Acta Medica Port
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According to the Portuguese clinical guidelines published in 1999, patients with traumatic brain injury and coagulopathies should remain in-hospital for 24 hours for clinical and image surveillance, despite having an admission computed tomography (CT) scan showing no intracranial lesions. Growing evidence suggests this practice is not only void of clinical relevance, but that it can also be potentially harmful for the patient. Nevertheless, up until now there is no published data concerning the economic impact of this clinical practice. ⋯ In spite of apparently not adding any clinical value to our practice, our in-hospital surveillance may represent a significant financial and time-consuming burden, costing five times as much and demanding our medical teams twice as much work when compared to a scenario without clinical surveillance and 24-hour CT scans.
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Haemophilus influenzae serotype A is a rare cause of meningitis and invasive disease in pediatric patients. A six-month-old infant presented to the emergency room with fever, cough and nasal drip. On admission, the infant was alert and hemodynamically stable but progressively became more lethargic with bulging of the fontanelle. ⋯ Viral detection in cerebrospinal fluid and nasopharyngeal aspirate tested positive for adenovirus. The infant completed 10 days of antibiotic therapy and was fully recovered upon discharge. Although cases of Haemophilus influenzae serotype a meningitis are rare, invasive disease caused by non-B serotypes as well as non-encapsulated isolates have been increasing, emphasizing the need for monitoring and continuous epidemiological surveillance.
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Observational Study
[Medication Reconciliation in Primary Care: Practices, Knowledge and Attitudes in the Lisbon and Tagus Valley Health Region].
Despite the importance of medication reconciliation for the continuity of care, there is currently no information on the practices, knowledge, and attitudes of Portuguese family doctors on this subject. This study aimed to characterize the formal medication reconciliation procedures in the Lisbon and Tagus Valley Health Region, as well as the perception of family doctors in this region about what they know, how they think and how they practice medication reconciliation. ⋯ The proportion of primary health care units with a formal medication reconciliation procedure is low. Family doctors in the Lisbon and Tagus Valley Region value medication reconciliation, although they do not include it in all consultations after hospital admission. Communication between levels of care and the standardization of processes are areas with potential for improvement to promote the safe and patient-centered use of medication.