Clinical, economical and safety impact of ferric carboxymaltose use in Patient Blood Management programme in Portuguese National Health Service hospitals.

Ferric carboxymaltose (FCM) can be used in Patient Blood Management (PBM) to promote the optimization of preoperative haemoglobin (Hb), which aims to minimise the use of allogeneic blood components and improve clinical outcomes, with better cost-effectiveness. This was an observational study conducted in a retrospective and multicentre cohort with adults from elective orthopaedic, cardiac and colorectal surgeries, treated according to local standards of PBM with allogeneic blood product transfusions (ABTs) on demand and with FCM to correct iron deficiency with or without anaemia. In this work, only the first pillar of the PBM model issue by Directorate-General for Health (DGS) was evaluated, which involves optimising Hb in the preoperative period with iron treatment if it's necessary/indicated. Before the implementation of PBM in Portugal, most patients did not undergo preoperative laboratory evaluation with blood count and iron kinetics. Therefore, the existence of Iron Deficiency Anaemia (IDA) or Iron Deficiency (ID) without anaemia was not early detected, and there was no possibility of treating these patients with iron in order to optimise their Hb and/or iron stores. Those patients ended up being treated with ABTs on demand. A total of 405 patients from seven hospitals were included; 108 (26.7%) underwent FCM preoperatively and 197 (48.6%) were transfused with ABTs on demand. In the FCM preoperative cohort, there was an increase in patients with normal preoperative Hb, from 14.4 to 45.7%, before and after FCM, respectively, a decrease from 31.7 to 9.6% in moderate anaemia and no cases of severe anaemia after FCM administration, while 7.7% of patients were severely anaemic before FCM treatment. There were significant differences (p < 0.001) before and after correction of preoperative anaemia and/or iron deficiency with FCM in Hb, serum ferritin and transferrin saturation rate (TS). In the ABT group, there were significant differences between pre- and postoperative Hb levels (p < 0.001). Hb values tended to decrease, with 44.1% of patients moving from mild anaemia before transfusion to moderate anaemia in the postoperative period. Concerning the length of hospital stay, the group administered with ABTs had a longer hospital stay (p < 0.001). Regarding the clinical outcomes of nosocomial infection and mortality, there was no evidence that the rate of infection or mortality differed in each group (p = 0.075 and p = 0.243, respectively). However, there were fewer nosocomial infections in the FCM group (11.9% versus 21.2%) and mortality was higher in the transfusion group (21.2% versus 4.2%). Economic analysis showed that FCM could reduce allogenic blood products consumption and the associated costs. The economic impact of using FCM was around 19%. The preoperative Hb value improved when FMC was used. Patients who received ABTs appeared to have a longer hospital stay. The FCM group reported fewer infections during hospitalisation. The economic results showed savings of around €1000 for each patient with FCM administration. The use of FCM as part of the PBM program had a positive impact on patients' outcomes and on economic results. However, it will be essential to perform studies with a larger sample to obtain more robust and specific results.

Hábitos Alimentares dos Estudantes do Ensino Superior / Eating Habits of Higher Education Students

A saúde é entendida como um recurso para a vida, exigindo a adoção de estilos de vida saudáveis para se atingir o bem-estar pleno. Atualmente, as alterações dos estilos de vida, nomeadamente os hábitos alimentares e de consumo começam a repercutir-se em problemas graves de saúde pública. A alimentação para além de ser uma necessidade fundamental do ser humano é um dos elementos do estilo de vida que mais interfere na saúde das pessoas. O início da idade adulta é crucial para o desenvolvimento de hábitos alimentares que serão decisivos na qualidade de vida dos indivíduos. Neste sentido, os estudantes do ensino superior tornam-se um grupo relevante para implementar programas de educação alimentar. Os objetivos deste estudo são avaliar os hábitos alimentares dos estudantes do ensino superior e identificar quais os fatores que interferem nos mesmos. Foi desenvolvido um estudo não ­ experimental, descritivo-correlacional, transversal e de natureza quantitativa. Foi selecionada uma amostra não probabilística por acessibilidade, constituída por 168 estudantes do Instituto Politécnico da Guarda, com idades compreendidas entre os 18 e os 49 anos, com uma média de idades de 24,40 anos. Para a recolha dos dados, foi utilizado um questionário de caraterização sociodemográfica, caraterização académica e caraterização socioeconómica, o Questionário de Imagem Corporal e a Escala de Hábitos Alimentares. Concluiu-se que os estudantes do ensino superior que apresentam melhores hábitos alimentares são os mais velhos; os do género feminino; os que coabitam com o cônjuge, companheiro(a) ou namorado(a) e os que vivem com os pais ou familiares; os que frequentam os cursos das áreas de Saúde e de Hotelaria e Turismo; os que habitualmente comem em casa; os que praticam mais frequentemente exercício físico/desporto e os que revelam melhor imagem corporal. Os resultados mencionados demonstram a necessidade de implementar estratégias conducentes à prática de estilos de vida saudáveis. Neste sentido, todos os espaços são profícuos para a promoção de estilos de vida saudáveis, sendo a escola um dos locais de excelência, que pode e deve fomentar a promoção de uma alimentação saudável

Health is regarded as a resource for everyday life, requiring the adoption of healthy lifestyles to achieve full wellness. Currently, changes in lifestyle, in particular dietary habits and of consumption begin to rebound in serious public health problems. Eating, besides being a fundamental human need, is one element of lifestyle that most affects people's health. The early adulthood is crucial to the development of eating habits that will be decisive in the quality of life of individuals. Therefore, students in higher education become a relevant group for implementing nutrition education programs. The objective of this study was to assess the eating habits of students in higher education and identify the factors that interfere therein. Thus, it was developed a non-experimental, descriptive-correlational, cross-sectional and quantitative in nature study. For the purpose it was selected a non-probability convenience sampling, consisting of 168 students attending Instituto Politécnico da Guarda, aged between 18 and 49 years, with a mean age of 24.40 years. For data collection, it was used a socio demographic, academic and socioeconomic characterization questionnaire, the Body Image Questionnaire and the Eating Habits scale. It was concluded that students in higher education that have better eating habits are the older ones; the female gender; those who live with a spouse, partner or boyfriend/girlfriend and those living with parents or relatives; those attending the courses in the Health, Hostelry and Tourism areas; those who usually eat at home; those who most frequently perform sport/physical exercise and those revealing better body image. The foregoing results express the need to implement strategies conducive to the practice of healthy lifestyles. Thus, all areas are suitable for promoting healthy lifestyles, being the school a place of excellence, that can and should encourage the promotion of healthy eating.