Acta Medica Port
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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.
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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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Estimating the prevalence of second-hand tobacco smoke exposure is a public health priority while evaluating the population-attributable disease burden and impact of smoking bans. We conducted a systematic review to analyze how secondhand tobacco smoke exposure has been assessed, and how its prevalence has been estimated among the Portuguese population since the implementation of the partial smoking ban in 2008. ⋯ A significant proportion of the Portuguese population, especially children and pregnant women, remain exposed to secondhand tobacco smoke. A comprehensive smoke-free policy is needed, not only in outdoor public places, but also in indoor private settings.
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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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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. ⋯ 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.