Publications by authors named "Vitor Tedim Cruz"

Background: Cognitive assessment and the early detection of cognitive impairments have been enhanced by the use of remote digital solutions. The Brain on Track® is one of these digital solutions used in clinical practice for online screening and monitoring of cognitive functioning.

Objectives: This study aimed to explore the validity and reliability of the Brain on Track® computerized test on a tablet device in adults.

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Adequate sodium and potassium intake, along with adherence to the Mediterranean diet (MedDiet), are key factors for preventing hypertension and cerebrovascular diseases. However, data on the consumption of these nutrients within the MedDiet are scarce. This cross-sectional study aims to assess the association between MedDiet adherence and sodium/potassium intake in the MIND-Matosinhos randomized controlled trial, targeting Portuguese adults at a high risk of dementia.

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Article Synopsis
  • Patients with acute intracerebral hemorrhage who were on factor Xa inhibitors were studied to evaluate the effectiveness of andexanet alfa in reversing hematoma expansion compared to usual care.
  • In a clinical trial, 263 patients received andexanet while 267 received standard treatment, focusing on hemostatic efficacy and safety outcomes.
  • Results showed that andexanet significantly improved hemostatic efficacy (67% vs. 53%) and substantially reduced anti-factor Xa activity, but also led to more thrombotic events (10.3% vs. 5.6% in usual care).
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Background: Stroke burden challenges global health, and social and economic policies. Although stroke recovery encompasses a wide range of care, including in-hospital, outpatient, and community-based rehabilitation, there are no published cost-effectiveness studies of integrated post-stroke pathways.

Objective: To determine the most cost-effective rehabilitation pathway during the first 12 months after a first-ever stroke.

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Computerized cognitive tests have the potential to cost-effectively detect and monitor cognitive impairments and thereby facilitate treatment for these conditions. However, relatively few of these tests have been validated in a variety of populations. Brain on Track, a self-administered web-based test, has previously been shown to have a good ability to differentiate between healthy individuals and patients with cognitive impairment in Portuguese populations.

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This study aims to estimate the prevalence and to identify the determinants of cancer-related neuropathic pain (CRNP), chemotherapy-induced peripheral neuropathy (CIPN) and cognitive decline among patients with breast cancer over five years after diagnosis. Women with an incident breast cancer (n = 462) and proposed for surgery were recruited at the Portuguese Institute of Oncology-Porto in 2012 and underwent systematic neurological examinations and evaluations with the Montreal Cognitive Assessment (MoCA) before treatment and after one, three, and five years. Multivariate logistic regression was used to assess the determinants of CRNP and CIPN, and multivariate linear regression for the variation in MoCA scores.

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Patient characteristics may influence access and acceptance of Prostate Specific Antigen test, and therefore, the timing of prostate cancer (PCa) diagnosis. A group of 361 patients from a cohort (n = 451) diagnosed with PCa in 2018-2020 at the Portuguese Institute of Oncology of Porto was evaluated before treatment, using a structured interview, the Medical Term Recognition Test, and the EORTC Quality of Life Questionnaire QLQ-PR25. PCa prognostic stages (I, II, III, IV) were attributed according to the American Joint Committee on Cancer eighth edition.

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Background: Evidence suggests an association between SARS-CoV-2 infection and worse performance on cognitive tests, and a higher risk of Parkinson's disease (PD) and dementia up to 6 and 12 months after infection, respectively. Longer follow-ups with comparison groups are needed to clarify the potentially increased risk of neurodegenerative diseases in COVID-19 survivors, namely those infected before mass vaccination.

Methods: A prospective study started in July 2022 with four cohorts of 150 individuals each, defined according to SARS-CoV-2 infection and hospitalisation status between March 2020 and February 2021: cohort 1-hospitalised due to SARS-CoV-2 infection; cohort 2-hospitalised, COVID-19-free; cohort 3-infected, not hospitalised; cohort 4-not infected, not hospitalised.

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Background: An individual's personal values strongly influence their immediate and long-term decisions. Psychological heterogeneity in clinical trial populations contributes to selection bias and may affect treatment outcomes and inevitably trial results.

Objectives: The objective of this study was to characterize for the first time the main interpersonal values of patients who participated in Phase II and III clinical trials.

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Cardiovascular (CV) guidelines stress the need for global intervention to manage risk factors and reduce the risk of major vascular events. Growing evidence supports the use of polypill as a strategy to prevent cerebral and cardiovascular disease, however it is still underused in clinical practice. This paper presents an expert consensus aimed to summarize the data regarding polypill use.

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Introduction: Transient ischaemic attack (TIA) and minor stroke are frequently assumed as temporary or non-disabling events. However, evidence suggests that these patients can experience relevant impairment and functional disability. Therefore, the present study aims to evaluate the feasibility and effectiveness of a 3-month multidomain intervention programme, composed of five non-pharmacological strategies, aimed at accelerating return to pre-event level of functionality in patients with TIA or minor stroke.

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Background: The nature and quality of stroke survivor rehabilitation varies throughout Europe, including in Portugal, having not been widely monitored or benchmarked.

Objectives: This study analyses the stroke care pathway from three perspectives: healthcare system, process, and patient.

Methods: The study uses data from a one-year single-center prospective cohort of first stroke patients, assessed at baseline, 3, 6, and 12 months.

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Background/aims: Clinical trials are fundamental for the development of new medicines and patient participation is based on free consent. Our study sought to identify psychological characteristics that may influence patient willingness to participate in a clinical trial.

Methods: A total of 100 participants were invited to participate with 80% positive response rate.

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Background And Objectives: Declines in stroke admission, IV thrombolysis (IVT), and mechanical thrombectomy volumes were reported during the first wave of the COVID-19 pandemic. There is a paucity of data on the longer-term effect of the pandemic on stroke volumes over the course of a year and through the second wave of the pandemic. We sought to measure the effect of the COVID-19 pandemic on the volumes of stroke admissions, intracranial hemorrhage (ICH), IVT, and mechanical thrombectomy over a 1-year period at the onset of the pandemic (March 1, 2020, to February 28, 2021) compared with the immediately preceding year (March 1, 2019, to February 29, 2020).

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Article Synopsis
  • The ATN scheme categorizes Alzheimer's disease biomarkers into three groups: Amyloidosis (A), Tauopathy (T), and Neurodegeneration (N), providing a framework that is relevant for both research and diagnosis.
  • In a study with 1,128 patients from various centers, the prevalence of ATN classifications showed that 47.8% fell into the Alzheimer's disease continuum, and ATN profiles were heavily influenced by factors like age and cognitive status.
  • While the ATN scheme effectively guides Alzheimer's diagnosis in real-world settings, it struggles with accuracy for other dementia types; adding markers for non-Alzheimer's conditions could improve differential diagnosis.
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To explore the association between the user's cognitive function and usability reported by the evaluator. A cross-sectional study was conducted with a community-based sample. Data about participants' age, sex, education, sleep quantity, subjective memory complaints, and cognitive function were collected.

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Prostate cancer (PCa) is the most prevalent among men, and psychological symptoms may affect many patients. This study aims to describe the prevalence of probable anxiety and depression before PCa treatments and after one year and to identify sociodemographic and clinical factors associated with these outcomes. Between February 2018 and March 2020, 292 patients recently diagnosed with PCa were recruited at the Instituto Português de Oncologia-Porto.

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Cognitive impairment is common among patients with different types of cancer, even before cancer treatment, but no data were reported among patients with prostate cancer (PCa), who may be at high risk due to advanced age. This study aims to estimate the prevalence of cognitive impairment before PCa treatment. Between February 2018 and April 2021, the NEON-PC cohort recruited 605 patients with PCa proposed for treatment at the Portuguese Institute of Oncology of Porto.

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Objectives: One of the long-term rehabilitation goals in stroke survivors is to achieve the best health-related quality of life (HRQoL). This study analyzes the evolution of HRQoL one-year post-stroke to establish the main pre-stroke, clinical, health care and rehabilitation predictors.

Materials And Methods: This study uses patient-level data from a one-year single-center prospective cohort study of first stroke patients, assessed at baseline, 3, 6 and 12 months.

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Purpose: The cognitive performance of patients with breast cancer (BCa) may be affected by cancer and its treatments. The Montreal Cognitive Assessment (MoCA) is a widely used cognitive impairment screening tool, but practice effects must be considered for longitudinal assessments. Since learning effects could be overcome through the alternate use of two versions of the MoCA, we aimed to explore their interchangeability by comparing their overall, and domain- and task-specific, scores among patients with BCa.

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Transthyretin-related familial amyloid polyneuropathy (ATTR-FAP) is a multisystemic disorder inherited as an autosomal dominant trait. Transitory events in ATTR-FAP patients are a feature of this disorder and remain poorly depicted in the literature. We aimed to describe a case series of ATTR-FAP patients who presented to our department with transitory events and document the clinical, neuroimaging and neurophysiological characteristics of the events.

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Article Synopsis
  • - The study analyzed endovascular treatment for ischemic strokes in Portugal over two years, focusing on treatment metrics across different regions and assessing access disparities due to uneven distribution of treatment centers.
  • - A total of 1,625 procedures were recorded, revealing an endovascular treatment rate of 8.27 per 100,000 inhabitants per year, with significant regional differences ranging from 1.58 to 16.53 per 100,000, particularly favoring areas near treatment centers.
  • - Geographic disparities were noted, with southern and inner regions showing lower treatment rates and longer times from stroke onset to intervention, indicating that access to timely care varies significantly across the country.
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Purpose: To identify trajectories of cognitive performance up to five years since diagnosis and their predictors, in a cohort of patients with breast cancer (BCa).

Methods: A total of 464 women with BCa admitted to the Portuguese Institute of Oncology, Porto, during 2012, were evaluated with the Montreal Cognitive Assessment (MoCA) before any treatment, and after one, three and five years. Probable cognitive impairment (PCI) at baseline was defined based on normative age- and education-specific reference values.

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Article Synopsis
  • COVID-19 has been linked to acute neurological issues, affecting over 30% of hospitalised patients, but there is a lack of comprehensive studies on this topic.
  • A retrospective study in Northern Portugal examined 1,261 hospitalised COVID-19 patients from March to June 2020, revealing that 36.2% experienced neurological symptoms, with headaches, delirium, and impaired consciousness being the most common.
  • The research indicates that younger patients are more likely to exhibit neurological manifestations, and those affected have a significant risk of severe outcomes, highlighting the need for improved healthcare strategies for COVID-19 patients with neurological complications.
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Objective: To measure the global impact of COVID-19 pandemic on volumes of IV thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with 2 control 4-month periods.

Methods: We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases.

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