Acta medica portuguesa最新文献

{"title":"[Unmet Challenges in COVID-19 Prevention for Immunocompromised Individuals: A Consensus Analysis from Portugal].","authors":"Ana Soraia Cunha, Beatriz Raposo, João V Cordeiro, Maria João Marques, Ana Rita Pedro","doi":"10.20344/amp.9949","DOIUrl":"10.20344/amp.9949","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), resulted in significant disease burden and mortality. Despite vaccination successes, new virus variants persist, affecting unvaccinated and immunocompromised individuals (ICI) severely. These high-risk groups face elevated mortality and hospitalization rates. Vigilance and targeted health measures remain crucial post-pandemic. The aim of this study was to develop consensus on the unmet needs in COVID-19 prevention among ICI.</p><p><strong>Methods: </strong>We performed a Delphi study involving 45 experts, including physicians, health managers, policymakers, public health experts, members of medical societies and patient organizations. Consensus was achieved at 65% for each identified strategy using a scale ranging from \"strongly agree\" to \"strongly disagree.\" Three Delphi rounds were conducted to address four key questions: identifying unmet needs in COVID-19 prevention for ICI; identifying the characteristics that distinguish ICI as a susceptible group; determining the main outcomes of COVID-19 in ICI; and indicating action plans for protecting ICI. The first round involved voting on pre-identified indicators. The second and third rounds involved analyzing the gathered information and voting on each indicator to achieve consensus.</p><p><strong>Results: </strong>A retention rate of 80% was achieved. Out of 89 valid indicators analyzed, 23 achieved consensus. These included: eight indicators highlighting the importance of raising awareness about COVID-19 and vaccination outcomes, ensuring safety and understanding, and developing targeted immunization strategies for ICI; five indicators identifying susceptible groups within ICI, such as individuals undergoing chemotherapy or radiotherapy, those with primary immunodeficiencies, solid organ transplant recipients, patients with chronic kidney disease, and bone marrow transplant recipients; two indicators showing improvements in clinical outcomes and reduced hospitalizations; and eight indicators recommending the development of effective therapies, more immunogenic vaccines, and treatments for viral infections in ICI.</p><p><strong>Conclusion: </strong>The study emphasized the importance of targeted immunization strategies, monitoring, and tailored education to address diverse needs of ICI. These findings provide a foundation for future policies to effectively manage and protect ICI during and beyond the COVID-19 pandemic.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"538-547"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752070","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":"[Letter to the Editor Replying to the Article: \"Medication Reconciliation in Primary Care: Practices, Knowledge and Attitudes in the Lisbon and Tagus Valley Health Region\"].","authors":"Lília Tomé, Sara Moreira, Maria Rodrigues, Mariana Guerner","doi":"10.20344/amp.23372","DOIUrl":"10.20344/amp.23372","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"592-593"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658075","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 Idiopathic Hypereosinophilic Syndrome Treated with Mepolizumab].","authors":"Margarida Gomes, Sofia Ferreira, Ana Mendes, Tiago Marques, Sara Silva","doi":"10.20344/amp.23406","DOIUrl":"10.20344/amp.23406","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"588-589"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144797938","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":"Penile Skin as a Rare Location of Melanoma in the Balkan Region: A Case Report.","authors":"Jasna Gacic, Aleksandar Lazarov, Marijana Lazarov Bandic, Jadran Bandic, Srdjan Nikolovski, Marko Nikolic","doi":"10.20344/amp.22254","DOIUrl":"10.20344/amp.22254","url":null,"abstract":"<p><p>Skin melanoma is very rarely found in the genital region. Additionally, out of all penile skin malignancies, melanoma is one of the rarest, with no cases reported before in the Balkan region. A 68-year-old male presented with atypical and irregular pigmented skin lesions on his left flank and penile shaft. After dermoscopy and radiological work-up, both lesions were completely excised, with pathological examination revealing a high-grade dysplastic nevus with nodular melanoma in the penile location. Wide re-excision was performed one month later, followed by skin reconstruction with a rotation cutaneous flap. No postoperative complications, long-term recurrence signs, nor local or distant metastases were observed. As a very rare case of this kind of condition in the Balkan region and globally, this is the first case of penile skin melanoma described in Serbia, additionally emphasizing the importance of thorough systematic clinical examination and conducting organ-preserving surgery.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"573-576"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522419","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 to Unleash the Potential of the Portuguese Registry of Intensive Care Medicine?","authors":"João João Mendes, Inês Amaral, João Gonçalves Pereira, José Artur Paiva, Paulo Figueiredo, Pedro Póvoa, Teresa Guimarães, Paulo Mergulhão","doi":"10.20344/amp.22673","DOIUrl":"10.20344/amp.22673","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"523-527"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741775","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":"[Anaphylaxis to Gadobutrol: A Rare Complication of Magnetic Resonance Contrast Media].","authors":"André Maçães, Duarte Nuno Silva, Ana Iva Santos, Isabel Rezende","doi":"10.20344/amp.23022","DOIUrl":"10.20344/amp.23022","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"590-591"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641397","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":"Selective Digestive Decontamination in Hemato-Oncological Patients Colonized with Carbapenem-Resistant Enterobacterales.","authors":"Sara De Abreu Luís, Carla Mimoso Santos","doi":"10.20344/amp.23139","DOIUrl":"10.20344/amp.23139","url":null,"abstract":"<p><p>Infections caused by multidrug-resistant Gram-negative bacteria, including carbapenem-resistant Enterobacterales, are a global threat and their gradual increase is alarming. They represent a major challenge to public health because of limited therapeutic options and high case-fatality rates. Hemato-oncological patients represent a high-risk subpopulation for these types of infections, more specifically in previous carbapenem-resistant Enterobacterales colonized patients, because of severe immunosuppression not only due to the disease itself but also due to treatment like intensive chemotherapy or allogeneic hematopoietic stem cell transplant. Selective digestive decontamination is a prophylactic intervention with the purpose of reducing or eliminating gut colonization by pathogenic agents, preserving beneficial endogenous flora but its application remains controversial due to great heterogeneity amongst studies. However, in this review we intend to examine the role of selective digestive decontamination in context of high-risk patients such as hemato-oncological carbapenem-resistant Enterobacterales carriers who will receive highly immunosuppressive treatments, as it appears to be an appealing short-term strategy for the prevention of difficult-to-treat infections.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"561-567"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820336","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":"Antithrombotic Treatment After Valve-in-Valve, Valve-in-Ring, and Valve-in-MAC Procedures: A Systematic Review and Meta-Analysis.","authors":"Gonçalo Terleira Batista, Gonçalo Costa, Joana Delgado Silva, Lino Gonçalves","doi":"10.20344/amp.22905","DOIUrl":"10.20344/amp.22905","url":null,"abstract":"<p><strong>Introduction: </strong>While antithrombotic therapy following transcatheter valve implantation has been extensively studied in various clinical trials, there remains a notable gap in evidence regarding the optimal approach following valve-in-valve (ViV), valve-in-ring (ViR) and valve-in-mitral annular calcification (ViMAC) procedures, warranting further assessment. This gap is particularly concerning due to the apparent increased risk of thrombosis associated with ViV interventions. The aim of this systematic review was to explore the potential benefits of anticoagulation in ViV, ViR, and ViMAC procedures.</p><p><strong>Methods: </strong>We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials, as well as the grey literature, for observational and interventional studies published until December 2023. Trials were included if a comparative analysis between the two antithrombotic strategies was feasible and excluded if patients under 18 years old were analysed. The primary efficacy endpoints were incidence of clinical and total valve thrombosis (VT), major bleeding was the sole safety primary endpoint. Additional analyses were performed regarding valves in the mitral position and valve type. The risk of bias was evaluated using the Newcastle-Ottawa scale. Data was assessed using the Review Manager 5.4 software.</p><p><strong>Results: </strong>A total of five observational and one case series were included (n = 614 on anticoagulation and n = 468 on antiplatelets), comprising a total of 1082 participants. Clinical VT rates were 4.2% for all procedures, and patients on anticoagulants were associated with a a lower risk of clinical VT (1.1% vs 8.3%; OR: 0.18; 95% CI: 0.07 - 0.42, I2: 0%) and total VT (1.3% vs 8.5%; OR: 0.16; 95% CI: 0.07 - 0.37, I2: 0%). Regarding bleeding events, the existing literature did not provide adequate information to enable a thorough analysis.</p><p><strong>Conclusion: </strong>Our study suggests a potential benefit of anticoagulation regimens to decrease the high rates of VT following valve-in-valve, valve-in-ring and valve-in-mitral annular calcification procedures. However, the lack of randomized controlled trials and data on bleeding and mortality emphasises the necessity for further research.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"528-537"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673692","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":"Atrial Fibrillation Patterns on Ambulatory Electrocardiogram Monitoring and Risk of Stroke.","authors":"Oleksii Skakun, Ihor Vandzhura, Yaroslava Vandzhura, Roksolana Denina, Pavlo Zvonar","doi":"10.20344/amp.23199","DOIUrl":"https://doi.org/10.20344/amp.23199","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"38 9","pages":"597-598"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938560","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":"[Medicine for Peace: An Ethical and Professional Imperative].","authors":"Carlos Cortes","doi":"10.20344/amp.23881","DOIUrl":"https://doi.org/10.20344/amp.23881","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"38 9","pages":"601-602"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938551","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}