Scielo RSS <![CDATA[Arquivos de Medicina]]> http://www.scielo.mec.pt/rss.php?pid=0871-341320150005&lang=en vol. 29 num. 5 lang. en <![CDATA[SciELO Logo]]> http://www.scielo.mec.pt/img/en/fbpelogp.gif http://www.scielo.mec.pt <![CDATA[<b>In times of economic recession, did Portuguese adolescents stay healthy so far, but no longer happy?</b>]]> http://www.scielo.mec.pt/scielo.php?script=sci_arttext&pid=S0871-34132015000500001&lng=en&nrm=iso&tlng=en Introdução: O presente estudo tem como objetivo compreender a evolução dos comportamentos de saúde e de risco dos adolescentes portugueses desde 1998 a 2014, com especial foco no período desde 2010 que coincide com o início da crise económica em Portugal. . Métodos: O estudo conta com a participação de adolescentes incluídos no estudo HBSC-Health Behaviour in School-aged Children, desde 1998, em Portugal, sendo a amostra constituída por 28 987 jovens do 6º 8º e 10º ano de escolaridade, correspondentes a 5 séries do estudo. Resultados: Aumentou em 2014 a percentagem de jovens que referiram mal estar físico e psicológico, comportamentos autolesivos e menores expectativas de futuro, nomeadamente ir para a universidade. Regista-se ainda um aumento dos jovens que reportam situações de fome. Conclusões: Esta investigação vem reforçar a importância de prevenir os efeitos da crise económica na saúde e nos comportamentos dos jovens portugueses e aponta algumas implicações nas políticas públicas nomeadamente na educação, saúde, emprego e solidariedade. . A saúde dos adolescentes é o exemplo do conceito “Saúde em todas as Políticas”. Em tempos de recessão económica o planeamento estratégico para os jovens deve envolver todas as áreas referidas como forma única de os preparar para um futuro com saúde.<hr/>Overview: This study goal is to understand the evolution of health and risk behaviours in the Portuguese adolescents since 1998 to 2014 with a special focus on the Portuguese economic crisis. Methods: This study includes adolescents who are part of the HBSC project/study-Health Behaviour in School-aged Children since 1998 in Portugal, s 28 987 young people from the 6th, 8th and 10th grade were, corresponding to 5 sets of the study. Results: in 2014 these youngsters reported more frequently physical and psychological symptoms, self-injurious behaviours and lower expectations about the future, for example, the vast majority do not plan to go to University. It was also acknowledged that there was a significant increase in the number of young people who report hunger. Conclusion: This research reinforces the importance of preventing the effects of the economic crisis on the health and behaviour of the young Portuguese population and highlights some implications for the public policies of the education and health, employment and social sectors. Adolescent health is the paradigm of “Health in all Policies”. During economic downturn periods, youth strategic planning should integrate all the referred areas as the unique way to prepare them for a future with health. <![CDATA[<b>A clinical perspective on the utility of calcitonin and carcinoembryonic antigen for the management of medullary thyroid carcinoma</b>: <b>a review of the literature</b>]]> http://www.scielo.mec.pt/scielo.php?script=sci_arttext&pid=S0871-34132015000500002&lng=en&nrm=iso&tlng=en O carcinoma medular da tiroide (CMT) é um tumor neuroendócrino raro com origem nas células C ou parafoliculares da tiroide. Metastização ganglionar é frequente, obtendo-se taxas de cura reduzidas assim que a doença se estende para além da glândula tiroide. Apenas a ressecção cirúrgica completa do tumor em fase inicial da doença oferece possibilidade de cura. Deste modo, o diagnóstico precoce e atempado desta patologia constitui um desafio clínico e é de importância crucial ao prognóstico da doença. As células C secretam uma diversidade de péptidos e hormonas, entre os quais a calcitonina e o antigénio carcinoembrionário (CEA) constituem biomarcadores tumorais estabelecidos para o CMT. O presente artigo oferece uma revisão da literatura publicada procurando avaliar a importância e utilidade destes marcadores no diagnóstico inicial de CMT, o seu papel na decisão da estratégica cirúrgica a adotar, bem como o seu interesse na monitorização da progressão da doença.<hr/>Medullary thyroid carcinoma (MTC) is a neuroendocrine tumor of parafolicular or C-cells of thyroid. There is a high prevalence of lymph node metastases, yielding low rate of cure once disease spreads beyond the thyroid gland. Only a complete surgical resection of the tumor in the early phase of the disease can offer the chance of cure. Thus, the early diagnosis of this disease is a clinical challenge and is of crucial importance for prognosis. Thyroid C-cells elaborate a number of peptides and hormones of which calcitonin and carcinoembryonic antigen (CEA) are established markers of MTC. This article offers a review of the published literature trying to evaluate the importance and usefulness of these markers in the early diagnosis of MTC, its role in the surgical strategic decision, as well as their interest in monitoring progression of the disease. <![CDATA[<b>Association between parity and breast cancer among women in north-central Nigeria</b>: <b>an exploratory case-control analysis</b>]]> http://www.scielo.mec.pt/scielo.php?script=sci_arttext&pid=S0871-34132015000500003&lng=en&nrm=iso&tlng=en Background: Many studies conducted over the years have recognized the substantial epidemiologic evidence on the contribution of reproductive factors for the occurrence of breast carcinoma, including parity. However, most studies evaluated relatively homogeneous populations, with a small number of women with high fertility, and the association of very high parity with breast cancer remains poorly understood. Therefore, we addressed this topic in an African population characterized by high fertility rates. Methods: We conducted a case-control analysis among women that were attending the Taimako breast and cervical cancer-screening centre, which is located in Nasarawa state of North-Central Nigeria. Results: Among cases, 34.5% of the women were 39 years or less. About a quarter had ever used oral contraceptives, nearly half had attained menopause, and nearly two thirds had parity higher than 4 (parity 5-6, 32.1%; parity 7-8, 25.0%, parity =9, 7.1%). Compared to women with parity 1-4 the risk of breast cancer tended to be higher among nulliparous women (OR=3.44, 95%CI: 0.68-17.54), though it was lower among those aged =45 years (OR=1.43, 95%CI: 0.11-18.22) and higher in participants aged >45 years (OR=12.07, 95%CI: 0.62-233.00). For women with higher parity, the OR estimates were similar for those with parity 5-6 (OR=2.54, 95%CI: 0.80-8.01) and 7-8 (OR=2.65, 95%CI: 0.74-9.48). Conclusion: Our results suggest that future increase in incident breast cancer cases in this setting may result from an improvement of screening and diagnostic services, rather than from a dramatic but unlikely reduction in parity. <![CDATA[<b>Breast milk supply in hospital setting</b>]]> http://www.scielo.mec.pt/scielo.php?script=sci_arttext&pid=S0871-34132015000500004&lng=en&nrm=iso&tlng=en Introdução: Pretendeu-se comparar a prevalência de aleitamento materno entre famílias de crianças muito pré-termo e famílias de crianças de termo em contexto hospitalar, e identificar os motivos para não amamentar. Métodos: Aplicou-se um questionário estruturado a 122 famílias de crianças muito pré-termo internadas em todas as UCIN de nível III do Norte de Portugal, 15 a 22 dias após o parto (julho 2013-junho 2014) e a 385 famílias de termo no puerpério (outubro-dezembro 2014). Resultados: A prevalência de aleitamento materno foi de 96,7% (IC95% 91,8-99,1) nas famílias de crianças muito pré-termo e de 96,4% (IC95% 94,0-98,0) nas famílias de termo. A ausência de leite e a recomendação médica foram os principais motivos invocados para não amamentar. Conclusões: A elevada prevalência de aleitamento materno em contexto hospitalar é semelhante entre crianças muito pré-termo e crianças de termo. Importa compreender as circunstâncias que enquadram as opções das famílias relativamente ao aleitamento materno.<hr/>Introduction: To compare the prevalence of breast milk supply, in the hospital setting, among families of very preterm infants and families of term infants, identifying the reasons for not breastfeed. Methods: A structured questionnaire was applied to 122 families of very preterm infants and hospitalized in all level III NICU located in Northern Portugal, 15-22 days after delivery (July 2013-June 2014), and to 385 families of term infants, in the puerperium (October-December 2014). Results: The prevalence of breast milk supply was 96.7% (95%CI 91.8-99.1) in the families of very preterm infants and 96.4% (95%CI 94.0-98.0) in the families of term infants. The absence of milk and medical recommendation were the main reasons reported for not breastfeed. Conclusions: The high prevalence of breastfeeding, in the hospital setting, is similar among very preterm and term infants. It is important to understand the circumstances that frame the families’ options regarding breast milk supply.