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11 results on '"Alexandre Carrilho"'

1. Portuguese Consensus and Recommendations for Acquired Coagulopathic Bleeding Management (CCBM)

Author

Manuela Gomes MD, Anabela Rodrigues MD, Alexandre Carrilho MD, José Aguiar MD, Luciana Gonçalves MD, Fernando Fernandez-Llimos PhD, Filipa Duarte-Ramos PhD, and Joana Rodrigues MSc

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

We aimed to determine how Portuguese physicians handle major bleeding. We also aim to establish global diagnostic and therapeutic recommendations to be followed in clinical practice by using a step-wise approach of evidence generation. This study followed a three-step process: a steering committee desk review, a Delphi technique, an expert panel meeting. A modified 3-round Delphi including 31 statements was performed. Questions were answered in a five-point Likert-type scale. Consensus threshold was established as a percentage of agreement among participants ≥90% in the first round, and ≥85% in the second and third rounds. The level of consensus achieved by panelists was discussed with the scientific committee (January-2020). Fifty-one physicians participated in the study (compliance rate >90%). Analyzing the three rounds, consensus was reached on 20 items (64.5%) in the first, 4/11 items (36.4%) in the second and 6/7 items (85.7%) in the third. One statement about administration of clotting factor concentrates for bleeding control did not reach consensus. A high level of consensus was reached toward the need for implementing Patient Blood Management strategies in Portuguese hospitals, reduce exposure to allogeneic blood components, to use goal directed therapies for acquired bleeding management, and the need for evaluating blood transfusion indirect costs. A final version with 12 recommendations was built, according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Our results provide critically appraised and updated evidence on bleeding coagulopathies management in Portugal. Additional studies, mainly about indirect costs of blood transfusion, are needed.

Published
2021
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2. Interventional Algorithm in Gastrointestinal Bleeding—An Expert Consensus Multimodal Approach Based on a Multidisciplinary Team

Author

Anabela Rodrigues MD, Alexandre Carrilho MD, Nuno Almeida MD, PhD, Cilénia Baldaia MD, Ângela Alves MD, Manuela Gomes MD, Luciana Gonçalves MD, António Robalo Nunes MD, PhD, Carla Leal Pereira MD, Mário Jorge Silva MD, José Aguiar MD, Rosário Orfão MD, Pedro Duarte MD, and Rui Tato Marinho MD, PhD

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

The approach to the patient with gastrointestinal bleeding (GIB) can be very complex. A multidisciplinary panel of physicians with expertise in Gastroenterology, Anesthesiology, and Transfusion Medicine worked together to provide the best knowledge and guide clinical practitioners in the real setting of health institutions, characterized by disparate availability of human and technical resources. The authors propose a global and personalized approach according to different clinical scenarios to improve the outcomes of patients with GIB, for whom the reduction of inappropriate transfusions is crucial. The goal of this document is to provide clear and objective guidance through interventional algorithms toward a goal-directed approach according to the clinical situation and supported by the latest available scientific data on GIB management in different settings.

Published
2020
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3. Quality of Sleep among Portuguese Anaesthesiologists: A Cross-Sectional Study

Author

Francisco Valente, Catarina Batista, Vânia Simões, Inês Tomé, and Alexandre Carrilho

Subjects
Anesthesiologists, Anesthesiology, Disorders of Excessive Somnolence, Portugal, Sleep, Sleep Deprivation, Medicine, Medicine (General), R5-920
Abstract

Introduction: Sleeping is essential to maintain proper relationships with others, keep alertness, and execute responsibilities, among many other functions. In the medical profession, there are several studies linking sleep deprivation with a decrease in responsiveness, cognition and attention. With this study we intended to characterize the sleep pattern of Portuguese anaesthesiologists and identify independent factors associated with sleep quality in this population. Material and Methods: An observational, cross-sectional study of senior and resident anesthesiologists working in Portugal was carried out through an online questionnaire. Individuals working exclusively in intensive care units, emergency departments or with previously diagnosed sleep disorders were excluded. Socio-demographic data, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Perceived Stress Scale were applied. Statistical significance was assessed using the Mann-Whitney test and the chi-square test. A multivariable analysis was performed to examine the association between the Pittsburgh Sleep Quality Index and certain variables. Results: Among 256 respondents, 46.1% reported “poor” quality of sleep (Pittsburgh Sleep Quality Index > 5). Within these individuals, 77.1% slept less than 7 hours per night (p < 0.001). Excessive daytime sleepiness (Epworth Sleepiness Scale > 10) was present in 41.0% of the sample, and the median Perceived Stress Scale score was 17.0. The independent factors associated with worse quality of sleep were the number of working hours/week (OR 1.03, 95% CI 1,01 to 1,06), perceived stress (OR 1.18, 95% CI 1.11 to 1.26), taking sleep medication (OR 14.72, 95% CI 5.55 to 39.08), and sleep hours/night (OR 0.25, 95% CI 0.15 to 0.42). Discussion: This fraction of Portuguese anaesthesiologists presented a poorer quality of sleep, with excessive daytime somnolence, perceived stress and higher sedative use compared to previously studied populations. Conclusion: Our study characterizes sleep patterns and identifies potential risk factors linked to sleep disturbances in a sample of Portuguese anaesthesiologists. Government and institutional policies can endorse sleep hygiene practices and habits, promoting healthier working environments.

Published
2019
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4. Quality of Sleep among Portuguese Anaesthesiologists: A Cross-Sectional Study

Author

Inês Tomé, Alexandre Carrilho, Catarina Batista, Francisco Valente, and Vânia Simões

Subjects
Gerontology, Male, Work, Time Factors, Perceived Stress Scale, lcsh:Medicine, Disorders of Excessive Somnolence/epidemiology, anesthesiologists, Anestesia, Anestesiologistas, Distúrbios do Sono por Sonolência Excessiva, Portugal, Privação do Sono, Sono, Transtornos do Sono-Vigília, Pittsburgh Sleep Quality Index, Sleep/physiology, education.field_of_study, lcsh:R5-920, Sleep hygiene, Stress, Psychological/epidemiology, Anesthesiologists, Anesthesiology, Disorders of Excessive Somnolence, Sleep, Sleep Deprivation, Sleep Wake Disorders, General Medicine, Middle Aged, Health Surveys/statistics & numerical data, Portugal/epidemiology, Female, medicine.symptom, lcsh:Medicine (General), Adult, Work/statistics & numerical data, Sleep Aids, Pharmaceutical/administration & dosage, Population, Statistics, Nonparametric, Intensive care, medicine, Humans, CHLC ANS, sleep, education, Chi-Square Distribution, sleep wake disorders, business.industry, lcsh:R, Health Surveys, portugal, sleep deprivation, anesthesiology, Sleep deprivation, Alertness, Cross-Sectional Studies, Sleep Aids, Pharmaceutical, disorders of excessive somnolence, Multivariate Analysis, business, Stress, Psychological
Abstract

Sleeping is essential to maintain proper relationships with others, keep alertness, and execute responsibilities, among many other functions. In the medical profession, there are several studies linking sleep deprivation with a decrease in responsiveness, cognition and attention. With this study we intended to characterize the sleep pattern of Portuguese anaesthesiologists and identify independent factors associated with sleep quality in this population.An observational, cross-sectional study of senior and resident anesthesiologists working in Portugal was carried out through an online questionnaire. Individuals working exclusively in intensive care units, emergency departments or with previously diagnosed sleep disorders were excluded. Socio-demographic data, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Perceived Stress Scale were applied. Statistical significance was assessed using the Mann-Whitney test and the chi-square test. A multivariable analysis was performed to examine the association between the Pittsburgh Sleep Quality Index and certain variables.Among 256 respondents, 46.1% reported "poor" quality of sleep (Pittsburgh Sleep Quality Index5). Within these individuals, 77.1% slept less than 7 hours per night (p0.001). Excessive daytime sleepiness (Epworth Sleepiness Scale10) was present in 41.0% of the sample, and the median Perceived Stress Scale score was 17.0. The independent factors associated with worse quality ofsleep were the number of working hours/week (OR 1.03, 95% CI 1,01 to 1,06), perceived stress (OR 1.18, 95% CI 1.11 to 1.26), taking sleep medication (OR 14.72, 95% CI 5.55 to 39.08), and sleep hours/night (OR 0.25, 95% CI 0.15 to 0.42).This fraction of Portuguese anaesthesiologists presented a poorer quality of sleep, with excessive daytime somnolence, perceived stress and higher sedative use compared to previously studied populations.Our study characterizes sleep patterns and identifies potential risk factors linked to sleep disturbances in a sample of Portuguese anaesthesiologists. Government and institutional policies can endorse sleep hygiene practices and habits, promoting healthier working environments.Introdução: O sono é essencial para executar tarefas, manter o estado de alerta, executar tarefas, entre outras funções. Diversos estudos na área médica relacionam a privação de sono com a redução da capacidade de resposta, cognição e nível de atenção. Os objetivos deste estudo foram a caracterização do padrão de sono dos anestesiologistas Portugueses e identificação de fatores de risco independentes para pior qualidade de sono. Material e Métodos: Efetuámos um estudo observacional e transversal em anestesiologistas e internos de formação específica em Anestesiologia a trabalhar em Portugal. Foram excluídos profissionais que trabalham exclusivamente em unidades de cuidados intensivos, serviços de urgência ou com patologias do sono previamente diagnosticadas. Foram colhidos dados sócio-demográficos e aplicadas as escalas de Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) e Perceived Stress Scale (PSS). A significância estatística foi analisada recorrendo aos testes de Mann-Whitney e qui-quadrado. A associação entre o Pittsburgh Sleep Quality Index e demais variáveis foi testada através de uma regressão logística. Resultados: Dos 256 casos admitidos, 46,1% apresentaram “má” qualidade de sono (Pittsburgh Sleep Quality Index5). Nestes, 77,1% dormiram menos de 7 horas por noite (p0,001). A sonolência diurna excessiva (Epworth Sleepiness Scale10) surgiu em 41,0% da amostra e a mediana da Perceived Stress Scale foi 17,0. Os fatores de risco independentes para “má” qualidade de sono foram: número de horas de trabalho semanais (OR 1,03, IC 95% 1,01 a 1,06), stress percecionado (OR 1,18, IC 95% 1,11 a 1,26), toma de medicamentos para dormir (OR 14,72, IC 95% 5,55 a 39,08) e número de horas dormidas por noite (OR 0,25, IC 95% 0,15 a 0,42). Discussão: A nossa amostra de anestesiologistas Portugueses apresentou pior qualidade de sono, com sonolência diurna excessiva, stress percecionado e uso de sedativos superiores a outras populações previamente estudadas. Conclusão: O presente estudo caracteriza o padrão de sono e identifica potenciais factores de risco relacionados com distúrbios do sono, numa amostra de Anestesiologistas Portugueses. Políticas de saúde governamentais e institucionais poderão ser orientadas para a promoção da higiene do sono, levando a ambientes de trabalho mais saudáveis.

Published
2019

5. Intraoperative transfusion practices and perioperative outcome in the European elderly: A secondary analysis of the observational ETPOS study

Author

Grusser L., Keszei A., Coburn M., Rossaint R., Ziemann S., Kowark A, Daniela Filipescu, Sibylle Kozek-Langenecker, Juan V Llau Pitarch, Susan Mallett, Peter Martus, Idit Matot, Jens Meier, Axel Unterrainer, Dieter Adelmann, Daniel von Langen, Petra Innerhofer, Nicole Innerhofer-Pompernigg, Stefan De Hert, Luc De Baerdemaeker, Jurgen van Limmen, Piet Wyffels, Björn Heyse, Margot Vanderlaenen, Maud Beran, David Kahn, Audrey Prospiech, Luc Jamaer, Freya Mulders, Stefan Jacobs, Wannes Baeten, Sofie Platteau, Isabelle Maquoi, Severine Lauwick, Marc Senard, Vincent Ninane, Jean-Pierre Lecoq, Pierre Boveroux, Grégory Hans, Marcel Vercauteren, Brigitte Leva, Benoit Plichon, Vojislav Vujanovič, Ismet Suljevic, Hened Kelle, Denis Gustin, Matea Bogdanovic Dvorscak, Tamara Lupis, Jadranka Pavičić Šarić, Nataša Paklar, Dagmar Oberhofer, Ira Skok, Borana Kirigin, Ikic Visnja, Marina Kresic, Slavica Kvolik, Renatas Krobot, Vladimir Cerny, Jana Striteska, Marcela Bilska, Petr Štourač, Hana Harazim, Olga Smékalová, Martina Kosinová, Jozef Klučka, Rita Pacasová, Kim Ekelund, Indrek Rätsep, Juri Oganjan, Nadezda Smirnova, Peeter Kivik, Juri Karjagin, Alar Rokk, Alar Sõrmus, Bertrand Rozec, Jean-Christophe Rigal, Jean-Pierre Gouraud, Anne-Marie Chupin, Xavier Ambrosi, Laurent Brisard, Sylvie Decagny, Charles Marc Samama, Lionel Lidzborski, Matthieu Boisson, Anne-Laure Arcade, Gilbert Lorre, Peter Rosenberger, Hannah Merz, Ulrich Goebel, Bettina Schnitter, Hartmut Buerkle, Roland Tomasi, Vera von Dossow-Hanfstingl, Florian Brettner, Andreas Bayer, André Gottschalk, Nicolas Jakobs, Mark Coburn, Ana Kowark, Rolf Rossaint, Rita Laufenberg, Marion Ferner, Michael Schuster, Lydia Strys, Susanne Mauff, Kornel Skitek, Ewa Zielinska-Skitek, Gregor Schittek, Andreas Hoeft, Andreas Fleischer, Maria Wittmann, Florian Kessler, Anne Rohner, Peter Kranke, Christian Wunder, Johanna Jokinen, Kristin Budow, Christopher Prasser, Eva Werner, Alina Balandin, Norbert Ahrens, Kai Zacharowski, Patrick Meybohm, Kassiani Theodoraki, George Giokas, Tasoulis Marios-Konstantinos, Ageliki Pandazi, Aikaterini Kyttari, Eygenia Koursoumi, Georgios Anthopoulos, Antonis Andreou, Athanasios Rantis, Dimitrios Valsamidis, Pelagia Klimi, Konstantinos Katsanoulas, Demetrios Korfiotis, Christos Soumelidis, Fotios Papaspyros, Olga Kiskira, Tilemachos Paraskeuopoulos, Donal Buggy, Mortimer Kelleher, Liz Coghlan, Vladimir Verenkin, Anat Cattan, Francesco Bona, Felicino Debernardi, Andrea Cortegiani, Santi Maurizio Raineri, Giuseppe Accurso, Elena Gramigni, Leonardo Cenni, Laura Campiglia, Irene Lorenzi, Maria Grazia Militello, Tamara Biscioni, Andrius Macas, Daiva Apanaviciute, Darius Trepenaitis, Arunas Gelmanas, Diana Bilshiene, Jurate Sipylaite, Gabija Tomkute, Egle Kontrimaviciut, Renatas Tikuisis, Francis Borg, Ion Chesov, Serghei Cobiletchi, Victoria Moghildea, Bas Verdouw, J F van Poorten, Nick van Dasselaar, Marcus Daniel Lance, Britta de Waal, Lucienne Kropman, Peter van Noord, Benedikt Preckel, Lena Koers, Markus W Hollmann, Holger Baumann, Ankie W M M Koopman-van Gemert, Tore Reikvam, Tore Hervig, Kasper Gymoese Berthelsen, Ingvild Hausberg Sørvoll, Mirosław Czuczwar, Michał Borys, Paweł Piwowarczyk, Suzana Parente, Diogo Martins, Gloria Tareco, Ligia Reis, Joana Amaral, Daniel Ferreira, José Manuel Gonçalves Aguiar, Zélia Moreira, Filipa Lagarto, Filipa Pereira, Maria Lina Miranda, Sofia Serra, Alexandre Carrilho, José Pinto, Sandra Dias, Rita Poeria, Filipe Linda, Silvia Pica, Helder Martinho, Francisco Matias, Claudia Alves, Valentina Almeida, Margarida Marques, Emilia Martires, Piedade Gomes, Elizabete Pereira, Joana Jesus, Claudia Carreira, Carlos Seco, Carlos Bento, Helena Vieira, Luciane Pereira, Fernando Pinto, Luisa Silva, Marta Azenha, Maged Zarif, Ana Bernardino, Ana Raimundo, Ana Lopes, Melissa Fernandes, Beatriz Campos, Ana Macedo, Filipe Pinheiro, Sonia Duarte, Alexandra Saraiva, Catia Real, Marilena Alina Paunescu, Alexandru Bogdan Prodan, Mihai Stefan, Cristian Boros, Marius Tifrea, Anca Dragan, Horhota Lucian, Alida Moise, Carmen Arion-Balescu, Natalia Mincu, Viorel Gherghina, Iulia Cindea, Dan Costea, Ravzan Popescu, Dana Tomescu, Ecaterina Scarlatescu, Esenia Calancea, Ruxandra Copotoiu, Sanda Maria Copotoiu, Victoria Barsan, Dan Corneci, Rely Manolescu, Toma Diana, Denisa Nitu, Georgian Popica, Gabriela Droc, Nicoleta Jipa Lavina, Roxana Ciobanasu, Anna Maria Munteanu, Denisa Anastase, Iona Grintescu, Liliana Mirea, Alexandra Manoleli, Ciobanu Elena, Mary Nicoleta Lupu, Madalina Nina Sandu, Bicolae Bacalbasa, Florenta Calarasu, Alexey Grytsan, Andrey Gasenkampf, Alexander Kulikov, Alexander Shmigelsky, Vojislava Nescovic, Rade Vukovic, Uros Petrovic, Milic Veljovic, Dragana Unic-Stojanovic, Gordana Jovanovic, Ivana Kvrgic, Dragana Rakic, Roman Záhorec, Daniel Cintula, Tomas Veselovsky, Katarina Galkova, Jordana Stevikova, Andrea Číková, Zora Flassikova, Anna Dobisova, Jasmina Markovic Bozic, Minca Voje, Andriy Grynyuk, Alenka Spindler Yesel, Sabina Stivan, Peter Poredos, Darja Kasnik, Jasna Uranjek, Raquel Ferrandis, Sofia Machado, Liliana Henao, Tania Moreno, Ana Izquierdo, Carlos Delgado, Angela Camps, Susana Manrique, Alejandro Arbelaez, Pilar Tormos, Helena Serrano, Irene Garcia, Elvira Bisbe Vives, Luís Moltó, Tania Villar, Enrique Moret, Raquel Tolós, Esther Martínez, Misericordia Basora, Beatriz Tena, Roger Pujol, Jorge Vera Bella, Thomas Mallor, Pablo Mondero, Luis Lopez, Francisco Hidalgo, Maria Bermudez Lopez, Ana Velasco, Begona Bascuas, Victoria Moral, Diana Gómez Martinez, Alfredo Merten, J A Fernández, Nadia Diana Kinast, A Font, Maggi Genaro, Emilia Guasch, Fernando Gilsanz, Raul Martinez, Renato Schiraldi, Ever Martinez, Marta Barquero López, Alexo Lopez Alvarez, Yvan Enrique Sanchez Sanchez, Adriana Roman Fernandez, Olalla Varela Garcia, Marian Angeles Orallo Moran, Veronica Gonzalez Monzon, Óscar Sánchez López, David Sanchez Perez, Pablo Molano Diaz, Concepcion Cassinello, Maria Pilar Jubera, Maria Soler Pedrola, Julio Belmonte Cuenca, Sören Söndergaard, Till Rudolph, Kristin Åkeröy, Monir Jawad, Yousif Saeed, Sergej Safonov, Mona Andersson, Jan Wernerman, Suzanne Odeberg-Wernerman, Tommi Blom, Nesil Deger Coskunfirat, Zekiye Bigat, Suat Sanlı, O Koray Coskunfirat, Atilla Ramazanoğlu, Neval Boztug Uz, Ali Emre Camci, Omur Aksoy, Esra Saka, Oguzhan Arun, Sevda Ozkardesler, Dilek Omur, Mert Akan, Zuleyha Kazak Bengisun, Hakan Yılmaz, Perihan Ekmekci, Onur Selvi, Neslihan Alkis, Çiğdem Yıldırım, Başak Ceyda Meço, Zekeriyye Alanoğlu, Sergiy Vorotyntsev, Yevgen Yakymenko, Galina Troyan, Mohammed Alousi, Sarah James, Paula Meale, Ahmed Chishti, Matt Garner, Rita Singh, Nicola Hirschauer, Charley Higham, Andrea Bell, Alistair Cain, Chris Perry, Katy Davies, Claire Leech, Verity Calder, Shaman Jhanji, Varma Sandeep, Karen Simeson, Philip Watt, Nigel Dunk, Rosemary Ferrie, Margaret Wright, Lynn Everett, Andrew Ferguson, Laura Espie, Gail Browne, Matthew Dickinson, Ashok Nair, Deborah Clements, Peter Carvalho, Thomas Collyer, Jens Bolten, Lajos Zsisku, Attila Petri, Mohammed Ramadan, Tracey Ellimah, Martus, Peter, Laufenberg, Rita, Ferner, Marion, Schuster, Michael, Strys, Lydia, Mauff, Susanne, Skitek, Kornel, Zielinska-Skitek, Ewa, Schittek, Gregor, Hoeft, Andreas, Fleischer, Andreas, Matot, Idit, Wittmann, Maria, Kessler, Florian, Rohner, Anne, Kranke, Peter, Wunder, Christian, Jokinen, Johanna, Budow, Kristin, Prasser, Christopher, Werner, Eva, Balandin, Alina, Meier, Jens, Ahrens, Norbert, Zacharowski, Kai, Meybohm, Patrick, Theodoraki, Kassiani, Giokas, George, Marios-Konstantinos, Tasoulis, Pandazi, Ageliki, Kyttari, Aikaterini, Koursoumi, Eygenia, Anthopoulos, Georgios, Unterrainer, Axel, Andreou, Antonis, Rantis, Athanasios, Valsamidis, Dimitrios, Klimi, Pelagia, Katsanoulas, Konstantinos, Korfiotis, Demetrios, Soumelidis, Christos, Papaspyros, Fotios, Kiskira, Olga, Paraskeuopoulos, Tilemachos, Adelmann, Dieter, Buggy, Donal, Kelleher, Mortimer, Coghlan, Liz, Verenkin, Vladimir, Cattan, Anat, Bona, Francesco, Debernardi, Felicino, Cortegiani, Andrea, Raineri, Santi Maurizio, Accurso, Giuseppe, von Langen, Daniel, Gramigni, Elena, Cenni, Leonardo, Campiglia, Laura, Lorenzi, Irene, Militello, Maria Grazia, Biscioni, Tamara, Macas, Andrius, Apanaviciute, Daiva, Trepenaitis, Darius, Gelmanas, Arunas, Innerhofer, Petra, Bilshiene, Diana, Sipylaite, Jurate, Tomkute, Gabija, Kontrimaviciut, Egle, Tikuisis, Renatas, Borg, Francis, Chesov, Ion, Cobiletchi, Serghei, Moghildea, Victoria, Verdouw, Bas, Innerhofer-Pompernigg, Nicole, van Poorten, J. F., van Dasselaar, Nick, Lance, Marcus Daniel, de Waal, Britta, Kropman, Lucienne, van Noord, Peter, Preckel, Benedikt, Koers, Lena, Hollmann, Markus W., Baumann, Holger, De Hert, Stefan, Koopman-van Gemert, Ankie W. M. M., Reikvam, Tore, Hervig, Tore, Berthelsen, Kasper Gymoese, Sørvoll, Ingvild Hausberg, Czuczwar, Mirosław, Borys, Michał, Piwowarczyk, Paweł, Parente, Suzana, Martins, Diogo, De Baerdemaeker, Luc, Tareco, Gloria, Reis, Ligia, Amaral, Joana, Ferreira, Daniel, Gonçalves Aguiar, José Manuel, Moreira, Zélia, Lagarto, Filipa, Pereira, Filipa, Miranda, Maria Lina, Serra, Sofia, van Limmen, Jurgen, Carrilho, Alexandre, Pinto, José, Dias, Sandra, Poeria, Rita, Linda, Filipe, Pica, Silvia, Martinho, Helder, Matias, Francisco, Alves, Claudia, Almeida, Valentina, Wyffels, Piet, Marques, Margarida, Martires, Emilia, Gomes, Piedade, Pereira, Elizabete, Jesus, Joana, Carreira, Claudia, Seco, Carlos, Bento, Carlos, Vieira, Helena, Pereira, Luciane, Heyse, Björn, Pinto, Fernando, Silva, Luisa, Azenha, Marta, Zarif, Maged, Bernardino, Ana, Raimundo, Ana, Lopes, Ana, Fernandes, Melissa, Campos, Beatriz, Macedo, Ana, Vanderlaenen, Margot, Pinheiro, Filipe, Duarte, Sonia, Saraiva, Alexandra, Real, Catia, Paunescu, Marilena Alina, Bogdan Prodan, Alexandru, Stefan, Mihai, Boros, Cristian, Tifrea, Marius, Dragan, Anca, Beran, Maud, Lucian, Horhota, Moise, Alida, Arion-Balescu, Carmen, Mincu, Natalia, Gherghina, Viorel, Cindea, Iulia, Costea, Dan, Popescu, Ravzan, Tomescu, Dana, Scarlatescu, Ecaterina, Kahn, David, Calancea, Esenia, Copotoiu, Ruxandra, Copotoiu, Sanda Maria, Barsan, Victoria, Corneci, Dan, Manolescu, Rely, Diana, Toma, Nitu, Denisa, Popica, Georgian, Droc, Gabriela, Prospiech, Audrey, Jipa Lavina, Nicoleta, Ciobanasu, Roxana, Munteanu, Anna Maria, Anastase, Denisa, Grintescu, Iona, Mirea, Liliana, Manoleli, Alexandra, Elena, Ciobanu, Lupu, Mary Nicoleta, Sandu, Madalina Nina, Jamaer, Luc, Bacalbasa, Bicolae, Calarasu, Florenta, Grytsan, Alexey, Gasenkampf, Andrey, Kulikov, Alexander, Shmigelsky, Alexander, Nescovic, Vojislava, Vukovic, Rade, Petrovic, Uros, Veljovic, Milic, Mulders, Freya, Unic-Stojanovic, Dragana, Jovanovic, Gordana, Kvrgic, Ivana, Rakic, Dragana, Záhorec, Roman, Cintula, Daniel, Veselovsky, Tomas, Galkova, Katarina, Stevikova, Jordana, Číková, Andrea, Jacobs, Stefan, Flassikova, Zora, Dobisova, Anna, Markovic Bozic, Jasmina, Voje, Minca, Grynyuk, Andriy, Spindler Yesel, Alenka, Stivan, Sabina, Poredos, Peter, Kasnik, Darja, Uranjek, Jasna, Baeten, Wannes, Ferrandis, Raquel, Machado, Sofia, Henao, Liliana, Moreno, Tania, Izquierdo, Ana, Delgado, Carlos, Camps, Angela, Manrique, Susana, Arbelaez, Alejandro, Tormos, Pilar, Platteau, Sofie, Serrano, Helena, Garcia, Irene, Bisbe Vives, Elvira, Moltó, Luís, Villar, Tania, Moret, Enrique, Tolós, Raquel, Martínez, Esther, Basora, Misericordia, Tena, Beatriz, Maquoi, Isabelle, Pujol, Roger, Vera Bella, Jorge, Mallor, Thomas, Mondero, Pablo, Lopez, Luis, Hidalgo, Francisco, Bermudez Lopez, Maria, Velasco, Ana, Bascuas, Begona, Moral, Victoria, Lauwick, Severine, Gómez Martinez, Diana, Merten, Alfredo, Fernández, J. A., Kinast, Nadia Diana, Font, A., Genaro, Maggi, Guasch, Emilia, Gilsanz, Fernando, Martinez, Raul, Schiraldi, Renato, Senard, Marc, Martinez, Ever, Barquero López, Marta, Lopez Alvarez, Alexo, Sanchez Sanchez, Yvan Enrique, Roman Fernandez, Adriana, Varela Garcia, Olalla, Orallo Moran, Marian Angeles, Gonzalez Monzon, Veronica, Sánchez López, Óscar, Sanchez Perez, David, Ninane, Vincent, Molano Diaz, Pablo, Cassinello, Concepcion, Pilar Jubera, Maria, Soler Pedrola, Maria, Belmonte Cuenca, Julio, Söndergaard, Sören, Rudolph, Till, Åkeröy, Kristin, Jawad, Monir, Saeed, Yousif, Lecoq, Jean-Pierre, Safonov, Sergej, Andersson, Mona, Wernerman, Jan, Odeberg-Wernerman, Suzanne, Blom, Tommi, Deger Coskunfirat, Nesil, Bigat, Zekiye, Sanlı, Suat, Coskunfirat, O. Koray, Ramazanoğlu, Atilla, Boveroux, Pierre, Boztug Uz, Neval, Camci, Ali Emre, Aksoy, Omur, Saka, Esra, Arun, Oguzhan, Ozkardesler, Sevda, Omur, Dilek, Akan, Mert, Bengisun, Zuleyha Kazak, Yılmaz, Hakan, Hans, Grégory, Ekmekci, Perihan, Selvi, Onur, Alkis, Neslihan, Yıldırım, Çiğdem, Ceyda Meço, Başak, Alanoğlu, Zekeriyye, Vorotyntsev, Sergiy, Yakymenko, Yevgen, Troyan, Galina, Alousi, Mohammed, Vercauteren, Marcel, James, Sarah, Meale, Paula, Chishti, Ahmed, Garner, Matt, Singh, Rita, Hirschauer, Nicola, Higham, Charley, Bell, Andrea, Cain, Alistair, Perry, Chris, Leva, Brigitte, Davies, Katy, Leech, Claire, Calder, Verity, Jhanji, Shaman, Sandeep, Varma, Simeson, Karen, Watt, Philip, Dunk, Nigel, Ferrie, Rosemary, Wright, Margaret, Plichon, Benoit, Everett, Lynn, Ferguson, Andrew, Espie, Laura, Browne, Gail, Dickinson, Matthew, Nair, Ashok, Clements, Deborah, Carvalho, Peter, Collyer, Thomas, Bolten, Jens, Vujanovič, Vojislav, Zsisku, Lajos, Petri, Attila, Ramadan, Mohammed, Ellimah, Tracey, Suljevic, Ismet, Kelle, Hened, Gustin, Denis, Bogdanovic Dvorscak, Matea, Lupis, Tamara, Pavičić Šarić, Jadranka, Paklar, Nataša, Oberhofer, Dagmar, Skok, Ira, Kirigin, Borana, Visnja, Ikic, Kresic, Marina, Kvolik, Slavica, Krobot, Renatas, Cerny, Vladimir, Striteska, Jana, Bilska, Marcela, Filipescu, Daniela, Štourač, Petr, Harazim, Hana, Smékalová, Olga, Kosinová, Martina, Klučka, Jozef, Pacasová, Rita, Ekelund, Kim, Rätsep, Indrek, Oganjan, Juri, Smirnova, Nadezda, Kozek-Langenecker, Sibylle, Kivik, Peeter, Karjagin, Juri, Rokk, Alar, Sõrmus, Alar, Rozec, Bertrand, Rigal, Jean-Christophe, Gouraud, Jean-Pierre, Chupin, Anne-Marie, Ambrosi, Xavier, Brisard, Laurent, Llau Pitarch, Juan V., Decagny, Sylvie, Samama, Charles Marc, Lidzborski, Lionel, Boisson, Matthieu, Arcade, Anne-Laure, Lorre, Gilbert, Rosenberger, Peter, Merz, Hannah, Goebel, Ulrich, Schnitter, Bettina, Mallett, Susan, Buerkle, Hartmut, Tomasi, Roland, von Dossow-Hanfstingl, Vera, Brettner, Florian, Bayer, Andreas, Gottschalk, André, Jakobs, Nicolas, Coburn, Mark, Kowark, Ana, Rossaint, Rolf, Grusser L., Keszei A., Coburn M., Rossaint R., Ziemann S., Kowark A, Daniela Filipescu, Sibylle Kozek-Langenecker, Juan V Llau Pitarch, Susan Mallett, Peter Martus, Idit Matot, Jens Meier, Axel Unterrainer, Dieter Adelmann, Daniel von Langen, Petra Innerhofer, Nicole Innerhofer-Pompernigg, Stefan De Hert, Luc De Baerdemaeker, Jurgen van Limmen, Piet Wyffels, Björn Heyse, Margot Vanderlaenen, Maud Beran, David Kahn, Audrey Prospiech, Luc Jamaer, Freya Mulders, Stefan Jacobs, Wannes Baeten, Sofie Platteau, Isabelle Maquoi, Severine Lauwick, Marc Senard, Vincent Ninane, Jean-Pierre Lecoq, Pierre Boveroux, Grégory Hans, Marcel Vercauteren, Brigitte Leva, Benoit Plichon, Vojislav Vujanovič, Ismet Suljevic, Hened Kelle, Denis Gustin, Matea Bogdanovic Dvorscak, Tamara Lupis, Jadranka Pavičić Šarić, Nataša Paklar, Dagmar Oberhofer, Ira Skok, Borana Kirigin, Ikic Visnja, Marina Kresic, Slavica Kvolik, Renatas Krobot, Vladimir Cerny, Jana Striteska, Marcela Bilska, Petr Štourač, Hana Harazim, Olga Smékalová, Martina Kosinová, Jozef Klučka, Rita Pacasová, Kim Ekelund, Indrek Rätsep, Juri Oganjan, Nadezda Smirnova, Peeter Kivik, Juri Karjagin, Alar Rokk, Alar Sõrmus, Bertrand Rozec, Jean-Christophe Rigal, Jean-Pierre Gouraud, Anne-Marie Chupin, Xavier Ambrosi, Laurent Brisard, Sylvie Decagny, Charles Marc Samama, Lionel Lidzborski, Matthieu Boisson, Anne-Laure Arcade, Gilbert Lorre, Peter Rosenberger, Hannah Merz, Ulrich Goebel, Bettina Schnitter, Hartmut Buerkle, Roland Tomasi, Vera von Dossow-Hanfstingl, Florian Brettner, Andreas Bayer, André Gottschalk, Nicolas Jakobs, Mark Coburn, Ana Kowark, Rolf Rossaint, Rita Laufenberg, Marion Ferner, Michael Schuster, Lydia Strys, Susanne Mauff, Kornel Skitek, Ewa Zielinska-Skitek, Gregor Schittek, Andreas Hoeft, Andreas Fleischer, Maria Wittmann, Florian Kessler, Anne Rohner, Peter Kranke, Christian Wunder, Johanna Jokinen, Kristin Budow, Christopher Prasser, Eva Werner, Alina Balandin, Norbert Ahrens, Kai Zacharowski, Patrick Meybohm, Kassiani Theodoraki, George Giokas, Tasoulis Marios-Konstantinos, Ageliki Pandazi, Aikaterini Kyttari, Eygenia Koursoumi, Georgios Anthopoulos, Antonis Andreou, Athanasios Rantis, Dimitrios Valsamidis, Pelagia Klimi, Konstantinos Katsanoulas, Demetrios Korfiotis, Christos Soumelidis, Fotios Papaspyros, Olga Kiskira, Tilemachos Paraskeuopoulos, Donal Buggy, Mortimer Kelleher, Liz Coghlan, Vladimir Verenkin, Anat Cattan, Francesco Bona, Felicino Debernardi, Andrea Cortegiani, Santi Maurizio Raineri, Giuseppe Accurso, Elena Gramigni, Leonardo Cenni, Laura Campiglia, Irene Lorenzi, Maria Grazia Militello, Tamara Biscioni, Andrius Macas, Daiva Apanaviciute, Darius Trepenaitis, Arunas Gelmanas, Diana Bilshiene, Jurate Sipylaite, Gabija Tomkute, Egle Kontrimaviciut, Renatas Tikuisis, Francis Borg, Ion Chesov, Serghei Cobiletchi, Victoria Moghildea, Bas Verdouw, J F van Poorten, Nick van Dasselaar, Marcus Daniel Lance, Britta de Waal, Lucienne Kropman, Peter van Noord, Benedikt Preckel, Lena Koers, Markus W Hollmann, Holger Baumann, Ankie W M M Koopman-van Gemert, Tore Reikvam, Tore Hervig, Kasper Gymoese Berthelsen, Ingvild Hausberg Sørvoll, Mirosław Czuczwar, Michał Borys, Paweł Piwowarczyk, Suzana Parente, Diogo Martins, Gloria Tareco, Ligia Reis, Joana Amaral, Daniel Ferreira, José Manuel Gonçalves Aguiar, Zélia Moreira, Filipa Lagarto, Filipa Pereira, Maria Lina Miranda, Sofia Serra, Alexandre Carrilho, José Pinto, Sandra Dias, Rita Poeria, Filipe Linda, Silvia Pica, Helder Martinho, Francisco Matias, Claudia Alves, Valentina Almeida, Margarida Marques, Emilia Martires, Piedade Gomes, Elizabete Pereira, Joana Jesus, Claudia Carreira, Carlos Seco, Carlos Bento, Helena Vieira, Luciane Pereira, Fernando Pinto, Luisa Silva, Marta Azenha, Maged Zarif, Ana Bernardino, Ana Raimundo, Ana Lopes, Melissa Fernandes, Beatriz Campos, Ana Macedo, Filipe Pinheiro, Sonia Duarte, Alexandra Saraiva, Catia Real, Marilena Alina Paunescu, Alexandru Bogdan Prodan, Mihai Stefan, Cristian Boros, Marius Tifrea, Anca Dragan, Horhota Lucian, Alida Moise, Carmen Arion-Balescu, Natalia Mincu, Viorel Gherghina, Iulia Cindea, Dan Costea, Ravzan Popescu, Dana Tomescu, Ecaterina Scarlatescu, Esenia Calancea, Ruxandra Copotoiu, Sanda Maria Copotoiu, Victoria Barsan, Dan Corneci, Rely Manolescu, Toma Diana, Denisa Nitu, Georgian Popica, Gabriela Droc, Nicoleta Jipa Lavina, Roxana Ciobanasu, Anna Maria Munteanu, Denisa Anastase, Iona Grintescu, Liliana Mirea, Alexandra Manoleli, Ciobanu Elena, Mary Nicoleta Lupu, Madalina Nina Sandu, Bicolae Bacalbasa, Florenta Calarasu, Alexey Grytsan, Andrey Gasenkampf, Alexander Kulikov, Alexander Shmigelsky, Vojislava Nescovic, Rade Vukovic, Uros Petrovic, Milic Veljovic, Dragana Unic-Stojanovic, Gordana Jovanovic, Ivana Kvrgic, Dragana Rakic, Roman Záhorec, Daniel Cintula, Tomas Veselovsky, Katarina Galkova, Jordana Stevikova, Andrea Číková, Zora Flassikova, Anna Dobisova, Jasmina Markovic Bozic, Minca Voje, Andriy Grynyuk, Alenka Spindler Yesel, Sabina Stivan, Peter Poredos, Darja Kasnik, Jasna Uranjek, Raquel Ferrandis, Sofia Machado, Liliana Henao, Tania Moreno, Ana Izquierdo, Carlos Delgado, Angela Camps, Susana Manrique, Alejandro Arbelaez, Pilar Tormos, Helena Serrano, Irene Garcia, Elvira Bisbe Vives, Luís Moltó, Tania Villar, Enrique Moret, Raquel Tolós, Esther Martínez, Misericordia Basora, Beatriz Tena, Roger Pujol, Jorge Vera Bella, Thomas Mallor, Pablo Mondero, Luis Lopez, Francisco Hidalgo, Maria Bermudez Lopez, Ana Velasco, Begona Bascuas, Victoria Moral, Diana Gómez Martinez, Alfredo Merten, J A Fernández, Nadia Diana Kinast, A Font, Maggi Genaro, Emilia Guasch, Fernando Gilsanz, Raul Martinez, Renato Schiraldi, Ever Martinez, Marta Barquero López, Alexo Lopez Alvarez, Yvan Enrique Sanchez Sanchez, Adriana Roman Fernandez, Olalla Varela Garcia, Marian Angeles Orallo Moran, Veronica Gonzalez Monzon, Óscar Sánchez López, David Sanchez Perez, Pablo Molano Diaz, Concepcion Cassinello, Maria Pilar Jubera, Maria Soler Pedrola, Julio Belmonte Cuenca, Sören Söndergaard, Till Rudolph, Kristin Åkeröy, Monir Jawad, Yousif Saeed, Sergej Safonov, Mona Andersson, Jan Wernerman, Suzanne Odeberg-Wernerman, Tommi Blom, Nesil Deger Coskunfirat, Zekiye Bigat, Suat Sanlı, O Koray Coskunfirat, Atilla Ramazanoğlu, Neval Boztug Uz, Ali Emre Camci, Omur Aksoy, Esra Saka, Oguzhan Arun, Sevda Ozkardesler, Dilek Omur, Mert Akan, Zuleyha Kazak Bengisun, Hakan Yılmaz, Perihan Ekmekci, Onur Selvi, Neslihan Alkis, Çiğdem Yıldırım, Başak Ceyda Meço, Zekeriyye Alanoğlu, Sergiy Vorotyntsev, Yevgen Yakymenko, Galina Troyan, Mohammed Alousi, Sarah James, Paula Meale, Ahmed Chishti, Matt Garner, Rita Singh, Nicola Hirschauer, Charley Higham, Andrea Bell, Alistair Cain, Chris Perry, Katy Davies, Claire Leech, Verity Calder, Shaman Jhanji, Varma Sandeep, Karen Simeson, Philip Watt, Nigel Dunk, Rosemary Ferrie, Margaret Wright, Lynn Everett, Andrew Ferguson, Laura Espie, Gail Browne, Matthew Dickinson, Ashok Nair, Deborah Clements, Peter Carvalho, Thomas Collyer, Jens Bolten, Lajos Zsisku, Attila Petri, Mohammed Ramadan, Tracey Ellimah, Anesthesiology, ACS - Diabetes & metabolism, APH - Quality of Care, ACS - Heart failure & arrhythmias, APH - Global Health, and ACS - Microcirculation

Subjects
Clinical Oncology, Male, Science, Clinical Decision-Making, Cancer Treatment, Surgical and Invasive Medical Procedures, Geographical Locations, Diagnostic Medicine, Outcome Assessment, Health Care, Medicine and Health Sciences, Humans, Blood Transfusion, Prospective Studies, Aged, Aged, 80 and over, Intraoperative Care, Multidisciplinary, Transfusion Medicine, Anemia, Hematology, Clinical Laboratory Sciences, Health Care, Europe, Surgical Oncology, Oncology, Age Groups, Elective Surgical Procedures, People and Places, Medicine, Population Groupings, Female, Geriatric Care, Clinical Medicine, Erythrocyte Transfusion, Research Article
Abstract

PLOS ONE 17(1), e0262110 (2022). doi:10.1371/journal.pone.0262110, Published by PLOS, San Francisco, California, US

Published
2022
Full Text
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6. Portuguese Consensus and Recommendations for Acquired Coagulopathic Bleeding Management (CCBM)

Author

Fernando Fernandez-Llimos, José Aguiar, Anabela Rodrigues, Joana F. Rodrigues, Luciana Gonçalves, Filipa Duarte-Ramos, Manuela E. Gomes, Alexandre Carrilho, and Faculdade de Farmácia

Subjects
Consensus, Blood transfusion, Blood management, Delphi Technique, medicine.medical_treatment, Delphi method, Hemorrhage, 030204 cardiovascular system & hematology, 03 medical and health sciences, Indirect costs, acquired blood coagulation disorders, 0302 clinical medicine, medicine, Diseases of the circulatory (Cardiovascular) system, Humans, 030212 general & internal medicine, Grading (education), computer.programming_language, Clotting factor, Portugal, grade approach, bleeding management, business.industry, Hematology, General Medicine, medicine.disease, RC666-701, Scale (social sciences), Original Article, Medical emergency, business, computer, Delphi
Abstract

We aimed to determine how Portuguese physicians handle major bleeding. We also aim to establish global diagnostic and therapeutic recommendations to be followed in clinical practice by using a step-wise approach of evidence generation. This study followed a three-step process: a steering committee desk review, a Delphi technique, an expert panel meeting. A modified 3-round Delphi including 31 statements was performed. Questions were answered in a five-point Likert-type scale. Consensus threshold was established as a percentage of agreement among participants ≥90% in the first round, and ≥85% in the second and third rounds. The level of consensus achieved by panelists was discussed with the scientific committee (January-2020). Fifty-one physicians participated in the study (compliance rate >90%). Analyzing the three rounds, consensus was reached on 20 items (64.5%) in the first, 4/11 items (36.4%) in the second and 6/7 items (85.7%) in the third. One statement about administration of clotting factor concentrates for bleeding control did not reach consensus. A high level of consensus was reached toward the need for implementing Patient Blood Management strategies in Portuguese hospitals, reduce exposure to allogeneic blood components, to use goal directed therapies for acquired bleeding management, and the need for evaluating blood transfusion indirect costs. A final version with 12 recommendations was built, according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Our results provide critically appraised and updated evidence on bleeding coagulopathies management in Portugal. Additional studies, mainly about indirect costs of blood transfusion, are needed.

Published
2021

7. Interventional Algorithm in Gastrointestinal Bleeding-An Expert Consensus Multimodal Approach Based on a Multidisciplinary Team

Author

Rui Tato Marinho, Mário J. Silva, Alexandre Carrilho, Luciana Gonçalves, Rosário Orfão, Ângela Alves, Nuno Almeida, Carla Leal Pereira, Pedro Duarte, C. Baldaia, António Robalo Nunes, José Aguiar, Manuela E. Gomes, and Anabela Rodrigues

Subjects
lcsh:Diseases of the circulatory (Cardiovascular) system, medicine.medical_specialty, Gastrointestinal bleeding, Consensus, gastrointestinal bleeding, Review, Patient Care Team / standards, HSJ ANS, Multidisciplinary team, management algorithm, coagulopathy, 03 medical and health sciences, 0302 clinical medicine, massive, Multidisciplinary approach, Anesthesiology, medicine, Humans, 030212 general & internal medicine, HSAC GAS, Combined Modality Therapy / methods, Gastrointestinal Hemorrhage / drug therapy, Patient Care Team, variceal and nonvariceal, business.industry, Expert consensus, Transfusion medicine, Multimodal therapy, Hematology, General Medicine, medicine.disease, Combined Modality Therapy, Management algorithm, lcsh:RC666-701, 030211 gastroenterology & hepatology, business, Gastrointestinal Hemorrhage, Algorithm, Algorithms
Abstract

The approach to the patient with gastrointestinal bleeding (GIB) can be very complex. A multidisciplinary panel of physicians with expertise in Gastroenterology, Anesthesiology, and Transfusion Medicine worked together to provide the best knowledge and guide clinical practitioners in the real setting of health institutions, characterized by disparate availability of human and technical resources. The authors propose a global and personalized approach according to different clinical scenarios to improve the outcomes of patients with GIB, for whom the reduction of inappropriate transfusions is crucial. The goal of this document is to provide clear and objective guidance through interventional algorithms toward a goal-directed approach according to the clinical situation and supported by the latest available scientific data on GIB management in different settings. info:eu-repo/semantics/publishedVersion

Published
2020

8. Interventional Algorithms for the Control of Coagulopathic Bleeding in Surgical, Trauma, and Postpartum Settings: Recommendations From the Share Network Group

Author

António Robalo Nunes, José Aguiar, Manuela C. Carvalho, Manuel Campos, Ângela Alves, Alexandre Carrilho, Anabela Rodrigues, Rosário Orfão, and Manuela E. Gomes

Subjects
Male, Blood transfusion, medicine.medical_treatment, Blood Loss, Surgical, HSJ ANS, algorithms, coagulopathy, 03 medical and health sciences, 0302 clinical medicine, Bleeding control, 030202 anesthesiology, factor concentrates, medicine, Coagulopathy, Humans, Blood Transfusion, Disseminated intravascular coagulation, business.industry, Postpartum Hemorrhage, 030208 emergency & critical care medicine, Hematology, General Medicine, Perioperative, Original Articles, Disseminated Intravascular Coagulation, medicine.disease, bleeding, Hemostasis, Practice Guidelines as Topic, hemostasis, Wounds and Injuries, Female, business, Algorithm, Clinical evaluation, Algorithms, Uncontrolled bleeding
Abstract

Several clinical settings are associated with specific coagulopathies that predispose to uncontrolled bleeding. With the growing concern about the need for optimizing transfusion practices and improving treatment of the bleeding patient, a group of 9 Portuguese specialists (Share Network Group) was created to discuss and develop algorithms for the clinical evaluation and control of coagulopathic bleeding in the following perioperative clinical settings: surgery, trauma, and postpartum hemorrhage. The 3 algorithms developed by the group were presented at the VIII National Congress of the Associação Portuguesa de Imuno-hemoterapia in October 2013. They aim to provide a structured approach for clinicians to rapidly diagnose the status of coagulopathy in order to achieve an earlier and more effective bleeding control, reduce transfusion requirements, and improve patient outcomes. The group highlights the importance of communication between different specialties involved in the care of bleeding patients in order to achieve better results. info:eu-repo/semantics/publishedVersion

Published
2014

9. Comparação entre o conhecimento declarativo e processual: estudo de caso. Análise da preleção de um treinador de hóquei em patins

Author

Lourenço, Hugo Alexandre Carrilho, Castelo, Jorge, orient., and Castelo, Jorge Fernando Ferreira, orient.

Subjects
HOCKEY, COMUNICAÇÃO, SPORTS COACHES, HÓQUEI EM PATINS, TEACHING, MESTRADO EM TREINO DESPORTIVO, COMMUNICATION, HÓQUEI, ENSINO, SPORT, TREINADORES DESPORTIVOS, DESPORTO, SPORTS COACHING, ROLLER HOCKEY, TREINO DESPORTIVO
Abstract

Este trabalho tem como objetivo analisar as preleções que um determinado treinador emitiu ao longo dos jogos analisados e comparar o nível de congruência entre o conhecimento declarativo e processual. Neste estudo foram analisados quatro jogos durante a época desportiva 2012 / 2013. Todos os jogos em análise foram referentes a uma equipa que competiu no Campeonato Nacional da 1.ª Divisão de Hóquei em Patins, sendo metade dos jogos em casa e a outra fora. O sistema de observação para a recolha de dados utilizados foi o Sistema de Análise da Informação em Competição (SAIC), tendo sido validada a introdução da categoria Arbitragem, assim como a introdução de novas quarenta e seis subcategorias na Dimensão Conteúdo. Globalmente, os resultados obtidos demonstram que existe um padrão na informação transmitida, sendo a informação essencialmente de cariz prescritiva/descritiva, tática e dirigida à Equipa. Sendo congruente o seu conhecimento declarativo com o processual. No que concerne às subcategorias, existem algumas incongruências, normalmente por sobrevalorizar algumas delas no inquérito de expetativas e posteriormente os resultados não demonstrarem tanta importância conferida pelo treinador no momento da reunião que antecede o jogo., This work aims to analyze the profile of the lecture that a particular coach sets over the analyzed games to identify the degree of consistency between the expectations of the manager in relation to the information you want to lecture in each game and the information that has effectively been lectured. In this case study, four games were observed during the 2012/2013 sports season. All games of this analysis referred to a team that competed in the First Division of the National Hockey Championship, with half the games being at home and the others away. The observation system for collecting data on the analysis of the lecture is the Information Analysis System on Competition (CAS), having been validated the introduction of the category Arbitration on the Content Dimension, as well as introducing the new forty-six subcategories also in the Content Dimension. Overall, the results show that there is a pattern in the data output by the coach used as an object of study, being the information essentially prescriptive/descriptive, tactical and team oriented. In what concerns the level of expectations by the coach, we can consider that there is a congruence between what the object of study considers to be the most important information and the information that effectively is addressed. Regarding the subcategories, there are some inconsistencies, usually by overvaluing some of them in the investigation of expectations and, posteriorly, the results do not show that much of importance given by the coach at the time of the lecture prior to the game., Orientador: Jorge Fernando Ferreira Castelo

Published
2013

10. Evaluation of inflammatory, metabolic, hormonal, and oxidative and nitrosative stress biomarkers in patients with multiple sclerosis : a follow-up study

Author

Wildéa Lice de Carvalho Jennings Pereira, Edna Maria Vissoci Reiche ., Karen Brajão de Oliveira, Damacio Ramón Kaimen Maciel, Sayonara Rangel Oliveira, and Alexandre Carrilho

Abstract

Introdução: Fatores genéticos, hormonais, ambientais e alterações nas vias metabólicas e imunológicas desempenham um papel importante no desenvolvimento e no curso clínico da esclerose múltipla (EM). Além disso, uma associação entre prolactinemia com sexo, incapacidade e formas clínicas dos pacientes com EM foi relatada com resultados conflitantes. Objetivo: Avaliar o papel de biomarcadores inflamatórios, metabólicos, hormonais, de estresse oxidativo e nitrosativo (IMO&NS) na incapacidade, progressão da doença e formas clínicas, bem como a associação de prolactina com formas clínicas e acúmulo de incapacidade ao longo do tempo em pacientes com EM durante 16 meses. Métodos: Foi realizado um estudo longitudinal com a inclusão de 140 pacientes com EM, nas formas recorrente-remitente (EMRR) e progressivas de EM (EMProg) que incluíram as formas primariamente progressiva (EMPP) e secundariamente progressiva (EMSP) . Os dados clínicos e laboratoriais foram obtidos na admissão (T0) e após oito (T8) e 16 meses (T16) da inclusão no estudo. A Escala do Estado de Incapacidade (EDSS) foi aplicada em T0, T8 e T16 e a variação dos escores de EDSS entre os tempos (?EDSS) foi calculada. Valores de ?EDSS (como variável contínua ou dicotomizada como ?0 ou > 0) foram usados para avaliar a progressão da incapacidade da doença. Os resultados foram expressos, também, como escores compostos ponderados por unidades z. Resultados: No primeiro artigo, foram avaliados 140, 128 e 122 pacientes com EM em T0, T8 e T16, respectivamente. A incapacidade em T0, T8 e T16 foi maior entre pacientes com EMProg do que aqueles com EMRR. Destes, 47 pacientes apresentaram acúmulo de incapacidade, aumentando de 3,4 (T0) para 4,5 (T8) e para 5,1 (T16). Idade, frequência de tabagismo, paratormônio (PTH) e homocisteína foram maiores, enquanto o ácido fólico foi menor entre esses pacientes. A variação da incapacidade (?EDSS) foi positivamente associada à hipertensão arterial sistêmica (HAS), idade, proteína C-reativa avaliada por método ultrassensível (usPCR), interleucina (IL)-17 e produtos avançados de oxidação proteica (AOPP) e negativamente associada ao ácido fólico e cálcio. A variação do ?EDSS de T8 a T16 foi predita pela redução de 25-hidroxivitamina D [25(OH)D] e ácido fólico de T0 a T8, e um aumento dos escores compostos pelas citocinas zIL-6+zIL-17-zIL-4 de T0 a T8. Além disso, 40,3% do ?EDSS em T16 foi explicado pela HAS, idade, tabagismo e o escore homocisteína-ácido fólico em T16 (positivamente), 25(OH)D em T8 (negativamente) e zIL-6+zIL-17-IL- 4 (positivamente) em T16. PTH, IL-6 e IL-4 foram mais elevados e 25(OH)D foi menor entre os pacientes com EMProg do que aqueles com EMRR. No segundo artigo, avaliamos os níveis séricos de prolactina e ferritina em 120 pacientes com EM, sendo 101 com EMRR e 19 com EMProg. Em uma primeira análise, a prolactina foi associada à incapacidade ao longo do tempo, mas após a introdução da idade e sexo na análise estatística, os efeitos da prolactina na incapacidade deixaram de ser significativos. Prolactina e ferritina não diferiram ao longo do tempo entre os dois grupos de estudo. Da mesma forma, após a introdução de idade e sexo como variáveis confundidoras, os efeitos do diagnóstico sobre os níveis de prolactina deixaram de ser significativos (P = 0,563). A fim de avaliar o papel da prolactina na resposta inflamatória em pacientes com EM, avaliamos a associação de prolactina com ferritina. O resultado mostrou que a prolactina estava associada negativamente à ferritina (P < 0,001) e que o diagnóstico de RRMS e ProgMS e o tempo (T0, T8 e T16) não tiveram efeitos significativos nos níveis de ferritina (P = 0,927 e P = 0,358, respectivamente). No entanto, após a introdução de idade e sexo, esta associação entre prolactina e ferritina não foi mais significativa (P = 0,599), enquanto o diagnóstico (mas não o tempo) tornou-se significativo (P = 0,001). A ferritina foi maior nos pacientes com EMRR do que nos com EMProg (239,5 ± 10,3 ng /mL versus 131,5 ± 21,7 ng/mL) após o ajuste para idade e sexo. Além disso, 21,6% da variação da incapacidade foi predita pela idade (P < 0,001) e sexo (P = 0,049), enquanto a prolactina não foi significativa. Conclusões: Os resultados mostraram que um conjunto de biomarcadores IMO&NS, juntamente com HAS e idade, foi fortemente associado com mudanças na incapacidade de pacientes com EM durante 16 meses de seguimento. A ativação imune e o metabolismo do PTH e do ácido fólico e homocisteína, bem como os baixos níveis de 25(OH)D e cálcio, desempenham um papel na progressão da EM e de suas formas clínicas. Esses biomarcadores podem ser úteis como possíveis biomarcadores laboratoriais para prever a progressão da incapacidade ao longo do tempo em pacientes com EM. Além disso, os resultados sugeriram que os efeitos da prolactina na incapacidade de pacientes com EM relatados previamente podem ser um resultado espúrio, porque essas correlações refletem as associações positivas de idade com a incapacidade e a associação negativa da idade com a prolactina. Background: Genetic, hormonal, environmental factors and changes in immunologic and metabolic pathways play an important role in the development and clinical course of multiple sclerosis (MS). Moreover, an association between prolactinemia with sex, disability and clinical forms of patients with MS has been reported with conflicting results. Objective: To evaluate the role of inflammatory, metabolic, oxidative and nitrosative stress (IMO&NS) biomarkers on disability, disease progression and clinical forms, as well as the association of prolactin with clinical forms and accumulating disability over time in MS patients during 16 months follow-up. Methods: A longitudinal study was carried out with 140 patients with MS, with both relapsing-remitting MS (RRMS) and progressive clinical forms of MS (ProgMS) that included MS primary progressive (PPMS) and MS secondary progressive (SPMS). Clinical and laboratory data were obtained at admission (T0), and eight (T8) and 16 months (T16) later the study inclusion. The Expanded Disability Status Score (EDSS) were applied at T0, T8 and T16 and the variation in the EDSS scores between the times (?EDSS) was calculated. Values of ?EDSS, expressed as continuous or dichotomized variable as ?0 or >0) were used to evaluate the progression of disability. The results were also expressed as z unit weighted composite scores. Results: The study followed-up 140, 128, and 122 MS patients at T0, T8 and T16, respectively. The disability at T0, T8 and T16 were higher among patients with ProgMS than those with RRMS. Of them, 47 patients showed accumulating disability, increasing from 3.4 (T0) to 4.5 (T8) and to 5.1 (T16). Age, frequency of smoking, parathormone (PTH) and homocysteine (Hcy) were higher while folic acid was lower among these patients. The ?EDSS were positively associated with systemic arterial hypertension (SAH), age, high sensitivity C-reactive protein measured with high sensitivity method (hsCRP), interleukin (IL)-17 and advanced oxidized protein products (AOPP), whilst they were negatively associated with folic acid and calcium. The ?EDSS from T8 to T16 were predicted by decreased 25-hydroxyvitamin D [25(OH)D] and folic acid from T0 to T8, and an increased cytokine composite score zIL-6+zIL-17-zIL-4 from T0 to T8. Moreover, 40.3% of the ?EDSS at T16 was explained by the SAH, age, smoking and zHcy-zfolic acid at T16 (positively), 25(OH)D at T8 (negatively) and zIL-6+zIL-17-IL-4 (positively) at T16. PTH, IL-6, and IL-4 were higher and 25(OH)D was lower among patients with ProgMS than those with RRMS. Secondly, we evaluated prolactin and ferritin serum levels among 120 patients with MS. Prolactin and ferritin did not differ over time between both groups. Firstly, prolactin was associated with disability over time but after introducing age and sex, the effects of prolactin on disability were no longer significant. Prolactin was associated with age and sex, whereby age was positively associated with disability. In the same way, after introducing age and sex, the effects of diagnosis on prolactin levels were no longer significant (P=0.563). In order to evaluate the role of prolactin in inflammatory response among MS patients, we evaluated the association of prolactin with ferritin. The result showed that prolactin was negatively associated with ferritin (P

Published
2019

11. Long-term effects of a physical activity promotion program for smokers

Author

Leandro Cruz Mantoani, Fábio de Oliveira Pitta ., Nídia A. Hernades Fujii, olavo Franco Ferreira Filho, Alexandre Carrilho, and Vanessa S. Probst

Abstract

Objetivos: Avaliar os efeitos após um ano do término da participação de tabagistas em um programa de incentivo ao aumento da atividade física diária. Métodos: Foram incluídos 49 tabagistas sem alterações espirométricas (23 homens/26 mulheres; 51[44-56]anos; IMC 25[23-28]kg.m-2; 20[13-30]cigarros/dia). Os indivíduos foram avaliados antes, imediatamente após, e um ano após o fim do programa quanto à função pulmonar, teste da caminhada de 6 minutos (TC6), hábitos tabagísticos, qualidade de vida, ansiedade, depressão e atividade física na vida diária. O programa (5 meses de duração) utilizou-se de pedômetro (meta de 10000 passos/dia) e cartilha informativa (incentivo a realizar mais atividade física). Resultados: Em relação ao final do protocolo, observou-se manutenção dos ganhos do programa de atividade física no longo prazo: número de passos/dia (pós versus 1 ano de seguimento: 10413 [8322-12378] vs 10673 [10240-10802]), distância percorrida no TC6 (604 [540-646] metros, 88 [81-97] %predito vs 602 [585-618] metros e 88 [84-92] %predito) níveis de ansiedade (35 [27-42] pontos vs 36 [33-40] pontos) e depressão (6[3-9] pontos vs 6 [4-9] pontos) (p>0,05 para todos).Em relação ao pré-programa, houve diminuição do número de cigarros fumados/dia (20[13-30]vs 15[6-20]; p0.05 for all).Furthermore, in comparison to pre-program, there was a decrease in the number of cigarettes smoked per day(20 [13-30]vs 15 [6-20] cigarrettes/day; p

Published
2013

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