1,192 results match your criteria: "Centro Hospitalar Lisboa-Norte[Affiliation]"

Type 2 inflammation: a Portuguese consensus using Web-Delphi and decision conferencing (INFLAT2-PT).

Expert Rev Clin Immunol

January 2025

CEGIST-Centro de Estudos de Gestão, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal.

Objectives: Atopic/allergic diseases impose a growing burden on public health, affecting millions of patients worldwide. The main objective of this study was to develop a national expert consensus on relevant clinical questions related to type 2 inflammation.

Methods: We conducted: a comprehensive literature review with a qualitative analysis to identify the most repeated themes on the overlap of conditions; a modified 3-round Web-Delphi (or e-Delphi); and a final online decision conference.

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Introduction: Unilateral biportal endoscopy (UBE) is a minimally invasive surgical (MIS) technique utilized for lumbar decompression, which has recently gained popularity in Europe. We aimed to explore the value of sequential adaptive e-learning, followed by simulator-based hands-on training modules for UBE at the occasion of the 2024 EANS Young Neurosurgeons meeting.

Materials And Methods: An adaptive e-learning was designed by learning engineers (Area 9 Lyceum), based on theoretical content provided by two endoscopic spine surgeons.

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Cardiophrenic Lymph Node Resection Through Abdominal Subxiphoid Approach: Surgical Technique.

Surg Technol Int

October 2024

Department of Digestive, Hepatobiliary, and Liver Transplantation Surgery, AP-HP, Hôpital de la Pitié-Salpêtrière, Paris, France.

While metastatic extension to the cardiophrenic lymph nodes (CPN) is relatively rare, cardiophrenic lymphadenectomy may be performed for diagnostic and/or therapeutic purposes. The subxiphoid approach is appropriate, especially for CPN in the prepericardiac area, offering adequate exposure while avoiding the morbidity associated with pleural or pericardial breach. In this article, we describe the surgical technique-detailing the retrosternal liberation section of the tranversus abdominis muscle, followed by cardiophrenic dissection and lymphadenectomy.

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Article Synopsis
  • Many heart failure (HF) patients do not receive optimal doses of RAAS inhibitors due to worries about hyperkalemia (HK).
  • The CARE-HK registry enrolled 2558 adults with chronic HF, primarily those with reduced ejection fraction, to evaluate RAASi treatment patterns and HK management across clinical practices in Europe and the USA.
  • The study aims to better understand how RAAS inhibitors are used in patients at high risk for HK and to analyze their treatment outcomes in routine medical settings.
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Introduction: Developed by the Global Vascular Guidelines committee, the Global Limb Anatomic Staging System (GLASS) is an angiographic scoring system used for quantifying infrainguinal disease extent and predicting treatment success with endovascular techniques (EVT). Currently, no other risk prediction model is available for patients with chronic limb threatening ischemia (CLTI) undergoing EVT. GLASS' validation and adoption outside academic institutions for research are limited.

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Deep brain stimulation (DBS) is a neurosurgical procedure that involves implanting electrodes into specific areas of the brain to treat a variety of medical conditions, including Parkinson's disease. Doubts and questions from patients prior to or following surgery should be addressed in line with the most recent scientific and clinical practice. ChatGPT emerges as an example of how artificial intelligence can be used, with its ability to comprehend and answer medical questions in an understandable way, accessible to everyone.

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Recommendations for the implementation of a national lung cancer screening program in Portugal-A consensus statement.

Pulmonology

November 2024

Pneumologia, ULS São João, CHUSJ, Porto, Portugal; FMUP, Porto, Portugal; i3S, UP, Porto, Portugal; Presidente da Sociedade Portuguesa de Pneumologia.

Article Synopsis
  • - Lung cancer is a major global health issue, and low-dose computed tomography (LDCT) screening can reduce mortality rates by up to 25%, making it a cost-effective solution that European countries are encouraged to explore for implementation.
  • - A task force reviewed literature and engaged in discussions to develop recommendations for launching lung cancer screening programs in Portugal, focusing on the guidelines of the World Health Organization tailored to the local healthcare system.
  • - Key areas covered in the recommendations include identifying eligible populations, invitation methods, radiological requirements, result reporting, referral processes, and the integration of smoking cessation programs as essential for effective lung cancer screening.
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Objective: Short-term outcomes of deep brain stimulation of the anterior nucleus of the thalamus (ANT-DBS) were reported for people with drug-resistant focal epilepsy (PwE). Because long-term data are still scarce, the Medtronic Registry for Epilepsy (MORE) evaluated clinical routine application of ANT-DBS.

Methods: In this multicenter registry, PwE with ANT-DBS were followed up for safety, efficacy, and battery longevity.

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Introduction: Myasthenia gravis (MG) is an autoimmune, neurologic disease that causes a wide range of symptoms. While the transsternal, transcervical and thoracotomy approaches are accepted as effective, there is still debate regarding the VATS approach.

Materials And Methods: We analyzed our center's surgical experience with thymectomy for myasthenia gravis, comparing the results of patients operated on using VATS and more invasive approaches, over a period of 10 years.

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Objectives: Activated clotting time (ACT) is commonly used to monitor anticoagulation during cardiac surgeries. Final ACT values may be essential to predict postoperative bleeding and transfusions, although ideal values remain unknown. Our aim was to evaluate the utility of ACT as a predictor of postoperative bleeding and transfusion use.

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Article Synopsis
  • The study investigates the relationship between renal disease and metabolic syndrome (MS) by evaluating kidney histology in participants from the European Nephrectomy Biobank.
  • Researchers defined MS based on criteria like BMI, blood pressure, glucose levels, and cholesterol, excluding patients with diabetes or known renal disease.
  • Results show that individuals with MS are older, have a higher prevalence of chronic kidney disease, and display more severe renal morphological changes compared to those without MS, suggesting that ischemic renal disease and potential diabetic nephropathy may contribute to their kidney issues.
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The impact of cardiopulmonary bypass time on the Sequential Organ Failure Assessment score after cardiac surgery.

Interdiscip Cardiovasc Thorac Surg

May 2024

Innate Immunity and Inflammation Laboratory, Instituto Gulbenkian de Ciência, Oeiras, Portugal.

Objectives: Postoperative organ dysfunction is common after cardiac surgery, particularly when cardiopulmonary bypass (CPB) is used. The Sequential Organ Failure Assessment (SOFA) score is validated to predict morbidity and mortality in cardiac surgery. However, the impact of CPB duration on postoperative SOFA remains unclear.

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Article Synopsis
  • Imposter syndrome (IS) is a common psychological issue affecting many professionals, particularly in competitive fields like neurosurgery, where a European survey found 94% of young neurosurgeons show symptoms of IS.
  • The survey involved 232 participants and assessed demographics, IS levels using the Clance Imposter Phenomenon Survey (CIPS), and possible compensatory behaviors.
  • Results indicated that IS was linked to experience level and sex, with male neurosurgeons being less likely to experience intense IS, while reading more than five articles weekly increased the risk, highlighting the need for tailored interventions to support affected individuals.
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[Not Available].

Alzheimers Dement

May 2024

Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.

Article Synopsis
  • Effective longitudinal biomarkers, like cerebral perfusion, are crucial for tracking disease progression in presymptomatic genetic frontotemporal dementia (FTD) carriers.
  • The study examined cerebral perfusion in various genetic FTD groups using advanced MRI techniques and found declines in gray matter perfusion across all groups, with specific regional patterns.
  • Results suggest that monitoring cerebral perfusion could serve as an early biomarker for detecting FTD before symptoms appear, especially highlighting differences among genetic subgroups.
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Introduction: We aimed to expand the range of the frontotemporal dementia (FTD) phenotypes assessed by the Clinical Dementia Rating Dementia Staging Instrument plus National Alzheimer's Coordinating Center Behavior and Language Domains (CDR plus NACC FTLD).

Methods: Neuropsychiatric and motor domains were added to the standard CDR plus NACC FTLD generating a new CDR plus NACC FTLD-NM scale. This was assessed in 522 mutation carriers and 310 mutation-negative controls from the Genetic Frontotemporal dementia Initiative (GENFI).

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Cardiopulmonary exercise testing in clinical practice: Principles, applications, and basic interpretation.

Rev Port Cardiol

September 2024

Department of Cardiology, Pulmonary Vascular Disease Unit, Centro Hospitalar Universitário de Santo António, Porto, Portugal; CAC ICBAS-CHP - Centro Académico Clínico Instituto de Ciências Biomédicas Abel Salazar - Centro Hospitalar Universitário de Santo António, Porto, Portugal; Department of Immuno-Physiology and Pharmacology, UMIB - Unit for Multidisciplinary Research in Biomedicine, ICBAS - School of Medicine and Biomedical Sciences, Universidade do Porto, Porto, Portugal; ITR - Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal.

Cardiopulmonary exercise testing (CPET) provides a noninvasive and integrated assessment of the response of the respiratory, cardiovascular, and musculoskeletal systems to exercise. This information improves the diagnosis, risk stratification, and therapeutic management of several clinical conditions. Additionally, CPET is the gold standard test for cardiorespiratory fitness quantification and exercise prescription, both in patients with cardiopulmonary disease undergoing cardiac or pulmonary rehabilitation programs and in healthy individuals, such as high-level athletes.

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Background: The role of capsule endoscopy in the evaluation of the small bowel is well established, and current guidelines position it as a first-line test in a variety of clinical scenarios. The advent of double-headed capsules further enabled the endoscopic assessment of colonic mucosa and the opportunity for a one-step noninvasive examination of the entire bowel (pan-enteric capsule endoscopy [PCE]).

Summary: We reviewed the technical procedure and preparation of patients for PCE, as well as its current clinical applications and future perspectives.

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Genomic insights into the expansion of carbapenem-resistant Klebsiella pneumoniae within Portuguese hospitals.

J Hosp Infect

June 2024

Laboratory of Bacterial Evolution and Molecular Epidemiology, Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa, Lisbon, Portugal. Electronic address:

Carbapenem-resistant Klebsiella pneumoniae (CR-KP) are a public health concern, causing infections with a high mortality rate, limited therapeutic options and challenging infection control strategies. In Portugal, the CR-KP rate has increased sharply, but the factors associated with this increase are poorly explored. In order to address this question, phylogenetic and resistome analysis were used to compare the draft genomes of 200 CR-KP isolates collected in 2017-2019 from five hospitals in the Lisbon region, Portugal.

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Advances in Cerebral Venous Thrombosis.

Stroke

August 2024

Instituto de Anatomia, Faculdade de Medicina, Universidade de Lisboa, Portugal (D.A.d.S., L.L.N.).

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Background: COVID-19 pandemic is thought to have changed the epidemiology of some pediatric neurosurgical disease: among them are the intracranial complications of sinusitis and otitis (ICSO). According to some studies on a limited number of cases, both streptococci-related sinusitis and ICSO would have increased immediately after the pandemic, although the reason is not clear yet (seasonal changes versus pandemic-related effects). The goal of the present survey of the European Society for Pediatric Neurosurgery (ESPN) was to collect a large number of cases from different European countries encompassing the pre-COVID (2017-2019), COVID (2020-2021), and post-COVID period (2022-June 2023) looking for possible epidemiological and/or clinical changes.

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Introduction: Information about pan-genotypic treatments for hepatitis in Portugal is scarce. We aimed to evaluate the effectiveness and safety of glecaprevir plus pibrentasvir (GLE/PIB) treatment for hepatitis C virus (HCV) infection in real-world clinical practice.

Methods: An observational prospective study was implemented in six hospitals with 121 adult HCV patients who initiated treatment with GLE/PIB between October 2018 and April 2019, according to clinical practice.

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