Central venous catheters are a leading cause of upper-extremity deep vein thrombosis. Concomitant severe thrombocytopenia makes anticoagulation for catheter-related thrombosis (CRT) in patients with acute leukemia (AL) a challenge. Incidence of CRT has been reported to be increased in those with peripherally inserted central catheters (PICC) vs. those with centrally inserted ones (CICC). Our objective is to compare the incidence rate of CRT in leukemia inpatients who received either a PICC vs. CICC. We retrospectively reviewed adult inpatients admitted to hematology wards with a new diagnosis of AL and who received either a PICC or a CICC. Baseline patient and catheter characteristics were recorded. Our primary outcome was the incidence rate of CRT in each group. The secondary outcomes included rates of infectious and mechanical complications. Six hundred sixty-three patients received at least one PICC (338) or CICC (325) insertion. A total of 1331 insertions were recorded, with 82 (11.7 %) and 41 (6.5 %) CRT in the PICC and CICC groups, respectively. The incidence rates were 1.89 and 0.52 per 1000 catheter day in the PICC and CICC groups, respectively. A PICC, when compared to CICC, was a significant risk factor for CRT (sHR 2.5, p < 0.0001). The prevalence and incidence rates of CRT in our AL patients were higher than predicted for a general cancer patient population. These rates were higher in the PICC group compared to the CICC group. We recommend careful consideration of thrombotic and bleeding risks of AL inpatients when choosing a central venous catheter.

Objective The aim of this study was the validation of the European Organization for Research and Treatment of Cancer's Multiple Myeloma Module (QLQ‐MY20) in Portuguese myeloma patients. Methods A total of 213 Portuguese patients diagnosed with multiple myeloma participated in this study and were assessed with the European Organization for Research and Treatment of Cancer's (EORTC) Questionnaire C30 (QLQ‐C30), the EORTC Multiple Myeloma Module (QLQ‐MY20), the Hospital Anxiety and Depression Scale (HADS) and the Satisfaction with Social Support Scale (SSSS). Results The validated version includes 17 items presenting good global adjustment and good internal consistency. Overall, the Portuguese validation maintains the original model with the exception of three items that were excluded. The instrument also showed good reliability and good convergent and divergent validity. Conclusion The Portuguese version of the EORTC Multiple Myeloma Module questionnaire seems to be a valid instrument for myeloma patients to help monitor interventions in this population focused on the promotion of quality of life.

ObjectiveCancer diagnosis affects patients, their families, and their caregivers in particular. This study focused on the validation of the CareGiver Oncology Quality of Life (CarGOQoL) questionnaire in Portuguese caregivers of patients with multiple myeloma, from the caregiver's point of view.MethodThis was a cross-sectional study with 146 caregivers of patients with multiple myeloma from outpatient medical oncology and clinical hematology consultations from five hospitals in north and central Portugal. Participants were assessed on quality of life (QoL), psychological morbidity and social support.ResultThe Portuguese version maintains 17 of the original 29 items version, maintaining general coherence and a dimensional structure that is clinically interpretable. Reliability findings indicated good internal consistency for the total scale (0.86) and respective subscales (0.75 to 0.88), which is in agreement with the alpha values from the previous CarGOQoL validation study for the corresponding subscales (0.74 to 0.89) and total scale (0.90).Significance of resultsThe CarGOQoL is a reliable and valid tool for clinical trials and intervention programs to assess QoL in caregivers of myeloma patients. Future studies should validate the adapted version in caregivers of other types of cancer patients including other chronic diseases.

BACKGROUND: The Vasco da Gama Movement (VdGM) is a European working group for young and future Family Doctors. It aims to improve the quality of Family Medicine, by holding preconference exchange programs amongst other activities. GOALS: To report and critically analyse the experiences of the medical conference exchange program in Spain as Portuguese GP residents and highlight the main differences in primary health care between the two countries. METHODS: Descriptive report and critical analysis. Preconference exchange promoted by VdGM, lasting for one week. One resident attended the Palma de Mallorca exchange (III Balearic Meeting of European Residents and Young General Practitioners) and the other three participated in the Madrid exchange (XVIII Conference of Family and Community Medicine Residents). The programs included: attending a Spanish Family Doctor practice, visiting the hospital emergency department, attending the medical conference and giving a presentation about their National Health System. CONCLUSIONS: This experience was a great opportunity for young family doctors to overview different approaches on primary healthcare, to interact with their peers and know more about other cultural settings. The authors believe that participating in such programs has increased their social and intercultural competencies, which will lead to better communication skills and improve patient-physician relationship. The authors hope to encourage other colleagues to participate in similar programs.

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