Acta Medica Port
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ChatGPT, a language model developed by OpenAI, has been tested in several medical board examinations. This study aims to evaluate the performance of ChatGPT on the Portuguese National Residency Access Examination, a mandatory test for medical residency in Portugal. The study specifically compares the capabilities of ChatGPT versions 3.5 and 4o across five examination editions from 2019 to 2023. ⋯ Notably, ChatGPT 4o achieved scores within the top 1% in two examination editions and exceeded the median performance of human candidates in all editions. Additionally, ChatGPT 4o's scores were high enough to qualify for any specialty. In conclusion, ChatGPT 4o can be a valuable tool for medical education and decision-making, but human oversight remains essential to ensure safe and accurate clinical practice.
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Physical activity is recommended as a strategy for promoting mental health, and it can even be integrated into treatment plans for psychiatric disorders affecting the general population. However, elite athletes are a subpopulation with protective and risk factors inherent to high-level competition and are not shielded from psychiatric symptoms and conditions. The mental health of elite athletes has been the subject of increasing attention, driven in part by the initiatives of the International Olympic Committee and the growing importance of sports psychiatry. ⋯ Elite athletes do not show a significantly different prevalence of generalized anxiety disorder compared to the general population. Identifying specific protective and risk factors can contribute to adopting more effective preventive and intervention strategies. As in the general population, psychotherapy is recommended for elite athletes as the initial treatment for this condition, combined, if necessary, with pharmacotherapy, according to the World Anti-Doping Agency Code.
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Immune checkpoint inhibitor and tyrosine kinase inhibitor combinations have become the new standard of care in the first-line treatment of metastatic clear cell renal cell carcinoma. However, there is a growing concern regarding severe immune-related adverse events. A 78-year-old man with metastatic clear cell renal cell carcinoma, treated with pembrolizumab and axitinib, was admitted to the emergency department 30 days after initiating treatment due to rapidly progressive myositis. ⋯ On the eleventh day, a sudden malignant arrhythmia occurred, followed by cardiac arrest. This represents one of the first case reports describing myocarditis and myositis during treatment with pembrolizumab-axitinib. While immune checkpoint inhibitor may play a major role, it is also possible that the tyrosine kinase inhibitor, while attempting to promote immune modulation, also increases severe toxicities.
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Comment Observational Study
[Analysis of Expectations in Routine Appointments: A Cross-Sectional Study in Portugal].
Preventive medicine is a subject of study due to the increasing evidence that it can cause more harm than good, and the population's interest in routine appointments is widely recognized. The main objective of this study was to understand users' expectations regarding routine appointments in primary health care and compare them to doctors' perceptions regarding these expectations. ⋯ It is important that general practitioners / family doctors are aware of patients' expectations. In this sample, patients revealed a greater appreciation for a higher number of preventive medical measures during consultations and more periodic analytical testing than thought by the doctors. Doctors also judged that users would show greater interest in the frequent implementation of screening programs.