Hemoculturas positivas num serviço de pediatria: 2003-2012

Introdução: Em situações clínicas selecionadas é aconselhada investigação complementar da criança com febre, nomeadamente realização de hemocultura. Objetivos: Analisar as hemoculturas positivas por bactérias patogénicas num serviço de pediatria, nomeadamente agentes mais frequentes, sua evolução, respetivos antibiogramas e correlação com dados clínicos. Material e Métodos: Estudo retrospetivo de dados micro- biológicos das bactérias patogénicas isoladas em hemoculturas e dados clínicos de crianças com idade entre um mês e 17 anos, admitidas num serviço de pediatria, entre 2003 e 2012. Resultados: No período estudado, a percentagem anual de hemoculturas positivas por bactérias potencialmente patogénicas variou entre 0,8% e 2,9%. No total isolaram-se 158 bactérias patogénicas, sendo mais frequentes: Staphylococcus aureus (29,1%), Streptococcus pneumoniae (27,8%), Escherichia coli (10,1%), Enterococcus faecalis (8,2%), Neisseria meningitidis (5,7%) e Streptococcus pyogenes (5,7%). Nenhuma Neisseria meningitidis foi resistente à resistente à ampicilina, 9% dos Streptococcus pneumoniae tiveram resistência intermédia à penicilina, 8,7% dos Staphylococcus aureus tiveram resistência à meticilina e 6,3% das Escherichia coli tinham resistência à amoxicilina/ácido clavulânico. Sessenta e sete porcento das hemoculturas positivas por bactérias patogénicas correspondiam a crianças com idade inferior a 36 meses. Os diagnósticos mais relevantes foram: bacteriémia oculta, pneumonia, sépsis, meningite e pielonefrite. Ocorreu um óbito devido a choque sético (Streptococcus pneumoniae). Conclusão: Nos 10 anos analisados, as bactérias mais frequentes foram: Staphylococcus aureus, Streptococcus pneumoniae e Escherichia coli. Verificou-se diminuição da incidência da Neisseria meningitidis após 2005 e do Streptococcus pneumoniae após 2007. As suscetibilidades das diferentes bactérias patogénicas aos antimicrobianos mantiveram-se estáveis. Enfatiza-se a importância epidemiológica e clínica da monitorização de dados microbiológicos.

The Europeanisation of Criminal Law and the Criminal Law Dimension of European Integration. Research Papers in Law, 3/2005

From the Introduction. In the academic year 1991-1992, Utrecht University, on my initiative, started to offer courses in European criminal law. This initiative came at a symbolic moment, just prior to the entry into force of the EU Treaty of Maastricht1 and the outlining of European policy in the areas of Justice and Home Affairs (JHA). The Director of the Legal Department, Paul DEMARET, was aware of the significance of this development and I have been given the opportunity to teach this subject at the College of Europe since 1995. Since then, JHA has evolved into one of the main areas of EU legislation. Now we are again on the threshold of an important historical feat. In June 2003, the European Convention reached agreement concerning a draft Treaty establishing a Constitution for Europe.2 The use of the term “Constitution” for the future EU Treaty is not simply cosmetic. The realisation has dawned that EU integration must be embedded in a treaty document which also regulates the rights and duties of citizens, not just with respect to European citizenship, but also with respect to, for example, Justice. Where JHA is concerned, this result acknowledges that the harmonisation of criminal law and criminal procedure and transnational cooperation cannot preclude the harmonisation of principles of due law and fair trial. Despite the substantial Europeanisation of criminal law, many criminal lawyers are defending the achievements and typicalities of their national criminal law like never before. EU initiatives are assessed from the perspective of the national agenda and national achievements. We are still too far removed from a European criminal law policy that is both European and enjoys national support. The core issue is therefore not how to keep our criminal (procedural) law national and free from European influences, but rather how to ensure democratic decision making, the quality of the constitutional state and the guarantees of criminal law in a national administrative model which has to operate increasingly interactively within a European and international context. In this contribution, the contours of the Europeanisation of criminal law are outlined and analysed. First, attention will be paid to the EC and, second, to the JHA. Following this, an evaluation and a look ahead at the current IGC are indicated.

The 2005 Reform of the Stability and Growth Pact: Too Little, Too Late? Bruges European Economic Research (BEER) Papers 6/November 2006

This paper analyses the main critiques addressed by the literature and the policymakers to the 1997 Stability and Growth Pact. It further indicates to what extent the 2005 reform of the Pact meets those critics. It finally argues that the 2005 reform may be too little and arrive too late to restore the Pact credibility, ensure its enforceability and correctly set the derogations to the excessive deficit procedure on the nature of the shocks which cause the output gap rather than its size: a 3% of GDP limit on deficit spending may be a too binding constraint in front of a strongly negative demand shock, while it is irrationally large in front of a supply shock. Some empirical evidence is provided to identify in the last years strongly negative demand shocks from other shocks in the 25 EU Member States. Had this identifying method been adopted in November 2003, the European Commission and the Council would have both agreed to stop the excessive deficit procedure against Germany, but they would have both proceeded against France which apparently was not at the time hit by a strongly negative demand shock.