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PubMed1999

Dietary guidelines and food nutrient intakes in Portugal.

The average intakes of nutrients by a group of 489 adult Portuguese (> or = 40 years) living in a metropolitan area of Northern Portugal were studied using a food frequency questionnaire, and used to compare with the most recent recommendations for the same population by the National Council of Food and Nutrition. The data suggested a relative concordance between consumption levels and nutritional goals, however we found differences between subgroups of the population. Higher intakes of total fat and saturated fat, and lower intakes of fibre/energy and carbohydrates were shared by younger people (40-55 years), and higher intakes of total fat, saturated fat, fibre/energy, protein and carbohydrates and lower intakes of alcohol by women. Nutrients have been analysed in terms of the percentage contribution to total energy intake, but as alcohol is energy dense, its consumption can decrease the proportion of the energy intake from nutrients other than alcohol, and some caution must be taken in interpreting these results.

Adult↗
PubMed1995

Birth, marriage and death in illegitimacy: a study in northern Portugal.

In populations in which the frequency of illegitimacy is high, illegitimates and legitimates may be subjected to different demographic and social pressures, with social and genetic consequences. A rural population from north-east Portugal is studied and variables from birth, marriage and death records are compared according to the legitimacy of the individuals. The analysis shows important differential demographic patterns in infant and child mortality and in migration prior to and related to marriage, especially in women. Some changes over time and gender differences are also evident.

Age Factors↗
PubMed1996

Post-natal depression in an urban area of Portugal: comparison of childbearing women and matched controls.

The point prevalence of depression measured on one occasion between 2 and 5 months after childbirth was estimated to be 13.1% in 352 mothers living in urban Portugal; the criterion was a score of 13 or more on a translated version of the Edinburgh Post-natal Depression Scale (EPDS). More detailed comparisons were made between a subgroup of 118 mothers and 118 matched controls who had not borne a child in the previous 2 years. Post-natal women were twice as likely as non-childbearing controls to meet the EPDS criterion for depression In comparison with controls, they were also more severely depressed as judged by their total scores on another questionnaire, the Zung Scale. Comparisons of individual symptom scores (Zung Scale) showed that childbearing women, as a whole, reported more somatic symptoms than controls, but when only those women judged to be depressed or dysphoric by the EPDS were compared, this difference disappeared. Stepwise logistic analyses of symptoms contributing to the categorization of a 'case' of post-natal versus non-post- natal depression did not reveal any very clear divergences in self-reported psychopathology. In childbearing women, two factors were found significantly to contribute to higher depression scores; women with more children and those from lower socio-economic groups were most at risk.

Adult↗
PubMed2000

Health technology assessment in Portugal.

The Portuguese healthcare system is often portrayed as a National Health Service (NHS) model, characterized by universal coverage, comprehensive benefits, nearly free services, national tax financing, and public ownership or control of the factors of production. However, in reality the system fails to accomplish these features in a complete way. There coexist a number of occupation-related health insurance schemes that were originally intended to be integrated into the NHS. In addition, in key areas the NHS does not provide the wide range of services it promises. The public sector has a predominant role in the provision of hospital stays and general practitioner consultations, but the private sector provides a major portion of specialist consultations, dental consultations, and diagnostic services. Major problems in the system led to health reforms in the 1990s. New reform proposals include some specific steps concerning health technology, including standards for medical equipment based on quality, geographic distribution, sustainability, and cost-effectiveness. A new National Plan of Health Equipment was completed in 1998, aimed at improving the distribution of equipment. Despite reforms, healthcare expenditures continue to rise. There is general agreement that gains in efficiency could be made. This situation is beginning to encourage interest in health technology assessment (HTA) in Portugal, although these activities are not yet very developed. Recently, legislation requiring presentation of economic evaluations for new pharmaceutical products was enacted. Present plans also call for the creation in the future of a national agency for HTA.

Delivery of Health Care↗
PubMed2000

Can economic evaluation guidelines improve efficiency in resource allocation? The cases of Portugal, The Netherlands, Finland, and the United Kingdom.

The use of economic evaluation in decision making appears to have increased over the past few years and economic evaluation is looked upon as another measure to help contain costs and improve efficiency in an evidence-based decision-making environment. Following the examples of Australia and the Canadian Province of Ontario, four European Union (EU) countries (Finland, the Netherlands, Portugal, and the United Kingdom) have recently introduced economic evaluation guidelines. In addition to the Australian and Canadian guidelines, which constitute a hurdle to reimbursement, the paradigm that seems to be evolving in the four EU countries follows a similar route. Finland and the Netherlands seem to be moving toward the notion of a fourth hurdle to reimbursement, whereas the National Institute for Clinical Excellence in England and Wales was in principle meant to influence practice, although in reality this essentially acts as a hurdle to reimbursement, requiring a different data set to that used by regulatory authorities. Whereas the Portuguese guidelines were developed to assist in preparing economic submissions to support reimbursement decisions, they are unclear about when such evidence will be required and also discuss the dissemination of economic evidence to broader audiences. The introduction of these guidelines poses a number of challenges to policy makers, the implications of which are analyzed in the paper: a) to ensure that economic evaluations are carried out scientifically without industrial or political bias; b) to define an acceptable methodology that would increase their credibility; and c) to address certain practical issues ranging from deciding how to use economic evaluations in policy making to setting up new institutions or improving the coordination and dissemination of evidence. The variation in the use of economic evaluation guidelines in the four EU countries highlights the differences in national pharmaceutical policies and is in line with policy makers' continuous attempts to contain costs. While the paper critically discusses the guidelines, it also points out that a series of methodologic issues need to be addressed if economic criteria are to be introduced in policy making with the aim to improve resource allocation. The paper concludes that economic evaluation as a discipline is beginning to impact on policy, whereas the consistent use of economic evaluation results is, in principle, being adopted by policy makers but needs to go a step further to reach practitioners.

Drug Therapy↗
PubMed1995

Genotypic evaluation of rickettsial isolates recovered from various species of ticks in Portugal.

Twelve rickettsial isolates, from Rhipicephalus sanguineus, R. turanicus, Dermacentor marginatus and Hyalomma marginatus, were subjected to genotypic analysis. Amplification of specific DNA sequences, restriction endonuclease digestion of amplified DNA products, and gel electrophoresis were used to identify specific DNA fragment-banding patterns. Five patterns were resolved. Four were homologous with those of previously described rickettsial genotypes, R. conorii, R. slovaca, R. rhipicephali and R. massiliae. The fifth pattern differed by only a single altered restriction endonuclease cleavage site. For the first time in Portugal a widely distributed spectrum of spotted fever group rickettsia was found among potential vector species stressing the need to determine their potential for human and domestic animals infection.

Animals↗
PubMed2003

Molecular epidemiology of Salmonella enteritidis phage type 1b and 6a isolates in Portugal.

Salmonella enterica serotype Enteritidis is an important serovar comprising 76 % of Salmonella isolates in Portugal in 2001. For better understand the epidemiology of salmonellosis, a total of 47 isolates of S. Enteritidis phage type (PT) 1b and 6a were analysed by pulsed-field gel electrophoresis (PFGE) and genomic DNA was subjected to macro restriction with XbaI. For PT 1b isolates, only three different patterns were observed, and PT6a showed a total of 10 digestion patterns. Curiously, the main pattern among PT1b isolates seams quite similar to main pattern of PT6a isolates, but when the two patterns were analysed with Bionumerics, we observed that they exhibited some differences. It was concluded that, in 2001, there was one predominant pattern for PT1b and PT6a and, possibly, we were in presence of clonal strains that exists all over the country.

Bacteriophage Typing↗
PubMed2003

Occurrence and specific congener profile of 40 polybrominated diphenyl ethers in river and coastal sediments from Portugal.

Forty polybrominated diphenyl ethers (PBDEs), from mono- through hepta-brominated, were analyzed in river and coastal sediment samples of the eight main river basins of Portugal to investigate the occurrence, geographical distribution, and detailed congener profiles. Thirty-two sediment samples taken along the different rivers from inland to the open sea revealed an increase toward the river mouth with a total PBDE concentration of 20 ng/g-dw, and levels decreased to 0.5 ng/g-dw in coastal sediments. PBDEs were detected in all samples analyzed, indicating a diffuse source of pollution in the aquatic environments. Maximum levels were encountered in sediments collected close to urban and industrial areas. Of 40 congeners included in the analytical work, 17 congeners were detected in river sediments. BDE 47 was found in all samples analyzed whereas BDEs 100 and 99 were found in more than 26 out of 32 samples analyzed at concentrations from 0.03 to 10 ng/g-dw. This study is unique in showing the presence of previously nondescribed lower brominated PBDEs in riverine and marine sediments. BDEs 7, 11, 12+13, 15, 30, 32, 17, 25, 28+33, 49, 75, and 71 were identified in two to five samples with a median of 0.03-0.55 ng/g-dw. The analytical method developed consisted of the use of Soxhlet extraction with a novel cleanup method employing alumina cartridges and analysis by gas chromatography-mass spectrometry operated in negative chemical ionization mode.

Cities↗
PubMed2003

Determination of sterol and fatty acid compositions, oxidative stability, and nutritional value of six walnut (Juglans regia L.) cultivars grown in Portugal.

Six cultivars (Franquette, Marbot, Mayette, Mellanaise, Lara, and Parisienne) of walnuts (Juglans regia L.) were collected during the 2001 crop, from Bragança, Portugal. Chemical composition, including moisture, total oil content, crude protein, ash, carbohydrates, and nutritional value, was evaluated. Fat was the predominant component, ranging from 62.3 to 66.5%. Total oil was extracted and analyzed for fatty acids, sterols, oxidative stability, and peroxide value. Fatty acids and sterols were determined by gas-liquid chromatography coupled to a flame ionization detector. Eighteen fatty acids were quantified. Polyunsaturated fatty acids and, in particular, linoleic acid were predominant. Beta-Sitosterol, delta(5)-avenasterol, and campesterol were the major sterols found. Differences were observed among the studied cultivars, especially in peroxide values and in the sterol profile.

Carbohydrates↗
PubMed2003

Assessment of pesticide residues in honey samples from portugal and Spain.

Fifty samples of honey collected from local markets of Portugal and Spain during year 2002 were analyzed for 42 organochlorine, carbamate, and organophosphorus pesticide residues. An analytical procedure based on solid-phase extraction with octadecyl sorbent followed by gas chromatography-mass spectrometry (GC-MS), for organochlorines, and by liquid chromatography-atmospheric pressure chemical ionization-mass spectrometry (LC-APCI-MS), for organophosphorus and carbamates, has been developed. Recoveries of spiked samples ranged from 73 to 98%, except for dimethoate (40%), with relative standard deviations from 3 to16% in terms of repeatability, and from 6 to 19% in terms of reproducibility. Limits of quantification were from 0.003 to 0.1 mg kg(-)(1). Most of the pesticides found in honey were organochlorines. Among them, gamma-HCH was the most frequently detected in 50% of the samples, followed by HCB in 32% of the samples and the other isomers of HCH (alpha-HCH and beta-HCH) in 28 and 26% of the samples, respectively. Residues of DDT and their metabolites were detected in 20% of the samples. Of the studied carbamates, both methiocarb and carbofuran were detected in 10% of the samples, pirimicarb in 4% and carbaryl in 2%. The only organophosphorus pesticides found were heptenophos in 16%, methidathion in 4%, and parathion methyl in 2% of honey samples. Results indicate that Portuguese honeys were more contaminated than Spanish ones. However, honey consumers of both countries should not be concerned about the amounts of pesticide residues found in honeys available on the market.

Carbamates↗
PubMed2006

Table olives from Portugal: phenolic compounds, antioxidant potential, and antimicrobial activity.

The phenolic compounds composition, antioxidant potential, and antimicrobial activity of different table olives from Portugal, namely, natural black olives "Galega", black ripe olive "Negrinha de Freixo", Protected Designation of Origin (PDO) "Azeitona de Conserva Negrinha de Freixo" olives, and "Azeitona de Conserva de Elvas e Campo Maior" Designation of Origin (DO) olives, were investigated. The analysis of phenolic compounds was performed by reversed-phase HPLC/DAD, and seven compounds were identified and quantified: hydroxytyrosol, tyrosol, 5-O-caffeoilquinic acid, verbascoside, luteolin 7-O-glucoside, rutin, and luteolin. The antioxidant activity was assessed by the reducing power assay, the scavenging effect on DPPH (2,2-diphenyl-1-picrylhydrazyl) radicals, and the beta-carotene linoleate model system. The antioxidant activity was correlated with the amount of phenolics found in each sample. The antimicrobial activity was screened using Gram-positive (Bacillus cereus, Bacillus subtilis, Staphylococcus aureus) and Gram-negative bacteria (Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae) and fungi (Candida albicans, Cryptococcus neoformans). PDO and DO table olives revealed a wide range of antimicrobial activity. C. albicans was resistant to all the analyzed extracts.

Anti-Infective Agents↗
PubMed2000

A highly polymorphic plasma protein locus in brown trout (Salmo trutta L.) populations from Portugal.

Genetic polymorphism of an unidentified plasma protein (PX) is described for the first time in Salmo trutta (L.) by means of isoelectric focusing. The analysis of 414 individuals from different geographic origins in Portugal allowed the identification of nine alleles. Heterozygosity in natural populations is generally above 0.60, thus giving similar values to those reported for brown trout microsatellite loci. Substructuring of Portuguese brown trout is evident between northern and southern basins. Genetic affinities between the southernmost rivers and the hatchery stock were detected, suggesting the existence of recent stocking influences.

Animals↗
PubMed1999

Diphtheria, pertussis, and measles in Portugal before and after mass vaccination: a time series analysis.

Techniques of time series analysis were used to examine historical records of the incidence of diphtheria, pertussis, and measles, and of deaths by measles in Portugal during the twentieth century. There are statistically significant seasonal and longterm oscillations in the incidence of these diseases. Seasonal oscillations appear to be in close association with the resumption of school classes in the fall in the case of diphtheria, but not in pertussis and measles. Long-term oscillations in pertussis (3.5-4 year period) and measles (3-year period), before vaccination, corroborate theoretical predictions about the dynamics of these diseases, whereas absence of long-term oscillations in diphtheria is probably due to the influential presence of carriers upon the dynamics of the disease. Mass vaccination strongly suppressed disease incidence, did not eliminate seasonal oscillations, and appeared to have acted to lengthen long-term periodicity in pertussis and measles.

Adolescent↗
PubMed2002

Cercaria sevillana n sp, a new cercaria (Digenea: Microphallidae) from Nassarius reticulatus (L) (Mollusca: Prosobranchia) in Portugal.

Cercaria sevillana n. sp. (Digenea: Microphallidae) was discovered infecting the gonads and digestive gland of the prosobranch Nassarius reticulatus (L.) (Nassariidae) collected from the Ria de Aveiro, Portugal. Cercariae were obtained by natural emission and were studied under a differential interference contrast microscope and scanning electron microscope (SEM). C. sevillana n. sp. is identical to the cercaria found by Dolgikh (1965) in the same mollusc host from the Black Sea, but erroneously named C. misenensis Palombi, 1940, which is a parasite of Cerithium rupestre Risso, 1826 (Cerithiidae). Cercaria sevillana n. sp. can be distinguished from C. misenensis by its tail being shorter than the cercarial body, as well as by differences in the pattern of penetration glands the size and shape of the stylet and excretory vesicle, and its behavioural pattern. An unusual structure of the tail of this new cercaria was observed by SEM; it is characterised by the presence of annular folded membranes arranged as overlapping flounces around its central axis. This resembles the traditional skirts of the women of Seville. Such a morphological feature of the tail has not been previously observed, but may be a feature of many microphallid cercariae.

Animals↗
PubMed2003

Boutonneuse fever in Portugal: 1995-2000. Data of a state laboratory.

From 1995 through 2000, 3239 clinical samples were tested for rickettsiosis at the Center for Vectors and Infectious Diseases Research--National Health Institute in Portugal. Boutonneuse fever due to R. conorii Malish or R. conorii Israel was laboratory confirmed in 374 samples (11.5%). Clinical and epidemiological features are discussed.

Boutonneuse Fever↗
PubMed2003

Systemic lupus erythematosus in Portugal: diagnosis and disease awareness from 1970 to 2001.

A survey of systemic lupus erythematosus patients was carried out in Portugal. The length of time from disease appearance to diagnosis remained unchanged over the 1970-2001 study period, while awareness of the disease increased considerably in the population in the mid-1990s, apparently as a result of an awareness campaign conducted by the national lupus support group. The data are compared to results from similar studies worldwide.

Health Care Surveys↗
PubMed2003

Assessment of yeast diversity in a marine environment in the south of Portugal by microsatellite-primed PCR.

The occurrence and diversity of yeasts in seawater was investigated in a study site located 20 Km off Faro, Portugal, above the Alvares Cabral Trench. A total of 43 water samples from different layers (above the permanent thermocline, under the thermocline and near the bottom) and directly from the surface, originated 234 isolates. All the isolates were identified using a molecular approach that included, in a first stage, MSP-PCR fingerprinting. A total of 31 MSP-PCR classes were formed, 8 for the pigmented yeasts and 23 for the non-pigmented yeasts. The pink coloured isolates were identified by direct comparison of the new fingerprints with those obtained for representative strains of the various species. For identification of the non-pigmented yeasts, a representative isolate of each MSP-PCR class was selected for sequence analysis and compared with reference sequences. The five most abundant yeast species were Sakaguchia dacryoidea, Pseudozyma aphidis, Rhodosporidium babjevae, R. diobovatum and Debaryomyces hansenii. The distribution of isolates and species in the major taxonomic groups indicated that the number of basidiomycetous yeasts and their diversity are prevalent in relation to their ascomycetous counterpart. Diversity indices were determined and superficial water and water near the bottom had the highest diversity. The sampling effort effectiveness was estimated, and found to correspond to approximately 60% of the species present. MSP-PCR identification proved suitable for pigmented basidiomycetous yeasts and, when used in conjunction with sequence analysis, was effective for the characterization of non-pigmented populations. Our results indicate that the MSP-PCR fingerprinting method is appropriate for the characterization of large groups of isolates due to its simplicity and good reproducibility.

Biodiversity↗
PubMed2003

The Dental Hygiene Program in Portugal.

The Dental Hygiene Program is a fairly recent addition in the field of the health professions in Portugal. In the past 19 years, the programme has developed community activities alongside with clinical work. This programme provides an education that is responsive, scientific and professional, in a learning environment that is dynamic, student-centred and that encourages collaboration between students and faculty. The community activities play a major role in the curricula of the programme and allow the students to develop skills in working with a wide range of population groups and to attend to their specific needs. Dental hygienists are integrated in health teams and work under the supervision of a physician or a dentist. Among other responsibilities, the following functions are part of the scope of the profession: to participate in health education programmes and sensitise the population to the prevention of dental diseases, to participate in the planning, implementation, and evaluation of the public health programmes and to perform clinical treatment for prevention and control of gingivitis, periodontitis, and dental caries. An overview of the activities developed in the year 2002 and future perspectives are presented in this article.

Clinical Competence↗