Que Urgência?

Objectivo: Caracterizar a população que utiliza o serviço de urgência, as circunstâncias que determinam a procura de um médico e as razões porque recorrem a um serviço de urgência hospitalar. Material e métodos: Numa amostra aleatória de 1000 utentes recolhem-se os dados relativos à idade/sexo/residência/classe social/tipo de assistência médica/patologia e razões da ida ao Hospital. Registam-se depois o diagnóstico, exames complementares e, a necessidade de atendimento num serviço hospitalar é avaliada. Resultados: Esta série (n = 1000) foi constituída por 533 (53,3%) crianças do sexo masculino e 467 (46,7%) do sexo feminino, com idades compreendidas entre os três dias de vida e os 15 anos (média de 3,4 anos), 92,4% provenientes da área da grande Lisboa. A grande maioria (94,2%) recorre por iniciativa própria, 46,7% nas primeiras 24 horas de doença e 26,3% já tinham consultas prévias pela mesma doença. Das várias razões apontadas como causa de consulta há a salientar 26,5% de utilizadores habituais. A patologia respiratória foi predominante (39,6%). Apenas 24,6% das situações foram consideradas urgentes, embora nem todas necessitassem do nível de cuidados de um hospital central. Não se verificaram diferenças relativamente ao grupo etário e ao estrato sócio económico, entre o grupo referenciado e o que recorreu por iniciativa própria, sendo contudo significativa a diferença destes grupos quanto à percentagem de internamentos e ao número de urgências. Conclusão: Após análise dos resultados, propõem-se algumas soluções possíveis para o grande afluxo de crianças ao serviço de urgência, por motivos não urgentes

Tuberculose Infantil — Anos 90. Revisão Casuística de 5 Anos

É apresentada a revisão de 204 casos de tuberculose doença diagnosticados e tratados no Hospital de D. Estefânia num período de 5 anos (1990-1994). Refira-se, nos casos estudados (204), a maior percentagem de crianças no grupo etário dos 5 aos 14 anos (67%), uma incidência de 32% para a raça negra e um predomínio nas classes sociais mais desfavorecidas, contribuindo o concelho da Amadora com a maior percentagem de casos. A inoculação prévia de BCG observou-se em 80% dos casos. As formas mediastino-pulmonares verificaram-se em 91% das crianças, tendo ocorrido complicações em 23%. A complicação mais frequente foi o derrame pleural. A tuberculose extrapulmonar observou-se em 9% das formas de tuberculose doença, sendo a meningite a mais frequente. A identificação da fonte de contágio foi possível em 42% dos casos e a pesquisa de BK positiva em 23%. Considerando o grupo racial como factor de variabilidade, verificou-se uma maior frequência de complicações na raça negra (29%) do que na raça branca (17%). Salienta-se a alta prevalência de tuberculose em Portugal e a sua incidência preferencial nas classes sociais mais desfavorecidas e nas zonas habitacionais urbanas mais degradadas

Twelve Years of Kawasaki Disease in Portugal: Epidemiology in Hospitalized Children

Kawasaki disease (KD) is the leading cause of acquired heart disease in developed countries. Reported incidences vary worldwide but incidence of KD has not been established in Portugal. The aims of the study were to describe the epidemiologic characteristics and estimate incidence rates of KD among hospitalized children in Portugal. METHODS: This study was a descriptive, population-based study, which used hospital discharge records of patients <20 years of age diagnosed with KD from the Hospital Register database for 2000-2011. Incidence rates were calculated using the number of KD patients and corresponding National census data. RESULTS: There were 533 hospitalizations of 470 patients with KD as the primary diagnosis in Portugal, 63 hospitalizations were transfers of patients between hospitals and there were no relapses. The mean age at admission was 2.8 years, with male predominance (male-to-female ratio: 1.6:1). Children <5 years and infants <1 year represented 83% and 23% of all the patients admitted, respectively. Mean annual incidence was 6.5 per 100,000 children <5 years, 4.5 per 100,000 infants <1 year and 7.8 per 100,000 infants 1-4 years. We found considerable differences between national territorial regions, with majority of cases in most dense regions. The mean length of hospital stay was 9 days, and the incidence peaked in spring (35%) and spring/winter (63%). Coronary aneurysms were reported in 8.5% of patients with a higher male-to-female ratio (3.4:1) and a lower mean age (1.93 years). Reported mortality was 0.4%. CONCLUSIONS: This is the first large-scale epidemiologic study of KD in Portugal. The highest incidences occurred among male children 1-4 years of age and in spring/winter.info:eu-repo/semantics/publishedVersio

Study protocol for a pilot randomised controlled trial evaluating the feasibility and effectiveness of non-pharmacological interventions to recover functionality after a transient ischaemic attack or a minor stroke: the 'Back to Normal' trial

Introduction Transient ischaemic attack (TIA) and minor stroke are frequently assumed as temporary or non-disabling events. However, evidence suggests that these patients can experience relevant impairment and functional disability. Therefore, the present study aims to evaluate the feasibility and effectiveness of a 3-month multidomain intervention programme, composed of five non-pharmacological strategies, aimed at accelerating return to pre-event level of functionality in patients with TIA or minor stroke. Methods and analysis Patients diagnosed with a TIA or a minor stroke are being recruited at the emergency or neurology departments of the Hospital Pedro Hispano, located in Matosinhos, Portugal (n=70). Those who accept to participate will be randomly allocated to two groups (1:1): (a) Intervention-receives a 3 months combined approach, initiating early post-event, composed of cognitive training, physical exercise, nutrition, psychoeducation and assessment/correction of hearing loss; (b) Control-participants will not be subject to any intervention. Both groups will receive the usual standard of care provided to these diseases. Recruitment began in May 2022 and is expected to continue until March 2023. Socio-demographic characteristics, lifestyles, health status, cognitive function, symptoms of anxiety and depression and quality of life will be assessed; as well as anthropometry, blood pressure and physical condition. Time to complete or partial recovery of instrumental activities of daily living will be assessed using an adapted version of the Frenchay Activities Index. All participants will be evaluated before the intervention and after 3 months. Ethics and dissemination This study was approved by the Ethics Committee of the Local Health Unit of Matosinhos (Ref. 75/CES/JAS). Written informed consent will be required from all the participants; data protection and confidentiality will be also ensured. The findings of this project are expected to be submitted for publication in scientific articles, and the main results will be presented at relevant scientific meetings. Trial registration number NCT05369637.This work was financed by national funds through the FCT - Foundation for Science and Technology, I.P., within the scope of projects UIDB/04750/2020 and LA/P/0064/2020. It was also supported by the Portuguese Stroke Society under the research scholarship Prof. Castro Lopes in cerebrovascular disease. The MIND-Matosinhos project was supported by 'Portugal Inovacao Social' and co-funded by the Operational Program Social Inclusion and Employment, Portugal 2020 and European Union, through the European Social Fund (POISE-03-4639-FSE-000793). Funders will not have any influence on the study design, execution, interpretation of data, writing and publication of manuscripts

Physicochemical stability and sensory acceptance of a carbonated cashew beverage with fructooligosaccharide added

The objective of this research was to determine the shelf life of a carbonated cashew beverage with fructooligosaccharides added using two different processing methods: by using additives (potassium sorbate/sodium benzoate) without pasteurization and by using pasteurization at 90°C for 1 min with addition of preservatives. Physicochemical analyzes (pH, titratable acidity, soluble solids (°Brix), vitamin C, reducing sugars) and sensory evaluation (triangular test and acceptance test) were performed throughout 60 days of storage at 20°C. The results show a decrease in vitamin C content in both processing methods (p &lt;0.05), while the other physicochemical parameters were similar and stable during the shelf life period. Hedonic scores between 5.0 (neither liked, nor disliked) and 6.0 (slightly liked) were obtained during the test period. The results suggest that it is possible to develop a potentially prebiotic cashew beverage that presents suitable physicochemical and sensory parameters.Keywords: Prebiotic beverages, stability, sensory analysisAfrican Journal of Biotechnology Vol. 12(20), pp. 2986-298

Quality of life, tuberculosis and treatment outcome; a case-control and nested cohort study

BACKGROUND: Global tuberculosis policy increasingly emphasises broad tuberculosis impacts and highlights the lack of evidence concerning tuberculosis-related quality of life (QOL). METHODS: Participants were recruited in 32 Peruvian communities 13/7/2016-24/2/2018 and followed-up until 8/11/2019. Inclusion criteria were: age ≥15 years for "patients" (n=1545) starting treatment for tuberculosis disease in health centres; "contacts" (n=3180) who shared a patient's household for ≥6 h·week-1; and randomly-selected "controls" (n=277). The EUROHIS-QOL questionnaire quantified satisfaction with: QOL; health; energy; activities of daily living (ADL); self; relationships; money; and living place. FINDINGS: Newly-diagnosed tuberculosis was most strongly associated with lower QOL scores (p<0.001). Patients initially had lower QOL than controls for all EUROHIS-QOL questions (p≤0.01), especially concerning health, ADL and self. Lower initial QOL in patients predicted adverse treatment outcomes and scores <13-points had 4.2-times (95%CI=2.3,7.6) increased risk of death versus those with higher QOL scores (both p<0.001). Patient QOL was re-assessed 6 months later and for patients with successful treatment, QOL became similar to participants who never had tuberculosis, whereas patients who did not complete treatment continued to have low QOL (p<0.001). Multidrug-resistant tuberculosis was associated with lower QOL before and during treatment (both p<0.001). Contacts had lower QOL if they lived with a patient who had low QOL score (p<0.0001) or were a caregiver for the patient (p<0.001). CONCLUSIONS: Tuberculosis was associated with impaired psycho-socio-economic QOL which recovered with successful treatment. Low QOL scores predicted adverse treatment outcome. This brief EUROHIS-QOL 8-item questionnaire quantified the holistic needs of tuberculosis-affected people, potentially guiding patient-centred care