Illusion or reality, abstract or concrete art? Models in health: do they answer the questions?

Universidade Federal de São Paulo (UNIFESP) Departamento de Ginecologia Setor de Tecnologia em Saúde da MulherUNIFESP, Depto. de Ginecologia Setor de Tecnologia em Saúde da MulherSciEL

Sedation in mechanically ventilated children: we are advancing

Universidade Federal de São Paulo (UNIFESP) Hospital São PauloUniversidade de São Paulo Hospital das Clínicas da Faculdade de Medicina Instituto da CriançaHospital Santa CatarinaUNIFESP, Hospital São PauloSciEL

It is impossible to know the way if we do not know where to start: tidal volume, driving pressure, and positive end-expiratory pressure

Univ Fed Sao Paulo, Hlth Technol Assessment Ctr, Sao Paulo, SP, BrazilUniv Sao Paulo, Fac Med, Dept Pediat, Pediat Intens Care Neonatol, Sao Paulo, SP, BrazilHealth Technologies Assessment Center, Universidade Federal de São Paulo, São Paulo, SP, BrazilWeb of Scienc

IMPACT of the BRAZILIAN PUBLIC MENTAL HEALTH POLICY ON SCHIZOPHRENIA HOSPITALIZATION: A 10-YEAR ANALYSIS

Universidade Federal de São Paulo, São Paulo, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc

Incidence and Risk Factors for Cardiovascular Collapse After Unplanned Extubations in the Pediatric ICU

BACKGROUND: Cardiovascular collapse is a life-threatening event after unplanned extubations (UEs) in the pediatric ICU (PICU). However, there is a paucity of pediatric studies assessing this complication. We sought to assess the incidence, risk factors, and outcome of cardiovascular collapse after UEs in PICU patients. METHODS: All children who had been mechanically ventilated for >= 12 h were prospectively tracked for UEs over an 8-y period. Subjects were included in the study if they were between ages 1 month and 16 y and had experienced UE. They were analyzed in 2 groups: those with cardiovascular collapse (defined as the need for cardiopulmonary resuscitation or circulatory dysfunction immediately after UE) and those with no cardiovascular collapse. RESULTS: Of the 847 subjects, 109 UEs occurred in 14,293 intubation days (0.76 UEs/100 intubation days), with 21 subjects (19.2%) experiencing cardiovascular collapse, of which 10 required cardiopulmonary resuscitation. Compared with subjects without cardiovascular collapse after UE, children with cardiovascular collapse were younger(<6 months old), with respiratory failure from lower respiratory tract diseases, lower P-aO2/F-IO2 (218 vs 282 mm Hg), and higher oxygenation indices (5.5 vs 3.5) before UE events. Logistic regression revealed that only an age <6 months old was strongly associated with cardiovascular collapse (odds ratio 3.4, P = .03). There were no differences between cardiovascular collapse and non-cardiovascular collapse subjects regarding the length of hospital stay, ventilator-associated pneumonia rate, and mortality. CONCLUSIONS: Cardiovascular collapse is a frequent complication of UEs, particularly in the youngest children. Specific bundles to prevent UEs may reduce morbidity related to these events.Hosp Servidor Publ Municipal, Dept Pediat, Pediat Intens Care Unit, Rua Castro Alves 60, BR-01532900 Sao Paulo, BrazilFed Univ Sao Paulo UNIFESP, Hlth Technol Assessment Unit, Sao Paulo, BrazilFed Univ Sao Paulo UNIFESP, Hlth Technol Assessment Unit, Sao Paulo, BrazilWeb of Scienc

Meta-analysis on the morbidity and mortality of clodronate, pamidronate and zoledronate in patients with bone metastases

Univ Toronto, Toronto, ON, CanadaPacific Gateway Int Coll, Toronto, ON, CanadaUniversidade Federal de São Paulo, São Paulo, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc

Cost effectiveness of peginterferon alfa-2B combined with ribavirin for the treatment of chronic hepatitis C in Brazil

The treatment of chronic hepatitis C (CHC) with peginterferon alpha-2b/ribavirin (PegIFN + Rib) produced larger sustained viral response (SVR) compared to the conventional (non-pegylated) interferon/ribavirin (IFN + Rib), but its cost-effectiveness was not assessed in Brazil. We developed a Markov model to mirror the natural disease history and cohorts of patients with hepatitis C virus (HCV), that received PegIFN + Rib or IFN + Rib treatment for 48 or 24 weeks, according to viral genotype and liver histology. The SVRs for the treatments PegIFN + Rib and IFN + Rib were respectively 48% and 34% (genotype 1), and 88% and 80% (genotype non-1). Three Delphi panels were conducted with hepatologists and intensivists, and another one with oncologists. The costs are expressed in 2006 Brazilian Reais (R$) and the benefits were discounted at 3$19,848.34 per QALY. Peginterferon alpha-2b with ribavirin is a cost-effective therapy for the treatment of naïve CHC adult patients compared to the interferon alpha-2b and ribavirin regime, irrespective of the viral genotype.Federal University of São PauloState University of Rio de JaneiroUNIFESPSciEL

ADMINISTRATIVE CLAIMS in A LARGE BRAZILIAN NATIONWIDE DATABASE: A DESCRIPTIVE ANALYSIS of the DIRECT MEDICAL COSTS of CORONARY ARTERY BYPASS GRAFTING (CABG) AMONG DIFFERENT REGIONS in A CONTINENTAL-SIZE COUNTRY

Universidade Federal de São Paulo, UNESP, São Paulo, BrazilImpacto Tecnol Gerenciais Saude, Curitiba, Parana, BrazilUniversidade Federal de São Paulo, UNESP, São Paulo, BrazilWeb of Scienc

Stress urinary incontinence: Effect of obesity in patients' perception of health related quality of life

Universidade Federal de São Paulo, São Paulo, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc