Browsing by Issue Date, starting with "2025-05"
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- The Use of Continuous Glucose Monitoring in People Living with Obesity, Intermediate Hyperglycemia or Type 2 Diabetes.Publication . Battelino, Tadej; Lalic, Nebojsa; Hussain, Sufyan; Ceriello, Antonio; Klobucar, Sanja; Davies, Sarah J; Topsever, Pinar; Heverly, Julie; Ulivi, Francesca; Brady, Kevin; Tankova, Tsvetalana; Galhardo, Júlia; Tagkalos, Kostas; Werson, Erik; Mathieu, Chantal; Schwarz, PeterA global trend towards increased obesity, intermediate hyperglycemia (previously termed prediabetes) and type 2 diabetes, has prompted a range of international initiatives to proactively raise awareness and provide action-driven recommendations to prevent and manage these linked disease states. One approach, that has shown success in managing people already diagnosed with type 2 diabetes mellitus, is to use continuous glucose monitoring (CGM) devices to help them manage their chronic condition through understanding and treating their daily glucose fluctuations, in assocation with glucose-lowering medications, including insulin. However, much of the burden of type 2 diabetes mellitus is founded in the delayed detection both of type 2 diabetes mellitus itself, and the intermediate hyperglycemia that precedes it. In this review, we provide evidence that using CGM technology in people at-risk of intermediate hyperglycemia or type 2 diabetes mellitus can significantly improve the rate and timing of detection of dysglycemia. Earlier detection allows intervention, including through continued use of CGM to guide changes to diet and lifestyle, that can delay or prevent harmful progression of early dysglycemia. Although further research is needed to fully understand the cost-effectiveness of this intervention in people at-risk or with early dysglycemia, the proposition for use of CGM technology is clear.
- 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.Publication . Silva-Cardoso, José; Moreira, Emília; Tavares de Melo, Rachel; Moraes-Sarmento, Pedro; Cardim, Nuno; Oliveira, Mário; Gavina, Cristina; Moura, Brenda; Araújo, Inês; Santos, Paulo; Peres, Marisa; Fonseca, Cândida; Pedro Ferreira, João; Marques, Irene; Andrade, Aurora; Baptista, Rui; Brito, Dulce; Cernadas, Rui; Dos Santos, Jonathan; Leite-Moreira, Adelino; Gonçalves, Lino; Ferreira, Jorge; Aguiar, Carlos; Fonseca, Manuela; Fontes-Carvalho, Ricardo; Franco, Fátima; Lourenço, Carolina; Martins, Elisabete; Pereira, Hélder; Santos, Mário; Pimenta, JoanaIn 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. HFpEF management in Portugal is challenging due to patient heterogeneity, diagnostic and therapeutic complexity, and organizational constraints on the healthcare system. Considering the above, a panel of Portuguese experts convened to address HFpEF management within the national context. This was done in a two-paper set. This, the second paper, identifies unmet needs and suggests a set of measures to improve the current organization of HFpEF management in Portugal. Our purpose is to create a multidisciplinary integrated care system, ensuring a seamless connection between hospitals and primary care. Additionally, we propose a practical approach to the management of HFpEF, including a roadmap for screening, diagnosis, referral and treatment. The aim is to help clinicians improve HFpEF management throughout the disease trajectory.
- Official Development Assistance and Private Voluntary Support for Reproductive, Maternal, Neonatal, and Child Health in Guinea-Bissau: Assessing Trends and Effectiveness.Publication . Casimiro, Anaxore; Branco, Joana; Maulide Cane, Réka; Andrade, Michel Jareski; Varandas, Luís; Craveiro, IsabelBackground: Reproductive, maternal, neonatal, and child health (RMNCH) remains a key priority for official development assistance and private voluntary assistance (ODA+) in low-income countries. In Guinea-Bissau, maternal and child mortality rates remain high, with the healthcare system heavily dependent on foreign aid. This study analyzes ODA+ trends for RMNCH in Guinea-Bissau from 2002 to 2018 and assesses its impact on maternal, neonatal, infsupplent, and under-five mortality rates. Methods: We used data from the OECD Creditor Reporting System and applied the Muskoka2 methodology to estimate RMNCH-related disbursements. Funding trends were categorized by donor type and RMNCH subsectors. A longitudinal analysis used regression models to assess the relationship between aid categories and mortality outcomes. Results: RMNCH funding accounted for 8.9% of total ODA+ to Guinea-Bissau, with most aid directed toward child health. Models revealed a negative association between child health funding and under-five and infant mortality, while reproductive health funding showed no significant correlation with maternal or neonatal mortality. Conclusions: Although variable, ODA+ for RMNCH in Guinea-Bissau has helped reduce child mortality. However, maternal and neonatal mortality require targeted interventions and improved coordination. Fluctuating aid disbursements emphasize the need for sustainable health financing and stronger donor alignment with national priorities.