Arte- Final (Portuguese Edition)

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Director's statement part of evaluation in digital form. Films of Portuguese film makers of any length and genre b. Films of Portuguese and International film makers of any length and genre. Subtitles — for the screening videos in any category, it is indispensable to send the list of subtitles in English and a DVD with the final version of the film in order to prepare electronic subtitles. The screening prints or copies that do not have original versions in English, should have English subtitles. Submission deadline —productions entries will be accepted up to July 15th, - online and postal date.

Films that were submitted in previous editions and were not selected, can not be submitted again. Five films will be awarded in total, three for the awards with cash prize, two for special mentions. The value declared for customs must not exceed 10 dollars. If the films are selected for the extensions, a screening fee is paid by the festival. Data The deadline for film submissions is the 15th of July Director's statement part of evaluation in digital form Submissions 1. The study excluded patients admitted with a diagnosis of VTE, or who were receiving chronic antithrombotic therapy.. Patients were enrolled sequentially in each participating center until the desired sample size of patients was achieved, and treated at the physician's discretion according to local clinical practice.

Data were collected from hospital charts and the relevant information was entered onto standardized case report forms. Patient demographics, admission discharge diagnoses, risk factors for VTE as defined in the ACCP guidelines 22 , risk factors for bleeding, duration of hospitalization, type of VTE prophylaxis and concomitant medication were obtained directly from patients at the time of enrollment and of hospital discharge.

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In order to assess the occurrence of thromboembolic and bleeding events, as well as cases of death or hospital readmission, patients were further contacted by telephone at six months after discharge.. Quantitative data were expressed as medians or means and standard deviation when appropriate, while categorical data were expressed as number and percentage of the population.

Exploratory analysis was performed using chi-square testing for categorical variables and two-sided t tests for continuous variables. A p-value of less than 0. The number of patients included and the study flow diagram are depicted in Figure Baseline demographic and clinical characteristics of the patients included.. The proportions of patients included in each of the four medical areas considered were Of the total population, patients The mean length of hospital stay was 8.

Six-month follow-up was obtained in According to the predefined classes of thromboembolic risk, patients 4. Considering the different medical areas individually, the distribution of the risk classes was as shown in Table 4. Distribution of risk classes by medical area..

Overall, patients During hospitalization, VTE prophylaxis was most frequently prescribed for orthopedic and oncology patients Regarding the outpatient setting, among the patients with six-month follow-up, VTE prophylaxis was also most frequently recorded in orthopedic and oncology patients In the study population, 59 patients 1. Even though contraindication for anticoagulation was identified, 22 patients received prophylaxis during hospitalization, and three during follow-up.. Major bleeding events were observed in 3. Mortality from any cause over the six-month study period was 3.

The validation of a RAM modified from the Caprini and Khorana scores in a heterogeneous hospitalized population that includes medical and cancer patients may be useful in clinical practice. Given the complexity of a significant number of medical and cancer patients, an ideal model must accurately identify a threshold for the risk of VTE and predict the correct risk level in heterogeneous patients at admission, irrespective of their initial or final diagnosis. The ARTE-RAM score presented in this study was based on both well-established and novel risk factors, aiming for a consensual version of a tool that can be widely used in daily clinical practice, responding to a perceived need in the medical community.

The ARTE study, including populations admitted to general surgery and medicine departments, was designed to assess a new risk scoring method and to demonstrate the value of individual risk assessment for a broad range of patients. The study was conducted in a cohort of patients hospitalized in four departments internal medicine, oncology, surgical or orthopedic of 14 hospitals in Portugal.. Despite the variety of prophylaxis measures, 45 of the treated patients 1. In a paper by Zakai et al. If ischemic stroke is excluded, we found an incidence of 3. This difference could be explained by a higher percentage of prophylaxis in our study The ARTE study corroborates other reports 29 that alert the medical community to the need for extended VTE prophylaxis beyond hospital discharge.

In fact, the majority of VTE events were recorded in the six-month follow-up period 0. Major bleeding events were mainly observed during hospital stay, when close medical vigilance enables immediate intervention to minimize its consequences. Of inpatients receiving anticoagulant prophylaxis, only 3.

This underlines the need for accurate risk estimation before the introduction of pharmacological VTE prophylaxis, in order to offer an appropriate strategy for each patient and especially to avoid underuse of anticoagulants based on wrongly perceived clinical assumptions of risk for bleeding complications..

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Several studies, including a Cochrane review, have evaluated the importance of interventions designed to increase the implementation of thromboprophylaxis in hospitalized adult medical and surgical patients. The Cochrane review, published in , 30 analyzed 55 studies, including randomized controlled trials and observational studies, that implemented a variety of system-wide strategies aimed at improving thromboprophylaxis rates in many settings and patient populations.

The authors found statistically significant improvements in prescription of prophylaxis therapies associated with education, alerts and multifaceted interventions. Multifaceted interventions with an alert component seems to be the most effective. Another review analyzed ambulatory cancer patients receiving chemotherapy 31 and confirmed the importance of primary thromboprophylaxis in reducing the incidence of symptomatic VTE..

Worldwide, the search for cost-effective strategies for prevention of VTE has been a fundamental concern in recent years. There is, however, no agreement as to the best approach on this issue. On one hand there is solid evidence showing the effectiveness of computerized decision support for the implementation of thromboprophylaxis. On the other hand, there have been doubts about its cost-effectiveness.. This study has several limitations. Firstly, although we made an initial assessment of risk factors at time of admission, identified by qualified physicians, there may have been intersite variability in data collection.

Secondly, for the purpose of classifying patients in disease categories, we used the admission diagnosis as the main diagnosis, accepting that, in some cases, this diagnosis could be wrong or the clinical course of the disease episode could modify the relative effect of VTE risk factors for example, a patient could be admitted for an acute condition attributed to cancer but undergo surgical intervention during hospital stay.

Thirdly, clinical diagnosis of DVT and PE is known to be unreliable and clinical examination alone underestimates the true incidence of VTE, 33 particularly in an outpatient setting, which may have contributed to underestimation of asymptomatic VTE events and hence of the true incidence of VTE. Finally, a large number of patients were lost to follow-up, hampering analysis of thromboprophylaxis and clinical outcomes after hospital discharge.. Thromboprophylaxis was administered to a significant number of these patients but its use may be less desirable in the outpatient setting.

The authors declare that they all contributed to the concept and design of the study and to the interpretation of data, as well as to the writing, revising and final approval of the version to be published.. The authors acknowledge the principal investigators who participated in the study: Daniel Ferreira Hospital da Luz ; Dr.

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Doutor Fernando Fonseca ; Dr. Rubina Silva Hospital Pedro Hispano.. Previous article Next article. November Pages Venous thromboembolism risk and prophylaxis in the Portuguese hospital care setting: Daniel Ferreira a ,. Doutor Fernando Fonseca, Amadora, Portugal. Venous thromboembolism in Portuguese hospitals: Where we stand and how we can improve. Rev Port Cardiol ; This item has received. Under a Creative Commons license. Show more Show less.

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Introduction 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 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 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. Objetivo Estudar o perfil de risco para TEV em doentes hospitalizados, num grupo de hospitais de Portugal. Introduction Venous thromboembolism VTE , including deep vein thrombosis DVT and pulmonary embolism PE , is the third most common cardiovascular disease, affecting per adults annually. This is a fairly effective treatment strategy for preventing VTE recurrence. Several clinical studies have shown the need to put into practice effective hospital strategies based on systematic and individualized assessment of VTE, and also to optimize the institution of proper prophylaxis in the context of in-hospital and outpatient management.

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Baseline demographic and clinical characteristics of the patients included. Distribution of risk classes by medical area. Rubina Silva Hospital Pedro Hispano. Incidence of venous thromboembolism: Thromb Haemost, 83 , pp. The Surgeon General's call to action to prevent deep vein thrombosis and pulmonary embolism. Venous thromboembolism prophylaxis in acutely ill hospitalized medical patients: Chest, , pp.

Economic burden of venous thromboembolism: J Med Econ, 14 , pp. Prog Cardiovasc Dis, 17 , pp. Autopsy verified pulmonary embolism in a surgical department: Br J Surg, 78 , pp. Autopsy proven pulmonary embolism in hospital patients: