Impact of Allergic Rhinitis Control on Work Productivity and Costs: A Real-World Data MASK-air Study.

Background: Allergic rhinitis (AR) has a substantial socioeconomic impact associated with impaired work productivity.

Objective: To study the impact of AR on work productivity and estimate the corresponding indirect costs for 40 countries.

Methods: We conducted a cross-sectional study using direct patient data from the MASK-air app on users with self-reported AR.

Long-term outcomes of primary cardiovascular prevention: A retrospective study at a referral center in Portugal.

Introduction And Objectives: Lifestyle changes are frequently insufficient to reduce cardiovascular (CV) risk in patients with dyslipidemia. This study aims to characterize the long-term evolution of lipid profile and CV risk of patients under primary prevention.

Methods: A retrospective study was performed of outpatients at a Portuguese cardiovascular risk clinic with ≥2 CV risk factors, followed for ≥2 years between 1995 and 2015.

Prognostic implications of fibrosis in low risk aortic stenosis patients.

Introduction And Objectives: Among patients with aortic stenosis (AS), interstitial fibrosis has been associated with progression to heart failure and is a marker of poorer prognosis. We aimed to assess the impact of myocardial fibrosis on clinical events after aortic valve replacement (AVR) in low risk, severe AS.

Methods: We prospectively followed 56 severe AS patients with ejection fraction >40%, who underwent AVR with simultaneous myocardial biopsies and collagen volume fraction (CVF) determination.

Does the type of seizure influence heart rate variability changes?

Objective: Heart rate variability (HRV), an index of the autonomic cardiac activity, is decreased in patients with epilepsy, and a low HRV is associated with a higher risk of sudden death. Generalized tonic-clonic seizures are one of the most consistent risk factors for SUDEP, but the influence (and relative risk) of each type of seizure on cardiac function is still unknown. Our objective was to assess the impact of the type of seizure (focal to bilateral tonic-clonic seizure - FBTCS - versus non-FBTCS) on periictal HRV, in a group of patients with refractory epilepsy and both types of seizures.

Heart rate variability in patients with refractory epilepsy: The influence of generalized convulsive seizures.

Objective: Patients with epilepsy, mainly drug-resistant, have reduced heart rate variability (HRV), linked to an increased risk of sudden death in various other diseases. In this context, it could play a role in SUDEP. Generalized convulsive seizures (GCS) are one of the most consensual risk factors for SUDEP.

The addition of neoadjuvant pertuzumab for the treatment of HER2+ breast cancer: a cost estimate with real-world data.

Background: Breast cancer (BC) is largely prevalent worldwide. HER2-positive BC account for roughly 20-25% of all BC cases and has an overall survival lower than other BC. Innovation on BC therapeutics is a constant, but novel therapies have higher costs.

Real-world treatment patterns and survival outcomes for advanced non-small cell lung cancer in the pre-immunotherapy era in Portugal: a retrospective analysis from the I-O Optimise initiative.

Background: As part of the multinational I-O Optimise research initiative, this retrospective cohort study of patients with advanced non-small cell lung cancer (NSCLC) evaluated real-world treatment patterns and survival prior to immunotherapy reimbursement in Portugal.

Methods: This study utilized a database held by IPO-Porto, Portugal's largest oncology hospital. Adult patients diagnosed with stage IIIB or IV NSCLC from January 2012 to December 2016 at IPO-Porto, with follow-up to June 2017, were included.

cTnI, BNP and CRP profiling after seizures in patients with drug-resistant epilepsy.

Purpose: To profile serum levels of high sensitivity Troponin I (hs-cTnI), B-Type Natriuretic Peptide (BNP), and high sensitivity C Reactive Protein (hs-CRP), after epileptic seizures in patients with focal drug-resistant epilepsy, relating the results to the revised SUDEP-7 inventory.

Methods: We prospectively evaluated patients admitted to our Epilepsy Monitoring Unit. hs-cTnI, BNP, and hs-CRP were measured at admission and after the first seizure.

Therapeutic Drug Monitoring by Pharmacists: Does It Reduce Costs.

Therapeutic drug monitoring (TDM) has as its main objective to ensure that the plasma drug concentration remains within the appropriate range. Regarding the economic dimension of TDM, it is known that there are gains in health outcomes; however, there is still little evidence for the benefit of this procedure performed by pharmacists within the hospital context. With this project, we aimed to create a matrix of cost avoidance associated with TDM performed by pharmacists and to quantify the total avoided costs in 1 year, by implementing a TDM process in a tertiary hospital.

Outcomes Management in a Real-World Evidence Context: The Case of Abiraterone and Enzalutamide in the Treatment of Metastatic Castration-Resistant Prostate Cancer.

At present, for patients with metastatic and castration-resistant prostate cancer, European Society for Medical Oncology and National Comprehensive Cancer Network guidelines recommend enzalutamide (E) or abiraterone (A). There are still a few studies comparing both drugs in a real-world setting, thus, in this article, we discuss an outcomes management methodology, supporting the follow-up of patients. This involves measuring relevant baseline traits and outcomes, such as overall survival (OS), treatment duration, patient-reported outcomes, and adverse events.

Moving the needle towards the democratization of echocardiography: a case report.

Background: Echocardiography has been traditionally performed in echo labs and the potential benefits of its use by primary care physicians (PCPs) are still unexplored. We present a case where POCUS (point-of-care ultrasound) was used as a complement of physical examination by a family doctor, allowing a prompt clinical decision in a heart failure (HF) patient.

Case Summary: An 85-year-old woman, living independently, asks her family doctor for a home consultation due to increasing dyspnoea.

Lipoprotein(a) as a key target in combined therapeutic approaches for cardiovascular disease.

Introduction And Objective: Lipoprotein(a) [Lp(a)] is an independent cardiovascular risk factor but is closely associated with other similar risk factors that are manageable with appropriate treatment and guidance. We aimed to study the impact of using combined therapy for managing Lp(a) levels in patients at high cardiovascular risk but without major adverse cardiovascular events, in primary prevention.

Methods: We conducted a retrospective observational study in 516 patients randomly selected from a group of 1677 patients who attended cardiovascular risk and metabolism consultations between 1995 and 2015.

Genetic Variants Are Not Rare in ICD Candidates with Dilated Cardiomyopathy: Time for Next-Generation Sequencing?

Background: Sudden cardiac death (SCD) risk stratification in dilated cardiomyopathy (DCM) has been based on left ventricular ejection fraction (LVEF), even though SCD may occur with LVEF > 35%. Family history of unexplained SCD, especially in the young, raises concern about potential inheritable risk factors. It remains largely unknown how genetic tests can be integrated into clinical practice, particularly in the selection of implantable cardioverter defibrillator (ICD) candidates.

Lipoprotein(a) in the Evaluation of Cardiovascular Risk in the Portuguese Population.

Introduction: High values of lipoprotein(a), related to atherosclerosis progression, are often considered a marker of thrombosis. We assessed the lipoprotein(a) profile in a group of patients with high vascular risk and no cardiovascular events, established its correlation with other cardiovascular risk factors and inferred the results for patients with metabolic disorders and, at least, two risk factors.

Material And Methods: This longitudinal observational study included 516 patients, who had at least two cardiovascular risk factors and regularly attended, for at least two years, the outpatient consultations at a clinic of metabolism and vascular risk for primary prevention.

Molecular characterization of Portuguese patients with dilated cardiomyopathy.

Introduction: Dilated cardiomyopathy (DCM) is a disease of the heart muscle characterized by ventricular dilatation and impaired systolic function. Familial forms account for 30-50% of cases. Autosomal dominant inheritance is the predominant pattern of transmission.

Real-world treatment patterns, resource use and cost burden of multiple myeloma in Portugal.

Objective: We provide a real-world overview of multiple myeloma (MM) treatment patterns, outcomes and healthcare resource use (HRU) in Portugal.

Methods: Data were collected retrospectively from consecutive patients diagnosed/treated at the Portuguese Oncology Institute of Porto (IPO-Porto) between 2012 and 2015. Primary objectives were progression-free survival (PFS) and overall survival (OS), with treatment patterns and HRU secondary.

Development of a benchmark tool for cancer centers; results from a pilot exercise.

Background: Differences in cancer survival exist between countries in Europe. Benchmarking of good practices can assist cancer centers to improve their services aiming for reduced inequalities. The aim of the BENCH-CAN project was to develop a cancer care benchmark tool, identify performance differences and yield good practice examples, contributing to improving the quality of interdisciplinary care.

A comparison of in-hospital acute myocardial infarction management between Portugal and the United States: 2000-2010.

Objective: To compare healthcare in acute myocardial infarction (AMI) treatment between contrasting health systems using comparable representative data from Europe and USA.

Design: Repeated cross-sectional retrospective cohort study.

Setting: Acute care hospitals in Portugal and USA during 2000-2010.

The Atlantic divide in coronary heart disease: Epidemiology and patient care in the US and Portugal.

Introduction And Objectives: We aimed to compare access to new health technologies to treat coronary heart disease (CHD) in the health systems of Portugal and the US, characterizing the needs of the populations and the resources available.

Methods: We reviewed data for 2000 and 2010 on epidemiologic profiles of CHD and on health care available to patients. Thirty health technologies (16 medical devices and 14 drugs) introduced during the period 1980-2015 were identified by interventional cardiologists.

Female Psychological Adjustment Following an Acute Coronary Syndrome.

Introduction: The outcomes of cardiovascular disease are consistently worse among women, regardless of age or disease severity. Such trend might arise from psychosocial factors, which should be examined in this population. Obective: To evaluate the influence of type-D personality on anxiety and depression symptoms reported by female patients after a first acute coronary syndrome.

Health technology assessment and value: the cancer value label (CAVALA) methodology.

In modern health care systems, the soaring prices of drugs pose at least three major challenges: the growing economic burden of diseases, the uncertainty regarding innovation in health care, and the use of generic drugs and new indications. In this context, the assessment of health care technology is not just about drugs, it is about ensuring that the system's resources, namely financial, yield maximum health benefits. So, the assessment is about relating inputs with outputs; and also, resources with health-related outcomes.