National Institute of Health Dr. Ricardo Jorge
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Pesquisa de bactérias entéricas multirresistentes em perus produzidos para consumo humano - Existe risco para a Saúde Pública?
No full textOrientadora Ângela Pista (Departamento de Doenças Infecciosas, INSA)As doenças de origem alimentar constituem um grave problema de saúde pública, e os produtos alimentares de origem animal são uma das principais fontes de contaminação. Igualmente preocupante é o aumento de estirpes multirresistentes.
Este estudo teve como objetivo analisar o papel dos perus enquanto reservatórios e potenciais fontes de transmissão de Escherichia coli (E. coli), Salmonella spp. e Shigella spp. ao Homem, através do isolamento e caracterização fenotípica e genotípica destas bactérias de fezes (n = 108) e carnes cruas de peru (n = 33), em Portugal.
Em nenhuma das matrizes foi isolada Shigella spp., enquanto Salmonella spp. foi apenas isolada numa amostra de fezes (0,9%). Isolou-se E. coli em todas as amostras de fezes e em 90,9% das amostras de carne. E. coli enteropatogénica foi identificada em 0,9% dos isolados de fezes. Os 138 isolados de E. coli sequenciados apresentaram genes de virulência de E. coli patogénica extraintestinal e 31,2% foram classificados como E. coli patogénica aviária. Foi observada uma grande diversidade de serotipos e sequências tipo.
Salmonella Newport foi suscetível aos antibióticos testados. Em E. coli, foram observadas resistências em 74,1% dos isolados de fezes e 90,0% dos de carne, e, respetivamente, 52,8% e 70,0% foram multirresistentes. No geral, as resistências mais frequentes foram à ampicilina, tetraciclina e ciprofloxacina, e foram identificados cinco isolados produtores de beta-lactamases de espetro alargado. Oito isolados de E. coli apresentaram genes de resistência para a colistina (mcr-1.1). A análise filogenética dos isolados de E. coli permitiu identificar 13 clusters. Foi identificado um cluster entre o isolado de Salmonella Newport e outro isolado nacional.
Os resultados deste estudo realçam o papel dos perus como uma potencial fonte de doenças zoonóticas para o Homem e a importância da abordagem One Health, de forma a garantir a segurança alimentar e promover a saúde pública.Foodborne diseases represent a major public health concern, with food-producing animals identified as a primary source of contamination. Furthermore, the emergence of multidrug-resistant strains is a significant cause for worry.
This study aimed to understand the role of turkeys as reservoirs and potential sources of transmission of Escherichia coli (E. coli), Salmonella spp., and Shigella spp. to humans, through the isolation and the phenotypic and genotypic characterization of these bacteria from turkey faeces (n = 108) and raw turkey meat (n = 33) in Portugal.
No Shigella spp. were isolated from the analysed samples, while Salmonella spp. were only isolated from faecal samples (0.9%). E. coli was isolated from all faecal samples and from 90.9% of meat samples. Enteropathogenic E. coli was identified in 0.9% of faecal isolates. All sequenced E. coli isolates carried virulence genes characteristic of extraintestinal pathogenic E. coli, with 31.2% of the isolates classified as avian pathogenic E. coli. A high diversity of serotypes and sequence types was observed.
The Salmonella Newport isolate was susceptible to all tested antibiotics. Among the E. coli isolates, resistance was observed in 74.0% of faecal isolates and 90.0% of the meat isolates and, respectively, 52.8% and 70.0% of the isolates were multi-drug resistant. The most prevalent resistances were observed to ampicillin, tetracycline, and ciprofloxacin. Five E. coli isolates were identified as extended-spectrum beta-lactamase (ESBL) producers, and eight carried colistin resistance genes (mcr-1.1). Phylogenetic analysis of E. coli isolates identified 13 clusters. Additionally, a cluster was observed between the Salmonella Newport isolate and a national isolate from the Enterobase Portuguese collection.
These findings highlight the role of turkeys and their meat as a potential source of zoonotic diseases to humans and emphasize the importance of a One Health approach to ensure food safety and promote public health
Impact of gold nanoparticle exposure on genetic material
No full textReviewMetal nanoparticles, with gold nanoparticles (AuNP) at the forefront, have gained immense attention due to their unique properties. At the nanoscale, gold exhibits remarkable physical, chemical, optical, and electronic features, making it ideal for a plethora of applications, including bioimaging, sensing, diagnostics, and drug delivery. Despite their promising utility, concerns have arisen regarding the potential adverse effects of AuNP on human health. Research has indicated that these nanoparticles can accumulate in vital organs and interact with proteins and cellular structures, potentially leading to diverse toxicological manifestations. The precise understanding of these nano-bio interactions is further complicated by the varied physicochemical properties of AuNP that influence their biological effects. This review aims to consolidate the current knowledge on the genotoxic effects of AuNP, shedding light on the underlying mechanisms and factors affecting their toxicity. The search was conducted in PubMed and Web of Science databases. Eventually, 32 studies focusing on the genotoxic effects of AuNP were included in the review. In vitro and in vivo findings revealed that AuNP can induce primary DNA damage, oxidative DNA damage, chromosomal damage, alterations in gene expression, and effects on epigenetic regulation. These effects were found to be influenced by various factors, including nanoparticle size, shape, and surface coating. However, the existing literature also highlights the challenges associated with assessing the genotoxicity of nanomaterials (NM), emphasizing the need for standardized and adapted testing protocols. The interference of nanoparticles with conventional toxicity assays may lead to unreliable results; thus, specific methodologies tailored for NM evaluation must be implemented. In conclusion, while AuNP hold tremendous potential for innovative applications, their safety profile remains a critical concern. Continued research is imperative to elucidate the mechanisms of AuNP induced genotoxicity and develop robust testing protocols, ensuring their safe and effective use in diverse applications.Highlights: • This review overhauls the current knowledge on genotoxicity of gold nanoparticles; • Their safety profile and effective use in diverse applications remains a concern; • Exposure can induce genetic damage and alter gene expression and epigenetics; • Physicochemical properties influence their biological behaviour and genotoxic power; • Proper testing protocols are needed for accurate nanogenotoxicity assessment.This research was funded by Ministry of Science and Innovation: MCIN/AEI/10.13039/501100011033 (Grant PID2020–114908GA-I00), Xunta de Galicia (ED431B 2022/16), National funds through FCT - Fundação para a Ciência e a Tecnologia, I.P. (projects UIDB/04750/2020, LA/P/0064/2020). Funding for open access charge: Universidade da Coruña/CISUG.info:eu-repo/semantics/publishedVersio
Update on the composition and distribution of the mosquito fauna (Diptera: Culicidae) in Cabo Verde, a country at risk for mosquito-borne diseases
No full textIssue Section: Population and Community EcologyMosquitoes play a critical role as vectors of pathogens affecting both humans and animals. Therefore, understanding their biodiversity and distribution is crucial to developing evidence-based vector control strategies. The current study updated the composition and distribution of mosquito species through a comprehensive survey of all municipalities of Cabo Verde. From October 2017 to September 2018, mosquito larvae and pupae were collected from 814 aquatic habitats. Anopheles gambiae (Giles, 1902) and Culex pipiens (Linnaeus, 1758) complexes were subjected to PCR-based techniques for sibling species identification. Ten mosquito species from 5 genera were identified: Aedes aegypti (Linnaeus, 1762), Aedes caspius (Pallas, 1771), Anopheles arabiensis (Patton, 1905), Anopheles pretoriensis (Theobald, 1903), Culex bitaeniorhynchus (Giles, 1901), Cx. pipiens, Culex quinquefasciatus (Say, 1823), Culex tritaeniorhynchus (Giles, 1901), Culiseta longiareolata (Macquart, 1838), and Lutzia tigripes (de Grandpre & de Charmoy, 1901). Santiago Island reported the highest number of species (n = 8). Ae. aegypti and Cx. quinquefasciatus were the most widely distributed species across the country. An. arabiensis was the sole species identified within the An. gambiae complex. The findings from our study will help guide health policy decisions to effectively control mosquito-borne diseases.info:eu-repo/semantics/publishedVersio
A Comparative Overview of the Role of Human Ribonucleases in Nonsense-Mediated mRNA Decay
No full text(This article belongs to the Special Issue Post-transcriptional Regulation in Mammals)Eukaryotic cells possess surveillance mechanisms that detect and degrade defective transcripts. Aberrant transcripts include mRNAs with a premature termination codon (PTC), targeted by the nonsense-mediated decay (NMD) pathway, and mRNAs lacking a termination codon, targeted by the nonstop decay (NSD) pathway. The eukaryotic exosome, a ribonucleolytic complex, plays a crucial role in mRNA processing and turnover through its catalytic subunits PM/Scl100 (Rrp6 in yeast), DIS3 (Rrp44 in yeast), and DIS3L1. Additionally, eukaryotic cells have other ribonucleases, such as SMG6 and XRN1, that participate in RNA surveillance. However, the specific pathways through which ribonucleases recognize and degrade mRNAs remain elusive. In this study, we characterized the involvement of human ribonucleases, both nuclear and cytoplasmic, in the mRNA surveillance mechanisms of NMD and NSD. We performed knockdowns of SMG6, PM/Scl100, XRN1, DIS3, and DIS3L1, analyzing the resulting changes in mRNA levels of selected natural NMD targets by RT-qPCR. Additionally, we examined the levels of different human β-globin variants under the same conditions: wild-type, NMD-resistant, NMD-sensitive, and NSD-sensitive. Our results demonstrate that all the studied ribonucleases are involved in the decay of certain endogenous NMD targets. Furthermore, we observed that the ribonucleases SMG6 and DIS3 contribute to the degradation of all β-globin variants, with an exception for βNS in the former case. This is also the case for PM/Scl100, which affects all β-globin variants except the NMD-sensitive variants. In contrast, DIS3L1 and XRN1 show specificity for β-globin WT and NMD-resistant variants. These findings suggest that eukaryotic ribonucleases are target-specific rather than pathway-specific. In addition, our data suggest that ribonucleases play broader roles in mRNA surveillance and degradation mechanisms beyond just NMD and NSD.Funding: This work was partially supported by Instituto Nacional de Saúde Doutor Ricardo Jorge and
Fundação para a Ciência e a Tecnologia (FCT), Portugal [UIDB/04046/2020 (DOI: 10.54499/UIDB/
04046/2020), and UIDP/04046/2020 (https://doi.org/10.54499/UIDP/04046/2020) Centre grants
from FCT (to BioISI)]. P.J.d.C. was recipient of a fellowship from the BioSys PhD programme
(SFRH/BD/52495/2014) and J.M. was a postdoc fellow (SFRH/BPD/98360/2013) from FCT. Work
at ITQB-NOVA was financially supported by FCT, Project MOSTMICRO-ITQB with references
UIDB/04612/2020 and UIDP/04612/2020, and LS4FUTURE Associated Laboratory (LA/P/0087/
2020). M.S. is a recipient of FCT DL57
Genetic Complexity of CC5 Isolates Associated with Sternal Bursitis in Chickens: Antimicrobial Resistance, Virulence, Plasmids, and Biofilm Formation.
No full text(This article belongs to the Special Issue Exploring the Epidemiology, Pathogenicity, and Therapeutic Options of Staphylococcus spp.: 2nd Edition)Sternal bursitis, a common inflammatory condition in poultry, poses significant challenges to both animal welfare and public health. This study aimed to investigate the prevalence, antimicrobial resistance, and genetic characteristics of isolates associated with sternal bursitis in chickens. Ninety-eight samples were collected from affected chickens, and 24 isolates were identified. Antimicrobial susceptibility testing revealed resistance to multiple agents, with a notable prevalence of aminoglycoside resistance genes. Whole genome sequencing elucidated the genetic diversity and virulence profiles of the isolates, highlighting the predominance of clonal complex 5 (CC5) strains. Additionally, biofilm formation assays demonstrated moderate biofilm production capacity among the isolates. These findings underscore the importance of vigilant monitoring and targeted interventions to mitigate the impact of sternal bursitis in poultry production systems.This work was supported by projects UIDB/00772/2020 (Doi:10.54499/UIDB/00772/2020) funded by the Portuguese Foundation for Science and Technology (FCT). This work received financial support from FCT/MCTES (UIDB/50006/2020 DOI 10.54499/UIDB/50006/2020) through national funds
Impact of influenza vaccination strategy on medically attended influenza in Portugal in five pre-pandemic seasons (2015/16 to 2019/20)
Get PDFAbstract publicado em: Popul Med. 2023;5(Suppl.):A2012. https://doi.org/10.18332/popmed/163790Background: There is limited research on the impact of the yearly influenza vaccination programs in the eligible population. This study aimed to estimate the number of primary care medically attended influenza-confirmed cases (MAICC) among the population aged ≥65 years averted by influenza vaccination programme in Portugal during five seasons in the pre-COVID pandemic period (2015/16 to 2019/20).
Methods: We compared the number of observed MAICC to the estimated number that would have occurred in a population without seasonal influenza vaccination (N). To estimate N, we used: i) number of MAICC estimated from national influenza surveillance systems, ii) vaccine coverage (VC) collected in a national telephone survey, iii) influenza vaccine effectiveness (IVE) estimates weighted by the proportion of virus circulation each season in Portugal. We estimated the number of MAICC averted (NAE) by the influenza vaccination programme per 100.000 inhabitants and number needed to vaccinate to prevent one MAICC. We used Monte-Carlo simulations to estimate 95% uncertainty intervals (UI).
Results: Comparing with results from 2015/16 to 2017/18 (NAE ranged 24 to 44 per 100.000 inhab) the season 2018/19 showed the highest NAE (62.3 per 100.000 inhab) attributed to the influenza vaccination programme. In 2019/20 season the vaccination strategy averted approximately 11.7 per 100.000 inhab (95%UI: 6.0 to 20.9) events and it was necessary to vaccinate 549 (95%UI: 436 to 742) to prevent one MAICC in primary care.
Conclusion: The influenza vaccination strategy had consistent and positive benefit, with more pronounced impact in 2018/19 season. This results were mainly due to a combination of a higher vaccination coverage assumed for 2018/19 (60.8%) and one of the highest vaccine effectiveness (34.8% vs. previous study range 8.5% to 40.6%). To maximize its impact, efforts should be conducted to increase the vaccine coverage. In addition, the surge for more effective vaccines should be maintained.info:eu-repo/semantics/publishedVersio
Public health institutes and the fight against climate change
Get PDFA investigação constitui uma das principais atividades do
Departamento de Alimentação e Nutrição (DAN) do Instituto
Nacional de Saúde Doutor Ricardo Jorge (INSA) sendo
desenvolvida de forma intensa, em domínios muito diversos,
de que são exemplos os artigos publicados nesta edição do
Boletim Epidemiológico Observações.
Um dos contributos emergentes para a saúde pública em
Portugal é, sem dúvida, a investigação para o combate às
alterações climáticas. O tema esteve em discussão na recente
reunião da International Association of National Public Health
Institute (IANPHI), onde o INSA, enquanto um dos 115
membros dos 98 países representados, participou de forma
destacada.
Os Institutos Nacionais de Saúde Pública (INSP) são
essenciais na conceção de políticas de adaptação baseadas
em evidências (preparação e prevenção de emergências,
entre outras) e no apoio a políticas de mitigação (por exemplo,
promoção de intervenções sobre determinantes-chave da
saúde, como dietas e estilos de vida). Deste domínio a
IANPHI desenvolveu um interessante roteiro para reforçar o
papel dos INSP nas políticas de mitigação e adaptação às
alterações climáticas. (...)info:eu-repo/semantics/publishedVersio
Tratamento de doenças lisossomais de sobrecarga: relatório 2022
No full textRelatório anual sobre o Tratamento de Doenças Lisossomais de Sobrecarga, referente às atividades realizadas pela respetiva Comissão Coordenadora em 2022. As Doenças Lisossomais de Sobrecarga (DLS) são um grupo de patologias raras e progressivas, caracterizadas por alta morbilidade e que atualmente incluem mais de 60 doenças. A apresentação clínica dessas patologias é extremamente variável, podendo variar de doença neurológica grave a casos menos graves.
Em Portugal, a prevalência dessas patologias em recém-nascidos é de 25 por cada 100.000 nados-vivos. Nos últimos anos, várias terapias de substituição enzimática, redução do substrato e um chaperone farmacológico foram desenvolvidas, possibilitando o tratamento de doentes com algumas dessas doenças, incluindo a Doença de Gaucher, Doença de Fabry, Doença de Pompe, Mucopolissacaridoses tipos I, II, IVA, VI e VII, Deficiência de lipase ácida lisossomal, a Alfa-manosidose e Doença de Niemann-Pick tipo C.
Pelo Despacho n.º 2545/2013, foi criada a Comissão Coordenadora do Tratamento das Doenças Lisossomais de Sobrecarga (CCTDLS), que opera junto ao INSA. Atualmente, esta comissão é composta por profissionais designados pelo INSA, pelos Centros de Referência nesta área, pela Administração Central do Sistema de Saúde, pela Direção-Geral da Saúde e pela Autoridade Nacional do Medicamento e Produtos de Saúde (Infarmed).
Do relatório da CCTDLS, relativo ao ano 2022, destaca-se a realização das seguintes atividades:
- Casos clínicos − Discussão e avaliação de 34 casos clínicos com emissão de 28 pareceres positivos relativos a pedidos de início de tratamento (21), ajuste de dose (3), mudança de fármaco (4). Foram emitidos pareceres para a Doença de Gaucher, Doença de Fabry, Mucopolissacaridoses tipo I e VI e Doença de Pompe;
- Monitorização − Monitorização da evolução clínica dos doentes com terapias em curso;
- Total de doentes − Atualização dos dados referentes ao número total de doentes com DLS em tratamento no território continental, detalhado por centro hospitalar, patologia e terapêutica. No final de 2022, 350 doentes estavam em tratamento, sendo 164 com Doença de Fabry, 98 com Doença de Gaucher, 34 com Doença de Pompe, 14 com Doença de Niemann-Pick tipo C, 10 com Mucopolissacaridose tipo I, 9 com Mucopolissacaridose tipo II, 3 com Mucopolissacaridose tipo IVA, 11 com Mucopolissacaridose tipo VI, 3 com Mucopolissacaridose tipo VII, 2 com Alfa-manosidose e 2 com Deficiência de lipase ácida lisossomal;
- Terapêutica domiciliária − Prestação de apoio técnico-científico na elaboração da Norma de Tratamento Domiciliário para Pessoas com Doenças Lisossomais de Sobrecarga. Em 2022, o Secretário de Estado Adjunto e da Saúde solicitou ao Departamento da Qualidade da DGS a continuidade deste processo que contou com o envolvimento da CCTDLS;
- Modelo de financiamento − Contribuição para a revisão do modelo de financiamento das DLS. Durante o ano de 2022 o modelo de financiamento dos centros de referência em relação ao tratamento dos doentes com DLS foi revisto passando as fórmulas a incluir a utilização da média ponderada, que considera o número de doentes pediátricos e adultos;
- Documentos técnicos − Elaboração de um documento com os critérios de início da terapêutica para todas as Mucopolissacaridoses com terapias atualmente disponíveis;
- Registo Nacional/Pataforma − Discussão sobre a criação de um Registo Nacional de Doenças Lisossomais de Sobrecarga e a implementação da Plataforma de Monitorização da Efetividade de Terapias pelo Infarmed.info:eu-repo/semantics/publishedVersio
Association between family socioeconomic factors, overweight and perceived consumption of soft drinks, sweet and savoury snacks among schoolchildren during the COVID-19 pandemic
Get PDFA nível global, a obesidade infantil, os hábitos alimentares e as desigualdades
socioeconómicas representam um desafio contemporâneo de saúde pública.
O principal objetivo deste estudo é caraterizar as associações entre os
fatores socioeconómicos da família com a perceção do consumo de alimentos
de elevada densidade energética durante a pandemia em comparação
com o período pré-pandemia e com a prevalência de excesso de peso das
crianças portuguesas em idade escolar.
Este estudo segue um desenho observacional transversal com base nos
dados da 6ª ronda do COSI Portugal. A informação relativa aos indicadores
socioeconómicos da família e aos hábitos alimentares das crianças durante
a pandemia foi obtida através do questionário aplicado à família. A prevalência
de excesso de peso infantil foi calculada tendo por base as medidas antropométricas
recolhidas de acordo com um protocolo metodológico.
Durante a pandemia, a menor escolaridade, bem como o desemprego maternos
estavam associados a uma diminuição do consumo dGlobally, childhood obesity, eating habits and socioeconomic inequalities
represent a contemporary Public Health challenge. The main objective of
this study is to characterise the associations between family socioeconomic
factors and the perceived consumption of energy-dense foods during
the pandemic in comparison to pre-pandemic period, and the prevalence
of overweight among Por tuguese school-age children.
This study follows an observational cross-sectional design based on
data from the 6th round of COSI Por tugal. The information on parental
socioeconomic indicators and children’s eating habits during and af ter
pandemic were obtained through family form. The data on anthropometric
measurements was collected according to a methodological protocol. During pandemic period, maternal lower education and unemployment
were associated with a decrease in children’s consumption of sof t drinks
containing sugar and of sweet and savour y snacks. Childhood overweight
was correlated with lower maternal and paternal eduinfo:eu-repo/semantics/publishedVersio
Sickle cell trait in São Tomé e Príncipe: a population-based prevalence study in women of reproductive age
No full textBackground
Sickle Cell Disorder is Africa’s most prevalent genetic disease. Yet, it remains a neglected condition, with high mortality under-five, and a lack of population-based studies in the region. This is the first of its kind in São Tomé e Príncipe, aiming to estimate the prevalence of sickle cell trait and other haemoglobin variants in women of reproductive age and its associated factors.
Methods:
We conducted a cluster survey in 35 neighbourhoods. Haemoglobin was assessed through point-of-care capillary electrophoresis or high-performance liquid chromatography, and sociodemographic data through questionnaires. The weighted prevalence of sickle cell trait (HbAS) and HbC carriers was estimated with a 95% confidence interval (95% CI). We calculated weighted prevalence ratios (95% CI) through robust Poisson regression for its association with age and individual and collective genetic heritage.
Findings:
The prevalence of sickle cell trait in women of reproductive age in São Tomé e Príncipe (n = 376) was 13.45% (95% CI: 9.05-19.00). The prevalence of HbC carriers was 8.00% (95% CI: 4.71-12.00). Older age and speaking Forro or Angolar were positively associated with having sickle cell trait.
Interpretation:
The prevalence of sickle cell trait in São Tomé e Príncipe ranks high in the West African region. The country should follow international guidelines, implementing newborn screening and comprehensive healthcare management.CIAS-UC (FCT: UIDB/00283/2020), APPDH and Forum Haematologico. This work was funded by CIAS - supported by FCT - Foundation for Science and Technology, I.P., within the scope of the project UIDB/00283/2020CIAS-UC - who paid for the ARKRAY® Lab001 and reagents for all the laboratory work, the flight and travel expenses of CB, the flight to Príncipe of GQ and publishing fees. APPDH paid for the flights of GQ to São Tomé. Forum Hematologico de Coimbra paid for the impression of forms and informed consent.info:eu-repo/semantics/publishedVersio