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Biomedical subjects

H Barros

Publications and source records attributed to H Barros.

At least 37 records · Page 2Linked to original sources
PubMed2002

Clinical profiles relating gender and depressive symptoms among adolescents ascertained by the Beck Depression Inventory II.

PURPOSE: Depressive disorders (DD) in adolescence are often misdiagnosed and under-recognised. A major clinical problem regards the high rate of co-morbidity with other disorders, namely substance abuse. The aim of this study was to assess the discriminative power of the Beck Depression Inventory II (BDI-II) to characterise specific social-demographic variables related to DD in adolescence. METHODS: A Portuguese version of the BDI-II and a social-demographic questionnaire were administered to 775 Portuguese adolescents (312 males, 463 females; mean age: 16.9 years); 83 adolescents performed a clinical interview following DSM-IV criteria. RESULTS: Mean BDI-II Portuguese version (BDI-II-P) total score was 10.31 (standard deviation: 8.4), with females reporting more depressive symptoms than males (P < 0.001). Low academic achievement, sleep disturbances, and alcohol consumption were consistently associated with depressive symptoms for both genders. Higher tobacco consumption was significantly associated with depressive symptoms in females. Familial factors did not appear to be associated with depressive symptoms in males. However, a higher frequency of siblings, having separated parents as well as a more extreme perception of the mother's educational style were consistently associated with depressive symptoms in females. CONCLUSION: The BDI-II-P showed discriminative power to characterise social-demographic variables related to DD especially in adolescent females.

Adolescent↗
PubMed1999

Susceptibility to tetanus and missed vaccination opportunities in Portuguese women.

Maternal and cord sera (96 pairs) were tested to measure antitetanus toxin IgG (ATT IgG) levels, using a commercial enzyme immunoassay. One mother had no detectable antitetanus antibody and four more had levels below those considered to be reliably protective (<160 mIU/ml). All five had been eligible for vaccination during pregnancy according to Portuguese guidelines, although one had received seven lifetime doses of TT. In maternal and cord sera, ATT IgG levels among those not vaccinated during the current pregnancy were significantly lower than among vaccinees (p < 0.0001), but there was no difference between those vaccinated once or twice during pregnancy. Among those not vaccinated during pregnancy, levels of ATT IgG decreased with time since last dose of vaccine (P = 0.0001). The total number of doses of vaccine was not significantly associated after controlling for time since last dose. Missed immunization opportunities occurred among half the women studied. Efforts to sustain protection against tetanus must be intensified.

Adolescent↗
PubMed1999

[Laparoscopy or laparotomy in acute cholecystitis (200 cases). Comparison of the results and factors predictive of conversion].

STUDY AIM: The aim of this prospective study was to compare the results of cholecystectomy for acute cholecystitis through laparoscopic and open approach and to assess factors responsible for conversion into laparotomy. PATIENTS AND METHODS: From January 1991 to October 1997, 200 patients with calculous acute cholecystitis were operated on in the same center, 100 through laparoscopy and 100 through laparotomy. Choice between these two procedures was only dependent on the disresponsibility of videolaparoscopic material. Comparison between laparoscopy and laparotomy groups concerned postoperative mortality and morbidity rates, hospital stay duration and late results. Intraoperative conversion into laparotomy occurred in 24 patients and factors responsible for conversion were assessed with univaried and multivaried analysis. RESULTS: Both groups were comparable with regard to sex ratio, age, ASA score but associated diseases incidence, plastron, fever above 38 degrees C and leucocytosis were significantly more frequent in the laparotomy group and delay between diagnosis and surgery was significantly longer in the laparoscopic group. There were two postoperative deaths in the laparotomy group, 0 in the laparoscopic group (NS). Morbidity rate was higher (32% versus 10%) (p = 0.0002) and hospital stay longer (12 +/- 10 days, versus 5 +/- 3) in the laparotomy group (p = 0.00005). Late results were similar in both groups. Conversion rate into laparotomy was 24%. Factors predisposing significantly to conversion were in univaried analysis: plastron, fever above 38 degrees C, leucocytosis, delay between diagnosis and surgery above 4 days, presence on ultrasonography of pericholecystic liquid and gallbladder wall edema, presence of "Klebsiella" in gallbladder bile. With multivaried analysis, leucocytosis and delay between diagnosis and surgery were the only independent factors. CONCLUSION: Videolaparoscopic cholecystectomy is a safe and efficient technique in the treatment of acute cholecystitis, with a lower postoperative morbidity rate and a shorter hospital stay. Conversion rate into laparotomy is significantly dependent on leucocytosis and delay between diagnosis and surgery. Laparoscopic cholecystectomy should be performed as soon as possible in acute cholecystitis.

Acute Disease↗
PubMed1999

Differences in behavior profile between normotensive subjects and patients with white-coat and sustained hypertension.

It has been hypothesized that white-coat hypertensives (WCHs) have lower cardiovascular risk than sustained hypertensives (HTs), but higher emotional reactivity. We evaluated 92 HT patients (clinic and daytime BP>140/90 mmHg), 52 WCHs (clinic BP>140190 and ambulatory daytime BP<134/ 85 mmHg), and 74 normotensive subjects (NTs, clinic BP<140/90 and ambulatory daytime BP<134/85 mmHg), aged between 24 and 72 years, and matched for educational level, age, gender, and weight for depression, psychopathology, well-being, and quality of life. HTs showed worse scores than WCHs and NTs on most of the psychological variables; no differences were found between WCHs and NTs except on physical mobility. Daytime BP variability was HTs>WCHs>NTs, whereas nighttime BP variability was HTs>WCHs=NTs. We conclude that HTs have worse psychological profiles than the other two groups. WCHs and NTs have similar psychological profiles, although WCHs have a higher daytime BP variability, which is not associated with higher emotional reactivity.

Adult↗
PubMed1999

Bone mineral density and depression: a community study in women.

In a community sample of 102 Portuguese white women we evaluated the relationship between osteoporosis and indexes of psychopathology and well-being. Depressive symptoms were assessed by the Beck Depression Inventory (BDI), psychopathology by the Hopkins Symptom Checklist-90 Revised (SCL-90-R), and quality of life using the Psychological General Well-Being Index. A questionnaire comprising social, demographic, clinical, and behavioral characteristics was also used. The sample prevalence of osteoporosis was 47.1%. Women with osteoporosis presented significantly higher scores on the total BDI (16+/-9 vs. 13+/-10, p=0.045) and lower scores in the hostility (0.8+/-0.6 vs. 1.2+/-0.7, p=0.012) and phobic anxiety (1.1+/-0.8 vs. 1.5+/-0.9, p=0.041) subscales of the SCL-90-R. No differences were found regarding mean general well-being scores (62+/-17 vs. 64+/-19, p=0.665). This study showed that women with osteoporosis have significantly higher levels of depressive symptoms and a corresponding higher prevalence of depression, independent of other factors strongly associated with osteoporosis, such as age or body mass index.

Adult↗
PubMed1999

Transplacental transfer of measles and total IgG.

This study was conducted to evaluate factors affecting the levels of total IgG (tIgG) and measles specific IgG (mIgG) in mother and cord sera, and the efficiency of transplacental transport of tIgG and mIgG. The study was conducted in four hospitals in Oporto, Portugal, where 1539 women and their newborns were enrolled. Measles IgG levels were lower among vaccinated mothers and respective cord sera than among vaccinated counterparts. Cord mIgG was strongly correlated with maternal levels in both vaccinated and unvaccinated groups. Transplacental transport efficiency (TTE) of mIgG decreased with increasing maternal levels, although almost one third of the observed effect was due to measurement error. The TTE was not affected by vaccination status. Monitoring maternal measles antibody levels and maternal vaccination status could be useful to determine when the age for measles vaccination can be reduced.

Adolescent↗
PubMed1999

A survey on hepatitis A in Portuguese children and adolescents.

In the early 1980s, Portugal could be classified as a highly endemic area for hepatitis A. However, marked economic and sanitary improvements took place during the following years. In this study we evaluated the temporal trends in the prevalence of hepatitis A in children and adolescents, to identify risk factors for the infection. The study sample included students aged 6 to 19 years (n=999), attending public and private schools. All randomly selected participants gave information on social, demographic, clinical and behavioural variables, but only 667 (67.4%) agreed to provide a blood sample for the determination of total and immunoglobulin M (IgM) anti-hepatitis A virus (HAV) antibodies. The prevalence of anti-HAV-positive subjects was 27.9%, with a linear age-related increase (r=0.87, P=0.011) from 20.9% at 6-7 years to 37.8% at 18-19 years. The crowding index and the level of maternal education were the only independent predictors of hepatitis A infection. This study showed a clear decrease in hepatitis A prevalence in our population. However, it remains a common infection in Portugal, easily acquired early in life and associated with indicators of poverty.

Adolescent↗
PubMed1999

Serum hyaluronan as a marker of liver fibrosis in asymptomatic chronic viral hepatitis B.

Increased concentrations of serum hyaluronan, a polysaccharide widely distributed in the extracellular space, have been demonstrated in liver disease of various aetiologies and proposed as a useful marker of liver fibrosis. The aim of the present study was to evaluate the association of serum hyaluronan with the extent of hepatic fibrosis in asymptomatic cases of chronic hepatitis B viral infection. The study was conducted in a consecutive sample of 111 asymptomatic chronic carriers of hepatitis B surface antigen. Liver function tests, alcohol consumption and cigarette smoking were determined and, for 84 subjects, liver biopsy was performed and degrees of inflammation and fibrosis were scored. Hyaluronan was measured using a radiometric assay. Mean serum hyaluronan increased with increasing fibrosis score (from 22.2 +/- 4.8 to 50.6 +/- 12.7 microg/l, p = 0.058) or pathological severity (from 18.8 +/- 5.9 to 50.6 +/- 12.5 microg/l, p = 0.048), even after adjusting for the effect of age. No such correlation was found with portal inflammation. The study showed that, in asymptomatic chronic carriers of hepatitis B, serum hyaluronan concentration correlates with hepatic fibrosis, a known marker of disease prognosis. This finding supports the hypothesis that hyaluronan might be of use in assessing and monitoring time trends in liver disease, substituting for repeated biopsies.

Biomarkers↗
PubMed1999

Acute myocardial infarction: psychosocial and cardiovascular risk factors in men.

BACKGROUND: Controversy still exists over the independent role of psychosocial factors in acute myocardial infarction (AMI). This study aimed to compare psychometric indices in Portuguese patients surviving a first episode of AMI and a community sample free of AMI. DESIGN: A community-based, case-control study. The study sample included 153 male patients with a first episode of AMI and 156 male controls randomly selected from the community. METHODS: Information on demographic, social, medical and behavioural characteristics was obtained using a structured questionnaire; anthropometric, blood pressure, and serum measurements were performed, and the psychometric evaluation was obtained using a self-evaluation questionnaires (Bortner scale, Beck Depression Inventory, SCL-90-R, Psychological General Well-Being and the Nottingham Health Profile). RESULTS: Cases of AMI more often exhibited type A behaviour (15.4 +/- 3.0 versus 14.7 +/- 2.7, P = 0.041), had more depressive symptoms (10.8 +/- 8.0 versus 8.6 +/- 8.0, P = 0.005) and showed worse scores on general well-being (68.4 +/- 17.7 versus 76.6 +/- 16.2, P < 0.001) than controls. Cases were significantly different from controls in terms of years of education (6.7 +/- 4.4 versus 9.0 +/- 4.7 years, P < 0.001), hypertension (43.1% versus 30.1%, P = 0.024), dislipidaemia (43.8% versus 34.0%, P = 0.038), type I obesity (53.6% versus 42.3%, P = 0.045), smoking (54.1% versus 26.5%, P < 0.001), no practise of exercise (68.5% versus 50.3%, P = 0.002) and presence of non-insulin-dependent diabetics (16.3% versus 6.4%, P = 0.010). After adjusting for such factors a similar set of significant psychometric results was found. CONCLUSION: Type A behaviour, depression and lower levels of well-being and quality of life, independent of other cardiovascular risk factors, were significant features of AMI cases.

Adult↗
PubMed1999

Upper-body adiposity and risk of myocardial infarction.

BACKGROUND: The relation between obesity and coronary heart disease (CHD) has long been studied, but no convincing conclusion has been drawn. OBJECTIVE: To estimate the relative risk associated with upper-body adiposity which is at present believed to be a better predictor of CHD. DESIGN: This was a community-based case-control study. METHODS: We studied 338 consecutively admitted patients who had had their first acute myocardial infarction (AMI) and 662 community controls who had not suffered AMI selected as a random sample of adults living in the catchment area of the hospital. We defined three classes of body mass index (BMI) and waist: hip circumference ratio on the basis of tertiles of distribution for controls. Odds ratios (OR) were estimated using unconditional logistic regression. Separate models were built for men and women. RESULTS: In univariate analysis we found a higher risk of AMI for men and women with hypertension, dyslipidaemia, diabetes and lower levels of education, for older women, for male smokers and for men with family histories of CHD. Both for men and for women a higher BMI was associated with a slightly higher risk, whereas the adjusted risk of AMI increased with increasing waist: hip circumference ratio [for men OR (second tertile)= 2.5, 95% confidence interval (CI) 1.3-4.9 and OR (third tertile)= 11.1, 95% CI 6.0-20.6; for women OR (second tertile) = 3.0, 95% CI 0.6-14.8 and OR (third tertile) = 14.1,95% CI 3.2-62.7]. This relation held for each BMI class and was stronger for classes of lower BMI. CONCLUSIONS: Distribution of body fat rather than BMI is a strong marker of risk for AMI and there is a clear interaction between these two variables.

Adult↗
PubMed1999

Neonatal cerebral Doppler: arterial and venous flow velocity measurements using color and pulsed Doppler system.

OBJECTIVE: To contribute to the establishment of reference values of blood flow velocity assessed by cerebral Doppler in healthy infants related to gestational age and birth weight during the first week of life. METHODS: Five arteries and three veins were evaluated respectively in 120 (74 premature) newborns and in 100 (70 preterm) infants. In a quarter of the latter three recordings at 5-minute intervals were made to assess reproducibility. The relation between flow measurements and gestational age was assessed by linear regression, means by analysis of variance (or Kruskall-Wallis test) and paired samples by Student's t test. RESULTS: There was a significant increase of arterial velocities with increasing gestational age and birth weight, but not for venous velocities. Significant higher values were found in the internal carotid artery followed by the medium cerebral artery. The venous velocities were highly reproducible and the main patterns observed were bandlike and sinusoid type. CONCLUSION: The knowledge of normal cerebrovascular physiology is essential to understand the pathogenesis of neonatal brain damage and can help pediatricians in an accurate interpretation of the flow profile in neurological pathology.

Arteries↗
PubMed1999

Tobacco smoking among Portuguese high-school students.

The aim of this study was to evaluate the prevalence, behavioural patterns, and determinants of smoking among a large sample of high-school students from Porto, the second largest city in Portugal, information on sociodemographic characteristics and personal history of tobacco, alcohol, coffee, and illicit drug use was obtained from 2974 students, aged 12-19 years (48.7% female, 51.3% male), using an anonymous self-administered questionnaire. Crude and adjusted odds ratios (OR) were calculated by logistic regression analysis to estimate the association between smoking and the characteristics evaluated. Overall, 35.8% students had never smoked, 39.4% had tried it ("experimental" smokers) but were not smokers, 3.3% were former smokers, 6.6% occasional smokers, and 14.9% regular smokers. The mean age for starting smoking was 13.4 +/- 2.1 years for males and 13.4 +/- 1.6 years for females. The prevalence of current smoking was higher among males than females, but the difference was not significant. Male students were significantly more likely to smoke more cigarettes per day than were females. The prevalence of smoking was significantly associated with the following variables: being aged > 12 years; having parents who had attended school for < 4 years; having a mother (OR = 1.88), siblings (OR = 1.96) or friends (OR = 1.75) who smoked; low academic performance (OR = 1.74 for one or two failures and OR = 2.27 for more than two failures at school); and consumption of coffee (OR = 2.90), alcohol (OR = 3.53), or illicit drugs (OR = 6.69). The prevalence of smoking among adolescents increased with age. There is therefore a need for school-based tobacco prevention programmes which also deal with family influences on smoking.

Adolescent↗
PubMed1998

Outcome of 88 pregnancies with absent or reversed end-diastolic blood flow (ARED flow) in the umbilical arteries.

OBJECTIVES: To investigate both perinatal and postneonatal morbidity and mortality in fetuses with absent or reversed end-diastolic flow (ARED flow) in the umbilical artery. STUDY DESIGN: A 5 year prospective follow-up of 88 fetuses with ARED flow. RESULTS: Sixteen stillbirths, 16 neonatal deaths, six postneonatal deaths and one death at 2 years of age were noted. Out of the 42 fetuses born alive, 36 showed a normal neurological development whereas six were mentally handicapped. Adverse prognosis was more frequently found in the group with absent end-diastolic flow at first examination and then reversed flow until delivery, compared to the groups of always absent or always reversed end-diastolic flows. CONCLUSIONS: Prompt delivery is recommended in these high-risk pregnancies in order to prevent long-term sequelae, obviously depending on the local limits of viability. Further studies appropriately designed for assessing long-term neurodevelopment of fetuses with ARED flow, although demanding, are mandatory.

Female↗
PubMed1998

Variation of embryonic/fetal heart rate at 6-13 weeks' gestation.

The aim of this study was to investigate changes in heart rate, namely the intraindividual variation, in normal embryos/fetuses between 6 and 13 weeks' gestation. A prospective study was performed of 41 singleton pregnancies undergoing routine ultrasound examination during the first trimester of pregnancy. For each case, the embryonic/fetal heart rate was measured on three consecutive occasions with a mean interval of 4 min. The difference in heart rate values between the serial measurements varied from 0 to 18 beats/min and was significantly associated with gestational age (Spearman r = 0.26, p < 0.01). In the group of 15 fetuses (examined before 10 weeks' gestation), the difference between measurements (median = 0 beats/min, range 0-8 beats/min) was significantly lower (z = 2.48, p < 0.05) than in fetuses assessed after 10 weeks of gestation (median = 3, range 0-18 beats/min). Reliable and reproducible information concerning embryonic/fetal heart rate may be obtained from a single measurement, especially when pregnancies are examined before 10 weeks of gestation.

Female↗
PubMed1998

[Risk factors for preterm labor].

OBJECTIVES: Most studies investigating preterm risk factors include medically induced preterm labor due to fetal or maternal complications and do not distinguish preterm labor from preterm premature rupture of membranes. Thus, the objective of this study was to determine the proportion of the three types of preterm birth and identify risk factors for spontaneous preterm labor in a sample of pregnant women who delivered at two level III units. STUDY DESIGN: From January to October 1996, we interviewed 385 women with live preterm newborns and, as controls, 357 mothers of term newborns. Preterm births were classified as preterm labor, preterm premature rupture of membranes and iathrogenic preterm. Independent associations between maternal sociodemographic, constitutional, nutritional and obstetric characteristics and preterm labor were identified using logistic regression analysis. RESULTS: In this sample of preterm births, 29% corresponded to preterm labor, 49% to preterm premature rupture of the membranes and 22% were iathrogenic preterm. The identified risk factors for preterm labor were multiple gestation, no paid work during pregnancy, less than six prenatal care visits, arm circumference less than 26 cm and previous preterm or low birth-weight. Gestational bleeding during the first or third trimester was significantly associated with preterm labor. CONCLUSIONS: As previously recognized, multiple gestation, prior preterm or low birthweight and gestational bleeding are established risk factors for preterm labor. However, prenatal care, maternal work and nutritional status have also been revealed as important issues in preterm risk, deserving special interest since they are susceptible to preventive intervention.

Adult↗