National Institute of Health Dr. Ricardo Jorge
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Vector-borne diseases in Portugal
Get PDFAs doenças transmitidas por vectores (DTV) representam
uma ameaça global significativa. Segundo a Organização
Mundial de Saúde, as DTV representam 17% de todas as
doenças infeciosas, causando mais de 700 000 mortes por
ano em todo o Mundo.
Enquanto que nos trópicos e subtrópicos os mosquitos
encontram-se entre os vectores responsáveis por patologias
com milhares de casos de infeção por ano, como por exemplo
a malária, febre amarela, dengue entre outras, na Europa são
os ixodídeos os vetores que apresentam maior relevo.
Na Europa, a DTV mais prevalente é a Encefalite Transmitida
por Carraças (na sigla em inglês TBE, Tick-borne Encephalitis).
O vírus da TBE é um flavivírus transmitido por carraças
do género Ixodes, sobretudo Ixodes ricinus, e provoca
anualmente cerca de 3000 infecções confirmadas.
Em Portugal, apesar do vector estar presente, nunca foram
notificados casos autóctones de TBE nem identificadas
carraças positivas para este vírus em pesquisas sistemáticas
realizadas desde 1987 pelo Instituto Nacional de Saúde
Doutor Ricardo Jorge. [...]info:eu-repo/semantics/publishedVersio
Vigilância Laboratorial da Tuberculose em Portugal: relatório 2023
Get PDFPor ocasião do Dia Mundial da Tuberculose que se celebra a 24 março, este ano dedicado ao tema "Sim! Nós podemos acabar com a TB!”, o Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA) disponibiliza o relatório de Vigilância Laboratorial da Tuberculose em Portugal referente ao ano de 2023, elaborado pelo Laboratório Nacional de Referência de Micobactérias do seu Departamento de Doenças Infeciosas.
Em 2019, e com a disseminação dos métodos de sequenciação genómica de nova geração, o Laboratório de Tuberculose e Micobactérias (atualmente, Laboratório Nacional de Referência de Micobactérias, LNR-TB), implementou metodologias baseadas em sequenciação do genoma total (WGS, whole genome sequencing) para efetuar, de forma sistemática e rotineira, a previsão de resistências e vigilância molecular dos casos de Tuberculose multirresistente (TB-RR/MR) em articulação com as Autoridades de Saúde.
Em 2023, o LNR-TB publicou o seu primeiro relatório de vigilância molecular, que incluiu dados retrospetivos de 2020-2022, com informações genómicas das estirpes de MTC (complexo Mycobacterium tuberculosis) em circulação em Portugal, não só dos casos resistentes como também dos casos sensíveis.
O presente relatório referente ao ano de 2023 pretende dar continuidade a este sistema de vigilância mais abrangente e robusto, fazendo a análise de possíveis relações filogenéticas de todas as estirpes de MTC isoladas no LNR-TB desde 2020, num contexto de confirmação diagnóstica inicial do caso de TB, enquadrando-as nas análises moleculares das estirpes que já se encontravam em vigilância desde 2013 (isto é, casos de TB- MR ou suspeitas de surtos). Do relatório apresentado, destacam-se os seguintes resultados:
- A confirmação bacteriológica da TB é essencial para a monitorização da doença e para o conhecimento do perfil de suscetibilidade aos antimicrobianos, pelo que devem ser sempre solicitadas análises laboratoriais auxiliares ao diagnóstico.
- Embora entre 2013 e 2022 se tenha assistido a uma tendência decrescente no número de casos de TB-RR/MR, com uma redução média de 2%/ano, em 2023 foram diagnosticados 20 novos casos de TB-RR/MR, correspondendo a um aumento de 50% relativamente a 2022.
- No global, a maioria dos casos de TB-RR/MR continua a ocorrer na região de Lisboa e Vale do Tejo, seguido da região Norte, e com uma tendência crescente na região do Algarve que importa vigiar.info:eu-repo/semantics/publishedVersio
Reporting monitoring data to EFSA. Reports, business rules and corrective actions - 2024
No full textAcesso restrito.Trabalho que decorre do que tem vindo a ser desenvolvido nos últimos anos com a EFSA em matéria de harmonização, recolha e reporte de dados, nomeadamente, e em particular, com a implementação do projeto ID RISK - A importância da harmonização do sistema de recolha de dados de controlos oficiais na Defesa do Consumidor. O projeto ID RISK é um projeto financiado pela EFSA, que envolve 3 instituições de 2 Estados-membros da União Europeia (UE): ASAE e Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA) de Portugal e Croatian Agency for Agriculture and Food (HAPIH) da Croácia. O ID RISK através da partilha de conhecimentos entre Portugal (ASAE e INSA) e Croácia (CSH), tem como objetivo reforçar a capacidade de recolha, gestão e transmissão de dados dos controlos oficiais, para produzir repositórios de informação com robustez e qualidade, para realizar estudos de avaliação de risco e de investigação científica.Reporting Monitoring Data EFSA Reporting Tools Business Rules Corrective Actions EFSA Europe Segurança alimentar alimentar Contaminantes Aditivo
Temperature frequency and mortality: Assessing adaptation to local temperature
No full textAssessing the association between temperature frequency and mortality can provide insights into human adaptation to local ambient temperatures. We collected daily time-series data on mortality and temperature from 757 locations in 47 countries/regions during 1979–2020. We used a two-stage time series design to assess the association between temperature frequency and all-cause mortality. The results were pooled at the national, regional, and global levels. We observed a consistent decrease in the risk of mortality as the normalized frequency of temperature increases across the globe. The average increase in mortality risk comparing the 10th to 100th percentile of normalized frequency was 13.03% (95% CI: 12.17–13.91), with substantial regional differences (from 4.56% in Australia and New Zealand to 33.06% in South Europe). The highest increase in mortality was observed for high-income countries (13.58%, 95% CI: 12.56–14.61), followed by lower-middle-income countries (12.34%, 95% CI: 9.27–15.51). This study observed a declining risk of mortality associated with higher temperature frequency. Our findings suggest that populations can adapt to their local climate with frequent exposure, with the adapting ability varying geographically due to differences in climatic and socioeconomic characteristics.This study was supported by the Australian Research Council (DP210102076) and the Australian National Health and Medical Research Council (GNT2000581). YW and BW were supported by China Scholarship Council [grant numbers 202006010044 and 202006010043]. AU was supported by the Czech Science Foundation (project number 22-24920S); PHNS by the São Paulo Research Foundation (FAPESP); ST by the Science and Technology Commission of Shanghai Municipality (grant number 18411951600); AG and FS by the Medical Research Council UK (grant ID MR/R013349/1), the Natural Environment Research Council UK (grant ID NE/R009384/1), and the EU’s Horizon 2020 project, Exhaustion (grant ID 820655); FdD by the EU’s Horizon 2020 project, Exhaustion (grant ID 820655). SL was supported by an Emerging Leader Fellowship of the Australian National Health and Medical Research Council (GNT2009866). YG was supported by the Career Development Fellowship (GNT1163693) and Leader Fellowship (GNT2008813) of the Australian National Health and Medical Research Council
Analysis of Genes Involved in Oxidative Stress and Iron Metabolism in Heart Failure: A Step Forward in Risk Stratification
No full textFree Full text ate PubMed Central: https://pmc.ncbi.nlm.nih.gov/articles/PMC11186693/Introduction: Heart failure (HF) is a clinical syndrome characterized by cardinal symptoms that may be accompanied by signs. It results from structural and/or functional abnormalities of the heart leading to elevated intracardiac pressures and/or inadequate cardiac output at rest and/or during exercise. The prevalence of iron deficiency and anemia justifies the current guidelines recommendation of screening. Genes HP, ACE, MTHFR, HFE, and CYBA are involved in oxidative mechanisms, iron metabolism, and
hematologic homeostasis. This study investigates the contribution of variants Hp1/2 (HP), I/D (ACE), C677T (MTHFR), C282Y and H63D ( HFE), and C242T (CYBA) to the development of HF, either independently or in epistasis.
Methods: We used a database of 389 individuals, 143 HF patients, and 246 healthy controls. Genotypes were characterized through PAGE electrophoresis, PCR, PCR-RFLP, and multiplex-ARMS. Data analysis was performed with the SPSS® 26.0 software (IBM Corp., Armonk, NY).
Results: We observed a significant association between the MTHFR gene and HF predisposition. The presence of allele T and genotype CT constituted risk, while genotype CC granted protection. Epistatic interactions revealed risk between genotype II of the ACE gene and genotypes CC (C282Y) or HH (H63D) of the HFE gene. Risk was also observed for interactions between genotype CC (CYBA) and genotypes 2-2 (HP),
CT (MTHFR), or HH (HFE-H63D).
Conclusion: We concluded that genes HP, ACE, MTHFR, HFE, and CYBA contribute to the susceptibility for HF, individually or in epistasis. This study contributes to the clarification of the role that genes involved in oxidative mechanisms and iron metabolism play in the physiopathology of HF. It is, therefore, a step forward in risk stratification and personalized medicine.info:eu-repo/semantics/publishedVersio
Aeromonas spp. in Freshwater Bodies: Antimicrobial Resistance and Biofilm Assembly
No full text(This article belongs to the Section Antibiofilm Strategies)Aeromonas spp. are environmental bacteria able to infect animals and humans. Here, we aim to evaluate the role of biofilms in Aeromonas persistence in freshwater. Aeromonas were isolated from water and biofilm samples and identified by Vitek-MS and 16S rRNA sequencing. Antibiotic susceptibility profiles were determined according to EUCAST, and a crystal violet assay was used to assess biofilm assembly. MTT and the enumeration of colony-forming units were used to evaluate biofilm and planktonic Aeromonas susceptibility to chlorination, respectively. Identification at the species level was challenging, suggesting the need to improve the used methodologies. Five different Aeromonas species (A. salmonicida, A. hydrophila, A. media, A. popoffii and A. veronii) were identified from water, and one species was identified from biofilms (A. veronii). A. veronnii and A. salmonicida presented resistance to different antibiotics, whith the highest resistance rate observed for A. salmonicida (multiple antibiotic resistance index of 0.25). Of the 21 isolates, 11 were biofilm producers, and 10 of them were strong biofilm producers (SBPs). The SBPs presented increased tolerance to chlorine disinfection when compared with their planktonic counterparts. In order to elucidate the mechanisms underlying biofilm tolerance to chlorine and support the importance of preventing biofilm assembly in water reservoirs, further research is required.info:eu-repo/semantics/publishedVersio
Unveiling Antibiotic Resistance, Clonal Diversity, and Biofilm Formation in Isolated from Healthy Swine in Portugal
No full textEscherichia coli, a commensal microorganism found in the gastrointestinal tract of human and animal hosts, plays a central role in agriculture and public health. Global demand for animal products has promoted increased pig farming, leading to growing concerns about the prevalence of antibiotic-resistant E. coli strains in swine populations. It should be noted that a significant portion of antibiotics deployed in swine management belong to the critically important antibiotics (CIA) class, which should be reserved for human therapeutic applications. This study aimed to characterize the prevalence of antibiotic resistance, genetic diversity, virulence characteristics, and biofilm formation of E. coli strains in healthy pigs from various farms across central Portugal. Our study revealed high levels of antibiotic resistance, with resistance to tetracycline, ampicillin, tobramycin, and trimethoprim-sulfamethoxazole. Multidrug resistance is widespread, with some strains resistant to seven different antibiotics. The ampC gene, responsible for broad-spectrum resistance to cephalosporins and ampicillin, was widespread, as were genes associated with resistance to sulfonamide and beta-lactam antibiotics. The presence of high-risk clones, such as ST10, ST101, and ST48, are a concern due to their increased virulence and multidrug resistance profiles. Regarding biofilm formation, it was observed that biofilm-forming capacity varied significantly across different compartments within pig farming environments. In conclusion, our study highlights the urgent need for surveillance and implementation of antibiotic management measures in the swine sector. These measures are essential to protect public health, ensure animal welfare, and support the swine industry in the face of the growing global demand for animal products.This work was supported by the projects UIDB/CVT/00772/2020 and LA/P/0059/2020 funded by the Portuguese Foundation for Science and Technology (FCT). This work received support and help from FCT/MCTES (LA/P/0008/2020 DOI 10.54499/LA/P/0008/2020, UIDP/50006/2020 DOI 10.54499/UIDP/50006/2020 and UIDB/50006/2020 DOI 10.54499/UIDB/50006/2020). Adriana Silva is grateful to FCT (Fundação para a Ciência e a Tecnologia) for financial support through the PhD grant SFRH/ BD/04576/2020
Individual risk factors associated with SARS-CoV-2 infection during Alpha variant in high-income countries: a systematic review and meta-analysis
No full textObjectives: This study aimed to systematically appraise risk factors associated with SARS-CoV-2 infection in high-income countries during the period of predominance of the Alpha variant (January 2020 to April 2021).
Methods: Four electronic databases were used to search observational studies. Literature search, study screening, data extraction and quality assessment were conducted by two authors independently. Meta-analyses were conducted for each risk factor, when appropriate.
Results: From 12,094 studies, 27 were included. The larger sample size was 17,288,532 participants, more women were included, and the age range was 18-117 years old. Meta-analyses identified men [Odds Ratio (OR): 1.23, 95% Confidence Interval (CI): 1.97-1.42], non-white ethnicity (OR: 1.63, 95% CI: 1.39-1.91), household number (OR: 1.08, 95% CI: 1.06-1.10), diabetes (OR: 1.22, 95% CI: 1.08-1.37), cancer (OR: 0.82, 95% CI: 0.68-0.98), cardiovascular diseases (OR: 0.92, 95% CI: 0.84-1.00), asthma (OR: 0.83, 95% CI: 0.75-0.92) and ischemic heart disease (OR: 0.82, 95% CI: 0.74-0.91) as associated with SARS-CoV-2 infection.
Conclusion: This study indicated several risk factors for SARS-CoV-2 infection. Due to the heterogeneity of the studies included, more studies are needed to understand the factors that increase the risk for SARS-CoV-2 infection.This work was funded by the Foundation for Science and Technology (FCT) through a PhD research scholarship (2020.09525.BD) granted under the Call DOCTORATES 4 COVID-19; and FCT (reference: CEECINST/00049/2021/CP2817/CT0001 and DOI: 10.54499/CEECINST/00049/2021/CP2817/CT0001). This study is sponsored by Pfizer (grant code #68639655; URL: https://www.pfizer.pt/).info:eu-repo/semantics/publishedVersio
Potential human exposure and risks of incidental nanoparticles released during rotary dry cutting of ceramic tiles
No full textRotary dry cutting and rectifying of ceramic tiles are sources of fine particulate matter (PM2.5) and nanoparticles (NPs). These activities are typically carried out inside industrial facilities during the manufacturing process, as well as outdoors and in residential indoor spaces during the installation phase, where mitigation measures are seldom implemented. This work aimed to understand the particle formation and release mechanisms, as well as particle properties (physical, chemical, and toxicological) and potential impacts on human health and the environment, for particles generated during ceramic tile rotary dry cutting operations. Aerosols were characterised in terms of particle number and mass concentrations, chemical composition, morphology and in vitro cytotoxicity. Two types of commercially available and representative tiles were tested in controlled chamber experiments: porous and non-porous ceramic body tiles (referred to in this work as A and B types, respectively). Results evidenced the release of fine particles and NPs during dry cutting of both materials, in comparable concentrations (20.000–45.000/cm3, 1-min average). However, the particle size distribution was significantly finer from A tiles (70% of the particle number concentration was nanosized (0.6 μm), in the smaller size fractions (<0.6 μm) larger differences were observed. The chemical composition of airborne aerosols was consistent with that of the deposited dust. In vitro cytotoxicity responses evidenced statistically significant differences between exposure to aerosols from both types of tiles: cell viability was lower after exposure to aerosols from A tiles (50% at the original concentration) compared to those from B tiles, which exhibited high cell viability regardless of the aerosol concentration. Overall, results evidenced NP formation and release during rotary dry cutting of ceramic tiles, varying physical-chemical and cytotoxic profiles as a function of the material being processed, and highlight this activity as a potential health hazard in scenarios where prevention and mitigation measures are not implemented.Highlights: - Rotary dry cutting of ceramic tiles generates and releases fine and nanoparticles; - Nanoparticle number concentrations released were comparable for both tiles; - Particles showed significant differences in size distribution and cytotoxicity; The main parameter controlling particle morphology was the actual cutting process; - Particle release may generate human exposure impact.This work was carried out in the framework of project LIFE-NanoHealth (LIFE20 ENV-ES-000187). It was also supported by the Spanish Ministry of Science and Innovation (Project CEX2018-000794-S), by the Government of Catalonia Agency for Administration of University and Research Grants (AGAUR) (project 2017 SGR41) and by the Government of Valencia (GAIA-IVACE)(IMAMCA/2023/1).info:eu-repo/semantics/publishedVersio
Chemometric and multielement techniques for the exploratory analysis of honey quality from different geographical origin
No full textThe proximal and mineral profiles of multi floral honeys from different geographic regions were determined and related to their origin. Moisture, °Brix sugars, ash, pH, free acidity, water activity (aw) and minerals content were determined by AOAC methods. In the exploratory analysis, non-supervised chemometric methods were applied to build classification rules and relate the origin of the samples based on their physicochemical parameters and mineral content. The means of the physicochemical parameters obtained were °Brix-sugars (82.44±1.68%), moisture (16.49±1.19%), pH (3.97±0.22), free acidity (24.07±6.79 meq/kg), aw (0.59±0.02), ash (0.24±0.11%). These values demonstrate the high quality of the honey analyzed. Among the minerals, K was the most abundant in all samples, ranging between 363.26-2034.11 mg/kg followed by P (45.43-115.63 mg/kg), while Cu was the least abundant (0.18-2.02 mg/Kg). The results showed differences in composition and mineral profile between honeys from different regions. The first three factors of the Principal Component Analysis method explained more than 67% of the variance and minerals had the highest discriminatory power, while hierarchical cluster analysis successfully classified the honey samples. The results show that mineral content is a capable geographical indicator to identify the origin of honey and the use of chemometric methods with proximal analysis and mineral content could be applied to determine the quality and authenticity of honey.info:eu-repo/semantics/publishedVersio