Educational pathways of General Practitioners in XXX: typology, temporality and influence on medical practice

The traditional pathway leading to general practice extends from secondary school graduation to the specialized medical degree. Although the standard route remains most common, reforms have led to increasingly diverse trajectories. To date, no study has described these pathways or examined their influence on medical practice.This study analyze the educational pathways and medical practice of…

A routine case of chest pain?

Case of chest pain at primary healthcare centre walk-in clinic.50-year-old male, active smoker, history of hypertension, hypothyroidism. Ramipril 10mg, amlodipine 5mg, eutirox 200 µg. Chest pain which initiated during the night, while at rest. Irradiates to upper abdomen, bilateral neck, left jaw. Improves in right lateral decubitus. Worsens on sitting and on anterior inclination. VAS…

From a Simple Urine Dipstick to Complex Diagnoses: The Power of a Tiny Test

A 70-year-old man with no relevant medical history appear  with legs edema coinciding with the onset of warm seasonal temperatures.  While initially evaluating for peripheral venous insufficiency, a rapid urine test was performed.The urine test showed significant proteinuria, leading to urgent labs that confirmed nephrotic-range proteinuria, hipoalbuminuria, hyperlipidemia and high triglycerides. A kidney biopsy was…

Catching Our Breath: A Simple Plan to Improve Pneumococcal Vaccination in COPD

Pneumococcal vaccination is essential for preventing pneumonia and reducing exacerbations in patients with Chronic Obstructive Pulmonary Disease (COPD), a particularly vulnerable group and a priority according to national and international guidelines. At USF do Arco, pneumococcal vaccination coverage was found to be below recommended levels, prompting the development of an intervention project aimed at improving…

Looking for the culprit, a case of hard “detective work” to reach the correct diagnosis

Case report of an unusual cause of severe hypocalcemiaData extracted from patient´s elctronic medical records. 64-year-old male patient, smoker, diagnosed with high blood pressure(HBP), rheumatoid arthritis(RA), hiperuricemia, gastroesophageal reflux disease(GERD), on chronic treatment with olmesartan/hydrochlorotiazide 40/12,5mg, lorazepam 1mg, methotrexate 15mg, adalimumab, paracetamole/tramadol 650/75mg and omeprazole 40mg, sometimes prednisone added for acute pain. Followed-up by rheumatologyst…

Acral fibrokeratoma: recognizing a rare but treatable skin lesion

Dermatological conditions are common in general practice and can present diagnostic challenges. Acral fibrokeratoma is a rare, benign, slow-growing tumour, usually hyperkeratotic, affecting extremities such as fingers, toes, or nails. Although uncommon, it should be considered in differential diagnoses of acral lesions. Diagnosis is histological and treatment requires complete excision. (1)A 61-year-old previously healthy woman…

The Impact of Coordinated Care on the Rapid Diagnostic Pathway for Symptomatic Arrhythmia in an Older Adult: Case Report

A 76-year-old female presented with recurrent episodes of paroxysmal atrial fibrillation (AF) , each resulting in emergency department (ED) admissions and successful pharmacological cardioversion to sinus rhythm. Despite multiple hospitalizations between June and September 2023, the patient was discharged without recommendations for further ambulatory diagnostics. She reported daily palpitations, visual disturbances, and weakness.  PMH included…

Impact of Extension Projects in the School Health Program: Playful Activities as a Tool for Addressing Mental Health in Adolescents in Primary Care

Extension projects integrated into the School Health Program play a key role in addressing mental health concerns among adolescents. This case report describes an innovative intervention using playful educational strategies to detect and manage bullying, harassment, anxiety, and depression among adolescents aged 12–16 within primary care settings. The initiative reinforced the importance of participatory activities…

Maternal obesity and overweight

Over the past few decades, overweight and obesity have been rising, with no signs of slowing down. In spite of being an important risk factor for the development of non-communicable diseases, these conditions can cause additional complications in pregnant women and, consequently, in their children.The aim of this review was to evaluate the prevalence of maternal…

Food as medicine, food as poison – Case report: Pomegranate extract triggering acute mixed hepatocellular–cholestatic liver injury (DILI)

Background: Herbal preparations, nutraceuticals, and concentrated food extracts are increasingly consumed by patients who perceive them as natural and therefore safe. However, many of these substances significantly influence drug metabolism—most notably through cytochrome P450 and P-glycoprotein inhibition—and may contribute to drug-induced liver injury (DILI). With rising multimorbidity and polypharmacy, interactions between prescribed therapy and food-derived…