Prospective study of loss of health-related quality adjusted life years in children and their families due to uncomplicated and hospitalised varicella.

Introduction And Aims: Although usually benign, varicella can lead to serious complications and sometimes long-term sequelae. Vaccines are safe and effective but not yet included in immunisation programmes in many countries. We aimed to quantify the impact on health-related quality of life (HRQoL) in terms of quality-adjusted life years (QALY) in children with varicella and their families, key to assessing cost-utility in countries with low mortality due to this infection.

Dupilumab for atopic dermatitis: a real-world Portuguese multicenter retrospective study.

Introduction: Atopic dermatitis (AD) is a difficult-to-treat inflammatory skin disease with a high impact on patients' quality of life. Dupilumab, an IL-4 and IL-13 inhibitor, was the first monoclonal antibody approved for the treatment of moderate-to-severe AD and is currently approved in patients aged 6 or older.

Methods: This is a nationwide, multicenter, retrospective, 48-week study designed by the Portuguese Group of AD to assess real-world efficacy and safety of dupilumab for the treatment of AD.

Adolescer Saudável: screening and follow-up of risk at school.

Objective: To characterize adolescents referred to medical consultation based on the screening tool "Perfil de Saúde do Utente Adolescente", and to compare to information gathered from a questionnaire and data assessed during the visit.

Methods: A retrospective and descriptive study, with analysis of the questionnaires filled out by adolescents and their respective medical records, in the period from January 2013 to June 2016.

Results: A total of 54 adolescents were seen, 57% male and mean age of 12±1.

Usefulness of Routine Fractional Flow Reserve for Clinical Management of Coronary Artery Disease in Patients With Diabetes.

Importance: Approximately one-third of patients considered for coronary revascularization have diabetes, which is a major determinant of clinical outcomes, often influencing the choice of the revascularization strategy. The usefulness of fractional flow reserve (FFR) to guide treatment in this population is understudied and has been questioned.

Objective: To evaluate the usefulness and rate of major adverse cardiovascular events (MACE) of integrating FFR in management decisions for patients with diabetes who undergo coronary angiography.

Impact of Routine Fractional Flow Reserve on Management Decision and 1-Year Clinical Outcome of Patients With Acute Coronary Syndromes: PRIME-FFR (Insights From the POST-IT [Portuguese Study on the Evaluation of FFR-Guided Treatment of Coronary Disease] and R3F [French FFR Registry] Integrated Multicenter Registries - Implementation of FFR [Fractional Flow Reserve] in Routine Practice).

Background: Fractional flow reserve (FFR) is not firmly established as a guide to treatment in patients with acute coronary syndromes (ACS). Primary goals were to evaluate the impact of integrating FFR on management decisions and on clinical outcome of patients with ACS undergoing coronary angiography, as compared with patients with stable coronary artery disease.

Methods And Results: R3F (French FFR Registry) and POST-IT (Portuguese Study on the Evaluation of FFR-Guided Treatment of Coronary Disease), sharing a common design, were pooled as PRIME-FFR (Insights From the POST-IT and R3F Integrated Multicenter Registries - Implementation of FFR in Routine Practice).

Impact of Routine Fractional Flow Reserve Evaluation During Coronary Angiography on Management Strategy and Clinical Outcome: One-Year Results of the POST-IT.

Background: Penetration of fractional flow reserve (FFR) in clinical practice varies extensively, and the applicability of results from randomized trials is understudied. We describe the extent to which the information gained from routine FFR affects patient management strategy and clinical outcome.

Methods And Results: Nonselected patients undergoing coronary angiography, in which at least 1 lesion was interrogated by FFR, were prospectively enrolled in a multicenter registry.

Successful Thrombolysis despite Having an Incidental Unruptured Cerebral Aneurysm.

Purpose. To report a case of successful thrombolysis performed in a patient with an incidental unruptured intracranial aneurysm and review the literature. Case Report.

Surveillance in ulcerative colitis: is chromoendoscopy-guided endomicroscopy always better than conventional colonoscopy? A randomized trial.

Background: Ulcerative colitis (UC) is associated with an increased risk of colorectal cancer. Chromoendoscopy showed superiority to conventional colonoscopy (CC) in surveillance studies including high-risk patients. We aimed to compare chromoendoscopy-guided endomicroscopy (CGE) with CC for intraepithelial neoplasia (IN) detection in patients with longstanding UC without primary sclerosing cholangitis and/or history of IN.

Rivaroxaban and dabigatran in patients undergoing catheter ablation of atrial fibrillation.

Aims: The recent availability of the novel oral anticoagulants (NOACs) may have led to a change in the anticoagulation regimens of patients referred to catheter ablation of atrial fibrillation (AF). Preliminary data exist concerning dabigatran, but information regarding the safety and efficacy of rivaroxaban in this setting is currently scarce.

Methods And Results: Of the 556 consecutive eligible patients (age 61.

Delirium in intensive care: an under-diagnosed reality.

Delirium occurs in up to 80% of patients admitted to intensive care units. Although under-diagnosed, delirium is associated with a significant increase in morbidity and mortality in critical patients. Here, we review the main risk factors, clinical manifestations and preventative and therapeutic approaches (pharmacological and non-pharmacological) for this illness.

[Patient with diabetes and chronic ischemic heart disease. Myocardial revascularization, how to do it?].

Diabetes is one of the reasons for major concerns when managing patients with acute or chronic ischemic heart disease. The presence of diabetes poses specific issues with respect to outcome and treatment options, leading to worse prognosis. The role of myocardial revascularization in the management of chronic ischemic heart disease is a matter of debate, largely due to some clinical studies that failed to demonstrate it's superiority.

[Growth and puberty in type 1 diabetes mellitus - experience from a pediatric endocrinology unit].

Background: Type 1 Diabetes Mellitus (T1DM) is the most common endocrine-metabolic disease in children. It is associated with vascular and neuropathic complications, and may also affect growth and development.

Objective: To correlate the metabolic control and disease duration with growth and puberty in patients with T1DM followed in a Pediatric Endocrinology Outpatient Clinic.

Protein-losing gastropathy associated with cytomegalovirus infection in a child.

Protein-losing gastropathy is a rare entity. Unlike the disease in adults, it usually is benign and self-limited in children. The aetiological contribution of cytomegalovirus has been insufficiently documented and the immunological status of patients was rarely described in most reports.

Morbid obesity in a child with monosomy 1p36 syndrome.

The monosomy 1p36 syndrome is a cause of syndromic obesity. It is characterised by psychomotor delay, hypotonia and typical craniofacial dysmorphism. Other features commonly associated are behavioural anomalies including hyperphagia and self-injuring, seizures, congenital heart disease and hypothyroidism.

[Anticoagulants and dual antiplatelet therapy combined, a challenge to our intelligence].

The combination of antiplatelet and anticoagulant drugs, a common practice in the setting of acute coronary syndromes, constitutes an important practical problem involving difficult decisions, that lack support both in terms of clinical evidence (adequate clinical studies are not available) and strong guidelines. The problem was particularly aggravated from the moment when practically all the patients with acute coronary syndromes started to be submitted to double antiplatelet therapy, especially those treated with drug eluting stents. Simply reminding that 10% of these patients have or will have atrial fibrillation gives us the dimension of the problem.

[Bleeding, the Achilles' heel in patients treated with anticoagulants. Approach in patients with atrial fibrillation].

Bleeding is always the Achilles' heel of all antithrombotic therapy, being unthinkable to use this type of therapy ignoring the complications that it may arise. The bleeding risk raises very particular problems, namely how to predict it and how to manage it. The withdrawal of antithrombotic drugs and transfusion are two important practical problems, involving clinical decisions that are generally very difficult.