Acta Medica Port
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The Marburg and Ebola viruses belong to the Filoviridae family and are known to cause emerging zoonotic diseases. These viruses have a high case fatality rate and are easily transmissible from person to person, which makes them capable of triggering outbreaks, including in non-endemic regions, and are also considered agents of bioterrorism. Fruit bats are the natural reservoirs of these filoviruses. ⋯ However, for the Zaire Ebola virus (EBOV), monoclonal antibodies have already been licensed for treatment and post-exposure prophylaxis, in addition to three vaccines available. Due to the public health importance and the possibility of cases outside Africa, this review aims to improve clinical knowledge and the approach to suspected cases of FD. Improved surveillance and preparedness for potential global outbreaks are essential measures to effectively respond to these public health threats and to ensure that healthcare professionals are well-informed and prepared to deal with these diseases.
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According to the Portuguese clinical guidelines published in 1999, patients with traumatic brain injury and coagulopathies should remain in-hospital for 24 hours for clinical and image surveillance, despite having an admission computed tomography (CT) scan showing no intracranial lesions. Growing evidence suggests this practice is not only void of clinical relevance, but that it can also be potentially harmful for the patient. Nevertheless, up until now there is no published data concerning the economic impact of this clinical practice. ⋯ In spite of apparently not adding any clinical value to our practice, our in-hospital surveillance may represent a significant financial and time-consuming burden, costing five times as much and demanding our medical teams twice as much work when compared to a scenario without clinical surveillance and 24-hour CT scans.
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The existence of intersected pathways between the mechanisms of insomnia, sleep-disordered breathing and persistent/chronic pain has been documented. Such concurrence will eventually contribute to a higher burden of cardiometabolic diseases, a main cause of death worldwide. The aim of this study was to evaluate the interactions between insomnia, sleep-disordered breathing, cardiometabolic risk, and psychosocial stress in patients seeking care at an orofacial pain clinic. ⋯ Prevalence data was estimated for insomnia, sleep disordered breathing/sleep apnea and increased risk of a combination of insomnia and sleep disordered breathing/sleep apnea, both regarding demographics and cardiometabolic risk factors. Psychosocial stress factors acting as additional cardiometabolic risk factors were assessed. Among patients with persistent orofacial pain, increased risk of combination of insomnia and sleep disordered breathing/ sleep apnea was present in 11.5% of cases, and it was likely to increase psychosocial stress as an aditional independent risk factor for cardiometabolic disorder.