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At least 181 records · Page 10Linked to original sources
PubMed2001

Determination of deoxynivalenol in wheat-based breakfast cereals marketed in Portugal.

Deoxynivalenol (DON), also known as vomitoxin, is one of a group of closely related secondary fungal metabolites--the trichothecenes--and is produced predominantly by several species of the genus Fusarium, especially Fusarium graminearum. The present study was carried out to evaluate the natural occurrence of DON in different kinds of wheat-based breakfast cereals widely consumed by the population. A total of 88 commercially available samples of wheat-based breakfast cereals were randomly collected from different supermarkets in Lisbon, Portugal. The samples were analyzed using immunoaffinity column, and DON was quantified by liquid chromatography. Detection limit was 100 microg/kg. Average recovery of DON was 80%. Of 88 analyzed samples, 72.8% contained levels of DON between 103 and 6,040 microg/kg, with mean level of 754 microg/kg, and 24 samples (27.2%) were not contaminated (< 100 microg/kg). These results indicate an incidence of this mycotoxin in these products, and the authors suggest a monitoring for the prevention of molds and mycotoxins. This is the first report in Portugal on natural contamination with DON in wheat-based breakfast cereals.

Chromatography, Liquid↗
PubMed1990

Leprosy in Portugal 1946-80: epidemiologic patterns observed during declining incidence rates.

Compulsory notification of leprosy in Portugal formed the basis for the establishment of a national patient registry used in an epidemiological study. Highest incidence rates were observed in the coastal counties in the middle of Portugal and particularly in the municipalities with a high annual rainfall. Peak incidence rates in males was observed at the age of 25-29 years against 50-59 in females. A continuous and increasing decline in incidence rates was observed throughout the observation period, 1946-80. Towards the end of the period the slopes of the incidence curves seemed to be identical with those observed in other countries where leprosy has previously been eradicated. This is consistent with the notion that towards the end of an endemic situation no new transmission of the disease occurs, and the incidence curve takes the shape of the right part of the distribution of incubation periods which apparently is uniform in leprosy, irrespective of time and place. The pattern observed in other areas during declining incidence rates, of an increase in age at onset by year of onset together with a lack of increase in age at onset by year of birth was confirmed by the Portuguese data, also consistent with a break in the transmission of the disease a long time before the final termination of the endemic situation.

Adolescent↗
PubMed1999

Unexpected pattern of beta-globin mutations in beta-thalassaemia patients from northern Portugal.

We characterized the genetic nature of beta-thalassaemia in northern Portugal. Of the 164 patients studied three were beta-thalassaemia major cases (one IVS-1-6/beta degrees 39 and two homozygous IVS-1-110). The analysis of the frequency of each mutation in the families revealed that the codon 6(-A) mutation was unexpectedly frequent (40%) and associated with the beta-globin haplotype E, and not with the usual European and North African CD6(-A) haplotypes. In contrast, the frequency of IVS-1-6 (8%) and beta degrees 39 (19%) was found to be lower than in the rest of the country. The frequency of all other mutations was similar to previous reports for central/southern Portugal. Six families carried none of the most frequent mutations in the Mediterranean area. These families were studied by gene sequencing, revealing that three families carried a previously described mutation (CD16 G --> A). The remaining families carried previously unidentified mutations: one showed an 86 bp insertion in exon 2 (named HGSA) and two showed a deletion of a cytidine in codon 11 (CD11(-C)). The results, showing a high frequency (82%) of beta degrees mutations, strongly indicates that genetic counselling should be intensified as a means of preventing the spread of the severe mutations found.

Adolescent↗
PubMed1999

[Prevalence of heart failure in Portugal].

UNLABELLED: The incidence and prevalence of heart failure are increasing, which presents an enormous problem for health care systems. In Portugal, there are no studies assessing this issue. The EPICA study was designed to estimate the prevalence of chronic heart failure in Portugal in 1998. This is a community-based epidemiological survey involving 13,000 primary care recipients, selected through a two-stage sampling procedure: each GP, from a random sample of 500, with proportionality to district population, will include 26 primary care recipients recruited sequentially within each age group. The cases will be identified according to ESC Guidelines: symptoms and signs of heart failure and echocardiographic evidence of cardiac dysfunction. The individuals will be screened for echo examination on the basis of a structured questionnaire (EPICA questionnaire) that was drafted from seven questionnaires previously used in epidemiological surveys for heart failure. Age and gender adjusted estimates of the prevalence of chronic heart failure will be obtained as well as a prevalence estimate for the whole population. The study will also estimate the test statistics (sensitivity, specificity and predictive values) for the EPICA questionnaire compared to echo data, as well as the seven other questionnaires used for the diagnosis of chronic heart failure. Their agreement will also be evaluated. PRELIMINARY RESULTS: 93% of the GPs recruited have participated. The final data will be available in early 2000.

Adult↗
PubMed2000

Human immunodeficiency virus type 2 (HIV-2) in Portugal: clinical spectrum, circulating subtypes, virus isolation, and plasma viral load.

The human immunodeficiency virus type 2 (HIV-2) is responsible for 4. 5% of AIDS cases in Portugal. Six HIV-2 subtypes have been described so far, subtype A being proposed as more pathogenic than the rest. The relationship between the clinical status and levels of both cellular and plasma HIV-2 viraemia is not well known, nor their modifications under antiretroviral therapy. Thirty-two consecutive HIV-2 infected persons (17 men, 15 women) attending two different hospitals in Lisbon in 1997 were enrolled prospectively in the study. All but 4 individuals most likely acquired the infection through heterosexual contact. More than half of the study population was of African origin, mainly from Guinea-Bissau. Eleven (34.4%) patients had developed clinical manifestations included within the B or C groups of the CDC classification system for HIV infection, with the rest being asymptomatic. Half of the population was undergoing antiretroviral treatment at the time of the study. HIV-2 subtypes were investigated using a new Nef-based restriction fragment length polymorphism (RFLP) method that allows differentiation of the main two variants, A and B. Plasma viral load was quantified using a new quantitative competitive reverse transcriptase polymerase chain reaction (QcRT-PCR) procedure as well as the Amp-RT assay. Virus isolation was attempted from peripheral blood mononuclear cells. All but one person carried HIV-2 subtype A. Plasma viraemia examined by QcRT-PCR was measurable in 15 (50%) of 30 subjects, yielding in all instances values below 20,000 HIV-2 RNA copies per ml. Plasma RT activity could be detected in only 10 (33%) of 30 subjects, a rate much lower than that seen in HIV-1 infection. Virus was isolated from 16 (53.3%) of 30 patients. A significant correlation was found between CD4+ counts, clinical status, rate of virus isolation, and plasma viral load by both QcRT-PCR and Amp-RT. In conclusion, HIV-2 subtype A is the predominant variant circulating in Portugal among both natives and immigrants. A lower cellular and plasma viral load with respect to HIV-1 was seen in persons without immunosuppression, from whom the rate of virus recovery was extremely low.

Female↗
PubMed2000

Variation in STR loci of the human myelin basic protein gene: north Portugal and São Tomé e Príncipe.

Allele frequencies and a single-base substitution polymorphism for 3 short tandem repeat (STR) loci of the human myelin basic protein (MBP) gene were evaluated in North Portugal and São Tomé e Príncipe. Strong linkage disequilibrium between loci MBPB and MBPC was found. However, the patterns of nonrandom allelic associations were very different in the 2 populations: levels of haplotypic diversity and heterozygosity were higher in the São Tomé population. Similarly, a difference in the frequency of base substitution G-->A at position 124 was found: the frequency reached 4.1% in North Portugal and 0.5% in São Tomé. In both populations it was always found to be associated with haplotypes B10/C11 and B12/C9.

Alleles↗
PubMed2000

Allelic distribution of four tetranucleotide repeat loci (D3S1358, D18S51, D19S253, and FGA) in a population from Porto (North Portugal).

Allele frequencies for four short tandem repeat loci were determined in a population sample from Porto (North Portugal), using the polymerase chain reaction (PCR), in order to investigate possible genetic differences between populations from the center and north of Portugal. After denaturing PAGE electrophoresis, nine alleles were identified for D3S1358 (n = 256), 13 alleles for D18S51 (n = 235), 10 alleles for D19S253 (n = 238), and 15 alleles for FGA (n = 181). No deviations from Hardy-Weinberg equilibrium were found. The allele frequencies observed are similar to those of the Portuguese population compared except for the D3S1358 system.

Alleles↗
PubMedDate not supplied

Management of acute myocardial infarction in Portugal. Results of a nationwide survey.

UNLABELLED: The management of acute myocardial infarction (AMI) has improved markedly over the last decade. Large-scale trials have produced a large amount of evidence, and recommendations and guidelines have been established. Whether and to what extent these data have influenced everyday practice on a nationwide scale remains to be ascertained. The present observational prospective, registry was designed to assess current practice in in-hospital management of AMI in Portugal. For a period of 3 months (February to May, 1999), 44 centers, distributed all over the country, Atlantic islands included, enrolled 1372 cases of AMI corresponding to 1366 patients (996 male, mean age 65 +/- 13 years; 370 female, mean age 72 + 11 years; p < 0.0001). Non-ST segment elevation infarcts were present in 26% of cases. In-hospital mortality was 11.2% (154 pts, mean age 74 +/- 10 years). RESULTS: 519 pts (37.8%) were managed with reperfusion therapy, 413 of them with fibrinolysis (30.1%) and 106 with primary PTCA (7.7%). Besides the invasive procedures performed within the first few hours after admission, coronary angiography was performed in 327 more pts (26.1%); 143 pts were revascularized (PTCA in 117 pts and CABG in 26) and 96 more pts were discharged and referred for further revascularization. The total number of pts given or referred for a revascularization procedure (including the primary treatment) was 316 (20.6%). Besides reperfusion therapy the most commonly used drugs for secondary prevention were aspirin in 91%; ACE inhibitors in 63%; beta-blockers in 45%; and statins in 28%. Based on the results of this nationwide survey it can be concluded that the main international guidelines and recommendations for the medical management of acute myocardial infarction are generally being applied in Portugal.

Adult↗
PubMed2000

Opportunities for teaching and studying medicine in medieval Portugal before the foundation of the University of Lisbon (1290).

This paper discusses where Portuguese physicians studied medicine. The careers of two thirteenth-century physicians, Petrus Hispanus and Giles of Santarem, indicate that the Portuguese travelled abroad to study in Montpellier or Paris. But it is also possible that there were opportunities for study in Portugal itself. Particularly significant in this respect is the tradition of medical teaching associated with the Augustinian house of Santa Cruz in Coimbra and the reference to medical texts found in Coimbra archives. From these sources it can be shown that there was a suitable environment for medical study in medieval Portugal, encouraging able students to further their medical interests elsewhere.

Education, Medical↗
PubMedDate not supplied

Gastric cancer (carcinoma) and Helicobacter pylori: situation in Portugal.

This article of review describes the gastric cancer and Helicobacter pylori situation in Portugal. Regarding gastric carcinoma, it refers to the incidence data, geographical distribution as well as nutritional factors, which are potentially cancerous. Also mentioned are the prevalence data of Helicobacter pylori in Portugal.

Helicobacter Infections↗
PubMed2002

Heart transplantation in Portugal: current status and future perspectives.

No other form of therapy, whether medical or surgical, has an impact comparable to heart transplantation on the quality of life and survival of selected patients with severe heart failure. In the EU and in the USA about 10 patients per million of population are transplanted each year. In Portugal, a country with a population of 10 million, 100 patients should be transplanted each year, but only 12 patients were in fact transplanted in 1999. We rank 17th, in terms of the rate of heart transplantation per million of population, among the 23 European countries with registries of this activity. This is due to structural and organizational deficiencies of three main types: the lack of professional teams dedicated to severe heart failure treatment and heart transplantation; the lack of infrastructure, particularly heart failure wards and heart failure outpatient clinics; and the inappropriate distribution of the tasks associated with heart transplantation and patient follow-up. We present an estimate of the number of potential heart transplant candidates in Portugal, based on the EPICA study and a prediction of the resources needed for a successful heart transplantation program serving a population of 2 million. This was based on what is known of the natural history, morbidity and mortality of severe heart failure, on our own experience in this field, and finally on the experience of a large international heart transplantation center. The recommendations of the British Transplantation Society and those of the Department of Cardiothoracic Surgery of Stanford University were also taken into account.

Forecasting↗
PubMedDate not supplied

[Cutaneous leishmaniasis. Unusual disease in Portugal?].

Due to its morbility and disfiguring scars, cutaneous leishmaniasis is a serious Public Health problem. The incidence of the disease, world wide, is estimated to be of 1 million to 1.5 million cases per year. In Portugal, it has been considered a rare disease and sporadic cases have been described. In Southwest Europe, Leishmania infantum has been the only agent responsible for the autochthonous cases of cutaneous leishmaniasis. In 1994, in an portuguese clinical case, the parasite isolated from a cutaneous lesion was identified as L. infantum zymodeme MON-29. As described in this work cutaneous leishmaniasis should not be considered, any longer, a rare disease in Portugal.

Humans↗
PubMedDate not supplied

[Portugal and Europe are poliomyelitis free].

On the 21st of June 2002, in Copenhagen, the Regional Commission for the Certification of Poliomyelitis Eradication, declared the European Region of the World Health Organization (WHO) as polio-free. The last case (not imported) of poliomyelitis in Europe had occurred in November 1998. The health impact is enormous. In Portugal, the last case of poliomyelitis caused by the wild poliovirus, had occurred in December 1986. The path to eradication in Portugal had begun with a vaccination campaign in 1965/1966, with the oral polio vaccine (Sabin). High vaccination coverage has been maintained since then. The Portuguese program to eliminate poliomyelitis follows the strategic recommendations of WHO, with three components: vaccination; surveillance of acute placid paralysis (AFP); laboratory containment of wild polioviruses. Global eradication has not yet been achieved but is likely to happen till 2005. Keeping the high levels of motivation among Portuguese health workers is essential, in order not to loose what has been achieved. High vaccination coverage has to be maintained. Surveillance of AFP has to be improved and the prompt notification of cases by hospital clinicians, sending stool samples to the reference laboratory, is essential for the success of this activity. The laboratory containment programme is important to prevent the accidental reintroduction of poliomyelitis from laboratories.

Acute Disease↗
PubMedDate not supplied

[Post-traumatic stress disorder (PTSD). Assessment of its rate of occurrence in the adult population of Portugal].

AIM: This is the first epidemiological study of posttraumatic stress disorder (PTSD) within the adult population (over 18 years of age) in Portugal. This study is particularly relevant given the proportion of the population exposed to trauma: 800,000 men participated in 14 years (from 1961 to 1975) of Portugal's colonial wars. METHODS: A representative sample of the adult nation-wide population was defined using bi-phasic and stratified methodology. In accordance with study inclusion/exclusion criteria, subjects from all geographical regions were selected, either randomly from the community or via the protocol defined stratification. Subjects identified as having been exposed to one or more traumatic events were further interviewed and assessed with the Short Screening Scale (Breslau, 1999) to determine the presence/absence of DSM-IV defined PTSD. FINDINGS: A representative sample of 2,606 subjects (53.3% men) was selected, aged 18 to 99 years old (mean = 43 years). Overall PTSD prevalence rate was 7.87% (205/2,606 subjects) with a statistically significative different distribution by gender: 4.8% for male and 11.4% for female subjects. Around 75% of the Portuguese adult population was exposed to at least one traumatic situation and 43.5% to more than one. We found that 11.6% of the sample were male exposed to combat/war and 9.9% of those developed PTSD. The most referred traumatic situation was Sudden violent death of family or friend, (29.3%), followed by Robed or assaulted, (22.7%) and Witnessing of serious accident or death, (22.2%). CONCLUSIONS: The prevalence of posttraumatic stress disorder (overall and by gender) was similar to that reported for other developed countries; lower than expected, given the extent of the population's exposure to combat.

Adolescent↗
PubMed2004

Burden of disease from hypercholesterolemia in Portugal.

Cardiovascular diseases are the main cause of death in Portugal, in developed countries and indeed, worldwide. Hypercholesterolemia is a major risk factor for these diseases. What are the potential health gains to be obtained by reducing the prevalence of hypercholesterolemia in the Portuguese population? How are they to be estimated and quantified? Studies of the burden of disease aim to measure and evaluate the impact of a disease or group of diseases on overall levels of health. Although they do not strictly speaking constitute an economic evaluation, since no specific interventions are analyzed, burden of disease studies do provide an accurate picture of a specific health problem and its magnitude, as well as an indication of changes in health policy and in preventive or corrective measures that might lead to improvement. This paper reports the results of a study of the disease burden of hypercholesterolemia in Portugal, calibrated for data from the year 2000. In this study, the disease burden is estimated as the component attributable to hypercholesterolemia in DALYs (disability-adjusted life years). DALYs are a measure used by international organizations such as the World Health Organization and the World Bank.

Adolescent↗
PubMedDate not supplied

Costs of illness due to hypeercholesterolemia in Portugal.

Cardiovascular diseases are the main cause of death in Portugal, in developed countries and, indeed, worldwide. Hypercholesterolemia is a major risk factor for these diseases, including ischemic heart disease, cerebrovascular disease, and peripheral vascular disease. This paper reports the results of a study of the cost of illness associated with hypercholesterolemia and the costs directly attributable to hypercholesterolemia in Portugal, estimated from data for the year 2000. The results indicate that the cost of the health care provided to deal with illnesses associated with hypercholesterolemia was Euros 735.9 million (direct costs) and the costs of lost production due to disability of patients of working age was Euros 74.82 million (indirect costs). The costs attributable to hypercholesterolemia, those that would be avoided if hypercholesterolemia were completely eliminated, amount to Euros 358.84 million in direct costs and Euros 28.31 million in indirect costs. These results confirm that hypercholesterolemia is a source of major health costs. This means that hypercholesterolemia deserves special attention from those who formulate health policy and should be given priority in implementing such policies.

Cost of Illness↗
PubMed2004

[Acceptance of the new conjugate vaccines. Meningococcal and pneumococcal vaccines, in the cohort born in 1999, in the North Region of Portugal].

The new conjugate vaccines against group C meningococcal infection and pneumococcal infection were introduced in Portugal in 2001. In 2001/2002, the media published several alarming news on meningococcal disease and there was an increased demand of those vaccines, not included in the Portuguese National Vaccination Programme. In order to assess the coverage with these new vaccines against Neisseria meningitidis and Streptococcus pneumoniae, we conducted a descriptive study of the cohort born in 1999, using a convenience sample, from eight health centres in the North of Portugal. Data was collected from the vaccination records of 1877 children born in 1999: 37.2% had received the group C meningococcal conjugate vaccine and 33.3% the pneumococcal conjugate vaccine, while 21,2% had received both. Most vaccinations with pneumococcal conjugate vaccine were performed after 23 months of age, above the recommended age range. The biggest number of group C meningococcal conjugate vaccines given in a month, was recorded in February of 2002, when the maximum number of reported cases of meningococcal disease was also observed. Correlation of both distributions over time was very high (R(2)=0.95). In February 2002 the number of pneumococcal conjugate vaccine doses given rose again, after having been decreasing since October 2001. This study suggested research hypothesis for the future.

Child, Preschool↗