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- Inconsistent risk stratification thresholds across European guidelinesPublication . Ferreira Santos, José; Ladeiras-Lopes, Ricardo; Dores, Hélder; Comprehensive Health Research Centre (CHRC) - pólo NMS; NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM); Sociedade Portuguesa de Cardiologia | Elsevier
- Real-world safety data of first-line drugs for rheumatoid arthritisPublication . Ramos Rodrigues, Joana; Pires, L.; Inês, L.; Morgado, M.; Pontes Ferreira, M.; Cunha, A.; Almeida, S.; Santos, Marta; Moniz, A. C.; Melim, D.; Bernardes, M.; Marques Gomes, C.; Diz Lopes, M.; Carvalho, D.; Polido Pereira, J.; Aguiar, J.; Sopa, I.; Duarte, C.; Canhão, F.; Palos, S.; Miguel, C.; Vieira, A.; Reynolds, L.; Oliveira, M.; Pinheiro, F.; Abreu, C.; Matias, S.; Duarte, A. C.; Chícharo, A.; Teixeira, V.; Teixeira, P. M.; Fonseca, A. R.; Lourenço, M. H.; Rua, C.; Silva, C.; Oliveira, M.; Águeda, A.; Rodrigues, M.; Assunção, H.; Nero, Patrícia; Couto, M.; Santos Carneiro, H.; Augusto, D.; Magalhães, M. F.; Madruga Dias, João; Melo, T.; Campinho, C.; Pereira, P.; Raposo, A.; Lagoas Gomes, J.; Valido, J.; Farinha, F.; Pereira da Silva, J. A.; Vilar, A.; Costa, J. A.; Cruz, M.; Garcia, J.; Araújo, F.; Sequeira, G.; Cordeiro, A. C.; Mourão, A. F.; NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM); Comprehensive Health Research Centre (CHRC) - pólo NMS; Sociedade Portuguesa de ReumatologiaObjectives: To assess adverse events (AE) associated with first-line therapies for rheumatoid arthritis (RA) in a real-world setting. Material and Methods: Retrospective multicenter cohort study of patients fulfilling classification criteria for RA and followed up in 66 rheumatology centers from the Rheumatic Diseases Portuguese Registry (Reuma.pt). All AE reports associated with first-line disease-modifying antirheumatic drugs (DMARDs) up to November 2024 were included. Demographic and clinical data were analyzed, and AE characteristics were investigated. Categorical and continuous variables were compared using chi-square tests and Mann–Whitney U tests, respectively. Statistical significance was defined as p < 0.05. Results: Among 1 880 AE entries, 377 (20.1%) were attributed to first-line DMARDs, most commonly methotrexate (62.9%) although no information on drug dosage was available. The median age at AE occurrence was 58.6 years (IQR: 19.32), and 82% were female. A causality assessment was available in 317 reports, with 40.3% deemed “probable,” 28.1% “possible,” and 10.6% “definitive.” Severe AE were reported in 13.2% of cases, with pulmonary involvement being the most common (20.8%). Overall, 46.7% of patients discontinued treatment for any reason. Male sex was significantly associated with severe AE (OR = 2.31; 95% CI: 1.17–4.55; p = .014), and older patients were more likely to experience severe AE (median age 65.7 vs. 57.9 years; p < .001). The most affected body organ systems were gastrointestinal (9.3%), skin (8.2%), and hematological (8.2%). The median time to AE onset from treatment initiation was 1.27 years (IQR: 2.63), and from disease onset was 8.56 years (IQR: 11.76). Conclusions: AE related to first-line RA therapies can lead to significant clinical consequences, including treatment discontinuation. Male sex and advanced age were associated with increased AE severity. The most affected systems appear consistent with known drug safety profiles, particularly that of methotrexate; however, the absence of information regarding drug dosage precludes more detailed conclusions. These findings emphasize the need for individualized monitoring strategies and improved pharmacovigilance to optimize long-term treatment safety and adherence in RA management.
- Cardiopulmonary exercise stress testing in PortugalPublication . Vilela, Eduardo M.; Bento, Luísa; Antunes, Alexandre; Oliveira, Luís; Mendes, Miguel; Abreu, Ana; Durazzo, Anaí; Cunha, Gonçalo; Dores, Hélder; Pereira, Hélder; Gameiro, João; Gonçalves, Lino; Teixeira, Madalena; Santos, Mário; Dinis, Paulo; Fontes-Carvalho, Ricardo; Amorim, Sandra; Gavina, Cristina; NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM); Comprehensive Health Research Centre (CHRC) - pólo NMS; Laboratório Associado de Translacção e Inovação para a Saúde Global - LA Real (Pólo NMS); Sociedade Portuguesa de Cardiologia | ElsevierIntroduction and objectives: Cardiopulmonary exercise testing (CPET) provides relevant data in several clinical contexts. Although reports highlight its application across various moments of the cardiovascular continuum, from heart failure (HF) to the assessment of athletes, its implementation has been described as suboptimal. This study aimed to assess perspectives on CPET training and usage patterns among cardiologists in Portugal. Methods: An online questionnaire divided into three parts (participant characteristics, training and application of CPET and knowledge assessment) was structured and sent to members of the Portuguese Society of Cardiology. The study population comprised physicians with a medical specialty in cardiology (specialists or residents from the second year onwards). Results: Seventy individuals (52.9% male, 57.1% ≤50 years old) provided valid answers. Most (58.6%) had access to CPET in their workplace, while 65.7% reported using it in their clinical practice; HF was the most frequent indication for use. Just under half of participants (48.6%) had not dedicated or intended to dedicate time to CPET during residency; lack of access, interest, and time were the most frequently reported reasons. Less than half of those who participated in CPET exams during residency thought they had become proficient in its use. Most participants (97.1%) reported that specific training during residency could improve usage. Conclusions: This survey provides up-to-date information on CPET implementation, highlighting challenges and areas of potential improvement, such as training and accessibility. These findings may provide a framework for optimizing the use of this key test in cardiovascular medicine.
- Reuma.pt-a dynamic registry supporting clinical practice and research in rheumatologyPublication . Vieira-Sousa, Elsa; Sepriano, Alexandre; Rodrigues, Ana Maria; Cravo, Ana Rita; da Silva, Jose A. P.; Santos, Maria Jose; Torres, Rita; C.Barreira, Sofia; Azevedo, Soraia; NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM); Comprehensive Health Research Centre (CHRC) - pólo NMS; Sociedade Portuguesa de Reumatologia
- A home-based ehealth intervention for an older adult population with food insecurityPublication . Gomes, Luís Antunes; Gregório, Maria João; Iakovleva, Tatiana A.; De Sousa, Rute Dinis; Bessant, John; Oliveira, Pedro; Branco, Jaime da Cunha; Canhão, Helena; Rodrigues, Ana Maria; Comprehensive Health Research Centre (CHRC) - pólo NMS; NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM); NOVA School of Business and Economics (NOVA SBE); Centro de Estudos de Doenças Crónicas (CEDOC); JMIR PublicationsBackground: Food insecurity is a global public health challenge, affecting predominately the most vulnerable people in society, including older adults. For this population, eHealth interventions represent an opportunity for promoting healthy lifestyle habits, thus mitigating the consequences of food insecurity. However, before their widespread dissemination, it is essential to evaluate the feasibility and acceptability of these interventions among end users. Objective: This study aims to explore the feasibility and acceptability of a home-based eHealth intervention focused on improving dietary and physical activity through an interactive television (TV) app among older adults with food insecurity. Methods: A pilot noncontrolled quasi-experimental study was designed with baseline and 3-month follow-up assessments. Older adult participants with food insecurity were recruited from 17 primary health care centers in Portugal. A home-based intervention program using an interactive TV app aimed at promoting healthy lifestyle behaviors was implemented over 12 weeks. Primary outcomes were feasibility (self-reported use and interest in eHealth) and acceptability (affective attitude, burden, ethicality, perceived effectiveness, and self-efficacy), which were evaluated using a structured questionnaire with a 7-point Likert scale. Secondary outcomes were changes in food insecurity (Household Food Insecurity Scale), quality of life (European Quality of Life Questionnaire with five dimensions and three levels and Functional Assessment of Chronic Illness Therapy-Fatigue), physical function (Health Assessment Questionnaire, Elderly Mobility Scale, grip strength, and regularity of exercise), and nutritional status (adherence to the Mediterranean diet). Results: A sample of 31 older adult individuals with food insecurity was enrolled in the 12-week intervention program with no dropouts. A total of 10 participants self-reported low use of the TV app. After the intervention, participants were significantly more interested in using eHealth to improve food insecurity (baseline median 1.0, IQR 3.0; 3-month median 5.0, IQR 5.0; P=.01) and for other purposes (baseline median 1.0, IQR 2.0; 3-month median 6.0, IQR 2.0; P=.03). High levels of acceptability were found both before and after (median range 7.0-7.0, IQR 2.0-0.0 and 5.0-7.0, IQR 2.0-2.0, respectively) the intervention, with no significant changes for most constructs. Clinically, there was a reduction of 40% in food insecurity (P=.001), decreased fatigue (mean -3.82, SD 8.27; P=.02), and improved physical function (Health Assessment Questionnaire: Mean -0.22, SD 0.38; P=.01; Elderly Mobility Scale: Mean -1.50, SD 1.08; P=.01; regularity of exercise: Baseline 10/31, 32%; 3 months 18/31, 58%; P=.02). No differences were found for the European Quality of Life Questionnaire with five dimensions and three levels, grip strength, or adherence to the Mediterranean diet. Conclusions: The home-based eHealth intervention was feasible and highly acceptable by participants, thus supporting a future full-scale trial. The intervention program not only reduced the proportion of older adults with food insecurity but also improved participants' fatigue and physical function.
- The hidden legacy of a surgical triumphPublication . Laranjo, Sérgio; NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM); Comprehensive Health Research Centre (CHRC) - pólo NMS; Sociedade Portuguesa de Cardiologia | Elsevier
- Exercise stress testing in the 21st centuryPublication . Dores, Hélder; Mendes, Miguel; Dores, Helder; Dinis, Paulo; Vilela, Eduardo; Mendes, Miguel; NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM); Comprehensive Health Research Centre (CHRC) - pólo NMS; Laboratório Associado de Translacção e Inovação para a Saúde Global - LA Real (Pólo NMS); Sociedade Portuguesa de Cardiologia | ElsevierUntil recent decades, exercise testing with electrocardiographic monitoring (ET) was a fundamental test to evaluate individuals with suspected or known cardiovascular disease (CVD). Since its inception, the landscape of CVD has profoundly changed; classical indications such as the diagnosis of ischemic heart disease have been progressively superseded by other modalities. ET can still, however, provide valuable data across the cardiovascular continuum. In this focused two-part article, we appraise the role of ET in contemporary settings: part I provides an overview of core parameters, while part II addresses select main areas of interest.
- Anti-Osteoporotic Medication-Related Jaw OsteonecrosisPublication . Ferreira Azevedo, Sofia; Pinto Oliveira, Cláudia; Prata, Ana Rita; Cunha, Inĕs; Barcelos, Anabela; Barcelos, Anabela; NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM); Comprehensive Health Research Centre (CHRC) - pólo NMS; Biblioteca Nacional de Portugal, Centro de Estudos Históricos, CELOM
- How did we get here?Publication . Branco, Jaime; Branco, Jaime; Comprehensive Health Research Centre (CHRC) - pólo NMS; NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM); Sociedade Portuguesa de Reumatologia
- Eosinophilic granulomatosis with polyangiitis treated with Mepolizumab and Rituximab combination therapy – a case reportPublication . Moniz, Ana Catarina; Moniz, Ana Catarina; Gago, L.; Gago, Laura; Santos, M. E.; Melim, D.; Dias Rodrigues, S.; Araújo, P.; Branco, Jaime; Branco, Jaime; Gonçalves, M. J.; Gonçalves, Maria João; NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM); Sociedade Portuguesa de Reumatologia