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Percorrer ULSALG por Objetivos de Desenvolvimento Sustentável (ODS) "17:Parcerias para a Implementação dos Objetivos"
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- Adherence to pharmacological therapy for hypertension in Portugal: insights from patients’ focus groupsPublication . Silva, Beatriz Rosendo; Vieira, Diogo; Ferreira, Ana Sofia Fernandes; Santos, Bárbara; Pratas, Carolina; Soares, Carolina A.; Coito, Catarina; Santeiro, Catarina; Gomes, Hugo Amorim; Pereira, João Pedro; Gato, Maria Martins; Martins, Susana Patrícia; Sousa, Tânia; Prazeres, Filipe; Santiago, Luiz Miguel; Rosendo, InêsPurpose: Medication adherence is crucial for blood pressure control. Knowledge of medication adherence and its influencing factors, particularly within cultural and healthcare contexts, is essential for developing effective strategies to enhance medication adherence. Qualitative studies have explored patients' perspectives globally. Few have focused on strategies to improve adherence, and such research is lacking in Portugal. This study aimed to gather the perspectives of Portuguese patients with Arterial Hypertension (HTN) concerning the most effective strategies to enhance adherence to antihypertensive medication and to understand its contributing factors. Methods: We conducted qualitative research through online focus groups of four to ten participants each. Participants were adult patients with HTN taking at least one antihypertensive drug from the primary care setting. The number of focus groups was achieved through theoretical saturation. Purposive sampling was used, with patients recruited through their family doctors. Participants were recruited from all seven Portuguese regions, representing both sexes, controlled and uncontrolled HTN, and a diverse range of educational levels, employment statuses, living arrangements, and socioeconomic statuses. Meetings were audio-recorded and transcribed. Two researchers conducted content analyses using MAXQDA 2023 through comparative analyses and consensus. Results are presented narratively. Results: Four focus groups were conducted. Findings reported patients' strategies to improve adherence to pharmacological therapy for HTN. These included changes to medication and blister packs, such as a color-coded system. Other strategies involved reducing medication costs and making specific suggestions for primary healthcare. Patients additionally proposed psychological support and technological aids. Barriers such as difficulties in accepting medication and facilitators, such as fears of complications associated with HTN, were also identified. Conclusion: These results highlight the multifaceted perspectives of Portuguese patients with HTN and emphasise the role of technology, family support, and primary health services in promoting adherence. Such insights should be incorporated when addressing medication adherence in HTN.
- Mismatch repair deficiency or microsatellite instability in locally advanced rectal cancer patients treated with total neoadjuvant therapyPublication . Benhima, Nada; Audisio, Alessandro; Gallio, Chiara; Ricco, Gianluca; Meillat, Hélène; Velenik, Vaneja; Carmen Riesco, Maria; Suárez Alecha, Javier; Rasschaert, Gertjan; López-Bravo, David Páez; Tougeron, David; Carvalho, Carlos; Borelli, Beatrice; Famiglietti, Federico; De la Pinta, Carolina; Manuel O’Connor, Juan; Artaç, Mehmet; Braam, Pètra M.; Puccini, Alberto; Waldhorn, Ithai; Vanden Bulcke, Alexander; Loi, Mauro; De Felice, Francesca; Eid, Michal; Deleporte, Amélie; Rossini, Chiara; Montenegro, Paola; Fiore, Michele; Van Den Eynde, Marc; Shamseddine, Ali; Geboes, Karen P.; Messina, Marco; Mulet Margalef, Núria; Houlzé-Laroye, Constance; Kirac, Iva; Pastorino, Alessandro; Salati, Massimiliano; Argalácsová, Soňa; Morano, Federica; Capdevila, Jaume; Garajovà, Ingrid; Antoun, Claire; Pinto, Cidália Maria Sousa; Lutz, Manfred P.; Adams, Richard A.; Chau, Amélie; Siebenhuener, Alexander; Dermine, Alexandre; Ghidini, Michele; Dulskas, Audrius; Papamichael, Demetris; Javed, Muhammad Ahsan; Ruiz-Garcia, Erika; Tomášek, Jiří; Petrillo, Angelica; Baratelli, Chiara; Vandamme, Timon; Spolverato, Gaya; Bock, Felix; Diaz, Marie; Campana, Luca Giovanni; Sur, Daniel; Karampeazis, Athanasios; Patsko, Veronika; Puleo, Francesco; Bounedjar, Adda; Fiorica, Francesco; Gilliaux, Quentin; Bernardini, Ilaria; De Stefano, Alfonso; Guren, Marianne Grønlie; Jakubauskas, Matas; Sert, Fatma; Gomez Galdon, Maria; Veron Sanchez, Ana; Vierasu, Ortansa-Irina; Assaf, Irene; Moretti, Luigi; Martinive, Philippe; Liberale, Gabriel; Van Laethem, Jean-Luc; Sclafani, FrancescoBackground: Data on the prognostic value of dMMR/MSI-H in locally advancer rectal cancer (LARC) are inconsistent and mostly from patients treated with conventional neoadjuvant therapy. We sought to evaluate oncological outcomes by mismatch repair/microsatellite (MMR/MS) status in LARC patients treated with total neoadjuvant therapy (TNT). Methods: Patients from the International Real-World Study of TNT in Rectal Cancer tested for dMMR/MSI-H by immunohistochemistry and/or molecular testing were included. Pathological complete response (pCR), complete response (CR, pCR + clinical complete response), event-free survival (EFS) and overall survival (OS) were assessed by MMR/MS status in the overall and matched populations. For the latter, variable-ratio matching according to nine variables (age, year of diagnosis, tumour location, staging modality, cT stage, cN stage, presence of lateropelvic lymphadenopathy, distance from the mesorectal fascia, TNT regimen) was applied. Results: Of 1911 patients, 1320 (69.1%) (09/2012-09/2025) had information on the MMR/MS status, 46 (3.5%) having dMMR/MSI-H tumours. No outcome differences were found by MMR/MS status in the overall population. In the matched population (n = 372), pCR was 14.2% among patients with pMMR/MSS tumours versus 12.5% among those with dMMR/MSI-H tumours (adjusted OR 1.07, 95%CI 0.39-2.91, p = 0.899), while CR was 18.9% and 16.7%, respectively (adjusted OR 0.95, 95%CI 0.35-2.58, p = 0.917). 3-year EFS and 5-year OS were 65.8% and 79.2%, and 67.6% and 93.5% in patients with pMMR/MSS and in those with dMMR/MSI-H tumours, respectively (adjusted HR EFS 1.30, 95%CI 0.57-2.89, p = 0.527; adjusted HR OS 2.52, 95%CI 0.67-9.42, p = 0.171). Conclusions: In this study, the dMMR/MSI-H phenotype did not hold prognostic value in LARC patients treated with TNT.
- Verrucous carcinoma of the esophagus: a deceiving entity with an uncertain etiology – case reportPublication . Carvalho, Isabel Malta; Gago, Tânia; Relvas, Luís; Portugal, Margarida; Cadilla, Jesus; Peixe, BrunoVerrucous carcinoma of the esophagus is an extremely rare malignancy, described as a well-differentiated variant of esophageal squamous cell carcinoma, typically exhibiting exophytic/verrucous growth and intraluminal involvement that is often rich in inflammation and hyperkeratosis, which hampers histologic diagnosis and consequently delays treatment. We report the case of a 58-year-old woman with progressive dysphagia and a circumferential, verrucous esophageal lesion, without histologic confirmation despite multiple biopsies and endoscopic resections, showing only focal p16 positivity. After further evaluation with CT, endoscopic ultrasound, and FDG-PET/CT, a presumptive diagnosis of locally advanced verrucous carcinoma of the esophagus was assumed, and palliative chemotherapy was initiated, followed by a sustained endoscopic and radiologic response. This case highlights the importance of multidisciplinary discussion when verrucous carcinoma of the esophagus is suspected and the unexpected, sustained response despite unresectability.