Heart failure in numbers: Estimates for the 21st century in Portugal.

Introduction And Objective: Heart failure is a major public health problem that affects a large number of individuals and is associated with high mortality and morbidity. This study aims to estimate the probable scenario for HF prevalence and its consequences in the short-, medium- and long-term in Portugal.

Methods: This assessment is based on the EPICA (Epidemiology of Heart Failure and Learning) project, which was designed to estimate the prevalence of chronic heart failure in mainland Portugal in 1998.

[Histiocytic necrotizing lymphadenitis: (Kukuchi-Fujimoto disease): a diagnostic challenge].

Kikuchi-Fujimoto disease, also called Histiocytic necrotizing lymphadentis, is a rare, benign and self-limited disease, with unknown etiology, that affects mainly young women, and is characterized by adenopathy (usually localized in the cervical region) and fever. Diagnosis is based on histopathological findings in ganglionar tissue obtained in excisional biopsy, which allows, in most cases, the differential diagnosis with other similar clinical conditions, but which have a completely different clinical evolution and therapeutic needs. We report a case of a twenty four year old woman with persistent cervical lymphadenopathy, in which histopathological examination followed by immunohistochemical analysis of ganglionar tissue revealed to be Kikuchi-Fujimoto disease.

Atrial fibrillation and thromboembolic risk: what is the extent of adherence to guidelines in clinical practice?

Background: Atrial fibrillation (AF) is the most common cardiac rhythm disorder in clinical practice, with a growing prevalence in recent decades. Through the use of thromboembolic risk scores it is possible to adjust thromboprophylaxis to individual risk. The aim of this study was to evaluate the conformity of antithrombotic therapy prescribed at hospital discharge with the guidelines in patients with AF and its influence on long-term morbidity and mortality.

Blood pressure in young adults.

Introduction: Hypertension (HT) is a major cardiovascular risk factor. Elevated blood pressure (BP) in childhood predisposes to HT in adulthood. Epidemiological studies in young age-groups are scarce.

[Clinical predictors of infectious pulmonary tuberculosis.].

Introduction: The immediate identification of infectious tuberculosis and implementation of effective isolation measures, are a priority of the national policies for disease control.

Objectives: To identify clinical predictor's factors related with sputum smear-positive, in patients with pulmonary tuberculosis diagnosis.

Population And Methods: This was a retrospective study involving 289 patients admitted consecutively with the diagnosis of tuberculosis (ICD-9-CM: 010-018) through the emergency department of a Central Hospital.

Portuguese study of familial dilated cardiomyopathy: the FATIMA study.

Dilated cardiomyopathy (DCM) is a myocardial disease, characterized by ventricular dilatation and impaired systolic function, that in more than 30% of cases has a familial or genetic origin. Given its age-dependent penetrance, DCM frequently manifests in adults by signs or symptoms of heart failure, arrhythmias or sudden death. The predominant mode of inheritance is autosomal dominant, and in these cases mutations are identified in genes coding for cytoskeletal, sarcomeric or nuclear envelope proteins.

Validity of a discharge diagnosis of heart failure: implications of misdiagnosing.

Heart failure (HF) costs are largely due to hospitalization. The validity of a death/discharge diagnosis of HF (DDHF) is largely unknown. The authors assessed the validity of DDHF and the impact of misdiagnosing.

Translating guidelines into clinical practice: benefits of an acute heart failure unit .

Unlabelled: Heart failure (HF) is a very prevalent condition, with high mortality, morbidity and costs, despite the development of effective drug therapy. Many patients still do not have access to appropriate treatment. Heart failure clinics have shown success in improving delivery of appropriate HF management, helping to reduce morbidity and mortality and costs.

Post-percutaneous coronary angioplasty atheroembolization--a feared iatrogenic complication.

Atheroembolic disease is a rarely recognized clinical entity. The growing use of antiplatelet and thrombolytic therapy and of invasive cardiovascular procedures in acute coronary syndromes has nevertheless transformed this feared iatrogenic complication into an increasingly frequent diagnosis. The authors review this entity through the case of a 71-year-old man who, fifteen days after undergoing thrombolysis for acute myocardial infarction with ST-segment elevation, followed by elective percutaneous coronary revascularization under triple antiplatelet therapy, came to the emergency department with a clinical setting of mental confusion, gastrointestinal bleeding, oliguria and cutaneous eruptions on the lower limbs; laboratory tests revealed severe azotemia and hyperkalemia.

Metformin-induced lactic acidosis: a case series.

Introduction: Unlike other agents used in the treatment of type 2 diabetes mellitus, metformin has been shown to reduce mortality in obese patients. It is therefore being increasingly used in higher doses. The major concern of many physicians is a possible risk of lactic acidosis.

Systemic markers of the redox balance and apolipoprotein E polymorphism in atherosclerosis: the relevance for an integrated study.

Prospective studies have demonstrated that an imbalance between oxidative damage and antioxidative protection can play a role in the development and progression of atherosclerosis. Also, genotypes with the apolipoprotein E epsilon4 allele have been associated with an increase risk for this pathology. Based on this knowledge, the aim of this study was to evaluate indicators of the redox balance, trace elements, and apolipoprotein E allelic profile in subjects from the Lisbon population with clinically stable atherosclerosis, at risk for atherosclerotic events, and in healthy subjects for comparison.

Acutely decompensated heart failure: characteristics of hospitalized patients and opportunities to improve their care.

Unlabelled: Heart failure (HF) remains a major public health problem in western countries, despite the enormous progress in its diagnosis and treatment. Acute and chronic decompensated HF are leading medical causes of hospitalization among people aged over 65 years in European countries, the USA, Australia and New Zealand. However, there have been few studies on acute and chronic decompensated HF and the European Society of Cardiology (ESC) guidelines on this subject have only just been published.

Epidemiology of heart failure in primary care in Madeira: the EPICA-RAM study.

Unlabelled: Chronic heart failure (CHF) is a serious public health problem all over the world. CHF has a high prevalence, affecting mainly the elderly, and causes severe disability and social and economic costs.

Aim: To estimate the prevalence of chronic heart failure in the Autonomous Region of Madeira in 2001.

Evaluation of the performance and concordance of clinical questionnaires for the diagnosis of heart failure in primary care.

Aim: To validate and estimate the performance statistics and concordance of seven clinical questionnaires for the diagnosis of chronic heart failure (HF).

Methods: Community-based epidemiological survey of patients aged >25 years attending a random sample of primary health care centers in Portugal. Heart failure was identified according to the Guidelines of the European Society of Cardiology (ESC).

The value of the electrocardiogram and chest X-ray for confirming or refuting a suspected diagnosis of heart failure in the community.

Background: There is a common assumption that a normal ECG or a normal heart size on chest X-ray virtually rules out a diagnosis of heart failure.

Aims: To assess the value of the electrocardiogram and chest X-ray in identifying patients with chronic heart failure in the community.

Methods And Results: This study was a secondary analysis of data prospectively collected at the time of patient's enrollment in the EPICA study, an epidemiological study of the prevalence of heart failure in Portugal.

Aetiology, comorbidity and drug therapy of chronic heart failure in the real world: the EPICA substudy.

Background: Chronic heart failure (CHF) is common and is frequently managed by primary care physicians (PCPs). Despite the European Society of Cardiology (ESC) Guidelines, standard treatments for CHF are frequently underutilised, particularly in primary care.

Aim: To evaluate current drug therapy for CHF in adults with HF diagnosed according to ESC guidelines in the context of the EPICA study.

The diagnosis of heart failure in primary care: value of symptoms and signs.

Background: The value of symptoms and signs in the diagnosis of CHF has rarely been tested in large numbers of patients in the community. The aim of this study was to evaluate the importance of symptoms, signs, and past medical history in the diagnosis of CHF in primary care.

Methods: Data on a sample of Portuguese men and women attending 365 primary care centres for any condition other than the treatment of acute infection, metabolic conditions or pregnancy were collected.

[Epidemiology of heart failure in mainland Portugal: new data from the EPICA study].

Heart failure (HF) is common, costly, disabling and lethal, and can be prevented. The progression of overt HF (CHF) can be slowed by correct management including precise diagnosis and appropriate therapy. Patients with CHF can be misdiagnosed, mainly in primary care, where patients are actually less symptomatic than those seen in hospitals.

Comparative value of BNP and NT-proBNP in diagnosis of heart failure.

Unlabelled: Heart failure (HF) remains a major diagnostic challenge. Brain natriuretic peptide (BNP) and the N-terminal portion of proBNP (NT-proBNP) have emerged as excellent diagnostic biohumoral indicators in cardiac disease. It is not clear which of the two is superior as a diagnostic marker in HF.

How patients with heart failure are managed in Portugal.

The prevalence of heart failure is increasing all over the world. It is a common and growing public health problem in Portugal as in many other European countries. This article provides a review of health service organization and current heart failure management in Portugal, discusses primary care and ward practices in different hospitals and reports on the use of proven standard therapies for the treatment of heart failure in the community.

Prevalence of chronic heart failure in Southwestern Europe: the EPICA study.

Aim: To estimate the prevalence of chronic heart failure (CHF) in mainland Portugal in 1998.

Methods And Population: A community-based epidemiological survey involving subjects attending primary care centres selected by a combined two-stage sampling and stratified procedure. General practitioners (GPs) randomly selected in proportion to the population of the District, evaluated subjects attending primary care centres aged over 25 years, recruited consecutively and stratified by age.