Acta medica portuguesa最新文献

{"title":"[Workforce Disruptions and the Redefinition of Clinical Roles: State of the Art of Artificial Intelligence in Healthcare].","authors":"João Frutuoso, Ana Pina, Ana Rita Maria, Manuel Pereira, Bernardo Duque Neves, Helena Donato, António Vaz Carneiro","doi":"10.20344/amp.24483","DOIUrl":"https://doi.org/10.20344/amp.24483","url":null,"abstract":"<p><p>We aimed to analyze the impact of artificial intelligence integration in healthcare, focusing on workforce changes, the redefinition of clinical roles, and ethical and organizational implications. A search of recent literature was conducted in the PubMed, Scopus, and Web of Science Core Collection databases, as well as in institutional documents. Based on this material, a narrative review was developed examining the application of artificial intelligence in clinical, administrative, and educational settings and its implications for the health workforce. Evidence shows mature adoption in domains such as medical imaging and clinical decision support systems. Administrative applications are expanding in documentation, billing, and scheduling. Reported benefits include improved diagnostic accuracy, therapeutic personalization, organizational efficiency, and patient safety. Identified risks include role substitution, skill erosion, job insecurity, and cognitive overload when technology is poorly integrated. A sustainable adoption of artificial intelligence in healthcare requires reliable real-world performance assessment, interoperability, algorithmic transparency, and strong ethical governance. Integration must be sociotechnical, balancing technological innovation with the preservation of essential human skills, ethical standards, and workforce stability.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"39 4","pages":"291-298"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632331","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":"Thoracic Ultrasound in Pediatric Intensive Care: A Valuable Tool for Children with Acute Bronchiolitis.","authors":"Filipa Curinha, Adriana Fernandes, Carla Pinto, Maria Teresa Dionísio","doi":"10.20344/amp.24309","DOIUrl":"https://doi.org/10.20344/amp.24309","url":null,"abstract":"<p><strong>Introduction: </strong>Available scoring systems for managing acute bronchiolitis lack accuracy in predicting severity and prognosis. Thoracic ultrasound may help fill this gap. This study evaluated changes in thoracic ultrasound parameters in children with acute bronchiolitis and their association with disease severity. Diaphragmatic ultrasound parameters were also compared between patients with and without invasive mechanical ventilation.</p><p><strong>Methods: </strong>A prospective observational study included children under 24 months admitted to a Pediatric Intensive Care Unit with acute bronchiolitis. Thoracic ultrasound assessed lung ultrasound score (LUS), diaphragmatic excursion (DE), diaphragmatic thickness (DT), and thickening fraction (DTf) on days one, three, and five. Clinical severity was assessed using the Bronchiolitis Score of Sant Joan de Déu (BROSJOD) and other indicators.</p><p><strong>Results: </strong>Twenty-six patients were enrolled. Lung ultrasound score decreased over time, while DE and DTf increased. On day one, LUS, DE, and DT positively correlated with BROSJOD (rs = 0.586, p = 0.005; rs = 0.599, p = 0.004; rs = 0.534, p = 0.013, respectively); DTf showed an inverse correlation (rs = -0.439, p = 0.047). By day five, only LUS remained significantly associated. LUS and DTf on day one varied with the fraction of inspired oxygen (FiO2) requirements. Lung ultrasound score on day one had an area under the curve of 0.806 for predicting FiO2 ≥ 50%, with a cut-off of 8.5 (sensitivity 63.6%, specificity 93.3%). Lower DT and DTf were consistently seen in patients requiring invasive mechanical ventilation (p < 0.05).</p><p><strong>Conclusion: </strong>Lung ultrasound score and DTf correlated with disease severity from the first day in the Pediatric Intensive Care Unit, indicating their potential as early markers of disease worsening. Lower DT and DTf may suggest severe disease and the need for ventilatory support escalation. Thoracic ultrasound is a promising, non-invasive tool for monitoring children with acute bronchiolitis.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"39 4","pages":"271-280"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632435","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":"Unusual Presentation of Kaposi Sarcoma Mimicking Pyogenic Granuloma in an Immunocompetent Patient.","authors":"José Ramos, Hugo Leme, Joana Nogueira","doi":"10.20344/amp.23544","DOIUrl":"10.20344/amp.23544","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"303-304"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145538415","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":"Deprescribing Antidepressants: A Gap in Psychiatry Training and Research.","authors":"Rebeca Cohen, Pedro Castro-Rodrigues","doi":"10.20344/amp.24260","DOIUrl":"10.20344/amp.24260","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"39 4","pages":"318-319"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632363","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 and Analogical Cognitive Stimulation in Older Adults with Alzheimer's Disease: A Multicenter Randomized Controlled Trial Study Protocol.","authors":"Susana I Justo-Henriques, Miguel Padeiro, Rosa C G Silva, Joana Macedo, Flávia Borges-Machado, Ricardo M V de São João, Oscar Ribeiro","doi":"10.20344/amp.24360","DOIUrl":"https://doi.org/10.20344/amp.24360","url":null,"abstract":"<p><p>The growing incidence of neurodegenerative diseases in older adults, with the prevalence of Alzheimer's disease, progressively affects their quality of life. Cognitive stimulation is a psychosocial intervention that has shown consistent benefits in the lives of people with dementia from mild to moderate stages. The present study aims to evaluate the effectiveness of digital and analogical cognitive stimulation, when compared with usual care, on overall cognitive function, emotional state, and quality of life. It also aims to investigate whether institutional and territorial characteristics of social care services moderate these effects. This is a three-arm multicenter randomized controlled trial with repeated measures (pre-intervention, post-intervention, and follow-up). The intervention consists of 24 individually applied (digital and analogical) cognitive stimulation sessions, twice a week, for 12 weeks, in two intervention groups. The control group receives usual care. The study follows the recommendations of the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT 2025), including the extension for non-pharmacological interventions. The sample size is estimated at 222 older adults with a probable diagnosis of mild to moderate Alzheimer's disease. Sociodemographic, social, health and clinical data, as well as information on care provider institutions, will be collected and analyzed. Outcomes include cognition (global cognition, memory, and executive function), emotional state (anxiety and depression), and quality of life. All outcomes will be assessed at baseline, endpoint, and follow-up, with comparisons between the intervention groups and the control group.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"39 4","pages":"281-286"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632339","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":"Transjugular Intrahepatic Portosystemic Shunt in Kidney Failure Patients.","authors":"Andreia Sá Lima, Manlio Falavigna, Sofia Ventura, Raquel Faria, Sofia Ferreira","doi":"10.20344/amp.24154","DOIUrl":"https://doi.org/10.20344/amp.24154","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"39 4","pages":"312-313"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632437","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":"[Breastfeeding Self-efficacy and Maintenance of Breastfeeding at Six Months: Cut-off Point of the Breastfeeding Self-Efficacy Scale - Short Form].","authors":"Mariana M Oliveira, Ana Cláudia Moura, Ana Filipa Mouro, Cláudia Miguel, Carolina Barroso, Diana Guedes, Francisca Santos, Maria Inês Abreu, Mariana Rocha Pinto, Nuno Sanches de Almeida, Rafaela Paiva, António Vinhas da Silva, Maria Adriana Rangel","doi":"10.20344/amp.23983","DOIUrl":"https://doi.org/10.20344/amp.23983","url":null,"abstract":"<p><strong>Introduction: </strong>Maternal perception of breastfeeding self-efficacy is a key determinant of breastfeeding maintenance at six months. The Breastfeeding Self-Efficacy Scale - Short Form is a validated tool used to assess this perception. The primary goal of this study was to define a Breastfeeding Self-Efficacy Scale - Short Form cut-off score with predictive value for breastfeeding maintenance at six months, and to identify sociodemographic, clinical, and support-related factors associated with breastfeeding self-efficacy and six-month breastfeeding maintenance.</p><p><strong>Methods: </strong>This prospective longitudinal observational study was conducted between February 2023 and June 2024 at a level III hospital in Portugal, using a convenience sample. During the postpartum inpatient stay, informed consent was obtained and participants completed a sociodemographic questionnaire. After the first postpartum week, the Portuguese version of the Breastfeeding Self-Efficacy Scale - Short Form was completed via telephone interview. At six months postpartum, breastfeeding maintenance and status (exclusive or non-exclusive) were assessed. Statistical analysis included non-parametric tests, Spearman correlations and Receiver Operating Characteristic curve analysis to determine the optimal cut-off point, using the IBM® SPSS Statistics® software.</p><p><strong>Results: </strong>Of the 618 women enrolled, 453 completed follow-up. At six months, 71.7% maintained breastfeeding, and 18.9% maintained exclusive breastfeeding. Women who continued breastfeeding had significantly higher Breastfeeding Self-Efficacy Scale - Short Form scores (p = 0.001). The receiver operating characteristic curve yielded an area under curve of 0.592, with an optimal cut-off of 54 points, with a sensitivity of 88.6% and a specificity of 28.9%).</p><p><strong>Conclusion: </strong>The use of the Breastfeeding Self-Efficacy Scale - Short Form at the end of the first postpartum week may be useful to identify mothers at higher risk of early breastfeeding cessation. The cut-off score of 54 points demonstrated high sensitivity, although its overall discriminative capacity was modest. These findings support the potential of the Breastfeeding Self-Efficacy Scale - Short Form as a clinical tool to inform breastfeeding promotion and maintenance strategies.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"39 4","pages":"246-258"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632232","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":"Psychiatry Without Language? Mental Health Care for Deaf Individuals in Portugal.","authors":"Maria Conde Moreno, Inês Capeto Coelho, Filipa Migueis Ramalheira","doi":"10.20344/amp.24199","DOIUrl":"https://doi.org/10.20344/amp.24199","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"39 4","pages":"314-315"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632455","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":"[Smoking in Portugal: Current Overview and the Role of Primary Health Care].","authors":"Daniela Catarina Ferreira da Rocha","doi":"10.20344/amp.23961","DOIUrl":"https://doi.org/10.20344/amp.23961","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"39 4","pages":"320"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632316","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 Abdominal Pain in Female Adolescence: An Overlooked Diagnosis.","authors":"Ana Bandeira Santos, Ana Sofia Gomes, Cidade Rodrigues, Hélder Ferreira, Paula Fonseca","doi":"10.20344/amp.24150","DOIUrl":"https://doi.org/10.20344/amp.24150","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"39 4","pages":"316-317"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632484","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}