The Best Articles of 2022 in the Arquivos Brasileiros de Cardiologia and Revista Portuguesa de Cardiologia

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2020 Top 10 Original Articles in the Arquivos Brasileiros de Cardiologia and the Revista Portuguesa de Cardiologia

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A importância do turismo criativo para o desenvolvimento de cidades de pequena dimensão e de áreas rurais: estudo de caso dos projetos-piloto do Noroeste de Portugal e inseridos no Projeto CREATOUR

Tese de Doutoramento em Geografia (Especialidade em Geografia Humana)Nas últimas décadas, o turista cultural tornou-se mais exigente com a qualidade da oferta dos destinos turísticos. Este tipo de turista passou a exigir um contacto mais direto com a cultura da comunidade que visita sendo a realização de atividades criativas uma das possibilidades. Paralelamente, os destinos turísticos existentes, principalmente, as cidades de pequena dimensão e as áreas rurais necessitam de atrair mais visitantes, potenciar, valorizar e promover os recursos turísticos e criar produtos turísticos mais inovadores, diferenciadores e autênticos. Estes dois aspetos têm conduzido à necessidade de desenvolver um novo segmento ligado ao turismo criativo para as pequenas cidades e áreas rurais, de forma a se conseguir atrair mais visitantes e, por sua vez, desenvolver a sua economia local e regional. Para se conseguir isto é necessário criar projetos criativos e inovadores, de modo a contribuir para o desenvolvimento de destinos turísticos culturais criativos. É neste contexto, que foi criado o projeto CRETOUR “Desenvolver Destinos de Turismo Criativo em Cidades de Pequena Dimensão e em Áreas Rurais”, que se iniciou em finais de 2016 e que terminou em abril de 2020. O seu principal objetivo foi o de desenvolver e implementar uma abordagem integrada e um plano de investigação centrados no turismo criativo em cidades de pequena dimensão e áreas rurais em quatro N.U.T.S. II de Portugal Continental: Norte, Centro, Alentejo e Algarve. A presente investigação centra-se na análise dos projetos criativos desenvolvidos na região do Noroeste de Portugal, relacionados com seis instituições do Projeto CREATOUR e na avaliação dos seus impactes nos territórios onde foram implementados. Foram utilizadas fontes primárias e secundárias para o desenvolvimento da nossa investigação e para alcançarmos os objetivos definidos. A nível de fontes primárias foi realizada uma recolha fotográfica e de vídeo da participação dos mentores dos projetos selecionados para a região do Noroeste Português nos IdeaLabs regionais e nacionais e na implementação dos projetos propostos. Foi também aplicada uma grelha de avaliação das atividades implementadas nos seis projetos-piloto na região, inquéritos por questionário aos participantes das atividades das instituições-piloto em estudo para determinar a sua perceção sobre as atividades desenvolvidas, inquéritos por entrevista semiestruturada aos mentores dos projetos-piloto para aferir qual a sua perceção sobre as atividades realizadas e aos agentes locais e regionais sobre a importância do desenvolvimento do turismo criativo na região do Noroeste Português. Concluímos que as atividades foram avaliadas de forma bastante positiva por parte dos elementos que as realizaram e que gostariam de repeti-las. Também se identificou que as seis instituições-piloto têm potencial para continuarem a realizar atividades no futuro. De acordo com as entrevistas realizadas aos agentes locais e regionais, aferiu-se que a região do Noroeste tem potencial para desenvolver um produto turístico criativo, mas foi salientado que os projetos-piloto e as entidades locais e regionais terão que trabalhar em parceria tentando interligar as atividades a produtos ou rotas já existentes na região do Noroeste de Portugal.In the last decades, the cultural tourist has become more demanding with the quality of the tourist destinations offer. This type of tourist began to require a more direct contact with the culture of the community that visits, with creative activities being one of the possibilities. At the same time, existing tourist destinations, mainly small cities and rural areas, need to attract more visitors, boost, value and promote tourist resources and create more innovative, differentiating and authentic tourist products. These two aspects have led to the need to develop a new segment linked to creative tourism for small towns and rural areas, in order to be able to attract more visitors and, in turn, develop their local and regional economy. To achieve this it is necessary to create creative and innovative projects, in order to contribute to the development of creative cultural tourist destinations. It is in this context that the CRETOUR project “Developing Creative Tourism Destinations in Small Cities and Rural Areas” was created, which began in late 2016 and ended in April 2020. Its main objective was to develop and implement an integrated approach and a research plan focused on creative tourism in small towns and rural areas in four NUTS II of Mainland Portugal: North, Center, Alentejo and Algarve. The present investigation focuses on the analysis of creative projects developed in the Northwest region of Portugal, related to six institutions of the CREATOUR Project and on the evaluation of their impacts in the territories where they were implemented. Primary and secondary sources were used for the development of our research and to achieve the defined objectives. At the level of primary sources, a photographic and video collection of the participation of the mentors of the selected projects for the Portuguese Northwest region was carried out in the regional and national IdeaLab, as well as in the implementation of the proposed projects. An evaluation grid was also applied to the activities implemented in the six pilot projects in the region, questionnaire surveys of participants in the activities of the pilot institutions under study to determine their perception of the activities carried out, surveys by semi-structured interview to the mentors of the pilot projects to assess their perception about the activities carried out and to local and regional agents about the importance of the development of creative tourism in the Portuguese Northwest region. We conclude that the activities were evaluated in a very positive way by the elements that performed them and they would like to repeat them. It was also identified that the six pilot institutions have potential to continue to carry out activities in the future. According to the interviews with local and regional agents, it was found that the Northwest region has the potential to develop a creative tourism product, however, it was pointed out that pilot projects and local and regional entities must work in partnership trying to interconnect activities to products or routes already existing in the Northwest region of Portugal

Protective effects of SGLT-2 inhibitors across the cardiorenal continuum: two faces of the same coin

The cardiovascular and renal systems are closely interconnected in health and disease. Disorders affecting one of these systems frequently involve the other. Both diseases progress through a continuous chain of events, defined as the ‘cardiorenal continuum’, which is initiated by risk factors that lead to subclinical disease, clinical events, and ultimately to heart failure and end-stage kidney disease. Previous studies have shown that interventions anywhere along this chain of events can interrupt the pathophysiological cascade and provide cardiovascular and/or kidney ‘protection’. More recently, clinical trials with SGLT-2 inhibitors (SGLT2i) have shown a significant reduction in cardiovascular and kidney outcomes. Evidence from EMPA-REG OUTCOME, CANVAS Program, DECLARE-TIMI 58, VERTIS-CV, CREDENCE, and more recently DAPA-HF, EMPEROR-Reduced, and DAPA-CKD show that the beneficial effects of SGLT2i are observed across all stages of the cardiorenal continuum, ranging from patients with diabetes and multiple risk factors to those with established cardiovascular disease and even independently of diabetes status. This review provides a critical appraisal of the efficacy and safety of SGLT2i, demonstrating that this is a novel way to disrupt the chain of pathological events in the cardiorenal continuum and prevent cardiovascular and kidney disease in patients with and without diabetes

The Top 10 Original Articles Published in the Arquivos Brasileiros de Cardiologia and in the Revista Portuguesa de Cardiologia in 2019

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Sodium-glucose co-transporter 2 inhibitors in the failing heart : a growing potential

© The Author(s) 2020Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are a new drug class designed to treat patients with type 2 diabetes (T2D). However, cardiovascular outcome trials showed that SGLT2i also offer protection against heart failure (HF)–related events and cardiovascular mortality. These benefits appear to be independent of glycaemic control and have recently been demonstrated in the HF population with reduced ejection fraction (HFrEF), with or without T2D. This comprehensive, evidence-based review focuses on the published studies concerning HF outcomes with SGLT2i, discussing issues that may underlie the different results, along with the impact of these new drugs in clinical practice. The potential translational mechanisms behind SGLT2i cardio-renal benefits and the information that ongoing studies may add to the already existing body of evidence are also reviewed. Finally, we focus on practical management issues regarding SGLT2i use in association with other T2D and HFrEF common pharmacological therapies. Safety considerations are also highlighted. Considering the paradigm shift in T2D management, from a focus on glycaemic control to a broader approach on cardiovascular protection and event reduction, including the potential for wide SGLT2i implementation in HF patients, with or without T2D, we are facing a promising time for major changes in the global management of cardiovascular disease.This paper had a non-restrictive financial support of Boehringer Ingelheim and Lilly Portugal.info:eu-repo/semantics/publishedVersio