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Spectrum of congenital anomalies in pregnancies with pregestational diabetes

Thu, 01 Mar 2012 00:00:00 GMT

Title: Spectrum of congenital anomalies in pregnancies with pregestational diabetes Authors: Garne, Ester; Loane, Maria; Dolk, Helen; Barisic, Ingeborg; Addor, Marie-Claude; Arriola, Larraitz; Bakker, Marian; Calzolari, Elisa; Dias, Carlos Matias; Doray, Berenice; Gatt, Miriam; Melve, Kari Klyungsoyr; Nelen, Vera; O’Mahony, Mary; Pierini, Anna; Randrianaivo-Ranjatoelina, Hanitra; Rankin, Judith; Rissmann, Anke; Tucker, David; Verellun-Dumoulin, Christine; Wiesel, Awi Abstract: Maternal pregestational diabetes is a well-known risk factor for congenital anomalies. This study analyses the spectrum of congenital anomalies associated with maternal diabetes using data from a large European database for the population-based surveillance of congenital anomalies. METHODS: Data from 18 population-based EUROCAT registries of congenital anomalies in 1990-2005. All malformed cases occurring to mothers with pregestational diabetes (diabetes cases) were compared to all malformed cases in the same registry areas to mothers without diabetes (non-diabetes cases). RESULTS: There were 669 diabetes cases and 92,976 non diabetes cases. Odds ratios in diabetes pregnancies relative to non-diabetes pregnancies comparing each EUROCAT subgroup to all other non-chromosomal anomalies combined showed significantly increased odds ratios for neural tube defects (anencephaly and encephalocele, but not spina bifida) and several subgroups of congenital heart defects. Other subgroups with significantly increased odds ratios were anotia, omphalocele and bilateral renal agenesis. Frequency of hip dislocation was significantly lower among diabetes (odds ratio 0.15, 95% CI 0.05–0.39) than non-diabetes cases. Multiple congenital anomalies were present in 13.6 % of diabetes cases and 6.1 % of non-diabetes cases. The odds ratio for caudal regression sequence was very high (26.40, 95% CI 8.98–77.64), but only 17% of all caudal regression cases resulted from a pregnancy with pregestational diabetes. CONCLUSIONS: The increased risk of congenital anomalies in pregnancies with pregestational diabetes is related to specific non-chromosomal congenital anomalies and multiple congenital anomalies and not a general increased risk.

Tuberculosis diagnosis after bleach processing for early stage tuberculosis laboratory capacity building

Thu, 01 Nov 2012 00:00:00 GMT

Title: Tuberculosis diagnosis after bleach processing for early stage tuberculosis laboratory capacity building Authors: David, Susana; Sutre, Ana Filipa; Sanca, Armando; Mané, Alfredo; Henriques, Victor; Portugal, Clara; Sancho, Luísa; Cardoso, Ana; Paixão, Eleonora; Duarte, Elsa Leclerc; Leite, Clarice Queico Fujimura; Salem, Julia Ignez; Antunes, Abílio Abstract: The diagnosis of tuberculosis is seriously hampered in the absence of standard biosafety laboratory facilities for specimen concentration and Mycobacterium tuberculosis culture. Within a laboratory twinning arrangement, heat-fixed direct smear and sediment from 74 bleach-processed and 20 non-processed specimens from Cumura Hospital, Guinea-Bissau, were sent to Lisbon for molecular evaluation of rifampicin resistance. Sequence analysis of a 369 base-pair rpoB locus detected 3.2% (3/94) resistant specimens. To our knowledge, this represents the first report on the molecular analysis of M. tuberculosis from bleach-processed sputum, an alternative to current diagnostic practice in low-resource settings.

Injury surveillance in Portugal

Fri, 01 Jun 2012 00:00:00 GMT

Title: Injury surveillance in Portugal Authors: Contreiras, Teresa Abstract: In Portugal, the National Health Service (NHS) is responsible for providing health care to its ten and a half million inhabitants. Health service planning and regulation take largely place at the central level in the Ministry of Health (MoH) and its institutions, through its National Health Plan. The management of the NHS is devolved to the 5 health regions, Norte, Centro, Lisboa e Vale do Tejo, Alentejo and Algarve, and to the 2 autonomous regions, Açores and Madeira. Primary care centres (377 at present) are the main pillar of the health system. The health administration board of each of these regions is accountable to the MoH and is responsible for strategic management of population health, supervision and control of hospitals, management of primary care/NHS primary care centres, and implementation of national health policies taking into account regional needs. The NHS operates the 77 hospitals that have an Emergency Department (ED). Injury awareness by both the public and health care providers has been reinforced by the adoption of the National Programme of Prevention of Injuries 2009-2016. This programme aims to reduce injuries and their impact on the population in general and especially on vulnerable groups as well as to ensure equitable access of injured persons to health care. It also highlights the need to collect, analyse and disseminate information on unintentional injuries through an integrated system of information. Results from the last Census in 2011 indicate that 15% of the population in Portugal belongs to the age group 0-14 years and about19% is 65 years or over, while in 2001these proportions were 16% and 16,5% respectively. This trend is expected to continue and certainly will have an impact on the annual number of injuries.

Potential human exposure pathways in a contaminated estuarine environment：A case study in Sado

Tue, 01 May 2012 00:00:00 GMT

Title: Potential human exposure pathways in a contaminated estuarine environment：A case study in Sado Authors: Paixão, Eleonora; Machado, Ausenda; Carvalho, Carla; Dias, Carlos Matias; Caeiro, Sandra Abstract: Background: The Sado River Estuary, located in Portugal on the Setúbal peninsula, have been shown to be contaminated and can lead to potential serious acute and chronic health effects on local human populations that have documented intense local fishing and agricultural activity. Methods: An epidemiological comparative study of two population, one exposed to the Sado estuary and another unexposed to this estuary was implemented. Questionnare data was on health status (diagnosed illnesses, use of medications), health determinants (tobacco, alcohol consumption), use of health care (medical appointments and hospitalization), reproductive history and potential routes of professional and leisure exposure and contamination was compared between of individuals living in an exposed small village (Carrasqueira) by the Sado estuary waters, and a sample of another similar population living in another estuarine area more that 2km away (Vila Nova de Mil Fontes- VNMF). Results: Data was collected from a total of 202 participants from all ages. Professions like fishers and agricultures are more likely to have higher risks of exposure to estuary river contaminants (directly or indirectly) and were more common in Carrasqueira. Past and actual leisure activities with higher probability of exposure were also more frequent in the estuary exposed village of Carrasqueira. Overall analysis of health data, showed a higher proportion of respondents that declared to have a chronic disease, confirmed by a medical doctor, in Carrasqueira than in VNMF location. In the reproductive history, a higher proportion of Miscarriages (<20 Weeks), Fetal Deaths and pregnancies with abnormal outcomes was found in the exposed village of Carrasqueira. Discussion and conclusions: The small dimension of the exposed population, may have limited the full risk assessment and quantification but allowed some preliminary conclusions. These first results suggest that ongoing multivariate analysis, considering others variables not included in this paper, namely dietary habits, may conduct to more robust results. Description: Artigo com base no trabalho aceite para apresentação oral publicado em : 2012 International Conference on Environmental Pollution and Public Health: proceeding. EPPH, 2012. ISBN: 978-1-61896-022-1