National Institute of Health Dr. Ricardo Jorge
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Diagnóstico Laboratorial de Porfirias - Pensar Porfiria
No full textMaterial informativo de sensibilização para pensar porfiria de apoio ao conhecimento e diagnóstico deste grupo de doenças raras. As porfirias são um grupo de oito doenças metabólicas raras, resultantes de diferentes deficiências enzimáticas na biossíntese do grupo heme
The first harmonized total diet study conducted in Portugal: Assessment of vitamin D occurrence and intake
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Sickle cell anemia: assessment of fetal hemoglobin in a group of Angolan children before and after treatment with hydroxyurea
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Extending High Fatty Foods Shelf-Life Protecting from Lipid Oxidation and Microbiological Contamination: An Approach Using Active Packaging with Pomegranate Extract
No full text(This article belongs to the Special Issue Innovations in Active Food Packaging during the Pandemic and into the 'New Normal')The search for new forms to extend foodstuffs’ shelf-life through the use of natural compounds and extracts continues to grow among researchers and the industry. In this line of thought, the main objective of this work was to develop, characterize and evaluate the effectiveness of an active food packaging based on polylactic acid (PLA) and incorporated with natural extracts obtained from grape and/or pomegranate by-products. In vitro, antioxidant methods were applied to evaluate the antioxidant capacity of three extracts: wort extract, freeze-dried pomegranate peels extract (PPE-FD), and natural pomegranate peels (PPE-N). Punicalagin (A + B) and ellagic acid were determined in PPE-FD, PPE-N, and active films by UHPLC-DAD. New PLA-based active packaging with PPE-FD (PLA/3PPE) and pomegranate peels (PLA/3PP) were developed, and their chemical, mechanical, and barrier properties were evaluated. Moreover, the effectiveness of the new film was carried out through the study of lipid oxidation state and microbial contamination of two high-fat content foodstuffs, almonds and beef meat. PPE-FD presented high antioxidant capacity and high content in total phenolics and flavonoid compounds. The PLA/3PPE and PLA/3PP prevented the lipid oxidation of meat and presented antimicrobial activity against Staphylococcus aureus. The addition of the PPE-FD and the pomegranate peels to the PLA did not affect the morphology of the polymer.
Although both PPE-FD and pomegranate peels presented punicalagin (A + B) and ellagic acid, only ellagic acid was identified and quantified in the active PLA. Active PLA films were not effective in delaying the lipid oxidation of almonds, but they showed to be significantly effective in delaying the lipid oxidation of beef meat and reducing the microbial growth in this food matrix over time.Cássia H. Barbosa is grateful for her Ph.D. Grant 2021.08154.BD is funded by Foundation for Science and Technology (FCT), Portugal.info:eu-repo/semantics/publishedVersio
Evaluating a training programe: European Health Information Training Programme - EHITP
Get PDFLecture invited by the IHMT, within the scope of the VAX-TRUST project - Workshop for evaluators in the session Health Intervention’s Evaluation – from concept to practice
Background: The InfAct (Information for Action) is a Joint Action of the European Commission’s 3rd Health Programme with the main goal to build a health information system infrastructure for a stronger European Union and to strengthen its core elements.
The InfAct Joint Action was developed along 36 months and structured in 10 work packages.
Portugal co-led the Work Package 6 (WP6) of this project, which included the development of the proposal of a flagship capacity building programme - the European Health Information Training Programme - and its evaluation. The evaluation objectives included: to evaluate the adequacy of the training programme to the health information needs in the European Member States; to identify possible changes regarding the participants selection process, the training activities and the pedagogical project; and to contribute to the understanding of the potential of the programme to add to available offers in learning on the topics of Public Health information, on the capacity building and behavioural changes in Public Health activities which can be attributed to the course, and of the potential of the programme to contribute to the alignment of health information criteria and procedures between the European Member States.
Methods: The evaluation process was developed using an observational descriptive study design using a mixed methodological approach with both document analysis and primary data collected by questionnaires and interviews analysis. Mixed quantitative and qualitative data collection methods and analysis were used.
Results: The proposal of the European Health Intervention’s Training Programme seemed adequate to the formative needs and capacities in line with the work performed by the InfAct project. In what concerns about its main thematic areas, it was also aligned with the areas identified in the previous formative needs and capacities mapping. The participants selection process proposed seemed, in general, adequate. The potential of the European Health Information Training Programme proposal to learning, capacity building and behavioral changes at work attributable to the course was considered positive, as well as the potential to the alignment of health information criteria and procedures between European Union Member States.
Discussion: In general, we found high consistency between the results obtained from data collected by the techniques used. However, different suggestions for improvement were outlined by the evaluation study population.'801553 InfAct' which has received funding from the European Union’s Health Programme (2014-2020)info:eu-repo/semantics/publishedVersio
Application of human biomonitoring data to support policy development, raise awareness and environmental public health protection among countries within the HBM4EU project
No full textContributor: Paula Alvito, Departamento de Alimentação e Nutrição, INSA.ReviewMost countries have acknowledged the importance of assessing and quantifying their population’s internal exposure from chemicals in air, water, soil, food and other consumer products due to the potential health and economic impact. Human biomonitoring (HBM) is a valuable tool which can be used to quantify such exposures and effects. Results from HBM studies can also contribute to improving public health by providing evidence of
individuals’ internal chemical exposure as well as data to understand the burden of disease and associated costs thereby stimulating the development and implementation of evidence-based policy.
To have a holistic view on HBM data utilisation, a multi-case research approach was used to explore the use of HBM data to support national chemical regulations, protect public health and raise awareness among countries participating in the HBM4EU project. The Human Biomonitoring for Europe (HBM4EU) Initiative (https://www.hbm4eu.eu/) is a collaborative effort involving 30 countries, the European Environment Agency (EEA) and the European Commission (contracting authority) to harmonise procedures across Europe and advance research into the understanding of the health impacts of environmental chemical exposure. One of the aims of the project was to use HBM data to support evidence based chemical policy and make this information timely and directly available for policy makers and all partners. The main data source for this article was the narratives collected from 27 countries within the HBM4EU project.
The countries (self-selection) were grouped into 3 categories in terms of HBM data usage either for public awareness, policy support or for the establishment HBM programme. Narratives were analysed/summarised using guidelines and templates that focused on ministries involved in or advocating for HBM; steps required to engage policy makers; barriers, drivers and opportunities in developing a HBM programme.
The narratives reported the use of HBM data either for raising awareness or addressing environmental/public health issues and policy development. The ministries of Health and Environment were reported to be the most prominent entities advocating for HBM, the involvement of several authorities/institutions in the national hubs was also cited to create an avenue to interact, discuss and gain the attention of policy makers. Participating in European projects and the general population interest in HBM studies were seen as drivers and opportunities in developing HBM programmes. A key barrier that was cited by countries for establishing and sustaining national HBM programmes was funding which is mainly due to the high costs associated with the collection and chemical analysis of human samples. Although challenges and barriers still exist, most countries within Europe were already conversant with the benefits and opportunities of HBM.
This article offers important insights into factors associated with the utilisation of HBM data for policy support
and public awareness.info:eu-repo/semantics/publishedVersio
Assessing exposure to environmental contaminants in portuguese mother-infant pairs: the project ARTEMIS
Get PDFObjective: Today chemicals play a major role in our daily lives, being present in the air we breathe, in the food we eat and in the products we use. As such, it is essential to know the levels of chemicals present in our bodies and assess the risks associated. For that, Human Biomonitoring (HBM), the measurement of the concentrations of chemicals in human biological samples, is a very useful technique. Nevertheless, Portuguese HBM data is scarce and more knowledge on the exposure to chemicals of the Portuguese population is needed. It is then proposed to develop a study to assess the current environmental exposure of Portuguese children and women of childbearing age, vulnerable groups of the population, to selected chemicals, particularly metals and endocrine disruptors.
Methods: The project ARTEMIS will evaluate exposure of children aged 6-11 years old and their mothers aged 45 years or less residing in four selected rural and urban areas in Portugal (LVT and Alentejo regions). Recruitment will be done through schools. Urine and hair samples will be collected for the analysis of exposure biomarkers, namely of metals (including mercury, cadmium and arsenic), bisphenols and cotinine. Additionally, saliva samples will be collected for the analysis of effect biomarkers (salivary proteome). Questionnaire data on socio-demographic characteristics, lifestyle, nutrition, health, and specific information on exposure to the selected chemicals will be collected using CATI (Computer-Assisted Telephone Interviewing). A biobank will also be established to allow further analysis of the samples.
Expected results: ARTEMIS will be an innovative project that will not only produce much needed data on the current exposure of the Portuguese population to chemicals, but also allow to evaluate time trends of exposure to some chemicals by comparison with the results from previous projects and to study the association of exposure with biomarkers of effect.ARTEMIS financiado pelo CHRC Research Grants 2022N/
Recomendações para o consumo de pescado para a população portuguesa
No full textApresentação pública das recomendações, INSA, 16 maio 2023Um grupo de trabalho promovido pela Direção Geral da Alimentação e Veterinária (DGAV) e que integrou a Autoridade de Segurança Alimentar e Económica (ASAE), a Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto (FCNAUP), o Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA), o Instituto Português do Mar e da Atmosfera (IPMA) e o Instituto de Saúde Pública da Universidade do Porto (ISPUP) elaborou um conjunto de recomendações para o consumo de pescado para a população portuguesa.
De acordo com as conclusões do estudo realizado, o consumo de pescado tem benefícios para a saúde, mas algumas espécies têm um teor de mercúrio elevado que pode representar riscos associados ao desenvolvimento cognitivo, sendo por isso de evitar em grupos vulneráveis como as grávidas, mulheres a amamentar e crianças pequenas.
Segundo os autores deste trabalho, o consumo de pescado, que inclui peixe, moluscos e crustáceos, tem benefícios para a saúde, diminuindo o risco de doença coronária e contribuindo para um adequado neuro-desenvolvimento do feto. Apesar disso, algumas espécies, como atum fresco (não o de conserva), cação, espadarte, maruca, pata roxa, peixes-espada e tintureira, contêm elevado teor de mercúrio, o que pode representar riscos para a saúde, designadamente ao nível do desenvolvimento cognitivo, devendo por isso ser evitadas por grávidas, mulheres a amamentar e crianças pequenas. Para estes grupos vulneráveis, a recomendação dos especialistas é o consumo de pescado entre 3 a 4 vezes por semana, sendo que para a população em geral o consumo de pescado deverá ser mais frequente, até 7 vezes por semana.
No entender dos investigadores, o consumo de pescado continua a ser essencial, sendo necessário fazer as escolhas certas relativamente às espécies e à frequência do seu consumo. Sardinha e cavala são algumas das opções a privilegiar, uma vez que têm menos mercúrio e maior teor de ácidos gordos ómega-3, que contribuem para um melhor desenvolvimento cognitivo nas crianças e para a prevenção de doença cardiovascular nos adultos. Espécies como abrótea, bacalhau, carapau, choco, corvina, dourada, faneca, lula, pescada, polvo, raia, redfish e robalo são outras das opções que apresentam, geralmente, valores baixos de mercúrio.
As recomendações para o consumo de pescado para a população portuguesa foram definidas tendo por base a frequência de consumo dos portugueses, obtida através do inquérito nacional IAN-AF. Os dados relativos ao teor de mercúrio foram, por sua vez, determinados através de amostras colhidas e analisadas no âmbito do controlo oficial e de diferentes estudos científicos, sendo posteriormente integrados numa avaliação de risco-benefício associado ao consumo de pescado pela população portuguesa. A investigação que fundamenta estas recomendações foi publicada no British Journal of Nutrition e contou com investigadores de todas as instituições nacionais envolvidas.info:eu-repo/semantics/publishedVersio
Atypical patterns i n serological d iagnosis of Epstein-Barr virus infection, 2015-2022
Get PDFOs testes laboratoriais de pesquisa de anticorpos específicos para o
vírus Epstein-Barr são uma das ferramentas usadas para a rápida e
correta identificação da infeção causada por este vírus. No entanto,
existem perfis serológicos atípicos que dificultam a obtenção de um
diagnóstico. Assim, o objetivo deste estudo foi determinar a frequ ência dos perfis serológicos atípicos e caracterizar a sua distribuição
em indivíduos cuja pesquisa de anticorpos foi realizada no Instituto
Nacional de Saúde Doutor Ricardo Jorge. Foi realizada uma análise
retrospetiva de 1346 indivíduos residentes em Portugal, com per fil serológico completo para o diagnóstico laboratorial da infeção
pelo vírus Epstein-Barr, obtido entre 2015 e 2022. Dos indivíduos
incluídos no estudo, 192 (14,2%) apresentaram um perfil serológico
atípico. O perfil serológico atípico mais frequente foi a presença de
anticorpos IgG VCA/EA isolados (8,3%; 112/1346), seguido da pre sença simultânea de anticorpos IgM VCA, IgG VCA/EA e IgG EBNA-1
(3,6%; 48/1346), depois o perfil de anticorpos IgG EBNA-1 isolados
(1,6%; 22/1346) e, por último, o perfil de anticorpos IgM VCA iso lados (0,7%; 10/1346). No geral, a frequência dos perfis serológi cos atípicos obtida neste estudo está de acordo com a literatura. Em
comparação com outro estudo realizado em Portugal, os perfis de
anticorpos IgG EBNA-1 isolados e anticorpos IgM VCA isolados apre sentaram uma frequência ligeiramente superior. O presente estudo
demonstra a importância dos perfis atípicos no diagnóstico seroló gico da infeção pelo vírus Epstein-Barr e a necessidade de efetuar
testes serológicos e moleculares adicionais, que variam de acordo
com a especificidade de cada perfil atípico.Specific antibody tests are used to determine different stages of
Epstein-Barr virus infection. However, the detection of atypical sero logical patterns may pose a diagnostic challenge. This study aims
to determine the frequency and distribution of atypical patterns in
individuals tested at the Portuguese National Institute of Health.
We reviewed 1346 individuals with serological patterns obtained
between 2015 and 2022, from individuals living in Portugal. Of those
included in this study, 192 (14.2%) showed an atypical pattern. Iso lated VCA IgG was the most frequent (8.3%, 112/1346), followed by
the simultaneous presence of antibodies VCA IgM, VCA/EA IgG, and
EBNA-1 IgG (3.6%, 48/1346), isolated EBNA-1 IgG (1.6%, 22/1346), and finally isolated VCA IgM (0.7%, 10/1346). The frequency of atypi cal serological patterns obtained in this study was similar to those
obtained in other studies. When comparing to another study conduc ted in Portugal, we found slightly higher percentages of the atypi cal serological patterns: isolated EBNA-1 IgG, and isolated VCA IgM.
This study highlights the importance of atypical serological patterns
in Epstein-Barr virus diagnosis, and the need to perform additional
serologic and molecular tests to better interpret them.info:eu-repo/semantics/publishedVersio
Pain in adolescents with cerebral palsy: preliminary data from the Cerebral Palsy Portuguese Surveillance Program
No full textA dor afeta negativamente a vida das pessoas com paralisia cerebral
(PC). Este estudo explora a prevalência de dor significativa em adolescentes com PC em Portugal e o seu impacto multidimensional. Foi
estudada uma amostra de conveniência de adolescentes registados no
Programa de Vigilância Nacional da Paralisia Cerebral (PVNPC) aos 5-8
anos de idade, seguindo o protocolo comum da SCPE, nas duas regiões de Portugal com maior cobertura regional, Grande Lisboa e Alto
Minho. Foi estimada a prevalência de dor e das suas características e
exploradas associações com aspetos funcionais, gravidade, complexidade do quadro clínico e participação social. Obteve-se informação
sobre a presença de dor em 107 de 164 adolescentes (65%). Referiram
ter dor 36 adolescentes (34%; IC95% 25,4-43,0); 21 (58%) localizaram a dor à anca, 17 (47%) aos membros inferiores, 7 (19%) à coluna
e 3 (9%) nos membros superiores. A dor foi referida em 13% dos adolescentes com 0 indicadores de complexidade e em 51% daqueles
com 1 ou mais indicadores de complexidade (Odds Ratio 7,1; IC95%
2,30-26,63; p<0,001). Todos os adolescentes com 4 indicadores de gravidade reportavam experiência de dor. A dor afeta cerca de 1/3 dos
adolescentes com PC, sendo tanto mais prevalente quanto maior a
complexidade da PC. A gestão da dor deve ser uma prioridade clínica
estratégica na PC, promovendo-se a implementação de modelos individualizados de avaliação e controlo. O PVNPC continuará a avaliar o
impacto da dor na funcionalidade, na qualidade de vida e nos níveis
de participação das pessoas com PC.Pain has a negative effect on the life of people living with cerebral
palsy (CP). We explored the prevalence of significative pain among
adolescents with CP in Portugal and its multidimensional impact. We
reassessed a convenience sample of adolescents registered at age
5-8 year-old to Programa de Vigilância Nacional da Paralisia Cerebral
(PVNPC), following the SCPE protocol, recruited from the two Portu guese regions with higher coverage rates, Greater Lisbon and High
Minho. The prevalence rate of pain was estimated, it was characte rized and associations with functionality, severity and clinical com plexity and social participation were explored. Information on the
experience of pain was obtained from 107 of 164 adolescents (65%).
Pain was reported by 36 adolescents (34%; IC95% 25.4-43.0); pain
was located on the hip by 21 (58%), 17 (47%) on the lower limbs, the
spine by 7 (19%) and by 3 (9%) on the upper limbs. Pain was repor ted by 13% of those adolescents with 0 indicators of complexity of CP
vs. 51% of those with 1 or more indicators of complexity (Odds Ratio
7.1; IC95% 2.30-26.63; p<0.001). Every adolescente with all 4 indica tors of complexity reported the experience of pain. Pain affects circa
1/3 of the adolescents with CP. Prevalence increases with the com plexity of CP. Pain management skills must be a estrategic clinical
priority in CP, the implementation of individualized models for asses sment and control being promoted. PVNPC will preservere on asses sing the impact of pain on funtionality, quality of life and the levels
of participation of people with CP.info:eu-repo/semantics/publishedVersio