Acta medica portuguesa最新文献

{"title":"Principles of the Orthogeriatric Model of Care: A Primer.","authors":"Cameron Stephen, Yashar Mashayekhi, Mohamed H Ahmed, Lia Marques, Maria P Panourgia","doi":"10.20344/amp.20768","DOIUrl":"10.20344/amp.20768","url":null,"abstract":"<p><p>It is well known that over the last few decades, there has been significant growth of the aging population worldwide and especially in Europe, with an increase of more than two years per decade since the 1960's. Currently, in Europe, people aged over 65 years old represent 20% of the population, creating many new and complex challenges for national healthcare systems. In many countries, geriatric medicine is an established medical specialty, integrated into the primary and secondary care of the older population. In some countries, such as Portugal, specialist training in geriatric medicine is not available, even though the life-expectancy in Portugal is currently 81 years due to a decrease in fertility and mortality, and people aged over 60 currently represent nearly a third of the population. There is strong evidence in the medical literature that a fracture following a fall, and especially a neck of femur fracture, is one of the most serious events that can happen in an older person's lifetime. These fractures have been associated with increased morbidity, loss of independence, a high rate of institutionalization, and mortality. Rates of mortality after a year from femoral fractures have been proven to be three to four times higher than the expected in the general population, ranging between 15% to 36%. This emphasizes the importance of developing well-organized care pathways for these patients, which combine specialized geriatric care (also known as orthogeriatric care). This narrative review will focus on the core principles of orthogeriatric care and how medical professionals, including those who are not specialized in geriatric care, can effectively use them.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"37 11","pages":"792-801"},"PeriodicalIF":0.8,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765277","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":"Insights from Portuguese Nephrologists and Rheumatologists Concerning the Treatment of ANCA Vasculitis.","authors":"Inês Ferreira, Ana Águeda, Carolina Belino, Bruno Schau, João Rovisco, Carina Ferreira","doi":"10.20344/amp.21635","DOIUrl":"https://doi.org/10.20344/amp.21635","url":null,"abstract":"<p><strong>Introduction: </strong>Antineutrophilic cytoplasmic antibodies-associated vasculitis (AAV) encompasses granulomatosis with polyangiitis, microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis. These rare diseases are characterized by an exaggerated immune response in blood vessels, leading to inflammation, vascular injury, ischemia, and necrosis of affected tissues and organs. Despite the existence of European recommendations for treating AAV, their implementation in Portugal remains unclear.</p><p><strong>Methods: </strong>To address this gap, an online Delphi panel was conducted involving 55 Portuguese nephrologists and rheumatologists, representing the main specialties involved in the management of AAV. The primary objective was to assess the level of consensus regarding the treatment of AAV in Portugal and the application of European recommendations in daily clinical practice. The specialists evaluated 29 statements formulated by a group of Portuguese experts with extensive experience in AAV, addressing key aspects of AAV management, rated on a 4-point Likert scale. Consensus was defined as > 70% of responses either strongly agreeing or strongly disagreeing with a statement, while the majority level required > 70% agreement or disagreement.</p><p><strong>Results: </strong>After one round, no statement reached consensus globally, and eight out of the 29 statements did not achieve a qualified majority. Nonetheless, this study demonstrates a high level of agreement within each medical specialty, due to the distinct characteristics of the patient populations treated by each specialty. While the results suggest partial adherence to European recommendations, they also highlight the need to standardize clinical practices for AAV treatment in Portugal.</p><p><strong>Conclusion: </strong>This study underscores the importance of aligning national practices with established European recommendations to ensure the best outcomes for patients with AAV.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"37 11","pages":"778-786"},"PeriodicalIF":0.8,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142764983","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":"Motivating Medical Students: Adaptation of the Academic Motivation Scale within the Framework of the Self-Determination Theory.","authors":"Rita Matos Sousa, Nuno Gabriel Silva Gonçalves, Vítor Hugo Pereira, John Norcini","doi":"10.20344/amp.21926","DOIUrl":"https://doi.org/10.20344/amp.21926","url":null,"abstract":"<p><strong>Introduction: </strong>Motivation plays a crucial role in the academic success and professional development of medical students. Understanding the intricacies of motivation within the context of medical education is essential for designing effective interventions and support systems. The aim of this study was to explore the adaptation of the Academic Motivation Scale within the framework of the self-determination theory and of the self-efficacy theory to assess motivation among medical students.</p><p><strong>Methods: </strong>The study adapted the Academic Motivation Scale to the Portuguese context, drawing upon insights from the self-determination theory. Two existing Portuguese scales, MATAMS and Ribeiro et al scale, served as foundational frameworks for the adaptation process. The study included qualitative interviews, which informed the creation of the Minho Medical Academic Motivation Scale - Minho-MEDAMS. This scale was applied to 281 medical students. To assess the scale's validity, we used the exploratory and confirmatory factor analyses, and the Cronbach's alpha to measure internal consistency.</p><p><strong>Results: </strong>The exploratory factor analysis showed strong results with a KMO of 0.862, leading to five factors and the removal of two items. The initial confirmatory factor analysis indicated poor fit, prompting the removal of items with low R-squared values. The final Minho-MEDAMS includes 18 items: six for intrinsic motivation, nine for extrinsic motivation and three for amotivation. This refined scale demonstrates high internal consistency (α = 0.831), making it a reliable tool for assessing medical students' motivation.</p><p><strong>Conclusion: </strong>The successful adaptation of the Academic Motivation Scale within the self-determination theory framework presents a valuable instrument for assessing motivation in medical students. The Minho-MEDAMS offers a comprehensive understanding of motivational dynamics, facilitating targeted interventions and support mechanisms to enhance student engagement and success. Its validity and reliability render it a practical tool for educators, administrators, and researchers in the field of medical education. Ultimately, the Minho-MEDAMS contributes to the advancement of strategies aimed at cultivating motivated and proficient healthcare professionals.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"37 11","pages":"757-766"},"PeriodicalIF":0.8,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142764988","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":"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":"10.20344/amp.21928","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"813-814"},"PeriodicalIF":0.8,"publicationDate":"2024-11-04","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":"European Alpha-1 Research Collaboration (EARCO) in Portugal: The Future Is Happening.","authors":"Maria Sucena, Raquel Marçôa, Catarina Guimarães","doi":"10.20344/amp.20953","DOIUrl":"https://doi.org/10.20344/amp.20953","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"37 11","pages":"754-756"},"PeriodicalIF":0.8,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142764799","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":"Idiopathic Systemic Capillary Leak Syndrome: Report of a Pediatric Case.","authors":"João Vasco, Francisca Albuquerque, Francisca Costa, Ana Dias Curado, Carlos Escobar","doi":"10.20344/amp.21531","DOIUrl":"10.20344/amp.21531","url":null,"abstract":"<p><p>The idiopathic systemic capillary leak syndrome is characterized by recurrent episodes of hypovolemia, with an unknown cause, presenting as a distributive and hypovolemic shock, due to fluid loss to the extravascular space. We describe a case of a previously healthy seven-year-old boy, who started with prodromal symptoms (abdominal pain, fatigue, nausea), followed by a fluid extravasation phase, with hemoconcentration, hypoproteinemia, and muscular edema in the abdominal wall and lower limbs, accompanied by pain - compartment syndrome. After a couple of days, spontaneous and fast recovery was noted, with clinical and analytic improvement. The inflammatory markers were always normal, and the blood cultures were negative. In this case, it is possible to distinguish the three idiopathic systemic capillary leak syndromes phases, as described in the literature. Although rare, this syndrome can be fatal, and the differential diagnosis with other causes of shock represents a challenge.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"802-804"},"PeriodicalIF":0.8,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142034916","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":"[Increase In Sexually Transmitted Infections: A New Undeniable Reality in Portugal].","authors":"Catarina Côrte-Real, Manuel Castro Pereira, Mariana Fleming Torrinha, Maria Manuel Pinho, Bernardo Mateiro Gomes, Rita Maciel Barbosa","doi":"10.20344/amp.21480","DOIUrl":"10.20344/amp.21480","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"751-753"},"PeriodicalIF":0.8,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141974782","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":"When Eyes Speak Louder: Uncontrolled Hypothyroidism Revealed Through Madarosis and Eyelid Edema.","authors":"Nuno Rocha Jesus, Juliana Silva, Patrícia Tavares","doi":"10.20344/amp.21720","DOIUrl":"https://doi.org/10.20344/amp.21720","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"37 11","pages":"805-806"},"PeriodicalIF":0.8,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765235","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":"Exposure to Second-Hand Tobacco Smoke in Portugal After the Implementation of the Smoking Ban: A Systematic Review.","authors":"Nerea Mourino, Sofía Ravara, Cristina Candal-Pedreira, Julia Rey-Brandariz, Leonor Varela-Lema, Alberto Ruano-Ravina, Mónica Pérez-Ríos","doi":"10.20344/amp.21802","DOIUrl":"10.20344/amp.21802","url":null,"abstract":"<p><strong>Introduction: </strong>Estimating the prevalence of second-hand tobacco smoke exposure is a public health priority while evaluating the population-attributable disease burden and impact of smoking bans. We conducted a systematic review to analyze how secondhand tobacco smoke exposure has been assessed, and how its prevalence has been estimated among the Portuguese population since the implementation of the partial smoking ban in 2008.</p><p><strong>Methods: </strong>A literature search was conducted in the Web of Science, MEDLINE and Embase databases until November 2022, applying a pre-designed search strategy and following the PRISMA 2020 guidelines. The search was not restricted by study period, study design, sample size or language, and was complemented by a manual literature search. A modified Newcastle-Ottawa scale was used to assess the quality of the studies.</p><p><strong>Results: </strong>Thirteen cross-sectional studies were included. The prevalence of second-hand tobacco smoke exposure among the three European studies ranged from 8.2% (adult population exposed at home in 2010) to 93.3% (adolescent/adult population exposed in bar/restaurant terraces in 2016). Three nationwide studies estimated children's exposure at home: ranging from 32.6% in 2010 - 2011 to 14.4% in 2016. According to the most recent studies, 49.8% of women living in Porto were exposed during the third trimester of pregnancy in 2010 - 2011; 32.6% and 38.4% of children were exposed at home, respectively in Lisbon and the Azores.</p><p><strong>Conclusion: </strong>A significant proportion of the Portuguese population, especially children and pregnant women, remain exposed to secondhand tobacco smoke. A comprehensive smoke-free policy is needed, not only in outdoor public places, but also in indoor private settings.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"767-777"},"PeriodicalIF":0.8,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278666","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 Rare Cause of Common Pain: Herpes Zoster-Induced Sciatica.","authors":"Maria João Cadório, João Oliveira, João Teixeira, Cátia Duarte","doi":"10.20344/amp.22038","DOIUrl":"10.20344/amp.22038","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"809-810"},"PeriodicalIF":0.8,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142338997","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}