Background: Community-acquired pneumonia (CAP) is one of the leading causes of morbidity and mortality worldwide, often leading to hospital admissions. In Portugal, the factors associated with in-hospital mortality due to CAP are not fully documented. The aim of this study was to characterize the trends of CAP hospitalization in all age groups and the factors associated with their mortality between 2000 and 2014.Methods: We conducted a cross-sectional study using CAP hospitalization data in all age groups, in Portugal Mainland. Logistic regression was used to identify the factors associated with in-hospital mortality.Results: Between 2001 and 2011, CAP hospitalization rate increased from 2.8 to 4.3 per 1000 population. Hospitalization rates were higher in the extreme ages ( ≤ 4 and ≥ 75 years). However, a decrease in the hospitalization rate and its mortality was observed, in the younger ages.A total of 548,699 hospitalization CAP episodes, between 2000 and 2014, were analyzed, with male (56.2%) and elderly ≥65 years (91.7%) predominance, resulting in 101,740 deaths (18.5%). Men had a significantly lower mean age (64.3 ± 26.4 years versus 67.9 ± 27.5 years;p < 0.001). During the studied 15 years, there was an increase of 45.2% in the number of annual hospitalizations, concomitant with the admission increase of individuals aged over 75 years. Since 2012 a decrease in hospitalizations and associated deaths were detected.The increase in age represented a progressive and significant rise in the probability of death, except for the age group 1–4 years. The age group ≥85 years old (Adjusted OR = 124.256; 95%CI: 97.838–157.807) and males (Adjusted OR = 1.261; 95%CI: 1.243–1.280) were significantly associated with death risk for CAP hospitalization. After 2010, this risk decreased (Adjusted OR = 0.961; 95%CI: 0.940–0.982). The main factors affecting mortality were age, sex, unemployment rate, number of performed procedures and admission quinquennia.Conclusions: Despite a trend of decrease in CAP hospitalizations and associated death since 2012, the numbers of in-hospital mortality showed, in the 15 years under analysis, an overall increase over time, mainly associated with age, in particular very old people ( ≥ 75 years), males and a higher parish unemployment rate. Therefore, the implementation of CAP preventive measures should be reinforced in these vulnerable groups.

Cystic fibrosis requires regular monitoring and intervention by healthcare teams; despite that, adherence to therapeutic measures is less than desired. The evolution of technology has allowed much of the care provided in person to be replaced by a telehealth delivery model, but studies on telerehabilitation are scarce and dispersed. This scoping review aimed to identify which domains of rehabilitation intervention are mediated by information and communication technologies and how they are developed in the provision of care to children and adolescents with cystic fibrosis. The data collection was conducted in February and June 2023, following the three steps recommended by the JBI for this type of review: (1) the search was conducted in MEDLINE, CINAHL, Scopus, JBI, and Web of Science; (2) the bibliographic references obtained from the included articles were analysed; and (3) the grey literature was checked. The eligibility criteria were children and adolescents and rehabilitation interventions mediated by information and communication technologies. The five studies included in this review were subjected to analysis, and a narrative synthesis of the results was carried out. The interventions identified included physical exercise programs (60%), management of the therapeutic regimen (40%), and symptom control (40%). The information and communication technologies were web-based platforms, video games, and telephones. The use of telerehabilitation included face-to-face meetings to ensure participants performed the exercises correctly, monitor their response to exercise, and teach them how to avoid risky situations during home workouts. In all studies, exercise sessions were supervised by the participants’ parents or caregivers.

Background: Community-Acquired Pneumonia (CAP) is regarded as a substantial part of the global burden of disease and a public health priority. In addition to host factors, such as demographic characteristics, comorbidities, CAP clinical severity, and in-hospital mortality may also be influenced by factors such as socioeconomic status, seasonal variations, and hospital differentiation. This study aims to analyse trends in hospital mortality among patients hospitalized with CAP in National Health Service (NHS) hospitals in mainland Portugal and the impact of various host and environmental factors on in-hospital mortality. Methods: This retrospective cross-sectional study analyzed 378,449 hospitalization episodes with CAP as the primary diagnosis (ICD-9-CM and ICD-10-CM/PCS) in mainland Portugal from 2010 to 2018. Data were sourced from the National Hospital Discharge Database and population census records. Variables included host factors (demographic characteristics, secondary diagnoses, CAP clinical severity indicators, Charlson score) as well as environmental factors, such as seasonality, socioeconomic factors and hospital differentiation. Trend analysis of hospitalization episodes and in-hospital mortality due to CAP was performed. Multivariable logistic regression was used to examine associations with in-hospital mortality, with statistical significance set at p < 0.05. Results: A decrease in the number of hospitalization episodes and in-hospital mortality rate over time was observed. The regression model identified advanced age, male gender, secondary diagnoses, CAP clinical severity, high Charlson score, the summer season, early school leaving rate, higher unemployment rate, and lower hospital differentiation as factors associated with an increased probability of death (p < 0.001). Conclusions: Throughout the nine-year period, a steady decline in in-hospital mortality rates was observed. In-hospital mortality exhibited a dual influence, shaped by host factors (such as age, gender, secondary diagnoses, CAP clinical severity, Charlson score) and environmental factors, including the summer season, socioeconomic vulnerability and hospital capabilities. Therefore, effectively reducing CAP in-hospital mortality requires comprehensive policies that focus on at-risk groups and address a broad range of both host and environmental risk factors. These policies should aim to improve healthcare access, increase vaccination coverage, and enhance thermal housing conditions, with particular attention to socially vulnerable individuals.

El presente artículo describe la metodología utilizada en la evaluación de tensiones equivalentes en recipientes a presión mediante el método de elementos finitos. Con base en las consideraciones resultantes, se diseñó una escotilla de inspeccióny se realizaron comprobaciones analíticas por medio de técnicas de simulación por computador. Esto generó puntos de comparación y un estudio sistemático con el fin de comprobar el comportamiento de las fuerzas resultantes en función de las modificaciones geométricas. También se definió un modelo a partir de tres propuestas de Manhole. Las configuraciones de escotilla de inspección responden a los formatos circular, elíptico-longitudinal y elíptico-transversal. Así, fue comprobado el trazado de tensiones sobre el objeto de estudio y se definió un procedimiento más incluyente en comparación con el método convencional, el cual se basa en expresiones de cálculo simplificadas.

Introduction: In-hospital CAP mortality remains high in the first days of hospitalization and few studies have tried to identify different risk profiles for early mortality. Aim: Determine the risk factors associated with CAP in-hospital deaths that occurred in the 1st day and up to the 3rd day of hospitalization. Methods: A retrospective analysis of CAP hospitalizations deaths that occurred in National Health Service, in Portugal Mainland, between 2010 and 2018 was made based on two binary logistic regression models. Results: Among 75845 in-hospital CAP deaths, most occurred on the 1st day (12.5%) followed by the 3rd day (9.4%). The risk factors associated with 1st day mortality were females [Adjusted OR (OR)=1.10 [1.05-1.16]], being from a county with higher unemployment rate (OR=1.01; [1.01-1.02]) or higher early leavers from education (ELE) rate (OR=1.02 [1.01-1.03]), admitted in a non-university hospital [level II and level I (OR=1.20/1.21]) and admission on Sunday (OR=1.10 [1.06-1.27]). Mortality in first 3 days showed an U-shaped effect for age [1-4 years (OR= 1.68 [1.51-1.87] and >95 years (OR= 1.84 [1.64-2.06)]; also living in a county with higher ELE rate (OR=1.01 [1.004-1.014), being admitted in Level I hospitals (OR=1.07 [1.04-1.10]), having cancer (OR=1.15 [1.10-1.19]), sepsis (OR=1.33 [1.10-1.59]) and submitted to mechanical ventilation (OR=1.558 [1.43-1.69]). Conclusion: Early CAP in-hospital mortality was related to patient features (age, sex), disease severity (sepsis, mechanical ventilation), comorbidities and social vulnerability. Healthcare features (less differentiated hospitals and Sunday admission day) were also relevant.