Orbital abscess is a frequent complication of pediatric acute sinusitis requiring surgical drainage combined with FESS. The preseptal transconjunctival approach provides safe orbital access, enabling effective drainage while preserving ocular function and avoiding facial scarring. We aimed to describe the case of a child with an orbital abscess treated with preseptal transconjunctival drai-nage combined with ESS. A 9-year-old boy presented with fever, purulent rhinorrhea, and left periorbital swelling. Computed tomograph showed left maxillary and ethmoidal sinusitis with an 8mm extraconal intraorbital abscess. After no improvement with intravenous antibiotics, he underwent FESS combined with preseptal transconjunctival abscess drainage. By postoperative day 7, complete resolution of infection and full recovery of ocular function were achieved. This case highlights timely surgical intervention in pediatric orbital complications of acute sinusitis. The combi-ned FESS and preseptal transconjunctival approach achieved infection control, preserved ocular function, and avoided scarring, supporting transorbital approaches in infectious orbital pathology.

Introduction: Pain is a very common symptom in Palliative Care, and a multidimensional approach is important. Currently, there are several scales that allow the assessment of isolated components of pain, but no tool for assessing total pain, resulting in a gap in this area. This study aimed to develop a total pain assessment protocol and subsequently assess its prevalence.
Methodology: Development of a total pain assessment protocol, applied to patients present in the Palliative Care Unit between January and February 2022. Formulation of a self-completion questionnaire, based on six validated scales (numerical pain scale, faces scale, McGill scale, HADS scale, FACIT-PAL scale and FACIT-SP-12 scale), with the aim of evaluating the presence of total pain (physical, emotional, social and spiritual). The presence of each of the aforementioned domains was assessed using descriptive statistics, medians, interquartile ranges and Spearman's correlation coefficient.
Conclusion: The presence of physical pain was verified in 100% of users on the numerical scale and in 91.7% on the face scale. According to the McGill scale, everyone indicated some degree of physical pain, and 83.3% some degree of psychological pain. Using the HADS scale, it can be seen that 75% had psychological pain. According to the FACIT-PAl and FACIT-Sp-12 scales, everyone presented some degree of social and spiritual pain. Finally, considering the presence of total pain in the presence of some degree of all types of pain, this was observed in the majority. This protocol represents a useful tool in clinical practice and for future studies.

Introduction: We aimed to identify the rate of symptomatic venous thromboembolism (VTE) in patients under-going shoulder arthroplasty (SA) and to evaluate the role of possible associated risk factors.
Methods: The authors retrospectively reviewed all patients who underwent shoulder arthroplasty (SA) at the same institution between February 2010 and October 2021. Patients were included if they had a follow-up of at least 3 months and consented to inclusion in the study. The authors identified cases in which symptomatic VTE occurred in the 3 months following surgery. Exclusion criteria included previous surgeries within a 3-month period or the use of pharmacological prophylaxis for VTE.
Results: One hundred and three patients (average age 69.33 years; 31.7% male) were eligible for the study. Two cases of symptomatic VTE were identified, corresponding to a VTE rate of 1.94% (95% CI: 0.24% - 6.84%). Pre-disposing factors for VTE (history of neoplasm, previous VTE, family history of VTE, oral contraceptive therapy, hormone therapy, peripheral vascular disease, BMI > 30) were analyzed. The presence of these risk factors did not statistically correlate with VTE occurrence (Fisher’s exact test p = 0.113).
Conclusion: The results of this single-center retrospective study suggest that the incidence of symptomatic VTE after shoulder arthroplasty, in patients without routine pharmacological prophylaxis, is relatively low. However, due to the small number of events and inherent methodological limitations, these findings must be interpreted with caution. The selective use of pharmacological prophylaxis in high-risk patients may be reasonable, but larg-er prospective studies are needed to clarify the precise role of pharmacological prophylaxis in this population.

Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma. In approximately 40% of cases, it presents in extranodal sites, particularly in the gastrointestinal tract. Its clinical presentation may mimic inflammatory bowel diseases, infectious conditions, or neoplasms, making early diagnosis challenging. We report the case of a 35-year-old man presenting with mechanical low back pain of several months duration and constitutional symptoms, initially managed under the suspicion of Crohn’s disease. Following an extensive multidisciplinary workup, a definitive diagnosis of anaplastic variant DLBCL, stage IV-B with intestinal involvement, was established. This case highlights the diagnostic complexity and underscores the importance of clinical follow-up, reconsideration of diagnostic hypotheses, and coordinated collaboration between primary care and hospital-based healthcare services.

Introduction: Arterial hypertension (HTN) is the most prevalent chronic disease in Portugal, affecting 36% of adults aged 25 to 74. It is a major risk factor for cardiovascular (CV) events, which remain the leading cause of morbidity and mortality worldwide. The World Health Organization estimates that approximately 600 million people have hypertension, accounting for over 7 million deaths annually. We aimed to characterize hypertensive patients with non-fatal major cardiovascular events followed in a local primary care unit over 10 years, assessing SCORE/SCORE2/OP risk factors, comorbidities, medical history, and pre-event pharmacological treatment.
Methods: A retrospective study was conducted using electronic health records (MIM@UF, SClínico, and RSE), including patients with HTN and major CV events between 2014 and 2024. Pregnant women, patients under 18 years old, and non-hypertensive individuals were excluded. Statistical analysis was performed using IBM SPSS®.
Results: A total of 185 patients were included (67% male), with a mean age of 72.7 years. The most prevalent comorbidities were dyslipidemia (87.6%), obesity (39.9%), and type 2 diabetes mellitus (39.5%). Stroke was the most frequent event (42.7%), followed by ischemic heart disease with angina (26.5%). Only 15.1% of patients with dyslipidemia had LDL levels within the target, despite 82.7% being on statins. Regarding HTN, 18.9% were untreated and 51.4% were on ?2 antihypertensive drugs, yet many remained uncontrolled.
Conclusion: Significant gaps persist in the control of HTN and dyslipidemia. Systematic risk stratification and therapeutic education are essential to prevent CV event recurrence in this high-risk population.

Introduction: Respiratory tract infections (RTI) are very common in pediatrics, being an important reason for work and school absenteeism. Avoidance of environmental factors that predispose to the risk of RTI is virtually impossible, as such forms of immunostimulation such as bacterial lysates, have been developed in recent years. In Portugal, only the OM-85, the Lantigen B, and the LW50020 are authorized and sold. We aimed to evaluate the effectiveness of bacterial immunotherapy in preventing recurrent RTIs in pediatric patients, based on the frequency of RTIs.
Methods: Systematic literature review of randomized clinical trials evaluating the efficacy of isolated bacterial immunotherapy in preventing recurrent RTI in pediatric age, with bacterial lysates marketed in Brazil, published on any date.
Results: Seven studies met the inclusion criteria and comprised 1097 children, of which 606 underwent the intervention. Of these, four were classified as moderate quality and three as high quality. Six studies evalua-ted the effectiveness of OM-85 and all found less RTI in the intervention group (p <0.05). Four studies that evaluated the prescription of antibiotic therapy found less antibiotic therapy in the OM-85 intervention group and one study in the LW50020 group (p <0.05). Two studies that evaluated school absenteeism found lower absenteeism in the group with OM-85 (p <0.05). Six studies described adverse effects, which were reduced and mainly gastrointestinal symptoms.
Conclusion: OM-85 demonstrated efficacy in reducing recurrent RTIs in children, with a good safety profile. However, more studies are needed that include and compare the different available lysates.

Dieulafoy’s lesion is a rare but potentially fatal cause of gastrointestinal bleeding, typically located in the stomach, with even rarer extragastric locations, as in the colon. Although endoscopy is the gold standard for diagnosis, it can be challenging due to the lesion’s small size, intermittent bleeding, or inaccessible location. In such cases, contrast-enhanced computed tomography has demonstrated a key role in identifying the source of bleeding and localizing the lesion, enabling prompt and effective endoscopic treatment, as illustrated in the present case. The diagnosis of Dieulafoy’s lesion remains challenging and requires high suspicion and close multidisciplinary collaboration.

Over the past 20 years, the Allergy Center of Hospital CUF Descobertas has developed a sustained trajectory grounded on three core pillars: differentiated clinical care, structured medical education, and scientific produc-tion with national and international impact. Embedded in a private institution with a clear academic activity, the Center has consolidated a multidisciplinary, patient-centred model of care for immune-allergic diseases across the entire life course, guided by the best available scientific evidence. Clinical activity has been accompanied by a strong commitment to medical training, including participation in the specialty residency program and the regular hosting of trainees from different hospitals and medical disciplines, generating an educational impact beyond the institution itself. In parallel, scientific output has been a defining element of this pathway, with more than 175 publications in indexed journals, encompassing clinical studies, international consensus documents, and practice-oriented recommendations. Leadership and participation in global scientific initiatives focusing on patient safety, health equity, and the defi-nition of clinical criteria have reinforced the Center’s international visibility and mirrored the conceptual evolution of the specialty, incorporating multimorbidity, environmental factors, digital innovation, and precision medicine. This article revisits the history and identity of the Allergy Center through these pillars, reflecting on its clinical, ins-titutional, and societal impact, while outlining a future vision grounded in scientific rigor and human-centred care.

This perspective highlights the value of international clinical experiences in Adolescent Medicine, drawing from the author’s residency training in Portugal and subsequent fellowship at Boston Children’s Hospital. Immersing in a new healthcare system provided a deeper appreciation of both shared global challenges and distinct cultural approaches to adolescent care. The article reflects on how international exchange fosters clinical growth through openness, vulnerability, and curiosity - qualities we ask of our adolescent patients and should also embrace as providers. Key topics explored include transitional care, adolescent autonomy, mental health screening, digital media use, and healthcare accessibility. Real-world examples, such as strengths-based communication, confidential care models, and virtual visit innovations, demonstrate how contrasting practices can inspire reimagined, more inclusive care standards. Programs supporting marginalized adolescents, particularly those living with HIV, underscore the urgency of equitable access. Ultimately, international experiences allow clinicians to exchange ideas, challenge assumptions, and build more responsive models of care. This piece invites pediatric providers to seek global learning opportunities and reminds us that, despite geographic and systemic differences, we are united by a shared goal: empowering adolescents to thrive.

KEY CLINICAL MESSAGE: Persistent dyspnea unresponsive to optimized asthma therapy should raise suspicion for structural airway obstruction. This case illustrates the importance of considering rare causes such as aortic arch malformations, highlighting the need for multidisciplinary assessment to achieve accurate diagnosis and safe management.

Airway obstruction in adults can arise from both structural and functional causes, sometimes mimicking common conditions such as asthma. We describe a 33-year-old woman referred to Immunoallergology for presumed uncontrolled asthma, who persisted with dyspnea and nasal obstruction despite optimized therapy. Pulmonary function testing suggested upper airway obstruction. Imaging revealed a right-sided aortic arch causing extrinsic tracheal compression and lingual tonsil hypertrophy contributing to retrobasilingual narrowing. Flexible nasoendoscopy confirmed turbinate and tongue-base hypertrophy with preserved laryngeal mobility. Multidisciplinary evaluation by Otorhinolaryngology, Pulmonology, Cardiology, and Thoracic Surgery deemed vascular surgery too high-risk, and conservative management with optimized medical therapy was recommended. This case illustrates the importance of considering rare structural anomalies in adults with refractory airway symptoms. A multidisciplinary, individualized approach is essential to achieve accurate diagnosis and safe management.

A 37-year-old woman who works as a veterinarian, with a medical history of ulcerative proctitis and xerophthalmia. Repeatedly sought care at the hospital and primary health center for urinary symptoms, initially interpreted as recurrent cystitis and empirically treated with antibiotics. Later developed myalgia and debilitating low back pain over 3 months, prompting further diagnostic investigations and referral to Orthopedics. Subsequently, she experienced progressive arthralgia and annular arthritis. Serology revealed a positive Brucella spp. IgM, leading to notification in the National Epidemiological Surveillance System (SINAVE), referral to Infectious Diseases, and initiation of targeted therapy with doxycycline (100 mg every 12 hours) and rifampicin (300 mg every 8 hours). Polymerase chain reaction (PCR) confirmed infection with Brucella melitensis, and magnetic resonance imaging (MRI) revealed a herniated disc. The instituted therapy resulted in a favorable clinical evolution. This case highlights the diagnostic challenges of brucellosis and underscores the importance of clinical suspicion in the context of occupational exposure.

Community-acquired pneumonia (CAP) remains a significant cause of morbidity and mortality in adults. Microorganisms classified as atypical, because they cannot be identified by traditional microbiological methods, represent a substantial diagnostic and therapeutic challenge. This review aims to synthesize the most recent evidence on the etiology, diagnosis, and therapeutic implications of atypical pneumonias in adults, integrating data from meta-analyses and current international recommendations. The main bacterial and viral agents are discussed, with an emphasis on suggestive clinical criteria, available diagnostic methods, and options for empirical therapy, addressing antimicrobial resistance and the rational use of antibiotic therapy, and offering a practical perspective for the management of CAP with suspected atypical pathogens.

Introduction: Gambling disorder, classified in the DSM-5 as a non-substance-related addictive disorder, is charac-terized by persistent and problematic gambling behavior that has a significant clinical impact. The World Health Organization (WHO) estimates that between 0.1% and 6% of the global population may develop this disorder. We aimed to characterize the risk of gambling disorder among the adult population in Portugal.
Methods: A cross-sectional study, using a convenience sample of adults recruited via social media and health units, was conducted using an online questionnaire with sociodemographic data, substance use, health status, and the Portuguese version of the South Oaks Gambling Screen (SOGS-PV).
Results: A total of 595 responses were included (mean age 39.2 years, 67.1% female). 10.9% (95% CI: 8.7–13.7) were at risk for gambling disorder. The most popular games are scratch cards (41.5%), lottery games (34.7%), and online games (22%). Contributing factors to gambling disorder included male gender (OR: 3.57; 95% CI: 1.99–6.52), tobacco use (OR: 2.60; 95% CI: 1.34–4.95) and having a mother (OR: 12.1; 95% CI: 0.534–138.2), friend (OR: 2.349; 95% CI: 0.948–5.423) or family member (OR: 2.85; 95% CI: 1.165–6.481) with gambling di-sorder. Only 1.7% reported discussing this topic with their family physician.
Conclusion: The risk of gambling disorder among Portuguese adults is significant. The presence of identifiable risk factors underscores the importance of opportunistic screening and preventive approaches in primary care, enhancing early detection and intervention.

Introduction: The pregnancy period and the first few months of life are a critical time for a child’s development. On the other hand, the transition to fatherhood represents a life event that increases the vulnerability to men-tal disorders in parents. Paternal postpartum depression (PPD) and its effects have received less attention than maternal postpartum depression (MPD), for which the impact on child development has already been described. This review article aims to synthesize the impact of PPD on child development.
Methods: A bibliographic search was conducted in June 2024 for meta-analyses, systematic reviews and rando-mized clinical trials published in the last 20 years, in Portuguese or English, in the databases PubMed, Cochrane Library, Database of Abstracts of Reviews of Effects, and BMJ Evidence-Based Medicine, using the terms “de-pression,” “father,” “infant,” and “development.” The Strength of Recommendation Taxonomy from the American Family Physician was used to assign levels of evidence and strength of recommendation.
Results: Of the 743 articles obtained, three met the selection criteria. These articles suggest that, like MPD, PPD negatively affects cognitive and language development in children up to 24 months of age.
Conclusion: Given the scientific evidence presented, the authors consider it relevant to create strategies and measures aimed at preventing mental illness in fathers.

Artificial intelligence (AI) has been transforming General Practice/Family Medicine, with applications in diagnostic support, treatments, and the automation of administrative tasks, contributing to greater efficiency and reducing the non-clinical workload of physicians.
However, the integration of AI requires an ethical and critical approach that safeguards clinical judgment, equity of access, data protection, and the humanization of care, ensuring that technology complements, rather than replaces, the doctor-patient relationship.
Family Medicine, due to its core characteristics as defined by World Organization of Family Doctors (WONCA), person-centred care, continuity, comprehensiveness, coordination, and contextual decision-making, presents a unique clinical environment where AI can have considerable impact.

Phagophobia is a rare condition that can be classified as an avoidant/restrictive food intake disorder, characterized by avoidance of swallowing due to fear of choking or suffocation, with a significant impact on the patient’s physical and mental health as well as on their family.
An eight-year-old girl developed phagophobia after a neighbor’s death by choking, subsequently restricting her diet to liquids only and experiencing weight loss. She began follow-up in child psychiatry and gradually resumed a normal diet. After experiencing a choking episode herself, she again restricted her food intake and started pharmacological treatment. Regarding the family impact, the mother developed a reactive depression, the brother presented partial food refusal, and there were occasional intrafamilial conflicts.
In this case, an early diagnosis likely contributed to a good response from both the patient and her family. Nevertheless, despite the absence of apparent prior family dysfunction, a significant family impact was evident, highlighting the importance of family-centered intervention to promote the recovery of both the patient and the family.

Introduction: Cardiovascular diseases are the leading cause of morbidity and mortality, with hypertension (HTN) being the most prevalent risk factor. Cardiovascular risk (CVR) stratification using Systematic Coronary Risk Estimation 2 (SCORE2) is currently recommended. The objective was to increase the proportion of patients with HTN undergoing CVR assessment using SCORE2.
Methods: A quality improvement study conducted in a Family Health Unit. Patients aged 40–69 years with uncomplicated HTN were included. Data were collected before the intervention (T0) and at 3 (T1) and 7 months (T2) following an educational intervention aimed at promoting the use of SCORE2 among the medical team.
Results: A total of 304 patients were included; 150 (49.3%) were male, with a median age of 59 years (interquartile range 52–64). Among patients with documented CVR assessment, the use of SCORE2 increased from 3.9% at T0 to 69.6% at T1, and from 6,6% to 47.4% at T2 (p<0.001). A significant reclassification to higher CVR categories was observed following implementation of the tool.
Conclusion: The intervention significantly increased the use of SCORE2 and led to reclassification to higher risk levels. The reduction in utilization at T2 highlights the need for structural integration of the tool into clinical information systems to ensure sustainability.

Alzheimer’s disease is currently understood as a clinical-biological entity whose characterization should take into account the use of biomarkers. Until recently, the use of biomarkers required a lumbar puncture or PET scan. The emergence of blood-based biomarkers has made the biological characterization of the disease more accessible and is considered one of the main advances in Alzheimer’s disease. Their use, however, must be careful, as their interpretation can be difficult—especially for the general population—and their value varies substantially depending on the population in which they are used. In this narrative review, we present the state of the art of blood biomarkers in Alzheimer’s disease, specifically the investigational data and their clinical applicability.

Digital health technologies have emerged as a transformative force in modern medicine, particularly in the field of cardiovascular care. With the advent of wearable devices, mobile health applications, telemedicine platforms, and AI-driven diagnostics, the potential to significantly enhance patient outcomes and revolutionize the delivery of cardiovascular care is more significant than ever. These technologies provide real-time monitoring, personalized treatment plans, and enhanced patient engagement, all of which are crucial for effectively managing chronic cardiovascular conditions and preventing adverse events. However, despite the promising potential of digital health, integrating these technologies into routine clinical practice has been met with numerous challenges. These include disparities in access to technology, concerns about data privacy and security, the absence of standardized protocols, and the need for interdisciplinary collaboration. Additionally, the long-term implications of widespread digital health adoption, including its impact on healthcare systems, costs, and the overall quality of care, have not been fully explored. This article addresses these gaps by critically examining the barriers to implementing digital health technologies in cardiovascular care, proposing strategies to overcome these challenges, and discussing the potential long-term effects on healthcare systems and patient outcomes. By doing so, it aims to provide a roadmap for successfully integrating digital health into cardiovascular care, ultimately leading to a more predictive, preventive, and personalized healthcare model.

Since the mid-20th century, research has increasingly highlighted the fundamental role of attachment behaviour in human development and the structuring of personality. Peter Fonagy introduced the concept of mentalization, a capacity that emerges within a context of secure attachment to caregivers. In contrast, under conditions of insecure attachment, the ability to mentalize tends to be compromised, leading to distorted self-representations and dysfunctional emotional regulation strategies.
In this context, a non-systematic literature review was conducted on the relationship between attachment, mentalization and personality disorders, integrating the classical theoretical contributions of Bowlby and Ainsworth with contemporary empirical evidence.
In conclusion, this review shows that understanding and treating personality disorders requires an integrative approach that considers attachment styles and mentalization capacity as central mechanisms of vulnerability and therapeutic change. The role of therapeutic interventions is reinforced, and more robust research in this field is needed.

Introduction: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death globally, with significant underdiagnosis and neglect. In Portugal, COPD prevalence was estimated at 14.2% in 2013. This study aimed to translate the "Understanding COPD Questionnaire" for the Portuguese population and evaluate its reliability and validity. The questionnaire assesses patients' knowledge of COPD, self-management skills, and satisfaction with pulmonary rehabilitation programs.
Methods: The translation process followed international guidelines, resulting in a consensus version.
Results: Reliability analysis, using Cronbach's alpha, showed an excellent internal consistency for Section A of the questionnaire (? = 0.92), which focuses on knowledge and self-efficacy regarding COPD. Dimension 1, related to knowledge about the disease, had the highest reliability. No items were excluded, as this would not improve the scale's consistency. Due to the limited number of participants who had attended pulmonary rehabilitation, Section B, which assesses satisfaction with such programs, could not be validated. However, this did not affect the primary goal of the questionnaire, which is to evaluate knowledge and self-management of COPD.
Conclusion: This study produced a reliable European Portuguese version of the "Understanding COPD Ques-tionnaire", with good internal consistency for Section A. The tool will be available to healthcare professionals, aiding in better understanding of patient health literacy and providing a foundation for more personalized care in COPD management.

Sclerosing cholangitis refers to a group of liver diseases characterized by inflammation and fibrosis of the bile ducts, which can lead to cirrhosis and liver failure. It is divided into two forms: primary, usually associated with inflammatory bowel disease, and secondary, caused by external factors.
Secondary sclerosing cholangitis associated with critically ill patients is a cholestatic disease that occurs in patients without known hepatobiliary pathology after admission to an Intensive Care Unit.
We present the case of a 55-year-old male patient admitted to the Intensive Care Unit due to septic shock associated with respiratory failure. During hospitalization, he developed abnormal liver enzyme levels, and magnetic resonance cholangiopancreatography and liver biopsy supported the diagnosis of secondary sclerosing cholangitis associated with critical illness.
This condition is of particular interest as it is associated with high morbidity and mortality, in addition to having a significant impact on the therapeutic management of patients.

Introduction: We intended to assess the prevalence of sexual dysfunction in men receiving opioid substitution therapy in a Portuguese center, which domains of sexual function are affected, and which factors influence sexual dysfunction.
Methods: We conducted a self-administered form, including: sociodemographic and clinical characterization; maintenance treatment with methadone or buprenorphine; presence of anxiety/depression, assessed with Hos-pital Anxiety and Depression Scale; sexual dysfunction, assessed with Massachusetts General Hospital – Sexual Functioning Questionnaire; erectile dysfunction, assessed with International Index of Erectile Function.
Results: A total of eighty-two patients participated in the study. Of these, 80.5% were receiving methadone treat-ment, with a mean current dose of 53.5 mg, a mean duration of treatment of 12.6 years, and a mean maximum dose of 86.2 mg. Buprenorphine was used by 19.5% of participants, with a mean current dose of 5.74 mg, a mean duration of treatment of 10.4 years, and a mean maximum dose of 8.07 mg. Antidepressants and antipsychotics were taken by 23.8% and 14.8% of participants, respectively. Anxiety and depression were present in 43.5% and 46.2% of cases, respectively. The Massachusetts General Hospital – Sexual Functioning Questionnaire revealed that 42.1% had sexual dysfunction and the item with the lowest score was general satisfaction. The International Index of Erectile Function revealed that 67.9% had erectile dysfunction and the item with the lowest score was achieving and maintaining an erection. There were no statistically significant differences between patients treated with methadone or buprenorphine, regarding the presence of sexual dysfunction and erectile dysfunction. The Factors significantly correlated with sexual dysfunction were: age, professional status, maximum methadone dose used by the patient, anxiety, and depression. The factors significantly correlated with erectile dysfunction were: age; marital status; maximum methadone dose used by the patient, tobacco, anxiety and depression.
Conclusion: We did not find evidence to switch from methadone to buprenorphine, if sexual dysfunction arises. Anxiety and depression seem to be the factors most correlated with sexual dysfunction and erectile dysfunction.

INTRODUCTION: The increasing number of breast cancer diagnoses, allied with a higher survival rate, brings new challenges. One of them is related to quality of life (QoL): understanding its dimensions with the goal of health resources optimization and continuous improvement of the QoL of women with breast cancer using Value-Based Healthcare (VBH) as the guiding concept.
METHODS: Observational, retrospective, longitudinal and descriptive-correlational study. EORTC QLQ-C30/ BR23 questionnaires were applied at different moments of follow-up to women with breast cancer followed in a private health institution for 2 years (n = 61).
RESULTS: Satisfactory QoL levels after 2 years of the diagnosis were identified. In the baseline moment, several factors that exert influence in the QoL of these women stand out: cognitive, social and sexual function; body image, future perspectives and the fatigue, pain, and secondary effects symptoms. After 2 years, these factors multiply and cover most of the questionnaire’s dimensions. Older women show lower global levels of QoL as well as worse physical and sexual function, and sexual satisfaction. Younger women show a positive QoL level trend, while older women show a negative trend.
CONCLUSION: QoL and its dimensions are not immutable. Health professionals and health institutions’ interven-tions must be dynamic and holistic to respond to women with breast cancer’s complex needs related to their QoL. Human, technical and material resources’ optimization, as well as a deepening of QoL-related knowledge, are ever more relevant to improve the health of all the people affected by this disease using VBH as the guiding concept.

INTRODUCTION: Given the rising rates of overweight and obesity, a growing number of individuals are seeking guidance from nutrition practitioners. This study aimed to assess adherence to nutrition intervention (Mediter-ranean Diet, MD) and its association with adiposity.
METHODS: We conducted this observational study at Hospital CUF Tejo with a sample of 53 patients with overweight and obesity regularly attending nutrition appointments. Participants completed a structured online questionnaire, and adherence to the MD was assessed through the PREDIMED questionnaire (low ? 5; mod-erate 6–9; high ?10). The number of appointments attended, follow-up duration, anthropometric and body composition data were extracted from clinical records.
RESULTS: Participants attended, on average, 3 nutrition consultations and had a moderate adherence to the MD. Weight, BMI and waist circumference significantly decreased after nutritional counselling, with a maintenance of weight and BMI 1 year and 10 months post-treatment. Age was positively and significantly associated with MD adherence (? = 0.047; 95% CI: 0.001;0.094). Male sex was associated with higher weight (? = 13.105; 95% CI: 7.663;18.547) and waist circumference (? = 6.695; 95% CI: 2.106;11.284) at the last nutrition appointment. Physical activity was negatively associated with waist circumference at the last appointment (? = -4.342; 95% CI: -8.648;-0.037). No association was observed between MD adherence and adiposity-related markers at the last nutrition consultation.
CONCLUSION: Tailored nutritional counselling provided by a nutrition professional in patients with overweight and obesity results in moderate adherence to the intervention and a reduction of adiposity-related markers.