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Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology, 2004
The use of echocardiography is still far from optimal. It is difficult or impossible to ensure th... more The use of echocardiography is still far from optimal. It is difficult or impossible to ensure the 24-hour presence at a hospital of a cardiologist with experience in echocardiography. As a result other specialties are becoming familiar with this technique. Echocardiography has been recognized as of paramount importance in diagnosis, prognosis and therapeutic decisions in several diseases and therefore echocardiographic training with different levels of experience should be supported and coordinated by a reference group in such matters. The authors review some aspects of echocardiography in emergency. They emphasize the importance of continuous training and accreditation as required conditions to perform echocardiography.
Revista Portuguesa De Pneumologia, 2004
The use of echocardiography is still far from optimal. It is difficult or impossible to ensure th... more The use of echocardiography is still far from optimal. It is difficult or impossible to ensure the 24-hour presence at a hospital of a cardiologist with experience in echocardiography. As a result other specialties are becoming familiar with this technique. Echocardiography has been recognized as of paramount importance in diagnosis, prognosis and therapeutic decisions in several diseases and therefore ecliocardiographic training with different levels of experience should be supported and coordinated by a reference group in such matters. The authors review some aspects of echocardiography in emergency. They emphasize the importance of continuous training and accreditation as required conditions to perform echocardiography.
The use of economic resources in Health Care is a constant concern of governments, hospital admin... more The use of economic resources in Health Care is a constant concern of governments, hospital administrators and health professionals, and the area of HIV care and follow-up is currently considered one of the areas with the highest consumption of resources. By studying outpatients of the Medicine/Immunodeficiency Consultation of the Hospital de Santo Antonio dos Capuchos (Lisbon) over a one year period (2002), we actually assessed its operating costs. Material and Methods: The study included outpatients of the Medicine/Immunodeficiency Consultation of the Hospital de Santo Antonio dos Capuchos, who were observed at least twice during 2002. The calculation of consultation costs, blood tests and other exams was based on the values defined in the Homogenous Diagnostic Groups (GDHs). The costs of antiretroviral therapy were calculated according to the values provided by the Hospital Pharmacy, assuming a monthly supply of same. Results: 107 patients were observed with a total of 498 consul...
Governments, hospital administrators and health providers are always concerned with economical re... more Governments, hospital administrators and health providers are always concerned with economical resources consumption in Health, being HIV care and follow-up nowadays considered as one of the areas of major consumption. By studying the outpatients of the Consulta de Medicina/ Imunodeficiencia of the Hospital de Santo Antonio dos Capuchos (Lisboa) during a year (2002), we have concretely tried to assess its functioning costs. Material and Methods: The study included the outpatients of the Consulta de Medicina/Imunodeficencia of the Hospital de Santo Antonio dos Capuchos that were observed, at least twice, during 2002. Cost evaluation concerning consultation, blood tests and other exams was based in the values defined in the Grupos de Diagnosticos Homogeneos (GDHs). Antiretroviral therapy costs were estimated according to the values provided by the Hospital Pharmacy and assuming its monthly dispense. Results: During 2002, 107 patients were observed, in a total of 498 consultations (€11...
Revista Portuguesa De Cardiologia, 2004
O consumo de recursos económicos com a Saúde é uma preocupação constante dos governantes, dos adm... more O consumo de recursos económicos com a Saúde é uma preocupação constante dos governantes, dos administradores hospitalares e também dos profissionais de Saúde, sendo a área do seguimento/tratamento dos doentes infectados pelo vírus da Imunodeficiência humana (vIh) apontada como uma das que mais recursos consome. Os AA procuraram, pela avaliação dos doentes seguidos na Consulta de Medicina/Imunodeficiência do hospital de Santo António dos Capuchos durante o período de um ano (2002), aferir de forma concreta os custos de funcionamento da mesma. Material e Métodos: Foram avaliados os utentes da Consulta de Medicina/Imunodeficiência do hospital de Santo António dos Capuchos (hSAC) que nela compareceram, pelo menos, duas vezes durante o ano de 2002. O cálculo dos custos das consultas e dos exames complementares de diagnóstico baseou-se nos valores definidos nos grupos de Diagnósticos homogéneos (gDhs). O custo da terapêutica anti-retroviral foi calculado segundo os valores que nos foram fornecidos pela Farmácia do hospital e assumindo o fornecimento mensal da mesma. Resultados: Foram avaliados 107 doentes correspondendo a 498 consultas (€11.424). Fizeram-se 244 determinações de carga viral €(24.321) e 245 estudos de subpopulações linfocitárias (€15.445). As restantes análises custaram €36.586. Dos 107 doentes, 85 estavam sob terapêutica anti-retroviral, com 3 ou 4 fármacos, tendo sido gasto, em média e por doente, €7.122. Foi necessário o internamento de 18 doentes, num total de 219 dias (€41.699). Conclusão: O custo médio anual por doente foi de €6.408.
Revista portuguesa de cardiologia : orgão oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology, 2004
The use of echocardiography is still far from optimal. It is difficult or impossible to ensure th... more The use of echocardiography is still far from optimal. It is difficult or impossible to ensure the 24-hour presence at a hospital of a cardiologist with experience in echocardiography. As a result other specialties are becoming familiar with this technique. Echocardiography has been recognized as of paramount importance in diagnosis, prognosis and therapeutic decisions in several diseases and therefore echocardiographic training with different levels of experience should be supported and coordinated by a reference group in such matters. The authors review some aspects of echocardiography in emergency. They emphasize the importance of continuous training and accreditation as required conditions to perform echocardiography.
Current Infectious Disease Reports, 2006
In recent years, several epidemiological studies have helped expand our knowledge of the incidenc... more In recent years, several epidemiological studies have helped expand our knowledge of the incidence of sepsis at the intensive care unit (ICU) and population levels. However, more data are needed from developing countries. Overall, even with a lack of standardized definitions--particularly of sepsis-associated organ dysfunction, hypoperfusion or hypotension, and septic-induced cardiovascular failure despite adequate fluid resuscitation--the incidence of sepsis seems higher in Brazil, the United Kingdom, and Portugal. In the future, in order to better identify patients that need early ICU admission, aggressive care, and new therapies, we must develop and apply better instruments for definition and risk stratification, especially for evaluating the risk of progressing from sepsis to severe sepsis and septic shock.
The Sepsis Text, 2002
When challenged by an invading microorganism, such as a bacteria, a fungus or a virus, the human ... more When challenged by an invading microorganism, such as a bacteria, a fungus or a virus, the human body starts a series of defense mechanisms, aimed at confining the invaders, controlling the damage and repairing the injured organs and tissues. Such a reaction, that involves a ...
Intensive Care Medicine, 2001
Introduction A significant number of critical ill patients die in the hospital after discharge fr... more Introduction A significant number of critical ill patients die in the hospital after discharge from the intensive care unit (ICU). Data on this so-called occult mortality, well known since the 1980s, vary significantly between series. Examples include the GiViTI study with 26 % of deaths occurring after ICU discharge [1], the Portuguese study (23 %) [2], the EURICUS-I study (31 %) [3], and the North Thames study (27 %) [4]. Several researchers have studied this problem, focusing mainly on factors outside the ICU [5], proposing inclusive new methods to deal with this problem [6]. Others have considered factors inside the ICU, such as the amount of nursing workload required by the patient in the 24 h before discharge to the ward [7].
Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology, 2004
The use of echocardiography is still far from optimal. It is difficult or impossible to ensure th... more The use of echocardiography is still far from optimal. It is difficult or impossible to ensure the 24-hour presence at a hospital of a cardiologist with experience in echocardiography. As a result other specialties are becoming familiar with this technique. Echocardiography has been recognized as of paramount importance in diagnosis, prognosis and therapeutic decisions in several diseases and therefore echocardiographic training with different levels of experience should be supported and coordinated by a reference group in such matters. The authors review some aspects of echocardiography in emergency. They emphasize the importance of continuous training and accreditation as required conditions to perform echocardiography.
Revista Portuguesa De Pneumologia, 2004
The use of echocardiography is still far from optimal. It is difficult or impossible to ensure th... more The use of echocardiography is still far from optimal. It is difficult or impossible to ensure the 24-hour presence at a hospital of a cardiologist with experience in echocardiography. As a result other specialties are becoming familiar with this technique. Echocardiography has been recognized as of paramount importance in diagnosis, prognosis and therapeutic decisions in several diseases and therefore ecliocardiographic training with different levels of experience should be supported and coordinated by a reference group in such matters. The authors review some aspects of echocardiography in emergency. They emphasize the importance of continuous training and accreditation as required conditions to perform echocardiography.
The use of economic resources in Health Care is a constant concern of governments, hospital admin... more The use of economic resources in Health Care is a constant concern of governments, hospital administrators and health professionals, and the area of HIV care and follow-up is currently considered one of the areas with the highest consumption of resources. By studying outpatients of the Medicine/Immunodeficiency Consultation of the Hospital de Santo Antonio dos Capuchos (Lisbon) over a one year period (2002), we actually assessed its operating costs. Material and Methods: The study included outpatients of the Medicine/Immunodeficiency Consultation of the Hospital de Santo Antonio dos Capuchos, who were observed at least twice during 2002. The calculation of consultation costs, blood tests and other exams was based on the values defined in the Homogenous Diagnostic Groups (GDHs). The costs of antiretroviral therapy were calculated according to the values provided by the Hospital Pharmacy, assuming a monthly supply of same. Results: 107 patients were observed with a total of 498 consul...
Governments, hospital administrators and health providers are always concerned with economical re... more Governments, hospital administrators and health providers are always concerned with economical resources consumption in Health, being HIV care and follow-up nowadays considered as one of the areas of major consumption. By studying the outpatients of the Consulta de Medicina/ Imunodeficiencia of the Hospital de Santo Antonio dos Capuchos (Lisboa) during a year (2002), we have concretely tried to assess its functioning costs. Material and Methods: The study included the outpatients of the Consulta de Medicina/Imunodeficencia of the Hospital de Santo Antonio dos Capuchos that were observed, at least twice, during 2002. Cost evaluation concerning consultation, blood tests and other exams was based in the values defined in the Grupos de Diagnosticos Homogeneos (GDHs). Antiretroviral therapy costs were estimated according to the values provided by the Hospital Pharmacy and assuming its monthly dispense. Results: During 2002, 107 patients were observed, in a total of 498 consultations (€11...
Revista Portuguesa De Cardiologia, 2004
O consumo de recursos económicos com a Saúde é uma preocupação constante dos governantes, dos adm... more O consumo de recursos económicos com a Saúde é uma preocupação constante dos governantes, dos administradores hospitalares e também dos profissionais de Saúde, sendo a área do seguimento/tratamento dos doentes infectados pelo vírus da Imunodeficiência humana (vIh) apontada como uma das que mais recursos consome. Os AA procuraram, pela avaliação dos doentes seguidos na Consulta de Medicina/Imunodeficiência do hospital de Santo António dos Capuchos durante o período de um ano (2002), aferir de forma concreta os custos de funcionamento da mesma. Material e Métodos: Foram avaliados os utentes da Consulta de Medicina/Imunodeficiência do hospital de Santo António dos Capuchos (hSAC) que nela compareceram, pelo menos, duas vezes durante o ano de 2002. O cálculo dos custos das consultas e dos exames complementares de diagnóstico baseou-se nos valores definidos nos grupos de Diagnósticos homogéneos (gDhs). O custo da terapêutica anti-retroviral foi calculado segundo os valores que nos foram fornecidos pela Farmácia do hospital e assumindo o fornecimento mensal da mesma. Resultados: Foram avaliados 107 doentes correspondendo a 498 consultas (€11.424). Fizeram-se 244 determinações de carga viral €(24.321) e 245 estudos de subpopulações linfocitárias (€15.445). As restantes análises custaram €36.586. Dos 107 doentes, 85 estavam sob terapêutica anti-retroviral, com 3 ou 4 fármacos, tendo sido gasto, em média e por doente, €7.122. Foi necessário o internamento de 18 doentes, num total de 219 dias (€41.699). Conclusão: O custo médio anual por doente foi de €6.408.
Revista portuguesa de cardiologia : orgão oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology, 2004
The use of echocardiography is still far from optimal. It is difficult or impossible to ensure th... more The use of echocardiography is still far from optimal. It is difficult or impossible to ensure the 24-hour presence at a hospital of a cardiologist with experience in echocardiography. As a result other specialties are becoming familiar with this technique. Echocardiography has been recognized as of paramount importance in diagnosis, prognosis and therapeutic decisions in several diseases and therefore echocardiographic training with different levels of experience should be supported and coordinated by a reference group in such matters. The authors review some aspects of echocardiography in emergency. They emphasize the importance of continuous training and accreditation as required conditions to perform echocardiography.
Current Infectious Disease Reports, 2006
In recent years, several epidemiological studies have helped expand our knowledge of the incidenc... more In recent years, several epidemiological studies have helped expand our knowledge of the incidence of sepsis at the intensive care unit (ICU) and population levels. However, more data are needed from developing countries. Overall, even with a lack of standardized definitions--particularly of sepsis-associated organ dysfunction, hypoperfusion or hypotension, and septic-induced cardiovascular failure despite adequate fluid resuscitation--the incidence of sepsis seems higher in Brazil, the United Kingdom, and Portugal. In the future, in order to better identify patients that need early ICU admission, aggressive care, and new therapies, we must develop and apply better instruments for definition and risk stratification, especially for evaluating the risk of progressing from sepsis to severe sepsis and septic shock.
The Sepsis Text, 2002
When challenged by an invading microorganism, such as a bacteria, a fungus or a virus, the human ... more When challenged by an invading microorganism, such as a bacteria, a fungus or a virus, the human body starts a series of defense mechanisms, aimed at confining the invaders, controlling the damage and repairing the injured organs and tissues. Such a reaction, that involves a ...
Intensive Care Medicine, 2001
Introduction A significant number of critical ill patients die in the hospital after discharge fr... more Introduction A significant number of critical ill patients die in the hospital after discharge from the intensive care unit (ICU). Data on this so-called occult mortality, well known since the 1980s, vary significantly between series. Examples include the GiViTI study with 26 % of deaths occurring after ICU discharge [1], the Portuguese study (23 %) [2], the EURICUS-I study (31 %) [3], and the North Thames study (27 %) [4]. Several researchers have studied this problem, focusing mainly on factors outside the ICU [5], proposing inclusive new methods to deal with this problem [6]. Others have considered factors inside the ICU, such as the amount of nursing workload required by the patient in the 24 h before discharge to the ward [7].