Acta medica portuguesa最新文献

{"title":"Challenges in Adherence to Magnetic Resonance Imaging Consensus Recommendations in Multiple Sclerosis: A Call for Improved Neurologist-Neuroradiologist Collaboration.","authors":"Mafalda Soares, David Berhanu","doi":"10.20344/amp.23611","DOIUrl":"https://doi.org/10.20344/amp.23611","url":null,"abstract":"<p><p>The consensus on MRI in multiple sclerosis Despite major treatment advances in multiple sclerosis (MS), neurologists still face some challenges: the delay in diagnosis and the monitoring of disease progression. Magnetic resonance imaging (MRI) plays an essential role in the clinical management of MS, aiding in the diagnosis, monitoring disease activity, and assessing treatment effects. In 2018 and 2020, the MS Study Group and the Portuguese Society of Neuroradiology published comprehensive guidelines for the use of MRI in MS, detailing the crucial information that neurologists should provide when requesting MRIs (part 1), as well as the suggested MRI acquisition protocols and the structure and content of neuroimaging reports from neuroradiologists (part 2).1,2.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"38 8","pages":"435-437"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144797940","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":"[Artificial Intelligence in Portugal's National Medical Residency Exam: A Psychiatric Perspective].","authors":"Ana Duarte, Carlos Siopa, Inês Chaves","doi":"10.20344/amp.23421","DOIUrl":"10.20344/amp.23421","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"518"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144612060","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":"[Guideline for Assessment and Management of Adolescents with Suicidal Ideation in Primary Health Care].","authors":"Joana Coelho Santos, Mariana Medeiros Neves, Inês Barroca, Graciete Carvalho","doi":"10.20344/amp.22367","DOIUrl":"10.20344/amp.22367","url":null,"abstract":"<p><p>Suicide is one of the main causes of death in adolescence globally, and depression, the psychiatric disorder that most often accompanies suicidal ideation, is one of the biggest causes of illness and disability in this population. The detection, approach and referral of high-risk situations by family physicians helps to reduce the risk of suicide in this age group. This guideline was created as part of the coordination between the Department of Child and Adolescent Psychiatry and the primary health care units of the Unidade Local de Saúde de Lisboa Ocidental and aims to systematize and operationalize the approach to adolescents with suicidal ideation seen in primary health care, enhancing early detection and appropriate intervention at the level of risk. This guideline presents definitions of the concepts needed to correctly characterize suicidal ideation and proposes a suicide risk assessment approach, which includes assessing and characterizing suicidal ideation and assessing the risk of committing suicide. Suicide risk assessment culminates in a decision on the referral and treatment of the adolescent, which may consist of immediate referral to the emergency department, a request for a Child and Adolescent Psychiatry consultation or more frequent Family Medicine appointments for reassessment and referral to a Psychology clinic, depending on the level of risk observed. Recommendations for crisis intervention and treatment of identified comorbidities are presented. Early detection and treatment of psychiatric illnesses, intervention in risk factors and restricting access to suicide methods, especially access to medication, stand out as effective measures to prevent suicide in adolescence.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"504-509"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802087","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":"Acute Aortic Dissection in the Third Trimester of Pregnancy as an Initial Presentation of Marfan Syndrome.","authors":"Marta Reis Santos, Alexandre Valentim Lourenço, Maria Pulido Valente","doi":"10.20344/amp.22287","DOIUrl":"10.20344/amp.22287","url":null,"abstract":"<p><p>Aortic dissection is rare and more common in men. In women, it is more frequent during pregnancy, especially in the third trimester. We present the case of a 30-year-old pregnant woman diagnosed with type B aortic dissection at 29 weeks of gestation. Following the diagnosis, fetal maturation was initiated, and the patient was transferred to a tertiary care center. Due to uncontrolled hypertension and persistent pain, and after evaluating the maternal and fetal risk-benefit, a cesarean section was performed at 29 weeks and six days. During the postoperative period, a multi-drug regimen was required for blood pressure control, but the patient recovered and was discharged. Genetic testing, prompted by a family history of sudden death (brother) and aortic dissection (father), identified a mutation in the FBN1 gene, confirming Marfan syndrome. This case highlights the importance of comprehensive patient history, the challenges of aortic dissection during pregnancy, and the need for a multidisciplinary approach in these cases.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"491-495"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727381","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":"Kaposi's Sarcoma: Demographic and Clinical Features, Histopathology, Treatment, and Outcomes in a 10-Year Lisbon Hospital Study.","authors":"Inês Pereira Amaral, Ivânia Soares, Madalena Pupo Correia, Inês Tribolet Abreu, Filipe Monteiro, Joana Antunes, Nuno Manso, Pedro De Vasconcelos, Luís Soares de Almeida, Paulo Filipe","doi":"10.20344/amp.17991","DOIUrl":"10.20344/amp.17991","url":null,"abstract":"<p><strong>Introduction: </strong>Kaposi's sarcoma (KS) is a rare angioproliferative neoplasm associated with human herpesvirus 8 infection, presenting as four subtypes: classic, endemic, iatrogenic, and epidemic. While well documented globally, comprehensive data on KS in Portugal remain scarce. The aim of this retrospective study was to provide a detailed analysis of KS cases diagnosed at Hospital Santa Maria, in Lisbon, between 2014 and 2023.</p><p><strong>Methods: </strong>A total of 113 histopathologically confirmed KS cases were included, focusing on demographic, clinical, and histopathological characteristics, as well as treatment strategies and outcomes.</p><p><strong>Results: </strong>The mean age at diagnosis was 59.4 years, with a male-to-female ratio of 4.4:1. Most patients (50.4%) were of African origin. Epidemic KS (45.1%) was the most prevalent subtype. Lesions mainly affected the lower limbs (47.8%), and disseminated, mucosal, and extracutaneous involvement were more common in HIV-positive patients. Tumor-stage lesions were frequent (59.3%). Single-modality treatment was used in 53.1% of cases, while 40.7% required combined therapies. Relapse rates were highest in endemic (39.1%) and iatrogenic KS (28.6%) subtypes. The disease-specific mortality rate was 8%.</p><p><strong>Conclusion: </strong>Our findings suggest that KS remains a significant concern, particularly in immunosuppressed patients. Early diagnosis and multidisciplinary management are essential to improve outcomes. However, limitations such as potential biases from its retrospective design and the single-center scope should be considered.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"438-440"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332301","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":"[Kaposi Sarcoma: Between the Skin and the World].","authors":"Sandra Medeiros, Miguel Nogueira","doi":"10.20344/amp.23636","DOIUrl":"https://doi.org/10.20344/amp.23636","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"38 8","pages":"438-440"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144797939","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":"Commentary on \"Anxiety and Generalized Anxiety Disorder in Elite Athletes\".","authors":"Marcelo Andrade Silami, Elisa Melo Ferreira","doi":"10.20344/amp.23189","DOIUrl":"10.20344/amp.23189","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"510-511"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245601","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 Perspective of Psychiatry and Child and Adolescent Psychiatry Residents About Psychotherapy Training in Portugal.","authors":"Rui M Salgado, Orlando Von Doellinger","doi":"10.20344/amp.23076","DOIUrl":"10.20344/amp.23076","url":null,"abstract":"<p><strong>Introduction: </strong>Psychotherapy is an effective treatment for various mental disorders. Most recommendations advocate training in psychotherapy for psychiatry and child and adolescent psychiatry residents. However, incorporating psychotherapy training into the curricula of psychiatric residency programs has proven difficult. In Portugal, competence in psychotherapy is not mandatory to become a psychiatrist or a child and adolescent psychiatrist. Our study aims to describe the perspectives of psychiatry and child and adolescent psychiatry residents on psychotherapy training in Portugal.</p><p><strong>Methods: </strong>The authors developed a voluntary, anonymous, online self-reported questionnaire to be applied to psychiatry and child and adolescent psychiatry residents. Data was collected during 2023.</p><p><strong>Results: </strong>The response rate was 29.9%. The main results were that most Portuguese psychiatry and child and adolescent psychiatry trainees stated that their institution did not provide psychotherapy training (95.2%) and were dissatisfied with the psychotherapy training provided by their residency centers (96.8%). All residents agreed that psychotherapy training involves a significant financial investment, and almost all (96.8%) believed it involved a substantial investment in terms of time in the long term. Likewise, most trainees (94.4%) considered psychotherapy training should be included within the residency work schedule. Crucially, psychiatry and child and adolescent psychiatry residents were interested in psychotherapy training (93.6%), and most regarded psychotherapy as a mandatory competence of the residency training program (85.7%). More than two-thirds (70.6%) of residents considered initiating or continuing psychotherapy training after residency. Regarding the modalities that should be included in the residency program, residents pointed out cognitive-behavioral therapy, family therapy, interpersonal psychotherapy, psychodynamic psychotherapy, and support psychotherapy. About 40% of respondents mentioned they were in personal psychotherapy during the residency.</p><p><strong>Conclusion: </strong>Modifications in residency curricula should seriously be considered so that future psychiatrists can be qualified to provide effective psychotherapy treatment. The authors believe they provided relevant data pooled from future psychiatrists and child and adolescent psychiatrists which can be useful to help define training in a perceived essential competence.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"469-479"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144493368","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":"From Sertoli-Leydig Cell Tumor to Uterine Inversion and Premature Ovarian Insufficiency.","authors":"Ana Mourato, Catarina Soares, Catarina Santana, Vera Sousa, Berta López","doi":"10.20344/amp.23095","DOIUrl":"10.20344/amp.23095","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"512-513"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186245","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":"Value-Based Geriatric Care: Good News from Portugal.","authors":"Mariana Alves, Lia Marques, Lucimere Bohn, Fernando Osório, Gonçalo Sarmento, Catarina Bekerman, Adelaide Belo, Ana Farinha, Ana Viegas, Rui Buzaco, Sofia Duque","doi":"10.20344/amp.22655","DOIUrl":"10.20344/amp.22655","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"441-445"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273854","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}