Browsing by Author "Palmeiro, Teresa"
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- Avaliação de idosos institucionalizados por espirometria e condensado brônquico do ar exalado: efeitos da exposição ambientalPublication . Belo, Joana; Carreiro-Martins, Pedro; Papoila, Ana Luísa; Palmeiro, Teresa; Caires, Iolanda; Alves, Marta; Nogueira, Susana; Aguiar, Fátima; Mendes, Ana; Cano, Manuela; Botelho, Maria A.; Neuparth, NunoNo estudo geriátrico dos efeitos na saúde da qualidade do ar interior em lares da 3.ª idade de Portugal (GERIA) foi estabelecido como objetivo principal de estudar os efeitos da qualidade do ar interior (IAQ) de equipamentos residenciais para pessoas idosos (ERPI) na saúde respiratória de idosos institucionalizados. Um total de 269 idosos responderam a um questionário elaborado pela equipa de investigadores do projeto GERIA, realizaram uma espirometria e a 150 idosos foi recolhida uma amostra de condensado brônquico exalado (EBC), para análise do respetivo pH e concentração de nitritos. Em relação aos dados sociodemográficos destaca se uma média de idade de 81,9±7,5 anos e uma maioria (70,6%) de idosos do sexo feminino. Relativamente aos resultados da espirometria, observou se que 14,5% apresentaram uma obstrução das vias aéreas. Os valores medianos das concentrações dos poluentes ambientais não revelaram uma concentração acima do referencial de segurança, porém foram observados valores máximos elevados e acima desse referencial. Da análise multivariada verificou se que cada incremento de 100 µg/m3 nos compostos orgânicos voláteis (TVOCS) se encontrava associado positiva mente a possibilidade acrescida dos idosos terem reportado infeção respiratória nos últimos três meses (=1.05; 95% CI: 1.00 to 1.09). Verificou se que o valor do pH diminuía com uma maior exposição a PM2,5 (= 0.04, 95%: 0.06 to 0.01e por cada aumento de 10 µg/m3). No que concerne à exposição a bactérias, verificou se que esta se associava positivamente à possibilidade dos idosos terem uma FVC diminuída (= 0,53, 95%: 0,87 a 0,20) e uma relação FEV1 /FVC aumentada (=0,22, 95%:0,08 a 0,37)
- Chronic respiratory diseases and quality of life in elderly nursing home residentsPublication . Carreiro-Martins, Pedro; Gomes-Belo, Joana; Papoila, Ana Luísa; Caires, Iolanda; Palmeiro, Teresa; Gaspar-Marques, João; Leiria-Pinto, Paula; Mendes, Ana Sofia; Paulo-Teixeira, João; Botelho, Maria Amália; Neuparth, NunoFew studies have assessed the quality of life (QOL) related to chronic respiratory diseases in the elderly. In the framework of the geriatric study on the health effects of air quality in elderly care centers (GERIA) study, a questionnaire was completed by elderly subjects from 53 selected nursing homes. It included various sections in order to assess respiratory complaints, QOL (World Health Organization QOL (WHOQOL)-BREF), and the cognitive and depression status. The outcome variables were the presence of a score lower than 50 (<50) in each of the WHOQOL-BREF domains (physical health, psychological health, social relationships, and environmental health). Chronic bronchitis, frequent cough, current wheezing, asthma, and allergic rhinitis were considered as potential risk factors. The surveyed sample was (n = 887) 79% female, with a mean age of 84 years (SD: 7 years). In the multivariable analysis, a score of <50 in the physical domain was associated with wheezing in the previous 12 months (odds ratio (OR): 2.03, confidence interval (CI): 1.25-3.31) and asthma (OR: 1.95, CI: 1.12-3.38). The psychological domain was related with a frequent cough (OR: 1.43, CI: 0.95-2.91). A score of <50 in the environmental domain was associated with chronic bronchitis (OR: 2.89, CI: 1.34-6.23) and emphysema (OR: 3.89, CI: 1.27-11.88). In view of these findings, the presence of respiratory diseases seems to be an important risk factor for a low QOL among elderly nursing home residents.
- O impacto do ambiente interior na saúde respiratória dos idosos: resultados preliminares do projeto GERIAPublication . Mendes, Ana; Papoila, Ana Luísa; Martins, Pedro; Caires, Iolanda; Palmeiro, Teresa; Aguiar, Lívia; Pereira, Cristiana; Neves, Paula; Botelho, Amália; Neuparth, Nuno; Teixeira, João Paulo
- Respiratory infections in elderly people: Viral role in a resident population of elderly care centers in Lisbon, winter 2013-2014Publication . Chasqueira, Maria-Jesus; Paixão, Paulo; Rodrigues, Maria-Lúcia; Piedade, Cátia; Caires, Iolanda; Palmeiro, Teresa; Botelho, Maria-Amalia; Santos, Madalena; Curran, Martin; Guiomar, Raquel; Pechirra, Pedro; Costa, Inês; Papoila, Ana; Alves, Marta; Neuparth, NunoObjective: The aim of this study was to analyze the etiology and clinical consequences of viral respiratory infections in 18 elderly care centers (ECC) in Lisbon, which housed a total of 1022 residents. Methods: Nasopharyngeal swabs were collected whenever an elderly had symptoms of acute respiratory infections (ARI). PCR and RT-PCR were performed for influenza A/B, human parainfluenza virus 1–4, adenovirus, human metapneumovirus (HMPV), respiratory syncytial virus (RSV), rhinovirus, enterovirus, human coronavirus and human Bocavirus (HBoV). Array cards for atypical bacteria were also used in severe cases. Results: In total, 188 episodes of ARI were reported, being rhinovirus the most frequently detected (n = 53), followed by influenza A(H3) (n = 19) and HBoV (n = 14). Severe infections were reported in 19 patients, 11 of which were fatal, Legionela pneumophila, rhinovirus, HMPV and RSV associated with these fatalities. Nine influenza strains were analyzed, all antigenically dissimilar from vaccine strain 2013/14. “Age”, “HMPV” and “Respiratory disease” showed an association with severe infection. Conclusions: In this study an etiologic agent could be found in 60% of the acute respiratory episodes. These data provides information about the circulating viruses in ECC and highlights the importance of searching both viruses and atypical bacteria in severe ARI.
- The impact of indoor air quality and contaminants on respiratory health of older people living in long-term care residences in PortoPublication . Mendes, Ana; Papoila, Ana Luísa; Carreiro-Martins, Pedro; Bonassi, Stefano; Caires, Iolanda; Palmeiro, Teresa; Aguiar, Lívia; Pereira, Cristiana; Neves, Paula; Mendes, Diana; Botelho, Maria Amália Silveira; Neuparth, Nuno; Teixeira, João PauloBackground: persons who are 65 years or older often spend an important part of their lives indoors thus adverse indoor climate might influence their health status. Objective: to evaluate the influence of indoor air quality and contaminants on older people’s respiratory health. Design: cross-sectional study. Setting: 21 long-term care residences (LTC) in the city of Porto, Portugal. Subjects: older people living in LTC with ≥65 years old. Methods: the Portuguese version of BOLD questionnaire was administered by an interviewer to older residents able to participate (n = 143). Indoor air contaminants (IAC) were measured twice, during winter and summer in 135 areas. Mixed effects logistic regression models were used to study the association between the health questionnaire results and the monitored IAC, adjusted for age, smoking habits, gender and number of years living in the LTC. Results: cough (23%) and sputum (12%) were the major respiratory symptoms, and allergic rhinitis (18%) the main selfreported illness. Overall particulate matter up to 2.5 micrometres in size median concentration was above the reference levels both in winter and summer seasons. Peak values of particulate matter up to 10 micrometres in size (PM10), total volatile organic compounds, carbon dioxide, bacteria and fungi exceeded the reference levels. Older people exposed to PM10 above the reference levels demonstrated higher odds of allergic rhinitis (OR = 2.9, 95% CI: 1.1–7.2). Conclusion: high levels of PM10 were associated with 3-fold odds of allergic rhinitis. No association was found between indoor air chemical and biological contaminants and respiratory symptoms.
- The impact of indoor air quality on respiratory health of older people living in nursing homes: spirometric and exhaled breath condensate assessmentsPublication . Belo, Joana; Carreiro-Martins, Pedro; Papoila, Ana L.; Palmeiro, Teresa; Caires, Iolanda; Alves, Marta; Nogueira, Susana; Aguiar, Fátima; Mendes, Ana; Cano, Manuela; Botelho, Maria A.; Neuparth, NunoIn the Portuguese Geriatric Study of the Health Effects of Indoor Air Quality in Senior Nursing Homes, we aimed to evaluate the impact of indoor air contaminants on the respiratory symptoms and biomarkers in a sample of elderly living in nursing homes. A total of 269 elderly answered a health questionnaire, performed a spirometry and 150 out of these collected an exhaled breath condensate sample for pH and nitrites analysis. The study included the evaluation of indoor chemical and microbiological contaminants. The median age of the participants was 84 (78-87) years and 70.6% were women. The spirometric data indicated the presence of airway obstruction in 14.5% of the sample. Median concentrations of air pollutants did not exceed the existing standards, although increased peak values were observed. In the multivariable analysis, each increment of 100 µg/m3 of total volatile organic compounds was associated with the odds of respiratory infection in the previous three months ( OR̂ =1.05; 95% CI: 1.00-1.09). PM2.5 concentrations were inversely associated with pH values ( β̂ = -0.04, 95%: -0.06 to -0.01, for each increment of 10 µg/m3). Additionally, a direct and an inverse association were found between total bacteria and FEV1/FVC and FVC, respectively.
- The Influence of Indoor Environment in Respiratory Health and Quality of Life of Older People Living in Elderly Care CentersPublication . Mendes, Ana; Papoila, Ana Luísa; Martins, Pedro; Bonassi, Stefanoa; Caires, Iolanda; Palmeiro, Teresa; Aguiar, Lívia; Pereira, Cristiana; Neves, Paula; Botelho, Amália; Neuparth, Nuno; Teixeira, João PauloThe mean age of the European population is rising and percentage of adults aged 65 years and older is projected to increase from 16% in 2000 to 20% in 2020. It has been estimated that older subjects spend approximately 19 to 20 h/day indoors. Older individuals may be particularly at risk for detrimental effects from pollutants, even at low concentrations, due to reduced immunological defenses and multiple underlying chronic diseases. This cross-sectional study explored environmental variables and buildings characteristics in 22 elderly care centers (ECC) out of a total of 58 institutions in Porto, Portugal.