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1.
Public Health ; 208: 32-39, 2022 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-35687953

RESUMEN

OBJECTIVE: We aimed to identify areas of high tuberculosis (TB) diagnosis delay in mainland Portugal in 2017 and ecological factors associated with these areas. STUDY DESIGN: This was an ecological study. METHODS: We considered all notified pulmonary TB cases from the Portuguese National Tuberculosis Surveillance System in mainland Portugal. Diagnostic delays were calculated at the municipality level. Demographic variables, proxies for TB awareness, health services capacity indicators, and socio-economic variables were included and extracted from official databases, such as Statistics Portugal, Ministeries, Foreigners and Border Services. We used spatial analysis to identify areas of high delay in 2017 and logistic generalised additive models to identify ecological factors associated with the identified cluster. RESULTS: We identified an area of high delay in 2017 in the South region of the country. Overall, municipalities with a smaller population density, smaller proportion of unemployed, fewer health centres and higher old-age dependency ratio, proportion of men, TB incidence, proportion of immigrants and high school dropout had a higher probability of belonging in a high delay area. CONCLUSION: The role of primary health care in TB diagnosis should be further explored. Interventions should address factors interplaying at the local and individual levels. Policies influencing social and health conditions, leading to changes in individual behaviour, can lead to sustained improvements over time.


Asunto(s)
Emigrantes e Inmigrantes , Tuberculosis Pulmonar , Tuberculosis , Diagnóstico Tardío , Humanos , Incidencia , Masculino , Tuberculosis/epidemiología , Tuberculosis Pulmonar/diagnóstico , Tuberculosis Pulmonar/epidemiología
2.
Public Health ; 211: 5-13, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-35988506

RESUMEN

OBJECTIVES: The SARS-CoV-2 virus has spread worldwide, leading governments to implement mitigation measures. Understanding the reluctance to adhere to non-pharmacological interventions might help promote adherence to these measures. This study aimed to identify factors associated with non-adherence to the first lockdown in Portugal. STUDY DESIGN: Cross-sectional study. METHODS: This study used data from a Portuguese community-based survey entitled 'COVID-19 Barometer: Social Opinion'. Data were collected on risk perception, health status and social experiences using a snowball sampling technique. The event of interest corresponded to participants who reported not staying home during the lockdown period, serving as a proxy for non-adherence to lockdown. Logistic regression was used to identify factors associated with non-adherence to the first lockdown. RESULTS: Responses from 133,601 individual questionnaires that were completed during the first week of the first lockdown in 2020 were analysed. A minority of participants (5.6%) reported non-adherence to lockdown (i.e. leaving home for reasons other than essential situations). Working in the workplace was the factor with the strongest association of non-adherence to the lockdown. Several other factors were also associated with non-adherence to the first lockdown; namely, being a man, being a student, having a low level of education, having a low income, living alone or with a high-infection-risk professional (e.g. doctor, nurse, pharmaceutical, health technician, firefighter, police officer, military, essential services worker), perceiving the risk of getting COVID-19 to be high, not having social support in case of infection, feeling agitated, sad or anxious every day, and considering the preventive measures to be unimportant or inadequate. CONCLUSIONS: Non-adherence to lockdown was associated with socio-economic, trust and perception factors. Future research should investigate the mechanisms underlying these associations to help identify the population groups who are most at risk of non-adherence.


Asunto(s)
COVID-19 , COVID-19/prevención & control , Control de Enfermedades Transmisibles , Estudios Transversales , Humanos , Masculino , Portugal/epidemiología , Cuarentena/métodos , SARS-CoV-2 , Aislamiento Social
3.
J Appl Microbiol ; 130(1): 90-99, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32640074

RESUMEN

AIMS: This work aimed to estimate the growth of Myceliophthora thermophila M.7·7 in solid-state cultivation (SSC) through quantification of N-acetyl-d-glucosamine (NAG) and enzyme activity. METHODS AND RESULTS: The fungus was cultivated in sugarcane bagasse and wheat bran. A consistent statistical analysis was done to assess the reliability of experimental data. Logistic model equation was fitted to experimental data and growth parameters were estimated. The results showed strong influence of the sample size on NAG and a minimum recommended sample size was identified. Scanning electron microscopy (SEM) was used to identify the strategy of substrate colonization. Wheat bran was attacked firstly, while sugarcane bagasse was consumed after wheat bran depletion. The biomass growth was poorly estimated by secretion kinetics of α-amylase, endoglucanase, protease and xylanase, but enzyme kinetics were important for understanding substrate colonization. CONCLUSIONS: In conclusion, the NAG concentration was strongly affected by the sample size and sampling procedure. The strategy of fungal colonization on the substrates was well characterized through SEM analysis. The colonization strategy has direct influence on the kinetic parameters of the logistic model. Myceliophthora thermophila has a well-defined dynamic of enzyme secretion to degrade the substrate, although the kinetics of enzyme secretion has shown not adequate to characterize the kinetics of fungal growth. SIGNIFICANCE AND IMPACT OF THE STUDY: The paper provides reliable growth kinetic parameters in the SSC of the cellulase producer fungus M. thermophila M.7·7, as well as a robust analysis on three indirect methods (NAG, enzymes and SEM) for estimation of fungal development.


Asunto(s)
Sordariales/crecimiento & desarrollo , Acetilglucosamina/metabolismo , Biomasa , Reactores Biológicos , Celulosa/metabolismo , Fibras de la Dieta/metabolismo , Proteínas Fúngicas/metabolismo , Cinética , Reproducibilidad de los Resultados , Saccharum/química , Sordariales/enzimología , Sordariales/metabolismo , Sordariales/ultraestructura
4.
Neurol Sci ; 42(5): 1995-2003, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-32997282

RESUMEN

BACKGROUND: Fingolimod, an oral sphingosine 1-phosphate receptor modulator, is approved by EMA for relapsing-remitting multiple sclerosis (RRMS). OBJECTIVES: To assess the effectiveness and safety of fingolimod in patients with RRMS in real-world clinical practice in Portugal. METHODS: Retrospective, multicentre, non-interventional study, reporting 3 years follow-up of data collected from October 2015 to July 2016. Sociodemographic data and previous treatments at baseline and data regarding disease evolution, including number of relapses, annualised relapse rates (ARR) and Expanded Disability Status Scale (EDSS), were collected. RESULTS: Two-hundred and seventy-five participants were enrolled in the REALMS study. Results showed that the main reason to switch to fingolimod was failure of previous treatment (56.7%) and only 3.6% were naïve patients. In the total population, there was a significant decrease in ARR of 64.6% in the first year of treatment, 79.7% in the second year and 82.3% in the third year, compared with baseline. More than 67.0% of patients had no relapses during the 3 years after switching to fingolimod. EDSS remained stable throughout the study. CONCLUSIONS: Therapy with fingolimod showed a sustained effectiveness and safety over the 3 years, particularly on patients switched from first-line drugs (BRACE). No new safety issues were reported.


Asunto(s)
Esclerosis Múltiple Recurrente-Remitente , Esclerosis Múltiple , Clorhidrato de Fingolimod/efectos adversos , Humanos , Inmunosupresores/efectos adversos , Esclerosis Múltiple Recurrente-Remitente/tratamiento farmacológico , Portugal/epidemiología , Estudios Retrospectivos , Resultado del Tratamiento
5.
Public Health ; 201: 41-47, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34742116

RESUMEN

OBJECTIVES: To characterize patient, healthcare, and total delay in diagnosing pulmonary tuberculosis (PTB) in critical (higher PTB incidence) and non-critical (lower PTB incidence) areas and their determinants considering clinical and sociodemographic factors. STUDY DESIGN: Retrospective cohort study. METHODS: Data was retrieved from the Portuguese National Tuberculosis Surveillance System (SVIG-TB). Were included in the study all active PTB patients (n = 11,762) notified between 2008 and 2017. Spatial analysis was used to define critical and non-critical areas. Kaplan-Meier estimator, logrank test, and Cox regression were conducted, stratified by area. RESULTS: PTB cases in critical areas (n = 6594, 56.1%) presented longer patient median delay (41 vs 31days), shorter healthcare median delay (7 vs 10 days), and longer total median delay (63 vs 61days) t.han non-critical areas. Patient and total delay increased in both areas over time, while healthcare delay only increased in non-critical areas. Icn both areas, being from a high TB incidence country and alcohol abuse were associated with longer patient delays. Being female, older age, and oncologic diseases were associated with longer healthcare delays. Respiratory diseases were only associated with a longer healthcare delay in non-critical areas. Being female, older, and from a high TB incidence country were associated with a longer total delay in both areas. CONCLUSIONS: Patient delay was significantly longer in critical areas, and healthcare delay was significantly longer in non-critical areas. Several factors associated with longer delays have been identified, most of which are shared by critical and non-critical areas. Differences in patient and healthcare delay, for example, by sex, age, or country of birth, highlight the need for targeted public health interventions to help reduce these differences.


Asunto(s)
Factores Sociodemográficos , Tuberculosis Pulmonar , Anciano , Diagnóstico Tardío , Atención a la Salud , Femenino , Humanos , Incidencia , Portugal/epidemiología , Estudios Retrospectivos , Tuberculosis Pulmonar/diagnóstico , Tuberculosis Pulmonar/epidemiología
6.
J Stroke Cerebrovasc Dis ; 30(8): 105922, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34157670

RESUMEN

OBJECTIVES: To determine the predictive value of early transcranial color-coded sonography (TCCS) for intracranial hemorrhage (ICH) in patients with large artery occlusion (LAO) stroke of carotid circulation, who were submitted to endovascular therapy (EVT) with successful reperfusion. MATERIALS AND METHODS: Retrospective study evaluating a cohort of consecutive stroke patients with LAO of the carotid circulation that were recanalyzed with EVT. We measured angle-corrected peak systolic velocities, end-diastolic velocities and mean flow velocities (PSV, EDV and MFV) of the symptomatic and asymptomatic middle cerebral artery (MCA). The ratio between MFV of the symptomatic MCA and MFV of the asymptomatic MCA (MCA-Ra) was calculated. Parenchymal hematoma in the 24 hours control CT was considered as ICH. Univariate associations and multivariate analyses were used to identify early independent predictors for ICH among TCCS findings. RESULTS: We included 234 patients, mean age 72.5 (SD 12.6) years, 52.1% male. The mean time between recanalization and TCCS was 12.3 hours (range 3-22). Patients who developed postinterventional ICH showed a higher MCA-Ra (1.02 ± 0.26 vs 1.16 ± 0,21, p = 0.036). In multivariate analysis, only higher MCA-Ra remained independently associated with postinterventional ICH (OR: 6.778, 95%CI: 1.152-39.892, p = 0.034). A value of MCA-Ra ≥ 1,05 was associated with ICH, showing a sensitivity of 81.3% and a specificity of 65.9%; the AUC based of the ROC analysis was 0.688 (95% CI 0.570-0.806). CONCLUSION: TCCS performed within the first 24 hours after stroke onset can help to predict hemorrhagic transformation in patients with LAO.


Asunto(s)
Procedimientos Endovasculares/efectos adversos , Infarto de la Arteria Cerebral Media/terapia , Hemorragias Intracraneales/diagnóstico por imagen , Accidente Cerebrovascular Isquémico/terapia , Trombectomía/efectos adversos , Ultrasonografía Doppler en Color , Ultrasonografía Doppler Transcraneal , Anciano , Anciano de 80 o más Años , Velocidad del Flujo Sanguíneo , Circulación Cerebrovascular , Femenino , Humanos , Infarto de la Arteria Cerebral Media/diagnóstico por imagen , Infarto de la Arteria Cerebral Media/fisiopatología , Hemorragias Intracraneales/etiología , Accidente Cerebrovascular Isquémico/diagnóstico por imagen , Accidente Cerebrovascular Isquémico/fisiopatología , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Sistema de Registros , Reproducibilidad de los Resultados , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento
7.
Public Health ; 186: 95-100, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32795770

RESUMEN

OBJECTIVES: The aim of the study was to characterise the existence of the healthy immigrant effect (HIE; better health initially, worsening with an increase in the length of residence) in a big city from a Western European country, particularly in a non-European Union immigrant population. STUDY DESIGN: This is a cross-sectional study. METHODS: We used data from the National Health Survey 2014 to compare the health status of the immigrant and Portuguese populations with different lengths of residence. After descriptive statistics, binary logistic regressions models, with adjusted levels and 95% confidence intervals, were used. RESULTS: Immigrants were healthier than the Portuguese population (<10 years: odds ratio [OR] = 0.07; 95% confidence interval [CI] = [0.01; 0.51]; ≥10 years: OR = 0.62; 95% CI = [0.19; 2.03]), but had an increased likelihood of suffering from chronic diseases and risk behaviours with the increase in their length of stay in Portugal. After living in Portugal for more than 10 years, the immigrants showed no statistical difference in the main health indicators. CONCLUSIONS: There was a tendency for the health status of immigrants to deteriorate over 10 years of residence in Portugal. To better understand the reasons behind the HIE, specific and tailored studies must be developed.


Asunto(s)
Emigrantes e Inmigrantes/estadística & datos numéricos , Estado de Salud , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Enfermedad Crónica/epidemiología , Estudios Transversales , Europa (Continente) , Femenino , Encuestas Epidemiológicas , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Aceptación de la Atención de Salud , Portugal , Asunción de Riesgos , Adulto Joven
8.
Hum Reprod ; 34(8): 1439-1449, 2019 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-31287145

RESUMEN

STUDY QUESTION: Can time-lapse imaging systems make it possible to identify novel early non-invasive biomarkers to predict live birth? SUMMARY ANSWER: From mostly high-grade embryos, out of 35 morphometric, morphologic and morphokinetic variables, only pronuclei (PN) position at time of PN juxtaposition and the absence of multinucleated blastomeres at the 2-cell stage (MNB2cell), were potentially associated with live birth. WHAT IS KNOWN ALREADY: Previous studies indicate that some kinetic markers may be predictive of blastocyst development and embryonic implantation. Certain teams have suggested including some of them in decisional algorithms for embryo transfers. STUDY DESIGN, SIZE, DURATION: Using a time-lapse incubator (EmbryoScope, Unisense FertiliTech), we retrospectively explored the associations between the morphometric, morphologic and morphokinetic parameters of oocytes, zygotes and embryos, and their associations with live birth. This study assessed 232 embryos from single embryo transfers after ICSI cycles performed between January 2014 and December 2017. PARTICIPANTS/MATERIALS, SETTING, METHODS: The morphometric, morphologic and morphokinetic parameters (18, 4 and 13, respectively) of oocytes, zygotes and early embryos were studied retrospectively. The associations between these parameters were examined using a Spearman's correlation, Mann-Whitney or chi-squared test as appropriate. We examined whether these parameters were associated with outcomes in univariate and multivariate logistic regression analyses. MAIN RESULTS AND THE ROLE OF CHANCE: Central PN juxtaposition was associated with a 2-fold increase in the odds of live birth (OR = 2.20; 95% CI, [1.26-3.89]; P = 0.006), while the presence of MNB2cell was associated with half the odds of live birth (OR = 0.51; 95% CI, [0.27-0.95]; P = 0.035). These two parameters were independent of embryo kinetics. The 33 remaining parameters had no significant association with the capacity of transferred embryos to develop to term. LIMITATIONS, REASONS FOR CAUTION: Even though the population size was relatively small, our analyses were based on homogeneous cycles, i.e. young women whose transferred embryos were found to be high-grade according to conventional morphology evaluation. In addition, our conclusions were established from a specific, highly selected population, so other study populations, such as women in an older age bracket, may yield different results. Finally, because we assessed day 2/3 transfers, our findings cannot be generalized to embryos cultured up to the blastocyst stage. WIDER IMPLICATIONS OF THE FINDINGS: It would be interesting to explore, prospectively, whether PN localisation is a relevant measure to predict embryo development when added into further algorithms and whether this parameter could be suitable for use in other IVF clinics. Further studies are needed, notably to explore the added value of timing evaluation in cohorts of embryos with low or intermediate morphology grade, as well as in other maternal populations (i.e. older women). STUDY FUNDING/COMPETING INTEREST(S): No external funding was used for this study. P. Sagot received funding from the following commercial companies: Merck Serono, Finox Biotech, Ferring, MSD France SAS, Teva Sante ́ SAS, Allergan France, Gedeon Richter France, Effik S.A., Karl Storz Endoscopie France, GE Medical Systems SCS, Laboratoires Genevrier, H.A.C. Pharma and Ipsen.All the authors confirm that none of this funding was used to support the research in this study. There are no patents, products in development or marketed products to declare. This does not alter the authors' adherence to all the journal policies on sharing data and materials.


Asunto(s)
Blastocisto/fisiología , Técnicas de Cultivo de Embriones , Transferencia de Embrión/métodos , Desarrollo Embrionario/fisiología , Nacimiento Vivo , Adulto , Biomarcadores , Femenino , Fertilización In Vitro , Humanos , Embarazo , Índice de Embarazo , Estudios Retrospectivos , Imagen de Lapso de Tiempo
9.
Epidemiol Infect ; 146(5): 600-605, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-29458448

RESUMEN

This study evaluated the impact of maternal vaccination against rubella on the levels of specific rubella IgG (rIgG) in 198 newborn cord sera samples. Detailed maternal vaccination data were available. Specific rIgG was measured using a commercial enzyme immunoassay. Most mothers (78.8%) had been vaccinated against rubella at least once in their lives. In 15 (7.6%) cord sera samples, the concentration of specific rIgG was below 11 IU/ml, which was classified as seronegative. Statistical analysis using multiple logistic regression (n = 198) showed that newborns of mothers born between 1986 and 1995, and those born to unvaccinated mothers, were more likely to be seronegative (odds ratio (ORs) 5.2 and 4.9, respectively, adjusted for sex and gestational age). For vaccinated mothers (n = 156), those born between 1986 and 1995 were more likely to have seronegative newborns (OR 11.5 adjusting for sex, gestational age and time since last vaccination). Mothers of the 15 (7.6%) seronegative newborns might have been susceptible to rubella during pregnancy. Checking the vaccination status therefore recommended.


Asunto(s)
Anticuerpos Antivirales/sangre , Sangre Fetal/química , Inmunoglobulina G/sangre , Vacuna contra la Rubéola/inmunología , Rubéola (Sarampión Alemán)/inmunología , Rubéola (Sarampión Alemán)/prevención & control , Vacunación/estadística & datos numéricos , Adolescente , Adulto , Factores de Edad , Femenino , Humanos , Técnicas para Inmunoenzimas , Masculino , Edad Materna , Persona de Mediana Edad , Madres/estadística & datos numéricos , Portugal , Rubéola (Sarampión Alemán)/virología , Adulto Joven
10.
Epidemiol Infect ; 146(14): 1763-1770, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-29991361

RESUMEN

The goal of this study was to analyse the spatial pattern of tuberculosis (TB) mortality using different approaches, namely: mortality rates (MR), spatial relative risks (RR) and Bayesian rates (Global and Local) and their association with human development index (HDI), Global and its three dimensions: education, longevity and income. An ecological study was developed in Curitiba, Brazil based on data from Mortality Information System (2008-2014). Spatial scan statistics were used to compute RR and identify high-risk clusters. Bivariate Local Indicator of Spatial Associations was used to assess associations. MR ranged between 0 and 25.24/100.000 with a mean (standard deviation) of 1.07 (2.66). Corresponding values for spatial RR were 0-27.46, 1.2 (2.99) and for Bayesian rates (Global and Local) were 0.49-1.66, 0.90 (0.19) and 0-6.59, 0.98 (0.80). High-risk clusters were identified for all variables, except for HDI-income and Global Bayesian rate. Significant negative spatial relations were found between MR and income; between RR and HDI global, longevity and income; and Bayesian rates with all variables. Some areas presented different patterns: low social development/low risk and high risk/high development. These results demonstrate that social development variables should be considered, in mortality due TB.


Asunto(s)
Crecimiento , Factores de Riesgo , Factores Socioeconómicos , Tuberculosis/mortalidad , Teorema de Bayes , Brasil/epidemiología , Humanos , Riesgo , Análisis Espacial
11.
Epidemiol Infect ; 146(3): 401-406, 2018 02.
Artículo en Inglés | MEDLINE | ID: mdl-29345601

RESUMEN

Although a national programme for control of visceral leishmaniosis (VL) is being run in Brazil, the disease continues to spread. This programme is essentially based on culling infected dogs from endemic regions. Thus, there is an urgent need to develop other control measures against VL to deter its advance. Here, a subunit vaccine, a recombinant vaccine, an insecticide-impregnated collar and the associations between these measures were evaluated for reducing the incidence of Leishmania infection in dogs. This was through a cohort study conducted in an endemic region of Brazil, considering the incidence and time of total exposure over a period of 1 year. The incidence of VL was estimated by means of serological and molecular diagnostic tests, 180 and 360 days after the application of the control measures. The estimates of the effectiveness (EF) were not significant in any cohort. The EF of the subunit vaccine, the recombinant vaccine and the collar were 26.4%, 32.8% and 57.7% and the upper limit of the 95% confidence interval for EF were 63.7%, 67.9% and 82.5%, respectively. In conclusion, under the conditions of this study, none of the immunogens for VL control was sufficiently effective to protect dogs against infection. On the other hand, use of collars impregnated with insecticide seems to constitute a method with better prognosis, corroborating other studies in this field.


Asunto(s)
Enfermedades de los Perros/prevención & control , Insecticidas/uso terapéutico , Leishmaniasis Visceral/veterinaria , Vacunación/veterinaria , Vacunas/uso terapéutico , Animales , Brasil/epidemiología , Estudios de Cohortes , Enfermedades de los Perros/epidemiología , Perros , Incidencia , Leishmania infantum/fisiología , Leishmaniasis Visceral/epidemiología , Leishmaniasis Visceral/prevención & control
12.
J Periodontal Res ; 53(5): 924-931, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30043971

RESUMEN

BACKGROUND: The aim of the present study is to evaluate the effect of orthodontic forces in healthy or diseased periodontium of rats submitted/not submitted to cigarette smoke inhalation. MATERIAL AND METHODS: Fifty-six male Wistar rats were allocated into two groups of conditions: smoking and non-smoking. Each group was divided into the following subgroups: control (C), orthodontic tooth movement (OTM), ligature-induced periodontitis (P) and P+OTM (POTM), with n = 14 each. Periodontitis was induced in the lower first molar by cotton ligature, and a 4 mm closed stainless steel spring was used for orthodontic movement. Animals were exposed to the smoke of 10 cigarettes for 8 minutes, 3 times a day for 60 days before P induction and OTM. Evaluation parameters were macroscopic analysis of dental movement, bone loss and bone density. In addition, the receptor activator of nuclear factor-kappaB (RANK) immunostaining and RANK ligand/osteoprotegerin ratio in the furcation region were assessed. RESULTS: There was no statistically significant difference between groups, ie, smoking and non-smoking conditions (P = .338). Bone loss intragroup analysis between the P and POTM groups was not significant in smoking (P = 1) and non-smoking (P = .5) conditions; both were different from OTM and C in each condition. Regarding bone density, POTM and P were significant to C (P < .05). The POTM group was significant to the P and C (P = .001) regarding dental movement. The RANK ligand/osteoprotegerin ratio in the non-smoking condition was higher in P and POTM compared to C and OTM and to P and POTM in the smoking condition. RANK immunostaining was significant in the smoking condition for the P and POTM groups (P < .05). CONCLUSION: Within the limitations of the present study, it was concluded that cigarette smoke inhalation had no influence on the evaluated groups, even with the presence of low levels of nicotine, carbon monoxide and tar. The POTM groups did not present greater bone loss compared to P groups, thus periodontal disease is essential for bone loss.


Asunto(s)
Periodontitis/patología , Periodoncio/patología , Fumar/efectos adversos , Técnicas de Movimiento Dental , Animales , Biomarcadores/metabolismo , Inmunohistoquímica , Masculino , Ligando RANK/metabolismo , Ratas , Ratas Wistar , Receptor Activador del Factor Nuclear kappa-B/metabolismo
13.
Arch Womens Ment Health ; 21(4): 453-459, 2018 08.
Artículo en Inglés | MEDLINE | ID: mdl-29502281

RESUMEN

We have defined a psychological intervention based on cognitive narrative therapy and the Ottawa decision framework to reduce adjustment problems following a termination of pregnancy (TOP) after a positive prenatal diagnosis (PND). The intervention is composed of four sessions: decision, subjectivation, metaphorization, and projecting. This study aims to assess the effectiveness of a cognitive narrative intervention to prevent depression and anxiety symptoms after TOP. The intervention was accepted by 24 participants. The outcome is compared with a control group of 67 women who also terminated a pregnancy after PND. Participants were from several Portuguese institutions; 64.4% had a genetic and 35.6% had ultrasound diagnosis; the mean age was 30.0 years and the mean gestational age was 19 weeks. There are two evaluations: a baseline at the 15th day and a sixth month follow-up after TOP, using Beck Depression Inventory, Zung Anxiety Scale, Perinatal Grief Scale, and an instrument capturing participant satisfaction. Six months after TOP, there is a lower mean of anxiety and depression (p < 0.05), between groups, with effect sizes on the follow-up of 0.54 for depression, 0.41 for anxiety, and 0.23 for perinatal grief. This intervention has very positive effects on women mental health, and we emphasize the importance of the meaning-making process in the context of terminating a wanted pregnancy.


Asunto(s)
Aborto Eugénico/psicología , Ansiedad/prevención & control , Terapia Cognitivo-Conductual/métodos , Depresión/prevención & control , Terapia Narrativa/métodos , Diagnóstico Prenatal/psicología , Adulto , Femenino , Pesar , Humanos , Estudios Longitudinales , Portugal , Embarazo , Resultado del Tratamiento
14.
Parasite Immunol ; 39(11)2017 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-28929498

RESUMEN

Visceral leishmaniosis is a zoonotic disease that is transmitted by Lutzomyia longipalpis sandflies. Dogs are the main peri-urban reservoir of the disease, and progression of canine leishmaniosis is dependent on the type of immune response elaborated against the parasite. Type 1 immunity is characterized by effective cellular response, with production of pro-inflammatory cytokines such as tumour necrosis factor alpha (TNF-α). In contrast, Type 2 immunity is predominantly humoral, associated with progression of the disease and mediated by anti-inflammatory cytokines such as interleukin 10 (IL-10). Although seemly important in the dynamics of leishmaniosis, other gene products such as toll-like receptor 2 (TRL-2) and inducible nitric oxide synthase (iNOS) exert unclear roles in the determination of the type of immune response. Given that the dog skin serves as a micro-environment for the multiplication of Leishmania spp., we investigated the parasite load and the expression of TLR-2, iNOS, IL-10 and TNF-α in the skin of 29 infected and 8 control dogs. We found that increased parasite load leads to upregulation of TLR-2, IL-10 and TNF-α, indicating that abundance of these transcripts is associated with infection. We also performed a xenodiagnosis to demonstrate that increased parasitism is a risk factor for infectiousness to sandflies.


Asunto(s)
Enfermedades de los Perros/parasitología , Interleucina-10/biosíntesis , Leishmania infantum/inmunología , Leishmaniasis Visceral/veterinaria , Óxido Nítrico Sintasa de Tipo II/biosíntesis , Receptor Toll-Like 2/biosíntesis , Factor de Necrosis Tumoral alfa/biosíntesis , Animales , Reservorios de Enfermedades/parasitología , Enfermedades de los Perros/diagnóstico , Perros , Insectos Vectores/parasitología , Interleucina-10/inmunología , Leishmania infantum/patogenicidad , Leishmaniasis Visceral/parasitología , Óxido Nítrico Sintasa de Tipo II/inmunología , Carga de Parásitos , Psychodidae/parasitología , Piel/parasitología , Piel/patología , Receptor Toll-Like 2/inmunología , Factor de Necrosis Tumoral alfa/inmunología , Zoonosis
15.
Arch Virol ; 162(3): 857-861, 2017 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-27885560

RESUMEN

Here we determined the relative expression of HERV-K and W proviruses in HIV infected and non-infected mothers as well as their respective babies up to 1 year-old. HIV-infected mothers, their babies and uninfected control groups presented expression of both HERV-K and HERV-W with relatively high frequency. While the level of HERV-K expression was similar among groups, the level of HERV-W expression in HIV-infected mothers was four-fold higher than the uninfected mothers from the control group (p < 0.01). HERV-W was down regulated in HIV-exposed babies in comparison to non-exposed babies. To our knowledge, this is the first report of HERV transcriptional activity in babies from 0-1 year-old.


Asunto(s)
Retrovirus Endógenos/aislamiento & purificación , Infecciones por VIH/transmisión , Infecciones por VIH/virología , VIH-1/aislamiento & purificación , Enfermedades del Recién Nacido/virología , Adulto , Retrovirus Endógenos/clasificación , Retrovirus Endógenos/genética , Femenino , VIH-1/clasificación , VIH-1/genética , Humanos , Lactante , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa , Masculino , Transcripción Genética
16.
Epidemiol Infect ; 145(6): 1130-1134, 2017 04.
Artículo en Inglés | MEDLINE | ID: mdl-28091336

RESUMEN

The goals of this article are: (i) to understand how individual characteristics affect the likelihood of patients defaulting their pulmonary tuberculosis (PTB) treatment regimens; (ii) to quantify the predictive capacity of these risk factors; and (iii) to quantify and map spatial variation in the risk of defaulting. We used logistic regression models and generalized additive models with a spatial component to determine the odds of default across continental Portugal. We focused on new PTB cases, diagnosed between 2000 and 2013, and included some individual information (sex, age, residence area, alcohol abuse, intravenous drug use, homelessness, HIV, imprisonment status). We found that the global default rate was 4·88%, higher in individuals with well-known risk profiles (males, immigrants, HIV positive, homeless, prisoners, alcohol and drug users). Of specific epidemiological interest was that our geographical analysis found that Portugal's main urban areas (the two biggest cities) and one tourist region have higher default rates compared to the rest of the country, after adjusting for the previously mentioneded risk factors. The challenge of treatment defaulting, either due to other individual non-measured characteristics, healthcare system failure or patient recalcitrance requires further analysis in the spatio-temporal domain. Our findings suggest the presence of significant within-country variation in the risk of defaulting that cannot be explained by these classical individual risk factors alone. The methods we advocate are simple to implement and could easily be applied to other diseases.


Asunto(s)
Antituberculosos/uso terapéutico , Cumplimiento de la Medicación , Tuberculosis Pulmonar/tratamiento farmacológico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Portugal , Medición de Riesgo , Análisis Espacial , Adulto Joven
17.
Epidemiol Infect ; 145(12): 2436-2444, 2017 09.
Artículo en Inglés | MEDLINE | ID: mdl-28726597

RESUMEN

Euthanasia of infected dogs is one of the measures adopted in Brazil to control visceral leishmaniasis (VL) in endemic areas. To detect infected dogs, animals are screened with the rapid test DPP® Visceral Canine Leishmaniasis for detection of antibodies against K26/K39 fusion antigens of amastigotes (DPP). DPP-positives are confirmed with an immunoenzymatic assay probing soluble antigens of promastigotes (ELISA), while DPP-negatives are considered free of infection. Here, 975 dogs from an endemic region were surveyed by using DPP, ELISA and real-time PCR (qPCR) for the diagnosis of VL. When DPP-negative dogs were tested by qPCR applied in blood and lymph node aspirates, 174/887 (19·6%) were positive in at least one sample. In a second sampling using 115 cases, the DPP-negative dogs were tested by qPCR in blood, lymph node and conjunctival swab samples, and 36/79 (45·6%) were positive in at least one sample. Low-to-moderate pairwise agreement was observed between all possible pair of tests. In conclusion, the official diagnosis of VL in dogs in Brazilian endemic areas failed to accuse an expressive number of infected animals and the impact of the low accuracy of serological tests in the success of euthanasia-based measure for VL control need to be assessed.


Asunto(s)
Enfermedades de los Perros/diagnóstico , Enfermedades de los Perros/epidemiología , Leishmania infantum/aislamiento & purificación , Leishmaniasis Visceral/veterinaria , Reacción en Cadena en Tiempo Real de la Polimerasa/veterinaria , Pruebas Serológicas/veterinaria , Animales , Brasil/epidemiología , Conjuntiva/parasitología , Enfermedades de los Perros/sangre , Perros , Ensayo de Inmunoadsorción Enzimática/veterinaria , Leishmaniasis Visceral/sangre , Leishmaniasis Visceral/diagnóstico , Leishmaniasis Visceral/epidemiología , Ganglios Linfáticos/parasitología , Sensibilidad y Especificidad , Estudios Seroepidemiológicos
18.
Genet Mol Res ; 16(1)2017 Mar 22.
Artículo en Inglés | MEDLINE | ID: mdl-28340263

RESUMEN

Myrciaria dubia (camu-camu) is an Amazon tree that produces a tart fruit with high vitamin C content. It is probably the fruit with the highest vitamin C content among all Brazilian fruit crops and it can be used to supplement daily vitamin C dose. This property has attracted the attention of consumers and, consequently, encouraged fruit farmers to produce it. In order to identify and select potential accessions for commercial exploitation and breeding programs, M. dubia has received considerable research attention. The identification and characterization of genetic diversity, as well as identification of the population structure of accessions preserved in germplasm banks are fundamental for the success of any breeding program. The objective of this study was to evaluate the genetic variability of 10 M. dubia populations obtained from the shores of Reis Lake, located in the municipality of Caracaraí, Roraima, Brazil. Fourteen polymorphic inter simple sequence repeat (ISSR) markers were used to study the population genetic diversity, which resulted in 108 identified alleles. Among the 14 primers, GCV, UBC810, and UBC827 produced the highest number of alleles. The study illustrated the suitability and efficiency of ISSR markers to study the genetic diversity of M. dubia accessions. We also revealed the existence of high genetic variability among both accessions and populations that can be exploited in future breeding programs and conservation activities of this species.


Asunto(s)
Myrtaceae/genética , Árboles/genética , Alelos , Brasil , Frutas/química , Frutas/genética , Frutas/metabolismo , Marcadores Genéticos/genética , Variación Genética , Repeticiones de Microsatélite , Myrtaceae/crecimiento & desarrollo , Myrtaceae/metabolismo , Filogenia , Fitomejoramiento/métodos , Polimorfismo Genético , Árboles/crecimiento & desarrollo , Árboles/metabolismo , Vitamina A/biosíntesis
19.
Soft Matter ; 12(7): 2118-26, 2016 Feb 21.
Artículo en Inglés | MEDLINE | ID: mdl-26745787

RESUMEN

Resveratrol is a natural active compound which has been attracting increasing interest due to its several pharmacological effects in cancer prevention, cardiovascular protection and treatment of neurodegenerative disorders and diabetes. The current work investigates how resveratrol affects membrane order and structure, gathering information determined by X-ray scattering analysis, derivative spectrophotometry, fluorescence quenching and fluorescence anisotropy studies. The results indicate that resveratrol is able to be incorporated into DMPC liposome model systems, either fluidizing or stiffening the bilayer, which largely depends on the membrane fluidity state. These findings suggest that the effects of resveratrol resemble cholesterol action on biological membranes, thereby contributing to the regulation of cell membrane structure and fluidity, which may influence the activity of transmembrane proteins and hence control the cell signaling pathways. The regulation of a number of cellular functions, thus may contribute to the pharmacological and therapeutic activities of this compound, explaining its pleiotropic action.


Asunto(s)
Colesterol/química , Membrana Dobles de Lípidos/química , Liposomas/química , Estilbenos/farmacología , Transporte Biológico , Cinética , Fluidez de la Membrana/efectos de los fármacos , Resveratrol , Estilbenos/química , Termodinámica
20.
Epidemiol Infect ; 144(15): 3139-3147, 2016 11.
Artículo en Inglés | MEDLINE | ID: mdl-27488930

RESUMEN

In Portugal, the recommended age for the second dose of MMR (MMR2) was changed from 10-13 years to 5-6 years for those born in 1994 and afterwards. This study aimed to assess if MMR schedule and time elapsed from the last dose are associated with the concentration of rubella and mumps IgG antibodies. Three Portuguese birth cohorts (convenience samples) were selected for this study (66, 59 and 41 participants born respectively in 1990-1993, 1994-1995 and 2001-2003). Geometric mean concentrations (GMC) for mumps IgG were respectively 36, 30 and 38 RU/ml (P = 0·236) and for rubella IgG were 18, 20 and 17 IU/ml (P = 0·641). For both specific antibodies, no differences were observed with time since MMR2. Receiving MMR2 at 5-6 or 10-13 years was not associated with concentration of both antibodies. The GMC of rubella IgG was lower in males (P = 0·029). Taking into account previous evidence and the logistics needed to change vaccination schedules, it seems reasonable that sustaining very high coverage with two doses of MMR is currently the most pragmatic way to control mumps and rubella rather than any changes to the schedule.


Asunto(s)
Esquemas de Inmunización , Inmunogenicidad Vacunal , Vacuna contra el Sarampión-Parotiditis-Rubéola/administración & dosificación , Virus de la Parotiditis/inmunología , Virus de la Rubéola/inmunología , Adolescente , Anticuerpos Antivirales/sangre , Niño , Preescolar , Estudios de Cohortes , Humanos , Paperas/prevención & control , Paperas/virología , Portugal , Rubéola (Sarampión Alemán)/prevención & control , Rubéola (Sarampión Alemán)/virología
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