2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC.

ACC/AHA
: American College of Cardiology/American Heart Association
ACCF/AHA
: American College of Cardiology Foundation/American Heart Association
ACE
: angiotensin-converting enzyme
ACEI
: angiotensin-converting enzyme inhibitor
ACS
: acute coronary syndrome
AF
: atrial fibrillation

/pdf/2016-esc-guidelines-for-the-diagnosis-and-treatment-of-acute-z18hg30pp1.pdf

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

/pdf/2016-esc-guidelines-for-the-diagnosis-and-treatment-of-acute-53v7yllhiz.pdf

ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012 : The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC

https://anmco.it/uploads/u_cms/media/2014/12/798e9298d77b7b8c9aa0514e43fe95a2.pdf

ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC.

2018 ESC/ESH Guidelines for the management of arterial hypertension.

We propose to analyse the long-term follow-up in patients older than 65 years of age who received a mechanical valve in the aortic position, using death and prosthetic-related complications as endpoints. From April 1988 to December 1995, 144 consecutive patients 65– 75 years of age (mean 67.7"2.5) were enrolled. Total duration of follow-up was 1663 patient-years (median 13.0 years) and was complete for 99% of the patients. Thirty-day mortality was 1.4% (ns2). At the end of the study, 77 patients (53.8%) were alive, with ages ranging from 77 to 91 years (mean 82.1"3.2 years). The overall 5-, 10- and 15-year actuarial survival was 87.4%"3.0, 67.7%"4.3 and 58.5%"4.5, respectively. Freedom from stroke was 93.3"3.1%, 84.6"3.3% and 71.7"4.5%, respectively, after identical periods. Freedom from major bleeding was 97.2"1.1%, 90.4"3.5% and 86.4"4.0%, respectively. Freedom from endocarditis was 95.7"2.3%, 95.0"2.1% and 94.4"2.5%, respectively, and freedom from reoperation was 98.0"1.2%, 97.6"1.3%, 96.9"2.4% and 96.4"2.6%, respectively. Freedom from major valve-related events was 87.7"2.6%, 73.9"3.4% and 61.5"4.6%, respectively. Nearly two-thirds of the patients were alive and free from major adverse valve-related events. Hence, we consider implantation of a mechanical prosthesis in elderly patients safe and appropriate, but the choice must be tailored for each specific patient. 2009 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.

Institutional report - Valves Long-term follow-up of elderly patients subjected to aortic valve replacement with mechanical prostheses

Resumo Os tumores neuroendocrinos primarios representam cerca de 4% do total dos tumores do mediastino anterior, incluindo o timo, afectando mais homens que mulheres numa razao de 3:1 e apresentando uma maior incidencia entre os 40 e os 60 anos. Antigamente classificados como timomas, desde 1972 sao considerados um grupo distinto de neoplasias timicas, podendo ser biologicamente activos, estando sobretudo associados a sindroma NEM-1 (19 a 25% dos doentes, sendo nestes casos mais agressivos). Sao descritos como tendo grande progressao local, recorrencia e metastases em elevada percentagem de casos, o que determina um mau prognostico. O estadiamento e o parâmetro mais importante para determinar a sobrevida. Tumores detectados em fase precoce e capsulados associam-se a um excelente prognostico, enquanto em estadios avancados, localmente invasivos, tem prognostico relativamente pobre. A remocao cirurgica completa, para todos os tumores timicos, e a base da terapeutica e o factor critico para a sobrevivencia a longo prazo, independentemente do tipo histologico. Sao uma causa de morte importante, nomeadamente os tumores associados a NEM-1 e sindroma de Cushing, e ha autores que defendem a realizacao de timectomia profilactica nestes doentes.

Tumor carcinóide do timo – Caso clínico

Atrial Fibrillation (AF) is the most common arrhythmia and is associated with an increased risk of heart-related deaths and the development of conditions such as heart failure, dementia, and stroke. Affecting mostly elderly people, AF is associated with high comorbidity, increased mortality and is a major socio-economic impact in our society. Therefore, the detection of AF episodes in personalized health (p-Health) environments can be decisive in the prevention of major cardiac threats and in the reduction of health care costs. In this paper we present a new algorithm for detection of AF based on the assessment of the three main physiological characteristics of AF: (1) the irregularity of the heart rate; (2) the absence of the P-wave and (3) the presence of fibrillatory waves. Several features were extracted from the analysis of 12-lead electrocardiogram (ECG) signals, the best features were selected and a support vector machine classification model was adopted to discriminate AF and non-AF episodes. Our results show that the inclusion of features from the analysis of the recovered atrial activity was able to increase the performance of the algorithm: sensitivity of 88.5% and specificity of 92.9%. In the WELCOME project it is being designed a novel light vest with an integrated sensor system that collects several signals, including 12-lead ECG signals. The proposed algorithm is currently integrated in the WELCOME feature extraction module, which is responsible for receiving raw signals, extraction higher level features (e.g. occurrence of AF episodes) and provide them to the clinical decision process.

Detection of Atrial Fibrillation Using 12-Lead ECG for Mobile Applications

Commentary: Mitral Stenosis After Undersized Annuloplasty for Secondary Mitral Regurgitation. Physics Can't Be Wrong.

Num trabalho publicado nesta edição da revista1, os autores, do Serviço de Cardiologia de Faro, assumem o objetivo de comparar a sua experiência de referenciação de doentes para cirurgia cardíaca no período de 1/01/2008 a 30/09/2014, dividido em dois grupos, de 1/01/2008 a 01/08/2011 (43 meses; 557 doentes) e de 01/08/2011 a 30/09/2014 (37 meses; 307 doentes). Esta divisão temporal está relacionada com alterações das vias de referência emanadas das respetivas Administrações Regionais de Saúde. Tanto quanto se sabe, mas não está claramente explicitado no trabalho, os doentes eram referenciados preferencialmente para um determinado hospital de Lisboa durante o primeiro período e passaram a ser predominantemente enviados para outro no segundo. Por razões não explicadas, o número de doentes referenciados em cada um dos períodos não é proporcional à duração de cada um, mas é possível que tal se deva a alguma dispersão da rede de referência no período mais recente. As características demográficas e clínicas dos doentes dos dois grupos eram semelhantes, mas o tempo médio de espera para cirurgia passou de 10,6 ± 18,5 dias para 55,7 ± 79,9 dias, respetivamente, o que determinou uma diferença significativa da morbilidade, refletida em novos internamentos (0,4 e 9,1%), e da mortalidade (0 e 2,3%) durante a espera. Importa, no entanto, salientar que os tempos de espera nos

Manuel J. Antunes

Papers

Institutional report - Valves Long-term follow-up of elderly patients subjected to aortic valve replacement with mechanical prostheses

Tumor carcinóide do timo – Caso clínico

Detection of Atrial Fibrillation Using 12-Lead ECG for Mobile Applications

Commentary: Mitral Stenosis After Undersized Annuloplasty for Secondary Mitral Regurgitation. Physics Can't Be Wrong.

A economia e os custos das redes de referenciação de doentes para cirurgia cardíaca