Acta medica portuguesa最新文献

{"title":"[Headache Management in Portugal: Consensus among the Portuguese Headache and Neurology Societies, the Portuguese Association of General and Family Medicine, and MiGRA].","authors":"Raquel Gil-Gouveia, Elsa Parreira, Isabel Pavão Martins, Isabel Luzeiro, Raúl Marques Pereira, Madalena Plácido, Filipe Palavra","doi":"10.20344/amp.22496","DOIUrl":"10.20344/amp.22496","url":null,"abstract":"<p><p>Headaches are a significant cause of global disability, with migraines ranking second of all conditions in terms of years lived with disability. Most headache patients, including those with migraine, can and should be effectively diagnosed, treated, and managed in primary healthcare settings. This approach not only reduces the disability associated with these conditions but also prevents progression to chronic forms or the development of medication overuse. The establishment of an efficient referral network, involving patient associations and healthcare professionals beyond primary care, is essential to ensure adequate support for more complex cases and to promote population health in a timely and effective manner. These guidelines for diagnosis, treatment, and referral are the result of a consensus among the Portuguese Headache Society, the Portuguese Society of Neurology, the Portuguese Association of Family Medicine, and MiGRA Portugal, the Portuguese association of migraine and headache patients. This document was designed to empower all physicians to contribute effectively to the management of these conditions.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"38 5","pages":"336-347"},"PeriodicalIF":0.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968566","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":"Paediatric Meningioangiomatosis PD-L1+: A Case Report.","authors":"Gabriele Gaggero, Silvia Bozzano, Antonia Ramaglia, Claudia Milanaccio, Marco Pavanello","doi":"10.20344/amp.22276","DOIUrl":"https://doi.org/10.20344/amp.22276","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"38 5","pages":"350-351"},"PeriodicalIF":0.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955703","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":"Hiperferritinemia Hereditária: Um Desafio Diagnóstico.","authors":"Mariana Gradim, Fátima Ferreira","doi":"10.20344/amp.22802","DOIUrl":"https://doi.org/10.20344/amp.22802","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"38 5","pages":"354-355"},"PeriodicalIF":0.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952897","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":"[Optimizing Hospital Referrals: From Overload to Solution].","authors":"Sara Santos Vale, Tânia Pessoa, Sara Batalha, Paula Kjollerström, Raquel Maia","doi":"10.20344/amp.22917","DOIUrl":"https://doi.org/10.20344/amp.22917","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"38 4","pages":"281-282"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787528","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":"[Hesitancy and Refusal of the COVID-19 Vaccine Among Healthcare Professionals: A Cross-Sectional Study in a Portuguese Hospital].","authors":"Vanessa Teófilo, Joana Amaro, Pedro Matos, Paulo Pinho, Salomé Moreira, Rui Ribeiro, Mariana Miller, Sofia Pinelas, Filipa Silva, Catarina Azevedo, Pedro Norton","doi":"10.20344/amp.22540","DOIUrl":"10.20344/amp.22540","url":null,"abstract":"<p><strong>Introduction: </strong>Vaccine hesitancy is recognized by the World Health Organization as a major global health threat. In the context of the COVID-19 pandemic, this issue has taken on unique dimensions. Healthcare professionals are considered one of the most reliable sources of information regarding vaccination. Their stance on immunization is a determining factor in their likelihood to recommend it to others, with potential repercussions for vaccination uptake rates in the general population. This study aimed to characterize the sociodemographic profile of healthcare professionals at a Portuguese tertiary hospital who declined COVID-19 vaccination and to analyze the reasons for hesitancy/refusal and future vaccination intentions.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in 2021, targeting healthcare professionals eligible for the completion of the primary COVID-19 vaccination schedule. Those who refused vaccination were asked to complete the \"COVID-19 Non-Vaccination Questionnaire\", which included a multiplechoice question and an open response field regarding reasons for hesitancy/refusal and future vaccination intentions. Variables analyzed included gender, age, and professional category.</p><p><strong>Results: </strong>Among the 6648 healthcare professionals in the sample, 2.3% (n = 153) declined to complete the vaccination schedule. The average age was 46 years (SD = 11), with the proportion in each age group being 1.2% aged ≤ 35 years, 2.5% aged 36 - 45 years, and 3.1% aged > 45 years. The vaccine refusal rate among all professionals of each gender was 2.3% for females and 2.4% for males. A higher proportion of refusals was observed among healthcare assistants (n = 53, 4.0%) and technical assistants (n = 13, 3.0%). Sixteen reasons for vaccine hesitancy/refusal were identified, with the most frequently reported being fear of adverse reactions (n = 31), insufficient research on vaccines (n = 22), and distrust in vaccine efficacy (n = 25). Only 28.1% (n = 43) expressed an intention to be vaccinated in the future.</p><p><strong>Conclusion: </strong>A high acceptance rate for the primary COVID-19 vaccination schedule was observed. The likelihood of vaccine refusal was similar between genders but higher among individuals over 45 years and operational support staff. The reasons for vaccine refusal that implied concerns about the vaccine's safety stood out. Further studies are needed to better understand the dynamics underlying vaccine hesitancy/refusal.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"38 4","pages":"217-227"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787524","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":"Renal Safety Issues of Intravenous Iodinated Contrast Media Are Questionable.","authors":"Bernardo Vidal Pimentel, Pedro Caiado Ferreira, Mariana Barosa","doi":"10.20344/amp.22484","DOIUrl":"10.20344/amp.22484","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"205-207"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571648","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 Unilateral Bertolotti's Syndrome.","authors":"Rita Moura de Gouveia, Janete Guimarães, Mariana Pinho Pereira, Gonçalo Costa, João Pedro Antunes","doi":"10.20344/amp.21840","DOIUrl":"https://doi.org/10.20344/amp.21840","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"38 4","pages":"264-265"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787546","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":"Carcinoid Complexity: A Syndrome Revealing Lung Tumor and Heart Disease.","authors":"Sofia R Lopes, Juliana Barata, Maria Inês Marques Vicente Lopes, Salete Valente","doi":"10.20344/amp.21387","DOIUrl":"https://doi.org/10.20344/amp.21387","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"38 4","pages":"276-277"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787500","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":"Automated Adjustment of the Fraction of Inspired Oxygen (FiO2) and the Time Spent in Normoxemia in Preterm Infants.","authors":"Gustavo Rocha, Paulo Soares, Filipa Flor-de-Lima, Rita Amaral","doi":"10.20344/amp.22397","DOIUrl":"10.20344/amp.22397","url":null,"abstract":"<p><strong>Introduction: </strong>The challenge of maintaining normoxemia in preterm infants undergoing respiratory support and oxygen therapy has led to the development of closed-loop automatic control systems for FiO2. The aim of this study was to assess the effectiveness of these systems in maintaining SpO2 within a target range (90% - 94%) in preterm neonates receiving supplemental oxygen.</p><p><strong>Methods: </strong>We conducted a single-centre prospective study over a three-year period (2020 - 2023) including preterm infants with a gestational age < 33 weeks who received supplemental oxygen within the first 24 hours of life and either invasive or non-invasive respiratory support. The closed-loop automatic control of FiO2 used was the Predictive Intelligent Control of Oxygenation feature on Fabian® ventilators. Two groups were randomized and compared, one receiving automatic plus manual control of FiO2, and the other receiving routine manual control. Uni- and multivariable regression analyses (linear or Poisson) were used to evaluate the association between the use of closed-loop automatic control of FiO2 and the parameters of manual adjustments, hypoxemia, hyperoxemia, and normoxemia.</p><p><strong>Results: </strong>The study included 89 patients, of which 45 received automatic plus manual control of FiO2 and 44 received routine manual control. The first group required fewer manual adjustments of FiO2, experienced fewer episodes of hypoxemia and hyperoxemia (p < 0.002), and spent more time with SpO2 within the target range (p < 0.001), compared to the second group. After adjustment for confounding, the total time spent in normoxemia was higher when in automatic plus manual control of FiO2 (β = 81.5; 95%CI: 47.9 - 115.2, p < 0.001).</p><p><strong>Conclusion: </strong>The use of closed-loop automatic control of FiO2 seems feasible and was associated with fewer episodes of hypoxia and hyperoxia, thereby maintaining SpO2 within normal limits for longer periods. Additionally, it has been shown to be associated with a reduction in manual interventions.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"38 4","pages":"208-216"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787551","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":"[Chronic Disease Medication Services and Comparison with the Portuguese Context].","authors":"Margarida Castel-Branco, Salomé Panta Baltazar, Hélder Mota-Filipe, Isabel Mota Figueiredo","doi":"10.20344/amp.22442","DOIUrl":"10.20344/amp.22442","url":null,"abstract":"<p><p>Over the past few years, there has been a growing effort to integrate community pharmacists into managing chronic patients with chronic disease, to alleviate the pressure on healthcare systems. Pharmacists are not only experts in medicines but also have clinical skills to promote adherence to therapy and ensure monitoring of the health status of patients with chronic disease, especially in the period between medical appointments. Chronic disease medication renewal in community pharmacies is a pharmacy service that seeks to streamline patients' access to their medication while still receiving adequate healthcare. We conducted a review of the legislation in force in different countries regarding the chronic medication renewal service and compared it with Portuguese legislation, proposing a pharmacy intervention protocol that optimizes the provision of the service. Repeat Dispensing in the United Kingdom is the service that most resembles its counterpart in Portugal: both require a 12-month medical prescription, allow access to the prescribing history (without access to clinical information). In neither of them is notification of the prescriber mandatory, both require informed consent and lead to the creation of written records of the process. Canada's Adapt a Prescription is more comprehensive because it allows prescriptions valid for 24 months, enables access to clinical information, and requires notification of the prescriber within 24 hours. Ireland's Prescription Extension is more limited in that it does not allow for therapeutic substitution, nor does it enable access to prescribing history or clinical information, requiring notification of the prescriber within seven days. In turn, Australia's Continued Dispensing and the United States' Emergency Refills differ significantly in that they do not require a long-term medical prescription, namely in situations when it is not possible to obtain a valid prescription and refusal to dispense the medicine could be life-threatening to the patient. The Chronic Medication Renewal service in Portugal arises as a response to the needs of the healthcare system and has potential in the healthcare provided to the population, specifically in the therapeutic management of patients with chronic disease.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"38 4","pages":"250-259"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787452","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}