Acta medica portuguesa最新文献

{"title":"[Contrast-induced neurotoxicity].","authors":"João Oliveira, Pedro Moniz, Ana Mafalda Reis","doi":"10.20344/amp.21892","DOIUrl":"10.20344/amp.21892","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"891-892"},"PeriodicalIF":0.8,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142520673","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":"Schizophreniform Disorder Related Hospitalizations: A Clinical and Demographic Analysis of a National Hospitalization Database.","authors":"Inês Teixeira da Cunha, Celeste Silveira, Alberto Freitas, Manuel Gonçalves Pinho","doi":"10.20344/amp.21714","DOIUrl":"10.20344/amp.21714","url":null,"abstract":"<p><strong>Introduction: </strong>Schizophreniform disorder manifests itself with similar symptoms to schizophrenia, but it is distinguished from the latter by its shorter duration, varying between at least one and six months. This study aimed to describe and analyze schizophreniform disorder related hospitalizations in a national hospitalization database.</p><p><strong>Methods: </strong>We planned a descriptive retrospective study using a nationwide hospitalization database containing all hospitalizations registered in Portuguese mainland public hospitals from 2008 to 2015. Hospitalizations with a primary diagnosis of schizophreniform disorder were selected based on the International Classification of Diseases version 9, Clinical Modification (ICD-9-CM) code of diagnosis 295.4x. Data regarding birth date, sex, residence address, diagnoses, length of stay, discharge status, and hospital charges were obtained. Comorbidities were analyzed using the Charlson Index Score. Independent Sample t tests were performed to assess differences in continuous variables with a normal distribution and Mann-Whitney-U tests when no normal distribution was registered.</p><p><strong>Results: </strong>In Portuguese mainland public hospitals, a total of 594 hospitalizations with a primary diagnosis of schizophreniform disorder occurred during the eight-year study period. Most, 72.1% (n = 428), were observed in male patients. The mean age at admission was 34.34 years in male patients and 40.19 years in female patients. The median length of stay was 17.00 days and in-hospital mortality was 0.5% (n = 3). Only 6.1% (n = 36) of the hospitalization episodes had one or more registered comorbidities. Forty-one readmissions were documented.</p><p><strong>Conclusion: </strong>Hospitalizations with a primary diagnosis of schizophreniform disorder occur more frequently in young male patients. This is, to the best of our knowledge, the first nationwide study analyzing all hospitalizations due to this diagnosis in Portugal.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"823-830"},"PeriodicalIF":0.8,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142138972","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":"Rebuttal to the Commentary on \"Assessment of the Implementation of the International Health Regulations during the COVID-19 Pandemic: Portugal as a Case Study\".","authors":"Guilherme Queiroz, Joana Maia, Filipa Gomes, José Chen-Xu, Joana China, Sofia Carmezim Pereira, Patrícia Pita Ferreira, José Ramalho, Joana Roque, José Pedro Teixeira, Constança Carvalho, Luis Oliveira, Diogo Simões, João Gomes, Carla Lopes, Tiago Correia","doi":"10.20344/amp.22262","DOIUrl":"https://doi.org/10.20344/amp.22262","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":"37 12","pages":"885-886"},"PeriodicalIF":0.8,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765304","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":"Purple Urine Bag Syndrome: Reporting a Case of Rare Incidence in Portugal.","authors":"Sónia Gonçalves Pereira, Olga Santos, Raquel Martins, Rafael Henriques, Margarida Cepa","doi":"10.20344/amp.22354","DOIUrl":"10.20344/amp.22354","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"895-896"},"PeriodicalIF":0.8,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602230","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":"Diagnostic Accuracy of Computed Tomography in Lymphangioleiomyomatosis.","authors":"Pedro Henrique Segatt, Marcelo De Queiroz Pereira da Silva, Thaís Nogueira Dantas Gastaldi, Márcio Luí S Duarte","doi":"10.20344/amp.22116","DOIUrl":"10.20344/amp.22116","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"811-812"},"PeriodicalIF":0.8,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278665","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":"[Assessment of the Effect of Implementing an Obesity Center of Integrated Responsibility on Hospital Performance in Portugal].","authors":"Jorge Carvalho, Adalberto Campos Fernandes","doi":"10.20344/amp.22103","DOIUrl":"10.20344/amp.22103","url":null,"abstract":"<p><p>The continuous increase in the prevalence of obesity has generated growing concern, having become an important challenge at a global level in economic and public health terms. In Portugal, the treatment of obesity presents significant problems in access to health services. In this context, there is a need to implement new management models that offer more effective responses. Centers of integrated responsibility, already implemented in this area, are a cutting-edge approach, and it is important to evaluate their performance and identify recommendations for improving the model. The main objective of this study is to assess the impact of implementing an obesity center of integrated responsibility on hospital performance. This study was conducted using a comprehensive multiple-case study approach, which was predominantly descriptive but also included explanatory elements. The methodological approach is a well-balanced mix of quantitative and qualitative analyses. The study evaluates various hospital performance indicators, encompassing the dimensions of access, production, efficiency, quality, and economic-financial, both before and after the implementation of the new model. The overall results indicate that the implementation of an obesity center of integrated responsibility led to improvements in hospital performance, particularly in the dimensions of access, production, and efficiency. While these findings are promising, the study also identifies areas for potential improvement in the model, such as organizational, functional, and legal aspects, including the method of granting incentives and the funding process. In the analyzed cases, this new organizational model proved to be a solution for improving hospital performance, particularly around obesity. These units can play a fundamental strategic role in the National Health System, contributing to access to specialized treatments, retention of professionals and financial sustainability.</p>","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"787-791"},"PeriodicalIF":0.8,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103302","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 Case of Pulmonary Lymphoepithelial-Like Carcinoma.","authors":"Mariana Tavares, Marcos Oliveira, Gonçalo Samouco, Luís Ferreira","doi":"10.20344/amp.21951","DOIUrl":"10.20344/amp.21951","url":null,"abstract":"","PeriodicalId":7059,"journal":{"name":"Acta medica portuguesa","volume":" ","pages":"807-808"},"PeriodicalIF":0.8,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142338996","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":"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}