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- Biofilms within the human body and its clinical implicationsPublication . Jordão, Luísa; Subtil, João; Lavado, Paula; Rodrigues, João; Reis, Lúcia; Faria, Isabel; Pessanha, Maria AnaBiofilms with medical implications could be find on medical devices or on organs. Here we discuss the results obtained in two studies one associated with an organ (adenoid) and another associated with a medical device (central venous catheters- CVC). In the first study, we evaluate the association between biofilm assembly on adenoids and the incidence of recurrent infections in a paediatric population comparing adenoid samples from adenoidectomy groups with and without infectious indication. Biofilms were present in 27.4% of the adenoid samples. For H. influenzae, S. aureus, S. pyogenes, S. pneumococcus and M. catarrhalis, no association was found between ability to assemble biofilms in vitro and the presence of biofilms on adenoids, and the same was found for antibiotic resistance. The most isolated bacterium was H. influenzae that revealed after further characterization to be non-typeable (NT). No statistical difference was found on biofilm presence between the two groups, infectious versus non-infectious diagnosis. The same was true for biofilm assembling ability of bacteria found on adenoid surface and core. As in other studies, we did not find a correlation between biofilm formation and susceptibility or resistance to antibiotics and this raise the question of the importance of biofilms on the pathogenesis of infectious diseases. In the second study, we explore the relation between the presence of biofilms on central venous catheters and central venous catheter-related bloodstream infection (CRBSI). Our preliminary results (relative to data collected over 10 months) show that Staphylococci, either coagulase negative or positive, are major etiologic agents of this healthcare associated infection.
- Patient and hospital characteristics that influence incidence of adverse events in acute public hospitals in Portugal: a retrospective cohort studyPublication . Sousa, Paulo; Uva, António Sousa; Serranheira, Florentino; Sousa-Uva, Mafalda; Nunes, CarlaObjective: To analyse the variation in the rate of adverse events (AEs) between acute hospitals and explore the extent to which some patients and hospital characteristics influence the differences in the rates of AEs. Design: Retrospective cohort study. Chi-square test for independence and binary logistic regression models were used to identify the potential association of some patients and hospital characteristics with AEs. Setting: Nine acute Portuguese public hospital centres. Participants: A random sample of 4250 charts, representative of around 180 000 hospital admissions in 2013, was analysed. Intervention: To measure adverse events based on chart review. Main Outcome Measure: Rate of AEs. Results: Main results: (i) AE incidence was 12.5%; (ii) 66.4% of all AEs were related to Hospital-Acquired Infection and surgical procedures; (iii) patient characteristics such as sex (female 11%; male 14.4%), age (≥65 y 16.4%; <65 y 8.5%), admission coded as elective vs. urgent (8.6% vs. 14.6%) and medical vs. surgical Diagnosis Related Group code (13.4% vs. 11.7%), all with p < 0.001, were associated with a greater occurrence of AEs. (iv) hospital characteristics such as use of reporting system (13.2% vs. 7.1%), being accredited (13.7% vs. non-accredited 11.2%), university status (15.9% vs. non-university 10.9%) and hospital size (small 12.9%; medium 9.3%; large 14.3%), all with p < 0.001, seem to be associated with a higher rate of AEs. Conclusions: We identified some patient and hospital characteristics that might influence the rate of AEs. Based on these results, more adequate solutions to improve patient safety can be defined.
- Plano Estratégico no âmbito da Saúde Pública para o Acompanhamento das Populações Expostas aos Incêndios de Pedrogão GrandePublication . Neto, Mariana; Pimentel, João Pedro; Morais, AntónioPlanificação do estudo dos Efeitos de Longo Prazo dos Incêndios Florestais na Saúde das Populações através de inquérito à população residente nos concelhos de Pedrógão Grande, Castanheira de Pera e Figueiró dos Vinhos (Ensaio-piloto. Penacova) para a recolha de dados populacionais relacionados com os efeitos da exposição aos incêndios de Pedrógão Grande em junho de 2017.