Acta medica portuguesa最新文献

{"title":"Clinical Outcomes of Chemo-Immunotherapy for Extensive Stage Small Cell Lung Cancer: A Real-World Single Centre Study in Portugal.","authors":"David Noivo, Maria Bragança, Ana Sofia Vilariça, Filipa Ferro, Andrea Lopes Machado, Direndra Hasmucrai, Paula Alves","doi":"10.20344/amp.22546","DOIUrl":"https://doi.org/10.20344/amp.22546","url":null,"abstract":"<p><p>Small cell lung cancer (SCLC) is an aggressive type of lung cancer. Recent studies have provided a new hope by adding atezolizumab to the standard treatment of extensive disease SCLC (E-SCLC). The aim of our study was to evaluate the real-life performance of atezolizumab plus chemotherapy in extensive stage SCLC in a Portuguese setting. Data was collected on twenty patients (70% were male with a mean age of 66.9 years) in treatment at a tertiary hospital in Portugal with E-SCLC treated with chemotherapy and atezolizumab between July 2022 and February 2024. All patients received a carboplatin plus etoposide regimen in combination with atezolizumab. The overall response rate was 55% (95% CI: 31.5 - 76.9) and the disease control rate was 70% (95% CI: 45.7 - 88.1). The median overall survival (OS) and progression-free survival (PFS) was 9.7 (95% CI:5.08 - 14.32) and 7.17 (95% CI:3.28 - 11.05) months, respectively. In total, 13 (65%) patients experienced disease progression and 10 (50%) died during follow-up from events related to the disease. Patients with a performance status score ≥ 2 had lower PFS (p = 0.003) and OS (p = 0.001). To the best of our knowledge, this is the first real-world clinical study in Portugal to evaluate real life outcomes for this combination therapy.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595815","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":"Recurrent Syncope During Migraine Attacks.","authors":"Mariana Dias da Costa, Beatriz Nunes Vicente, Filipa Dourado Sotero, Isabel Pavão Martins","doi":"10.20344/amp.22134","DOIUrl":"10.20344/amp.22134","url":null,"abstract":"<p><p>Migraine is a cyclic condition with attacks consisting mainly of intense headaches, sensory intolerance, and nausea or vomiting. Loss of consciousness during attacks is often attributed exclusively to a neurally mediated reflex to pain, although it may also be due to migraine's autonomic impairment, with cardiac conduction abnormalities, probably in relation to a degree of reduced sympathetic function. We report the case of a 51-year-old woman presenting episodes of syncope exclusively after vomiting during migraine attacks. A 24-hour Holter monitoring performed during a migraine attack disclosed an intermittent complete atrioventricular block coincident with an episode of syncope. The patient was implanted with a pacemaker without further syncopes on subsequent attacks. This case highlights the importance of clinical suspicion and investigation of syncope during migraine attacks. Recurrent syncope during migraine should not be attributed to pain to avoid misdiagnosis and ensure the treatment of other important causes of syncope.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"182-184"},"PeriodicalIF":0.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738000","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":"Strategies and Factors to Promote Research in Primary Care in Portugal: A Cross-Sectional Study.","authors":"Maria Beatriz Morgado, Carolina Penedo, Rubina Correia, Sandra Diniz Amaral, Paulo Jorge Nicola, Margarida Gil Conde","doi":"10.20344/amp.22171","DOIUrl":"https://doi.org/10.20344/amp.22171","url":null,"abstract":"<p><strong>Introduction: </strong>Research is crucial for building an efficient health system care. This reality is particularly evident in primary care, the cornerstone of healthcare services. However, research in primary care is not consistently implemented across Europe. With this study we aimed to: 1) identify the factors and strategies that healthcare professionals consider relevant for promoting research in primary care in Portugal; 2) analyze whether the prioritized strategies vary according to the geographical area, professional group, workplace, interest, and experience in research of the participants.</p><p><strong>Methods: </strong>We conducted an analytical cross-sectional study using an online survey applied in the first semester of 2023. We designed the survey based on strategies identified in a previous qualitative study. We included health professionals working in Primary Care in Portugal (continental and autonomous regions). We intended to obtain at least 200 answers for each professional category and geographical area. The survey was initially sent to a convenience sample to assess the acceptability and interpretation of the questions. We then disseminated the survey through all national Health Center Clusters and through professional associations. We conducted an analysis using a 5% significance level.</p><p><strong>Results: </strong>The sample consisted of 1027 participants: 507 doctors, 377 nurses, 106 diagnostic and therapeutic technicians, and 30 secretaries. The majority worked in the Lisbon and Tagus Valley region (51.9%), followed by the North (22.1%) and Centre (17.1%). Around half of the participants worked in a Family Health Unit, 16.5% worked in a Personalized Healthcare Unit, 11% in a Community Care Unit, and 8.7% in a Public Health Unit. The factors promoting research mentioned by a greater proportion of participants were research training (76%), access to mentors (71%) and grants (56%). As for strategies to promote research, most participants supported the existence of dedicated time for research (82%), public grants (65%), institutional support (51%), access to support services (58%) and research data (57%).</p><p><strong>Conclusion: </strong>There seems to be a consensus on which factors are currently promoting research and what future strategies might be useful for promoting research in primary care in Portugal. Nevertheless, there are some differences between certain sub-groups. This information might be useful to tailor initiatives directed at specific sub-groups. Our intention is to help form policies and strategies to promote research in primary care in Portugal, contributing to the national development on the subject.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"38 3","pages":"137-147"},"PeriodicalIF":0.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603314","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":"Cutaneous Manifestations Related to Glycemic Control.","authors":"Alexandra Ramos Rodrigues, Ana Luísa Matos, Carlos Pedro Mendes","doi":"10.20344/amp.22239","DOIUrl":"10.20344/amp.22239","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"185-186"},"PeriodicalIF":0.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073268","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":"[Papulonecrotic Tuberculid as Manifestation of Lymph Node Tuberculosis].","authors":"José Ramos, Hugo Leme, Ângela Roda, João Alves","doi":"10.20344/amp.22669","DOIUrl":"10.20344/amp.22669","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"199-200"},"PeriodicalIF":0.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389844","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 Fear of Cancer Recurrence among Adolescents and Young Adults: The Portuguese Validation and Psychometric Assessment of the \"Fear of Cancer Recurrence 7\" Scale.","authors":"Maria Carolina Neves, Célia M D Sales, Joana Oliveira, Ana Bártolo, Judith B Prins, Sara Monteiro","doi":"10.20344/amp.22085","DOIUrl":"https://doi.org/10.20344/amp.22085","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescents and young adults with cancer experience high levels of fear of cancer recurrence (FCR), negatively impacting their lives. However, no measure has been validated worldwide to assess FCR levels among these young people. This study aims to validate the FCR7, a scale that measures FCR, for the Portuguese population of adolescents and young adults.</p><p><strong>Methods: </strong>Ninety-two participants were recruited online. They were primarily women (83.7%) with a mean age of 26.01 years at recruitment and 19.38 years at cancer diagnosis, with a variety of cancer diagnoses and previous treatments. Most participants were no longer under active treatment (75%), and approximately 75.1 months had passed since their diagnosis. Fear of cancer recurrence, anxiety and depression levels, and quality of life were assessed.</p><p><strong>Results: </strong>The results showed that FCR7 has good model fit and reliability. Concurrent and divergent validity were also confirmed, with FCR being positively related to anxiety and negatively associated with quality of life. A cut-off score was found, discriminating between clinical and non-clinical levels of FCR. Almost 70% of the participants experienced clinical levels of FCR. We conclude that FCR7 is a valid unidimensional scale to assess FCR levels among Portuguese adolescents and young adults.</p><p><strong>Conclusion: </strong>More research should be conducted to validate FCR measures to be used among adolescents and young adults across the globe. The existence of a valid and brief measure to assess FCR among this population in Portugal is an asset for national health professionals and researchers.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"38 3","pages":"148-159"},"PeriodicalIF":0.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603285","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":"[Approach to Scabies in Children: An Update].","authors":"Sofia Seabra Vieira, Diana Bernardo, Susana Machado","doi":"10.20344/amp.22450","DOIUrl":"10.20344/amp.22450","url":null,"abstract":"<p><p>Scabies is a common dermatological infection that globally affects more than 200 million people. It is caused by the parasite Sarcoptes scabiei var. hominis and its transmission primarily occurs through direct contact. Symptoms typically appear three to six weeks after infestation, with intense itching being the most characteristic manifestation. Lesions most commonly appear on the hands, wrists, armpits, periumbilical area, buttocks, and genital region, although the clinical manifestations vary with age. In infants and children, they also affect the face, scalp, palms, soles, ankles, and chest. Therefore, diagnosis is clinical but challenging due to the diversity of manifestations. Treatment aims to eliminate the parasite and relieve symptoms, using options such as topical 5% permethrin, benzyl benzoate, sulfur sulfate, or systemic ivermectin. Permethrin is recommended as the first-line treatment for children over two months, while ivermectin is used in more severe cases. Adherence to treatment and the disinfestation of clothing and bedding are crucial to prevent reinfestation. Early recognition and effective treatment are essential given its prevalence and significant impact on public health, particularly in pediatric populations.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"175-181"},"PeriodicalIF":0.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063115","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":"Before a Diagnosis of Schizophreniform Disorder is Made, All Causes of Secondary Psychosis Should Be Ruled Out.","authors":"João Gama Marques, Josef Finsterer","doi":"10.20344/amp.22700","DOIUrl":"https://doi.org/10.20344/amp.22700","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"38 3","pages":"204"},"PeriodicalIF":0.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603311","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":"[What is the Purpose of Índex das Revistas Médicas Portuguesas?]","authors":"Jorge Crespo","doi":"10.20344/amp.22587","DOIUrl":"https://doi.org/10.20344/amp.22587","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"38 3","pages":"135-136"},"PeriodicalIF":0.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603321","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":"Performance of ChatGPT in the Portuguese National Residency Access Examination.","authors":"Gonçalo Ferraz-Costa, Mafalda Griné, Manuel Oliveira-Santos, Rogério Teixeira","doi":"10.20344/amp.22506","DOIUrl":"10.20344/amp.22506","url":null,"abstract":"<p><p>ChatGPT, a language model developed by OpenAI, has been tested in several medical board examinations. This study aims to evaluate the performance of ChatGPT on the Portuguese National Residency Access Examination, a mandatory test for medical residency in Portugal. The study specifically compares the capabilities of ChatGPT versions 3.5 and 4o across five examination editions from 2019 to 2023. A total of 750 multiple-choice questions were submitted to both versions, and their answers were evaluated against the official responses. The findings revealed that ChatGPT 4o significantly outperformed ChatGPT 3.5, with a median examination score of 127 compared to 106 (p = 0.048). Notably, ChatGPT 4o achieved scores within the top 1% in two examination editions and exceeded the median performance of human candidates in all editions. Additionally, ChatGPT 4o's scores were high enough to qualify for any specialty. In conclusion, ChatGPT 4o can be a valuable tool for medical education and decision-making, but human oversight remains essential to ensure safe and accurate clinical practice.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"170-174"},"PeriodicalIF":0.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862940","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}