Unidade Local De Research Articles

Pediatric Allergy Management at ULSNE: Insights into Public Health Implications

Abstract Introduction Pediatric allergies present a complex challenge to public health systems, affecting both policy-making and clinical management. This study explores the management trends and challenges of pediatric allergies at the Unidade Local de Saúde do Nordeste (ULSNE) in Portugal, emphasizing its implications for refining healthcare practices over a seven-year period. Methods A retrospective review of medical records was performed, from children aged 0 to 18 who presented with allergic reactions at ULSNE’s emergency services between 2017 and 2023. The analysis concentrated on demographics, allergen types, reaction severity, and the management strategies deployed. Results The analysis revealed a wide range of allergens, from food to insect stings, with medication being the most prevalent triggers. Significant findings include observing severe allergic reactions across all age groups, highlighting the need for acute emergency interventions. The data underscores a critical demand for early diagnosis and tailored-made management plans to efficiently handle the diverse severity of allergic reactions observed. Conclusions This study demonstrates the complexity of managing pediatric allergies within ULSNE’s public health framework. Standardized, evidence-based management methods should be adopted to strengthen emergency response capabilities, as shown by the frequency of severe responses and the prevalence of various allergens. As an outcome, our results support a comprehensive, interdisciplinary strategy that includes medical personnel, educational institutions, and family involvement to create a supportive community that is supportive of both immediate care and long-term preventive measures. Subsequent efforts should give precedence to educational programs designed to increase consciousness and encourage preventive measures in community environments. Key messages • A rapid response is essential for healthcare systems to have fast, effective strategies ready for children’s severe allergic reactions. • Emphasizes a collective approach involving healthcare workers, schools, and families to prevent and manage children’s allergies, enhancing safety and awareness.

Can Breastfeeding Prevent Long-Term Overweight and Obesity in Children? A Population-Based Cohort Study.

The aims of this study were to assess the impact of exclusive breastfeeding up to 6 months of age on reducing the incidence of overweight and obesity in children up to 10 years of age and to estimate the annual incidence of obesity and overweight in the study population. Our retrospective cohort analysis using electronic health records included children from zero to ten years old, born between 1 January 2006 and 31 December 2022, followed up at the Unidade Local de Saúde de Matosinhos (ULSM). Information on their comorbidity history was collected, and positive or negative control results were defined. In the first year of life, around 29% of the children on exclusive breastfeeding were obese and 20% were overweight. This trend was reversed by the age of 9. Asthma and allergic rhinitis were used as positive control outcomes and allergic dermatitis as a negative control outcome. There seems to be no relationship between exclusive and non-exclusive breastfeeding and the development of overweight or obesity at the age of 10. The results showed that breastfeeding is associated with a lower risk of asthma in the future.

Efficacy and Safety of Diode Laser Transscleral Cyclophotocoagulation in Patients with Glaucoma.

To evaluate the efficacy and safety of transscleral diode cyclophotocoagulation (TSCPC) at 2 years of follow up. This is a retrospective review of the records of all adult patients who underwent their first TSCPC treatment between 2014 and 2019 at Unidade Local de Saúde de São João, Porto, Portugal. Data regarding intraocular pressure (IOP), best corrected visual acuity, number of IOP-lowering medications, use of oral acetazolamide, retreatments and complications during a 2-year period following TSCPC were registered. The primary outcome was overall success at 2 years, defined as IOP≥ 6 and ≤21 mmHg, with at least 20% IOP reduction from baseline, with or without IOP-lowering medications (qualified and complete success, respectively), without the development of phthisis bulbi or loss of light perception due to glaucoma and no further glaucoma procedures except TSCPC retreatment. Ninety-six eyes from 96 patients were included, mean age was 63 (±14) years. Mean IOP at baseline was 39.1 (±13.3) mmHg. Mean IOP reduction at 2 years was 18.5 (42.9%) mmHg (±16.0, min -16.0, max 56.0) (p < 0.001) and a significant reduction in the number of IOP-lowering medications and use of oral acetazolamide was observed. IOP reduction at 2 years was positively correlated with baseline IOP (r=0.682; p < 0.001). Overall success (including complete and qualified) was achieved in 42 patients (43.8%), with 34 (35.4%) presenting qualified success. Neovascular glaucoma (NVG) was the predominant diagnosis (n = 30, 31.3%), with a higher mean baseline IOP of 46.3 mmHg (±11.8, min 21.0, max 70.0) and a larger mean IOP reduction at 2 years of 24.7 (51.0%) mmHg (±16.4, min -2.0, max 55.0). Thirteen patients (13.5%) developed persistent hypotony, eight of which converted to phthisis bulbi, of which half had NVG. TSCPC can be an effective IOP-lowering procedure, demonstrating a stronger effect when the preoperative IOP is highest. However, there is a wide variability in the effect (specially in eyes with NVG) and some relevant complications, including 8.3% of patients developing phthisis bulbi after 2 years of follow up.

Robotic Colorectal Surgery: Analysis of the First Three Years of Activity in a Hospital of the Portuguese National Health Service

Minimally invasive surgery has been increasingly accepted and used in colorectal surgery. Several studies report that robotic surgery may provide advantages over 'conventional' laparoscopy, namely in rectal surgery. This paper provides an account of the first three years of experience with robotic surgery in the Unidade de Patologia Colorretal of the Unidade Local de Saúde S. José. Variables were defined to develop a prospective database containing the data of consecutive patients operated by three internationally certified colorectal surgeons using the Da Vinci Xi® system between November 2019 and October 2022. The database was converted into an anonymized version that was used for this study. The analysis was performed on the data of all the patients operated during this period. Eighty patients were included, 47 male, median age 70 years, and median BMI 26 kg/m2 . ASA score was II in 53.7% and III in 41.3% of pa- tients. Of the total, 97.6% had malignant or potentially malignant disease. Operative procedures consisted of 34 colectomies proximal to the splenic flexure, 20 distal colectomies and 26 anterior resections. There were two synchronous resections of liver metastases. Early perioperative outcomes and histopathological results were analyzed: median operative time: 300 minutes; median estimated blood loss: 50 mL; conversion rate: 2.5%; median days until first bowel movement: three days; median length of hospital stay: six days; complication rate: 20%, of which 5% were Clavien III and 0% Clavien IV/V; anastomotic leak rate: 2.5%; 30-day readmission rate: 1.3%; median lymph nodes resected: 20; R0 resection rate: 100%; mesorectal integrity rate: 95,8% complete/near complete. Our results show that the adoption of robotic colorectal surgery in our center was safe and resulted in similar or improved short-term clinical outcomes and histopathological results when compared to those described in the literature.

DNA damage targeted therapy for advanced breast cancer.

Breast cancer (BC) is the most prevalent malignancy affecting women worldwide, including Portugal. While the majority of BC cases are sporadic, hereditary forms account for 5-10% of cases. The most common inherited mutations associated with BC are germline mutations in the BReast CAncer (BRCA) 1/2 gene (gBRCA1/2). They are found in approximately 5-6% of BC patients and are inherited in an autosomal dominant manner, primarily affecting younger women. Pathogenic variants within BRCA1/2 genes elevate the risk of both breast and ovarian cancers and give rise to distinct clinical phenotypes. BRCA proteins play a key role in maintaining genome integrity by facilitating the repair of double-strand breaks through the homologous recombination (HR) pathway. Therefore, any mutation that impairs the function of BRCA proteins can result in the accumulation of DNA damage, genomic instability, and potentially contribute to cancer development and progression. Testing for gBRCA1/2 status is relevant for treatment planning, as it can provide insights into the likely response to therapy involving platinum-based chemotherapy and poly[adenosine diphosphate (ADP)-ribose] polymerase inhibitors (PARPi). The aim of this review was to investigate the impact of HR deficiency in BC, focusing on BRCA mutations and their impact on the modulation of responses to platinum and PARPi therapy, and to share the experience of Unidade Local de Saúde Santa Maria in the management of metastatic BC patients with DNA damage targeted therapy, including those with the Portuguese c.156_157insAlu BRCA2 founder mutation.

#1751 Validation of the ReDO Death Score in a Portuguese cohort

Abstract Background and Aims Mortality within the first year after dialysis start is estimated to be 20-30%, and it is mostly due to cardiovascular disease. Prognostic assessment after starting hemodialysis is challenging. Clark et al. developed the Recovery and Death Outcome risk score, which accurately predicted the likelihood of renal recovery to dialysis independence and of death within 1 year after discharge from in-hospital dialysis initiation. These models can be used at discharge or soon after patients start outpatient dialysis. We aimed to validate the Death Outcome risk score to predict one-year mortality after dialysis start in our population. Method .Retrospective analysis of hospitalized patients who initiated hemodialysis in a tertiary care hospital (Unidade Local de Saúde Santa Maria), from January 1st of 2016 to December 31st of 2019, and were discharged to outpatient dialysis. The risk of death within one year of discharge was calculated according to the ReDO score. We evaluated all-cause mortality within one year of hospital discharge. We classified patients into death outcome risk groups (labeled D1 to D4) according to the ReDO predictive score. Cox regression method was used to determine if the risk score was predictive of mortality within the first year after discharge. The discriminatory ability for the ReDO score to predict mortality was determined using the receiver operating characteristic (ROC) curve. Results 369 patients were included, with a mean age of 71.1 ± 14.3 years. The majority were male (59.9%, n = 221) and 87% were Caucasian (n = 321). The median Charlson score was 7 ± 3. The mortality rate within one year after discharge was 22.2% (n = 82). The one-year survival was significantly lower in patients with the highest probability of death (D4 = 61.3% vs. D3 = 67.6% vs. D2 = 81.3% vs. D4 = 97.3%, p &amp;lt; 0.001). The ReDO Death score accurately predicted the one-year risk of mortality, with an area under the ROC curve of 0.741, [95% CI (0.687–0.794), p &amp;lt; 0.001] (Fig. 1). The optimal REDO Death risk cut-off was &amp;gt;30%, with a hazard ratio of 6.57 [95% CI (3.48–12.2), p &amp;lt; 0.001] for one year risk of death, with a sensitivity of 78.0% and specificity of 60.6%. Conclusion We validated the ReDO score for 1-year mortality prediction after starting hemodialysis during hospitalization in a Portuguese population. This score can be used as a tool to inform goals of care discussion at the time of transition to out-of-hospital care, involving the in-hospital nephrology care team, the patient, and, if applicable, the future care team, as it can enlighten clinical decisions and, in some cases, lead to better end-of-life planning.

Dry Eye Disease Symptoms Among Glaucoma Patients at a Portuguese Hospital.

Glaucoma-related dry eye disease (DED) is often underestimated, but it is an important comorbidity affecting 40% to 59% of glaucoma patients. It may be an exacerbation of a pre-existing condition or a novel disease starting after the initiation of topical medication. The cumulative effect of medication, preservatives and excipients leads to an alteration in tear film composition and ocular surface stability. The main purpose of this investigation was to study a group of Portuguese glaucoma patients regarding the presence of DED symptoms and correlate the severity of the symptoms with the usage of different types of glaucoma topical medications. This is a cross-sectional observational study of patients diagnosed with primary and secondary open-angle glaucoma. The questionnaire Standardized Patient Evaluation of Eye Dryness (SPEED) translated to Portuguese (SPEED-Vp) was taken by patients followed in the Glaucoma Department of Unidade Local de Saúde Entre Douro e Vouga, Santa Maria da Feira, Portugal. Data was collected regarding their age, gender, type of topical medication in use as well as frequency and duration of usage. A statistical analysis was performed. A total of 75 patients answered the SPEED-Vp questionnaire. The mean age was 72 ± 7 years old. Fifty-two percent (n=39) were male, and 48% (n=36) were female patients. About 49.33% (n=37) had been on intraocular pressure (IOP)-lowering eyedrops for more than five years. About 61.43% (n=43) of patients used IOP-lowering eyedrops with preservatives. Most of the patients used prostaglandin analogs (75.71%, n=53) and beta-blockers (72.86%, n=51). SPEED score average was 2.75. About 25.33% (n=19) had no DED symptoms, 58.67% (n=44) had mild symptoms, 8% (n=6) had moderate symptoms and 8% (n=6) had severe symptoms. No statistically significant correlation was found between SPEED score and age, gender, number of eyedrop containers, number of active principles, application frequency, presence of preservatives, number of eyedrop containers with preservatives, duration of eyedrops usage or any of the medication groups. Although a high percentage of patients were on eyedrops with preservatives, this low rate of symptoms might be because patients tended to devalue these symptoms;were already on treatment with artificial tears; or have an underestimation of the sensation of dry eye due to decreased neuronal corneal nerve responses and density. These results were surprisingly positive. This might also be the result of the healthcare provider's sensibilization to this issue (early diagnosis, early prescription of artificial tears and change from preservative to preservative-free medication).

Exploring Telerehabilitation with Clynx® Platform: Usability and Impact Assessment

Telerehabilitation offers a transformative approach to physiotherapy, offering convenience, practicality, and sustainability. This paper presents a clinical study conducted at Unidade Local de Saúde do Oeste, in Portugal, involving 37 physiotherapy patients with chronic shoulder pain who utilized the Clynx® Platform for an average of 15.22 home-based sessions. Analysis of physiotherapist login data and patient travel data allowed for evaluation of platform usability, physiotherapist time management, and environmental impact. Patients highlighted schedule flexibility and time optimization as primary advantages, with 36.85% of sessions occurring on weekends and after hours, catering especially to busy professionals. In this study, telerehabilitation saved over 12,000 kilometres of travel and related expenses, while reducing carbon emissions by over 1.30 tons. The Clynx® Platform optimized physiotherapist-patient time management, saving approximately 45.30% of time in mild patient care, which could be redirected to more acute cases, potentially alleviating waiting lists in public hospitals. Telerehabilitation demonstrated positive impacts on usability, socioeconomic factors, and environmental indicators for both patients and healthcare professionals, driving the digitization of physiotherapy towards efficient, sustainable, and patientcentric care. This study underscores telerehabilitation as a promising avenue for the future of physiotherapy.

Tuberculose bovina no estado do Rio Grande do Norte com base em dados secundários

ABSTRACT: This study determined the frequency of positive tests for bovine tuberculosis in animals and breeders/establishments in Rio Grande do Norte, Brazil. Data were provided by the Instituto de Defesa e Inspeção Agropecuária do Rio Grande do Norte (IDIARN), from its Unidade Local de Sanidade Animal e Vegetal (ULSAV’S), acquired in monthly reports issued by qualified Veterinarians under the National Program for the Control and Eradication of Brucellosis and Animal Tuberculosis (PNCEBT), from June 2012 to December 2021. For diagnosis, the comparative cervical test was used as a routine and confirmatory test. A total of 45,804 cattle were tested, 53 (0.1%) of which tested positive. Secondary data are essential in the evaluation of sanitary measures, allowing rapid generation of hypotheses about diseases and providing support for decision-making. Measures such as raising awareness among producers, sanitary control in the acquisition and sale of cows for reproduction, inspection of sanitary barriers, and conducting epidemiological surveys to understand the actual situation of this disease in the state of Rio Grande do Norte are crucial.

A Comparative Study of Classification Algorithms for Early Detection of Diabetes

Diabetes is a chronic disease that affects millions of people worldwide. Early detection of diabetes is crucial for preventing or delaying the onset of its associated complications. In this study, in collaboration with Unidade Local de Saúde do Alto Minho (ULSAM), we conducted a comprehensive comparison of various classification algorithms for the early detection of diabetes. We collected and pre-processed a dataset of patient records, containing personal information, associated medical problems and drugs. The dataset was divided into training and testing sets and used to train and evaluate several popular classification algorithms. The results of our study revealed that the Multilayer Perception (MLP), Gradient Boost Machine (GBM) and Random Forest (RF) algorithms had the highest overall performance, closely followed by Support Vector Machines. These findings demonstrate the potential of these algorithms for use in the early detection of diabetes and suggest that further research is needed to refine and optimize these models for clinical use.

Identifying Diabetic Patient Profile Through Machine Learning-Based Clustering Analysis

Given the rapid growth over the past 15 years, Diabetes is currently a key issue in medical science and healthcare administration. Considering the importance of the health sector in our society, it is critical to correctly diagnose and treat Diabetes in order to avoid immediate difficulties and reduce the chance of long-term issues. The analysis of vast amounts of data that are available in organizations is an important factor to describing their internal factors, predicting future trends, and prescribing the best course of action to improve their performance in light of the increasing technological evolution and the emergence of Artificial Intelligence (AI). The main objective of this project, which is being carried out in collaboration with the Unidade Local de Saúde do Alto Minho (ULSAM), is to define a typology of diabetic patients by building Machine Learning (ML) models from registered clinical information, medication, complementary diagnostic tools, therapeutic and monitoring data, and registered medication data.

Proceedings of the 28th European Paediatric Rheumatology Congress (PReS 2022)

Proceedings of the 28th European Paediatric Rheumatology Congress (PReS 2022)

Developing a physical activity initiative for a community mental health service

Developing a physical activity initiative for a community mental health service

Seizure Exacerbation and Hormonal Cycles.

1. Diana Bordalo, MD* 2. Raquel Oliveira, MD† 3. Paula Fonseca, MD*,‡ 4. Teresa Temudo, PhD§ 1. *Department of Pediatrics, 2. ‡Adolescent Medicine Unit, Unidade de Vila Nova de Famalicao, Vila Nova de Famalicao, Portugal; 3. †Department of Pediatrics, Unidade Local de Saude do Alto Minho, Viana do Castelo, Portugal; 4. §Neuropediatric Unit, Department of Pediatrics–Centro Materno-Infantil do Norte, Centro Hospitalar do Porto, E.P.E. Porto, Portugal A 16-year-old girl presents to the pediatric emergency department after an episode of loss of consciousness, preceded by dizziness and followed by a generalized tonic-clonic seizure that lasted ∼10 minutes, with spontaneous recovery. She reports 2 previous episodes of loss of consciousness, one not witnessed, the other interpreted as a vasovagal syncope. Family history is positive for epilepsy in a great-grandmother. She has been otherwise previously healthy. Upon physical assessment, she is hemodynamically stable, nonfebrile, and has a normal neurological examination. Initial laboratory findings are normal, including urine toxicology screening, serum electrolytes, and inflammatory markers. An electrocardiography and an electroencephalography (EEG) performed 24 hours after the seizure are normal. Continuous ambulatory electrocardiography monitoring is normal. Due to the atypical seizure presentation with unwitnessed episodes, a tilt table test and a brain magnetic resonance imaging are performed, both reported as normal. During the follow-up period, the patient has recurrent seizures, and notes that these episodes follow a monthly pattern, always on the third day of the menstrual cycle. She had her menarche at ∼12 years old with irregular periods for the first 2.5 to 3 years, during which time she was seizure-free. She currently experiences some …

A guided internet-delivered individually-tailored ACT-influenced cognitive behavioural intervention to improve psychosocial outcomes in breast cancer survivors (iNNOVBC): Study protocol

BackgroundInternet-delivered interventions can provide remarkable opportunities in addressing breast cancer survivors' unmet support care needs, as they present an effective strategy to improve care coordination and provide access to efficacious, cost-efficient and convenient survivorship care. Nevertheless, research focusing on improving survivors' psychosocial needs using internet-based tools is scarce and its practical implementation is limited. ObjectivesTo study the acceptability, feasibility, efficacy and cost-effectiveness of iNNOVBC, a 10weeks guided internet-delivered individually-tailored Acceptance and Commitment Therapy (ACT)-influenced cognitive behavioural (CBT) intervention developed to improve mild to moderate anxiety and depression in Breast cancer survivors when compared to treatment as usual (TAU) in a waiting list control group (WLC). MethodsA two-arm, parallel, open label, multicentre, waiting list randomized controlled trial will be conducted to investigate the efficacy and cost-effectiveness of INNOVBC. The primary outcomes in this research will be anxiety and depression. Secondary outcomes will include psychological flexibility, fatigue, insomnia, sexual dysfunction and Health Related Quality of Life (HRQoL). Ethical approvalThis study has been reviewed and approved by Comissão Nacional de Proteção de Dados; Instituto Português de Oncologia do Porto Francisco Gentil; Unidade Local de Saúde de Matosinhos, EPE; Centro Hospitalar de São João and Ordem dos Psicólogos ethical committees. Expected resultsIt is anticipated that iNNOVBC will show to be an efficacious and cost-effective program in improving the outcomes of interest in this study, as opposed to a WLC under TAU. The results of this research will be published in accordance with CONSORT-EHEALTH guidelines. ConclusionsThis study will inform on the acceptability, feasibility, efficacy and cost-effectiveness of iNNOVBC, in improving psychosocial outcomes in breast cancer survivors when compared to TAU in a WLC. Its conclusions will contribute to understand the idiosyncrasies of designing and implementing internet-delivered interventions in breast cancer survivors.Trial Registration code: INNOVBC (NCT03275727).

&lt;br /&gt;&lt;br /&gt; SIGNIFICADO DA DOR NA EXPERIÊNCIA DA PESSOA COM DOR ONCOLÓGICA

Objective: understanding the meaning of the pain on the person´s with oncological pain experience . Method: qualitative methodology on ten oncologic patients accompanied on the pain medical consult. As an instrument for data collection, we developed partially structured interviews. To treat the data we used phenomenology. The research was approved by the Unidade Local de Saude do Baixo Alentejo Ethics´ commission. Results: after the signification unities organization, originated by the interviews procedure, the central thematics emerged, being one of them: The meaning of pain. Through the organization of the signification unities to this central thematic, one sub-thematic stood out: The description of pain. Conclusion: besides being a subjective and multidimensional experience, the chronic and oncological pain is for sure an individual and particular experience, since the meaning of pain is unique for each person, as the person who experiences it is the only one who can describe it. Descriptores: Pain. Oncology. Patient. Experience.

Hyperbaric oxygen therapy as an adjuvant to source control in necrotizing soft tissue infections

Necrotizing soft tissue infections (NSTI) are rare but potentially lethal disorders, and adequate management is time- and resource-demanding. This study aims to assess whether variations in the treatment modalities - surgery, hyperbaric oxygen (HBO₂) therapy and negative pressure wound therapy - had an impact on the length to definitive source control in NSTI patients who underwent HBO₂. This is a retrospective study of all NSTI patients treated with hyperbaric oxygen therapy between March 2007 and May 2015 at Unidade Local de Saúde de Matosinhos (ULSM) Hyperbaric Unit. A multiple linear regression model was used to assess the impact of different treatment modalities in the posdiagnosis time until source control. 58 patients were included; overall mortality was 13.8%. Mean time until source control was 10.4 days (±5.4). All patients were under empiric and broad-spectrum antibiotics on the day of diagnosis. Patients underwent an average of 0.62 (±0.29) surgical interventions and 1.06 (±0.52) HBO₂ sessions per day. The regression model (R2=0.86) showed that after adjusting for other covariates, doubling the number of HBO₂ sessions per day shortened source control by five days (? β = -5.25; 95% CI -6.49 to 4.01), and for each day that HBO₂ was delayed, source control was achieved one day later (β = 1.03; 95% CI 0.82 to 1.24). More intensive HBO₂ protocols with earlier and more frequent sessions shorten the time until definitive source control in necrotizing soft tissue infections, potentially lowering the impact of systemic effects of infection and complications associated with organ dysfunction.

Avaliação da implementação de uma consulta de cirurgia endócrina no litoral alentejano

The Unidade Local de Saúde do Litoral Alentejano (ULSLA) covers a geographical area with 100.000 inhabitants. Given the absense of an Endocrinologist in our center, patients with thyroid disease are followed by the primary health care providers and referred to Internal Medicine when necessary. Until 2010, most of the patients who needed surgery were sent to the Hospital de São Bernardo (110Km away from Hospital do Litoral Alentejano). In 2011, an Endocrine Surgery unit was created, which started to receive these patients. We present the data on the evolution of care to this condition in the Department of Surgery of the ULSLA, with a total of 118 patients operated from 2005 to 2014, 87% of which were operated on after the creation of this unit.We performed a prospective (2011‐2014) study of every patient submitted to thyroid surgery. The demographical data, the type of intervention performed, the cytological and histological characterization of the nodules, as well as the morbidity and mortality are presented.The Endocrine Surgery unit in the Hospital do Litoral Alentejano–ULSLA, created in 2011, started to give a better response to this type of condition. The prospective registry protocol allowed for an accurate evaluation of the surgical activity without loss of data. With the dedication of a team to this condition we achieved an adequate response to the population needs, with a low morbidity, according to the parameters found in literature.

Dementia in Alto Minho, a Descriptive Study.

Dementia in Alto Minho, a descriptive study. Introduction With approximately 35.6 million people with dementia worldwide, dementia has become a major focus of attention and intensive research in developed countries. In Portugalthere is still little informationabout this disease, and that’s why wepropose to characterize apopulation of patients with dementiafollowed in the outpatient neurology department of UnidadeLocal de Saude do Alto Minho (ULSAM). Objective Description of a population of 103 patientsfollowed in the outpatient neurology department of ULSAM in 2014. Methodology 103 patients followed in the outpatient neurology department of ULSAM between January and March 2014 were randomly chosen. We collectedSocio-demographic and medical data by consulting the electronic records ofpatients. Data were analyzed using SPSS version 20.0. Results The average age of patients was 77 years. There wasa predominance of females with61.17% women. The most frequent diagnosis was of mixed dementiawith 26 cases, followed by Alzheimer's disease with 24 cases and 17 cases with vasculardementia. The most widely usedanti-dementia drug was memantine. About 83% ofpatients were on some type of psychotropic medication, over 50% of patients werebeing treated with antidepressants, 42% with antipsychotic drugs, 33% with anxiolytic / hypnotic and15% with mood stabilizers. Around one third ofthe total patients had been followedin psychiatry in the last five years, mainly for depressivesymptoms, psychotic symptoms ofsenility, or behavioral disturbances. More than 50% ofpatients had 2 or more risk factors for cardio-vasculardisease, and 76.60% had high bloodpressure. Conclusion: Interestingly, in our sample there isan over representation of vascularetiology as a primary cause, orcofactor of dementia, and there is a high prevalence ofcardiovascular risk factors andparticularly arterial hypertension. Thisleads us to think that better prevention of cardio-vascular disease risksfactors and particularly hypertension could have a significant impact in the prevention of dementia in the Alto Minho. Finally we realize through the great use of psychotropicdrugs in these patients that theinvolvement of psychiatrists in their attendance is essential.

A qualidade de vida na pessoa com úlcera venosa

Having a chronic wound such as venous ulcer, results in changes in everyday life, turning a decisive role in the individual’s life. The challenge of health care is to provide to these individuals a global and integrated care, where quality of life is the primary outcome. The objectives of this study are: assess the quality of life of people with venous ulcers and analyze the influence of wound characteristics. A non-probabilistic accidental sample of 31 people with venous ulcer being cared in the health centers of a Unidade Local de Saude. For data collection, it was used the Cardiff Wound Impact Scheme and a form to register the characteristics of the wound. There was a reduction in the quality of life in the domain of wellness. The quality of life is affected by the amount of exudate and pain, and pain increases with the increase in ulcer area. Venous ulcers change the quality of life, affecting all aspects of the Cardiff Wound Impact Scheme. The characteristics of the wound, namely the amount of exudate, pain and area adversely affect the quality of life.