Browsing by Author "Sousa, J"
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- Avaliacao do risco de tromboembolismo venoso: racional, objectivos e metodologia: estudo ARTEPublication . França, A; Sousa, J; Felicíssimo, P; Ferreira, DO tromboembolismo venoso (TEV) é uma situação clínica frequente e com elevadas morbilidade e mortalidade. O risco de TEV é particularmente elevado em doentes hospitalizados e em doentes oncológicos, sendo ainda factor de mau prognóstico para a doença oncológica. Os resultados de diferentes estudos clínicos têm evidenciado a necessidade de se desenvolverem estratégias hospitalares eficazes, através do recurso a avaliações sistemáticas e individualizadas do risco de TEV e, de forma complementar, de se optimizar a instituição de profilaxia e a sua correcta utilização em contexto de internamento e de ambulatório. O estudo Avaliação de Risco de Tromboembolismo Venoso – ARTE, é um estudo não interventivo, multicêntrico, prospectivo, de âmbito nacional, dividido em duas fases, uma em contexto de internamento e outra em ambulatório, por follow-up telefónico, até aos 6 meses após a alta hospitalar. O presente estudo decorre até à inclusão de 4000 doentes, distribuídos de forma equitativa por 4 classes de doentes: médicos, cirúrgicos, oncológicos e ortopédicos. Este estudo tem como base a recolha de dados dos processos clínicos e uma abordagem directa aos doentes hospitalizados nos serviços de medicina, oncologia, cirurgia e ortopedia dos centros participantes. Os principais objectivos do presente estudo são: avaliar o perfil de risco de TEV da população em estudo, por meio de um modelo de avaliação de risco (MAR) adaptado dos modelos de Caprini e de Khorana et al., assim como, validar o referido MAR para a população portuguesa. Paralelamente, os objectivos secundários são: determinar a proporção de doentes em risco de TEV, de acordo com score de risco, a realizar profilaxia; determinar a duração da profilaxia durante o internamento; determinar a proporção de doentes em profilaxia prolongada, na alta; determinar a incidência de eventos tromboembólicos (Trombose Venosa Profunda – TVP; Acidente Vascular Cerebral – AVC; Tromboembolismo Pulmonar – TEP; Acidente Isquémico Transitório - AIT), eventos hemorrágicos (hemorragias major e minor) e morte aos 6 meses. Cada doente participante no estudo é contactado telefonicamente aos 3 e 6 meses após alta hospitalar, avaliando-se a ocorrência de eventos tromboembólicos e hemorrágicos, bem como de re-internamento. O presente artigo descreve o racional, objectivos e metodologia do estudo ARTE.
- Prevenção secundária no enfarte agudo do miocárdioPublication . Ferreira, R; Ferreira, D; Correia, M; Sá, ME; Sousa, J; Sousa, J; Tavares, M
- Sexuality, emotionality, healthy responsibility: take care of yourself A sexual education projectPublication . Vilelas, J; Sousa, J; Baltar, P; Rodrigues, LINTRODUCTION. Adolescence is a period of doubt and discovery, during which the biggest problems related to the discovery of sexuality arise. Portugal is part of the European countries with the largest number of teenage mothers. Despite the rising availability of information in this area, this phenomenon still occurs with all the negative consequences involved. This project intends to develop and implement a Sexual Education project named "Sexuality, Emotionality, Responsibility: Take Care of Yourself", which aims at promoting healthy behaviours on an individual and group level (prevention, self-protection and protection of others). METHODS. This is an action research project. During first phase, a questionnaire will be applied to teenagers (10 to 18 years of age), who attend a group of schools in Lisbon area. Subsequently, "Love Workshops" will be implemented, aiming at progressively developing self-responsibilization, promoting physical, psychological, and social health. In schools, dialogue and discussion areas between students, parents, teachers and, eventually, other professionals will be created. Peer education will be one of the used strategies because prevention messages will thus be adapted to different values and needs of each peer group, mediated by "Affection Ambassadors", facilitating behavioural change. At the final phase, people involved will assess the intervention process. CONCLUSIONS. We hope to be able to promote prioritization of sexual education as a determinant of health, contributing to empowerment and emotional development of teenagers, aiming at healthy and responsible sexuality, through nursing interventions that use dynamic methods focused on the teenager and the group.
- Venous thromboembolism risk and prophylaxis in the Portuguese hospital care setting: The ARTE study.Publication . Ferreira, D; Sousa, J; Felicíssimo, P; França, AINTRODUCTION: Venous thromboembolism (VTE) is a relatively common complication during hospital stay and determination of VTE risk is critical to choosing the best prophylactic strategy for each patient. OBJECTIVES: In the present study we studied the risk profile for VTE in hospitalized patients in a group of hospitals in Portugal. METHODS: Based on an open cohort of 4248 patients hospitalized in surgical, internal medicine, orthopedic or oncology departments, we determined thromboembolic risk at admission by applying a new score, modified from the Caprini and Khorana scores. Thrombotic, embolic and bleeding events and death were assessed during hospital stay and at three and six months after discharge. RESULTS: The median duration of hospital stay was five days and thromboembolic prophylaxis was implemented in 67.2% (n=2747) of the patients. A low molecular weight heparin was used as prophylaxis in the majority of cases (88.3%). Most patients were classified as high (68%) or intermediate risk (27%). The overall incidence of thromboembolic events was 1.5%. Major bleeding events were recorded in 3.89% of patients and all-cause mortality was 3.4%. CONCLUSIONS: In this study, we propose a modified VTE risk score that effectively risk-stratifies a mixed inpatient population during hospital stay. The use of this score may result in improvement of thromboprophylaxis practices in hospitals.