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Introduction: Neurodevelopmental disorders are characterized by delay or variation in the acquisition of abilities or skills in several domains of development: motor, social, language, and cognitive. These disorders can manifest from childhood to adulthood, and therefore continuity of care is essential throughout these various developmental periods. However, several studies show that there is limited access to adult health care in this clinical domain., Methods: A cross-sectional observational study was carried out by distributing an anonymous survey among psychiatry physicians, at a national level, in the period between October 6 and December 6, 2020., Results: Data was collected from 83 psychiatry physicians (43 residents and 40 specialists). At the national level, only 16.9% of psychiatric departments had a subspecialized neurodevelopment clinic. Physicians reported that they observed few patients with neurodevelopment disorders: 72.3% observed one or none per week. When there was a neurodevelopmental disorders clinic in the psychiatry department, 64.3% of physicians reported that this clinic did not include a multidisciplinary team. The transition of these patients from the pediatric/child and adolescent psychiatry department to the psychiatric department occurred through regular intrahospital transfer in 51.8% of cases, but it occurred through a specific protocol or with a transitional medical appointment in only 15.7% of cases. Finally, 88% of psychiatry physicians considered the existence of a neurodevelopmental disorders clinic in adults to be pertinent and reported not having specialized training in the field of neurodevelopment., Conclusion: This study made it possible to identify some difficulties and barriers regarding adequate access for patients with neurodevelopmental disorders throughout the various developmental stages, from childhood to adulthood: lack of training in this clinical field, need of better communication between departments, lack of specific protocols, shortage of multidisciplinary teams, and asymmetry in the distribution of differentiated care.

The aim of the present study was to estimate depressive disorder and symptomatology prevalence and incidence in perinatal period in a population-based sample. Three-hundred and eighty six Portuguese women (mean age=30.08 years, SD=4.21) were interviewed with the Diagnostic Interview for Genetic Studies and completed Beck Depression Inventory-II/BDI-II and Postpartum Depression Screening Scale/PDSS, in pregnancy and postpartum. OPCRIT polydiagnostic system generated ICD-10 and DSM-IV diagnoses. One-month prevalence in pregnancy was of 2.3%/ICD-10 and 1.3%/DSM-IV; in postpartum it was of 16.6% and 11.7%. Pregnancy incidence was of 0%/ICD-10 and .3%/DSM-IV and in postpartum of 7.5%/ ICD-10 and 4.9%/DSM-IV. Depression pregnancy point-prevalence found with BDI-II cutoffs ranged from 13.7% to 19.4% in pregnancy and from .8% to 13.0% in postpartum and with PDSS from 14.2% to 17.9% in pregnancy and from 3.9% to 12.7% in postpartum. In the same sample, different diagnostic systems generated different prevalence and incidence rates. Higher prevalence rates were found using self-reported questionnaires. ICD-10 generated higher prevalence and incidence rates than DSM-IV.

Introduction: Iron deficiency anemia is the micronutrient deficiency most prevalent in the world primarily affecting young children and pregnant or puerperal women. It is also associated with an increase in perinatal and maternal morbidity and mortality. Increasing iron demands in pregnancy are common knowledge, however the evidence of a clinical effect of routine iron supplementation in uncomplicated pregnancy is controversial., Aim: To determine if routine iron supplementation in uncomplicated pregnancy has clinical effects for the mother or newborn., Methodology: A systematic review was conducted in the electronic databases Medline, Cochrane Library, Medscape, DARE, United States Preventive Services Task Force and National Guideline Clearinghouse using the keywords iron and pregnancy. Articles published until August 2008 were chosen for the review. The Strength of Recommendation Taxonomy (SORT) was used to grade the level of evidence., Results: Routine iron supplementation in uncomplicated pregnancy increases or maintains the levels of blood iron and ferritin and results in a substantial reduction of women with low hemoglobin. However, this supplementation does not have detectable effects in any of the important clinical outcomes (p.e. preterm labor, duration of pregnancy, cesarean rate, birthweight, perinatal mortality or Apgar at birth). Iron supplementation is also responsible for some undesired effects., Discussion: The evidence seems to show that there are no clinical improvements to recommend routine iron supplementation in all pregnancies. Women who show signs or symptoms of anemia at any time during pregnancy should be evaluated.

Introduction: It is thought that in the XXI century cardiovascular disease will become the main cause of disability ant death in the world. Cardiac complaints are very common in clinical practice and the high prevalence of coronary disease and its sequels puts the family doctor in the frontline of the struggle against this pathology. This review pretends to inform about the presentation, diagnosis and urgent approach of the acute coronary syndrome as well as the need of continuity of care and secondary prevention., Review: Coronary disease can appear as a myocardial infarction and occurs predominantly in a population susceptible to atherogenesis due to various risk factors. Acute thoracic discomfort is the most usual clinical presentation and the initial evaluation intends to determine its cause through a brief clinical history, physical exam, electrocardiogram and dosing of markers of cardiac necrosis. After confirmation of the diagnosis the patient is submitted to urgent treatment that depends on the form of presentation of the acute coronary syndrome. It usually involves study of coronary anatomy by coronariography and revascularization. After the acute event the coronary patient must initiate a medical therapy with drugs that reduce mortality (antiplatelet therapy, beta-blockers, angiotensin converting enzyme inhibitors and statins) and aggressively control the modifiable risk factors., Conclusion: The family doctor has a primordial role in continuing care initiated at the hospital and in implementing aggressive secondary prevention measures. By knowing and putting them into practice, the family doctor takes his part in reducing the burden of cardiovascular diseases and in controlling this epidemic.

Introduction: Dizziness is a non specific and incapacitating symptom. Its classification is based on the patient complaints and categorized in pre-syncope, disequilibrium, lightheadness and vertigo. Vertigo is the most prevalent cause of dizziness. This article pretends to review the management of vertigo, its causes, differential diagnosis and treatment., Methods: The articles used in this review were obtained from a Medline search with the keywords vertigo and dizziness, from publications from the past 5 years in the English, Spanish and Portuguese languages., Discussion: Vertigo is the most prevalent cause of dizziness in primary care. It is caused by an asymmetric involvement in the basal activity of the central and peripheric vestibular pathways. It occurs in episodes and the intensity of this symptom diminishes as the causative factor dissipates or compensation occurs. The clinical evaluation is bases on the clinical history and physical examination. The first step in the differential diagnosis is to differentiate central vertigo from peripheral vertigo. Knowing the duration of symptoms, precipitating factors and associated symptoms and performing the Dix-Hallpike manoeuvre is important in achieving this. The treatment of vertigo must be specific and oriented to the cause, and the use of symptomatic therapy must be reserved to the acute episodes. The definite treatment are rehabilitation exercises.

Introduction: In Portugal, the medical school selection process relies exclusively on past academic results, involving the most stringent criteria of all courses, with no attention given to the personality traits of the students. In a competitive context, perfectionism dimensions may be relevant to consider. Socially Prescribed Perfectionism (SPP) has been correlated with Neuroticism, while Self-Oriented Perfectionism (SOP) is strongly associated with Conscientiousness. These domains of personality have been linked (lower levels of Neuroticism and higher levels of Conscientiousness) to academic and professional success in Medicine. The premedical syndrome describes premedical students as overachieving, excessively competitive, cynical, dehumanized, overspecialized and narrow. Our main objective was to compare SPP and SOP levels between Medical and Humanities students, as they may be possible indicators of the premedical syndrome among Portuguese medical students., Material and Methods: The Portuguese version of the Multidimensional Perfectionism Scale was administered to 908 undergraduate students from Medicine and Humanities courses of Coimbra University. The sample covered students from the 1st to the 5th year of the courses but most of the students were from the 1st year (n=436)., Results: With respect to SPP, significant statistical differences were found, with Medicine students showing lower levels (mean 48.60+/-11.02; p=0.023) than Humanities students (mean 50.00+/-9.56). No significant differences were found in SOP., Discussion and Conclusion: Our results are reassuring, suggesting the lack of a negative impact of the medical school selection process in the personality traits of the students and the probable absence of the premedical syndrome.