Acta medica portuguesa最新文献

{"title":"[Parvovirus B19 in Adolescents and Adults: A Case Series of Clinical Mimicry].","authors":"Inês Abreu, Ivânia Soares, Filipe Silva Monteiro, Gustavo Almeida-Silva, Paulo Filipe","doi":"10.20344/amp.23424","DOIUrl":"https://doi.org/10.20344/amp.23424","url":null,"abstract":"<p><p>Parvovirus B19 (PvB19), the etiological agent of erythema infectiosum, can manifest in diverse clinical forms. This study underscores the virus's capacity to mimic other diseases, as illustrated by the diagnostic challenges encountered across five cases. The first three cases correspond to an overlap of papulo-purpuric gloves and socks syndrome with petechial exanthema with periflexural and periorificial distribution, the first initially diagnosed as a drug eruption, the second as scarlet fever, and the third as autoimmune thrombocytopenia. The remaining two cases correspond to leukocytoclastic vasculitis that, only after thorough investigation, were associated with Parvovirus B19 infection. This case series emphasizes the need for healthcare professionals to be alert to this important imitator and be mindful of this differential diagnosis when approaching exanthemas and vasculitis.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Professionals' Perspectives on the Referral Process in Mild Cognitive Impairment: Facilitators, Barriers, and Solutions.","authors":"Magda Fonseca, Natália Araújo, Luís Ruano, Mariana Amorim","doi":"10.20344/amp.23241","DOIUrl":"https://doi.org/10.20344/amp.23241","url":null,"abstract":"<p><strong>Introduction: </strong>Early detection and referral of patients with mild cognitive impairment or early-stage dementia can contribute to improved outcomes for both patients and caregivers. Few studies explore the quality and underlying context of referral decision-making by Primary Care Clinicians. This study aimed to explore the perspectives of healthcare professionals from Northern Portugal regarding the facilitators, barriers, and solutions within the referral process to the Neurology service for patients suspected of having mild cognitive impairment.</p><p><strong>Methods: </strong>Two face-to-face focus groups were conducted with 11 primary and secondary care professionals from Northern Portugal, with experience in the field of dementia, selected and recruited through an email invitation. The discussion focused on the benefits of referrals, the strengths and challenges faced at different levels of care, and possible improvement strategies. Data were analyzed using inductive and deductive thematic analysis, with triangulation employed to ensure research rigor.</p><p><strong>Results: </strong>The study identified facilitators and barriers at the levels of patients and caregivers, healthcare professionals, and the healthcare system. This process is influenced by interconnected factors, including the sociodemographic and literacy context of patients and caregivers, clinical practice regarding the application of referral criteria, and the organizational and research context of the local healthcare system concerning dementia. Solutions were proposed to overcome the highlighted barriers, whose implementation is supported by many of the facilitators described.</p><p><strong>Conclusion: </strong>A deeper understanding of the interplay between sociodemographic, clinical, and organizational factors can lead to more objective and effective referral decisions, ultimately supporting timely diagnosis and enhancing quality of life. The findings of this study are valuable for optimizing local referral processes and may be useful in similar healthcare contexts. It is recommended that future research include the perspectives of patients and caregivers to enhance the approach to the national dementia strategy.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Practical Recommendations from Clinical Experts for Optimizing Screening, Diagnosis, and Treatment of Iron Deficiency during Pregnancy in Portugal].","authors":"João Mairos, Nina Monteiro, Nuno Clode, Tiago Maricoto, Rúben Catarino, Bruno Fidaldo Dias","doi":"10.20344/amp.23610","DOIUrl":"https://doi.org/10.20344/amp.23610","url":null,"abstract":"<p><p>Iron deficiency is a clinical condition characterized by the depletion of iron stores, potentially affecting up to 95% of pregnant women in Portugal. If not identified and treated early, this condition can progress from fatigue, tiredness and reduced work productivity to anemia, increasing the risk of maternal-fetal complications. Therefore, early detection of iron deficiency during pregnancy is crucial for promptly addressing iron deficits and preventing complications during childbirth and the postpartum period. Scientific evidence and international guidelines recognize serum ferritin as the most reliable marker for detecting iron deficiency. However, in Portugal, its measurement is not currently standardized in the pregnancy monitoring guidelines for any trimester. This lack of formal recommendation leads to a heterogeneous clinical approach, contributing to the underdiagnosis and undertreatment of iron deficiency, with a significant negative impact on maternal and fetal health. To address this gap, the Portuguese Association of Family Medicine, the Portuguese Society of Obstetrics and Maternal-Fetal Medicine, and the Anemia Working Group Portugal established a working group of four clinical experts. This group convened to develop a set of practical guidelines aimed at standardizing serum ferritin measurements across all three trimesters of pregnancy in the national healthcare system. Through these recommendations, experts aim to raise awareness among key stakeholders involved in pregnancy monitoring in Portugal and to urge national health authorities to incorporate this indicator into the digital IT systems used for pregnancy surveillance in primary healthcare. The aim of this initiative is to ensure a more effective approach to gestational iron deficiency and reduce its burden on maternal and fetal health.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Lipemia in Blood Donation: What are the Implications?]","authors":"Mariana Gradim, Matilde Quelhas, Catarina Carvalho, Maria Rosales","doi":"10.20344/amp.23537","DOIUrl":"https://doi.org/10.20344/amp.23537","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145123763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term High-Flow Nasal Cannula in Chronic Respiratory Failure in a Patient with Bronchiectasis.","authors":"Ana Isabel Santos, Jessica Cemlyn-Jones, Denny Rodrigues","doi":"10.20344/amp.23254","DOIUrl":"https://doi.org/10.20344/amp.23254","url":null,"abstract":"<p><p>High-flow nasal cannula (HFNC) is a gas delivery system that provides heated and humidified air at higher flow rates than conventional oxygen therapy. While studies on the role of HFNC as a long-term treatment for chronic respiratory failure are limited, most of them focus on patients with chronic obstructive pulmonary disease. We present the case of a woman with severe bronchiectasis and chronic hypercapnic respiratory failure under nocturnal non-invasive ventilation (NIV) and 24-hour conventional oxygen therapy, who experienced multiple and prolonged hospital admissions. Long-term daytime HFNC was initiated, maintaining nocturnal NIV, resulting in significant improvements in dyspnea, better secretion management, and a reduction in exacerbation rates. While more research is needed, HFNC should be considered for long-term management of chronic respiratory failure in patients with bronchiectasis.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145090947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disentangling a Functional Speech Disorder in the Context of another Neurological Disease: A Case Report.","authors":"Beatriz Stein, Filipa Sotero, José Fonseca","doi":"10.20344/amp.23435","DOIUrl":"https://doi.org/10.20344/amp.23435","url":null,"abstract":"<p><p>This clinical case describes the communication profile of a functional speech disorder. A 48-year-old woman was admitted to the emergency service due to sudden changes in speech, generalized dystonia and gait ataxia. Magnetic resonance imaging showed multiple supra and infratentorial inflammatory lesions involving the posterior occipito-temporal lobes bilaterally, frontal convexity bilaterally, insula and paramedian frontal cortex on the left, diencephalon, rhombencephalon. On the third day, a speech pathology evaluation was conducted, revealing inconsistencies in speech: repetitions of initial sounds, without characteristics of an acquired stutter, a clenched articulation, not justified by an orofacial motor disorder, an inconsistent pattern in voice and prosody. Three days later, another assessment was carried out, showing a significant improvement in speech intelligibility. There was a marked variability in speech features defects found over the days, as well as in their severity. These behaviors appear simultaneously with a speech pattern that is not justified by any of the neurological lesions found.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transient Neonatal Pustular Melanosis: A Benign Mimicker of Infection.","authors":"João Pedro Valente, Luísa Castello-Branco Ribeiro, Teresa Campos","doi":"10.20344/amp.23416","DOIUrl":"https://doi.org/10.20344/amp.23416","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing the Risks of the New Tobacco Product Wave in Portugal.","authors":"André Vicente, Luís Neves, Teresa Leão","doi":"10.20344/amp.23143","DOIUrl":"https://doi.org/10.20344/amp.23143","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Locally Advanced and Metastatic Salivary Gland Cancer: A 10-year Experience of an Oncology Center in Portugal.","authors":"Ana Raquel Teixeira, Cláudia Agostinho, Catarina Dias, Rita Soares, Marta Pina, José Dinis, Luísa Lopes-Conceição, Cláudia Vieira","doi":"10.20344/amp.22800","DOIUrl":"https://doi.org/10.20344/amp.22800","url":null,"abstract":"<p><strong>Introduction: </strong>Scientific evidence regarding salivary gland cancer systemic treatment is limited and the therapeutic approach to locally advanced or metastatic disease is mainly based on consensus. This study aimed to evaluate treatment patterns and outcomes in patients with advanced salivary gland cancer.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study in a comprehensive cancer center in Portugal, including adult patients diagnosed with primary malignant salivary gland tumors between 2012 and 2021. Data on demographics, tumor characteristics, treatments, and outcomes were collected from institutional cancer registries and electronic medical records. The study was approved by the institutional Ethics Committee.</p><p><strong>Results: </strong>A total of 116 patients with salivary gland cancer were identified and, of these, 45 had locally advanced or metastatic disease: 24 received systemic anti-neoplastic treatment and 21 received best supportive care. One-year overall survival in systemic anti-neoplastic treatment group was 70% (versus 14% in best supportive care group, p < 0.001) and progression-free survival was 37%. The most commonly used systemic treatment was chemotherapy (n = 29, 59%). Seven patients (14%) received androgen deprivation therapy, and two patients (4%) received other targeted therapy (olaparib and erdafitinib).</p><p><strong>Conclusion: </strong>Systemic treatment was associated with significantly improved survival in patients with advanced salivary gland cancer. Despite the heterogeneity of therapeutic approaches, including emerging biomarker-driven therapies, clinical decision-making remains largely consensus-based. These findings underscore the need for further research to support personalized treatment strategies and guide evidence-based care.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regulação para o Uso Problemático de Smartphones e Redes Sociais entre Jovens: Um Desafio e uma Oportunidade para a Saúde Pública.","authors":"Filipa Cristovão, Leticia Senna, Diana Mendes, Ewa Veiga, Allan Valente, Vasco Ricoca Peixoto","doi":"10.20344/amp.23409","DOIUrl":"https://doi.org/10.20344/amp.23409","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144999405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}