Acta medica portuguesa最新文献

Introduction: Estimating the prevalence of second-hand tobacco smoke exposure is a public health priority while evaluating the population-attributable disease burden and impact of smoking bans. We conducted a systematic review to analyze how secondhand tobacco smoke exposure has been assessed, and how its prevalence has been estimated among the Portuguese population since the implementation of the partial smoking ban in 2008.

Methods: A literature search was conducted in the Web of Science, MEDLINE and Embase databases until November 2022, applying a pre-designed search strategy and following the PRISMA 2020 guidelines. The search was not restricted by study period, study design, sample size or language, and was complemented by a manual literature search. A modified Newcastle-Ottawa scale was used to assess the quality of the studies.

Results: Thirteen cross-sectional studies were included. The prevalence of second-hand tobacco smoke exposure among the three European studies ranged from 8.2% (adult population exposed at home in 2010) to 93.3% (adolescent/adult population exposed in bar/restaurant terraces in 2016). Three nationwide studies estimated children's exposure at home: ranging from 32.6% in 2010 - 2011 to 14.4% in 2016. According to the most recent studies, 49.8% of women living in Porto were exposed during the third trimester of pregnancy in 2010 - 2011; 32.6% and 38.4% of children were exposed at home, respectively in Lisbon and the Azores.

Conclusion: A significant proportion of the Portuguese population, especially children and pregnant women, remain exposed to secondhand tobacco smoke. A comprehensive smoke-free policy is needed, not only in outdoor public places, but also in indoor private settings.

Introduction: Schizophreniform disorder manifests itself with similar symptoms to schizophrenia, but it is distinguished from the latter by its shorter duration, varying between at least one and six months. This study aimed to describe and analyze schizophreniform disorder related hospitalizations in a national hospitalization database.

Methods: We planned a descriptive retrospective study using a nationwide hospitalization database containing all hospitalizations registered in Portuguese mainland public hospitals from 2008 to 2015. Hospitalizations with a primary diagnosis of schizophreniform disorder were selected based on the International Classification of Diseases version 9, Clinical Modification (ICD-9-CM) code of diagnosis 295.4x. Data regarding birth date, sex, residence address, diagnoses, length of stay, discharge status, and hospital charges were obtained. Comorbidities were analyzed using the Charlson Index Score. Independent Sample t tests were performed to assess differences in continuous variables with a normal distribution and Mann-Whitney-U tests when no normal distribution was registered.

Results: In Portuguese mainland public hospitals, a total of 594 hospitalizations with a primary diagnosis of schizophreniform disorder occurred during the eight-year study period. Most, 72.1% (n = 428), were observed in male patients. The mean age at admission was 34.34 years in male patients and 40.19 years in female patients. The median length of stay was 17.00 days and in-hospital mortality was 0.5% (n = 3). Only 6.1% (n = 36) of the hospitalization episodes had one or more registered comorbidities. Forty-one readmissions were documented.

Conclusion: Hospitalizations with a primary diagnosis of schizophreniform disorder occur more frequently in young male patients. This is, to the best of our knowledge, the first nationwide study analyzing all hospitalizations due to this diagnosis in Portugal.

The cerebellar cognitive affective syndrome is a neuropsychiatric syndrome composed of affective (anxiety, depression, euphoria, and emotional lability) and cognitive symptoms (executive, attentional, and visuospatial deficits) that was described in the 1990s. We present the case of a 49-year-old woman with a history of an acute neurological episode at the age of 28, after which she reported a change in personality, brief and alternating periods of depression, hypomania, and mixed episodes, and cognitive impairment that had a major impact on her personal and occupational level of functioning. She was initially diagnosed with bipolar disorder, but a clinical, neuropsychological, and imaging re-evaluation prompted a diagnostic reconsideration in favor of a cerebellar cognitive affective syndrome. This enabled therapeutical and prognostic refinement. Here, we discuss the diagnostic challenges of this syndrome and the implications that an accurate diagnosis has for patients.