Study of mortality by Diabetes Mellitus in Portugal

A diabetes mellitus (DM) é considerada um dos problemas de saúde pública de maior importância a nível mundial, pela elevada prevalência, morbilidade e mortalidade (Sousa, 2006), prevendo-se um agravamento na próxima década relacionado com o envelhecimento da população e com as alterações progressivas no estilo de vida (Cruz, 2005). A Organização Mundial de Saúde (WHO) estima que a diabetes possa vir a ser responsável pela primeira regressão na esperança média de vida dos últimos 200 anos. Pretende-se, com o presente estudo, avaliar a evolução temporal e a distribuição geográfica da mortalidade por DM em Portugal

Determinants of fatal outcome in patients admitted to intensive care units with influenza, European Union 2009–2017

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/32258201/Background: Morbidity, severity, and mortality associated with annual influenza epidemics are of public health concern. We analyzed surveillance data on hospitalized laboratory-confirmed influenza cases admitted to intensive care units to identify common determinants for fatal outcome and inform and target public health prevention strategies, including risk communication. Methods: We performed a descriptive analysis and used Poisson regression models with robust variance to estimate the association of age, sex, virus (sub)type, and underlying medical condition with fatal outcome using European Union data from 2009 to 2017. Results: Of 13 368 cases included in the basic dataset, 2806 (21%) were fatal. Age ≥40 years and infection with influenza A virus were associated with fatal outcome. Of 5886 cases with known underlying medical conditions and virus A subtype included in a more detailed analysis, 1349 (23%) were fatal. Influenza virus A(H1N1)pdm09 or A(H3N2) infection, age ≥60 years, cancer, human immunodeficiency virus infection and/or other immune deficiency, and heart, kidney, and liver disease were associated with fatal outcome; the risk of death was lower for patients with chronic lung disease and for pregnant women. Conclusions: This study re-emphasises the importance of preventing influenza in the elderly and tailoring strategies to risk groups with underlying medical conditions.info:eu-repo/semantics/publishedVersio

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

The first case of type F botulism, in Portugal

Poster abstract publicado em: Toxicon. 2016;123(Suppl. 25):S55-6. Disponível em: https://doi.org/10.1016/j.toxicon.2016.11.157The first case in Portugal of type F botulism was identified in July 2016. Type F botulinum toxin (BoNT/F) was detected and a BoNT/F producing strain was isolated in the stool of a patient with clinical signs of botulism. Worldwide, few cases of type F botulism have been reported in adults. Most cases of botulism described in humans have been caused by toxins of type A, B or E. The microorganisms that have been identified as producers of toxin F are C. botulinum and C. baratii. Ingestion of contaminated food or, more rarely, wound infection, toxin production in the intestinal tract if immunologically immature (infant botulism) or intestinal colonization in the adult, can produce the clinical syndrome of botulism.N/

First case of botulism type F, in Portugal

A nível mundial, estão descritos poucos casos de botulismo tipo F em humanos. Em julho de 2016 foi identificado o primeiro caso de botulismo tipo F, em Portugal. Foi detetada toxina botulínica tipo F (BoNT/F) nas fezes de um doente com quadro clínico típico de botulismo e isolada a estirpe de Clostridium botulinum produtora de BoNT/F.Worldwide few cases of type F botulism are described in humans. In July 2016 the first case of type F botulism in Portugal was identified. Botulinum toxin type F (BoNT/F) was detected in the stool of a patient with clinical symptoms typical of botulism and the strain of Clostridium botulinum F producer of BoNT was isolated.info:eu-repo/semantics/publishedVersio