Browsing by Author "Pereira, E"
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- Choque cardiogénico…ou algo maisPublication . Arantes, C; Ribeiro, S; Marques, J; Vieira, C; Ramos, V; Galvão-Braga, C; Martins, J; Salgado, A; Oliveira, J; Pereira, E; Rocha, S; Correia, A
- Corticoterapia em altas doses no traumatizado medular – benefício ou prejuízo?Publication . Bandeira-Rodrigues, E; Duarte, R; Maia, J; Vaz, H; Pereira, ESequelae of the traumatic injuries to the spinal cord represent a high personal, family and social damage. Since 1984, it has been investigated and considered that the treatment with sodium succinate methylprednisolone in high doses was a solution to revert or to prevent the aggravation of such injuries. We present a revision of literature on this subject. It is well established that this therapeutic has a high rate of complications, but concerning its advantages and real effectiveness, there is no agreement between paper authors. While some defend it, others state that this is a total contraindication in this pathology. There are already some medical centers worldwide that do not use it. In Portugal, the practice of its administration is generalized. Not to do it could be difficult to defend in a litigation situation. But are we really helping our patients with it?
- Stent for Life in Portugal: This initiative is here to stayPublication . Pereira, H; Pinto, FJ; Calé, R; Pereira, E; Marques, J; Almeida, M; Mello, S; Dias Martins, L; behalf of the participating centres in the Stent for Life Initiative in PortugalAIMS: Portugal has one of the lowest rates of primary percutaneous coronary intervention (p-PCI) in Western Europe. This study assessed the progress of Portuguese p-PCI performance indicators one year after Portugal joined the Stent for Life (SFL) initiative. METHODS AND RESULTS: Two national surveys were carried out, each covering a period of one month: the first when Portugal joined the SFL in 2011 (Moment Zero), and the second one year later (Moment One). A total of 397 consecutive patients with probable ST-segment elevation myocardial infarction were enrolled (201 at Moment Zero and 196 at Moment One) from 15 centers. During this period, the number of patients who arrived at a local hospital without p-PCI decreased (62-47%; p=0.004) and transportation to a p-PCI hospital by the National Institute for Medical Emergencies (INEM) increased significantly (13-37%; p<0.001). Shorter times to revascularization were observed, due to shorter patient delay (118-102 min; p=0.008). Door-to-balloon delay and system delay remained unchanged. CONCLUSIONS: Improvements in performance indicators for p-PCI demonstrate the success of the first year of the local SFL plan, which was mainly focused on raising public awareness of the need to use the INEM emergency services, which has reduced patient delay, and on improving secondary transportation.
- Traumatic brain injury in portugal: trends in hospital admissions from 2000 to 2010Publication . Dias, C; Rocha, J; Pereira, E; Cerejo, AIntroduction: Traumatic brain injury has a considerable socio-economic impact, being a major cause of morbi-mortality, often with permanent disability. We sought to characterize health resource utilization of adult traumatic brain injury patients in Portugal between 2000 and 2010. Material and Methods: Retrospective study of medical records of adult patients with ICD9 diagnostic code of traumatic brain injury included in the National Diagnosis Related Groups Database from 2000-2010. Descriptive statistical analysis was performed and trends during the decade were evaluated. Results: We analysed 72 865 admissions to 111 hospitals, 64.1% males, mean age 57.9 ± 21.8 years (18-107). We found a decrease in number of traumatic brain injury in younger patients and an increase in older ones. The number of traffic accidents decreased and the number of falls increased. There was an increase of moderate to severe traumatic brain injury admissions: 47.2% in 2000 / 80% in 2010. Patients admitted in Intensive Care have nearly doubled (15.8% vs 29.5%) as well as the number submitted to neurosurgical procedures (8.2% vs 15.2%). Total mortality increased from 7.1% to 10.6%. Discussion: The decrease of traumatic brain injury may be associated with the trauma prevention campaigns, road network improvement and health politics. The increase in mortality may be related to better pre-hospital care, enabling more severe cases to arrive in hospital alive, and although treated more frequently in Intensive Care and requiring more neurosurgical procedures, they end up having higher mortality. Also this may be due to an increase in patients' age and worse pre-morbid status. Conclusion: Traumatic brain injury in Portugal is changing. Although hospital admissions due to global traumatic brain injury have decreased, mortality rate has increased.