Point-of-care ultrasound can make the difference in patients with heart failure at primary care.

Background: Primary healthcare centers (PHC) play a pivotal role in the first-line management of patients with diabetes and hypertension, major risk factors for heart failure (HF) development. Point-of-care cardiac ultrasound (POCUS), integrated as an extension of the physical examination, holds significant potential to enhance diagnostic accuracy and clinical management in this setting.

Objectives: Evaluate the impact of POCUS on clinical decision-making in patients with HF and at risk of developing HF in PHC and compare POCUS findings with clinical assessment alone, conventional echocardiography, and electrocardiogram results.

Pertuzumab in Combination with Trastuzumab and Docetaxel in the Neoadjuvant Treatment for HER2-Positive Breast Cancer.

Introduction: This study aims to assess safety and effectiveness of pertuzumab in combination with trastuzumab and docetaxel in the neoadjuvant treatment (NeoT) of HER2-positive breast cancer.

Methods: Two consecutive retrospective cohorts ( = 94, 2012-2015 and 2015-2017) of adult women with HER2-positive breast cancer, receiving NeoT at the breast clinic in Portugal (IPO-Porto), were followed. All patients had surgery and received trastuzumab as adjuvant therapy.

Small cell lung cancer treatment and survival in Portugal: A retrospective analysis from the I-O Optimise initiative.

Objective: We aim to describe treatment patterns and overall survival (OS) among a Portuguese cohort of patients with small cell lung cancer (SCLC).

Methods: This study utilised a database held by IPO-Porto, Portugal's largest oncology hospital. Adult patients diagnosed with SCLC at IPO-Porto between January 2012 and June 2017, with follow-up to December 2017, were included.

Treatment and outcomes for early non-small-cell lung cancer: a retrospective analysis of a Portuguese hospital database.

Aim: This observational study evaluated treatment patterns and survival for patients with stage I-IIIA non-small-cell lung cancer (NSCLC).

Materials & Methods: Adults newly diagnosed with NSCLC in 2012-2016 at IPO-Porto hospital were included. Treatment data were available for patients diagnosed in 2015-2016.

The historical evolution of knowledge of the involvement of neurohormonal systems in the pathophysiology and treatment of heart failure.

Our knowledge of the pathophysiology of heart failure (HF) underwent profound changes during the 1980s. Once thought to be of exclusively structural origin, HF began to be seen as the consequence of hormonal imbalance. A number of seminal studies were published in that decade focusing on the impact of neurohormonal activation in HF.

Holistic view of patients with melanoma of the skin: how can health systems create value and achieve better clinical outcomes?

Patients with skin cancer should be treated in healthcare units that ensure holistic and multidisciplinary approaches. Current healthcare units, especially those dedicated to cancer care, must evolve to integrated patient-centred systems. The current review presents a holistic health services perspective towards managing patients with melanoma of the skin, based on a literature search.

Benchmarking Cancer Centers: From Care Pathways to Integrated Practice Units.

Structuring cancer care into pathways can reduce variability in clinical practice and improve patient outcomes. International benchmarking can help centers with regard to development, implementation, and evaluation. A further step in the development of multidisciplinary care is to organize care in integrated practice units (IPUs), encompassing the whole pathway and relevant organizational aspects.

Risk-sharing agreements, present and future.

Risk-sharing agreements between pharmaceutical companies and payers stand out as a recent practice, the use of which has been increasing in the case of innovative medicines, particularly in the field of oncology, which aims to ensure better budgetary control and a lower risk of spending on medicinal products without full evidence of clinical benefit. In this article, the authors discuss the types of existing agreements, as well as those used in Portugal, their advantages, disadvantages and future challenges of implementation, as well as their potential role in access to therapeutic innovation, namely medicines for cancer treatment. For this purpose, a nonsystematic review of indexed and nonconventional literature was carried out.

The cost of cancer treatment in Portugal.

Introduction: Cancer is the second most common cause of death in Portugal, with 24.3% of these deaths caused by malignant neoplasms. The strong impact on lost productivity and rising treatment costs make cancer a priority.

Depression predicts mortality and hospitalization in heart failure: A six-years follow-up study.

Background: The aim of this study is to evaluate the prevalence of depressive symptoms (DS) and its relation on hospitalization for cardiovascular (CV) causes and all-cause mortality risk among outpatients with HF.

Methods: A prospective study was conducted on 130 adult outpatients with HF. The Beck Depression Inventory Scale-second edition (BDI-II) was used to screen for DS.

The Effect of Exercise Training on Diastolic and Systolic Function After Acute Myocardial Infarction: A Randomized Study.

After acute myocardial infarction (AMI), diastolic dysfunction is frequent and an important determinant of adverse outcome. However, few interventions have proven to be effective in improving diastolic function. We aimed to determine the effect of exercise training on diastolic and systolic function after AMI.

Health-related quality of life and utilities in gastric premalignant conditions and malignant lesions: a multicentre study in a high prevalence country.

Background And Aims: A recent review of economic studies relating to gastric cancer revealed that authors use different tests to estimate utilities in patients with and without gastric cancer. Our aim was to determine the utilities of gastric premalignant conditions and adenocarcinoma with a single standardized health measure instrument.

Methods: Cross-sectional nationwide study of patients undergoing upper endoscopy (n=1,434) using the EQ-5D-5L quality of life (QoL) questionnaire.

Comparative analysis and meta-analysis of major clinical trials with oral factor Xa inhibitors versus warfarin in atrial fibrillation.

Objectives: A comparative analysis of three major clinical trials with factor Xa inhibitor oral anticoagulant (XOAC) drugs versus warfarin in atrial fibrillation-Rocket-AF (rivaroxaban), Aristotle (apixaban) and Engage AF Timi 48 (edoxaban; two different doses and sets of data)-was carried out.

Methods: Data were extracted from the original reports (study level) and a meta-analysis was carried out.

Results: When compared with warfarin, XOAC therapy was associated with a decrease in haemorrhagic stroke, with a similar pattern for all regimens and meta-analysis showing a risk ratio of 0.

Effects of hypoglycemic agents on mortality and major cardiovascular outcomes in patients with type 2 diabetes mellitus: a narrative review [88].

Type 2 diabetes mellitus acts as a risk factor for cardiovascular disease. It has been hypothesized that control of plasma glucose levels would reduce cardiovascular disease in type 2 diabetic patients--thus lowering parameters such as mortality rate, myocardial infarction or stroke. A narrative review was carried out looking at data on mortality and cardiovascular disease outcomes, including myocardial infarction and stroke, associated with hypoglycemic therapy in type 2 diabetic patients, starting with the University Group Diabetes Trial (1970-1978) and ending with the Veterans Affairs Diabetes Trial (2009).

Survival of patients with familial dilated cardiomyopathy on optimal heart failure therapy.

Background: Familial dilated cardiomyopathy (FDCM) is characterized by clinical and genetic heterogeneity. There are still few survival studies concerning this subgroup of patients.

Aim: To determine the prognosis of patients with FDCM on optimal medical therapy and attending a heart failure clinic.

Glomerular filtration rate and coronary artery disease burden in patients with acute coronary syndrome.

Background: Mild renal dysfunction may be associated with increased cardiovascular morbidity and mortality.

Methods: The relation between estimated glomerular filtration rate (eGFR), as calculated from plasma creatinine at admission, and coronary artery disease burden (CADB), was studied in a cohort of 110 patients with acute coronary syndrome and coronary atherosclerosis.

Results: A relatively weak but significant negative correlation was found between eGFR and CADB as measured by angiography (coefficient correlation of - 0.

Troponin I as a marker of right ventricular dysfunction and severity of pulmonary embolism.

Background: Cardiac troponin I (cTnI) is a specific marker which allows detection of minor myocardial cell damage. In patients with severe pulmonary embolism (PE), the rise in pulmonary artery pressure can lead to progressive right ventricular dysfunction (RVD), and clinical studies have demonstrated the presence of ischemia and even right ventricular infarction. Our aims were to determine the prevalence and diagnostic utility of cTnI in identifying patients with RVD and to ascertain whether it correlates with severity of PE.

Tetralogy of Fallot: prognostic factors after surgical repair.

Introduction And Objective: Corrective surgery for tetralogy of Fallot (TF) has led to excellent survival. However; several years after surgery, the majority of patients have right ventricular (RV) dilatation, and 10% will need reoperation of the RV outflow tract due to limited exercise capacity, ventricular arrhythmias or symptoms of heart failure (HF). Our aim was to identify predictive factors of adverse outcome: moderate to severe RV dilatation, HF, reoperation of the RV outflow tract and cardiac death.

Heart transplantation. A Portuguese hospital center's experience.

Cardiac transplantation is the gold standard therapy for patients below 60 years presenting with severe heart failure (HF) despite maximal medical therapy, who have no other surgical option and no contraindications to this procedure. We evaluated our experience with this important form of heart failure therapy. Between February 1987 and December 2002, 32 patients, aged 37 +/- 16 years, 19 males, with ejection fraction of 18 +/- 7%, underwent heart transplantation in our center.