Acta medica portuguesa最新文献

{"title":"[Mild Traumatic Brain Injury: National Consensus Clinical Recommendations].","authors":"Filipa Ferreira, Armando Lopes, Carla Freitas, Carolina Domingues, Helena Silva, Inês Nunes, João Lemos, Jorge Pereira, José Luís Alves, Adelina Pereira","doi":"10.20344/amp.24437","DOIUrl":"https://doi.org/10.20344/amp.24437","url":null,"abstract":"<p><p>Mild traumatic brain injury accounts for approximately 80% of cranial trauma worldwide. Despite its apparent benign nature, it is associated with high costs and sequelae. The evaluation of victims should follow a logic of severity stratification to guide subsequent management decisions. The systematic use of computed tomography is consensual as a diagnostic tool in moderate or severe cases, but it remains controversial in mild cases. In recent years, serum biomarkers have emerged as an objective and complementary tool in risk stratification for injury. Glial fibrillary acidic protein and ubiquitin C-terminal hydrolase L1 assist decision-making in patients with a Glasgow Coma Scale score between 14 and 15 within the first 12 hours after trauma. This consensus aims to establish a decision algorithm based on the combination of clinical scores such as the Canadian CT Head Rule (high sensitivity) and biomarkers. The main objective of the algorithm is to standardize the approach based on evidence and seek to reduce exposure to radiation and time spent in the Emergency Department, while simultaneously allowing safe clinical discharge. In moderate-risk cases, when glial fibrillary acidic protein and ubiquitin C-terminal hydrolase L1 are negative within the first 12 hours after trauma, the need for cranio-encephalic computed tomography is excluded due to the high negative predictive value of these biomarkers, allowing discharge unless another clinical indication exists. All high-risk patients will undergo cranio-encephalic computed tomography; those under antithrombotic therapy will additionally undergo biomarker testing. Both results negative allow consideration of discharge; both results positive imply admission. If the Computed Tomography is negative and at least one biomarker is positive, the following is suggested: repetition of Cranio-Encephalic Computed Tomography in patients aged 75 years or older, due to elevated serum values even in the absence of trauma in 95% of this subgroup and the current absence of age-adjusted cut-offs; biomarkers should be repeated if age is below 75 years. This consensus also aims to present a new proposed classification of traumatic brain injury that seeks a more complete and individualized characterization.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148519758","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":"Theca Lutein Cysts in Pregnancy: A Reversible Condition.","authors":"Daniela Alpoim, Rita Jesus, Ana Edral","doi":"10.20344/amp.24193","DOIUrl":"https://doi.org/10.20344/amp.24193","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"39 8","pages":"484-485"},"PeriodicalIF":1.2,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148676673","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":"Psychological Distress and Quality of Life in Fibrotic Interstitial Lung Diseases: A Real-World Observational Study.","authors":"Maria João Moura, Mara Sousa, Ana Luísa Fernandes, Natália Melo, Inês Neves","doi":"10.20344/amp.24629","DOIUrl":"10.20344/amp.24629","url":null,"abstract":"<p><p>Fibrotic interstitial lung diseases are chronic, often progressive conditions that have a substantial impact on patients' quality of life. We conducted a prospective observational cross-sectional study including 44 outpatients with fibrotic interstitial lung diseases, assessing anxiety, depression, symptom burden, and quality of life using validated patient-reported outcome measures. Clinically significant anxiety and depression were present in 34.1% and 43.2% of patients, respectively. Psychological distress was associated with greater dyspnea severity and poorer self-perceived health status, although not with lung function parameters. These findings highlight the high prevalence and likely under-recognition of psychological distress in these patients, and support the routine integration of systematic mental health assessment into fibrotic interstitial lung diseases care pathways.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"39 9","pages":"539-543"},"PeriodicalIF":1.2,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890704","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":"[Comment on the Article \"Regulating for Problematic Smartphone and Social Media Use Among Youth: A Public Health Challenge and Opportunity\"].","authors":"Cecília Elias, Isabella Teixeira, Catarina De Paraíso Camarinha, Andreia Silva Costa, Paulo Jorge Nogueira","doi":"10.20344/amp.24355","DOIUrl":"https://doi.org/10.20344/amp.24355","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"39 6-7","pages":"427-428"},"PeriodicalIF":1.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148203762","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":"[Horned-Viper Bite: A Clinical Case and Review of Therapeutic Approach].","authors":"Cristiano Gante, Adriana Watts Soares, João Brazete, Rafael Terceiro, Fátima Rato","doi":"10.20344/amp.24300","DOIUrl":"10.20344/amp.24300","url":null,"abstract":"<p><p>Envenomation by the horned viper (Vipera latastei), endemic to the Iberian Peninsula, typically causes local and hematologic toxicity, potentially leading to venom-induced consumption coagulopathy. We report the case of a 39-year-old man bitten on the fourth finger of his left hand. The first dose of antivenom (ViperFav®) was administered 10 hours after the incident, followed by two additional doses due to persistent coagulopathy and transient thrombocytopenia. Hyperbaric oxygen therapy (10 sessions) and a transdermal nitroglycerin patch were used to optimize local perfusion as adjuvant therapies that are still discussed in the medical literature. Clinical evolution was favorable, with preservation of finger viability and progressive laboratory recovery. This case highlights the importance of early antivenom administration, continuous hematologic monitoring, and the potential benefits of integrating adjuvant therapies to prevent necrosis and systemic complications. A multidisciplinary approach enabled full functional recovery without sequelae.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"39 6-7","pages":"405-408"},"PeriodicalIF":1.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148203803","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":"Paroxysmal Sympathetic Hyperactivity: A Structured Approach for Clinical Practice.","authors":"Rita Dos Santos Almeida, João Faia, Bárbara Quental, Patrícia Carrão, Inês Barros, Carla Ferreira Santos, Ana Albuquerque","doi":"10.20344/amp.23395","DOIUrl":"10.20344/amp.23395","url":null,"abstract":"<p><p>Paroxysmal sympathetic hyperactivity is a neurological syndrome characterized by sudden episodes of sympathetic overactivity often triggered by non-noxious stimuli. First described by Wilder Penfield in 1929, it commonly follows severe brain injury and is associated with diffuse lesions involving diencephalic and brainstem structures. Its pathophysiology is not completely understood, but it is believed to result from an imbalance between excitatory and inhibitory pathways within the central nervous system. Diagnosis is clinical, based on exclusion of alternative causes and supported by the Paroxysmal Sympathetic Hyperactivity Assessment Measure. Management includes both pharmacological and non-pharmacological strategies. Despite growing recognition, clinical approaches remain heterogeneous. Further research is needed to clarify mechanisms and develop standardized, evidence-based diagnostic and treatment guidelines to improve outcomes.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"398-404"},"PeriodicalIF":1.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145970544","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":"Cutaneous Metastasis as the Initial Presentation of Pancreatic Adenocarcinoma.","authors":"Jorge Lindo, João Luís Fernandes, José Carlos Cardoso, Maria Manuel Xavier","doi":"10.20344/amp.24745","DOIUrl":"https://doi.org/10.20344/amp.24745","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"39 6-7","pages":"429-430"},"PeriodicalIF":1.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148203844","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":"Measuring Antimicrobial Prescribing Quality and Driving Behavioral Change: A Call to Action Against Antimicrobial Resistance.","authors":"Carlos Palos, Paulo Sousa, José-Artur Paiva","doi":"10.20344/amp.24396","DOIUrl":"10.20344/amp.24396","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"379-382"},"PeriodicalIF":1.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759463","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":"Practices and Parental Perspectives on Children's Play in Portugal: A Cross-Sectional Survey.","authors":"Marta Martins Carvalho, João Filipe Nico, Armanda Rebelo, Mariana Flórido, Filipa Inês Cunha","doi":"10.20344/amp.24268","DOIUrl":"10.20344/amp.24268","url":null,"abstract":"<p><strong>Introduction: </strong>Play is recognized as a fundamental right and an essential component of healthy development. However, modern lifestyles and digital media use have transformed children's play patterns. The aim of this study was to describe families' perceptions, practices, and limitations regarding play and parent-child co-play in Portugal.</p><p><strong>Methods: </strong>An analytical cross-sectional study was conducted through an online questionnaire distributed to parents of children aged three to 10 years across Portugal. The survey addressed demographic data, structured activities, digital media use, general play characteristics, co-playing with parents, and parental opinions on play. Data were analyzed using SPSS® v.28.0.</p><p><strong>Results: </strong>A total of 4637 valid responses were obtained. The median child age was six years, and 53% were boys. Seventy-five percent of children participated in extracurricular activities, and television was the most frequently used digital medium (69%). The most common duration of co-playing during weekdays was less than one hour (46%) and of one to three hours during weekends (43%). Nearly half (46%) reported playing while simultaneously performing household tasks. The main barriers to co-playing were household duties (87%) and work-related constraints (58%). Children with siblings showed less co-playing time during weekdays and weekends. Additionally, children with extracurricular activities showed less co-playing time during the week. Male sex, rural living environment and lower parental education level were associated with increased outdoor play. Parents valued play highly: 100% agreed it supports development, 99% saw it as essential for socialization, and 93% disagreed that school play could replace home play.</p><p><strong>Conclusion: </strong>Parents in Portugal acknowledge the vital role of play but face time and environmental barriers that restrict opportunities for free, high-quality play. Promoting distraction-free co-play and facilitating safe, outdoor play environments should be a priority in pediatric and public health strategies.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"39 6-7","pages":"387-393"},"PeriodicalIF":1.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148203324","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":"Littre Hernia Associated with Cryptorchidism: A Rare Surgical Finding.","authors":"Rui Ferreira-Santos, Nuno Silva Gonçalves, Cláudio Branco, Carlos Veiga, Joaquim Costa Pereira","doi":"10.20344/amp.24633","DOIUrl":"https://doi.org/10.20344/amp.24633","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"39 6-7","pages":"424-425"},"PeriodicalIF":1.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148203328","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}