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Glutathione S-tranferases and cytochrome P450 activities in Mytilus galloprovincialis from the South coast of Portugal: effect of abiotic factors.

To assess the health of aquatic organisms, biomarkers that measure changes at the biochemical level have been used as effective early warning tools in ecological risk assessment. In order to develop an integrated risk assessment strategy for the south coast of Portugal, mussels Mytilus galloprovincialis were collected from six sites along the coast with different organic contaminant characteristics. Additionally, an active biomonitoring approach was followed by transplanting indigenous mussels from site 4 to 6 and vice versa (from site 6 to 4) for 28 days. PAHs and PCBs contents were measured and the associated responses of phase I and phase II detoxification mechanisms evaluated by measuring cytochrome P450 and GST activities. GST activity was also determined on different tissues (gills, digestive gland, foot, mantle and gonads) of M. galloprovincialis and the impact of abiotic parameters (temperature, salinity, pH, conductivity and dissolved oxygen) on the GST activity assessed. Results indicate that CYP 450 follow the same pattern of PAHs and a direct relationship exist between CYP 450 and PAH levels from the different sites. Although there is a decrease between GST and PAHs concentrations it was not significant. The majority of the GST activity was in the gills and the digestive gland (around of 75% of the activity measured in all tissues) followed in decreasing order by the mantle, gonads. An inverse relationship between GST activity and salinity was detected along with temperature although not significant. These two biomarkers respond to changes of these two groups of compounds and to salinity especially for GST. In conclusion CYP 450 in mussels gives a reliable response as biomarker for organic contaminants in risk assessment in the South Coast of Portugal.

Animals↗

Human leptospirosis in Portugal: A retrospective study of eighteen years.

INTRODUCTION: Leptospirosis, an under-recognized public health problem, needs to be confirmed through specific laboratory diagnosis. DESIGN: We describe herein a series of 4618 symptomatic patients for whom a microagglutination test (MAT) serology was available, representing a unique picture of human leptospirosis in central mainland Portugal and the Azores islands of São Miguel and Terceira, over eighteen- and twelve-year periods, respectively. RESULTS: The distribution of the 1024 (22%) cases identified was an average 57 cases per year, with higher frequency in males (67%). These represent the majority of leptospirosis notifications in Portugal, with a higher annual incidence rate in the islands, compared to the central mainland (11.1 and 1.7/100,000 population, respectively). Middle-aged adults (25-54 years) were most frequently infected (45%). Cases occurred mainly in December and January. Serovars from nine presumptive serogroups caused infection, with a predominance of Icterohaemorrhagiae, Pomona, and Ballum, accounting for 66% of cases. CONCLUSIONS: Seropositivity was associated with both anicteric and icteric leptospirosis. Several risk factors and a higher transmission risk in certain areas were emphasized. Leptospirosis was confirmed as a steadily increasing public health problem; good surveillance, communication, and laboratory support are thus necessary to reduce the impact of leptospirosis in areas at risk.

Adolescent↗

Cost-minimization analysis for Portugal of five doublet chemotherapy regimens from two phase III trials in the treatment of advanced non-small cell lung cancer.

OBJECTIVES: Economic evaluations of chemotherapy regimens for stage IIIB or IV non-small cell lung cancer (NSCLC) have been conducted for many European countries, but not for Portugal. This study evaluates the total health care costs of five commonly used doublet regimens with similar efficacy results. METHODS: Using the methodology reported by Schiller [Schiller JH, Tilden D, Aristides M, Lees M, Kielhorn A, Maniadakis N, et al. Restropective cost analysis of gemcitabine in combination with cisplatin in non-small cell lung cancer compared to other combination therapies in Europe. Lung Cancer 2004;43:101-12], we conducted a cost-minimization analysis to compare vinorelbine-cisplatin (Vin/Cis), gemcitabine-cisplatin (Gem/Cis), paclitaxel-carboplatin (Pac/Carb), docetaxel-cisplatin (Doc/Cis), and paclitaxel-cisplatin (Pac/Cis). The perspective was that of the Portuguese National Health Service and included only direct medical costs (reimbursed costs plus co-payments): chemotherapy acquisition, chemotherapy administration, hospitalizations due to adverse events, and other medical resources. Unit costs were drawn from official sources (Diagnosis Related Groups and retail/hospital costs) (2003 value [Diagnosis Related Groups (DRG) published at Diário da República; 2003]). Resource use was estimated from two multicenter randomized phase III trials [Comella P, Frasci G, Panza N, Manzione L, De Cataldis G, Cioffi R, et al. Randomized trial comparing cisplatin, gemcitabine, and vinorelbine with either cisplatin and gemcitabine or cisplatin and vinorelbine in advanced non-small-cell lung cancer: interim analysis of a phase III trial of the Southern Italy Cooperative Oncology Group. J Clin Oncol 2000;18:1451-7; Schiller JH, Harrington D, Belani CP, Langer C, Sandler A, Krook J, et al. Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer. N Engl J Med 2002;346:92-8]. A time horizon of a full course of therapy was adopted. One-way sensitivity analyses were performed. RESULTS: The least and the most costly chemotherapy regimens were Gem/Cis and Pac/Carb, respectively. Total mean cost per patient was estimated at euro7083 for Gem/Cis and euro10,008 for Pac/Carb, a mean cost savings of euro2925 per patient for Gem/Cis. The differences were mainly due to the higher chemotherapy acquisition costs of Pac/Carb than for Gem/Cis. Gem/Cis was less costly in all sensitivity analyses except when 100% inpatient chemotherapy administration was assumed. CONCLUSION: Gem/Cis should be considered as a cost-saving alternative to the other four regimens in treating NSCLC patients in Portugal.

Antineoplastic Combined Chemotherapy Protocols↗

Estimated BVDV-prevalence, -contact and -vaccine use in dairy herds in Northern Portugal.

A study to evaluate BVDV-prevalence, recent -contact and -vaccine use in dairy herds in the "Entre Douro e Minho" (EDM) region in North Portugal was carried out in 124 dairy herds in 2003. Herds were visited to ascertain BVDV-vaccine use and to collect a bulk tank milk (BTM) sample and serum from 1268 cattle to analyse BVDV-antibodies using an NS2-3 ELISA. Fifty-three percent of farmers used inactivated BVDV-vaccines whilst the remaining farmers were not presently using BVDV-vaccines. BMT-antibody results included 35% positives, 25% negative and 39% inconclusive, and were similar in vaccinated and non-vaccinated herds (p>0.05) and allowed estimating a 10% BVDV herd-prevalence from prior knowledge of the relationship between BMT-antibody results and probability of PI cattle in the herd. Overall individual seroprevalence was 27% and was 23% in non-vaccinated and 36% in vaccinated cattle (p<0.05). Contact of the herd with BVDV was assessed according to seroprevalence in young and adult cattle in the herd and it was estimated that 35% of herds were infected or had recent contact with BVDV, 40% were not infected and did not have recent contact with BVDV and the BVDV-infection and -contact status of remaining herds was undetermined. The results from this study indicate BVDV is endemic and BVDV-vaccines are widespread in the dairy-cattle population in EDM region in Portugal.

Animals↗

Air quality assessment for Portugal.

According to the Air Quality Framework Directive, air pollutant concentration levels have to be assessed and reported annually by each European Union member state, taking into consideration European air quality standards. Plans and programmes should be implemented in zones and agglomerations where pollutant concentrations exceed the limit and target values. The main objective of this study is to perform a long-term air quality simulation for Portugal, using the CHIMERE chemistry-transport model, applied over Portugal, for the year 2001. The model performance was evaluated by comparing its results to air quality data from the regional monitoring networks and to data from a diffusive sampling experimental campaign. The results obtained show a modelling system able to reproduce the pollutant concentrations' temporal evolution and spatial distribution observed at the regional networks of air quality monitoring. As far as the fulfilment of the air quality targets is concerned, there are excessive values for nitrogen and sulfur dioxides, ozone also being a critical gaseous pollutant in what concerns hourly concentrations and AOT40 (Accumulated Over Threshold 40 ppb) values.

Air Pollutants↗

Global sleep dissatisfaction for the assessment of insomnia severity in the general population of Portugal.

BACKGROUND AND PURPOSE: This study examines the prevalence and associated factors of insomnia symptoms and sleep dissatisfaction in the general population of Portugal. PATIENTS AND METHODS: We interviewed by telephone 1858 participants aged 18 years or older and representative of the general population of Portugal using the Sleep-EVAL system. Participation rate was 83%. The questionnaire included the assessment of sleep habits, insomnia symptomatology according to DSM-IV and ICSD classifications, associated and sleep/mental disorders and daytime consequences. RESULTS: Insomnia symptoms occurring at least 3 nights per week were reported by 28.1% of the sample and global sleep dissatisfaction (GSD) by 10.1%. Difficulty maintaining sleep was the most frequent symptom (21.0%); 29.4% of subjects with insomnia symptoms reported GSD. Daytime consequences, medical consultations for sleep and use of sleep medication were at least 2 times more frequent among subjects with insomnia symptoms and GSD compared to subjects with insomnia symptoms without GSD; insomnia diagnoses were also more frequent in the GSD group. CONCLUSIONS: The results show a severity gradation among subjects with only 1 insomnia symptom, those with 2 or 3 insomnia symptoms but without GSD and those with at least 1 insomnia symptom and GSD. Specific sleep or psychiatric disorders were identified for the majority of GSD subjects (86%); this rate dropped to 50.6% when only 1 insomnia symptom without GSD was reported. GSD appeared to be a good indicator of the presence of a sleep or psychiatric disorder and a good discriminator of the severity of sleep disturbances among subjects with insomnia symptoms.

Adolescent↗

Biologic and molecular characterization of Toxoplasma gondii isolates from pigs from Portugal.

Little is known of Toxoplasma gondii infections in animals in Portugal. In the present paper, we report the first isolation of viable T. gondii from pigs in Portugal. Antibodies to T. gondii were found in 52 (15.6%) of 333 pigs prior to slaughter using the modified agglutination test (MAT) at a serum dilution of 1:20. Attempts were made to isolate T. gondii from 37 seropositive pigs. Samples of brain and/or heart from each pig were digested in acid pepsin, and bioassayed into mice. Viable T. gondii was isolated from 15 pigs. Restriction fragment length polymorphism on products of SAG2 locus amplified by PCR and microsatellite analysis revealed that 11 isolates were Type II and four were Type III. The results indicate that phenotypically and genetically T. gondii are similar to isolates from pigs from the U.S.

Agglutination Tests↗

Leishmania infantum MON-98: infection in a dog from Alto Douro, Portugal.

We report the isolation of Leishmania infantum zymodeme MON-98 in Portugal, its first known occurrence outside the focus of El Agamy, Egypt. One dog found to be infected with Acanthocheilonema dracunculoides during a survey of canine filariosis in the Alto Douro region, north-east Portugal, was also discovered to have Leishmania in bone marrow. The isolated strain was identified by isoenzyme analysis. A search for other possible cases of L. infantum MON-98 infection in dogs, vectors and particularly humans is necessary to establish the real epidemiological importance of this zymodeme in the endemic region of Alto Douro.

Animals↗

Paralytic shellfish toxins in the freshwater cyanobacterium Aphanizomenon flos-aquae, isolated from Montargil reservoir, Portugal.

Montargil reservoir, located in a dry flat area in the centre of Portugal, was filled in 1958 to fulfil agricultural, electric and industrial requirements. In May 1996, an intensive bloom of phytoplankton was detected. The algal community was strongly dominated by cyanobacteria with predominance of Aphanizomenon flos-aquae from May to June and Microcystis aeruginosa from July to August. Extracts of samples collected during the bloom period showed high toxicity by mouse bioassay. During the M. aeruginosa predominance period, the toxicity was ascribed to the presence of hepatotoxins, but clear symptoms of paralytic shellfish poison were observed when A. flos-aquae was the dominant species. In order to confirm the production of neurotoxins a strain of A. flos-aquae was isolated and established in culture. In this manuscript, we show the morphological characteristics and confirm paralytic shellfish toxins production by the strain isolated and maintained in culture. Identification of the saxitoxin analogs was achieved using high performance liquid chromatography with postcolumn fluorescence derivatization (HPLC-FLD) and liquid chromatographic mass spectrometry technique (LC-MS). The toxins found in the culture extract were GTX5 (64.5 mol%), neoSTX (23.0 mol%), dcSTX (6.1 mol%), STX (5.4 mol%) and GTX6 (1.1 mol%). This is, to our knowledge, the first report of unambiguous evidence of paralytic shellfish toxins produced by freshwater cyanobacteria in Portugal. The toxin profile is rather different from the previously reported PSP producing A. flos-aquae and demonstrates its diversity in terms of toxin production.

Animals↗

Evaluation of organochlorine pesticide residues in human serum from an urban and two rural populations in Portugal.

Organochlorine pesticide residues were measured in human serum from an urban and two rural populations in Portugal, in an attempt to evaluate the contamination level of Portuguese population. Serum levels of 12 residues were determined using a validated methodology that included gas chromatography-electron-capture detection. It was made an attempt to point out the differences of contamination between rural and urban populations; and among these, if it could be established a relation with sex and with age of individuals. p,p'DDE, alpha-hexachlorocyclohexane (HCH), p,p'DDD, and beta-HCH were the most frequently identified residues. p,p'DDE concentrations ranged from undetected to 390.5 microg/l in urban samples, and from undetected to 43.5 microg/l and to 171.2 microg/l in both rural samples. Maximum alpha-HCH concentration level was 114.4 microg/l in urban samples, 261.3 and 45.5 microg/l in both rural samples. Mean total DDT levels were always higher than mean total HCH levels. About p,p'DDE, in all three populations, the majority of the results above the limit of quantification were found among female sex. The analysis of different aged groups showed that younger groups continue to reveal contamination. Comparing obtained results with others from Europe, Asia and America, it was observed that Portugal is between the highest levels of contamination.

Adult↗

Aflatoxin M1 in yoghurts in Portugal.

Aflatoxin M1 (AFM1) may occur in milk and milk products, resulting from the ingestion of aflatoxin B1 in feedstuffs by dairy cow. Ninety-six samples of commercial yoghurts (48 natural yoghurts and 48 yoghurt with pieces of strawberries) that are produced in Portugal were analyzed for the presence of AFM1 by immunoaffinity column extraction and high-performance liquid chromatography (HPLC). The limit of detection was 10 ng/kg. The recoveries of AFM1 from the samples spiked at levels of 10.0, 50.0, 100.0 and 150.0 ng/kg were 88.0%, 91.0%, 93.0% and 99.0%, respectively. AFM1 was detected in 18 (18.8%) of yogurt samples ranging from 19 to 98 ng/kg, and 78 samples (81.2%) did not reveal the presence of the toxin. Of the 48 natural yoghurts tested, only two (4.2%) were contaminated with 43 and 45 ng/kg of AFM1. Of the 48 yoghurts with pieces of strawberries tested, 16 samples (33.3%) contained levels ranging from 19 to 98 ng/kg; six samples (12.5%) were contaminated with low levels ranging from 19 to 35 ng/kg; four samples (8.3%) were contaminated with levels ranging from 36 to 50 ng/kg, two samples (4.2%) with levels of 51 and 65 ng/kg and four samples (8.3%) presented high contamination levels, from 90 to 98 ng/kg. This paper reports the data of the first survey on the presence of AFM1 in yoghurt in Portugal.

Aflatoxin M1↗

Distribution of trace metals in moss biomonitors and assessment of contamination sources in Portugal.

A biomonitoring survey using the moss species [Hypnum cupressiforme Hedw. and Scelopodium touretii (Brid.) L. Kock] was performed in the whole territory of Portugal, in order to evaluate the atmospheric deposition of the following elements: Cd. Cr, Cu, Fe, Mn, Ni, Pb and Zn. The concentrations of the same elements were also obtained in two types of soil samples, collected under the moss and in nearby plots without any plant coverage, and relationships between moss and soil concentrations was investigated using the multivariate statistical method of Co-inertia Analysis. Also, relationships between concentrations in moss and several anthropogenic, geologic, pedologic and environmental parameters were screened using the same method of Co-inertia Analysis. Higher concentrations of Cu, Pb and Zn were found in areas of higher population density, with higher gasoline consumption, while higher values of Fe and Cr occur in the driest region, with lower plant coverage, indicating strong contamination by resuspended soil particles. Results also show good agreement between moss and soil contents, even for elements with high contribution of anthropogenic sources. The spatial pattern in Portugal of element contents in mosses were also detected and discussed in relation to local contamination sources.

Absorption↗

Air quality management in Portugal: example of needs and available tools.

The Framework Directive (FWD) and the proposed Daughter Directives are the newest legislative instruments concerning a new political strategy and air quality management approach for Europe. Additionally, the member countries of the United Nations Economic Commission for Europe have included the concepts of critical load and level for planning air pollution abatement strategies and as a base of international agreements concerning limitation of the emissions of air pollutants. These concepts imply an accurate knowledge about pollutants deposition fluxes. The paper describes the main needs and the tools available to define a strategy of air quality management in Portugal. Two study cases are presented: (1) extensive monitoring plan to assess the impact of an urban incinerator plant; and (2) contribution to a methodology to estimate critical levels for a coastal region in Portugal. These different approaches allowed illustrating the complexity of the implementation of an air pollution management strategy.

Air Pollution↗

Ageing in Portugal: regional iniquities in health and health care.

The health of the Portuguese has improved considerably in the last twenty years. Economic and social transformations that have contributed to the progressive amelioration of problems of feeding, sanitation, hygiene, housing and social conditions in general, as well as health services, have had decisive effect on this phenomenon. The spectacular regression of the indicators related to transmitted diseases, infant, perinatal (more than 50% between 1985 and 1994) and maternal mortality, and the mortality of children 1 to 4 yr old, also reflects this impact. The positive changes that took place in health indicators were reflected in the growth of life expectancy at birth (2.2 yr more for male and 2.3 more for women between 1985 and 1994) in spite of the fact that the difference in life expectancy in relation to EU countries has grown. Improvement in life expectancy, especially in the older age groups, is not normally associated with significant reductions in morbidity. In fact, increased longevity has become more generally associated with chronic illness or other disabilities requiring more medical services and other forms of personal care. This paper reviews some of the evidence for regional differences in the health status of elderly people in Portugal and considers how health services have reacted to these differences. A preliminary study of health status and patterns of utilisation of elderly people was undertaken. After 30 yr of a National Health Service (NHS) in Portugal we may ask why do inequities in health and access to health care of the elderly population persist? Proactive policies to prevent illness and promote health are still relatively underdeveloped in the Portuguese NHS, and the factors that influence health, such as housing, diet and occupational health hazards, remain largely absent from health and welfare policies. Poor accessibility to health services is the most serious barrier consumers have to face in order to get a medical appointment, and this is more relevant to the oldest part of the population. Geographical location of health care facilities unequally affects the ease of access of different groups of consumers and influences utilisation patterns. Examining the distribution of health services resources is an important way to understand the inequities of access to health and to health care.

Aged↗

[Evaluation of the safety of stress echocardiography in Spain and Portugal].

UNLABELLED: INTRODUCTION. There are few studies that evaluate the safety of stress echocardiography with discordant results. They are done in well-trained centers with highly selected populations leading to selection bias. OBJECTIVE: To assess the safety of the different modalities of stress echocardiography in Spain and Portugal. METHOD: Severe complications were retrospectively analyzed during the stress echocardiography performed in 29 hospitals in Portugal and Spain, from the beginning of their activity to September, 1999. In this period 22,105 stress echocardiograms were performed: 10,975 exercise echos, 2,969 low dose dobutamine echos, 6,832 high dose dobutamine echocardiograms, 1,276 dypiridamole echocardiograms, 41 paced echocardiograms and 12 with adenosine. A complication was defined as severe when it was life-threatening or led to hospital admission. RESULTS: We registered 26 complications, one death, 3 ventricular fibrillations, 10 sustained ventricular tachycardias, 2 complete atrioventricular blocks, 6 acute myocardial infarctions, 2 ruptures of the free wall or ventricular septal defects, 1 transient ischemic attack and 1 severe symptomatic hypotension. We had one severe complication for every 2,743 exercise stress, 1 every 1,231 dypiridamole, 1 every 325 high dose dobutamine without any complications with low dose dobutamine stress. We found a relationship between experience in dobutamine stress echocardiography and the frequency of complications. Three complications appeared once the test was finished. CONCLUSIONS: The stress echocardiography is a safe technique, but not harmless. The exercise stress echo is the safest of all the modalties of stress echocardiography. There is a relation between experience and the number of complications.

Aged↗

An ethnobotanical study of medicinal and aromatic plants in the Natural Park of "Serra de São Mamede" (Portugal).

This paper reports an ethnobotanical study conducted in the year 2000 in the Natural Park of "Serra de São Mamede" (Portugal). Informal interviews involving 45 informants provided data about 165 useful plants, 150 of which had medicinal and/or aromatic use. Two hundred and twenty-four popular names were noted, 98 of which had not been documented before. The most relevant plants are mentioned in this paper, along with their local names, the parts of them used, popular uses (or troubles treated), preparation and administration processes, and citation frequency. This is the first study of medicinal and aromatic plants in Portugal to use ethnobotanical methodology.

Data Collection↗

Y-chromosome STR haplotypes in the Açores Archipelago (Portugal).

Allele and haplotype frequencies of 10 Y-chromosome STR loci were co-amplified in a sample from the Açores Islands (Portugal). We found high haplotype diversity in the Açores sample (0.998). The genetic profile of this population revealed to be statistically different from that of Madeira Island and from North Portugal, two related populations with already a fairly amount of published data. This result stresses the importance of using local databases in forensic genetics.

Chromosomes, Human, Y↗

Research on aging in Portugal.

This review presents an analysis of the current state of gerontological and geriatric research in Portugal, and highlights the need for a national consensus and funding for age-related research projects. Such efforts must be multidisciplinary, since the process of aging encompasses biological, psychological, social, economic and cultural aspects. Demographic studies reveal a growing population of elderly in Portugal as a result of a healthier population in general. This increased life expectancy, however, is accompanied by a parallel increase in degenerative pathologies and care costs among the elderly. Preventive medicine is an important tool to reduce health care costs and avoid or abbreviate suffering from age-related syndromes, but such projects on a national basis neither exists, nor does gerontology or geriatrics receive funding to perform needed research. Consequently, research on aging depends on the initiative of individual investigators who, without funding or cohesive programs, can do little to improve the low scientific output in this area. The implementation of a national program, that can establish health care policy and priorities as well as fund the necessary research, will permit organized cooperation among the different scientific disciplines related to aging. This is a crucial step toward improving present knowledge, ensuring application of experimental and statistical results to the clinical care of the aging population, and attract young investigators to this field.

Aging↗