CatólicaMed (CM)
URI permanente desta comunidade:
Navegar
Percorrer CatólicaMed (CM) por título
A mostrar 1 - 10 de 16
Resultados por página
Opções de ordenação
- Arrhythmic risk stratification in patients with left ventricular ring-like scarPublication . Parisi, Vanda; Graziosi, Maddalena; Lopes, Luis R.; Luca, Antonio De; Pasquale, Ferdinando; Tini, Giacomo; Targetti, Mattia; Cueto, Maria R.; Moura, Ana R.; Ditaranto, Raffaello; Torlasco, Camilla; Taglieri, Nevio; Nardi, Elena; Lovato, Luigi; Augusto, João B.; Galiè, Nazzareno; Crotti, Lia; Gasperetti, Alessio; Biffi, Mauro; Autore, Camillo; Merlo, Marco; Olivotto, Iacopo; Sinagra, Gianfranco; Elliott, Perry M.; Biagini, ElenaAims Left ventricular (LV) ring-like scar on cardiac magnetic resonance (CMR) has been linked to malignant arrhythmias in patients with non-ischaemic cardiomyopathy. This study aimed to perform a comprehensive evaluation of this phenotype and to identify risk factors for life-threatening arrhythmic events (LAEs), a composite of sudden cardiac death (SCD), aborted SCD, and sustained ventricular tachycardia. Methods and results One hundred and fifteen patients [median age 39 (interquartile range, IQR, 28–52), 42% females] were identified at 6 referral centres. Inclusion criteria were ring-like LV scar [≥3 contiguous segments with sub-epicardial/midwall late gadolinium enhancement (LGE) in the same slice] and one among: pathogenic/likely pathogenic genetic variant, family history for cardiomyopathy, or arrhythmogenic cardiomyopathy diagnosis. During the study follow-up, survival free from LAEs was 60% (3.8 events/100 patients/year); at a median follow-up of 4.6 years (IQR 1.7–8.4) it was 84%. On multivariable analysis, anterior Q waves [hazard ratio (HR): 1.030, 95% confidence intervals (CI): 1.014–1.046, P < 0.001], QRS width (HR: 4.642, 95% CI: 1.296–16.628, P = 0.018), and LV end-diastolic volume index (LVEDVi; HR: 1.011, 95% CI: 1.001–1.021, per mL/m2 increase, P = 0.040) were independently associated with LAEs; with good discrimination power (Harrell’s C-index = 0.796). Three risk categories were identified: normal electrocardiogram (ECG), abnormal ECG and no LAEs predictive variables, abnormal ECG and ≥1 LAEs predictive variables, with a decreasing survival from 100 to 65% and 49%, respectively (Log-rank test = 0.015). Conclusion In this study, the LV ring-like scar phenotype was associated with a high rate of malignant arrhythmias in presence of anterior Q waves, QRS prolongation, and increased LVEDVi. A normal ECG identified a lower risk sub-group.
- Catheter-related right atrial endocarditis in a dialysis patientPublication . Ribeiro, Maria Inês; D'Orey, Francisco; Sampaio, João Prosil; Santos, João Grade; Pereira, VeraHemodialysis catheters are frequently used for vascular access in end-stage chronic kidney disease patients lacking mature arteriovenous fistula. The incidence of infective endocarditis in hemodialysis patients is higher than in the general population and is associated with severe and potentially life-threatening complications. A high index of suspicion is imperative for early diagnosis and timely intervention to enhance the prognosis of this high-mortality condition. Imaging studies, like transthoracic and transesophageal echocardiography, are crucial for prompt diagnosis. We present a case of a 36-year-old woman undergoing hemodialysis, whose prolonged use of a permanent catheter led to the development of infective endocarditis complicated with septic pulmonary embolism. Our case report presents an example of right atrial endocarditis with a poor outcome due to delayed diagnosis.
- Correction to: Surgery of the primary tumor in patients with de novo metastatic breast cancer: a nationwide population-based retrospective cohort study in Belgium (Breast Cancer Research and Treatment, (2024), 203, 2, (351-363), 10.1007/s10549-023-07116-6)Publication . Brandão, Mariana; Martins-Branco, Diogo; Angelis, Claudia De; Vuylsteke, Peter; Gelber, Richard D.; Damme, Nancy Van; Walle, Lien van; Ferreira, Arlindo R.; Lambertini, Matteo; Poggio, Francesca; Verhoeven, Didier; Barbeaux, Annelore; Duhoux, Francois P.; Wildiers, Hans; Caballero, Carmela; Awada, Ahmad; Piccart-Gebhart, Martine; Punie, Kevin; Azambuja, Evandro deIn the original publication of the article, the following article note has been missed to include. “Mariana Brandão and Diogo Martins-Branco have contributed equally to this work.” The original article has been corrected.
- Correction to: worsening heart failure: progress, pitfalls, and perspectives (Heart Failure Reviews, (2025), 10.1007/s10741-025-10497-z)Publication . Fonseca, Cândida; Baptista, Rui; Franco, Fátima; Moura, Brenda; Pimenta, Joana; Sarmento, Pedro Moraes; Cardoso, José Silva; Brito, DulceThe order of the authors' first and last names was reversed in the original publication. The correct author names are as follows: Incorrect Author List: Fonseca Cândida · Baptista Rui · Franco Fátima · Moura Brenda · Pimenta Joana · Pedro Moraes Sarmento · Silva Cardoso José · Brito Dulce Correct Author List: Cândida Fonseca · Rui Baptista · Fátima Franco · Brenda Moura · Joana Pimenta · Pedro Moraes Sarmento · José Silva Cardoso · Dulce Brito The original article has been corrected.
- Feedback based on experience sampling data: examples of current approaches and considerations for future researchPublication . Bartels, Sara Laureen; van Zelst, Catherine; Melo Moura, Bernardo; Daniëls, Naomi E.M.; Simons, Claudia J.P.; Marcelis, Machteld; Bos, Fionneke M.; Servaas, Michelle N.Methodologies such as the Experience Sampling Method (ESM) or Ecological Momentary Assessment allow the gathering of fine-graded, dynamic, personal data within a patient's daily life. Currently, it is studied whether feedback based on experience sampling data (ESM-based feedback) can be used as a clinical tool to inform shared decision-making in clinical practice. Although the potential of feedback is recognized, little is known on how to generate, use, and implement it. This article (i) presents n = 15 ongoing ESM projects within the Belgian-Dutch network for ESM research wherein ESM-based feedback is provided to various patient populations, and (ii) summarizes qualitative data on experiences with ESM-based feedback of researchers (n = 8) with extensive expertise with ESM (average of 10 years) involved in these ongoing studies. The following aspects appear to be of relevance when providing ESM-based feedback: training for healthcare professionals and researchers, the use of online interfaces and graphical visualizations to present data, and interacting with patients in a face-to-face setting when discussing the contextual relevance and potential implications. Prospectively, research may build on these aspects and create coherent consensus-based guidelines for the use of ESM-based feedback.
- Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021Publication . GBD 2021 Nervous System Disorders Collaborators; Steinmetz, Jaimie D.; Seeher, Katrin Maria; Schiess, Nicoline; Nichols, Emma; Cao, Bochen; Servili, Chiara; Cavallera, Vanessa; Cousin, Ewerton; Hagins, Hailey; Moberg, Madeline E.; Mehlman, Max L.; Abate, Yohannes Habtegiorgis; Abbas, Jaffar; Abbasi, Madineh Akram; Abbasian, Mohammadreza; Abbastabar, Hedayat; Abdelmasseh, Michael; Abdollahi, Mohammad; Abdollahi, Mozhan; Abdollahifar, Mohammad Amin; Abd-Rabu, Rami; Abdulah, Deldar Morad; Abdullahi, Auwal; Abedi, Aidin; Abedi, Vida; Abeldaño Zuñiga, Roberto Ariel; Abidi, Hassan; Abiodun, Olumide; Aboagye, Richard Gyan; Abolhassani, Hassan; Aboyans, Victor; Abrha, Woldu Aberhe; Abualhasan, Ahmed; Abu-Gharbieh, Eman; Aburuz, Salahdein; Adamu, Lawan Hassan; Addo, Isaac Yeboah; Adebayo, Oladimeji M.; Adekanmbi, Victor; Adekiya, Tayo Alex; Adikusuma, Wirawan; Adnani, Qorinah Estiningtyas Sakilah; Adra, Saryia; Afework, Tsion; Afolabi, Aanuoluwapo Adeyimika; Afraz, Ali; Afzal, Saira; Aghamiri, Shahin; Agodi, Antonella; Bettencourt, Paulo J. G.Background: Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021. Methods: We estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined. Findings: Globally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer. Interpretation: As the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed. Funding: Bill & Melinda Gates Foundation.
- Heart with Mozambique: a Portuguese contribution to the eradication of rheumatic heart diseasePublication . Almeida, Inês Grácio de; Esteves, Ana; Gil, Victor
- Multidisciplinary team care in pituitary tumoursPublication . Marques, Pedro; Sagarribay, Amets; Tortosa, Francisco; Neto, Lia; Ferreira, Joana Tavares; Subtil, João; Palha, Ana; Dias, Daniela; Sapinho, InêsThe optimal care for patients with pituitary tumours is best provided in a multidisciplinary and collaborative environment, which requires the contribution of multiple medical specialties working together. The benefits and advantages of the pituitary multidisciplinary team (MDT) are broad, and all relevant international consensus and guidelines in the field recommend that patients with pituitary tumours should always be managed in a MDT. Endocrinologists and neurosurgeons are normally the leading specialties within the pituitary MDT, supported by many other specialties with significant contributions to the diagnosis and management of pituitary tumours, including neuropathology, neuroradiology, neuro-ophthalmology, and otorhinolaryngology, among others. Here, we review the literature concerning the concepts of Pituitary MDT/Pituitary Tumour Centre of Excellence (PTCOE) in terms of their mission, goals, benefits, structure, proposed models of function, and barriers, and we also provide the views of different specialists involved in our Pituitary MDT.
- Perturbação de hiperatividade/défice de atenção no adulto: um posicionamento de peritos portugueses sobre diagnóstico e tratamentoPublication . Madeira, Nuno; França, Gustavo; Jesus, Gustavo; Fernandes, João M.; Almeida, Susana S.; Filipe, Carlos N.A perturbação de hiperatividade e défice de atenção (PHDA) é uma perturbação do neurodesenvolvimento que frequentemente persiste na vida adulta, afetando aproximadamente 1,5% - 3% da população adulta em Portugal. A PHDA não tratada em adultos está ligada a um risco aumentado de abuso de substâncias, criminalidade, baixo desempenho académico e profissional. Menos de 20% dos adultos com PHDA são diagnosticados e tratados adequadamente, devido a sintomas sobrepostos com outras perturbações mentais, à existência de comorbilidades, ou ao desconhecimento e preconceitos sobre esta perturbação. Este documento de posicionamento resulta da realização de reuniões de peritos envolvendo seis psiquiatras portugueses experientes na gestão da PHDA em adultos. Visa orientar estratégias de diagnóstico e tratamento, bem como abordar as principais barreiras e limitações no acompanhamento destes doentes no contexto português, ao nível do diagnóstico e tratamento. Este documento pretende ainda esclarecer e desmistificar preconceitos, aumentar a consciencialização médica e promover a discussão para a elaboração de diretrizes para melhorar o diagnóstico, tratamento e qualidade de vida dos adultos com PHDA em Portugal.
- A Portuguese expert panel position paper on the management of heart failure with preserved ejection fraction - part I: pathophysiology, diagnosis and treatmentPublication . Silva-Cardoso, José; Moreira, Emília; Melo, Rachel Tavares de; Moraes-Sarmento, Pedro; Cardim, Nuno; Oliveira, Mário; Gavina, Cristina; Moura, Brenda; Araújo, Inês; Santos, Paulo; Peres, Marisa; Fonseca, Cândida; Ferreira, João Pedro; Marques, Irene; Andrade, Aurora; Baptista, Rui; Brito, Dulce; Cernadas, Rui; Santos, Jonathan dos; Leite-Moreira, Adelino; Gonçalves, Lino; Ferreira, Jorge; Aguiar, Carlos; Fonseca, Manuela; Fontes-Carvalho, Ricardo; Franco, Fátima; Lourenço, Carolina; Martins, Elisabete; Pereira, Hélder; Santos, Mário; Pimenta, JoanaHeart failure (HF) with preserved ejection fraction (HFpEF) affects more than 50% of HF patients worldwide, and more than 70% of HF patients aged over 65. This is a complex syndrome with a clinically heterogeneous presentation and a multifactorial pathophysiology, both of which make its diagnosis and treatment challenging. A Portuguese HF expert panel convened to address HFpEF pathophysiology and therapy, as well as appropriate management within the Portuguese context. This initiative resulted in two position papers that examine the most recently published literature in the field. The present Part I includes a review of the HFpEF literature covering pathophysiology, clinical presentation, diagnosis and treatment, including pharmacological and non-pharmacological strategies. Part II, the second paper, addresses the development of a holistic and integrated HFPEF clinical care system within the Portuguese context that is capable of reducing morbidity and mortality and improving patients’ functional capacity and quality of life.