Bial (Portugal)

Heart failure (HF) remains a major clinical and public health challenge in Portugal, associated with high morbidity, mortality, and economic burden. Despite notable therapeutic advances, the degree of underdiagnosis in Portugal remains substantial, as evidenced by findings from the recent Portuguese Heart Failure Prevalence Observational Study (PORTHOS), which estimated that 90% of identified cases corresponded to new diagnoses. Early detection of HF in primary care (PC) is crucial for the implementation of cost-effective strategies capable of modifying the disease course. Natriuretic peptides, particularly NT-proBNP, have consistently demonstrated robust utility as a tool for ruling-out HF diagnosis and are recommended by leading international societies for outpatient use due to their reliability and analytical stability. In Portugal, however, several barriers hinder their systematic use in primary care, including the absence of specific NT proBNP coding within prescribing and laboratory reporting systems, as well as persistent uncertainty regarding appropriate reference values. To address these gaps, a multidisciplinary working group was convened, including representatives from Cardiology, Internal Medicine, and General Practice/Family Medicine, in collaboration with the Portuguese Society of Cardiology and its Heart Failure Working Group, the Heart Failure Study Group of the Portuguese Society of Internal Medicine, the Portuguese Association of Family Medicine, the National Association of Family Health Units, the National Association of Clinical Laboratories, and the Portuguese Association of Clinical Analysts. This document, resulting from a literature review and structured expert consensus, proposes three technical recommendations to foster the appropriate and standardized use of NT-proBNP in Portuguese PC: (1) the use of NT-proBNP as the preferred biomarker for HF diagnosis in primary care; (2) the adoption of NT-proBNP cut-off values for exclusion (rule-out) and confirmation (rule-in) of HF, in alignment with international recommendations; and (3) the implementation of specific reporting guidance for clinical laboratories. Furthermore, it calls upon national health authorities to effectively integrate NT-proBNP into the National Health System, thereby contributing to reducing HF underdiagnosis in Portugal and improving health outcomes.

In the era of a dynamic development of technology, artificial intelligence has ceased to be solely a subject of research and has become a major factor impacting social, economic and educational reality. Therefore, a study was undertaken to examine parents’ attitudes towards the use of artificial intelligence in the education and upbringing of children. A survey-type research was conducted among 162 parents raising children attending grades 1-3 from several primary schools in Lubelskie Voivodeship. The main research problem was formulated as the question: How do parents perceive the use of artificial intelligence in the education and upbringing of children? The results of the study showed that respondents perceive both benefits and dangers related to the use of artificial intelligence in education. In contrast, they leave the area of parenting outside the influence of AI algorithms.

Foster families play a special role in supporting the development of a child after experiencing relational trauma. Parents awareness of the educational methods they use affects the child functioning in social, psychological, and physical aspects. Therefore, it is important to rationalize the use of positive and negative reinforcements. Considering the significance of the factors described, research was organized and conducted among foster parents from the Foster Parenting Association “One Heart”. The aim of the study was to determine what positive and negative reinforcements foster parents use in the upbringing process and what behavioral consequences they observe in the adopted children. In organizing the research, the research problem was formulated as follows: what is the role of rewards and punishments in raising children from foster families from the Foster Parenting Association “One Heart”? The study used the diagnostic survey method, along with the corresponding questionnaire technique. The research involved parents from 22 foster families affiliated with the Foster Parenting Association “One Heart”. The research results, based on the analysis of parents; statements, allow for a better understanding of the relationship between the use of punishments and rewards and the functioning of children in foster families. At the same time, they provide practical guidance for developing forms of support for foster families – so that educational measures effectively support the development of young people, taking into account the specifics of their previous experiences and individual needs.

Activation of the sympathetic nervous system is observed in pulmonary arterial hypertension patients. This study investigates whether inhibiting the conversion of dopamine into noradrenaline by dopamine β‐hydroxylase (DβH) inhibition with BIA 21‐5337 improved right ventricular (RV) function or remodeling in pressure overload‐induced RV failure. RV failure was induced in male Wistar rats by pulmonary trunk banding (PTB). Two weeks after the procedure, PTB rats were randomized to vehicle (n = 8) or BIA 21‐5337 (n = 11) treatment. An additional PTB group treated with ivabradine (n = 11) was included to control for the potential heart rate‐reducing effects of BIA 21‐5337. A sham group (n = 6) received vehicle treatment. After 5 weeks of treatment, RV function was assessed by echocardiography, magnetic resonance imaging, and invasive pressure–volume measurements before rats were euthanized. RV myocardium was analyzed to evaluate RV remodeling. PTB caused a fourfold increase in RV afterload which led to RV dysfunction, remodeling, and failure. Treatment with BIA 21‐5337 reduced adrenal gland DβH activity and 24‐h urinary noradrenaline levels confirming relevant physiological response to the treatment. At end‐of‐study, there were no differences in RV function or RV remodeling between BIA 21‐5337 and vehicle‐treated rats. In conclusion, treatment with BIA 21‐5337 did not have any beneficial—nor adverse—effects on the development of RV failure after PTB despite reduced adrenal gland DβH activity.

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IntroductionIn BIPARK-1 and BIPARK-2, addition of once-daily opicapone to levodopa/carbidopa significantly reduced daily “OFF”-time relative to placebo in adults with Parkinson's disease (PD) and motor fluctuations. Diary data from these studies were pooled and analyzed post hoc to characterize “OFF”-times around nighttime sleep and to explore the effects of opicapone 50 mg. Methods“OFF” before sleep (OBS), “OFF during the nighttime sleep period” (ODNSP), early morning “OFF” (EMO), and duration of nighttime sleep and awake periods were analyzed descriptively at baseline. Mean changes from baseline to Week 14/15 (end of double-blind treatment) were analyzed using two-sided t-tests in participants with data for both visits. ResultsAt baseline, 88.3 % (454/514) of participants reported having OBS (34.0 %), ODNSP (17.1 %), or EMO (79.6 %). Those with ODNSP had substantially shorter mean duration of uninterrupted sleep (4.4 h) than the overall pooled population (7.1 h). At Week 14/15, mean decrease from baseline in ODNSP duration was significantly greater with opicapone than with placebo (−0.9 vs. −0.4 h, P < 0.05). In participants with ODNSP at baseline, the decrease in total time spent awake during the night-time sleep period was significantly greater with opicapone than with placebo (−1.0 vs. −0.4 h, P < 0.05), as was the reduction in percent time spent awake during the night-time sleep period (−12.8 % vs. −4.5 %, P < 0.05). Conclusion“OFF”-times around nighttime sleep were common in BIPARK-1 and BIPARK-2. Opicapone may improve sleep by decreasing the amount of time spent awake during the night in patients with PD who have night-time sleep period “OFF” episodes.

This retrospective study aimed to explore the therapeutic potential of Bifidobacterium bifidum supplementation on elderly ischemic stroke patients. We retrospectively analyzed electronic medical records from 153 elderly ischemic stroke patients. Patients were stratified into 2 groups: those receiving B bifidum supplementation (Intervention group, n = 73) and those receiving standard treatment without any additional supplementation (Control group, n = 80). Outcomes were assessed using the National Institutes of Health Stroke Scale (NIHSS), Montreal Cognitive Assessment (MoCA), Self-Rating Depression Scale (SDS), and Self-Rating Anxiety Scale (SAS). Inflammatory markers, immunological indicators, neurotrophic factor, and gut-brain axis (GBA)-related markers were also evaluated at baseline and during 4-week follow-up. Compared to the control group, the intervention group exhibited significant improvements in the NIHSS, MoCA, SDS and SAS scores (P < .001). Enhanced levels of brain-derived neurotrophic factor (BDNF) and reduced levels of NPY were observed in the intervention group. Additionally, inflammatory markers, including IL-6, IL-8, IL-1β, and TNF-α, were significantly reduced in the intervention group, as well as significant increases in immunoglobulin levels (Ig A, Ig G, and Ig M) (P < .001). Besides, lower incidences of diarrhea and constipation were observed in the intervention group (P < .001), while the incidence of abdominal pain was no significant changed. B bifidum supplementation offers promising therapeutic benefits in improving neurological, cognitive, and psychological outcomes in elderly ischemic stroke patients, which may be achieved by regulating the GBA, reducing inflammation and promoting immune function. These findings highlight the importance of integrating gut health strategies in stroke management.

The issue of gifted children growing up in a natural family environment has been addressed quite widely. However, small amount of research regarding gifted children residing in the foster care environment is noticeable. At the same time, the issue of having, developing and supporting abilities is extremely significant, especially with regard to pupils of foster care environments deprived of their primary developmental environment, which is the family. Foster care environments can also effectively support the potential of their pupils. The publication is an attempt to answer the question of what support activities are undertaken in the foster care environment in relation to gifted pupils? The research method is case studies. The research indicates various forms of support for gifted pupils: the organization of additional activities, depending on the interests or abilities of the pupil or the financial support as the one they need for the future process of independence, as well as emotional support and others. At the same time, some differences are visible between the activities of institutional and family care, as the latter definitely more often uses the help of psychological and pedagogical counseling centers or organizations supporting gifted students, even if in the form of funded scholarships.