Percorrer por autor "Silva, Norberto Anibal Pires"
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- Accidents at work and its impact on a hospital in northern PortugalPublication . Martins, Matilde; Silva, Norberto Anibal Pires; Correia, Teresa I.G.In order to describe the accidents at work in a hospital in northern Portugal and analyze its main impact in the period 2008 to 2010, we conducted a retrospective cross-sectional study. The information was obtained using the registration notification of accidents at work for 387 workers. The higher prevalence of accidents fell in superior health technician (56.1%) in workers of the female gender (81.9%) in the age group 30-39 years (37.2%), with higher education to the 12th years (55.8%), working in shifts (72.4%) and inpatient services (35.9%). The main cause was the needle stick (45.7%) and the lesion was mainly in the hands (37.5%). The wounds (32.6%) were the most frequent type of injury, followed by sprains and strains (23%). Resulted in absence from work 27.4%, with the sprains and strains the main reason. Preventive strategies should be adopted aiming at the promotion of health of health professionals.
- Acidentes de trabalho versus absentismo laboralPublication . Martins, Matilde; Silva, Norberto Anibal Pires; Correia, Teresa I.G.As últimas estatísticas da Administração Central dos Serviços de Saúde (ACSS) sobre acidentes de trabalho nas instituições de saúde, apontam para um aumento da incidência de acidentes e, consequentemente, para o aumento do absentismo laboral. Aanalisar as consequências dos acidentes de trabalho nas instituições de saúde do distrito de Bragança. O estudo transversal retrospectivo, recorrendo ao registo de acidentes de trabalho notificados, e aos balanços sociais das instituições, constituindo uma amostra de 223 trabalhadores. Do total dos acidentes 40,8% resultaram em absentismo laboral temporário, faltando em média 67,23 dias por acidente, num total 6 116 dias, o que ascendeu a um custo aproximado de 168 856.27l euros. Os factores que contribuíram significativamente (p <0,000) para absentismo laboral, influenciando a média de dias perdidos, foram a idade superior a 45 anos, o baixo nível habilitacional, o desempenhar tarefa em horário fixo, os acidentes por quedas e as lesões musculosqueléticas. Os Odds Ratios e respectivos IC a 95% demonstraram que os trabalhadores com lesões musculosqueléticas apresentam um risco maior de ter absentismo laboral (OR=18,113; IC=7,786-42,135). O possuir habilitações superiores ao 12º ano e o praticar horário por turnos revelaram-se como factores protectores (OR=0,325 e OR=0,451 respectivamente). Discussão: Os dados da ACSS de 2009, indicam como número de dias perdidos 52 702, resultando em incapacidade temporária 1 581 e 87 em incapacidade permanente. Também a corroborar os nossos dados, vários estudos referem as pessoas com baixos salários, com baixo nível habilitacional e a desempenhar menos especializadas as mais expostas a acidentes e acidentes mais graves. Conclusões: Dada a relevância, humana e económica, deste problema os estudos apontam para a realidade dos acidentes de trabalho em meio hospitalar e para a necessidade de implementação de melhores condições laborais de forma a reduzi-los em número e em consequências nefasta.
- Acidentes de trabalho versus absentismo laboralPublication . Martins, Matilde; Silva, Norberto Anibal Pires; Correia, Teresa I.G.Introdução: As últimas estatísticas da Administração Central dos Serviços de Saúde (ACSS) sobre acidentes de trabalho nas instituições de saúde, apontam para um aumento da incidência de acidentes e, consequentemente, para o aumento do absentismo laboral. Objectivo: analisar as consequências dos acidentes de trabalho nas instituições de saúde do distrito de Bragança. Material e Métodos: estudo transversal retrospectivo, recorrendo ao registo de acidentes de trabalho notificados, e aos balanços sociais das instituições, constituindo uma amostra de 223 trabalhadores. Resultados: do total dos acidentes 40,8% resultaram em absentismo laboral temporário, faltando em média 67,23 dias por acidente, num total 6 116 dias, o que ascendeu a um custo aproximado de 168 856.271 €. Os factores que contribuíram significativamente (p <0,000) para absentismo laboral, influenciando a média de dias perdidos, foram a idade superior a 45 anos, o baixo nível habilitacional, o desempenhar tarefa em horário fixo, os acidentes por quedas e as lesões musculosqueléticas. Os Odds Ratios e respectivos IC a 95% demonstraram que os trabalhadores com lesões musculosqueléticas apresentam um risco maior de ter absentismo laboral (OR=18,113; IC=7,786-42,135). O possuir habilitações superiores ao 12º ano e o praticar horário por turnos revelaram-se como factores protectores (OR=0,325 e OR=0,451 respectivamente). Discussão: Os dados da ACSS de 2009, indicam como número de dias perdidos 52 702, resultando em incapacidade temporária 1 581 e 87 em incapacidade permanente. Também a corroborar os nossos dados, vários estudos referem as pessoas com baixos salários, com baixo nível habilitacional e a desempenhar funções menos especializadas as mais expostas a acidentes e acidentes mais graves. Conclusões: Dada a relevância, humana e económica, deste problema os estudos apontam para a realidade dos acidentes de trabalho em meio hospitalar e para a necessidade de implementação de melhores condições laborais de forma a reduzi-los em número e em consequências nefasta.
- Cardiovascular risk factors in patients with ischemic and hemorrhagic strokePublication . Barreira, Ilda; Martins, Matilde; Preto, Leonel; Silva, Norberto Anibal Pires; Preto, Pedro; Mendes, EugéniaBackground: Stroke is the second worldwide most common cause of death and the main reason of functional disability. Early identification and treatment of modifiable risk factors can reduce the risk of stroke. In stroke patients, the identification of cardiovascular risk factors is also important to preventing another stroke. Objective: To assess the prevalence of cardiovascular risk factors in stroke patients. Methods: Analytical and retrospective cohort study. The data were collected through electronic health records of all patients with stroke admitted to an emergency department for seven years (2010 to 2016). Research protocol has been approved by an ethics committee. Results: Were analyzed the electronic health records of 756 patients with ischemic stroke (78.6±10.7 years) and 207 with intracerebral hemorrhage (76.1±11.9 years). In ischemic stroke the most common risk factors were hypertension (66.7%), hypercholesterolemia (30.7%), diabetes mellitus (26.5%), atrial fibrillation (25.4%), obesity (11.4%) and smoking (5.2%). In hemorrhagic stroke the most prevalent risk factors were hypertension (57.0%), diabetes (25.6%), dyslipidemia (23.7%), atrial fibrillation (17.4%), obesity (15.5%) and smoking (9.2%). Conclusions: Hypertension was more prevalent in ischemic stroke and is associated with type of stroke (x2 = 6.633, df = 1, p = 0.010). Atrial fibrillation also prevailed in thromboembolic events with statistical significance (p = 0.016). Diagnosis and control of cardiovascular risk factors is a fundamental objective for primary and secondary prevention of stroke.
- Cardiovascular risk factors in patients with ischemic and hemorrhagic strokePublication . Barreira, Ilda; Martins, Matilde; Preto, Leonel; Silva, Norberto Anibal Pires; Preto, Pedro; Mendes, EugéniaEnquadramento: O acidente vascular cerebral (AVC) é a segunda causa de morte mais comum no mundo e o principal motivo de incapacidade funcional. A identificação precoce e o tratamento de fatores de risco modificáveis podem reduzir o risco de acidente vascular cerebral. Em pacientes com AVC, a identificação de fatores de risco cardiovascular (FRCV) também é importante para prevenir outro AVC. Objetivo: Avaliar a prevalência de fatores de risco cardiovascular em doentes com AVC.. Método: Estudo retrospetivo e analítico. Os dados foram recolhidos através dos registos eletrónicos de todos os doentes com AVC admitidos consecutivamente num Serviço de Urgência (ULSNE) desde janeiro de 2010 até dezembro de 2016. O protocolo de investigação foi submetido e aprovado pela Comissão de Ética. Resultados: 963 doentes foram incluídos no estudo, dos quais756 com AVC Isquémico (78,6 ±10,7 anos) e 207 com ACV Hemorrágico (76,1 ±11,9 anos). No AVC Isquémico o fator de risco mais frequente foi a HTA (66,7%), seguido da Dislipidémia (30,7%), Diabetes (26,5%), FA (25,4%), obesidade (11,4%) e tabagismo (5,2%). Conclusões: Os doentes com AVC Isquémico eram significativamente mais velhos (p=0,004). A hipertensão foi mais prevalente no AVC isquémico e está associada ao tipo de AVC (Qui-Quagrado= 6,633, gl = 1, p= 0,010). A FA foi mais prevalente no AVC Isquémico, com significância estatística (p=0,016).
- Characterization of patients undergoing noninvasive ventilation admitted in unit intermediate carePublication . Martins, Matilde; Ribas, Patrícia; Sousa, Joana; Cunha, Andreia; Silva, Norberto Anibal Pires; Correia, Teresa I.G.Non-invasive ventilation (NIV) is the application of a ventilatory support without resorting to invasive methods. Today it’s considered a credible therapeutic option, with enough scientiic evidence to support its application in various situations and clinical settings related to the treatment of acute respiratory disease, as well as chronic respiratory disease. Objectives: Characterize patients undergoing NIV admitted in Unit Intermediate Care (ICU) in the period from October 1st 2015 to June 30th 2016. Methods: Prospective study conducted in ICU between October 2015 and June 2016. In this study were included all patients hospitalized in this unit (ICU) and in that time period a sample of 57 participants was obtained. As data collection instruments we used a questionnaire for sociodemographic and clinical data and the Braden scale. Results: Participants were mostly male 38 (66.7%), the average age 69.5 ± 11.3 years, ranging between 43 and 92 years. They weighed on average 76.6 kg (52 and 150), with an average body mass index of 28.5 kg/m2 (20 to 58.5). With skin intact 28 (49.1%) with abnormal perfusion 12 (21.1%), with altered sensitivity 11 (19.3%) and a high risk of ulcer on the scale of Braden 37 (65%). The admission diagnosis was respiratory failure 33 (57.3%) and had different backgrounds. We used reused mask 53 (93.0%), the average time of NIV was 7.1 days (1-28), 4.8 days of hospitalization (1-18) and an average of 7.8 IPAP pressure. 11 (19.3%) of the participants developed face ulcer pressure.Conclusions: The NIV is used in patients with advanced age, obesity, respiratory failure and high risk of face ulcer development.
- Code stroke in an emergency department - evaluation of results after 7 years of protocol implementationPublication . Barreira, Ilda; Martins, Matilde; Preto, Leonel; Silva, Norberto Anibal Pires; Preto, PedroFibrinolysis reduces mortality and disability after an ischemic stroke, and its benefits are documented with level of evidence I [1]. The major goal of the Code Stroke (CS) is to treat the eligible cases by fibrinolysis, within the therapeutic window of 4.5 hours after symptom onset [2]. Thus, an emergency department must operate efficient mechanisms to receive, diagnose, treat or transfer patients with stroke [3]. Objective: The main objective was to evaluate the results of the CS protocol implementation in an Emergency Department (ED) of a hospital in the North of Portugal. As secondary objectives we aimed to: (i) Characterize the patients in sociodemographic and clinical variables; (ii) Calculate the activation rate of CS protocol and the rate of fibrinolysis. Methods: Retrospective descriptive analysis, using data from the Manchester triage system and other secondary source of information, of all patients with ischemic stroke, hemorrhagic stroke, and transient ischemic attack (TIA) admitted to the Emergency Department between January 1, 2010 and December 31, 2016. Socio-demographic data, care times, cardiovascular risk factors and other clinical variables were collected. The statistical analysis was performed by ANOVA, at 0.05 significance level. Results: In the 7 years analyzed, 1200 patients with cerebrovascular disease were admitted in the ED. Among this patients, 63.0% presented ischemic stroke, 17.3% hemorrhagic stroke and 19.8% TIA. The population was predominantly male (54.8%) and had a mean age of 77.4 (± 11.2) years. Stroke code was activated 431 times, covering 37.2% (n= 282) of ischemic stroke, and have received thrombolytic therapy 18.4% (n= 52) of these patients. Door-to-needle time was, in average, 69.5 minutes. Mean (±SD) NIHSS (National Institutes of Health Stroke Scale) score was 14.8 (±5.2) before treatment, decreasing to 11.8 (± 6.0) at two hours post- fibrinolysis (p <0.05). For all patients (N= 1200), we obtained the following prevalences of risk factors: Hypertension (64.7%), dyslipidemia (30.3%), diabetes (26.5%), atrial fibrillation 23.3%), obesity (12.9%), smoking (6.3%) and ischemic heart disease (5.9%). The 24-hour mortality rate was 0.9% for ischemic stroke, 10.6% for hemorrhagic stroke, and 0% for TIA. Conclusions: High rates of activation protocol were obtained for acute ischemic stroke, but only 52 patients met the criteria for fibrinolysis. The high age and comorbidity of patients with ischemic disease and its origin, predominantly rural, may have influenced the therapeutic window and the eligibility criteria for fibrinolysis.
- Complicações da utilização de equipamentos de proteção individual na pandemia de Covid-19Publication . Silva, Maria do Céu Vaqueiro; Martins, Matilde; Silva, Norberto Anibal PiresNo final de 2019 o mundo conheceu um vírus altamente contagioso, que conseguiu espalhar o medo um pouco por todo o lado, colocando-nos a todos num estado constante de alerta e de apreensão. Desde janeiro de 2020 que a pandemia tem vindo a conquistar um lugar de destaque nas notícias mundiais, tendo a World Health Organiza tion (WHO) declarado, a 11 de março de 2020, estado de emergência em saúde pública e de grande relevância internacional (Gerolin et al., 2020). Desconhece-se um tratamento específico para as infeções por coronavírus, recorrendo-se a fármacos para tratar os sintomas, como antipiréticos e analgésicos. Em quadros mais graves da doença, associados a quadros de insuficiência respiratória grave e pneumonia, exige internamento, muitas vezes em unidades de cuidados intensivos, com necessidade de intubação orotraqueal e ventilação mecânica (Direção-Ge ral da Saúde [DGS], 2020).
- Descrição das complicações resultantes da utilização de equipamento de proteção individual no atendimento de doentes por covid-19Publication . Silva, Maria do Céu Vaqueiro; Martins, Matilde; Silva, Norberto Anibal PiresNo final de 2019 surge, na China, um coronavírus altamente contagioso, que rapidamente se propagou pelos 5 continentes, tendo a OMS, a 11 de março de 2020, declarado a COVID-19 como uma pandemia (Caldas & Tavares, 2020). Sem tratamento eficaz, os Equipamentos de Proteção Individual (EPI) foram à época a medida mais eficaz de prevenir e controlar a transmissão do vírus (Hu et al., 2020). Vários relatos e estudos surgiram sobre as dificuldades e as complicações que os profissionais de saúde experienciaram com a utilização prolongada destes equipamentos (Duan et al., 2021 ; Galanis et al., 2021; Hu et al., 2020; Mesquita et al., 2020; Ruskin et al., 2021).
- Epidemiology of accidents at work in a hospital unit of the region of OportoPublication . Martins, Matilde; Barbiéri, Maria do Céu; Silva, Norberto Anibal Pires; Correia, Teresa I.G.Work accidents constitute a public health problem. The hospital environment is complex and represents a large number of occupational hazards for both workers providing direct care and for support services. To describe an epidemiological profile of work accidents in a hospital in the region of Porto in 2010. Identify the main consequences of accidents. A retrospective cross-sectional epidemiological study, covering the period from January 1 to December 31, 2010. The information was obtained using the registration of accidents at work, related to 130 employees. Data collection was performed by one of the investigators, after authorization of the Board and took place during the month of April 2011, weekdays between 9:00 and 17:00 hours in the Occupational Health. Data were coded and entered into SPSS ® database with the ID number to ensure and respect the anonymity of the participants There were 130 reported accidents at work in a hospital with 2300 employees, corresponding to an incidence rate of 5.65% and (12.3%) of accidents while traveling. The highest number of accidents was found in females (86.2%), professional categories Auxiliary Medical Action (AAM) (46%) and nurses (42.3%). The most vulnerable age group was between 30-34 years (28.5%), with over 10 years of service (48.5%), with undergraduate (46.2%) in the legal system of appointment (93, 8%) and practice time per shift (74.6%). The services with the highest prevalence were: medicine (14.6%), the operating room (12.3%) and urgency (11.5%). The accidents occurred on average for 12.4 hours (± 4.4 s), with increasing prevalence in the month of June (19.2%). The leading causes were falls (33.1%), overexertion or inadequate movements (19.2%) and with the same percentage of the needle sticks. About 31% of accidents were caused by tools / instruments / tools. There were 29.2% and 24.6% of wounds contusions / crushing execution with sprains / strains. The body parts most affected were the hands (35, 4%) followed by the trunk (16.9%). Resulted in an absolute inability 31.2% and lost on average 8.9 days of work, ranging between the minimum and a maximum of 179, totaling 1155 days. Inability of the events that caused 30% are due to accidents while traveling, 12.5% occurred on stairs and in the percentage equal to BO. About 58% had relapsed in AAM, 62.5% in people with schooling less than 12 years and 25% in the age group of 35-39 years. The musculoskeletal injuries accounted for 70.5% of absenteeism. The profile of occupational accidents may be related to the activity performed, education, and injury. This knowledge constitutes a scientific basis for implementing preventive measures.