RCAAP Repository

Marie-Antoinette Hily nasceu em França, em 1946, e doutorou-se em sociologia, em 1993, com uma tese sobre os portugueses em França. Integrou o centro de investigação Migrinter em Poitiers, França, entre 1996 e 2011. Foi diretora da Revue Européenne des Migrations Internationales, entre 2000 e 2014. É autora de uma vasta obra publicada em livros e revistas científicas sobre migrações, mobilidade residencial, circulações migratórias e redes transnacionais.

Thoracic aortic aneurysms (TAA) may grow asymptomatically until they rupture, with a mortality over 90%. The true incidence and prevalence of this condition is uncertain and epidemiologic data is scarce, understudied and dispersed. Therefore, we aimed to conduct a systematic review and meta-analysis of the incidence and prevalence of TAAs in population-based studies. We searched MEDLINE, EMBASE and CENTRAL from inception to October 2020 for all population-based studies reporting on incidence and/or prevalence of TAAs. Data were pooled using a random effects model. The main outcome was the overall available worldwide incidence and prevalence of TAAs. The secondary outcomes were to evaluate the incidence of ruptured TAAs, differences in the location of these aneurysms (either ascending, arch or descending aorta) and differences in prevalence/incidence across different study designs. Twenty-two studies were included in the review and meta-analysis. The pooled incidence and prevalence of TAAs was 5.3 per 100,000 individuals/year (95% confidence interval [CI]: 3.0; 8.3) and 0.16% (95% CI: 0.12; 0.20), respectively. The pooled incidence of ruptured aneurysms was 1.6 per 100,000 individuals/year (95% CI: 1.3; 2.1). We found a significant difference of the prevalence in autopsy-only studies, which was 0.76% (95% CI: 0.47; 1.13) and the prevalence of TAAs dropped down to 0.07% (95% CI: 0.05;0.11) when these studies were excluded from the overall analysis. The current epidemiologic information provided serve as a base for future public-health decisions. The lack of well-design population-base studies and the limitations encountered serve as calling for future research in this field.

Após catorze décadas de evolução médica e tecnológica, a endocardite infeciosa continua a desafiar médicos no seu diagnóstico e manejo diário. O aumento da incidência, alterações demográficas (afetando pacientes mais idosos), microbiologia com taxas de infeção por Staphylococcus mais elevadas, com complicações graves ainda frequentes e uma mortalidade substancial tornam a endocardite uma doença muito complexa. Apesar de tudo, a inovação no seu diagnóstico, nomeadamente na área da microbiologia e imagem, e a melhoria nos cuidados intensivos e na cirurgia cardíaca (quanto às técnicas, materiais usados e momento de intervenção) podem ter um impacto no seu prognóstico. Os desafios persistem, incluindo repensar a profilaxia, melhorar os critérios de diagnóstico incluindo a endocardite com culturas negativas e endocardite de prótese valvar, o timing para a intervenção cirúrgica, e sua realização ou não na presença de acidente vascular cerebral isquêmico e em usuários de drogas intravenosas. Uma estratégia combinada na endocardite infeciosa é fundamental, incluindo decisões e protocolos clínicos avançados, um manejo multidisciplinar, organização e políticas de saúde que culminem em melhores resultados para os nossos pacientes.

Accelerated and premature cardiovascular calcification is a hallmark of chronic kidney disease (CKD) patients. Valvular calcification (VC) is a critical indicator of cardiovascular disease and all-cause mortality in this population, lacking validated biomarkers for early diagnosis. Gla-rich protein (GRP) is a cardiovascular calcification inhibitor recently associated with vascular calcification, pulse pressure, mineral metabolism markers and kidney function. Here, we examined the association between GRP serum levels and mitral and aortic valves calcification in a cohort of 80 diabetic patients with CKD stages 2-4. Mitral and aortic valves calcification were detected in 36.2% and 34.4% of the patients and associated with lower GRP levels, even after adjustments for age and gender. In this pilot study, univariate, multivariate and Poisson regression analysis, show that low levels of GRP and magnesium (Mg), and high levels of phosphate (P) are associated with mitral and aortic valves calcification. Receiver operating characteristic (ROC) curves showed that the area under the curve (AUC) values of GRP for mitral (0.762) and aortic (0.802) valves calcification were higher than those of Mg and P. These results suggest that low levels of GRP and Mg, and high levels of P, are independent and cumulative risk factors for VC in this population; the GRP diagnostic value might be potentially useful in cardiovascular risk assessment.

Objective: To perform a systematic review and meta-analysis of all population-based studies reporting on incidence of acute aortic dissections (AADs). Methods: We searched the MEDLINE, EMBASE, CENTRAL, and Open Grey databases from inception to August 2020 for population-based studies reporting on the incidence of AAD. A systematic review was conducted following the PRISMA guidelines using a registered protocol (CRD42020204007). Data were pooled using a random effects model of proportions using Freeman-Tukey double arcsine transformation. The main outcome was the incidence of AAD. Secondary outcomes were incidence type A aortic dissections (TAAD) and type B aortic dissections (TBAD), the incidence of aortic dissection repair and medical management, and the incidence of in-hospital mortality. In addition, we estimated the proportion of aortic dissection repair and mortality (in hospital, overall and specific mortality according to subtype) among patients with AAD. Results: Thirty-three studies were included. The pooled incidence of AADs was 4.8 per 100,000 individuals/year (95% confidence interval [CI], 3.6-6.1). The incidence of TAAD was 3.0 per 100,000/year (95% CI, 1.8-4.4) and the incidence of TBAD was 1.6 per 100,000/year (95% CI, 1.1-2.2). The incidence of AAD needing repair was 1.4 per 100,000/year (95% CI, 1.0-2.0) (or 1.4 [95% CI, 1.2-1.7] for TAAD and 0.4 [95% CI, 0.2-0.7] for TBAD). The incidence of medically managed AAD was 3.4 per 100,000/year (95% CI, 2.4-4.5). The incidence of in-hospital death owing to AAD was 1.3 per 100,000 individuals/year (95% CI, 0.9-1.9), 1.0 (95% CI, 0.6-1.4; I2 = 97%) for TAAD, and 0.3 for TBAD (95% CI, 0.2-0.4; I2 = 96%). Conclusions: A global estimate regarding the incidence rate of AADs was achieved. The incidence of AAD varied significantly between study designs and geographical regions. More accurate information on AAD epidemiology is crucial for public health decisions, clinical understanding, and healthcare management.

Pesquisa encomendada pela Comissão Nacional para as Comemorações dos Descobrimentos Portugueses para integrar a Secção Documental da Revista Mare Liberum. Consta de um estudo dividido em três capítulos, publicado no nº 13, seguido de uma colecção de súmulas de documentos ordenada cronologicamente, e de uma bibliografia referindo fontes manuscritas e impressas, guias de documentação e de estudo, para além de outros utensílios, e ainda uma relação de estudos específicos. Segue-se a esta contextualização aprofundada e ao confronto de testemunhos, a publicação, no nº 14, de uma Compilação de Documentos, catorze no total, transcritos do original, cinco dos quais publicados pela primeira vez. Em virtude de razões fundamentadas no terceiro capítulo do Estudo, propõe-se uma fixação com maior rigor da data de dois pareceres anónimos que se publicam. Inquire-se ainda sobre a sua utilização por Diogo do Couto no Diálogo do Soldado Prático que trata dos enganos e desenganos da Índia e sobre a provável troca de documentos e de informações entre aquele autor e Manuel Severim de Faria. Foi publicada pela CNPCDP a Edição conjunta de estudo e compilação de documentos, em 1998 (divulgada no RUL).

Background: Depression is the most prevalent mental disorder. In the treatment of depressive symptoms, patients' religious practices and beliefs are often not considered. We carried out a systematic review and meta-analysis of RCTs to analyse the effect of religious interventions on depression. Methods: A literature screening was performed on August 2021, using the Cochrane Collaboration, PubMed, Scopus, and Web of Science databases. Primary source articles published from 2015 to August 2021 in peer-reviewed journals were eligible for inclusion if data were presented on religious interventions' effects on depression. Results: The literature search yielded 208 potentially relevant publications. Eight articles were identified and included in the review. One of the articles was excluded from the meta-analysis because it did not report the mean data for the baseline and follow-up assessment results. From the 7 out of 8 included studies, the results consistently indicated that religious-based interventions effectively reduced depressive symptoms among vulnerable persons with chronic medical illness, pregnant women, haemodialysis patients, elderly nursing home residents, people with major depressive disorders or dysthymia, and coronary artery bypass graft surgery patients. Limitations: The definition of the religious-based intervention varied substantially among the trials. These differences can make interpretation and comparing implications on the treatment of depression difficult. Conclusion: Compared to standard/other usual therapies for treating depression, religious-based interventions provide superior effects. This review and meta-analysis strongly suggest that patients' religious beliefs should be considered when diagnosing and treating depression.

Background: The COVID-19 pandemic has had a disproportionately hard impact on refugees and other migrants who are often exposed to the virus with limited means to protect themselves. We tested the hypothesis that during the COVID-19 pandemic, refugees and other migrants have suffered a negative impact on mental health and have been unjustly discriminated for spreading the disease in Europe (data collection from April to November 2020). Methods: Participants in the ApartTogether Survey (N = 8297, after listwise deletion of missing items final N = 3940) provided data regarding to their difficulties to adhere to preventive recommendations against COVID-19 infection (CARE), self-perceived stigmatization (SS), and psychological distress (PD). Structural Equation Modeling was used to investigate PD as a mediator in the pathway linking CARE to SS, while adjusting for the housing and residence status. To improve confidence in the findings, single hold-out sample cross-validation was performed using a train/test split ratio of 0.8/0.2. Results: In the exploratory set (N = 3159) SS was associated with both CARE (B = 0.200, p < 0.001) and PD (B = 0.455, p < 0.001). Moreover, PD was also associated with CARE (B = 0.094, p = 0.001) and mediated the effect of CARE on SS (proportion mediated = 17.7%, p = 0.001). The results were successfully replicated in the confirmation set (N = 781; total effect = 0.417, p < 0.001; proportion mediated = 29.7%, p < 0.001). Follow-up analyses also found evidence for an opposite effect (i.e., from SS to CARE, B = 0.132; p < 0.001), suggesting that there might be a vicious circle between the self-perceived stigmatization and the access to health care and the use of preventive measures against COVID-19 infection. Conclusions: Refugees and other migrants who had more difficulties in accessing health care and preventive measures against COVID-19 infection experienced worse mental health and increased discrimination. These negative effects appeared to be stronger for those with more insecure housing and residence status, highlighting from one side the specific risk of insecure housing in the impact of COVID-19 upon mental health and infection protection, and for another side the need to proper housing as a strategy to prevent both COVID-19 and mental distress.

Introduction: We investigated the mediating role of leisure activity engagement as marker of cognitive reserve in the relation between neighborhood socio-economic position (SEP) and cognitive decline over 6 years. Methods: The study analyzed longitudinal data from 897 older adults who participated in the two waves (2011 and 2017) of the Vivre-Leben-Vivere (VLV) survey in Switzerland (M = 74.33 years in the first wave). Trail Making Test parts A and B were administered in both waves. Leisure activity engagement was assessed during interviews. Neighborhood SEP was derived from the Swiss Neighborhood Index of Socio-Economic Position (Swiss-SEP), provided by the Swiss National Cohort (SNC). Results: Latent change score modeling revealed that 42.5% of the relationship between higher neighborhood SEP and smaller cognitive decline was mediated via a higher frequency of leisure activities in the first wave. Conclusion: Neighborhood SEP constitutes an important contextual factor potentially influencing the pathways of cognitive reserve accumulation and, therefore, should be taken into account to better understand their effects on cognitive decline in old age.

This study aimed to assess the trends of health-related cardiorespiratory fitness (CRF) during two school years with a 3-month summer break in children and adolescents. A 2-year longitudinal study, including 440 6th to 8th graders (218 boys), mean age 12.3 years, was conducted. The Progressive Aerobic Cardiovascular Endurance Run (PACER) was used to assess CRF. Physical activity was measured using accelerometers. Repeated measures linear models were used to analyses differences and trends in VO2peak and health-related CRF. Overall differences between time-point VO2peak were significant for both boys (p<0.001) and girls (p=0.003). Pairwise comparisons showed that VO2peak improved from the beginning to the end of the same school year for boys (school-year 1: 1.53 ml/kg/min, 95%CI=0.98, 2.09; school-year 2: 1.81 ml/kg/min, 95%CI=1.28, 2.34) and girls (school-year 1: 0.85 ml/kg/min, 95%CI=0.43, 1.27; school-year 2: 1.05 ml/kg/min, 95%CI=0.73, 1.36), while, differences in CRF during summer break were not significant. However, significance was only maintained for girls when performing monthly adjusted analysis. Improvements in CRF were observed during school year and remained unchanged during summer break. These findings provide relevant information for the health education community, suggesting the need for additional efforts to counteract the summer break effects on CRF, especially for girls.

Aims: The purpose of this research was to identify the needs of older persons waiting for elective open-heart surgery. Design: A qualitative exploratory design methodology, using Focus Groups. Methods: A purposive sampling technique was used. Three interviews were conducted with experienced nurses, individuals waiting for open-heart surgery (≥65years) and individuals having had open-heart surgery (≥65years); enrolling up to 17 participants from October 2019 to January 2020. Qualitative data analysis was conducted using the iteractive model and MaxQDA® software, and EQUATOR COREQ guidelines were followed. Results: Three themes were identified from the analysis of all three Focus Groups: (i) Needing health information; (ii) Needing emotional support; and (iii) Needing access to care.

The main objective of this study is to understand and characterize the adoption of an ecological perspective and the physical, psychological, social, and contextual health factors that may influence the adjustment to and mental health experiences during the COVID-19 pandemic. The study included 5479 participants, of which 3710 were female (67.7%), aged between 18 and 90 years old, with a mean age of 48.57 years (SD = 14.29), were considered three age groups: 21.5% up to 35 years old, 61.8% between 36 and 64 years old, and 16.7% 65 years old or more. The mental health and individual adjustment to the COVID-19 situation are explained by socio-demographic factors, health-related factors, lifestyles, attitudes and behaviors, lockdown experience, and place of residence. A better adaptation and mental health are observed among men, people with a higher educational level, people with lower sadness, nervousness, and burnout, and people whose health situation did not worsen with the pandemic. In terms of lifestyle, a better adaptation is related to a better quality of sleep, fewer nightmares, a higher practice of physical activity, and less consumption of processed foods and sweets. A better adaptation is also associated with lower levels of dependence on alcohol, TV, and SN (social networks) and a more positive experience of the lockdown imposed by the pandemic. Gender and age group differences in the described context were studied. Promoting a better adjustment and improved mental health when dealing with the COVID-19 requires an ecological understanding and multitarget interventions, targeting physical, mental, and social health together with the contextual environment.

O Linfoma Primário da Tiroide (LPT) é uma patologia rara que corresponde a cerca de 5% dos tumores da tiroide. O LPT pode ser classificado em Hodgkin ou não Hodgkin, podendo este último ter origem em células tipo B, que é o mais comum, ou em células T. O subtipo mais comum é o linfoma difuso de grandes células B (LDGCB), sendo seguido pelo Linfoma MALT (Mucosa Associated Lymphoid Tissue). O Linfoma de MALT da tiroide parece ter um elevado número de casos associados a Tiroidite de Hashimoto (TH), sendo que o principal sintoma é o aparecimento de uma massa indolente na região cervical anterior. O tratamento destes casos pode passar por quimioterapia, radioterapia ou cirurgia, sendo que em geral o prognóstico destes casos é favorável, tendo os pacientes uma elevada taxa de sobrevida. O caso apresentado será de uma paciente de 72 anos diagnosticada com um Linfoma MALT da tiroide e tratada com recurso a cirurgia que se encontra há 11 anos sem sinais de recidiva. Este tipo de Linfoma é uma patologia rara que pode surgir em diversos órgãos sendo mais comum no trato gastro intestinal. Locais menos comuns incluem glândulas salivares, anexos oculares, pele, tiroide e mama.

Background: Cancer patients must deal with several health challenges, including emotional distress and depressive symptoms. This study aimed to evaluate evidence from published systematic reviews and meta-analyses about the efficacy of exercise on depressive symptoms in cancer patients. Methods: We searched for previous meta-analyses of randomised controlled trials on PubMed, Web of Science and Scopus, with data inception to 30 December 2021. Two independent researchers assessed the methodological quality using the Assessment of Multiple Systematic Reviews 2 (AMSTAR2) instrument. Six meta-analyses were integrated. All included middle-aged and older adults. Five presented moderate quality, and one presented low quality. Results: Overall, a significant reduction in depressive symptoms was observed among the included studies. However, the heterogeneity between studies was high, and high-quality evidence for the efficacy of exercise on depressive symptoms was limited. Conclusions: Exercise could be a possibility in the treatment of depressive symptoms in cancer patients, especially when supervised and outside the home. The better dose of exercise needs to be clarified. More high-quality evidence is needed to better prescribe exercise to this vulnerable population.

The reader will find gathered together in this volume a selection of articles and essays that have been separately published over the past three decades as a result of my teaching practice and research activity. In chronological terms, they span a period from 1985 until May 2008. These texts were chosen because they are considered to be representative of the type of work I usually do in my classes, undoubtedly as a result of my own academic background, based on a deliberate and specific form of approach to literary texts, my own choice of English authors and, lastly, my most recent interest in inter-art studies.

Com o aumento do número de doentes submetidos a cirurgia de reconstrução do ligamento cruzado anterior (LCA) do joelho, torna-se fundamental desenvolver ferramentas que possibilitem o seu estudo e otimização. É neste contexto que surgem os registos de reconstruções do LCA. Este trabalho pretende explorar a hipótese de criação e implementação de um registo de reconstruções do LCA em Portugal, compreendendo o levantamento do estado da arte dos registos do LCA, a exploração do Registo Português de Artroplastias (RPA) e a auscultação da opinião dos médicos ortopedistas quanto à temática em estudo. Para o efeito, procedeu-se a uma pesquisa sistemática com recurso ao Google, Medline (via Pubmed) e Cohcrane Library, e ao desenvolvimento de um inquérito em formato online através da plataforma de formulários da Google, com posterior análise estatística dos dados recorrendo aos softwares Microsoft Excel e SPSS. Apurou-se que os registos do LCA encontrados assemelham-se bastante entre si, sobretudo no que diz respeito à natureza dos dados recolhidos e às metodologias de recolha, organização e divulgação dos mesmos. Caracterizam-se pela recolha de dados do pré/intra/pósoperatório através do preenchimento de formulários estandardizados, em papel ou digital, procurando envolver tanto o cirurgião como o doente, divulgando posteriormente os seus dados através de relatórios anuais. Apurou-se que o RPA foi criado e implementado após um processo complexo e moroso, envolvendo um vasto leque de entidades e respetivos apoios ou pareceres favoráveis. A sua organização está dependente de diversas comissões e tanto o seu modus operandi como a divulgação dos conteúdos assemelham-se bastante ao observado para os registos do LCA. Porém, desde 2013/2014 que o RPA não reporta a sua atividade. O inquérito realizado revelou que a maioria dos ortopedistas inquiridos considera exequível e de uma importância elevada a criação e implementação de um registo do LCA em Portugal, mostrando-se disposta a colaborar caso o projeto se concretize. No entanto, alguns inquiridos apontam as questões burocráticas, o baixo sucesso verificado com o RPA e uma provável fraca adesão global como motivos para não colaboração ou exequibilidade do projeto. Portanto, conclui-se que criar e implementar um registo do LCA em Portugal constitui uma tarefa difícil, mas exequível e desafiante. Seria necessário desenvolver formulários estandardizados para a recolha de dados, preferencialmente em formato digital, desenvolver um website e uma organização competente, reunir parceiros, apoios e financiamento, sendo também benéfico realizar um balanço formal da experiência portuguesa com um projeto semelhante, o RPA.

Health literacy entails the knowledge, motivation, and competencies to access, understand, appraise, and apply health information in order to make judgments and decisions in everyday life concerning health care, disease prevention, and health promotion to maintain or improve quality of life throughout the life course. It has become an essential concept in public health. It is considered a modifiable determinant of health decisions, health behaviors, health, and healthcare outcomes. Prior studies suggest highly variable levels of health literacy across European countries. Assessing and monitoring health literacy is critical to support interventions and policies to improve health literacy. This study aimed to describe the process of adaptation to Portugal of the short-form version of the Health Literacy Survey (HLS19-Q12) from the Health Literacy Population Survey Project 2019-2021, also establishing the health literacy levels in the Portuguese population. The sample comprised 1247 valid cases. The survey consisted of a brief questionnaire on the determinants of health literacy, plus the HLS19-Q12 questionnaire and the specific health literacies packages on digital health literacy, navigational health literacy, and vaccination health literacy. The results suggest that 7 out of 10 people in Portugal (mainland) have high health literacy levels and support the results of other studies concerning the main socioeconomic determinants of general health literacy. Furthermore, the results suggest that "navigation in the health system" tasks are the most challenging tasks regarding specific health literacies. The overall data suggest the HLS19-Q12 as a feasible measure to assess health literacy in the Portuguese population. Thus, it can be used in Portugal to assess the population's needs and monitor and evaluate policies and initiatives to promote health literacy by addressing its societal, environmental, personal, and situational modifiable determinant factors.

Introdução: A infeção associa à bolha pode surgir no contexto de uma complicação de um procedimento, a trabeculectomia, que é realizada para o tratamento do glaucoma quando a terapêutica médica não é suficiente. A beblite/endoftalmite é complicação é grave e ameaçadora para a visão, podendo desenvolver-se dias a anos após a cirurgia. Através deste trabalho pretende-se a descrição de um caso clínico representativo desta complicação. Caso clínico: Apresenta-se um caso clínico de um homem caucasiano de 77 anos com diagnóstico anterior de glaucoma de ambos os olhos e antecedentes oftalmológicos de catarata total OD, com amaurose. No sentido de controlar as pressões intraoculares elevadas (PIO) foi submetido a diversas abordagens, inicialmente iridotomia com laser YAG, posteriormente cirurgia XEN do olho esquerdo (OE). Um mês após procedimento, apresentou olho branco e implante XEN recoberto ao nível da conjuntiva. Mesmo com otimização terapêutica o doente mantém PIO elevadas do OE pelo que é submetido a trabeculectomia com mitomicina C. Mais tarde, o doente recorre por diminuição da acuidade visual e fotopsias, com valores de PIO elevados. Constata-se, a existência de uma endoftalmite associada à bolha (EAB) procedendo-se a terapêutica otimizada do OE com lavagem da câmara anterior com excisão de membrana inflamatória e VVPP 23G+ SF6 a 10% com despitalização da córnea. Sem complicações no pós-operatório. 6 meses após,o doente apresenta PIO estáveis e controladas sem alterações na biomicroscopia, mantendo apenas timolol em ambos os olhos. Discussão: Na abordagem destes doentes que desenvolvem infeção associada à bolha, é indispensável um diagnóstico e tratamento precoces para proporcionar melhor outcome visual. A bolha deve ser avaliada frequentemente para detetar sweating bleb, para evitar complicações adicionais, uma vez que a IAB continua a ser uma ameaça significativa à acuidade visual após a trabeculectomia.

O linfoma de Hodgkin de predomínio linfocitário nodular (LHPLN) é um subtipo raro de linfoma de Hodgkin (LH), representando cerca de 5% destes. É uma entidade distinta do LH Clássico, quer histologicamente quer clinicamente, com um curso mais indolente, tendência para recidivas mais tardias e transformações para linfomas mais agressivos. Não existe consenso acerca da melhor abordagem terapêutica, especialmente nos estádios avançados. Os objetivos deste estudo são: caracterização da apresentação clínica do LHPLN e da abordagem terapêutica; determinação das sobrevivências livre de doença (DFS), livre de progressão (PFS) e global (OS) e dos fatores prognósticos que as influenciam. Realizou-se uma análise unicêntrica, retrospetiva dos doentes com LHPLN diagnosticados e tratados entre 2003 e 2020, no serviço de Hematologia do IPOLFG, com seguimento mínimo de 1 ano. Foram identificados 48 doentes, com uma mediana de seguimento de 6,1 anos. A maioria (83%) obteve resposta completa a 1ª linha terapêutica, com 5 progressões e 8 recaídas, com tempo mediano até a recaída de 44 meses. A DFS aos 5 e 10 anos foi de 87,80% (IC95%: 73,04%-94,76%) e 58,54% (IC95%: 27,18%-80,24%), a PFS aos 5 e 10 anos foi de 77,57% (IC95%: 62,18%-87,31%) e 48,48% (IC95%: 20,83%-71,60%) e a OS a 5 e 10 anos de 97,73% (IC95%: 84,94%-99,68%) e 86,87% (IC95%: 47,28%-97,39%), respetivamente. Estadios avançados e envolvimento de 3 ou mais áreas nodais demonstraram ser fatores de mau prognóstico para a PFS. Verificaram-se 3 transformações para linfoma de alto grau. À data do último follow-up 94% dos doentes estavam vivos. Apesar da pequena dimensão da amostra, assim como do período de follow-up curto, confirmamos que o LHPLN é um linfoma de curso indolente e de evolução favorável. Seria importante prosseguir com um estudo multicêntrico, para verificar os resultados obtidos a nível nacional e aferir as práticas diagnósticas e terapêuticas.

Large-sided games (LSG) are commonly used in the training contexts for providing either technical/tactical or locomotor/physiological stimuli. Despite natural similarities with the official match, the locomotor profile seems to be different, which must be considered by the coaches to identify compensatory strategies for achieving the ideal dose of training. The aim of this study was two-fold: (1) to investigate the locomotor demands imposed by LSGs and the official matches; and (2) to compare the effect of different pitch sizes' LSG conditions in the locomotor demands. This study followed an observational design. Sixteen professional football players from the same team (26.3 ± 3.0 years old) were included. The study was conducted over four weeks. The same GK + 10 × 10 + GK play format with different pitch sizes (i.e., area per player ranging between 195 m2 to 291 m2) was analyzed. Three official matches were also collected in which the 10 most demanding minutes were considered for further comparisons. Only the same players who participated in matches were considered in comparison with the LSG. The data were obtained using a 10-Hz global positioning system technology. Total distance (TD) and mechanical work (MW) scores increased 20% and 23%, respectively, between the smallest and biggest pitch sizes (p < 0.001). There was a significant difference in locomotor intensity metrics between opponents from different positions on the table (p = 0.001). The biggest LSG (i.e., 291 m2 per player) was the only one that required similar levels of locomotor intensity as required in the official full match. The present study demonstrates that LSG pitch size variation requires different locomotor intensities. Bigger pitch sizes cause an increase in TD and MW. In addition, considering the position on the table, the level of opponents induces different TD covered. Finally, the largest LSG simulates the official match more accurately.