GLORIA

GEOMAR Library Ocean Research Information Access

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Online Resource
    Online Resource
    Cambridge University Press (CUP) ; 2017
    In:  International Journal of Technology Assessment in Health Care Vol. 33, No. S1 ( 2017), p. 38-39
    In: International Journal of Technology Assessment in Health Care, Cambridge University Press (CUP), Vol. 33, No. S1 ( 2017), p. 38-39
    Abstract: Patient Blood Management (PBM) describes a multidisciplinary approach that strives to optimize patients own blood and has been reported to reduce blood components utilization while achieving improved patient outcomes and reduced healthcare costs. The aim of this study was to evaluate the public health and economic impact related to the implementation of a nationwide PBM program in Portugal. METHODS: A decision-model comparing two scenarios (“current clinical practice” and “with PBM implementation”) was used to estimate the PBM impact including hospital-assisted patients from the following therapeutic areas: surgery (orthopaedic, cardiac and urologic), cardiology, oncology, gastrointestinal bleeding, abnormal uterine bleeding, hemodialysis, inflammatory bowel disease and pregnancy. Model inputs were obtained from Portuguese national health databases and literature review. The public health impact was measured in life years (LY) gained, disability-adjusted life years (DALY) reduction, hospital length of stay (LOS) and 30-day readmission rate reduction. The economic value was expressed in total and hospitalization costs savings. RESULTS: A total of 384,704 patients were eligible for PBM strategies. We estimated that a one year nationwide PBM implementation could avoid 594 premature deaths, representing a gain of 1,481 LY and a reduction of 3,660 DALYs relative to the current paradigm. An 8.4 percent and 37.3 percent reduction in length of stay and 30-day readmission rate are expected, respectively. This corresponds to EUR70.4 million savings in hospitalization costs. Although PBM closer monitoring would imply additional physician visits and medicines use, leading to EUR24.1 million in additional expenditure, in this population the overall PBM implementation can generate net savings of more than EUR67.7 million per year (6.3 percent reduction of public expenditure). CONCLUSIONS: The implementation of a nationwide PBM in Portugal may represent a great public health impact, especially in decreased mortality and disability, with substantial public expenditure reduction.
    Type of Medium: Online Resource
    ISSN: 0266-4623 , 1471-6348
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2017
    detail.hit.zdb_id: 2020486-3
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 2
    In: Acta Médica Portuguesa, Ordem dos Medicos, Vol. 35, No. 10 ( 2022-05-27), p. 749-757
    Abstract: Introduction: Anaemia and iron deficiency are associated with increased mortality and poor surgical outcomes. Consensus in their definitions is expected to optimize their management, which is encompassed by patient blood management, providing patient-centred care while improving patient safety and clinical outcomes. Patient blood management implementation is even more relevant in contingency times and faces barriers due to lack of standardization, among others. The aim is to establish a consensus on these diagnoses and implement patient blood management principles in clinical practice in Portugal.Material and Methods: Eight experts in Transfusion Medicine, Haematology, Anaesthesiology, Internal Medicine, and Obstetrics/Gynaecology were assembled; a focus group was conducted, defining 33 statements. A Delphi panel was conducted, with experts from the clinical specialities named above as well as from General Surgery, Urology, and Orthopaedics.Results: The Delphi panel’s rounds had 70 (Round 1) and 46 (Round 2) respondents. Specialists were consensual in only two statements, on the existence of a preoperative patient blood management consultation for candidates to elective surgeries in which the use of blood derivatives is anticipated and, on the importance of the correction of postoperative anaemia and iron deficiency. Of the remaining 31 statements, 27 reached high agreement or disagreement by the respondents.Conclusion: Consensus was reached in only two (6%) of the 33 statements. There was a consensual agreement on the relevance of establishing patient blood management as the standard of care and of valuing preoperative and postoperative patient blood management interventions. Nevertheless, our results point to the lack of awareness regarding patient blood management principles – which could result in better postoperative outcomes, shorter hospitalizations, reduced costs and increased availability of beds. Training and literacy initiatives could help further implement patient blood management standards in Portuguese hospitals.
    Type of Medium: Online Resource
    ISSN: 1646-0758 , 0870-399X
    Language: Unknown
    Publisher: Ordem dos Medicos
    Publication Date: 2022
    detail.hit.zdb_id: 2133563-1
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 3
    Online Resource
    Online Resource
    Ordem dos Medicos ; 2022
    In:  Acta Médica Portuguesa Vol. 35, No. 10 ( 2022-07-15), p. 758-764
    In: Acta Médica Portuguesa, Ordem dos Medicos, Vol. 35, No. 10 ( 2022-07-15), p. 758-764
    Abstract: O envelhecimento populacional tem-se traduzido no aumento de prevalência de doenças crónicas como a doença renal crónica. A anemia é uma das complicações mais frequentes da doença renal crónica, com impacto não só na qualidade de vida como no prognóstico do doente e nos custos associados. O conhecimento nesta área terapêutica tem aumentado de forma significativa: desde o aparecimento da eritropoietina recombinante em 1989, passando pelo uso de doses crescentes de ferro parentérico e, mais recentemente, a novas moléculas como os inibidores do hypoxia-inducible factor. Os autores pretendem rever, de uma forma pragmática, o estado da arte da anemia associada à doença renal crónica, desde a epidemiologia, à fisiopatologia, ao diagnóstico e ao tratamento.
    Type of Medium: Online Resource
    ISSN: 1646-0758 , 0870-399X
    Language: Unknown
    Publisher: Ordem dos Medicos
    Publication Date: 2022
    detail.hit.zdb_id: 2133563-1
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 4
    Online Resource
    Online Resource
    SMC Media ; 2019
    In:  European Journal of Case Reports in Internal Medicine , No. Vol 6 Iss 12 ( 2019-11-20)
    In: European Journal of Case Reports in Internal Medicine, SMC Media, , No. Vol 6 Iss 12 ( 2019-11-20)
    Abstract: Pituitary apoplexy is a rare medico-surgical emergency that stems from an acute expansion of a pituitary adenoma from infarction or haemorrhage and where the treatment strategy is still controversial. Clinical presentation is highly variable and a high index of suspicion is needed to make the diagnosis. Furthermore, in less than half of cases, a precipitating event is identified. We report a case of a 74-year-old female who, after introduction of anticoagulation for pulmonary thromboembolism, presented with pituitary apoplexy heralded by acute adrenal insufficiency, headaches, visual symptoms and hypogonadotropic hypogonadism. Timely initiation of corticosteroids was crucial, and after stabilisation, a conservative treatment strategy was favoured with good long-term prognosis. Long-term follow-up of pituitary function also revealed new growth hormone deficiency.
    Type of Medium: Online Resource
    ISSN: 2284-2594
    Language: English
    Publisher: SMC Media
    Publication Date: 2019
    detail.hit.zdb_id: 3016175-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 5
    In: Anemia, Hindawi Limited, Vol. 2020 ( 2020-07-29), p. 1-10
    Abstract: Anemia and iron deficiency (ID) can impair quality of life and socioeconomic development. We evaluated the prevalence of anemia and ID in the adult Portuguese population in real-life contexts by gender, age, and pregnancy status. We performed a cross-sectional screening in adult individuals in mainland Portugal from 2013 to 2017. Participants completed a survey about demographics and signs or symptoms compatible with anemia, and ID and hemoglobin and ferritin concentrations were determined by point-of-care tests. We estimated and compared prevalence ratios (PR) of anemia and ID using Poisson regression with robust variance and the Wald chi-square test. We collected data from 11,030 individuals (26% men, 64% nonpregnant women, and 10% pregnant women). We found anemia in 51.8% (95% CI 50.1–53.4%) of nonpregnant women in fertile age, 46.6% (95% CI 44.7–48.6%) of nonpregnant women 〉 51 years, 38.2% (95% CI 35.4–41.1%) of pregnant women, and 33.3% (95% CI 31.6–35.1%) of men. The prevalence of ID was 72.9% (95% CI 71.4–74.4%) in nonpregnant women in fertile age, 50.5% (95% CI 48.5–52.4%) in nonpregnant women 〉 51 years, 94.8% (95% CI 93.3–96.0%) in pregnant women, and 28.9% (95% CI 27.3–30.6%) in men. We found significant associations between the prevalence of anemia or ID and nonpregnant women (PR: 1.50, 95% CI 1.42–1.59 or PR: 2.21, 95% CI 2.09–2.35, respectively), manifestation of signs or symptoms (PR: 1.19, 95% CI 1.53–1.23 or PR: 1.22, 95% CI 1.18–1.26), pregnant women (PR: 0.74, 95% CI 0.68–0.80 or PR: 1.30, 95% CI 1.27–1.33), and nonpregnant women ≤51 years (PR: 1.11, 95% CI 1.06–1.17 or PR: 1.42, 95% CI 1.36–1.48). In conclusion, anemia and ID represent moderate to severe public health problems, particularly among women in fertile age and in 3rd trimester, of pregnancy emphasizing the need to raise the public and health professionals’ awareness of these problems and their prevention, diagnosis, and treatment.
    Type of Medium: Online Resource
    ISSN: 2090-1267 , 2090-1275
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2020
    detail.hit.zdb_id: 2595393-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 6
    Online Resource
    Online Resource
    Elsevier BV ; 2019
    In:  Journal of Minimally Invasive Gynecology Vol. 26, No. 7 ( 2019-11), p. 1334-1339
    In: Journal of Minimally Invasive Gynecology, Elsevier BV, Vol. 26, No. 7 ( 2019-11), p. 1334-1339
    Type of Medium: Online Resource
    ISSN: 1553-4650
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2019
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...