Browsing by Author "Cordeiro, R."
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- Biological toxins detection: a rapid diagnosis in an emergency responsePublication . Lopes de Carvalho, I.; Cordeiro, R.; Saraiva, M.; Cunha, I.C.; Pelerito, A.; Núncio, M.S.Toxins are chemical substances of biological origin, and they can be considered chemical or biological warfare agents. Four toxins are included in the list of bioterrorism agents: botulinum toxin (BoNT), saxitocin, ricin, and staphylococcal enterotoxin B. BoNT is included in Category A, while the other 3 are considered Category B. Botulism is a potentially fatal disease caused solely by the action of serologically distinct neurotoxins (BoNT/A, /B, /C, /D, /E, /F/ or /G) that prevent acetylcholine release at neuromuscular junctions, resulting in paralysis. The Emergency Response and Biopreparedness Unit is the Portuguese national reference laboratory for biological events or catastrophes and has skilled professionals, know-how, Biosafety Level (BSL)-3 facilities, capacity to work 24 hours per day, 7 days per week, and trained human resources to increase lab capacity in emergency situations. The laboratory diagnosis capacity includes the detection of bacteria, viruses, and toxins that are considered bioterrorism agents, using microbiology, immunology, and molecular biology techniques. Participation in European projects such as EquaTox allowed the upgrade of biosafety procedures and technical skills and the implementation of the best techniques to detect the biological toxins that can be used as biological weapons.
- CYP2D6 and IL-6 c-174G variants in schistosomiasis haematobiaPublication . Cordeiro, R.; Alves, H.; Bordalo, A.; Richter, J; Botelho, M.C.AIM: To study the polymorphic variants in CYP2D6 and the C-174G promoter polymorphism of the IL-6 gene on S. haematobium infected patients from an endemic area of Guinea Bissau. BACKGROUND: - Our group has shown that schistosome egg associated catechol estrogens induce tumor-like phenotypes in urothelial cells. These estrogen metabolites might also be the cause of schistosomiasis associated infertility; - The cytochrome P450 (CYP) genes are oxygenases involved in estrogen biosynthesis and metabolism, generation of DNA damaging procarcinogens, and response to anti-estrogen therapies; - IL6 Interleukin-6 (IL-6) is a pleiotropic cytokine expressed in many tissues. These cytokine is largely expressed in female urogenital tract as well as reproduction organs. Very high or very low levels of IL-6 are associated with estrogen metabolism imbalance.
- Monkeypox virus infection in HIV-1- coinfected patients previously vaccinated against smallpox: A series of 4 cases from PortugalPublication . Brazão, C.; Garrido, P.M.; Alpalhão, M.; Roda, A.; Vieitez-Frade, J.; Ferreira, J.A.; Pelerito, A.; Lopes de Carvalho, I.; Cordeiro, R.; Borrego, M.J.; Filipe, P.Monkeypox is a zoonotic orthopoxvirus that incidentally causes disease in humans similar to smallpox, although with lower mortality. This virus is endemic to western and central Africa, with outbreaks in occidental countries related to exotic pet trade and international travel. Coincident immunity to monkeypox virus was previously achieved with vaccinia virus vaccination; however, eradicating smallpox and subsequent lack of vaccination efforts paved the way for monkeypox to gain clinical relevance. Clinically, initial manifestations include fever, headache, myalgia, fatigue and lymphadenopathy. After 1–2 days, skin and mucosal umbilicated lesions develop with subsequent centrifugal dissemination. Since early May 2022, many countries in Europe, Australia and the United States have reported an increasing number of monkeypox cases, configuring an outbreak with public health implications.1 Portugal is one of the most affected countries, with numerous confirmed cases. Sequencing of the virus has been achieved in Portugal, suggesting this virus belongs to the West African clade of monkeypox virus. (...)
- Ongoing monkeypox virus outbreak, Portugal, 29 April to 23 May 2022Publication . Duque, M.P.; Ribeiro, S.; Martins, J.V.; Casaca, P.; Leite, P. P.; Tavares, M.; Mansinho, K.; Duque, L.M.; Fernandes, C.; Cordeiro, R.; Borrego, M.J.; Pelerito, A.; Lopes de Carvalho, I.; Núncio, S.; Manageiro, V.; Minetti, C; Machado, J.; Haussig, J.M.; Croci, R.; Spiteri, G.; Casal, A.S.; Mendes, D.; Souto, T.; Pocinho, S.; Fernandes, T.; Firme, A.; Vasconcelos, P.; Freitas, G.Up to 27 May 2022, Portugal has detected 96 confirmed cases of monkeypox. We describe 27 confirmed cases (median age: 33 years (range: 22–51); all males), with an earliest symptom onset date of 29 April. Almost all cases (n = 25) live in the Lisbon and Tagus Valley health region. Most cases were neither part of identified transmission chains, nor linked to travel or had contact with symptomatic persons or with animals, suggesting the possible previously undetected spread of monkeypox.
- Outbreak of monkeypox in an STD clinic in LisbonPublication . Caldeira, M.; Fernandes, C.; Neves, J.; João, A.; Calado, R.; Pinto, A.R.; Borrego, M.J.; Cordeiro, R.; Machado, J.; Pelerito, A.; Lopes de Carvalho, I.; Vieira, L.; Núncio, M.S.; Lopes, M.J.P.We present the preliminary results of the first 43 patients with a definitive diagnosis of human infection with monkeypox virus, from the dermatovenereology department of Hospital Santo António dos Capuchos, Lisbon, in May 2022 [...].
- Paralytic shellfish poisoning due to ingestion of contaminated mussels: a 2018 case report in Caparica (Portugal)Publication . Lopes de Carvalho, I.; Pelerito, A.; Ribeiro, I.; Cordeiro, R.; Núncio, M.S.; Vale, P.In Portugal, the potent paralytic shellfish toxins (PSTs) have appeared irregularly since the onset of a national monitoring program for marine biotoxins in 1986. In years where high contamination levels were attained in bivalves, sporadic cases of human poisonings have been recorded, as in 1994 and 2007. The reappearance of high contamination levels led to the appearance of new cases during the autumn of 2018. This study details toxin ingestion, symptomatology and toxin elimination and metabolization in the fluids of two patients, who ingested mussels from the Portuguese southwest coast and required hospitalization due to the severity of symptoms. Toxin elimination was confirmed by ELISA in plasma and urine samples. In mussel samples, the toxin profile obtained by HPLC-FLD displayed a wide diversity of toxins, typical of Gymnodinum catenatum ingestion. However, in the urine samples, the toxin profile was reduced to B1 and dcSTX. Abundant compounds in mussels having an O- sulphate at C11, such as C1þ2 and dcGTX2þ3, were absent in urine. In plasma, PSTs were not detected by HPLC- FLD. Calculated toxin ingestion, resulting from consumption of an estimated 200-g portion, was in the range of 104–120 μg STX eq./kg b. w.
- Paralytic Shellfish Poisoning due to ingestion of contaminated mussels: a case report in Caparica (Portugal)Publication . Ribeiro, I.; Pelerito, A.; Cordeiro, R.; Vale, P.; Núncio, M.S.; Lopes de Carvalho, I.In Portugal, the potent paralytic shellfish toxins (PSTs) have appeared irregularly since the onset of a national monitoring program for marine biotoxins in 1986. In years where high contamination levels were attained in bivalves, sporadic cases of human poisonings have been recorded, as in 1994 and 2007. The reappearance of high contamination levels led to the appearance of new cases during the autumn of 2018. This study reports the case of two patients that ingested mussels from the Portuguese southwest coast and required hospitalization due to the severity of symptoms. Details of toxin ingestion, symptomatology and toxin metabolization in the fluids are described. The diagnosis was confirmed by ELISA in plasma and urine samples. In mussel samples, the toxin profile obtained by HPLC-FLD displayed a wide diversity of toxins, typical of Gymnodinum catenatum ingestion. However, in the urine samples toxin profile was reduced to B1 and dcSTX. Abundant compounds in mussels having an O-sulfate at C11, such as C1+2 and dcGTX2+3, were absent in urine. In plasma, PSTs were not detected by HPLC-FLD. Calculated toxin ingestion, resulting from consumption of an estimated 200-gram portion, was in the range of 104-120 µg STX eq./kg b.w. This study alerts physicians to be aware of this human syndrome with only sporadic occurrence in Portugal.
- Toxinas: o diagnóstico rápido em resposta a emergênciasPublication . Lopes de Carvalho, I.; Cordeiro, R.; Pelerito, A.; Núncio, M.S.As toxinas são substâncias químicas de origem biológica que causam doença no Homem podendo algumas ser utilizadas como armas biológicas. Na lista de agentes de bioterrorismo estão incluídas quatro toxinas: neurotoxinas botulínica (BoNt), saxitocina, ricina e enterotoxina estafilocócica B (SEB). O botulismo é uma doença potencialmente fatal causada pela ação das neurotoxinas que impedem a libertação de acetilcolina nas junções neuromusculares, resultando em paralisia muscular. A saxitocina é também uma neurotoxina, usualmente associada à ingestão de moluscos contaminados, que se liga ao canal de cálcio do nervo impedindo a passagem de iões de sódio através da membrana celular, bloqueando a passagem dos impulsos nervosos. A ricina causa toxicidade multiorgânica bloqueando a síntese proteica e além de já ter sido utilizada como arma biológica no passado, tem sido utilizada em tentativas de suicídio na Europa. Relativamente à SEB, é uma causa comum da intoxicação alimentar, mas se inalada pode induzir a um quadro sistémico e por vezes levar à morte. O conhecimento dos sinais e sintomas associados a estas doenças, provocadas tanto por inalação ou ingestão destas toxinas, por parte da comunidade médica, bem como o diagnóstico laboratorial disponível, é fundamental. A resposta eficaz a um ataque de bioterrorismo só será possível se a suspeição clínica for rapidamente confirmada pelo laboratório e a fonte de infeção for prontamente eliminada após investigação epidemiológica.
- Vacinação anti-raiva em humanos: a importância de avaliar a eficácia da vacinação nos profissionais e viajantesPublication . Cordeiro, R.; Almeida Santos, J.; Pelerito, A.; Lopes de Carvalho, I.; Núncio, M.S.A raiva (RABV) é uma doença zoonótica causada pelo vírus do género Lyssavirus. Tanto a RABV animal como a humana são evitáveis pela vacinação. A vacinação préexposição é indicada a indivíduos que viajem para áreas geográficas de risco, para profissionais que manipulem o vírus ou que tenham contacto com animais potencialmente infetados. O esquema de vacinação pré-exposição inclui três doses. No entanto, caso se mantenha o risco de exposição é aconselhada uma avaliação dos anticorpos IgG anti-RABV a cada seis meses. Se o título de anticorpos for inferior a 0,5IU/ml é recomendado um reforço com uma dose da vacina. Desde 2018, o INSA tem disponível a quantificação de anticorpos IgG anti-RABV em amostras humanas, tendo sido até ao momento analisados 12 soros provenientes de profissionais de saúde e viajantes. Pelos valores determinados verificou-se que em dez indivíduos com vacinação completa a vacinação foi eficaz. Contudo, em dois destes casos, a concentração de anticorpos foi perto do limite inferior o que indicia um possível reforço da vacina na próxima avaliação. Outros dois indivíduos tinham esquema vacinal incompleto, resultando numa concentração de anticorpos que não evidencia seroconversão. Estes resultados revelam a importância da quantificação de anticorpos IgG anti-RABV, pois permite verificar a eficácia da vacinação e, consequentemente, a necessidade de reforço, evitando assim administrações desnecessárias