Acta medica portuguesa最新文献

{"title":"Bone Infarction of the Jaw with Regional Hematoma Collections: A Rare Complication in Sickle Cell Disease.","authors":"Luísa Castello-Branco Ribeiro, Sofia Grilo, Carlos Escobar","doi":"10.20344/amp.23141","DOIUrl":"10.20344/amp.23141","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"577-578"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144705966","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":"Communication in Neonatal Intensive Care: Translation and Validation of the \"Parents' Experiences of Communication in Neonatal Care\" Questionnaire for the Portuguese Population.","authors":"Rita Melo Parente, Rita Guerreiro, Laura Garcia, Bruno Sanches, Raquel Gomes, Maria Clara Rocha, Anselmo Costa","doi":"10.20344/amp.22739","DOIUrl":"https://doi.org/10.20344/amp.22739","url":null,"abstract":"<p><strong>Introduction: </strong>Communication is a fundamental aspect in healthcare, more so in fragile environments such as Neonatology. To optimize communication strategies with parents, it is essential to assess its quality. The aim of this study was to validate, for the Portuguese population, an instrument for assessing the quality of communication between healthcare professionals and parents in neonatal care units.</p><p><strong>Methods: </strong>The Parents' Experiences of Communication in Neonatal Care questionnaire was developed in the United Kingdom to evaluate communication with parents specifically. The 28-question instrument was adapted and translated to European Portuguese following a three-step protocol: translation, review, and back-translation. Subsequently, the validation process was conducted in three stages: (1) face validity through cognitive interviews; (2) content validity through external panel evaluation; and (3) performance assessment through a four-month pilot study in a tertiary neonatal intensive care unit.</p><p><strong>Results: </strong>Cultural adaptation resulted in the removal of two questions. The remaining questions were translated to Portuguese. Cognitive interviews were conducted with a convenience sample of ten parents, leading to important revisions in two questions. Five external professionals evaluated the item's relevance in a 4-point Likert scale. Four questions presented an item content validity index value below the threshold of 0.78. Two questions were adjusted and two were eliminated at this stage. The questionnaire was delivered to 31 parents, with a total of 60 questionnaires completed. Five questions were reviewed due to a non-response rate greater than 5%, and one for exceeding 95% uniform responses. No question had a dropout rate greater than 5%, nor did any have a rate of non-informative answers exceeding 5%. A significant correlation (Kendall's Tau > 0.7) was found between three sets of questions.</p><p><strong>Conclusion: </strong>The European Portuguese version of Parents' Experiences of Communication in Neonatal Care survey contains 24 questions. This is the first comprehensive and valid instrument at national level to objectively measure satisfaction with communication of parents of children admitted to the neonatal intensive care units. Its use will enable monitoring of interventions aimed at improving communication, which is crucial for enhancing family-centered care.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"38 9","pages":"548-556"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938539","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":"Osimertinib: A Game-Changer in Stage IV EGFR-Driven Lung Cancer.","authors":"Sofia Silva, Joana Duarte, Carla Simão, Margarida Felizardo","doi":"10.20344/amp.22031","DOIUrl":"10.20344/amp.22031","url":null,"abstract":"<p><p>Lung cancer has a high mortality rate; however, treatment with tyrosine kinase inhibitors targeting specific molecular alterations has significantly improved the survival of patients with advanced or metastatic non-small cell lung carcinoma (NSCLC). EGFR mutations are present in approximately 15% of NSCLC cases. Osimertinib was approved in Portugal by Infarmed (Portuguese Medicines Agency) in 2021 as a first-line therapy for advanced NSCLC with EGFR sensitizing mutations. A 55-year-old man, a former smoker, presented to the Emergency Department with a six-month history of dry cough and dyspnea that had worsened and was now accompanied by fever. Chest CT revealed multifocal pulmonary consolidations that were already present in a scan performed three months earlier. Bronchial biopsies confirmed a diagnosis of lung adenocarcinoma with an EGFR exon 19 deletion. Staging tests revealed stage IV-A disease (pulmonary metastasis and, later, right adrenal metastasis identified on PET-FDG). The patient was started on osimertinib. He was discharged and progressively recovered his baseline general condition, achieving a performance status of 0 and resuming physical activity. Despite the extensive thoracic disease, the patient achieved a complete metabolic response documented on PET-CT five months after initiating therapy, along with significant clinical improvement. Osimertinib effectively inhibits the EGFR signaling pathway and has been established as the firstline treatment for patients with stage IV disease since the FLAURA trial. However, such complete responses are rare and raise further questions about the factors influencing these responses, the optimal duration of therapy in these cases, and the role of circulating tumor DNA in therapy monitoring and discontinuation decisions.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"568-572"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956521","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":"[Recommendations for Contraception in Women with Gynecologic Cancer: From Diagnosis to Post-Treatment].","authors":"Lúcia Correia, Mariana Teves, Mónica Pires, Amália Pacheco, Fátima Palma","doi":"10.20344/amp.22396","DOIUrl":"10.20344/amp.22396","url":null,"abstract":"<p><p>The incidence of gynecologic cancer in women of reproductive age is increasing, as is the trend towards fertility-sparing treatments, highlighting the importance of safe and effective contraceptive counseling. Selecting a contraceptive method requires careful consideration of the tumor's histological subtype, its hormonal expression, and the timing of counseling within the cancer care continuum (diagnosis, treatment, and post-treatment phases). The Portuguese Society of Contraception and the Section of Gynecologic Oncology of the Portuguese Gynecological Society present recommendations about contraception in women with gynecologic cancer who have undergone fertility-sparing treatments, from diagnosis to the end of the reproductive age.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"579-587"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143951705","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 Gastroenteritis Hospitalizations in Children with and without Risk Factors: Reflections on Rotavirus Vaccination in Portugal.","authors":"Ana Laura Martins Leite de Almeida, Rui Leite, Alberto Freitas, Inês Azevedo","doi":"10.20344/amp.22954","DOIUrl":"https://doi.org/10.20344/amp.22954","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"38 9","pages":"599-600"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938509","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.23700","DOIUrl":"10.20344/amp.23700","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"519-520"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726431","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":"January 2021 and COVID-19 in Portugal: The Deadliest Month since 1919.","authors":"Filipe Froes, Marta Reis, António Diniz","doi":"10.20344/amp.23023","DOIUrl":"https://doi.org/10.20344/amp.23023","url":null,"abstract":"<p><p>The COVID-19 pandemic was the second pandemic of the 21st century and lasted 1150 days, from March 11, 2020, to May 5, 2023. It was one of the deadliest pandemics of the last century, alongside the 'Spanish flu' pandemic of 1918-1919. In Portugal, it was responsible for the deaths of 26 655 residents, with the year 2021 recording the highest mortality, with 11 991 deaths. In the first three years of the pandemic, all-cause mortality in Portugal exceeded 1200 deaths per 100 000 inhabitants, representing the highest values since 1957. The greatest impact of the pandemic occurred between December 2020 and February 2021, with 37 days of more than 4000 hospital admission beds occupied daily, 39 days of more than 600 intensive care unit beds occupied daily, and 20 days with more than 200 daily deaths. The month with the greatest impact was January 2021, with 5805 deaths due to COVID-19. The peak of hospital admissions occurred on January 31, 2021, with 6869 beds occupied, and the peak of mortality was on January 30, 2021, with 297 deaths. In absolute numbers, the monthly all-cause mortality in January 2021 in Portugal was the highest recorded since 1919.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783204","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":"Sporotrichosis with Bone and Joint Manifestations: A Diagnostic Challenge.","authors":"Bernardo Reis Simões de Jesus, Daniel Pires Penteado Ribeiro, Márcio Luí S Duarte","doi":"10.20344/amp.23062","DOIUrl":"10.20344/amp.23062","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"514-515"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172302","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":"Magnetic Resonance Imaging in Multiple Sclerosis: An Analysis of the Implementation of the Portuguese Consensus.","authors":"Alyne Cordeiro, Ana João Marques, Ana Rita Castro, Cristiana Silva, Duarte Carapinha, Francisca Ferreira, Miguel Schön, Daniela Jardim Pereira, João Paulo Gabriel, Luís Ruano, Mariana Santos, Miguel Grunho, Mónica Santos, José Vale, Maria José Sá, Ricardo Soares Dos Reis","doi":"10.20344/amp.22637","DOIUrl":"10.20344/amp.22637","url":null,"abstract":"<p><strong>Introduction: </strong>Magnetic resonance imaging (MRI) plays a critical role in diagnosing and monitoring people with multiple sclerosis (MS). The 2020 Portuguese Consensus on Magnetic Resonance Imaging in Multiple Sclerosis aimed to standardize MRI use. This study evaluated the implementation of the consensus in clinical practice.</p><p><strong>Methods: </strong>This is an observational, retrospective, longitudinal and multicentric study comprising patients diagnosed with MS between 2019 and 2022 from seven hospital centers in Portugal. We collected demographic data and details regarding MRI requests, protocols, and reports. We performed descriptive and comparative analyses between the period before and after guideline publication.</p><p><strong>Results: </strong>We included 242 patients, mainly female (66.0%), with a mean age of 37 (SD 13). A total of 989 MRIs were performed, 69.1% follow-ups, 68.1% brain MRIs, and 31.9% spinal cord MRIs. Around half of the MRI requests fulfilled all the recommended information. All mandatory sequences in the neuroimaging protocol were performed in 82.5% of brain MRIs and 71.1% of spinal cord MRIs. None of the reports fulfilled all the suggested parameters. Magnetic resonance imaging technical description and imaging findings had the least compliance, mainly concerning gadolinium information (0.85%), lesion load (18.6%), and atrophy characterization (27.1%). After the implementation of the consensus, physicians reported the MS phenotype more often (p < 0.05) and neuroradiologists reported more technical parameters (p < 0.05). When MRIs were performed in a private setting, neuroimaging protocols were similar, but the reports fulfilled more frequently the suggested topics regarding the conclusion (p < 0.05).</p><p><strong>Conclusion: </strong>This study suggests incomplete adherence to the Portuguese Consensus on MRI in MS. Information provided by the physician in MRI requests was often insufficient, which could hamper MRI protocol planning. Magnetic resonance imaging reports were frequently lacking relevant information for the diagnosis and follow-up of MS patients. Further efforts are needed to ensure full implementation and optimize MS care.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"446-459"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558774","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":"Subdural Hematoma in an Infant with Glutaric Aciduria Type 1: A Case Report on Conservative Management.","authors":"Lúcia Marques, Patrícia Lipari Pinto, Hugo Loureiro Cadilha, Patrícia Janeiro, Ana Gaspar","doi":"10.20344/amp.23093","DOIUrl":"10.20344/amp.23093","url":null,"abstract":"<p><p>Glutaric aciduria type 1 is an inherited metabolic disorder associated with subdural hematomas, possibly due to the widening of external cerebrospinal fluid spaces. We present the case of an infant with macrocephaly since birth, diagnosed with glutaric aciduria type 1 through newborn screening, who exhibited accelerated cephalic growth during follow-up. At eight months of age, cranial magnetic resonance imaging revealed bilateral subdural hematomas with intracranial mass effect. The infant displayed no signs of intracranial hypertension, history of trauma, or signs of abuse. Although surgical treatment was considered, a multidisciplinary discussion led to the decision to manage conservatively with close monitoring. The patient remained clinically stable, and imaging showed a clear reduction in the dimensions of the hematomas. This case highlights that conservative management can be an effective approach for large subdural hematomas with mass effect in glutaric aciduria type 1, provided there is no associated symptomatology, thereby avoiding the risk of metabolic decompensation.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"38 8","pages":"496-501"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144797941","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}