Pneumonias adquiridas durante o internamento hospitalar : impacte na saúde e implicação nos custos

RESUMO - Introdução: O presente estudo pretende analisar o impacte na saúde e a implicação nos custos da Pneumonia adquirida durante o internamento hospitalar. Está comprovado que as infeções hospitalares constituem um problema de Saúde pública dos hospitais em todo o mundo. Metodologia: A população em estudo abrange 97 033 episódios de internamento, ocorridos em 10 hospitais, no ano de 2010. O trabalho compreende três fases: i) caracterização da população em estudo; ii) identificação das variáveis que influenciam os resultados em saúde; iii) estimação dos custos do internamento com Pneumonia. Resultados: Os episódios de internamento com Pneumonia ocorreram maioritariamente no sexo masculino (58.1%). A faixa etária com mais episódios foi a dos 80 aos 89 anos. A taxa de Prevalência foi de 4.16% e a taxa de Mortalidade foi de 34.56%. Os doentes com Pneumonia tiveram uma demora média superior em 13 dias em relação aos doentes sem Pneumonia para o mesmo conjunto de GDH. Pertencer ao sexo masculino e os episódios de internamento ocorridos em hospitais não universitários levam a um aumento da probabilidade de morrer. Por sua vez apresentar uma maior duração de internamento e um número superior de comorbilidades levam a uma diminuição deste risco. Os custos em excesso dos episódios de internamento devido à aquisição de Pneumonia como doença secundária foram de aproximadamente 18 milhões de euros. Conclusão: O trabalho foi elaborado tendo em vista a quantificação do fenómeno em Portugal, tanto em termos da carga da doença, como das implicações financeiras. Os valores encontrados são preocupantes, pelo que se torna necessário tomar medidas e introduzir práticas na atividade hospitalar que minimizem as infeções hospitalares em geral e da Pneumonia em particular. Por sua vez é expectável, face ao descrito na literatura internacional, que a introdução destas práticas melhor os resultados em saúde e o desempenho financeiro dos hospitais.

Consumption and emotional compensation in economic crisis

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics

Earth-based mortars for masonry plastering

9th International Masonry Conference 2014, 7-9 July, Universidade do Minho, Guimarães

Measuring poverty in Portugal: An absolute approach

The aim of this article is to measure poverty in Portugal from an absolute perspective. We estimated several absolute poverty lines and defined maximum and minimum thresholds. We applied aggregation measures to these thresholds and constructed probit models to assess the effect of some variables on poverty. The intervals obtained contain the poverty lines constructed by other approaches. We got evidence that poverty is positively correlated with the number of people in the household, with living alone; negatively correlated with the number of workers in the household, the share on non-food expenditure and the existence of a heating device at home.

Comparateive analysis: Public and private school management systems

The Portuguese educational system has counted, for many years, with the co-existence of both public and private schools. In fact, the country’s growth and development led, in the past, to an increasing demand for free of charge public education that could only be matched through the creation of “publicly-subsidized and privately owned and managed schools”. Still, the demographic evolution of Portugal recently generated a decrease on the demand for public educational services. This situation has raised doubts about the true contribution of this type of school for the public education system. This paper aims at answering this question by isolating the impact of different property and management schemes on the performance of students, resorting to cross-section data on 9th grade students from 2010. The results corroborate the well known result on the relevance of the family socio-economic background for students’ performance, but do also sustain the existence of a significant positive impact of private ownership and management schemes on the overall performance of students. These results suggest that there might be gains associated with the expansion of such schemes within the public education system.

Gold nanoprobes for assessing expression of critical genes in the infection pathway of MRSA

Staphylococcus aureus is an important opportunistic pathogen that can cause a wide variety of diseases from mild to life-threatening conditions. S. aureus can colonize many parts of the human body but the anterior nares are the primary ecological niche. Its clinical importance is due to its ability to resist almost all classes of antibiotics available together with its large number of virulence factores. MRSA (Methicillin-Resistant S. aureus) strains are particularly important in the hospital settings, being the major cause of nosocomial infections worldwide. MRSA resistance to β-lactam antibiotics involves the acquisition of the exogenous mecA gene, part of the SCCmec cassette. Fast and reliable diagnostic techniques are needed to reduce the mortality and morbidity associated with MRSA infections, through the early identification of MRSA strains. The current identification techniques are time-consuming as they usually involves culturing steps, taking up to five days to determine the antibiotic resistance profile. Several amplification-based techniques have been developed to accelerate the diagnosis. The aim of this project was to develop an even faster methodology that bypasses the DNA amplification step. Gold-nanoprobes were developed and used to detect the presence of mecA gene in S. aureus genome, associated with resistance traits, for colorimetric assays based on non-crosslinking method. Our results showed that the mecA and mecA_V2 gold-nanoprobes were sensitive enough to discriminate the presence of mecA gene in PCR products and genomic DNA (gDNA) samples for target concentrations of 10 ng/μL and 20 ng/μL, respectively. As our main objective was to avoid the amplification step, we concluded that the best strategy for the early identification of MRSA infection relies on colorimetric assays based on non-crosslinking method with gDNA samples that can be extracted directly from blood samples.