[SYSVENT: Proof of Concept Study of a Prototype to Ventilate Critical Care Patients]. / SYSVENT: Prova de Conceito de um Protótipo para Ventilar Doentes em Cuidados Intensivos.

INTRODUCTION: The new coronavirus pandemic has led to scarcity of invasive ventilation resources in hospitals in several countries. In this context, the Portuguese Medical Association invited intensive care physicians who, in collaboration with SYSADVANCE S.A., developed SYSVENT OM1, a ventilator capable of operating in controlled and assisted modes (volume and pressure) and able to treat patients admitted to intensive care units. In this study we do the proof of concept comparing programmed tidal volume, inspiratory pressure and positive end-expiratory pressure with those measured by the ventilator and an external measuring equipment. MATERIAL AND METHODS: We set up the ventilator in tandem with an artificial lung and a flow analyzer. We measured expiratory tidal volume, and inspiratory pressure against three levels of compliance, each with six steps of tidal volume. Positive end-expiratory pressure was measured at 2 cmH2O incremental along eight steps. For each measurement, we performed three readings. RESULTS: Considering each of the three single variables, the mean value of the highest difference between programmed values and measured values is, for all of them, within what we considered to be acceptable for a prototype model (tidal volume = -28.1 mL, inspiratory pressure = 0.8 cmH2O and positive end-expiratory pressure = -1.1 cmH2O). This difference is greater when evaluated with the external measuring equipment in comparison with the ventilator. DISCUSSION: The results showed a good monitoring and accuracy performance. Technical limitations related with the artificial lung and the flow analyzer have been documented, which do not compromise the results, but limit their amplitude. CONCLUSION: For tested parameters, the ventilator has a good operating performance, is in accordance with the initial premises and has potential for clinical use.

Introdução: A pandemia pelo novo coronavírus provocou rotura em hospitais de vários países por falta de recursos para ventilaçãoinvasiva. Assim, a Ordem dos Médicos convidou intensivistas que, em colaboração com a SYSADVANCE S.A., desenvolveram o SYSVENT OM1, um ventilador capaz de operar em modos controlados e assistidos (volume e pressão) e apto para tratar doentes em cuidados intensivos. Neste estudo fazemos a prova de conceito, comparando volume-corrente, pressão inspiratória e pressão positiva tele-expiratória programados, com os valores medidos pelo ventilador e por um equipamento de medição externo.Material e Métodos: Montámos o ventilador em série com um pulmão artificial e um analisador de fluxos. Medimos o volume-corrente expiratório e a pressão inspiratória, em três níveis de compliance e seis patamares de volume-corrente. A pressão positiva tele-expiratória foi medida com incrementos de 2 cmH2O ao longo de oito patamares. Para cada medição realizámos três leituras.Resultados: Considerando cada uma das três variáveis isoladamente, a média da diferença máxima entre os valores programados e os valores medidos situa-se, para todas elas, dentro do que considerámos ser aceitável para um modelo protótipo (volume-corrente = -28,1 mL, pressão inspiratória = 0,8 cmH2O e pressão positiva tele-expiratória = -1,1 cmH2O). Essa diferença é maior quando avaliada com o equipamento de medição externa comparativamente com o ventilador.Discussão: Os resultados mostraram uma boa capacidade de monitorização e de precisão. Documentaram-se limitações técnicas relacionadas com o pulmão artificial e com o analisador de fluxos que não desvirtuam os resultados, mas limitam a sua amplitude.Conclusão: Para os parâmetros testados, o ventilador apresenta boa performance de funcionamento, está de acordo com as premissasiniciais e tem potencial para uso clínico.

[Correction to the article "SYSVENT: Proof of Concept Study of a Prototype to Ventilate Critical Care Patients", Published on Acta Med Port 2021 Jan;34(1):12-19.] / Errata ao artigo "SYSVENT: Prova de Conceito de um Protótipo para Ventilar Doentes em Cuidados Intensivos", Publicado em Acta Med Port 2021 Jan;34(1):12-19.

On page 13, in Table 1, first line on the third column (under 'Amplitude'), where it reads: "[0,21; 1].", It should read: "[21; 100]". Article published with errors: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14516.

Na página 13, Tabela 1, primeira linha da terceira coluna (intitulada 'Amplitude') onde se lê: "[0,21; 1]"Deverá ler-se: "[21; 100]". Artigo publicado com erros: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14516.

Long-lasting control with erlotinib in advanced non-small cell lung cancer (NSCLC). / Erlotinib no controlo tumoral prolongado do carcinoma do pulmão de não pequenas células avançado (CPNPC).

The authors present a clinical case of a caucasian male patient, 59 years-old, non-smoker, with an advanced non-small cell lung carcinoma (NSCLC), with 3 years of follow-up, received erlotinib for 18 months, after failure of more than one chemotherapy schedule, without evidence of oncologic progression. The patient evidences excellent quality of life, controlled sintomatology, recovery of the capacity of tolerance to the effort and it maintains his professional activities. The treatment with erlotinib has been well tolerated, although exhibiting grade 1 cutaneous toxicity. Rev Port Pneumol 2008; XIV (Supl 3): S9-S15.

The Portuguese Severe Asthma Registry: Development, Features, and Data Sharing Policies.

The Portuguese Severe Asthma Registry (Registo de Asma Grave Portugal, RAG) was developed by an open collaborative network of asthma specialists. RAG collects data from adults and pediatric severe asthma patients that despite treatment optimization and adequate management of comorbidities require step 4/5 treatment according to GINA recommendations. In this paper, we describe the development and implementation of RAG, its features, and data sharing policies. The contents and structure of RAG were defined in a multistep consensus process. A pilot version was pretested and iteratively improved. The selection of data elements for RAG considered other severe asthma registries, aiming at characterizing the patient's clinical status whilst avoiding overloading the standard workflow of the clinical appointment. Features of RAG include automatic assessment of eligibility, easy data input, and exportable data in natural language that can be pasted directly in patients' electronic health record and security features to enable data sharing (among researchers and with other international databases) without compromising patients' confidentiality. RAG is a national web-based disease registry of severe asthma patients, available at asmagrave.pt. It allows prospective clinical data collection, promotes standardized care and collaborative clinical research, and may contribute to inform evidence-based healthcare policies for severe asthma.

[Pericardioperitoneal shunt in the treatment of pericardial effusions in neoplasic patients]. / Derivação pericardioperitoneal no tratamento de derrames pericárdicos em doentes neoplásicos.

Neoplasia-related pericardial effusions are a frequent finding and pose diagnostic and therapeutic challenges. Although they appear in the context of an underlying neoplastic disease, 50% of these effusions have a benign etiology; they are indirectly caused by the tumor. The remaining cases (neoplastic pericardial effusions - NPE) derive from extension of tu- moral disease to the epi and/or pericardium and have, therefore, a worst prognosis. Despite several treatment options, the lack of appropriate guidelines difficults the evaluation of their efficacy and safety. Pericardioperitoneal shunt (PPS) is a surgical pericardial drainage method, which has demonstrated its usefulness in the management of NPE. At the CHC, this procedure is performed under videoassisted toracoscopic guidance (VATS). During the last 8 years, 18 patients have been submitted to this therapeutic option, which proved to be safe, efficacious and with low morbimortality rates.