National Institute of Health Dr. Ricardo Jorge
Repositório Científico do Instituto Nacional de SaúdeNot a member yet
9086 research outputs found
Sort by
Occupational studies developed in Portugal in the scope of HBM4EU – Main results and way forward
No full textIntroduction: Within the EU human biomonitoring initiative (HBM4EU), targeted national studies on occupational settings, where exposure to chemicals could occur, were performed. These studies aimed to provide information on occupational exposure to chemicals using biomonitoring approaches to support the implementation of new risk management measures (RMM) and policy actions at national and European levels.
Methods: Cross-sectional studies were performed in two occupational settings: i) a setting with plating, welding and painting activities, targeting exposure to chromium VI [Cr(VI)]; and ii) a setting dedicated to processing of electronic waste (e-waste), targeting exposure to metals. Both studies included a control group obtained from the Portuguese general population, employed in different companies with no known exposure to Cr(VI) or involvement on tasks related with recycling of e-waste. Studies enrolled 50 workers and 27 controls (chromates study) and 26 workers and 12 controls (e-waste study). Spot urine samples were collected in the beginning and the end of the work week, and concentrations of metals were determined. Protocols were submitted to Ethics Committees with the approvals being granted before recruiting the studies’ participants (companies and workers). Descriptive statistical analysis was performed as well as inferential analysis (Wilcoxon test, Mann–Whitney test, and Kruskal–Wallis test).
Results: Regarding chromates study, median levels obtained for workers were 0.33 µg/g crea for Cr, in the post-shift samples. Results showed that painters presented higher levels of Cr in post-shift urine samples than the control group (p0.05). Platers showed higher levels of Cr in post-shift urine samples when compared to pre-shift samples (p0.05). Regarding RMM, the use of respiratory protection equipment by painters was identified as a promotor of lower exposures (p<0.05). Regarding e-waste study, median levels obtained for workers were 0.21, 0.43 and 12.70 µg/g crea for cadmium (Cd), mercury (Hg) and lead (Pb), respectively, in the post-shift samples. Statistically significant differences between workers and control group were found for urinary Pb levels (p<0.05), and no significant differences were found between pre- and post-shift urine samples for Cd, Hg and Pb.
Conclusions: The results obtained showed that workers are exposed to metals in these occupational settings, thus, RMM in place need to be improved. Based on the results obtained, the implementation and enforcement of new regulatory actions should be considered. The results also claim attention for the need of updating the occupational limit values as it is being discussed at European level for Cr(VI), Pb and Cd due to the related health effects [3]. The differentiated data provided by biomonitoring tools demonstrated that these should be used more often to perform exposure assessment.H2020 no 733032info:eu-repo/semantics/publishedVersio
Serão as bolachas de arroz ou de milho, numa perspetiva de saúde pública, uma opção alimentar no lanche escolar saudável?
No full textPoster em congresso nacional com apresentação oral do mesmo.A prática dos hábitos alimentares saudáveis deve ser promovida, constituindo um alicerce essencial para a promoção da saúde pública. A escola constitui um local privilegiado para promover hábitos alimentares saudáveis e para melhorar o nível de literacia. Os lanches escolares são muitas vezes preparados pelas famílias das crianças, e por vezes apresentam uma qualidade nutricional pobre, sendo constituídos por alimentos de elevada densidade energética, ricos em sal, açúcar e gordura saturada. De acordo com a Direção-Geral da Saúde, um lanche saudável deve incluir leite e/ou derivados, fruta e cereais ou derivados. O objetivo deste trabalho foi avaliar a informação nutricional de bolachas de arroz ou milho com cobertura (BCC) e sem cobertura (BSC), e estimar o potencial impacto na saúde pública.
Em 2023, foi desenvolvida uma base de dados através da consulta de websites de hipermercados e/ou produtores de bolachas de arroz ou milho. Nesta base de dados foi incluída, por exemplo, informação relativa aos ingredientes e declaração nutricional. Foi realizada uma análise detalhada da informação recolhida, considerando as orientações existentes, como a Estratégia Integrada para a Promoção da Alimentação Saudável (EIPAS), o descodificador de rótulos, o Nutri-Score e o Guia para lanches escolares saudáveis.
Foram incluídos 65 tipos de bolachas (42 BSC e 23 BCC). 83% das BSC não cumprem a meta definida pela EIPAS para o sal (0,3 g/100 g) e 91% das BCC não cumprem a meta definida pela EIPAS para o açúcar (5 g/100 g). Após aplicação do descodificador de rótulos, verificou-se que para as BSC 17% são classificadas como tendo níveis altos de sal (>1,5 g/100 g). Nas BCC, 100%, 74% e 61%, têm níveis altos de ácidos gordos saturados (>5 g/100 g), de açúcares (>22,5 g/100 g) e de gordura (>17,5 g/100 g), respetivamente. O Nutri-Score permite classificar 69% das BSC em “A” ou “B” (melhor qualidade nutricional) e 100 % das BCC em “D” ou “E” (pior qualidade nutricional). O Guia para lanches escolares saudáveis, inclui uma lista de alimentos a privilegiar, a incluir de vez em quando e a evitar, de forma a tornar os lanches mais saudáveis e evitar a monotonia. Esta classificação, para o grupo dos cereais e derivados, baseia-se em critérios nutricionais para gordura, ácidos gordos saturados, ácidos gordos trans, açúcar, sal e fibra. Apesar das BSC poderem ser uma opção a privilegiar no lanche escolar saudável, verifica-se que apenas 26% cumprem o critério para o teor de fibra (>3 g/100 g) e que 29% e 21% não cumprem o critério para o sal (<1 g/100 g) e para a gordura (≤8 g/100 g), respetivamente.
Este trabalho suporta a necessidade de continuarem a ser desenvolvidas estratégias baseadas na saúde em todas as políticas, com o envolvimento de todos os que possam contribuir para uma oferta alimentar mais saudável. Identifica-se ainda como primordial a necessidade de continuar a trabalhar na reformulação destes produtos alimentares, e de promover e motivar a literacia interpretativa da informação nutricional para pais e educadores.info:eu-repo/semantics/publishedVersio
Hepatitis A in Portugal – epidemiological overview of incidence in the last decade
Get PDFBackground. Hepatitis A is an acute liver disease with faecal-oral transmission caused by a hepatotrophic picornavírus - Hepatitis A Virus (HAV). Food contamination with HAV can occur at any time: cultivation, harvesting, processing, handling and even after cooking.1,2 Food and water contamination happens more frequently in developing countries where the disease is common but can also happen in developed countries. Although uncommon, foodborne outbreaks have occurred due to people consuming contaminated fresh and frozen imported food products. Therefore, monitoring the disease is an essential tool for the early implementation of preventive measures, applying the One Health approach to both the human and environmental dimensions to mitigate the impact that an outbreak may have on the population.3
Methods. Retrospective observational study, which analyses the incidence of reported cases of Hepatitis A in Portugal between 2012 and 2022. Data presented were collected from the Directorate-General for Health (DGS) and the European Center for Disease Prevention and Control (ECDC). Descriptive statistics were performed using Microsoft Excel® software.
Results. Portugal had 806 cases of Hepatitis A between 2012 and 2022, the majority of which were male (n=597, 74.1%), aged between 25 and 44 years (n=397; 49.3%). Between 2012 and 2016, there was a gradual increase in incidence, from 0.1 in 2012 to 0.5 per 100 000 population in 2016. In 2017, there was a peak in incidence (4.7 per 100 000 population), corresponding to an outbreak of Hepatitis A that year. After 2017, the incidence gradually decreased. However, it never reached values lower than those of 2012, even during the years of the COVID-19 pandemic. During the study period, the incidence in men and women was similar, except between 2016 and 2019, where the incidence in men was higher. In terms of age, the incidence of Hepatitis A by age group showed high heterogeneity over the years, without a predominance.
Conclusions. In Portugal, the incidence, except for 2017, was relatively low. However, most diagnoses occur in adults when the disease can present greater severity, with consequences in terms of morbidity and mortality. The decrease in incidence is a good indicator of improved hygiene and sanitary conditions, but it increases the possibility of outbreaks since the population tends to see its natural immunity against the disease reduced. It is essential to monitor the incidence of the disease in the population of Portugal to develop timely public health strategies to control potential outbreaks of Hepatitis A. Strategies to be implemented must take into account not only the human dimension in terms of prevention with vaccination, diagnosis and treatment of the disease but also measures in the environmental dimension, since transmission of the disease occurs via the faecal-oral route, it is essential to implement legislation and measures that promote food and water safety and alert the population to risk behaviours.
References. 1Hofmeister MG, Foster MA, Teshale EH. Epidemiology and Transmission of Hepatitis A Virus and Hepatitis E Virus Infections in the United States. 2019. 2Castaneda D, Gonzalez AJ, Alomari M, et al. From hepatitis A to E: A critical review of viral hepatitis. World J Gastroenterol 2021; 27: 1691–1715. 3Jefferies M, Rauff B, Rashid H, et al. Update on global epidemiology of viral hepatitis and preventive strategies. Australia World J Clin Cases 2018; 6:589–599.N/
Multidrug-resistant Escherichia coli and Salmonella spp. in pigs slaughtered for human consumption, a potential source for Humans?
Get PDFObjective: To assess the role of pig reservoir as potential
transmission vehicle of Salmonella spp. and E. coli to
humans, in order to understand the epidemiology and
population structure of these zoonotic agents in Portugal.This work was developed within the scope of the strategic project “ResisCampyOH”, supported
by FMV-ULHT in 2022-2023.info:eu-repo/semantics/publishedVersio
15q11.2q13.1 interstitial gain in a fetus with an increased risk for T21: When classification and clinical outcome are divergent
No full textIntroduction: Copy number variants (CNV) of the 15q11.2q13.1 region are associated to recurrent microdeletion/microduplication syndromes in which the phenotype is dependent on the parental origin of the CNV.
We report the case of a fetus from a healthy 39-year-old G6P3A2 woman, with an increased risk for trisomy 21 in the 1st trimester prenatal screening. Chromosomal microarray analysis (CMA) was requested and revealed a pathogenic duplication in which the outcome was dependent of the parental origin of the affected allele.
Methods: DNA was extracted from a chorionic villus sample and CMA was performed using Cytoscan™ 750K. Parental follow-up studies to assess the origin of the CNV were performed.
Results: The CMA profile revealed a male fetus with a 4,89 Mb interstitial gain in 15q11.2q13.1.
CMA of the parents showed that the duplication was paternally inherited.
Discussion: The detected CNV is a recurrent known microduplication and according to the American College of Medical Genetics and Genomics guidelines is classified as pathogenic.
However the phenotype is dependent on the parental origin of the duplication. When it arises in the maternally allele it has a severe outcome with hypotonia, cognitive deficit, seizures, among others. If the CNV occurs in the paternal allele although some patients might show developmental delays and behavioral disturbances most cases are rarely symptomatic.
In this case, CMA of both parents showed that the CNV identified in the fetus was paternally inherited. Although the CMA result did not explained the increased risk for T21 after determining the duplication had been inherited from the father it allowed the prediction of the most likely resulting phenotype for the fetus as a milder or even asymptomatic.
Follow-up ultrasounds at gestation age of 17w+6d and echocardiogram at 21w+3d showed no structural abnormalities. The baby was born at 37w+5d with an Apgar index of 10/10/10, with no dysmorphic features or malformations, and a normal physical exam.
This case illustrates that although the use of genetic tools using artificial intelligence and following determined guidelines can be helpful for the purpose of consistency and standardization on the classification we always need careful evaluation from a clinical laboratory geneticist on the context of each case. Additionally it also shows how critical parental testing can be, not only to assess recurrence risk but to provide the best possible tool to ascertain the outcoming phenotype and allow the best choices to the couple after genetic counselling.N/
Strategies for Monitoring Microbial Life in Beach Sand for Protection of Public Health
Get PDFReviewThe 2021 revised guidelines of the World Health Organization recommend monitoring the quality of sand in addition to water at recreational beaches. This review provides background information about the types of beaches, the characteristics of sand, and the microbiological parameters that should be measured. Analytical approaches are described for quantifying fungi and fecal indicator bacteria from beach sand. The review addresses strategies to assess beach sand quality, monitoring approaches, sand remediation, and the proposed way forward for beach sand monitoring programs. In the proposed way forward, recommendations are provided for acceptable levels of fungi given their distribution in the environment. Additional recommendations include evaluating FIB distributions at beaches globally to assess acceptable ranges of FIB levels, similar to those proposed for fungi.Financial support from CESAM (UID/AMB/50017-POCI-01-0145-FEDER-007638) and
CITAB (UID/AGR/04033/2019), via FCT/MCTES, from national funds (PIDDAC), cofounded by
FEDER, (PT2020 Partnership Agreement and Compete 2020) and the work of Dr. Monika Novak
Babiˇc was supported by the Slovenian Research Agency (ARRS) through the postdoctoral research
project (grant number Z7-2668) and the research program, grant number P1-0198.info:eu-repo/semantics/publishedVersio
Nutritional quality of foods consumed by the Portuguese population according to the Nutri-Score and consistency with nutritional recommendations
Get PDFIn the last few years, public health authorities have shown interest in introducing front-of-pack labelling (FOPL), as one of the main policies to combat diet-related non-communicable diseases (NCDs). Nutri-Score is a FOPL that categorizes a food product into five categories according to its nutritional value.
This study aimed to investigate the ability of Nutri-Score to discriminate the nutritional quality of foods consumed by the Portuguese population and the consistency with the food-based dietary guidelines.
The applicability of Nutri-Score was assessed by applying it to 165 food products that were considered under the PT-Total Diet Study (PT-TDS).
At least three categories (colours/letters) of the Nutri-Score were observed for most of the food groups and for sub-groups a minimum of two categories were identified. The Nutri-Score showed moderate agreement with the Portuguese Nutrient Profile Model (PT-NPM) (k = 0.416).
The food classification according to the Nutri-Score was consistent with the nutritional recommendations. Food groups in which consumption is encouraged were more favourably classified than those in which consumption should be limited (i.e., Vegetables and Pastries were classified as A (93.0%) and E (57.1%), respectively).
Appropriate food labelling with a system such as Nutri-Score can be relevant to health-promoting purchasing choices, improving diet quality and consequently public health.This work has been funded by the National Health Institute Doutor Ricardo Jorge, I.P., under the project ‘Incentivo aos Estudos de Dieta Total’ (Reference number 2016DAN1260). Elsa Vasco and M. Graça Dias
previous work (unpublished) contributed to this study, and they were responsible for the sampling plan, collection and treatment of food products, which we thank.
This manuscript was developed under the scope of WHO Collaborating Centre on Nutrition and Childhood Obesity—National Health Institute Dr. Ricardo Jorge.
Ricardo Assunçao ˜ thanks FCT/MCTES for the financial support to CESAM (UIDP/50017/2020 + UIDB/50017/2020), through national funds.info:eu-repo/semantics/publishedVersio
Prevention, protocols, and lab capacity: lessons from a norovirus outbreak in the Algarve
No full textOutbreak Investigation Team: Carlos Lopes, Ana Fonseca, Soraia Almeida, Maria Jesus Ferreira, Tiago Almendra, Natalie des Neves, Aida Fernandes, Carolina Queiroz, Carla Maia, Joaquim Bodião, Ana Cristina GuerreiroThis brief report presents the findings of an epidemiological investigation into a large-scale outbreak of norovirus gastroenteritis that occurred in a hotel in Algarve, Portugal, in August 2022. A total of 244 cases were reported, primarily affecting Portuguese families, with the parents aged 40-50 years and the children aged 0-19 years. Reported symptoms included vomiting, nausea, abdominal pain, and diarrhoea. Norovirus genotype GI.3 [P3] was detected in stool samples from eight probable cases, while food samples tested negative for norovirus and common pathogenic bacteria. The investigation data collected suggest that the source of the outbreak was likely in the hotel's common areas, with subsequent person-to-person transmission in other areas. The final report emphasizes the importance of improving outbreak prevention and control measures, including the development of a foodborne outbreak investigation protocol, the establishment of an outbreak response team, and the enhancement of regional laboratory capacity.info:eu-repo/semantics/publishedVersio
Visual comet scoring revisited: a guide to scoring comet assay slides and obtaining reliable results
No full textMeasurement of DNA migration in the comet assay can be done by image analysis or visual scoring. The latter accounts for 20%-25% of the published comet assay results. Here we assess the intra- and inter-investigator variability in visual scoring of comets. We include three training sets of comet images, which can be used as reference for researchers who wish to use visual scoring of comets. Investigators in 11 different laboratories scored the comet images using a five-class scoring system. There is inter-investigator variation in the three training sets of comets (i.e. coefficient of variation (CV) = 9.7%, 19.8%, and 15.2% in training sets I-III, respectively). However, there is also a positive correlation of inter-investigator scoring in the three training sets (r = 0.60). Overall, 36% of the variation is attributed to inter-investigator variation and 64% stems from intra-investigator variation in scoring between comets (i.e. the comets in training sets I-III look slightly different and this gives rise to heterogeneity in scoring). Intra-investigator variation in scoring was also assessed by repeated analysis of the training sets by the same investigator. There was larger variation when the training sets were scored over a period of six months (CV = 5.9%-9.6%) as compared to 1 week (CV = 1.3%-6.1%). A subsequent study revealed a high inter-investigator variation when premade slides, prepared in a central laboratory, were stained and scored by investigators in different laboratories (CV = 105% and 18%-20% in premade slides with comets from unexposed and hydrogen peroxide-exposed cells, respectively). The results indicate that further standardization of visual scoring is desirable. Nevertheless, the analysis demonstrates that visual scoring is a reliable way of analysing DNA migration in comets.Certain authors have acknowledged funding as follows:
statutory funding for INTC and IRH (Maria Wojewódzka
and Marcin Kruszewski); Spanish Ministry of Science and
Innovation MCIN/AEI/10.13039/501100011033 (Grants
PID2020- 113788RB-I00 and PID2020-114908 GA-I00),
and Xunta de Galicia (Grant ED431B 2022/16) (Vanessa
Valdiglesias and Blanca Laffon); Spanish Ministry of Science
and Innovation (Ref.: PID2020-115348RB-I00) (Amaya
Azqueta); Università degli Studi di Firenze fund RICATEN21
and RICATEN22 (Lisa Giovannelli).info:eu-repo/semantics/publishedVersio
Avaliação da Segurança de Nanomateriais de Celulose Inovadores
No full textAgradecemos Universidade de Coimbra e RAIZ, pela produção/caracterização das CNMsIntrodução: Na sociedade atual verifica-se uma preocupação acrescida com a exposição humana a materiais que, embora previamente considerados seguros, poderão revelar-se perigosos para a saúde quando usados à nanoescala. Este poderá ser o caso dos nanomateriais de celulose (CNMs), produzidos de fontes naturais, explorados para diversas aplicações, em particular na indústria alimentar. Podem ser usados como aditivos alimentares (e.g. estabilizadores ou espessantes), fonte de fibra não calórica, ou em embalagens alimentares(1). Antecipa-se um aumento da exposição humana, por ingestão de alimentos contendo CNMs, contaminados através das embalagens alimentares ou por acumulação no ambiente(1). Porém, o conhecimento sobre a sua segurança, em particular os seus efeitos no trato gastrointestinal (GIT), permanece limitado(1). É imperativo estudar os seus potenciais efeitos no organismo após ingestão oral, antes da sua colocação no mercado, avaliando a sua segurança com base nas recomendações da Autoridade Europeia para a Segurança Alimentar(2).
Objetivos: Este trabalho visou investigar os potenciais efeitos de dois CNMs no GIT, através da avaliação de potenciais efeitos citotóxicos e genotóxicos em dois modelos celulares intestinais humanos (Caco-2 e HT29-MTX-E12).
Metodologia: Estudaram-se duas celuloses micro/nanofibriladas (CNFs) inovadoras, produzidas a partir de polpa kraft branqueada industrial de Eucalyptus globulus. A citotoxicidade foi avaliada pelos ensaios MTT e clonogénico, enquanto a genotoxicidade foi analisada pelos ensaios do micronúcleo e do cometa.
Resultados: Não se observou efeitos citotóxicos após exposição aos CNFs nas concentrações testadas, independentemente da linha celular utilizada. Também, não se observaram alterações cromossómicas nas duas linhas celulares expostas a cada CNFs através do ensaio do micronúcleo. Porém, os resultados do ensaio do cometa revelaram a indução de quebras no DNA das células HT29-MTX-E12, após 3h e 24h de exposição para as duas CNFs. Esse efeito foi inconsistente nas células Caco-2 após um tratamento semelhantes com as mesmas amostras.
Conclusões: Os resultados obtidos suscitam preocupação sobre a segurança destas CNMs, pois observou-se um efeito genotóxico que deverá continuar a ser investigado, através de testes complementares. Destaca-se a importância de investigar os efeitos genotóxicos, associados a um potencial efeito carcinogénico, para além de uma simples análise da sua citotoxicidade, como é frequentemente utilizada para afirmar a biocompatibilidade de CNMs. Assim, deverá promover-se novas metodologias de produção, uma maior purificação ou uma alteração das propriedades físico-químicas destas CNFs, para reduzir a sua toxicidade, prevenindo, assim, eventuais efeitos nefastos na saúde humana.
Referências:
1. Vital N, Ventura C, Kranendonk M, Silva MJ, Louro H. Toxicological Assessment of Cellulose Nanomaterials: Oral Exposure. Nanomaterials [Internet]. 2022 Sep 27; 12(19): 3375
2. EFSA Scientific Committee. Guidance on risk assessment of nanomaterials to be applied in the food and feed chain: human and animal health. EFSA Journal [Internet]. 2021 Aug 3; 19(8):6768Financiamento: FCT/MCTES(PTDC/SALPUB/29481/2017;PTDC/SAUPUB/32587/2017); (UIDB/00009/2020;UIDP/00009/2020); NV com bolsa FCT/MCTES(2020.07168.BD).Agradecemos Un. de Coimbra e RAIZ, pela produção/caracterização das CNMs.info:eu-repo/semantics/publishedVersio