Acta Medica Port
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Migraine is a cyclic condition with attacks consisting mainly of intense headaches, sensory intolerance, and nausea or vomiting. Loss of consciousness during attacks is often attributed exclusively to a neurally mediated reflex to pain, although it may also be due to migraine's autonomic impairment, with cardiac conduction abnormalities, probably in relation to a degree of reduced sympathetic function. We report the case of a 51-year-old woman presenting episodes of syncope exclusively after vomiting during migraine attacks. ⋯ The patient was implanted with a pacemaker without further syncopes on subsequent attacks. This case highlights the importance of clinical suspicion and investigation of syncope during migraine attacks. Recurrent syncope during migraine should not be attributed to pain to avoid misdiagnosis and ensure the treatment of other important causes of syncope.
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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. ⋯ 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.
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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. ⋯ This study underscores the importance of aligning national practices with established European recommendations to ensure the best outcomes for patients with AAV.
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The idiopathic systemic capillary leak syndrome is characterized by recurrent episodes of hypovolemia, with an unknown cause, presenting as a distributive and hypovolemic shock, due to fluid loss to the extravascular space. We describe a case of a previously healthy seven-year-old boy, who started with prodromal symptoms (abdominal pain, fatigue, nausea), followed by a fluid extravasation phase, with hemoconcentration, hypoproteinemia, and muscular edema in the abdominal wall and lower limbs, accompanied by pain - compartment syndrome. ⋯ In this case, it is possible to distinguish the three idiopathic systemic capillary leak syndromes phases, as described in the literature. Although rare, this syndrome can be fatal, and the differential diagnosis with other causes of shock represents a challenge.