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Browsing by Issue Date, starting with "2020-10-01"

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  • Compreensão Emocional da Morte Pelas Crianças em Idade Pré-escolar: Uma Dimensão Esquecida
    Publication . Silva, Filipa Martins; Lopes, Ana Filipa; Carneiro, Vânia; Campelo, Álvaro
    Introdução: É ainda parca a evidência científica quanto ao entendimento que as crianças têm sobre o conceito de morte, recentemente apontado pela International Children’s Palliative Care Network como área prioritária de investigação. Em particular, a evicção da emoção nesta área de investigação é uma lacuna importante. Este estudo visa desenvolver uma visão aprofundada da dimensão emocional da compreensão da morte pela criança, procurando, também, relacioná-la com a dimensão cognitiva. Material e Métodos: Entrevistámos crianças (três a seis anos), com recurso a um livro ilustrando o cenário hipotético em que uma criança se deparava com a de morte de um familiar. Colocámos questões para avaliar os subconceitos cognitivos da morte e a dimensão emocional (o que sentiria a criança e o que lhe devia ser dito pelos pais). Resultados: Dos 54 participantes, a maioria disse que a criança se sentiria triste (n = 46, 85%) e que os pais deveriam informá-la (n = 47, 87%); estas respostas não variaram significativamente com a idade. A compreensão cognitiva do conceito de morte das crianças que referiram a tristeza foi significativamente superior. Discussão: Mesmo as crianças mais pequenas sentem a morte, não sendo possível desligar as compreensões cognitiva e emocional. Adicionalmente, as crianças devem ser informadas, com vista a uma elaboração adequada e multidimensional da morte. Conclusão: Este estudo fornece informação valiosa aos profissionais de saúde e outros adultos interessados sobre a forma como a criança em idade pré-escolar se posiciona em relação à morte.
    2020-10-01Journal article Open access Show more
  • Impact of the COVID-19 Pandemic on Ophthalmology Residency Training in Portugal
    Publication . Silva, Nisa; Laiginhas, Rita; Meireles, Angelina; Barbosa Breda, João
    Introduction: The purpose of this study was to provide objective and real-life data concerning the impact of the COVID-19 pandemic on ophthalmology residency training in Portugal. Material and Methods: Descriptive survey-based study applied to current Portuguese ophthalmology residents (n = 80 eligible). Results: Seventy-five residents participated (94% response rate). All except one (99%) admitted a change in their routine clinical practice during the pandemic, and most (89%) continued to be engaged in ophthalmology department duties. Twenty-five percent were deployed to COVID-19 units, which was combined with ophthalmological activities in about half of them (47%). A significant proportion of participants stated that they were enrolled in the following ophthalmological activities: emergency/inpatient care (87%), outpatient visits (73%; general 70% vs subspecialty 29%), and surgical procedures (64%). Twenty-five percent did not assist in any outpatient visits and 36% did not participate in any surgical procedures. On a scale from 1 (no impact) to 5 (maximum impact), most participants classified their perceived negative impact of the pandemic on the training program as 3 (24%), 4 (40%), or 5 (27%). Participants highly agreed with the extension of the residency program (80%) in order to to make up for training disruption. Discussion: Most trainees provided ophthalmological care during the pandemic. However, those clinical activities were essentially related to general and emergency care. Surgical experience was significantly curtailed. As such, strategies are needed to guarantee a high-quality learning process. Further studies are required to develop an international perspective on how ophthalmology training programs have been affected so that educational organizations can make recommendations regarding standardized adjustments to training programs. Conclusion: The COVID-19 pandemic has significantly impacted the training of ophthalmology residents nationwide.
    2020-10-01Journal article Open access Show more
  • Oral ulcer as presentation of cavitating pulmonary tuberculosis
    Publication . Fragoso, Joana; Oliveira, Mariana Marques; Gonçalves, Celina; Méndez, Josefina; Sarmento-Castro, Rui
    Tuberculosis is an indolent infection that can invade any organ. Although the most frequent form of presentation is pulmonary, it can have an extra-pulmonary presentation, including rare cases of oral tuberculosis. We present a clinical case of a 44 year-old man, active smoker, with an ulcerated lesion on the posterior third of the tongue, initially interpreted as a probable neoplasm. The pathological study of the biopsy performed on the lesion, showed alterations compatible with a chronic granulomatous process and the presence of acid-fast bacilli. The concomitant diagnosis of pulmonary tuberculosis was made in a subsequent study. The patient started therapy with isoniazid, rifampin, pyrazinamide and ethambutol with complete resolution of the oral lesion and pulmonary tuberculosis. This case exemplifies the importance of including tuberculosis in the differential diagnosis of ulcerated and neoformative lesions and the value of performing a microbiological study alongside the pathological one.
    2020-10-01Journal article Open access Show more