Search

Introduction Health organisations should support healthcare workers who are physically and psychologically affected by patient safety incidents (second victims). There is a growing body of evidence which focuses on second victim support interventions. However, there is still limited research on the elements necessary to effectively implement and ensure the sustainability of these types of interventions. In this study, we propose to map and frame the key factors which underlie an effective implementation of healthcare worker support interventions in healthcare organisations when healthcare workers are physically and/or emotionally affected by patient safety incidents. Methods and analysis This scoping review will be guided by the established methodological Arksey and O'Malley framework, Levac and Joanna Briggs Institute (JBI) recommendations. We will follow the JBI three-step process: (1) a preliminary search conducted on two databases; (2) the definition of clear inclusion criteria and the creation of a list of search terms to be used in the subsequent running of the search on a larger number of databases; and (3) additional searches (cross-checking/cross-referencing of reference lists of eligible studies, hand-searching in target journals relevant to the topic, conference proceedings, institutional/organisational websites and networks repositories). We will undertake a comprehensive search strategy in relevant bibliographic databases (PubMed/MEDLINE, Embase, CINHAL, Web of Science, Scopus, PsycInfo, Epistemonikos, Scielo, Cochrane Library and Open Grey). We will use the Mixed Methods Appraisal Tool V.2018 for quality assessment of the eligible studies. Our scoping review will be guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews. Ethics and dissemination This study will not require ethical approval. Results of the scoping review will be published in a peer-review journal, and findings will be presented in scientific conferences as well as in international forums and other relevant dissemination channels.

A revisão por pares de artigos, também conhecida como peer review ou refereeing é, indubitavelmente, muito importante para o desenvolvimento e actualização da Medicina. Este tipo de revisão consiste na submissão de um trabalho científico ao escrutínio de pelo menos um especialista na matéria que é analisada. A qualidade do artigo depende muitas vezes dos comentários e/ou sugestões feitas pelos revisores. Apesar deste sistema já ter sido muitas vezes criticado, a verdade é que ainda não se conseguiu provar que existe algo melhor para avaliar a qualidade científica de determinado manuscrito. O presente trabalho pretende assim demonstrar a importância da revisão por pares, não esquecendo o papel fulcral que desempenham não só os revisores, mas também o editor-chefe. São ainda abordadas algumas questões de extrema relevância para o tema, como o motivo pelo qual se deve aceitar ser revisor, como encontrar revisores, como rever um manuscrito. info:eu-repo/semantics/publishedVersion

Submitted by RIHUC REPOSITORIO (rihuc@huc.min-saude.pt) on 2020-07-14T11:50:58Z No. of bitstreams: 1 AMP.pdf: 262099 bytes, checksum: 7e5d36e8e92251aff310aa6b231bddd1 (MD5) Approved for entry into archive by RIHUC REPOSITORIO (rihuc@huc.min-saude.pt) on 2020-08-26T09:03:51Z (GMT) No. of bitstreams: 1 AMP.pdf: 262099 bytes, checksum: 7e5d36e8e92251aff310aa6b231bddd1 (MD5) Made available in DSpace on 2020-08-26T09:03:52Z (GMT). No. of bitstreams: 1 AMP.pdf: 262099 bytes, checksum: 7e5d36e8e92251aff310aa6b231bddd1 (MD5) Previous issue date: 2020-02-03 info:eu-repo/semantics/publishedVersion

Background/Purpose: The onset of psoriatic arthritis (PsA) often occurs between the ages of 30 and 50 years. Accordingly, many female patients are diagnosed during childbearing age, potentially impacting their pregnancy outcomes. However, there is a paucity of data concerning the fetal and maternal outcomes in this population and most of the information is extrapolated from studies on rheumatoid arthritis (RA). We aim to review the available evidence on the relationship between PsA and adverse pregnancy outcomes. Methods: We systematically searched two databases, PubMed and Embase, for original studies from inception of the databases until May 31, 2020, addressing fetal and maternal outcomes in pregnant women with PsA. A variety of terms adjusted to the specificities of the two databases and related to key subject areas of the review question were used. The search was filtered to only include human participants and publications in English. The eligible studies had to present a comparator group (healthy individuals or patients without known auto-immune rheumatic diseases -ARD's), as well as at least one clinical outcome of interest. Studies including patients with other ARD's were eligible only if results from patients with PsA were presented separately. Two authors independently selected studies and extracted data. Results: Of a total of 708 references, 5 observational studies fulfilled the inclusion criteria: 3 prospective and 2 retrospective studies (table 1). Concerning maternal outcomes, the odds of delivery by caesarian section was higher among PsA women compared with the control groups, in 3 out of 4 studies. However, the majority of studies did not find an increased risk of pre-eclampsia or gestational hypertension among PsA patients. Likewise, no study has found an increased risk of gestational diabetes in pregnant women with PsA. Maternal and fetal outcomes in PsA patients. Regarding fetal outcomes, 3 studies revealed an increased risk of preterm birth in PsA patients, out of 4 studies reporting this outcome. Spontaneous miscarriages, stillbirths, neonatal deaths and small for gestational age newborns occurred at similar rates in women with PsA and the comparator groups, across the different studies. Only one of the included studies, has assessed the influence of disease activity in the outcomes. Smith et al observed that active disease (defined as RAPID3 score ≥ 7 and HAQ >0.5) at 32 weeks of gestation increased the risk for preterm birth in PsA. Conclusion: Despite the limited available data, these studies suggest an increased risk for delivery by caesarian section and preterm births among pregnant women with PsA. Increased disease activity seems to contribute to a higher risk of preterm birth as in RA. Nonetheless, this effect should be further examined. info:eu-repo/semantics/publishedVersion

AIMS: To assess stroke rate after transcatheter mitral valve repair (TMVR) with MitraClip, comparing it with surgical mitral valve repair (SMVR) and optimal medical treatment (OMT). METHODS AND RESULTS: We systematically searched PubMed, Embase and Cochrane Controlled Register of Trials, in December 2018, for studies comparing TMVR with SMVR and/or OMT for the treatment of severe mitral regurgitation. Random-effects and cumulative meta-analysis was performed. Ten studies were included: seven of TMVR versus SMVR and three of TMVR versus OMT, providing a total of 1881 patients and 61 pooled strokes (16 in TMVR versus SMVR and 45 in TMVR versus OMT). There was no difference in stroke incidence between TMVR and SMVR (pooled OR 0.49 [0.17, 1.42], P=0.19). Cumulative meta-analysis showed a significantly lower stroke rate in TMVR, compared to SMVR (OR 0.4 [0.24, 0.67], P< 0.01). For TMVR versus OMT, no difference in stroke rate was identified (pooled OR 1.09 [0.60, 1.97], P=0.79). Post-procedure de novo atrial fibrillation was more frequent in SMVR when compared with TMVR. CONCLUSIONS: Although with a low number of pooled events, there was a trend for a lower post-procedure stroke in TMVR when compared with SMVR and a similar one between TMVR and OMT alone. info:eu-repo/semantics/publishedVersion

info:eu-repo/semantics/publishedVersion

info:eu-repo/semantics/publishedVersion

info:eu-repo/semantics/publishedVersion

info:eu-repo/semantics/publishedVersion

info:eu-repo/semantics/publishedVersion

A quantidade de nova informação disponível para médicos está a crescer a uma taxa exponencial, contudo, a quantidade de tempo que os médicos podem dedicar a fazer a sua triagem é que não. Saber qual a ferramenta a usar para cada tipo de informação e estratégias para a usar com eficácia pode economizar tempo valioso. O objetivo deste artigo é dar a conhecer os principais recursos de informação e as técnicas de pesquisa mais sofisticadas. Porque conhecendo as técnicas de pesquisa mais “elaboradas”, a eficácia na investigação aumentará. Os recursos listados permitem que a procura e publicação de informação em Medicina se acelerem e simplifiquem radicalmente. É importante que reconheçam as oportunidades e limitações dos recursos mencionados, assim como a sua utilidade. É impossível ser exaustivo nesta abordagem.

Background. Splenectomy is an effective procedure for children and adults with severe or refractory idiopathic thrombocytopenic purpura (ITP). Data regarding pediatric patients are limited. Procedure. Sixty-eight Intercontinental Childhood ITP Study Group (ICIS) investigators from 57 institutions in 25 countries participated in a splenectomy registry. Data from 153 patients were submitted, of whom 134 had a splenectomy and were analyzed. Results. The median age at splenectomy was 11.8 (2.7-20.7) years. The median postsplenectomy follow-up was 2.0 (0.1-4.5) years. Pre-splenectomy vaccination was not administered in 21 children (15.7%). Open and laparoscopic splenectomy procedures were performed in 67 and 65 evaluable children, respectively. Surgical technique was not reported in two children. Overall immediate platelet response to splenectomy was achieved in 113 patients (86.3%). Eighty percent of responders maintained their status of response during the following 4 years. Older age, longer duration of ITP, and male gender correlated with a complete response. Post-splenectomy sepsis was reported in seven patients without lethal outcome, although sepsis might be differently defined at participating institutions. Conclusions. Splenectomy is effective in children with ITP. Management varies greatly in different institutions. These Registry data may serve as a basis for future clinical trials to assess the indication and timing of splenectomy. Pediatr Blood Cancer 2007;49:829834. (c) 2006 Wiley-Liss, Inc.

The availability of scientific information is growing exponentially. Healthcare professionals who wish to keep up-to-date with scientific literature and find the best information should spend their time finding resources that summarize the best available evidence. This manuscript aims to provide bibliographic research knowledge and skills, to contribute to an increase in the use of e-learning, to “Push and Pull” correct information and, in other words, to indicate how to deal with information overload.

PURPOSE This study assesses the efficacy of an iron-fortified (15 mg Fe, as stabilized ferrous sulfate (SFE-171), per liter) fluid whole cow's milk (IFFWCM) for the treatment of mild iron deficiency in children. Previous studies in healthy adult volunteers showed a mean 10.2 +/- 4.7% iron absorption. PATIENTS AND METHODS Seventeen children (12 to 48 months old) with iron deficiency (serum iron (SI) < 60 micrograms/dl, transferrin saturation (TS) < 15%, serum ferritin (SF) < 15 ng/ml) were included in this study; 11 of them were anemic. As treatment, they received IFFWCM, instead of the customary whole cow's milk, for at least 4 months; medicinal iron was not administered. Hematocrit (Hct), hemoglobin (Hb), SI, TS, and SF were determined monthly. RESULTS The Hb increased from 10.3 +/- 0.8 to 12.7 +/- 0.6 g/dl in the group with anemia (delta F-B: 2.4 +/- 1.0 g/dl) and from 12.6 +/- 0.7 to 13.5 +/- 0.3 g/dl in the group without anemia (delta F-B: 0.9 +/- 0.5 g/dl); the difference between both groups was significant (p < 0.01); the rate for Hct values showed a similar pattern. In the whole group, the SI increased to 84.8 +/- 37.4 micrograms/dl, with no difference between children with anemia and children without anemia; TS showed a similar pattern (delta F-B: 19.0 +/- 11.0%). The mean SF increased from 12.1 +/- 2.7 ng/ml to 27.9 +/- 25.4 ng/ml. Normal values for Hct, Hb, SI, and TS were reached by 100% of children; the rate for SF was 56.3%. Time required to reach normal Hct in the children with anemia was 59.4 +/- 33.0 days. Acceptance and tolerance were excellent; no treatment had to be discontinued. The group of patients with anemia was compared with an historical group composed of 55 children matched for age, basal Hct, and achieved Hct increase, treated with medicinal FS (4-6 mg/kg/day): time required to reach normal Hct was shorter in the FS-treated group (39.0 +/- 14.5 days) (p = 0.050). CONCLUSION The use of IFFWCM alone could be an effective, relatively inexpensive, and well-tolerated treatment of iron deficiency in children.