PHYSIOTHERAPEUTIC APPROACHES AND THE EFFECTS ON INSPIRATORY MUSCLE FORCE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN THE PRE-OPERATIVE PREPARATION FOR ABDOMINAL SURGICAL PROCEDURES

The EUPEMEN (EUropean PErioperative MEdical Networking) Protocol for Bowel Obstruction: Recommendations for Perioperative Care

Mechanical bowel obstruction is a common symptom for admission to emergency services, diagnosed annually in more than 300,000 patients in the States, from whom 51% will undergo emergency laparotomy. This condition is associated with serious morbidity and mortality, but it also causes a high financial burden due to long hospital stay. The EUPEMEN project aims to incorporate the expertise and clinical experience of national clinical specialists into development of perioperative rehabilitation protocols. Providing special recommendations for all aspects of patient perioperative care and the participation of diverse specialists, the EUPEMEN protocol for bowel obstruction, as presented in the current paper, aims to provide faster postoperative recovery and reduce length of hospital stay, postoperative morbidity and mortality rate.

MULTIPROFESSIONAL ELECTRONIC PROTOCOL FOR DIGESTIVE SURGERY VALIDATION

Background:

The creation of a computerized clinical database with the ability to collect prospective information from patients and with the possibility of rescue and crossing data enables scientific studies of higher quality and credibility in less time.

Aim:

To validate, in a single master protocol, the clinical data referring to Surgery of Digestive System in a multidisciplinary way, incorporating in the SINPE^© platform, and to verify the incidence of digestive diseases based on the prospectively performed collections.

Method:

Organize in one software, in a standardized structure, all the pre-existing items in the SINPE^© database; the theoretical basis was computerized through the MIGRASINPE^© module creating a single multiprofessional master protocol for use as a whole.

Results:

The existing specific protocols were created and/or adapted - they correspond to the most prevalent digestive diseases - unifying them. The possibility of multiprofessional use was created by integrating all data collected from medicine, nursing, physiotherapy, nutrition and health management in a prospective way. The total was 4,281 collections, distributed as follows: extrahepatic biliary tract, n=1,786; esophagus, n=1015; anorectal, n=736; colon, n=550; small intestine, n=86; pancreas, n=71; stomach, n=23; liver, n=14.

Conclusions:

The validation of the unification and structuring in a single master protocol of the clinical data referring to the Surgery of the Digestive System in a multiprofessional and prospective way was possible and the epidemiological study carried out allowed to identify the most prevalent digestive diseases.

Multidisciplinary electronic protocol for collection of clinical and surgical data on chronic venous insufficiency

Background

Use of electronic protocols for data collection and storage enables clinical research to be conducted dynamically, contributing to medical advances.

Objectives

To create an electronic data base for collection of clinical and surgical data on chronic venous insufficiency (CVI), to facilitate production of scientific studies.

Methods

Initially, a database was constructed by means of a bibliographic review of text books and relevant scientific articles for all vascular diseases and then a database on CVI was extracted. These data were computerized using the Integrated Electronic Protocols System (SINPE©) and then assessed in a pilot project.

Results

The multidisciplinary electronic protocol for vascular diseases covered the following items: history taking, physical examination, work-up tests, types of treatment, and progression. Using these items, a master protocol was created containing 6,145 items, and then a CVI-specific protocol containing 2,877 items was compiled. The protocol's functionality was tested in a pilot project, collecting data from medical records. The information collected was analyzed and illustrated graphically.

Conclusions

It proved possible to create an electronic protocol for collection of clinical and surgical data on CVI. The protocol was incorporated into the SINPE©, greatly facilitating production of scientific research in the area.