Evaluating Portuguese Public Hospitals Performance: Any Difference before and during COVID-19?

COVID-19 is a well-known respiratory disease that has spread worldwide since January 2020, causing many deaths and massive pressure on health systems. This pandemic’s appearance compromised health service sustainability and quality as many procedures were postponed or canceled, with an expected increase of adverse events like nosocomial infections, in-hospital deaths, and the worsening of the patient’s clinical status. For instance, the year 2020 featured an increase in undesirable results in Portugal: a rise of 10% in delayed first medical appointments, 0.02% in avoidable bloodstream infections, and more than 100 post-operative pulmonary embolisms and septicemia cases per 100,000 inpatients. Therefore, assessing whether the healthcare providers’ performance has changed is paramount. In this case, we evaluated public hospitals in Portugal. To this end, we developed a network data envelopment analysis model relating to efficiency and effectiveness. We observed consistent drops in efficiency when the pandemic started, followed by a recovery to levels above the pre-pandemic ones. Regarding effectiveness, we observed a positive trend during the evaluated period. We conclude that, apart from the great resilience of public healthcare providers, the Portuguese state was unprepared for a pandemic like COVID-19, but still the actions taken (including massive vaccination) were beneficial.info:eu-repo/semantics/publishedVersio

Synthesis and properties of Co-doped titanate nanotubes and their optical sensitization with methylene blue

Here we report on a novel chemical route to synthesize homogenous cobalt doped titanate nanotubes (CoTNT), using an amorphous Co-doped precursor. The influence of the synthesis temperature, autoclave dwell time and metal doping on the structural and microstructural as well as on the optical properties of the synthesized titanate nanotubes is studied and discussed. The optical band gaps of the CoTNT samples are red shifted in comparison with the values determined for the undoped samples, such red shifts bringing the absorption edge of the CoTNT samples into the visible region. CoTNT materials also demonstrate particular high adsorption ability for methylene blue, the amount of the adsorbed dye being higher than the one predictable for a monolayer formation. This suggests the possibility of intercalation of the dye molecule between the TiO6 layers of the TNT structure. It is also shown that the methylene blue sensitized Co-doped nanostructures are highly stable under UV radiation and present a strong and broad absorption in the visible region.Comment: 31 pages, 3 tables, 7 figure

The new automated daily mortality surveillance system

The experience reported in an earlier Eurosurveillance issue on a fast method to evaluate the impact of the 2003 heatwave on mortality in Portugal, generated a daily mortality surveillance system (VDM) that has been operating ever since jointly with the Portuguese Heat Health Watch Warning System. This work describes the VDM system and how it evolved to become an automated system operating year-round, and shows briefly its potential using mortality data from January 2006 to June 2009 collected by the system itself. The new system has important advantages such as: rapid information acquisition, completeness (the entire population is included), lightness (very little information is exchanged, date of death, age, sex, place of death registration). It allows rapid detection of impacts (within five days) and allows a quick preliminary quantification of impacts that usually took several years to be done. These characteristics make this system a powerful tool for public health action. The VDM system also represents an example of inter-institutional cooperation, bringing together organisations from two different ministries, Health and Justice, aiming at improving knowledge about the mortality in the population

Clinical outcomes in TMD patients after arthrocentesis with lysis, lavage and viscossuplementation

Abstract in proceedings of the Fourth International Congress of CiiEM: Health, Well-Being and Ageing in the 21st Century, held at Egas Moniz’ University Campus in Monte de Caparica, Almada, from 3–5 June 2019.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.info:eu-repo/semantics/publishedVersio

Rhinitis: Epidemiological Knowledge in Portugal

Nas últimas décadas verificou-se, nos paises Ocidentais, um aumento substancial na prevalência de rinite alérgica, sendo o subdiagnóstico e o subtratamento diliculdades acrescidas para a qualidade de vida dos doentes com esta doença inflamatória crónica.É objectivo deste trabalho de revisão, apresentar dados epidemiológicos nacionais referentes à prevalência de rinite, caracterizando alguns factores de risco, realçando-se o problema da falta de diagnóstico desta situação c1ínica tão prevalente no nosso pais

Thrombolysis in Patients Aged over 80 Years Is Equally Effective and Safe

BACKGROUND: Despite stroke's high prevalence in the elderly, intravenous thrombolysis is licensed in Europe only for patients younger than 80 years old. We aimed to compare the functional outcomes and complication rates in patients older versus younger than 80 years old treated with intravenous thrombolysis. METHODS: A retrospective observational study of patients who received intravenous thrombolysis in a stroke unit between January 1, 2009, and June 30, 2012, was conducted. Variables were compared between 2 subgroups (≤80 and >80 years). RESULTS: Overall, 512 patients underwent intravenous thrombolysis, of which 13.1% were over 80 years. The mean age was 65.4 years in the younger subgroup and 82.9 years in the older subgroup. Prior independence rates did not differ between the subgroups. Prevalence of atrial fibrillation and cardioembolic stroke was higher in the older subgroup (P = .004 and .026). Only 3% of the elderly with atrial fibrillation were taking oral anticoagulants. Symptoms-to-needle time was lower in the older subgroup (P = .048). Stroke severity was higher in patients over 80 years (P = .026). There was significant improvement in the National Institutes of Health Stroke Scale score 7 days after intravenous thrombolysis (P < .001) in both subgroups. The proportion of patients with 3 months' favorable outcome and independence, hemorrhagic transformation, and mortality rates were similar in both subgroups. CONCLUSIONS: Elderly patients' benefits and outcomes from intravenous thrombolysis treatment were identical to the younger subgroup without excess hemorrhagic transformation or mortality. These results favor the use of intravenous thrombolysis in patients over 80 years.info:eu-repo/semantics/publishedVersio

Endoscopic Submucosal Dissection of Early Gastric Cancer Using the Insulated Tip Knife

AbstractEndoscopic submucosal dissection (ESD) is an endoscopic technique in which a gastrointestinal mucosal neoplasm can be excised by cutting through the submucosa with an endoscopic knife. It can be used with diagnostic or therapeutic intent and allows en bloc removal of the specimen. ESD usually begins with identification and evaluation of the lesion and assessment of the margin with chromo-endoscopy. The subsequent steps include marking, submucosal injection, and circumferential and submucosal dissection. Complications should be promptly recognized and dealt with immediately if necessary.This video demonstrates the main steps of the technique and management of complications. This article is part of an expert video encyclopedia

The chemistry and bioactive properties behind microalgae-enriched gluten-free breads

This work aims to: (i) assess volatiles composition of microalgae-enriched gluten-free breads (prepared with Tetraselmis chuii, Chlorella vulgaris and Microchloropsis gaditana); (ii) report the bioaccessibility of protein and minerals after a static in vitro digestion model; (iii) understand how it affects the bioactive properties of gluten-free breads in regard to antioxidant capacity and the α-amylase inhibitory potential. Therefore, nutritional composition and bioactive properties of gluten-free breads before and after in vitro digestion model were examined. Identification of compounds responsible for the overall aroma of microalgae using GC–MS was done. There was a considerable decrease in protein and minerals available after in vitro digestion, as well as in the antioxidant potential. The overall aroma of microalgae-enriched breads was mainly due to the presence of alcohols, representing the major class of volatiles present in breads (3% to 59%), being lower for T. chuii-enriched bread. Terpenes also existed in considerable amounts especially in M. gaditana (24%) where γ-terpinene was the most abundant. Alkanoic acids were the most abundant lipophilic bioactive compounds (25%–68%), and 9,12-octadecadienoic acid was the major identified compound (13%–51%). Phytic acid is also present in all microalgae-enriched breads and may contribute to the decrease in the bioaccessibility of nutrients.info:eu-repo/semantics/publishedVersio

Transition to loss of consciousness during anesthesia Induction with Remifentanil and Propofol: EEG patterns

SFRH/BD/98915/2013;UID/SEM/50022/2013info:eu-repo/semantics/publishedVersio