Acta medica portuguesa最新文献

{"title":"Epilepsy Secondary to Occipital Cobblestone Malformation in an Adult Patient with Merosin-Deficient Congenital Muscular Dystrophy Type 1A.","authors":"Miguel Schön, Carla Bentes, Carlos Morgado, Miguel Oliveira Santos","doi":"10.20344/amp.21928","DOIUrl":"https://doi.org/10.20344/amp.21928","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142374954","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":"Assessing the Burden of Atopic Dermatitis in Portugal through Patient-Centered Experiences.","authors":"Michelle Tu, Freya Moxham, Alan Schwartz, Joana Camilo, Korey Capozza","doi":"10.20344/amp.21248","DOIUrl":"10.20344/amp.21248","url":null,"abstract":"<p><strong>Introduction: </strong>Adult patients and caregivers of children with atopic dermatitis experience high physical, mental, and financial burden in Portugal. We outline the experience of atopic dermatitis management and how the current medical care model impacts patient-centered concerns such as financial burden, quality of life, disease burden, and treatment satisfaction.</p><p><strong>Methods: </strong>We conducted a survey of 419 Portuguese adults and caregivers of children to capture the experience of managing atopic dermatitis in Portugal.</p><p><strong>Results: </strong>Respondents reported average satisfaction with treatment, with a mean satisfaction rating of 3.15/5.00 (SD = 0.77). Adults reported slightly better control of atopic dermatitis symptoms (mean = 56.6) than pediatric patients (mean = 55.9, caregiver reported). Nearly 34% of adults and 39% of caregivers of children and adolescents indicated that their healthcare providers asked about their priorities at the last medical visit. Additionally, only 40% of adult patients and 32% of caregivers reported that patient training was offered to them. Respondents seeing dermatologists reported higher satisfaction than those seeing other healthcare providers (p = 0.01) but there were no differences in long-term control of symptoms by provider type (p = 0.85) when controlling for severity. Portuguese adult patients scored 0.86/1.00 on the EQ-5D (where 0 = death and 1 = perfect health). Financial concern was high as nearly 80% of patients and caregivers reported using savings, borrowing money, and/or reducing spending to cover atopic dermatitis-related costs.</p><p><strong>Conclusion: </strong>Portuguese patients with atopic dermatitis and caregivers experience financial burden, lower health-related quality of life, higher disease burden, and treatment satisfaction issues with their current medical care. These factors often deteriorate as the disease's severity increases. Providers, researchers and policymakers should focus on better addressing patient-centered concerns for individuals suffering from atopic dermatitis to improve care and health outcomes.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142374955","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":"The Role of Dermatology in the Diagnosis of the 'Great Imitators' in Medicine.","authors":"Dora Mancha, Pedro De Vasconcelos, Luís Soares-de-Almeida","doi":"10.20344/amp.21817","DOIUrl":"10.20344/amp.21817","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142374962","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":"Digital Cognitive-Behavioral Therapy for Insomnia in Cancer Survivors: Protocol for a Pragmatic Clinical Trial.","authors":"Maria Inês Clara, Annemieke Van Straten, Maria Cristina Canavarro, Ana Allen Gomes","doi":"10.20344/amp.21094","DOIUrl":"10.20344/amp.21094","url":null,"abstract":"<p><strong>Introduction: </strong>Insomnia is one of the most prevalent, persistent, and distressing conditions associated with cancer, affecting almost half of all cancer survivors. Although cognitive-behavioral therapy for insomnia is well established as the gold-standard treatment for insomnia, its accessibility is very limited in routine care. We aim to examine the real-world effectiveness and acceptability of a digital cognitive-behavioral therapy for insomnia for cancer survivors with insomnia symptoms through a randomized controlled trial in Portugal.</p><p><strong>Methods and analysis: </strong>Our cancer trial will test the effects and acceptability of an accessible internet-delivered self-administered cognitive-behavioral therapy for insomnia digital intervention with clinician support, OncoSleep. This online program includes six interactive, personalized weekly sessions featuring evidence-based techniques targeting psychophysiological hyperarousal and maladaptive conditioning, tailored for cancer survivors. Research study procedures include screening for eligibility in the general population and randomization into one of two arms: the digital CBT-I program or a waitlist control group. Insomnia severity (primary outcome), fatigue, sleep diary outcomes, psychological distress, and quality of life (secondary outcomes) will be assessed at baseline and post-intervention.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141974783","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":"The Effect of Globalization on Hemoglobinopathies and its Genetic Inheritance: The Booster Effect of Genetic Combinations.","authors":"Catarina Guerreiro Ferreira, Ana Filipa Lima, Adelina Sitari, Anabela Ferrão, Elsa Rocha","doi":"10.20344/amp.21772","DOIUrl":"10.20344/amp.21772","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142374961","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":"Aggressive Giant Extraskeletal Aneurysmal Bone Cyst of the Thigh: Overcoming Challenges with a Multidisciplinary Approach.","authors":"António Proença Caetano, Teresa Neves, Carlos Pedrosa, José Portela, Filipe Veloso Gomes, Élia Coimbra, Tiago Bilhim","doi":"10.20344/amp.19801","DOIUrl":"10.20344/amp.19801","url":null,"abstract":"<p><p>Aneurysmal bone cysts are vascular benign fibroblastic lesions usually found in bone that are locally destructive, with a greater incidence in the first and second decades of life. Patients usually undergo curettage or, less frequently, surgical resection, which may lead to growth disturbances and deformities in cases of large or complex lesions. Minimally invasive techniques such as sclerotherapy and endovascular embolization have been developed as an alternative or complement to surgery, with promising results. The authors present a rare case of an extraskeletal aneurysmal bone cyst successfully treated with minimally invasive techniques followed by surgical resection and provide a literature review of the current treatment options.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995051","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":"Bridging the Gap: Use of Mental Health Apps in the Adolescent Population.","authors":"Eduarda Costa, Miguel Henriques","doi":"10.20344/amp.22045","DOIUrl":"10.20344/amp.22045","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142374956","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":"Logistic Regression: Limitations in the Estimation of Measures of Association with Binary Health Outcomes.","authors":"Lara Pinheiro-Guedes, Clarisse Martinho, Maria Rosário O Martins","doi":"10.20344/amp.21435","DOIUrl":"10.20344/amp.21435","url":null,"abstract":"<p><strong>Introduction: </strong>Logistic regression models are frequently used to estimate measures of association between an exposure, health determinant or intervention, and a binary outcome. However, when the outcome is frequent (> 10%), model estimates for relative risks and prevalence ratios might be biased. Despite the availability of several alternatives, many still rely on these models, and a consensus is yet to be reached. We aimed to compare the estimation and goodness-of-fit of logistic, log-binomial and robust Poisson regression models, in cross-sectional studies involving frequent binary outcomes.</p><p><strong>Methods: </strong>Two cross-sectional studies were conducted. Study 1 was a nationally representative study on the impact of air pollution on mental health. Study 2 was a local study on immigrants' access to urgent healthcare services. Odds ratios (OR) were obtained through logistic regression, and prevalence ratios (PR) through log-binomial and robust Poisson regression models. Confidence intervals (CI), their ranges, and standard-errors (SE) were also computed, along with models' relative goodness-of-fit through Akaike Information Criterion (AIC), when applicable.</p><p><strong>Results: </strong>In Study 1, the OR (95% CI) was 1.015 (0.970 - 1.063), while the PR (95% CI) obtained through the robust Poisson mode was 1.012 (0.979 - 1.045). The log-binomial regression model did not converge in this study. In Study 2, the OR (95% CI) was 1.584 (1.026 - 2.446), the PR (95% CI) for the log-binomial model was 1.217 (0.978 - 1.515), and 1.130 (1.013 - 1.261) for the robust Poisson model. The 95% CI, their ranges, and the SE of the OR were higher than those of the PR, in both studies. However, in Study 2, the AIC value was lower for the logistic regression model.</p><p><strong>Conclusion: </strong>The odds ratio overestimated PR with wider 95% CI and higher SE. The overestimation was greater as the outcome of the study became more prevalent, in line with previous studies. In Study 2, the logistic regression was the model with the best fit, illustrating the need to consider multiple criteria when selecting the most appropriate statistical model for each study. Employing logistic regression models by default might lead to misinterpretations. Robust Poisson models are viable alternatives in cross-sectional studies with frequent binary outcomes, avoiding the non-convergence of log-binomial models.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142374960","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":"A Case of Giant Cell Tumor of the Fibula.","authors":"João Martins Gama, Rui Caetano Oliveira, José Casanova","doi":"10.20344/amp.21067","DOIUrl":"10.20344/amp.21067","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141074592","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":"How Can We Improve Care for Patients with Atopic Dermatitis in Portugal?","authors":"Tiago Torres","doi":"10.20344/amp.22158","DOIUrl":"10.20344/amp.22158","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142374959","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}