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1.
Phys Rev E ; 107(5-1): 054201, 2023 May.
Article in English | MEDLINE | ID: mdl-37329106

ABSTRACT

We study conditions leading to collapse on a nonequilibrium toy model introduced here for the interaction dynamics between a social and an ecological system based on the concept of essentiality of services and goods. One key difference from previous models is the separation between purely environmental collapse and that caused by an imbalance in the population consumption of essential goods. By studying different regimes defined by phenomenological parameters, we identify sustainable and unsustainable phases as well as the likelihood of collapse. The behavior of the stochastic version of the model is analyzed with a combination of analytical and computational techniques introduced here and shown to be consistent with key features of such processes in real life.

2.
Public Health ; 205: 14-25, 2022 Apr.
Article in English | MEDLINE | ID: mdl-35219838

ABSTRACT

OBJECTIVES: We aimed to review the literature regarding the use of machine learning to predict chronic diseases. STUDY DESIGN: This was a systematic review. METHODS: The searches included five databases. We included studies that evaluated the prediction of chronic diseases using machine learning models and reported the area under the receiver operating characteristic curve values. The Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis scale was used to assess the quality of studies. RESULTS: In total, 42 studies were selected. The best reported area under the receiver operating characteristic curve value was 1, whereas the worst was 0.74. K-nearest neighbors, Naive Bayes, deep neural networks, and random forest were the machine learning models most frequently used for achieving the best performance. CONCLUSION: We found that machine learning can predict the occurrence of individual chronic diseases, progression, and their determinants and in many contexts. The findings are original and relevant to improve clinical decisions and the organization of health care facilities.


Subject(s)
Machine Learning , Bayes Theorem , Chronic Disease , Humans , Prognosis , ROC Curve
3.
Ecotoxicology ; 30(9): 1841-1853, 2021 Nov.
Article in English | MEDLINE | ID: mdl-34224071

ABSTRACT

Pharmaceutical drugs have emerged as major micropollutants in aquatic ecosystems. Their presence has been systematically reported in monitoring surveys, and their wide distribution and constant presence in the wild is a direct consequence of their massive use, in both human and veterinary therapeutics. Drugs used to treat parasitic infections in livestock are major contaminants, given the amounts in which they are administered, and reach the aquatic compartment in high amounts, where they may affect non target species. Some of these drugs are prone to find their final deposit in sediments of estuarine areas, exerting their toxic effects preferentially at these locations. Sediment dwelling organisms of coastal areas, such as polychaetas, are especially prone to have their major physiological functions compromised after being exposed to pharmaceutical drugs. Ivermectin is one of the most used antiparasitic drugs, and its effects are not limited to biochemical traits, but also behavioral features may be compromised considering their neurotoxic actions. Despite these putative effects, little is known about their toxicity on polychaetas. The present study aimed to characterize the toxicity of realistic levels of ivermectin on the polychaeta Hediste diversicolor, in biochemical and behavioral terms. The obtained results showed that low levels of ivermectin are capable of causing significant disturbances in mobility and burrowing activity of exposed worms, as well as alterations of metabolic and anti-oxidant defense efficacy of exposed animals, suggesting that its environmental presence may mean a major environmental concern.


Subject(s)
Polychaeta , Water Pollutants, Chemical , Animals , Antiparasitic Agents/toxicity , Ecosystem , Humans , Ivermectin/toxicity , Oxidative Stress , Water Pollutants, Chemical/toxicity
4.
J Hosp Infect ; 112: 1-5, 2021 Jun.
Article in English | MEDLINE | ID: mdl-33757810

ABSTRACT

This article presents the incidence of hospital-acquired pneumonia (HAP) in Portugal during a four-year period (2014-2017). Data were retrieved from the 100 Portuguese hospital diagnosis discharge database for adult patients and included gender, age, chronic comorbidities, mortality and hospital length of stay. There were 28,632 episodes of HAP, an incidence of 0.95 per 100 admissions. HAP patients had both a prolonged hospital length of stay (mean 26.4 days) and high mortality (33.6%). Most episodes occurred in patients aged ≥65 years and in males (76.1% and 61.7%, respectively). Invasive ventilation was required in 18.8%.


Subject(s)
Hospitals , Pneumonia , Adult , Humans , Incidence , Male , Pneumonia/epidemiology , Portugal/epidemiology
5.
Environ Toxicol Pharmacol ; 81: 103522, 2021 Jan.
Article in English | MEDLINE | ID: mdl-33144098

ABSTRACT

Due to their wide use, pharmaceuticals can be discarded, metabolized and excreted into the environment, potentially affecting aquatic organisms. Lipid-regulating drugs are among the most prescribed medications around the world, to control human cholesterol levels, in more than 20 million patients. Despite this massive use of lipid-regulating drugs, particularly simvastatin, the role of these drugs is not fully characterized and understood in terms of its potential toxicological effects at the environmental level. This work intended to characterize the toxicity of an acute (120 h post-fertilization) and chronic (60 days) exposure to the antihyperlipidemic drug simvastatin (in concentrations of 92.45, 184.9, 369.8, 739.6 and 1479.2 ng L-1), in the freshwater species zebrafish (Danio rerio). The concentrations hereby mentioned were implemented in both exposures, and were based on levels found in wastewater treatment plant influents (11.7 ± 3.2 µg L-1), effluents (2.65 ± 0.8 µg L-1) and Apies River (1.585 ± 0.3 µg L-1), located in Pretoria, South Africa and, particularly in the maximum levels found in effluents from wastewater treatment plants in Portugal (369.8 ng L-1). The acute effects were analysed focusing on behavioural endpoints (erratic and purposeful swimming), total distance travelled and swimming time), biomarkers of oxidative stress (the activities of the enzymes superoxide dismutase, catalase, glutathione peroxidase), biotransformation (the activity of glutathione S-transferases) and lipid peroxidation (levels of thiobarbituric acid reactive substances). Animals chronically exposed were also histologically analysed for sex determination and gonadal developmental stages identification. In terms of acute exposure, significant alterations were reported in terms of behavioural alterations (hyperactivity), followed by a general reduction in all tested biomarkers. Also, the analysis of chronically exposed fish evidenced no alterations in sex ratio and maturation stages. In addition, the analysis of chronically exposed fish evidenced no alterations in terms of sexual characteristics, suggesting that the chronic exposure of Danio rerio to simvastatin does not alter the sex ratio and maturation stages of individuals. This assumption suggests that simvastatin did not act as an endocrine disruptor. Moreover, the metabolism, neuronal interactions and the antioxidant properties of SIM seem to have modulated the hereby-mentioned results of toxicity. Results from this assay allow inferring that simvastatin can have an ecologically relevant impact in living organisms.


Subject(s)
Simvastatin/toxicity , Water Pollutants, Chemical/toxicity , Animals , Behavior, Animal/drug effects , Embryo, Nonmammalian , Embryonic Development , Female , Male , Oocytes/drug effects , Oocytes/growth & development , Oxidative Stress/drug effects , Sex Ratio , Spermatogenesis/drug effects , Swimming , Zebrafish
6.
Environ Pollut ; 265(Pt B): 114993, 2020 Oct.
Article in English | MEDLINE | ID: mdl-32806449

ABSTRACT

Among the most used non-steroidal anti-inflammatory drugs (NSAIDs), ketoprofen (KTF) assumes an important position. Nevertheless, its ecotoxicological effects in non-target organisms are poorly characterized, despite its use and frequency of occurrence in aquatic matrices. Thus, the aim of this study was to evaluate the possible toxicological effects of KTF contamination, in two freshwater species, Lemna minor and Daphnia magna, by measuring biochemical, physiological and population parameters. To attain this objective, both species were exposed to KTF at the same concentrations (0, 0.24, 1.2, 6 and 30 µg/L). L. minor plants were exposed during 4 d to these levels of KTF, and the enzymatic activity (catalase (CAT), glutathione S-transferases (GSTs) and carbonic anhydrase (CA)), and pigments content (chlorophylls a, b and total and carotenoids) were analyzed to evaluate the toxicity of this drug. D. magna was acutely and chronically exposed to KTF, and enzymatic activities (CAT, GSTs and cyclooxygenase (COX)), the feeding rates, and reproduction traits were assessed. In L.minor, KTF provoked alterations in all enzyme activities, however, it was not capable of causing any alteration in any pigment levels. On the other hand, KTF also provoked alterations in all enzymatic activities in D. magna, but did not affect feeding rates and life-history parameters. In conclusion, exposure to KTF, provoked biochemical alterations in both species. However, these alterations were not reflected into deleterious effects on physiological and populational traits of L. minor and D. magna.


Subject(s)
Araceae , Ketoprofen , Water Pollutants, Chemical , Animals , Daphnia , Fresh Water
7.
Environ Toxicol Pharmacol ; 80: 103468, 2020 Nov.
Article in English | MEDLINE | ID: mdl-32805388

ABSTRACT

Due to their widespread use, pharmaceuticals can be metabolized, excreted and ultimately discarded in the environment, thereby affecting aquatic organisms. Lipid-regulating drugs are among the most prescribed medications around the world, controlling human cholesterol levels, in more than 20 million patients. Despite this growing use of lipid-regulating drugs, particularly those whose active metabolite is clofibric acid, the potential toxicological effects of these pharmaceuticals in the environment is not fully characterized. This work intended to characterize the toxicity of an acute (120 hours post-fertilization) and chronic (60 days post-fertilization) exposures to clofibric acid in concentrations of 10.35, 20.7, 41.4, 82.8, and 165.6 µg L-1 in zebrafish (Danio rerio). The concentrations which were implemented in both exposures were based on predicted environmental concentrations for Portuguese surface waters. The acute effects were analysed focusing on behavioural endpoints (small and large distance travelled, swimming time and total distance travelled), biomarkers of oxidative stress (activity of the enzymes superoxide dismutase, Cu/Zn- and Mn SOD; catalase, CAT; glutathione peroxidase, Se- and total GPx), biotransformation (activity of glutathione S-transferases, GSTs) and lipid peroxidation (thiobarbituric acid reactive substances, TBARS). Chronically exposed individuals were also histologically analysed for sex determination and gonadal developmental stages. In terms of acute exposure, significant alterations were reported, in terms of behavioural alterations (hypoactivity), followed by an overall increase in all tested biomarkers. Chronically exposed organisms did not show alterations in terms of sex ratio and maturation stages, suggesting that clofibric acid did not act as an endocrine disruptor. Moreover, the metabolism of clofibric acid resulted in increased levels of both forms of SOD activity, especially for animals exposed to higher levels of this drug. An increase of CAT activity was observed in fish exposed to low levels, and a decrease in those exposed to higher amounts of clofibric acid. Both GPx forms had their activities increased. The enzyme of biotransformation GSTs were increased at low levels of clofibric acid but inhibited at higher amounts of this substance. Lipid peroxidation levels were also changed, with an induction of this parameter with increasing amounts of clofibric acid. Changes also occurred in behavioural endpoints and patterns for control organisms and for those exposed to clofibric acid were significantly distinct, for all types (light and darkness) of exposure, and for the two analysed endpoints (small and large distance). Results from this assay allow inferring that clofibric acid can have an ecologically relevant impact in living organisms exposed to this substance, with putative effects on the metabolism of individuals, affecting their behaviour and ultimately their survival.


Subject(s)
Clofibric Acid/toxicity , Hypolipidemic Agents/toxicity , Water Pollutants, Chemical/toxicity , Zebrafish/metabolism , Animals , Behavior, Animal/drug effects , Biotransformation , Catalase/metabolism , Female , Glutathione Peroxidase/metabolism , Glutathione Transferase/metabolism , Lipid Peroxidation/drug effects , Male , Oxidative Stress/drug effects , Superoxide Dismutase/metabolism , Thiobarbituric Acid Reactive Substances/metabolism
8.
Pulmonology ; 26(5): 264-267, 2020.
Article in English | MEDLINE | ID: mdl-32482604

ABSTRACT

INTRODUCTION: Hospitalizations due to community-acquired pneumonia (CAP) in mainland Portugal from 2000 to 2009 accounted for 3.7% of all hospital admissions in population with 18 or more years of age. There is no direct-cost data regarding these admissions. METHODS: In this observational descriptive study all adult hospitalizations associated with CAP diagnosis were retrospectively analyzed for the period between 2000 and 2009. Patients under 18 years old, those with pneumonia as secondary diagnosis, patients with tuberculous or obstructive pneumonia, and immunocompromised patients were excluded from the study. The direct cost of hospitalization was calculated according to the diagnosis-related groups (DRG), established for the respective year of hospitalization. RESULTS: There were 294,026 hospital admissions with an average annual direct cost of 80 million Euros, which almost doubled between 2000 and 2009. The average direct hospitalization costs per admission, including wards and Intensive Care Units (ICU), amounted to €2,707, with an increasing trend. The average hospitalization cost was €2,515 for admissions resulting in live discharge, and €3,457 for the deceased. CONCLUSION: The average direct cost of adult hospitalizations associated with CAP amounted to €2,707 in mainland Portugal from 2000 to 2009, showing an increase of 37.5% in hospitalization cost of living and deceased patients. The economic impact of CAP-related hospital admissions justifies the need for better implementation of preventive measures.


Subject(s)
Delivery of Health Care/economics , Hospitalization/economics , Intensive Care Units/economics , Pneumonia/economics , Aged , Aged, 80 and over , Community-Acquired Infections/epidemiology , Costs and Cost Analysis , Delivery of Health Care/organization & administration , Diagnosis-Related Groups/standards , Female , Hospitalization/statistics & numerical data , Humans , Male , Middle Aged , Patient Discharge/economics , Pneumonia/diagnosis , Portugal/epidemiology , Retrospective Studies
9.
Sci Total Environ ; 739: 139715, 2020 Oct 15.
Article in English | MEDLINE | ID: mdl-32534307

ABSTRACT

Salicylic acid (SA) is a pharmaceutical drug that may exert toxic effects by its own; however, simultaneous exposure of plants to SA and to other substances, often results in the significant changes in the patterns of toxic response/resistance to these other sources of chemical stress. Thus, the aim of this work was to investigate the capacity of SA of modulating Lemna minor responses co-exposed to the pharmaceutical drug, diclofenac - DCF. To attain this objective, L. minor was exposed for 7 days, to DCF alone, and to combinations of DCF with SA. After exposure, biochemical, physiological and population endpoints were analyzed as follows: catalase (CAT) and glutathione S-transferases (GSTs) activities, pigments content (chlorophyll a (Chl a), b (Chl b) and total (TChl), carotenoids (Car) and [Chl a]/[Chl b] and [TChl]/[Car] ratios), and growth specific rate, fresh weight and root length. Single exposures to DCF were capable of causing effects in all analyzed endpoints. However, co-exposure of DCF with SA partially reverted these effects. Finally, we may suggest that SA is capable to prevent the toxicity of DCF in macrophytes, by modulating the toxic response of exposed plants.


Subject(s)
Araceae , Water Pollutants, Chemical , Antioxidants , Chlorophyll , Chlorophyll A , Diclofenac , Salicylic Acid
10.
J Public Health (Oxf) ; 42(2): 395-402, 2020 05 26.
Article in English | MEDLINE | ID: mdl-32166309

ABSTRACT

BACKGROUND: Heatwaves can lead to increased mortality. In the Portuguese heat-health warning system (HHWS), ÍCARO, a daily report with heat-related mortality prediction is sent to heat-health action plan (HHAP) practitioners. HHAP practitioners assess risk and implement measures to prevent heatwave-related impact, but ÍCARO's use and understanding are unknown. We assessed ÍCARO's use and understanding by key HHAP practitioners. METHODS: We conducted semi-structured interviews with national/regional HHAP practitioners. Interviews were recorded, transcribed and analysed using thematic content analysis. To maximize credibility a validation process was implemented through researcher triangulation; a sample of 30 segments was recorded by independent researchers. RESULTS: We conducted six interviews with nine professionals (mean time 52 min) from five regions. We identified four categories: report's content and presentation, report's reception and communication, ÍCARO and risk assessment and other issues. Practitioners use ÍCARO and perceived it as relevant; they raised issues on its interpretation and felt these were not fully addressed, given researchers' use of statistical/epidemiological terms. We identified the need for improved communication and report's clarity. CONCLUSIONS: Our study stresses the need for collaboration between experts within HHWS/HHAP. Despite ÍCARO's understanding being challenging, practitioners consider it a relevant tool. Researchers should use less statistical language and clarify ÍCARO's interpretation. Practitioners' needs should be considered when developing/revising tools.


Subject(s)
Hot Temperature , Language , Communication , Health Planning , Humans , Portugal
11.
Environ Res ; 177: 108609, 2019 10.
Article in English | MEDLINE | ID: mdl-31376628

ABSTRACT

The global occurrence of pharmaceuticals in the aquatic environment has been considered a particularly concerning problem with unknown consequences. Non-steroidal anti-inflammatory drugs (NSAIDs) including diclofenac (DCF) and salicylic acid (SA), are among the most frequently prescribed drugs in the world, being consequently commonly found in the aquatic environment. Prolonged experiments (with duration of exposure that surpass those recommended by already established testing guidelines) are important to obtain ecologically relevant data to address the issue of NSAIDs ecotoxicity, because by being more realistically (namely in terms of levels and durations of exposure), such tests may indicate realistic challenges posed to aquatic organisms. Among the most common test species that are used for assessing environmental quality, plants play a leading role. Lemna species are among the most important plants used for ecotoxicity testing. Therefore, the aim of this study was to evaluate the temporal effect of a prolonged exposure of DCF and SA on Lemna minor. To attain this purpose, L. minor plants were chronically exposed to 0, 4, 20, and 100 µg/L of both pharmaceuticals, and samplings were performed at 6, 10 and 14 days of exposure. The analyzed endpoints were: levels of chlorophyll a, b and total, carotenoids; and enzymatic biomarkers, such as catalase, ascorbate peroxidase and glutathione-S-transferases. Diclofenac was responsible for alterations in all analyzed parameters in different intervals of exposure. Salicylic acid exposure was not capable of causing alterations on pigment contents of L. minor, however, enzymatic biomarkers were altered at all sampling intervals. Thus, it is possible to conclude that both pharmaceuticals can cause damage on the tested macrophyte species, biochemical parameters being more sensitive than physiological ones. Additional prolonged experiments are required to understand the chronic effects of different pharmaceuticals in the aquatic environment, especially in plants.


Subject(s)
Araceae/physiology , Diclofenac/toxicity , Salicylic Acid/toxicity , Water Pollutants, Chemical/toxicity , Chlorophyll A , Toxicity Tests
12.
BMC Cancer ; 19(1): 512, 2019 May 29.
Article in English | MEDLINE | ID: mdl-31142284

ABSTRACT

BACKGROUND: Cancer is a leading cause of morbidity and mortality in the world. In Portugal, colorectal cancer is one of the most incident cancers; thus, it is crucial to act to fight it. Knowledge of the geographical distribution of the incidence and mortality of colorectal cancer can facilitate the execution of these actions and make them more effective. METHODS: Our paper aims to describe and discuss the geographical patterns of colorectal cancer incidence and mortality in mainland Portugal municipalities (2007-2011). We used the Besag, York and Mollié (BYM) model to compute the relative risk (RR) and posterior probability (PP). We performed a cluster analysis with Global Moran's Index and Local Moran's Index (LISA). We ran a geographically weighted regression (GWR) to compare incidence and mortality patterns. RESULTS: Incidence and mortality have different distributions of RR values. The interval of RR concerning incidence was higher than the interval of RR concerning mortality. PP values reinforce the finding of higher heterogeneity of the incidence of colorectal cancer. The comparison of the cluster maps for incidence and mortality shows a few municipalities classified with the same cluster type in both maps. Additionally, the GWR results show that the percentage of RR mortality explained by RR incidence differs throughout mainland Portugal. From the comparison of our results with the prevalence of risk factors (at NUTS II level), the need to be aware of smoking habits, alcohol consumption and the unhealthy diet of the Portuguese population stands out. CONCLUSIONS: There are differences in the geographical distribution of the RR incidence and RR mortality of colorectal cancer in mainland Portugal municipalities. Likewise, it is relevant to highlight the cluster of two municipalities with high RR values concerning colorectal cancer's incidence and mortality. Future research is necessary to explain the geographical differences in the distribution of colorectal cancer in mainland Portugal municipalities. Based on our findings, it may be interesting to examine the influence of smoking, alcohol consumption, diet and screening on colorectal cancer in greater detail. Additionally, it may be relevant to develop an analysis focused on municipalities where the incidence values explain the mortality values poorly (or well).


Subject(s)
Colorectal Neoplasms/epidemiology , Cities/epidemiology , Cluster Analysis , Colorectal Neoplasms/mortality , Female , Humans , Incidence , Male , Portugal/epidemiology , Regression Analysis , Risk Factors
13.
Environ Toxicol Pharmacol ; 68: 27-36, 2019 May.
Article in English | MEDLINE | ID: mdl-30870693

ABSTRACT

Cerium dioxide nanoparticles (CeO2-NPs) have a variety of uses, especially in the production of solar panels, oxygen pumps, gas sensors, computer chips and catalytic converters. Despite their worldwide use, the few published studies demonstrate that metallic nanoparticles, in general, are still not properly characterized in terms of their potencial ecotoxicological effects. CeO2-NPs, in particular, have demonstrated extreme antioxidant activity, but their in vivo toxicity is still unknown. This work intended to characterize the chronic toxicity (28 days) of three different ecologically relevant concentrations (0.1, 0.01, and 0.001 µg/L) of CeO2-NPs in the rainbow trout (Oncorhynchus mykiss), in terms of biomarkers of oxidative stress [activity of the enzymes glutathione S-transferases (GSTs) and catalase (CAT)] and neurotoxicity [activity of the enzyme acetylcholinesterase (AChE)], as well as histological alterations in liver and gills. In the hereby study, GSTs activity was increased in gills of fish exposed to the highest CeO2-NPs level. Moreover, a potential anti-oxidant response was also reported, with a significant increase of CAT activity observed in livers of the same fish. AChE, however, was not significantly altered in fish eyes. Individuals exposed to CeO2-NPs also presented marked changes in the gills (e.g. epithelial lifting, intercellular edema, lamellar hypertrophy and hyperplasia, secondary lamella fusion and aneurysms) and liver (e.g. hepatocyte vacuolization, pyknotic nucleus, enlargement of sinusoids and hyperemia). The semi-quantitative analysis (organs pathological index) also showed the establishment of a dose-effect relationship. Further studies about the ecotoxicological effects of the CeO2-NPs have yet to be conducted, considering their properties, as the aggregation chemistry and the ratio of its redox state, which may affect their availability to the organism and their toxicity in the environment and biota.


Subject(s)
Cerium/toxicity , Metal Nanoparticles/toxicity , Water Pollutants, Chemical/toxicity , Acetylcholinesterase/metabolism , Animals , Catalase/metabolism , Gills/drug effects , Gills/metabolism , Liver/drug effects , Liver/metabolism , Liver/pathology , Neurotoxicity Syndromes , Oncorhynchus mykiss , Oxidative Stress/drug effects
14.
Sci Total Environ ; 657: 926-937, 2019 Mar 20.
Article in English | MEDLINE | ID: mdl-30677958

ABSTRACT

In the last years the environmental presence of pharmaceuticals has gained increasing attention. Research data show that these compounds can cause toxicological effects in different species of fish, mollusks and macroinvertebrates. However, the literature is scarce in terms of ecotoxicity data especially focusing on plants as test organisms. Ecotoxicological plant-based tests following the standard OEDC guideline 221 (OECD, 2006) are strongly restricted due to the recommended end-points: growth and yield of plants. It is necessary to develop and validate alternative macrophyte-based tests (non-standard endpoints), more sensible and providing additional information about the chemical contamination effects in plants. To attain this purpose, species from the Lemna genus were selected. Thus, the aim of this study was to analyze the toxic effects of pharmaceuticals in non-standard endpoints on two macrophyte species, Lemna minor and Lemna gibba. To this purpose an acute assay (96 h) was performed with L. minor and L. gibba exposed to chlorpromazine (CPZ), paracetamol (APAP), and diclofenac (DCF), in the following concentration ranges: 0 to 20 µg/L, 0 to 125 µg/L, and 0 to 100 µg/L, respectively. The analyzed endpoints were: levels of chlorophyll a and b, total chlorophyll, carotenoids, anthocyanins; chlorophyll fluorescence; and catalase activity. In general, higher concentrations of the tested pharmaceuticals caused significant effects on both Lemna species in terms of the different endpoints analyzed. In conclusion, acute exposures to CPZ, APAP, and DCF differently affected the defensive system of the tested species; among chlorophylls, chlorophyll b content was more affected, but pharmaceutical exposure was not able to cause alterations on chlorophyll fluorescence.


Subject(s)
Araceae/drug effects , Araceae/metabolism , Drug-Related Side Effects and Adverse Reactions , Water Pollutants, Chemical/toxicity , Acetaminophen/toxicity , Anthocyanins/metabolism , Aquatic Organisms/drug effects , Carotenoids/metabolism , Catalase/metabolism , Chlorophyll A/metabolism , Chlorpromazine/toxicity , Diclofenac/toxicity , Ecotoxicology/methods , Environmental Biomarkers/drug effects
15.
Pulmonology ; 25(2): 66-70, 2019.
Article in English | MEDLINE | ID: mdl-30026065

ABSTRACT

INTRODUCTION: Community-acquired pneumonia (CAP) remains a common and serious infection with wide variability in intra-hospital mortality. METHODS: We performed a retrospective analysis of adult patients admitted with CAP in mainland Portugal between the years 2000 and 2009. RESULTS: The intra-hospital mortality rate was 20.4% with deaths in all age groups. The average age of deceased patients was 79.8 years, significantly higher than surviving patients with 71.3 years. Patients aged 50 or more presented a relative risk of death 4.4 times the risk of patients under this age group. Likewise, in patients aged 65 or more the risk of death was 3.2 times the risk of patients <65 years. Men died more at a younger age than women, the men who died were, on average, 4 years younger than women, 78.1 vs 82.1 years old. Relative risk of death in men was 17% higher than women after adjustment for year of admission and age. CONCLUSION: CAP remains an important cause of hospital mortality in all age groups.


Subject(s)
Community-Acquired Infections/mortality , Hospital Mortality/trends , Pneumonia/mortality , Adolescent , Adult , Aged , Aged, 80 and over , Community-Acquired Infections/epidemiology , Female , Hospitalization/statistics & numerical data , Humans , Male , Middle Aged , Pneumonia/epidemiology , Portugal/epidemiology , Retrospective Studies , Risk , Young Adult
16.
Mar Environ Res ; 141: 233-246, 2018 Oct.
Article in English | MEDLINE | ID: mdl-30227982

ABSTRACT

Oxytetracycline (OTC) is an antibiotic widely used in human and veterinary medicines. Since the primary toxicity occurs mainly at molecular/biochemical levels, the study of different biological responses corresponds to a sensitive and crucial approach. The aim of the present study was to assess the toxic effects of OTC in gilthead seabream (Sparus aurata) through the use of multibiomarkers and elucidate about the possible toxicological mechanisms involved. S. aurata were acutely (96 h: 0.04-400 µg/L) and chronically (28 days: 0.0004-4 µg/L) exposed to OTC. Detoxification, antioxidant defense, lipid peroxidation, genotoxicity, neurotransmission and energy metabolism biomarkers were evaluated. OTC impaired the detoxification pathways and caused peroxidative damage and genotoxicity. The relevance of the here-obtained data is high, since significant effects were recorded for levels already reported to occur in the wild, meaning that environmentally-exposed marine organisms (including those cultured at fish farms) are not completely exempt of risks posed by OTC.


Subject(s)
Anti-Bacterial Agents , Ecotoxicology , Oxytetracycline , Sea Bream , Animals , Anti-Bacterial Agents/toxicity , Biomarkers/metabolism , Energy Metabolism , Humans , Lipid Peroxidation , Oxytetracycline/toxicity
17.
Ecotoxicol Environ Saf ; 164: 100-108, 2018 Nov 30.
Article in English | MEDLINE | ID: mdl-30098505

ABSTRACT

Oxytetracycline (OTC) is a tetracycline antibiotic, widely used in human and veterinary medicines, including in aquaculture. Given this use, OTC has been detected in different aquatic environments. Some recent works have demonstrated unintentional biological activity of OTC in non-target aquatic organisms. This study investigated the acute and chronic effects of OTC on the physiology of the fish species Oncorhynchus mykiss (rainbow trout), namely through the quantification of the activity of enzymes involved in different biochemical pathways, such as detoxification (phase II - glutathione S-transferases - GSTs, uridine-diphosphate-glucuronosyltransferases - UGTs), neurotransmission (acetylcholinesterase - AChE) and energy production (lactate dehydrogenase - LDH). The here-obtained data demonstrated the induction of GSTs activity in gills, and inhibition of AChE activity in eyes tissue, in chronically exposed organisms, as well as alterations in LDH activity following both exposures. Considering this set of results, we can infer that OTC exposure may have induced the glutathione pathway of detoxification in gills with the involvement of GSTs, or indirectly due to the metabolites that may have been produced. In turn, these metabolites may have interfered with the mechanism of neurotransmission, also causing physiological and biochemical disturbances in rainbow trout after OTC exposure, namely disturbances in energetic metabolism. In addition, it is important to stress that such occurrences took place at low, environmentally realistic levels of OTC, suggesting that organisms exposed in the wild may be putative targets of toxic effects by commonly used drugs such as antibiotics.


Subject(s)
Anti-Bacterial Agents/toxicity , Environmental Exposure/adverse effects , Oncorhynchus mykiss/metabolism , Oxytetracycline/toxicity , Synaptic Transmission/drug effects , Acetylcholinesterase/metabolism , Animals , Biomarkers , Gills/drug effects , Gills/metabolism , Glucuronosyltransferase/metabolism , Glutathione/metabolism , Glutathione Transferase/metabolism , L-Lactate Dehydrogenase/metabolism , Water Quality
18.
Water Sci Technol ; 2017(3): 835-844, 2018 Jul.
Article in English | MEDLINE | ID: mdl-30016301

ABSTRACT

Antibiotics (e.g. ciprofloxacin) have been detected in surface water and groundwater for several decades. In order to understand the potential impact of the continuous exposure of aquatic organisms to ciprofloxacin, a chronic assay was carried out with Daphnia magna. This approach allowed evaluation of the effects of ciprofloxacin on life-history and sub-individual parameters (antioxidant status and metabolic response: activities of catalase and glutathione S-transferases - GSTs; peroxidative damage; thiobarbituric acid reactive substances and genotoxic effects (genetic damage index, measured by the comet assay). Life-history parameters of D. magna showed no significant effects after ciprofloxacin exposure. Concerning oxidative stress and metabolism parameters, no significant alterations were reported for catalase and GSTs activities. However, a dual response was observed, with a significant decrease in lipid peroxidation levels at low ciprofloxacin concentrations (<0.013 mg/L), while a significant increase was verified at high ciprofloxacin concentrations (0.078 mg/L). The genotoxicity assay detected a significant increase in genetic damage index up to 0.013 mg/L of ciprofloxacin. The here-tested ciprofloxacin concentrations, which are ecologically relevant, did not cause significant impacts concerning the life-history parameters of D. magna; however, at the same levels of ciprofloxacin an oxidative stress and genotoxic damage scenarios were recorded.


Subject(s)
Ciprofloxacin/toxicity , Daphnia/drug effects , Water Pollutants, Chemical/toxicity , Animals , Anti-Bacterial Agents/chemistry , Anti-Bacterial Agents/toxicity , Antioxidants , Catalase , Ciprofloxacin/chemistry , Comet Assay , DNA Damage , Daphnia/genetics , Glutathione Transferase , Lipid Peroxidation , Mutation , Oxidative Stress , Water Pollutants, Chemical/chemistry
20.
Arch Environ Contam Toxicol ; 74(4): 616-626, 2018 May.
Article in English | MEDLINE | ID: mdl-29368034

ABSTRACT

The assessment of transgenerational effects should be incorporated in standard chronic toxicity protocols for the sake of a realistic extrapolation of contaminant effects to the population level. We propose a simple add-on to the standard 21-day chronic Daphnia magna assay, allowing the assessment of the reproductive performance of the offspring (F1 generation) born from the first clutch of the parental (F0) generation. The extended generational assay was performed simultaneously with the standard reproduction assay. With this design, we evaluated the lethal, reproductive, and transgenerational effects of four widespread and extensively used substances: a biocide/anti-fouling (copper sulphate), an industrial oxidizing agent (potassium dichromate), a pharmaceutical (paracetamol), and a quaternary ammonium compound (benzalkonium chloride). Benzalkonium chloride was the most toxic in terms of lethality, whereas paracetamol, copper sulphate, and potassium dichromate caused deleterious effects in the reproductive performance of exposed D. magna. Adverse effects in the fitness of the daughter (F1) generation were observed in the case of maternal exposure to paracetamol and copper sulphate, although they were not very pronounced. These findings highlight the usefulness of our approach and reinforce the view-shared by other authors-of the need for a generalised formal assessment of the transgenerational effects of pollutants.


Subject(s)
Daphnia/drug effects , Ecotoxicology/methods , Water Pollutants, Chemical/toxicity , Acetaminophen/toxicity , Animals , Benzalkonium Compounds/toxicity , Copper Sulfate/toxicity , Daphnia/physiology , Female , Male , Maternal Exposure , Potassium Dichromate/toxicity , Reproduction/drug effects , Toxicity Tests, Chronic/methods
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