi：
更新日期：2007-11-01 00:00:00
abstract：:From January 1980 until October 1991 we operated 112 patients with Gastric cancer in which Surgery was considered palliative by intra-operative criteria or by pathological analysis of the resected specimen. Locally irresectable tumour was found in 24.1% of the cases, peritoneal metastases (mets.) in 21.4%, liver mets....
journal_title：Acta medica portuguesa
pub_type： 杂志文章
doi：
更新日期：1993-02-01 00:00:00
abstract：:Atrial septum aneurysms are an uncommon condition, underestimated before the routine use of echocardiography. Their clinical importance has increased after being associated with thromboembolic events. The authors made a review of clinical, diagnostic and therapeutic features of this entity after reporting six clinical...
journal_title：Acta medica portuguesa
pub_type： 杂志文章
doi：
更新日期：1998-04-01 00:00:00
abstract：INTRODUCTION:The objective of the study was to evaluate the experience of our service in the treatment of esophageal perforations. MATERIALS AND METHODS:Retrospective chart review of the nine cases occurred between January 1, 1996 and December 31, 2011. Seven occurred after accidental ingestion of foreign bodies and i...
journal_title：Acta medica portuguesa
pub_type： 杂志文章
doi：
更新日期：2013-03-01 00:00:00
abstract：:Twelve cases of extreme umbilical blood flow impairement (8 cases with loss of end-diastolic blood flow and 4 cases with reversed flow) found among 658 pregnancies studied by continuous Doppler between April 1st 1989 and March 31st 1990, are reported. The findings were associated to intra-uterine growth retardation (9...
journal_title：Acta medica portuguesa
pub_type： 杂志文章
doi：
更新日期：1991-05-01 00:00:00
abstract：:The authors report the importance of not only all over the world but also in Portugal and, particularly, in Dona Estefânia Hospital. Some considerations are made about the usefulness of molecular biology methods in prenatal diagnosis. With this tool can also be do the origins and migrations of populations, which contr...
journal_title：Acta medica portuguesa
pub_type： 杂志文章
doi：
更新日期：1995-06-01 00:00:00
abstract：:Spontaneous ileopsoas hematoma is a rare and potentially lethal complication of liver cirrhosis, with exceptional mention in medical literature. In this article we present a clinical case diagnosed in a patient with alcoholic liver cirrhosis. ...
journal_title：Acta medica portuguesa
pub_type： 杂志文章
doi：
更新日期：2012-01-01 00:00:00
abstract：:A new case of nephrotoxic effect of Maneb is related. The patient used this product as fungicide and developed a progressive illness with acute renal failure. The study by light and electron microscopy revealed severe tubular lesions that disappeared some months later with tubular cell regeneration. However, in spite ...
journal_title：Acta medica portuguesa
pub_type： 杂志文章
doi：
更新日期：1989-08-01 00:00:00
abstract：UNLABELLED:In Portugal, there have been many studies on the prevalence of overweight and obesity in children and adolescents. However, because many of the studies are not submitted to publication in scientific journals, these results remain unknown. OBJECTIVE:To obtain recent data on the prevalence of overweight and o...
journal_title：Acta medica portuguesa
pub_type： 杂志文章,评审
doi：
更新日期：2011-03-01 00:00:00
abstract：INTRODUCTION:Creatine deficiency syndromes are a recently described group of diseases characterized by inborn errors of creatine metabolism. Clinical features include a spectrum of neurodevelopment disorders of diverse severity. They are characterized by low levels of cerebral creatine caused by different pathogenic mu...
journal_title：Acta medica portuguesa
pub_type： 杂志文章
doi：
更新日期：2012-11-01 00:00:00
abstract：:A case of angiosarcoma, Raynaud's disease and arteriovenous malformation of the intestinal tract is presented. We propose the association of these three vascular diseases, which has not yet been described. The study of more cases is important in order to understand the physiopathological mechanisms involved. ...
journal_title：Acta medica portuguesa
pub_type： 杂志文章,评审
doi：
更新日期：1994-02-01 00:00:00
abstract：INTRODUCTION:Intertrochanteric fractures incidence has been increasing over the past few years and therefore so have all the problems associated with it. It is important to search for possible ways to reduce comorbidities as well as postoperative mortality. We decided to assess the impact of some routine pre-operative ...
journal_title：Acta medica portuguesa
pub_type： 杂志文章
doi：10.20344/amp.4280
更新日期：2014-03-01 00:00:00
abstract：:There is a wide acknowledgement of obesity as a relevant clinical entity. Such relevance can be inferred by the huge worldwide amount of research and related health promotion and clinical efforts. Though the evidence sustains some cues for the therapeutic success, the overall long-term effectiveness of obesity treatme...
journal_title：Acta medica portuguesa
pub_type： 杂志文章,评审
doi：
更新日期：2014-01-01 00:00:00
abstract：:The authors describe the case of a 49 year-old caucasian male with left pleural effusion. The etiology of the effusion was exsudative with a preponderance of neutrophils. Ten days after admission and on empirical antibiotic therapy, the patient still had fever and the pleural effusion that became purulent. The thoraci...
journal_title：Acta medica portuguesa
pub_type： 杂志文章
doi：
更新日期：2000-09-01 00:00:00
abstract：:Essencial Thrombocytemia is a rare chronic myeloproliferative disease of unknown etiology, characterized by markedly elevated platelet production (> 600,000/ml). It is more frequent among women above 50 years of age and may be associated with hemorrhagic or thrombotic tendencies. The authors report a case of Essencial...
journal_title：Acta medica portuguesa
pub_type： 杂志文章
doi：
更新日期：2003-03-01 00:00:00
abstract：BACKGROUND:Meningitis is an uncommon clinical manifestation of invasive infection by Streptococcus pyogenes. CASE REPORT:A four years-old female child, previously healthy, started a history of high fever, associated to right otorrhea, prostration and vomiting. On admission she was haemodynamically stable but prostrate...
journal_title：Acta medica portuguesa
pub_type： 杂志文章
doi：
更新日期：2011-12-01 00:00:00
abstract：:A case of acute ischemia of the right inferior limb after anti-tuberculous therapy in a 42-Year old woman is reported. This complication was confirmed by artheriography and the investigation revealed vasculitis and anti-histone antibodies. Drug-induced lupus was then diagnosed. A brief review about this subject is als...
journal_title：Acta medica portuguesa
pub_type： 杂志文章
doi：
更新日期：2003-07-01 00:00:00
abstract：:Secondary malignancy of the penis is a rare clinical condition, often associated with disseminated genitourinary malignancies. The prognosis is poor and the treatment options include penectomy, local surgical excision, radiation therapy, chemotherapy and supportive therapy. Neither of these therapeutic options lead to...
journal_title：Acta medica portuguesa
pub_type： 杂志文章
doi：10.20344/amp.5775
更新日期：2015-07-01 00:00:00
abstract：:The oncocytic tumors of the adrenal gland are rare. To date there's only 147 cases published. The authors present a case of a 34 year-old man admitted to the hospital with lumbar pain and fever. At medical examination a mass was found in the left upper quadrant of the abdomen. The hormonal measurements of the adrenal ...
journal_title：Acta medica portuguesa
pub_type： 杂志文章
doi：
更新日期：2013-01-01 00:00:00
abstract：INTRODUCTION:The use of adequate assessment tools in health care is crucial for the management of care. The lack of specific tools in Portugal for assessing the performance of children who use cochlear implants motivated the translation and adaptation of the EARS (Evaluation of Auditory Responses to Speech) test batter...
journal_title：Acta medica portuguesa
pub_type： 杂志文章
doi：
更新日期：2014-01-01 00:00:00
abstract：:Kikuchi and Fujimoto's disease, also known as histiocytic necrotizing lymphadenopathy, is a rare and benign disorder of the lymph nodes of young adults. The etiology of this disease is unknown, an autoimmune mechanism has been suggested, although some cases of association with several viruses has been described. We re...
journal_title：Acta medica portuguesa
pub_type： 杂志文章
doi：
更新日期：2005-05-01 00:00:00
abstract：:This cross-sectional survey, conducted during March-July 1992, in a rural village in Guiné-Bissau, studied the determinants of vaccination coverage in 344 children aged 2 to 9 years of age, as well as the determinants of health care service attendance during the month preceding the survey. One hundred and three (29.9%...
journal_title：Acta medica portuguesa
pub_type： 杂志文章
doi：
更新日期：2001-05-01 00:00:00
abstract：:Congenital absence of the inferior vena cava is a rare vascular anomaly, and most cases are asymptomatic. Nevertheless, patients with inferior vena cava malformations may have increased risk of deep venous thrombosis. Particularly, cases of bilateral deep venous thrombosis may arise owing to an insufficient collateral...
journal_title：Acta medica portuguesa
pub_type： 杂志文章
doi：10.20344/amp.7744
更新日期：2017-04-28 00:00:00
abstract：:A correlation between urinary tract infection, vesicoureteral reflux and voiding disorders has increasingly been reported. Voiding dysfunction increases the incidence of recurrent urinary tract infection, induces and perpetuates vesicoureteral reflux, even after surgical antireflux treatment, and may result in permane...
journal_title：Acta medica portuguesa
pub_type： 杂志文章
doi：
更新日期：1998-07-01 00:00:00
