Gender Based Analysis of a Population Series of Patients Hospitalized with Infective Endocarditis in Portugal - How do Women and Men Compare?

Abstract Background: The impact of gender on the outcome of patients hospitalized with infective endocarditis (IE) is not fully understood. Objective: To verify the association between gender and the clinical profile of patients hospitalized with IE, treatment strategies, and clinical outcomes. Methods: This is a retrospective nationwide study of patients hospitalized with IE, based on hospital admissions between 2010 and 2018 in Portugal. Descriptive statistics were used to present variables. An inferential analysis was performed using multiple logistic regression. A 95% confidence interval and a 5% significance level were considered. Results: In total, 3266 (43.1%) women and 4308 (56.9%) men were hospitalized with IE. The women were older (76 vs 69 years old, p<0.001), more frequently presented arterial hypertension (39.8% vs 35.4%, p<0.001) and atrial fibrillation (29.5% vs 21.2%, p<0.001), and had less cardiovascular comorbidities. Acute heart failure was more common in women (32.9 vs 26.9%, p<0.001) and acute renal failure (13.6% vs 11.7%, p<0.001) and sepsis (12.1% vs 9.1%, p<0.001), in men. Women were less likely to undergo cardiac surgery (OR 0.48 - 95%CI 0.40-0.57, p<0.001) and had a higher postoperative mortality (OR 1.84, 95% CI 1.19-2.84, p=0.006). In-hospital mortality rates were comparable between genders (20.3% vs 19.6%, p=0.45). Conclusions: Women were less likely to undergo cardiac surgery when hospitalized with IE, and the female gender was a predictor factor for postoperative mortality. Overall, in-hospital mortality was not influenced by gender. Further research is necessary to fully clarify the impact of gender on IE management and outcomes.

Perspectivas temporais e regionais da insegurança alimentar durante a crise econômica em Portugal, 2011-2013 / Time and regional perspectives of food insecurity during the economic crisis in Portugal, 2011-2013

Food insecurity (FI) has received much attention in recent years, even in high-income countries, due to the increasing trend of poverty and social inequalities indicators, as a result of the global financial crisis. The establishment of a monitoring system of FI becomes a priority for food and nutrition policies. Our study aims to evaluate FI trends during the economic crisis in Portugal and to identify regional disparities throughout the country. Data derived from three surveys conducted by the Portuguese Directorate-General of Health, concerning FI of the Portuguese population, during the period that Portugal was under the International Monetary Fund financial assistance program (2011–2013). Data were collected by face-to-face interviews and FI was evaluated using a psychometric scale. Logistic regression models were used to identify regional disparities in FI. The prevalence of FI was relatively unchanged at national and regional levels, during the analysis period. Data from 2013 indicates a high prevalence of FI (50.7%), including 33.4% for low FI, 10.1% for moderate FI and 7.2% for severe FI. Disparities according health region were also found for household FI. Algarve, Lisboa and Vale do Tejo were the two regions with the highest levels of FI, even after controlling for other socioeconomic variables. High levels of FI found in Portugal and the different regional profiles suggest the need for regional strategies, in particular in the most affected regions based on a broader action with different policy sectors (health, social security, municipalities and local institutions in the field of social economy)...

As questões da insegurança alimentar (IA) têm merecido uma atenção crescente nos últimos anos, mesmo nos países desenvolvidos, considerando a tendência crescente dos indicadores de pobreza e de desigualdades sociais, em resultado da crise económica global. A implementação de um sistema de monitorização da IA tornou-se uma prioridade das políticas de alimentação e nutrição. Este estudo pretende avaliar as tendências da IA durante a crise económica em Portugal, identificando possíveis iniquidades regionais. Os dados analisados provêm de três inquéritos conduzidos pela Direção-Geral da Saúde, referentes à IA da população portuguesa, durante o período em que Portugal esteve sob intervenção do programa de assistência financeira do Fundo Monetário Internacional (2011-2013). Os dados foram recolhidos por entrevistas face-a-face e a IA avaliada através de uma escala psicométrica. Utilizaram-se modelos de regressão logística para identificar iniquidades regionais na IA. A prevalência de IA manteve-se relativamente inalterada, a nível nacional e regional, durante este período. Em 2013 verificou-se uma elevada prevalência de IA (50,7%) (33,4% IA leve, 10,1% IA moderada e 7,2% IA grave). Iniquidades regionais foram também encontradas para a IA. As regiões do Algarve e de Lisboa e Vale do Tejo foram as que apresentaram níveis de IA mais elevados, mesmo após ajuste para as variáveis socioeconómicas. Os níveis de IA em Portugal e as disparidades regionais encontradas sugerem a necessidade de implementar estratégias a nível regional, em particular nas regiões mais afetadas, envolvendo os diferentes sectores com capacidade interventiva (saúde, segurança social, autarquias, instituições locais na área da economia social)...