Open excision vs. percutaneous intermetatarsal ligament release for Morton's neuroma: A comparative analysis - Is width important?

Background: Morton's interdigital neuroma, caused by compression of the interdigital nerve, often requires surgery when conservative treatment fail. This study compared open neurectomy and percutaneous intermetatarsal ligament release (PILR), focusing on various predictive factors.

Methods: A retrospective study, comprising 46 patients (58 feet) with Morton's neuroma who underwent either open excision (n = 24) or PILR (n = 22) from 2012 to 2022.

Thromboprophylaxis and adult congenital heart disease: The latest on indications, risk scoring and therapy.

Advances in medical care have significantly extended the lifespan of patients with congenital heart disease (CHD), allowing most to survive into adulthood. However, they continue to face significant cardiovascular morbidity, particularly atrial arrhythmias (AA), heart failure, and thromboembolic (TE) events. TE events in adult CHD patients arise from various factors, including AA, intracardiac repairs, cyanotic CHD, Fontan palliation, pregnancy, and mechanical heart valves (MHV).

Impact of technical, patient-related and measurement variables on serial Hounsfield unit-based quantitative coronary plaque analysis in computed tomography: time for a new chapter.

This review article explores the challenges and controversies involved in accurately identifying and reliably quantifying coronary plaque over time through coronary computed tomography angiography (CCTA), particularly focusing on lipid-rich, low-attenuation plaques. It highlights significant variability in lipid-rich plaque measurements across studies, questioning their reliability for tracking biological plaque transformation in clinical practice. To address this issue, the review article proposes suggestions for serial CCTA plaque measurements, aiming for realistic goals for reproducible and meaningful serial plaque CCTA imaging.

Role of Octaspline Multielectrode Catheter and Unipolar Reference Location for Premature Ventricular Contraction Ablation.

Background: An accurate local activation time (LAT) map is essential during premature ventricular contraction (PVC) ablation. The aim of this study was to evaluate whether the use of a novel octaspline multielectrode catheter, with and without the use of a catheter-embedded unipolar reference, improves LAT mapping during PVC ablation compared to a pre-existing pentaspline mapping catheter.

Methods: This study prospectively assessed 10 consecutive patients referred for PVC ablation from January to June 2023.

A Portuguese expert panel position paper on the management of heart failure with preserved ejection fraction - Part II: Unmet needs and organization of care in Portugal.

In Portugal, a 15.2% prevalence of heart failure with preserved ejection fraction (HFpEF) was recently identified among those aged ≥50 years. HFpEF represents 90% of Portuguese heart failure patients.

Dual Posteromedial Portal Technique: Arthroscopic Loop Suspensory Fixation-Posterior Cruciate Ligament Tibial Avulsion Fracture.

Posterior cruciate ligament avulsion fracture injuries have been associated with an increased risk of meniscal tears and premature patellofemoral/medial compartment osteoarthritis. Sports-related trauma is a common cause of posterior cruciate ligament avulsion fractures. Surgical management is recommended for displaced bony avulsion of the posterior cruciate ligament to stabilize the knee and prevent knee pain, nonunion, and osteoarthritis progression.

Potential predictors of efficacy outcomes following tofacitinib dose reduction in patients with ulcerative colitis in stable remission: a post hoc analysis of outcomes from the RIVETING study.

Background: Tofacitinib is an oral Janus kinase inhibitor for the treatment of ulcerative colitis (UC).

Objectives: To investigate potential predictors of efficacy in RIVETING.

Design: This post hoc analysis included patients with UC in stable remission (⩾6 months) on tofacitinib 10 mg twice daily (BID) maintenance therapy (⩾2 years of treatment), who received tofacitinib 5/10 mg BID in RIVETING.

Portuguese National Registry of Interventional Cardiology: Official report of percutaneous coronary angiography and intervention from 2014 to 2023.

Introduction And Objectives: To present the report on the trends in percutaneous coronary activity data in Portugal from the last decade (from 2014 to 2023).

Methods: Data were extracted from the Portuguese National Registry of Interventional Cardiology (RNCI) and the numbers in recent years were compared and complemented by information from the 2023 European Society of Cardiology Atlas in Interventional Cardiology (IC) survey, which was administered to the director of every IC department. Linear regression analysis was used to assess trends in activity over time.

Respiratory epithelial adenomatoid hamartoma, a different presentation.

Respiratory epithelial adenomatoid hemartoma (REAH) has been included in the World Health Organization's classification of tumors since 2005. It results from non-neoplastic overgrowth of glandular tissue. It is rarely located in the upper airway and in 70% of these cases it is present in the nasal septum.

Combined Anterior Cruciate Ligament and Anterolateral Ligament Reconstruction Using Suspensory Button Fixation.

Despite advancements in surgical techniques for anterior cruciate ligament reconstruction, some patients still experience rotational instability after surgery. Anterior cruciate ligament and anterolateral ligament reconstruction have been described using hamstring tendon autograft while preserving the insertion of the semitendinosus tendon. This article describes a combined anterior cruciate ligament and anterolateral ligament reconstruction using a hamstring tendon autograft with a suspensory button fixation.

Criteria for medication reconciliation in major orthopedic surgery in high-risk patients: A consensus based on the Delphi method.

Background: Medication reconciliation is relevant in transitional care, however, given limited resources, it is necessary to identify the patients who benefit most from this activity.

Aim: To validate criteria to identify patients at high risk of medication errors undergoing major orthopedic surgery.

Method: Delphi Method in 3 phases, April to June 2023, to obtain consensus on the inclusion criteria, previously defined.

Direct oral anticoagulants versus vitamin K antagonists for cerebral venous thrombosis (DOAC-CVT): an international, prospective, observational cohort study.

Background: There is an unmet need for high-quality data from prospective studies on the safety and effectiveness of direct oral anticoagulants (DOACs) for the treatment of cerebral venous thrombosis (CVT). We aimed to compare the safety and effectiveness of DOACs versus vitamin K antagonists (VKAs) for the treatment of CVT in a setting that reflects daily clinical practice.

Methods: DOAC-CVT was an international, prospective, observational cohort study done in 65 hospitals in 23 countries across five continents.

A Portuguese expert panel position paper on the management of heart failure with preserved ejection fraction - Part I: Pathophysiology, diagnosis and treatment.

Heart failure (HF) with preserved ejection fraction (HFpEF) affects more than 50% of HF patients worldwide, and more than 70% of HF patients aged over 65. This is a complex syndrome with a clinically heterogeneous presentation and a multifactorial pathophysiology, both of which make its diagnosis and treatment challenging. A Portuguese HF expert panel convened to address HFpEF pathophysiology and therapy, as well as appropriate management within the Portuguese context.

Worsening heart failure: progress, pitfalls, and perspectives.

For most patients with chronic heart failure (HF), the clinical course of the disease includes periods of apparent clinical stability punctuated by episodes of clinical deterioration with worsening signs and symptoms, a condition referred to as worsening heart failure (WHF). Over time, episodes of WHF may become more frequent, and patients may enter a cycle of recurrent events associated with deterioration in their quality of life and functional capacity, hospitalizations, and ultimately death. WHF is apparently an old concept but seems to have acquired new boundaries in terms of definition and clinical and prognostic value due to the fast-paced evolution of the HF treatment landscape and the emergence of new drugs in this setting.

Clinical-genomic profiling of MDS to inform allo-HSCT:Recommendations from an international panel on behalf of the EBMT.

For patients with myelodysplastic neoplasm/syndrome (MDS), allogeneic hematopoietic cell transplantation (allo-HCT) represents the only potentially curative treatment, capable of eradicating disease-related mutant hematopoietic cells and establishing normal donor hematopoiesis. Biologic-assignment clinical trials have indicated that in eligible patients, allo-HCT is associated with superior clinical outcomes compared to non-transplant therapy. However, this therapeutic option is only available to a subset of patients, and the outcome is influenced by multiple factors inherent to the patient, the MDS subtype, and the allo-HCT procedure itself.

How to Avoid and Handle Problems in the Placement of Cement-Augmented Fenestrated Percutaneous Pedicle Screws?

Background And Objectives: Pedicle screws with a central cannula and fenestrations allow cement augmentation, providing lower risk for screw loosening and pullout, especially in these patients with poor bone quality. This study aims to offer suggestions for resolving issues and reducing complications associated with the use of cement-augmented fenestrated pedicle screws.

Methods: A retrospective study was conducted across multiple centers on patients who received fenestrated pedicle screws with cement augmentation (CAFPS).

Suspicion and referral of patients with transthyretin amyloid cardiomyopathy: Recommendations by a Portuguese multidisciplinary expert panel.

Early diagnosis of transthyretin amyloid cardiomyopathy (ATTR-CM) is crucial for better disease management and outcome. To ensure timely diagnosis, a multidisciplinary panel of Portuguese experts, including cardiologists, internal medicine specialists, and general practitioners, have developed a national consensus to aid physicians in enhancing the referral of patients with suspicion of ATTR-CM in Portugal. A structured approach was used to develop the consensus: (1) an online survey aimed at identifying clinical red flags, patient journeys, and diagnostic tools related to ATTR-CM; (2) a face-to-face roundtable meeting where the survey findings were discussed and a consensus was reached on referral and diagnostic algorithms for ATTR-CM in Portugal; and (3) critical review of the proposed algorithms.

Curcumin in Ophthalmology: Mechanisms, Challenges, and Emerging Opportunities.

Ocular diseases affecting the anterior and posterior segments of the eye are major causes of global vision impairment. Curcumin, a natural polyphenol, exhibits anti-inflammatory, antioxidant, antibacterial, and neuroprotective properties, making it a promising candidate for ocular therapy. However, its clinical use is hindered by low aqueous solubility, poor bioavailability, and rapid systemic elimination.

White matter alterations in episodic migraine without aura patients assessed with diffusion MRI: effect of free water correction.

Objective: To assess the effect of modeling free water (FW) on the identification of white matter (WM) microstructure alterations using diffusion Magnetic Resonance Imaging (dMRI) in episodic migraine without aura patients compared with healthy controls.

Background: Diffusion tensor imaging (DTI) studies examining WM in migraine patients previously overlooked the potential influence of FW partial volume effects. Correcting FW effects could offer a clearer understanding of WM changes in migraine.

High specificity clinical signs of impending death: A scoping review.

Background: Accurate diagnosis of impending death is essential to provide proper care in the last days and hours of life. Recognising the death situation immediately allows adjustment of care goals, ensuring that they suit the patient's condition, as well as tuning the team's and family's expectations.

Objective: To map and describe evidence on high specificity clinical signs of impending death in cancer and noncancer hospitalised patients over 18 years of age.

Diagnosis of Chronic Kidney Disease in Adults in Portugal: Practical Recommendations from National Clinical and Laboratory Experts.

Chronic kidney disease represents a significant public health issue, affecting approximately 9.8% of the adult population in Portugal. Despite this figure, early diagnosis of this disease in high-risk groups remains limited.