Acta Medica Port
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Practice Guideline
Diagnosis of Chronic Kidney Disease in Adults in Portugal: Practical Recommendations from National Clinical and Laboratory Experts.
Chronic kidney disease represents a significant public health issue, affecting approximately 9.8% of the adult population in Portugal. Despite this figure, early diagnosis of this disease in high-risk groups remains limited. Although only two parameters are essential for its diagnosis - estimated glomerular filtration rate (eGFR) and albuminuria - in Portugal, over 50% of stage 3 - 5 patients have not undergone simultaneous assessment of eGFR and albumin-uria. ⋯ This national consensus among the key stakeholders in the chronic kidney disease screening and diagnosis process culminated in the development of four practical guidelines. These guidelines will enable the consistent provision of eGFR and albuminuria measurements, regardless of the attending physician's medical specialty, the laboratory, or geographic location. Additionally, through this collective effort, experts want to raise awareness among national authorities to the need of developing new guidelines, based on scientific evidence and clinical practice, to address the underassessment of albuminuria and eGFR in this disease's management.
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Urinary tract infections are common in pediatrics. Knowledge of local resistance patterns is crucial to guide empirical antibiotic therapy. We aimed to review the pathogens implicated in urinary tract infections, local resistance patterns, and the impact of switching first-line empirical antibiotic regimens. ⋯ E.coli remains the predominant pathogen in pediatric urinary tract infections. Resistance to A-C in our sample was high (33.1%). The switch from A-C to cefuroxime as first-line agent resulted in a decreasing trend in A-C resistance, while cefuroxime resistance remained low and even slightly lower.
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Observational Study
Pembrolizumab plus Pemetrexed and Platinum in Metastatic Non-Squamous Non-Small Cell Lung Cancer: A Real-Life Study at a Portuguese Centre.
First-line therapy for metastatic non-small-cell lung cancer without targetable mutations is platinum-based chemotherapy plus pembrolizumab if programmed death ligand 1 is < 50%. The aim of this real-life retrospective study is to assess the efficacy and safety of this therapy. This retrospective observational study was conducted at the Pulmonary Oncology Department in Unidade Local de Saúde Santa Maria, in Lisbon, Portugal. ⋯ Treatment was discontinued in three patients due to adverse effects. There were no treatment-related deaths reported. With median progression-free survival and overall survival of 6.7 and 12.2 months, respectively, and no new safety signals, these results complement data from clinical trials, providing information from a real-world setting.
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A distinctive bleeding history is the first diagnostic stage of congenital hemorrhagic diseases. Furthermore, since it is in fact an assessment of the patient's phenotype, it is not a (mere) complementary diagnostic method or test - it is an integral and intrinsic step to establish the patient's clinical history, which is a medical act. The International Society on Thrombosis and Haemostasis-Bleeding Assessment Tool (ISTH-BAT) is a standardized bleeding assessment tool used during the diagnostic workup of suspected bleeding disorders. This study aimed to translate and culturally adapt the ISTH-BAT questionnaire to the European Portuguese language. ⋯ A formal translation and cultural adaptation process ensures that the new version maintains the same concepts as the original. After translation, several changes were necessary to ensure that the questionnaire was understandable by non-medical patients. We propose a European Portuguese version of the ISTH-BAT, which will require validation in further studies.