Acta Medica Port
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In Portugal, constitutional and legal norms stipulate that the healthcare system should be organized to ensure equity in access to healthcare. To guarantee this objective, it is usually assumed that individuals from different socio-economic groups presenting equal levels of need should have access to the same level of care. The present narrative review describes current knowledge on this topic. ⋯ In Portugal, equity in access has not been achieved for most types of health care. Particularly in the case of specialized health care, better-off groups of the population used more care for a given level of need. The situations where inequity exists should be examined and corrected; potential access barriers within the National Health Service should be considered, as the public healthcare system bears the responsibility for ensuring equity.
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Scabies is a common dermatological infection that globally affects more than 200 million people. It is caused by the parasite Sarcoptes scabiei var. hominis and its transmission primarily occurs through direct contact. Symptoms typically appear three to six weeks after infestation, with intense itching being the most characteristic manifestation. ⋯ Permethrin is recommended as the first-line treatment for children over two months, while ivermectin is used in more severe cases. Adherence to treatment and the disinfestation of clothing and bedding are crucial to prevent reinfestation. Early recognition and effective treatment are essential given its prevalence and significant impact on public health, particularly in pediatric populations.
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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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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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It is well known that over the last few decades, there has been significant growth of the aging population worldwide and especially in Europe, with an increase of more than two years per decade since the 1960's. Currently, in Europe, people aged over 65 years old represent 20% of the population, creating many new and complex challenges for national healthcare systems. In many countries, geriatric medicine is an established medical specialty, integrated into the primary and secondary care of the older population. ⋯ Rates of mortality after a year from femoral fractures have been proven to be three to four times higher than the expected in the general population, ranging between 15% to 36%. This emphasizes the importance of developing well-organized care pathways for these patients, which combine specialized geriatric care (also known as orthogeriatric care). This narrative review will focus on the core principles of orthogeriatric care and how medical professionals, including those who are not specialized in geriatric care, can effectively use them.