In the community, malnutrition is manifested by the loss of muscle mass, being associated with a decrease in muscle strength, an increased risk of frailty, functional impairment and impaired healing of chronic wounds, as well as a higher incidence of infections. It is estimated that malnutrition affects one in three elderly people at home and one in three patients in elderly care institutions. Malnutrition is reversible as long as the patient has access to timely nutritional screening that identifies their nutritional risk and as long as an individualized nutritional intervention is instituted. Disease associated malnutrition continues to be perceived as a secondary problem in primary health care, so the implementation of nutritional risk screening, as a routine parameter, is the first step in improving access to nutritional care in the community. In this article, the Malnutrition Universal Screening Tool is proposed for routine nutritional screening in primary care.

Introduction: Emergency Department (ED) overcrowding and inadequate use are widespread challenges. Telephone triages (TTs) are among the most studied solutions. The Portuguese "Call First, Save Lives" (CFSL) innovative project implemented a pre-hospital telephone triage (SNS24) to optimize patient referral pathways (RPs). This study provides the first patient-centered integrated evaluation of its implementation at the Local Health Unit of Braga (LHUB). Methods: A questionnaire was applied to a convenience sample of 128 adult patients attending the LHUB Emergency Department (July-September 2025), assessing sociodemographic characteristics, referral pathways and patient satisfaction. Clinical data and ED-episode outcomes were extracted from health records. Results: A clear gap between the project's awareness (93.8%) and actual SNS24-referrals (24.2%) was found. Self-referral predominated (56.3%). Most patients (58.6%) did not contact the line, mentioning perceived urgency, undesirable operational barriers (such as excessive waits and unanswered calls) or simply not considering it. Understanding of the "Call First, Save Lives" benefits was limited, and satisfaction was low (2.98/5) and significantly associated with the RP (p=0.004).             Primary care services (PCS) were largely bypassed, despite high Family Physician coverage (89.8%) and satisfaction (80.9%).             Referral pathways did not influence waiting time or triage category. Older age was a significant predictor of not contacting (p=0.016) nor being referred by SNS24 (p=0.043). Conclusion: The "Call First, Save Lives" project at the Local Health Unit of Braga still faces significant implementation challenges. Self-referral persists within a saturated system, where “calling first” has yet to demonstrate measurable impacts. Misconceptions about telephone triages and primary care service, along with limited health literacy, sustain direct ED access. These findings underscore the need to optimize SNS24 performance, triage algorithms and patient engagement.

Introduction: A large number of patients from primary health care are referred to the hospital emergency department daily. The aim of our study is to identify the major reasons for that, the approach in the emergency department and the destination of these patients. Material and Methods: Descriptive study. All patients from primary health care (PHC) were selected at ARS Alentejo Central, referred to the emergency department (ED) of Hospital Espírito Santo de Évora, for the specialty of Internal Medicine, in the month of January and July 2017. To perform the statistical analysis, the Speed Statistics® (SPSS) was used. Results: About 15% of patients admitted to the emergency department are from PHC and 50% of these are forwarded for internal medicine. About 57% of patients have priority and the most frequent reason for referral is respiratory symptoms. A major conclusion carries out complementary diagnostic tests. It was found that 75% of the admitted patients were discharged to the home, 25% of whom had no acute pathology or had not been diagnosed in the ED. Discussion and Conclusion: More studies are necessary to identify the gaps in the path of the patient with acute pathology and what motivates the transfer of patients from PHC to ED. It is necessary to reflect and change the strategy, with the objective of improving the efficiency of the national health system, culminating in greater comfort for the patient. It would also be attractive to make multidisciplinary teams, in support of PHC, to discuss cases of acute pathology and decide on the best diagnostic and therapeutic approach. In this way, it would be possible to reduce the consumption of resources, creating a more patient-centred approach.

Background: Overweight and obesity affect 53.6% of the Portuguese population and it is growing [1]. Body fat excess increases the risk of developing insulin resistance, cardiovascular, psychological and cancer problems [2], having a negative impact on health and higher costs as the disease sets and worsens [5]. It is urgent to evaluate how this complex disease behaves, so that health services can guarantee an adequate and standardized intervention, correct diagnosis, but also a clinical monitoring and treatment adapted to the needs of each region. Methods: To assess the prevalence of overweight/obesity and analyze their relationship with the various associated pathologies in the different areas of Portugal, between the years 2015 to 2019, it was made descriptive analysis of data obtained online on the BI-CSP platform, indicators 202, 203, 204, 205, 206, 210, 211, 213, 214, 217, 224 and 234 for the national total, for the different Health Regions and for a representative random sample of Health Care Centers. Quotients between indicators and growth dynamics were calculated. Results: The North Health Region is the one with the highest proportion of overweight and obesity, with 36.7%, in contrast to Algarve Health Region, the region with the best results, 18.3%. The Alentejo Health Region has the largest fraction of users with non-insulin-dependent diabetes, arterial hypertension, coronary artery disease, myocardial infarction and transient ischemic stroke. It was also found that the overweight and obesity growth, with a growth dynamic of +2.12 and +0.73 between 2015 and 2019 in the total national, respectively, did not reflect a positive growth dynamic of the quotients calculated between indicators. Discussion: There is a discrepancy between weight values for Health Regions and between the Primary Health Care users and the national values. The increase in overweight or obesity proportions did not lead to an equivalent increase in the higher risk pathologies proportion, which can be justified by the complexity of the disease and the presence of limiting factors not studied, such as age population, educational level, eating habits and physical exercise. Conclusion: The presence of an increased body mass index is not strictly associated with serious health problems. There must be found an explanation for differences between regions to improve equality. Invest in primary prevention and apply a systematic intervention across health care units that allows a regular assessment of the patient’s nutritional status using reliable anthropometric parameters for early diagnosis, referencing and intervention.

Introduction: Patients with Erectile Dysfunction who wish to initiate or resume sexual activity have a high prevalence of cardiovascular diseases. This highlights the importance of stratifying their cardiovascular risk and subsequently identifying the need for further evaluation using the Princeton IV Consensus guidelines. Objectives: Assess compliance with Princeton criteria among patients with Erectile Dysfunction at the Barquinha Family Health Unit, characterize their cardiovascular risk factors, and compare the diagnostic prevalence of Erectile Dysfunction among different patient lists within the same unit. Methods: This is a cross-sectional, observational, and descriptive study. A list of patients diagnosed with Erectile Dysfunction at the Barquinha Family Health Unit was obtained, coded as an active problem using Y07 – Impotence (ICPC-2 Classification). After the recruitment process and obtaining informed consent, the final sample size was 35 patients. Results: The mean age at diagnosis was 61.4 ± 11.7 years, with 88.6% of patients being ≥ 50 years old. Notably, 57.1% belonged to List A, 2.9% to List B, 8.6% to List C, and 31.4% had no assigned Family Physician. At the time of Erectile Dysfunction diagnosis, most patients (65.7%) had more than three cardiovascular risk factors. The most prevalent cardiovascular risk factors were: Overweight/Obesity (82.9%), Dyslipidemia (77.1%), and Hypertension (57.1%). Regarding the Princeton criteria, these were met in 27 patients (77.1%), with the majority belonging to List A. Conclusion: The results reinforce that patients with Erectile Dysfunction frequently present several Cardiovascular Risk Factors. This condition may be the first warning sign of future Cardiovascular events, making its proper management in Primary Health Care essential.

Introduction: Chronic kidney disease (CKD) is a common complication of type 2 diabetes mellitus (T2DM) and is associated with increased cardiovascular risk, higher morbidity, mortality, and a substantial socioeconomic burden. Early diagnosis and timely initiation of appropriate therapy are essential to slow disease progression and reduce cardiovascular events.Objective: To evaluate the clinical management of CKD in patients with T2DM followed in a Primary Health Care Unit, with particular emphasis on diagnostic coding, clinical control, and optimization of cardiovascular protective therapies.Methods: A retrospective, cross-sectional study was conducted based on the analysis of clinical records of patients with T2DM and CKD followed at USF da Luz. Sociodemographic and clinical variables were collected. The prescription of drugs with proven cardiorenal benefit—angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ACE inhibitors/ARBs), sodium–glucose cotransporter–2 (SGLT2) inhibitors and finerenone—was assessed, as well as therapeutic changes after CKD coding.Results: This study found that the prevalence of CKD among patients with T2DM was 39.4%. Only 27.1% of patients with CKD had a formally coded diagnosis. Patients with coded CKD were older (mean age 81.8 vs. 79.1 years), had higher serum creatinine levels (1.41 vs. 1.03 mg/dL) and lower estimated glomerular filtration rate (42.1 vs. 56.1 mL/min), reflecting more advanced stages of kidney disease. Prescription of ACE inhibitors/ARBs at maximal doses and SGLT2 inhibitors was more frequent in patients with coded CKD.Conclusion: CKD coding was associated with more appropriate therapeutic optimization and may contribute to a reduction in cardiorenal risk. These findings underline the importance of formal CKD registration and an integrated cardiorenal approach in primary care.

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A violência apresenta-se como um grave problema de saúde pública. É um fenômeno frequente que gera impacto no âmbito físico, psicológico e social da vida das pessoas, famílias e comunidades. Dentre os tipos de violência, a intrafamiliar é de elevada prevalência. É um fenômeno sistêmico, no qual todos os membros da família estão envolvidos. Na Atenção Primária à Saúde (APS), famílias em situação de violência são frequentemente atendidas por profissionais da Estratégia Saúde da Família. Entretanto, observa-se ausência ou pouco espaço existente na formação médica para abordar o tema. O objetivo deste estudo foi conhecer a perspectiva de Médicos de Família e Comunidade (MFC), preceptores de Programas de Residência em MFC, sobre a Abordagem Familiar em contextos de violência intrafamiliar na APS. Trata-se de estudo de abordagem qualitativa de caráter descritivo e exploratório. Foram realizadas entrevistas com 15 preceptores. Foram identificados potencialidades e desafios para a prática cotidiana da Abordagem Familiar com famílias em situação de violência, na APS. Como potencialidades, destacam-se: o fortalecimento do vínculo do profissional e família; ampliação dos recursos terapêuticos e da efetividade das intervenções; favorecimento do cuidado integral; articulação da rede intersetorial; promoção da reflexão e do autocuidado familiar. Dentre os desafios, foram relatados: falhas na formação médica e falta de experiência; a violência silenciada e o medo de abordar as situações de violência intrafamiliar; falta de diretrizes específicas para profissionais de saúde da APS; más condições de trabalho, dificuldades na articulação da rede intersetorial e não valorização da gestão sobre a importância da abordagem. A importância da Abordagem Familiar por MFC foi destacada pelos entrevistados, sobretudo na abordagem de violência intrafamiliar. Entretanto há muitos desafios para sua aplicação na prática. São necessários esforços e diretrizes para que os MFCs e demais profissionais que atuam na APS possam ser valorizados e capacitados a fim de realizar a abordagem familiar e a abordagem da violência intrafamiliar de forma sistemática e cotidiana, considerando a alta prevalência e a gravidade deste fenômeno.

Este estudo tem como objeto: a organização da demanda de atendimento em uma unidade de urgência e emergência no contexto da pandemia da COVID-19. Questões norteadoras: qual a demanda de atendimentos de uma Policlínica em um município do Estado do Rio de Janeiro no contexto da pandemia da COVID-19? E que estratégias podem ser utilizadas para organização do fluxo de atendimento na rede de atenção à saúde de um município de médio porte do Estado do Rio de Janeiro, para alcançar a resolutividade das demandas encaminhas ao serviço de urgência e emergência de uma Policlínica municipal? Objetivo geral: desenvolver de forma participativa, junto com a equipe de enfermagem de uma Policlínica uma proposta de reorganização do atendimento da unidade de urgência e emergência, a partir da análise da demanda de atendimentos de uma instituição de um município do estado do Rio de Janeiro no contexto da pandemia da COVID-19. Metodologia: estudo de método misto com abordagem sequencial transformadora. A fase quantitativa foi transversal, descritiva com análise documental dos registros disponíveis no serviço de urgência e emergência da policlínica. Os dados objetivos foram obtidos por observação sistemática nas visitas exploratórias nas UBS. A fase qualitativa utilizou o método da pesquisa participativa, por meio de 44 entrevistas com os profissionais de saúde e um grupo focal com 14 profissionais de enfermagem, composto por 8 técnicos e 6 enfermeiros. Após a Carta de Anuência da Secretaria de Saúde do município e a aprovação do projeto de pesquisa pelo Comitê de Ética em pesquisa da UERJ, a coleta de dados foi iniciada. Resultados: Procedimentos Técnicos somam 88,70% dos atendimentos. Isso reflete a dificuldade de interligar a AB e a Rede de UE, pois são procedimentos realizados na atenção básica. Da análise de conteúdo das entrevistas emergiram as seguintes categorias: A interligação entre a Rede de Atenção à Saúde nas unidades de EU e a AB; Atenção resolutiva, humanizada e acolhedora; Estratégia de reorganização da RAS do município; Impactos da Pandemia COVID-19 na demanda de atendimento da unidade de urgência e emergência. Foram apresentadas as categorias e subcategorias oriundas da fase qualitativa e os resultados quantitativos para fomentar a discussão dentro do grupo focal, resultando na elaboração do Plano de Ação. Com a integração dos resultados foi possível realizar algumas meta-interferências, como: A falta de continuidade e alinhamento entre as coordenações da UBS e os serviços de UE; A necessidade de fortalecimento e investimento na AB. Conclusão: Para a articulação entre a atenção básica e a rede de urgência e emergência é necessário o estabelecimento da lógica do cuidado de transição.