Acta médica portuguesa (Acta Med Port)

Publications in this journal

• Article: Muscle tissue changes with aging

  Ana Pereira, Aldo M. Costa, António J. Silva, Mário C. Marques
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  ABSTRACT: Sarcopenia is characterized by a progressive generalized decrease of skeletal muscle mass, strength and function with aging. Recently, the genetic determination has been associated with muscle mass and muscle strength in elderly. These two phenotypes of risk are the most commonly recognized and studied for sarcopenia, with heritability ranging from 30 to 85% for muscle strength and 45-90% for muscle mass. It is well known that the development and maintenance of muscle mass in early adulthood reduces the risk of developing sarcopenia and leads to a healthy aging. For that reason it seems important to identify which genetic factors interact with aging and in particular with the musculoskeletal response to exercise in such individuals. This review is designed to summarize the most important and representative studies about the possible association between certain genetic polymorphisms and muscle phenotypes in older populations. Also we will focuses on nutrition and some concerns associated with aging, including the role that exercise can have on reducing the negative effects of this phenomenon. Some results are inconsistent between studies and more replication studies underlying sarcopenia are needed, with larger samples and with different life cycles, particularly in the type and level of physical activity throughout life. In future we believe that further progress in understanding the genetic etiology and the metabolic pathways will provide valuable information on important biological mechanisms underlying the muscle physiology. This will enable better recognition of individuals at higher risk and the ability to more adequately address this debilitating condition.
  Acta médica portuguesa 01/2013; (in press).
• Article: Rui Lopes, Rosa Rodrigues, Isabel Domingues, Rosário Curral e António Roma-Torres (2011), Antibiomania, um episódio de mania induzido por claritromicina , Acta Med Port. ; 24(5):827-83

  Rui Lopes, Rosa Rodrigues, Isabel Domingues, Rosário Curral, António Roma-Torres
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  ABSTRACT: Antibiomania, or mania induced by antibiotics, is a rare, but important side effect of clarithromycin and others antibiotics. Although underestimated due to low clinical incidence, this phenomenon is being reported in a growing number of cases of mania associated with administration of antibiotics, in patients without a previous diagnosis of Bipolar Affective Disorder. The importance of Antibiomania in current clinical practice is associated with the increasing introduction and prescription of new antibiotics, and to the need for awareness of the phenomenon as a possible differential diagnosis of secondary mania. There are several theories that may explain Antibiomania, one of the most studied is related to the interaction of antibiotics with neurotransmitters, including the gamma butyric acid (GABA). However, the mechanism is still unknown. The authors present a case of a manic episode triggered by clarithromycin in a patient with no clinical history of disturbance of mood, followed by a brief literature review of the subject, including treatment strategies
  Acta médica portuguesa 01/2011; 24(5-24 (5)):827-83.
• Article: A Artrite e a História Clínica

  L.Silva, L.Sampaio, J.Pinto, F.Ventura
  Acta médica portuguesa 01/2011;
• Article: Acta Med Port. 2010 Sep-Oct;23(5):745-54. Epub 2010 Oct 22. [Food and beverages available in automatic food dispensers in health care facilities of the Portugal North Health Region].

  Rodrigues FG, Ramos E, Freitas M, Neto M
  Acta médica portuguesa 09/2010; 23(5):745-54.
• Article: Ethical and legal issues in late stage of dementia

  Lia Fernandes
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  ABSTRACT: ABSTRACT: As we enter the 21st century, growth of the elderly population, the costs of care, and the advances of medical science and technology will continue to have an impact on the patient-physician relationship. Transformation of the health care system will also raise ethical issues inherent to changing roles. The special nature of Alzheimer's patients and the natural course of their disease require special care on the part of physicians to meet the ethical challenges and establish medical goals, in conjunction with their patients and their families. In spite of these rapid advances in biomedical sciences, were not sufficiently developed in the most fitness answers, regarding special moral and ethical attitudes, which must be taken into account, in particular when we try to understand the experience of people with dementia. This article explores emerging issues in relation to awareness in dementia and its impact on legal and ethical matters. The different approaches and principles demonstrated in relation to ethical issues are discussed, with an exploration of the concepts of mental capacity, testamentary capacity, power of attorney, court of protection, advance directives, decision making, participation in research and treatment, informed consent and older people driving. The tensions that exist between the imperatives of doing no harm and of maintaining autonomy in addressing legal and ethical issues are highlighted. The review emphasizes the importance of considering competency and awareness as being multi-faceted, to be understood in the context of social interaction, trying to deal with the challenge of protecting, but not overprotecting, people with dementia. Late stage of dementia is a terminal disease where the goal of the care may not be prolongation of life at all costs, but rather achievement: quality of life, dignity and comfort. In the initial late dementia, quality of life is the target, treating medical problems and psychiatric symptoms. The dignity of people with severe dementia will be preserved, mostly when this influences patient's behaviour, maximizing individual Independence in daily living activities. Finally, comfort is the last and the most important goal of care in late stages of dementia, using appropriate medical strategies and eliminating aggressive interventions (cardiopulmonary resuscitation, acute care setting, tube feeding and antibiotic treatment). The future work will focus on promoting more evidence-based decision-making on treatment and guidelines for prognostic information. Physician must be knowledgeable about broadly intersecting medical, legal, finance and ethics, underlying the long-term management of dementia.
  Acta médica portuguesa 01/2008; 21 (Jan-Feb)(1):65-72.
• Article: Infecção por Pneumocystis jirovecii em imunocompetentes com patologia pulmonar, em Portugal

  MATOS O, COSTA M. C, CORREIA I, MONTEIRO P, VIEIRA J. R, SOARES J, BONNET M, ANTUNES F
  Acta médica portuguesa 01/2006;
• Article: Acta Med Port. 2006 May-Jun;19(3):225-34. Epub 2006 Sep 7. [Breast pathology: evaluation of the Portuguese scientific activity based on bibliometric indicators]. Donato HM, De Oliveira CF.

  Donato H, Oliveira CF
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  ABSTRACT: NTRODUCTION AND OBJECTIVES: The bibliometric analysis of the Portuguese scientific production in the field of breast pathology since 1995 to date (July 2005) provides an overview on the developed scientific activity on this subject and allows the characterisation of some relevant features as well as its evolution along the studied period. MATERIAL AND METHODS: Documents collected, reflecting the national scientific production in the field of breast pathology between 1995 and July 2005 in 3 databases, Medline (with search interface PubMed), Science Citation Index and Index of the Portuguese medical journals were studied. We applied quantitative and qualitative bibliometric indicators to the found number of articles and the journals where they were published. The quantitative indicators based on the number of published articles illustrate Portugal's position in the area of breast pathology within the international scientific community; further, it also allows the identification of the participation of the different institutions and national bodies, allocated by geographic areas, in scientific production as well as the establishment of international collaboration. Qualitative indicators were used to investigate the influence, and the impact of the scientific production. These are indicators based on the journal classification where the articles were published and also the citations they received. The number of citations obtained by the articles collected in the performed search, was determined, based on the Science Citation Index and the Impact Factor (IF) of the journals, which is annually published in the Journal Citation Reports (JCR). In spite of all its constraints, it is difficult not to accept the opinion that the Impact Factor is today one of the few means (if not the sole one) which enables an assessment of the influence of a journal in the international scientific community. RESULTS: During the evaluated period, the Portuguese scientific production in the selected area showed an increase of 200%. We analysed 348 documents (232 published in the selected international Databases and 16 in the national Database. We noticed that articles published by one single author are very rare, n=6 and that co-authorship is the most common way of publishing. The distribution of article production is as follows: 59% in the North Zone, 26% in the South Zone and 15% in the Central Zone of the country. The national institutions with a higher rate of publishing in renowned international journals are IPATIMUP, IPO Porto and IPO Lisboa. The institutions which publish the larger number of papers in Portuguese journals are Hospitals and Health Centres. The international journals selected by the national scientists present a high impact factor. In the whole of the 232 articles selected in the international databases, 81 have not received any citation and 120 obtained a total of 1.856 citations. It should be noted that the more recent articles have not yet received citations. The articles resulting from international collaboration, were those receiving an higher rate of citations. CONCLUSIONS: An increase of the investigation in breast pathology is observed, this being illustrated by the increase in the number of articles published in well-recognized international journals. It is also noticed a trend to publish in journals with a higher impact factor as well as an increasing role of co-authorship and international collaboration.
  Acta médica portuguesa 01/2006; 19(3):225-34.
• Article: Intracellular Ca2+ concentration in the N1E-115 neuronal cell line and its use for peripheric nerve regeneration. J M Rodrigues, A L Luís, J V Lobato, M V Pinto, A Faustino, N Sooraj Hussain, M A Lopes, A P Veloso, M Freitas, S Geuna, J D Santos, A C Maurício

  J M Rodrigues, A L Luís, J V Lobato, M V Pinto, A Faustino, N Sooraj Hussain, M A Lopes, A P Veloso, M Freitas, S Geuna, J D Santos, A C Maurício
  Acta médica portuguesa 09/2005; 18(5):323.
• Article: [Central nervous system lesions in Adams-Oliver syndrome].

  L P da Silva, F Leal, G C Santos, J M Amaral, M J Feijóo
  Acta médica portuguesa 12/2001; 14(4):455-6.
• Article: Imunodeficiência primária por défice de ZAP-70

  L.T. Barata, R. Henriques, C. Hivroz, E. Jouanguy, A. Paiva, A.M. freitas, H. Brêda Coimbra, A. Fisher, H. Carmona Mota
  Acta médica portuguesa 01/2001; 14(4):413-417.
• Article: [Liver involvement in HIV infection and various parasitic diseases].

  A Meliço-Silvestre, S Da Cunha
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  ABSTRACT: During the course of systemic infections, the liver is an organ which is frequently involved. The pathology of the human immunodeficiency virus with all its infections, opportunistic tumours and some parasitoses, such as amebiasis, kala-azar, hydatidosis, schistosomiasis and fascioliasis, evolve into hepatic compromise. This development is what we attempt to summarise.
  Acta médica portuguesa 01/2000; 12(12):345-55.
• Article: [Etiologic diagnosis of viral meningitis. Study of 142 cases].

  J A Nogueira, J Simões, N Pontinha, A Pinto, A Freitas-Fonseca, H Lecour
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  ABSTRACT: Viral meningitis is a common disease, most often benign and striking predominantly children. In 1997, there was an outbreak of viral meningitis in the North of Portugal and this pathology accounted for 496 admissions to the Infectious Diseases Department of S. João Hospital. The authors' aim was to determine the etiology of the cases of viral meningitis admitted to the S. João Hospital by, in a first phase, searching enterovirus and serology for mumps in a sample of 142 patients with symptoms, signs and cerebrospinal fluid (CSF) cytochemical abnormalities typical of viral meningitis, in the absence of any bacterial or fungal growth (in blood and/or CSF) and with negative soluble bacterial antigens in CSF. The enterovirus was detected by polymerase chain reaction (PCR) and, in a small number of cases, by shell vial culture. The diagnosis of mumps was made by the detection of specific IgM antibodies in serum, using an enzyme-linked immunosorbent assay. The diagnosis was reached in 70 patients (49.3%): 47 (33.1%) had mumps meningitis and 23 (16.2%) enterovirus infection (PCR positive in all; culture positive in only 2 cases). In 72 patients (50.7%), the agent was not identified. Although only two agents were searched for, the diagnosis was made in a high proportion of cases. The culture method used for the isolation of enterovirus was found to have a low sensitivity.
  Acta médica portuguesa 01/2000; 12(12):341-4.
• Article: [Infective endocarditis].

  R Proença, A Serrano, T Martins, J Machado, F Maltez, F Coutinho, A Morgado
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  ABSTRACT: Two different series of patients with Infectious Endocarditis (IE), hospitalized in the same ward of Curry Cabral Hospital in Lisbon, are presented and compared. The two series were separated by a ten-year period--the first included patients observed from 1970 to 1976 and the second from 1988 to 1998. In the first series (20 patients), IE occurred mainly in patients with previous cardiac valvular lesion, the course was subacute and Streptococcus viridans was the predominant agent. In the last series (65 patients), most of the patients were young and had no previous valvular lesions. Right side endocarditis predominated and the course was acute. Most of patients were drug addicts and had HIV infection. Staphylococcus aureus was the predominant agent. The ages of the two series were significantly different (p < 0.005). The diagnostic value of transthoracic and transesophageal echocardiography is stressed. The details of the evolution of patients with HIV infection are presented according to the values of CD4+ lymphocyte counts. The relatively good prognosis of IE in drug addicts with antibiotic treatment, even with HIV infection, is emphasized.
  Acta médica portuguesa 01/2000; 12(12):381-6.
• Article: [Human immunodeficiency virus type 2 infection].

  K Mansinho
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  ABSTRACT: The isolation of a second retrovirus, HIV-2, led to fears that a second AIDS pandemic, similar in scope and magnitude to that caused by HIV-1, might ensue. However, the peculiar biologic properties of HIV-2, namely the lower transmissibility of this virus through both sexual and vertical routes, contributed to a more regionalized distribution of the virus, which became endemic in West Africa. HIV-2 is genetically more closely related to SIV than to HIV-1. When it comes to clinical disease, the spectrum of opportunistic infections and tumors (except for Kaposi sarcoma) are similar to that observed with HIV-1. Controlled longitudinal studies suggest that the rate of progression to advanced HIV related disease and mortality are far lower for HIV-2 than for HIV-1. Understanding how, immunologically and virologically, HIV-2 behaves differently from HIV-1 may provide some insight into the mechanisms governing HIV-1 pathogenesis.
  Acta médica portuguesa 01/2000; 12(12):367-70.
• Article: [Rickettsia infections in Portugal].

  J Oliveira, R Côrte-Real
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  ABSTRACT: After a brief introduction about rickettsioses, we analyse Mediterranean Spotted Fever (MSF) in Portugal, and review Portuguese medical literature. We focussed on the seasonal summer pattern of the disease. MSF is very frequent in Portugal, nearly 1,000 cases are reported every year and young age groups are the most afflicted. Although usually regarded as a benign condition, MSF has emerged as a potentially lethal disease in recent years. The clinical presentation is protean, but usually suggestive enough to allow a clinical diagnosis. The complications are well documented, elderly and people with chronic debilitating diseases being the most affected. Q fever is also endemic in Portugal, although with more modest numbers (about 50 cases a year). Serological studies, however, suggest a higher incidence, probably because the disease is unfamiliar to many clinicians and, as such, it is difficult to diagnose and, consequently, then an important number of subclinical or self-limited cases. In Portugal, fever with hepatic involvement is the most common clinical presentation. Other less frequent clinical forms are atypical pneumonia and CNS involvement. Chronic Q fever is a rare condition.
  Acta médica portuguesa 01/2000; 12(12):313-21.