Browsing by Issue Date, starting with "2018-05-01"
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- Asthma-COPD overlap: a Portuguese surveyPublication . Padrão, E.; Araújo, D.; Bom, A. Todo; Cordeiro, C. Robalo; Sousa, J. Correia de; Cardoso, J.; Morais-Almeida, M.; Costa, R.; Pavão, F.; Leite, R. B.; Marques, A.Introduction: The overlap between asthma and chronic obstructive pulmonary disease (COPD) (ACO) has been discussed for many years but clinical recommendations for this entity have been diverse. This study is intended to reach a consensus on diagnosis, treatment and patient orientation for ACO, within the Portuguese medical community. Methods: This study was conducted by a multidisciplinary panel of experts from three distinct medical specialties (Pulmonology, Family Medicine and Immunoallergology). This panel selected a total of 190 clinicians, based on their expertise in obstructive airway diseases, to participate in a Delphi structured survey with three rounds of questionnaires. These results were ultimately discussed, in a meeting with the panel of experts and some of the study participants, and consensus was reached in terms of classification criteria, treatment and orientation of ACO patients. Results: The majority of clinicians (87.2%) considered relevant the definition of an overlap entity between asthma and COPD. A consensus was achieved on the diagnosis of ACO – presence of simultaneous clinical characteristics of asthma and COPD together with a fixed airflow obstruction (FEV1/FVC < 0.7) associated with 2 major criteria (previous history of asthma; presence of a previous history of smoking exposure and/or exposure to biomass combustion; positive bronchodilation test (increase in FEV1 of at least 200 mL and 12%) on more than 1 occasion) plus 1 minor criteria (history of atopy; age ≥40 years; peripheral eosinophilia (>300 eosinophils/μL or >5% of leukocytes); elevation of specific IgEs or positive skin tests for common allergens). A combination of inhaled corticosteroid (ICS) with long-acting beta2-agonist (LABA) or long-acting muscarinic antagonist (LAMA) was considered as first line pharmacological treatment. Triple therapy with ICS plus LABA and LAMA should be used in more severe or symptomatic cases. Non-pharmacological treatment, similar to what is recommended for asthma and COPD, was also considered highly important. A hospital referral of ACO patients should be made in symptomatic or severe cases or when there is a lack of diagnostic resources. Conclusions: This study highlights the relevance of defining ACO, within the Portuguese medical community, and establishes diagnostic criteria that are important for future interventional studies. Recommendations on treatment and patient's orientation were also achieved.
- Os deveres dos administradores das sociedades comerciaisPublication . Duarte, Rui PintoOs propósitos deste texto são apresentar um panorama dos deveres dos administradores das sociedades comerciais e discutir os conteúdos dos mais importantes desses deveres.
- Translation and adaptation of a questionnaire on the needs of postpartum adolescentsPublication . Sarreira-de-Oliveira, Paula; Néné, ManuelaOBJECTIVE: Describe the processes of translation to the Portuguese language and cultural adaptation of the Postpartum Learning Needs (PLN) to the Portuguese context. METHOD: Methodological study of an instrument that was constructed and validated in Jordan. Here are presented the procedures referring to linguistic, semantic and cultural validation, involving the stages of translation from English to European Portuguese, synthesis of translations, back-translation to the original language, expert committee, and pre-testing. RESULTS: In the translation process, some vocabulary variations were solved through consensus among translators. The expert committee found that the version translated to Portuguese presented semantic, idiomatic, cultural and conceptual equivalence, while needing some adjustments. Pre-testing was applied to 45 adolescent mothers, of whom 86.6% considered the items comprehensible. CONCLUSION: Semantic, idiomatic, cultural and conceptual equivalences were conceptually satisfactory among questionnaire versions, which is relevant for the Portuguese culture and easily understandable. It is crucial to assess the psychometric properties of the questionnaire so its adapted version can be made available.
- The past, present and future of the EU's federal experiencePublication . Coutinho, Francisco Pereira; Pires, Martinho LucasIn 2017 we celebrated the 60th anniversary of the Treaty of Rome and the 25th anniversary of the Treaty of Maastricht. The commemoration of these historic events was the perfect excuse for a critical and renewed discussion of European integration. It was also an opportunity for discussing the EU through the lens of "federalism", i.e. to look at it from the perspective of federal theory and / or through its substantive and formal dimension. This issue of Perspectives on Federalism includes papers presented in conferences organized at Warsaw University in June 2016 and at Lisbon Nova Law School on May 2017 under the Jean Monnet Project "More EU - More Europe to Overcome the Crisis". The articles discuss, either from a more general or from a more specific standpoint, within a variety of subjects, some of the federal features of the EU.