Implementation of Orthogeriatrics in Portugal.

Introduction: Orthogeriatrics is the subspecialty of geriatrics that is dedicated to the care of elderly patients with fragility fractures. The Orthogeriatrics Unit of the Vila Nova de Gaia Hospital Centre was the first unit created in Portugal in October 2015, in a co-management model.

Methods: Patients older than 65 years and with femur fractures were admitted to the unit after surgery.

Chylous Ascites due to Mantle Cell Lymphoma.

Unlabelled: Chylous ascites is rare and results in accumulation of lymph in the abdominal cavity, due to several mechanisms. The ascitic liquid is milky because of the high concentration of triglycerides (>200 mg/dl). The higher incidence compared to the past is explained by increased survival of patients with cancer and more aggressive surgery.

Unexplained lymphadenopathies: autoimmune lymphoproliferative syndrome in an adult patient.

Autoimmune lymphoproliferative syndrome (ALPS) is characterised by massive enlargement of the lymphoid organs, autoimmune cytopenias and a predisposition to develop lymphoid malignancies. The basic defect is a disturbance of the lymphocyte apoptosis, and a high number of circulating TCRab CD3CD4CD8 T-cells (double-negative T cells (DNT cells)). We describe a case of a 41-year-old man with fever, hepatosplenomegaly, multiple lymphadenopathy, autoimmune haemolytic anaemia and severe thrombocytopenia.

Inpatients' opinions on a hospital in Portugal.

Background: Little is known about the relationship between the opinions of inpatients and the degree to which hospitals are improving in performance over time. The aim of this study was to determine the personal assessment level of inpatients or their representatives regarding aspects of health care in an internal medicine ward.

Methods: We carried out a questionnaire in September 2011 with 284 discharged patients and patient representatives, focusing on their opinions about the department, health professionals and amenities, with response options ranging from 1 (very bad) to 5 (very good).

[Whipple's Disease: retrospective analysis of twelve cases and review of the literature].

Background: Whipple's disease is a rare and chronic bacterial disease with multiorganic involvement. Although there is no valid estimate of its actual prevalence, only about 1,000 cases have been reported.

Objective: To describe the demographic, clinical, laboratory, endoscopic and pathologic features, type of treatment used, its duration and response.

[Hyperusers and emergency].

Introduction: The emergency service is the source of medical assistance for users in need of other medical care. The hyperusers make substantial part of the emergency services and their impact on the health system is unknown.

Objective: To know the pattern of the emergency unit (UU) of Espinho's Hospital used by frequent visitors and compare them with infrequent visitors.

[Basic emergency].

The increasing demand of health care and lack of its accessibility, in the scope of the National Health Service, are the most determining factors for the use of emergency departments. These facts are reproducible in the town of Espinho in spite of its two emergency consultations working at the same time, open consultation in the primary cares and hospital unit for emergency consultation, twenty meters distant from each other. This study attempt to investigate the reasons why the inhabitants of Espinho choose the institution, based on the opinion survey performed during the first fortnight of July 2002.