Percorrer por autor "Rodrigues, Ana"
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- Acidente Vascular Cerebral: evolução e tendência da taxa de incidência na população sob observação da rede Médicos-Sentinela de 1990 a 2012Publication . Sousa Uva, Mafalda; Antunes, Liliana; Rodrigues, Ana; Pinto, Daniel; Nunes, Baltazar; Dias, Carlos MatiasO Acidente Vascular Cerebral (AVC) tem sido descrito como uma das principais causas de morte em Portugal (em 2012 128,6/105). Embora tenha vindo a ser realizada a monitorização das taxas de mortalidade por AVC em Portugal, permanece escassa a informação relativa a outras relevantes medidas epidemiológicas de frequência desta doença, designadamente, a prevalência e a incidência. A Rede de Médicos Sentinela é o único sistema de observação em saúde que tem permitido o cálculo anual das taxas de incidência de AVC, na população sob observação da rede que inclui, exclusivamente, indivíduos inscritos nas listas de utentes dos cuidados de saúde primários. O objectivo do presente trabalho foi Descrever a evolução e analisar as tendências das estimativas de incidência de AVC entre 1990 e 2012, na população sob observação pela Rede Médicos- Sentinela (MS). Observou-se que a taxa de incidência de AVC não tem sofrido alterações significativas no período estudado e tem-se mantido sempre superior nos homens, o que se poderá dever à maior prevalência de hipertensão arterial e à maior prevalência de consumo de tabaco neste sexo.
- Chlamydia trachomatis outbreak: when the virulence-associated genome backbone imports a prevalence-associated major antigen signaturePublication . Borges, Vitor; Cordeiro, Dora; Salas, Ana Isabel; Lodhia, Zohra; Correia, Cristina; Isidro, Joana; Fernandes, Cândida; Rodrigues, Ana; Azevedo, Jacinta; Alves, João; Rôxo, João; Rocha, Miguel; Corte-Real, Rita; Vieira, Luís; Borrego, Maria José; Gomes, João PauloChlamydia trachomatis is the most prevalent sexually transmitted bacterium worldwide and the causative agent of trachoma. Its strains are classified according to their ompA genotypes, which are strongly linked to differential tissue tropism and disease outcomes [ocular disease, urogenital disease and lymphogranuloma venereum (LGV)]. While the genome-based species phylogenetic tree presents four main clades correlating with tropism/prevalence, namely ocular, LGV, urogenital T1 (more prevalent genotypes) and urogenital T2 (less prevalent genotypes), inter-clade exchange of ompA is considered a rare phenomenon probably mediating marked tropism alterations. An LGV epidemic, associated with the clonal expansion of the L2b genotype, has emerged in the last few decades, raising concerns particularly due to its atypical clinical presentation (ulcerative proctitis) and circulation among men who have sex with men (MSM).
- Evolução da incidência anual de diabetes de 1992 a 2012 na população sob observação da rede médicos-sentinelaPublication . Antunes, Liliana; Sousa-Uva, Mafalda; Nunes, Baltazar; Rodrigues, Ana; Dias, Carlos MatiasA Diabetes Mellitus é uma doença crónica conhecida como uma das principais causas de morbilidade e mortalidade a nível global. As suas complicações graves incluem problemas cardiovasculares, insuficiência renal e amputações. A prevalência de diabetes em Portugal em 2012 era 12,7%, (10,4% nas mulheres e 15,2% nos homens). Globalmente, a diabetes aumenta com a idade e a obesidade é conhecida como um dos principais fatores de risco da Diabetes Mellitus tipo 2. O objectivo do presente trabalho foi Descrever a evolução e analisar as tendências das estimativas de incidência de Diabetes Mellitus (DM) entre 1992 e 2012, na população sob observação pela Rede Médicos-Sentinela (MS).Verificou-se um aumento da taxa de incidência anual de 261,7 para 647,9/105 utentes no período em estudo. Esse aumento foi significativo em ambos os sexos[ 6,8% ao ano nos homens (IC95% 6,0–7,7) e 4,6% nas mulheres (IC95% 3,4–5,8)].
- Evolução da Taxa de incidência anual de diabetes entre 1992 e 2012 na população sob observação pela Rede “Médicos-Sentinela”Publication . Sousa-Uva, Mafalda; Antunes, Liliana; Nunes, Baltazar; Rodrigues, Ana; Dias, Carlos Matias
- Investigating the role of symptom valorisation in tuberculosis patient delay in urban areas in PortugalPublication . de Morais, Margarida; Sousa, Sofia; Marques, Jéssica; Moniz, Marta; Duarte, Raquel; Leite, Andreia; Soares, Patricia; Carreira, Mário; Pereira, Sofia; Alves, Catarina; Alves, Filipe; Rodrigues, Ana; Moreira, Ana; Cardoso, Márcia; Mota, Sandra; Gomes, Ana; Ferreira, Liliana; Lopes, Marta; Correia, Isabel; Rachadell, Juan; Gameiro, Maria; Dias, Ângela; Pereira, Manuel; Gonçalves, Jorge; Gonçalves, Maria; Taveira, Adriana; Neves, Celene; Silva, Lucinda; Mendes, Maria; Teixeira, Maria; Pereira, Maria; Piedade, Milena; Teixeira, Antónia; Carvalho, CarlosBackground: Diagnosis delay contributes to increased tuberculosis (TB) transmission and morbimortality. TB incidence has been decreasing in Portugal, but median patient delay (PD) has risen. Symptom valorisation may determine PD by influencing help-seeking behaviour. We aimed to analyse the association between symptom valorisation and PD, while characterising individuals who disregarded their symptoms. Methods: A cross-sectional study was conducted among TB patients in Lisbon and Oporto in 2019 - 2021. Subjects who delayed seeking care because they did not value their symptoms or thought these would go away on their own were considered to have disregarded their symptoms. PD was categorised using a 21-day cut-off, and a 30-day cut-off for sensitivity analysis. We estimated the effect of symptom valorisation on PD through a directed acyclic graph. Then, a multivariable regression analysis characterised patients that disregarded their symptoms, adjusting for relevant variables. We fitted Poisson regression models to estimate crude and adjusted prevalence ratios (PR). Results: The study included 75 patients. Median PD was 25 days (IQR 11.5-63.5), and 56.0% of participants had PD exceeding 21 days. Symptom disregard was reported by 38.7% of patients. Patients who did not value their symptoms had higher prevalence of PD exceeding 21 days compared to those who valued their symptoms [PR 1.59 (95% CI 1.05-2.42)]. The sensitivity analysis showed consistent point estimates but wider confidence intervals [PR 1.39 (95% CI 0.77-2.55)]. Being a smoker was a risk factor for symptom disregard [PR 2.35 (95% CI 1.14-4.82)], while living in Oporto [PR 0.35 (95% CI 0.16-0.75)] and having higher household incomes [PR 0.39 (95% CI 0.17-0.94)] were protective factors. Conclusions: These findings emphasise the importance of symptom valorisation in timely TB diagnosis. Patients who did not value their symptoms had longer PD, indicating a need for interventions to improve symptom recognition. Our findings also corroborate the importance of the socioeconomic determinants of health, highlighting tobacco as a risk factor both for TB and for PD.
- Lymphogranuloma venereum: a retrospective analysis of an emerging sexually transmitted disease in a Lisbon Tertiary CenterPublication . Neves, José Miguel; Ramos Pinheiro, Rita; Côrte-Real, Rita; Borrego, Maria José; Rodrigues, Ana; Fernandes, CândidaBackground: Lymphogranuloma venereum (LGV) is a sexual transmitted infection (STI), currently endemic within the population of men who have sex with men (MSM) of Western Countries. L2B variant has been reported as the predominant strain in the current LGV epidemics, although a shift towards L2-434 has been observed in some European countries. Objectives: To evaluate and characterize the population with LGV infection diagnosed in Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal. Methods: A retrospective analysis of all LGV diagnoses between 2016 and 2019 was performed. The diagnosis was established through ompA-genotyping of samples yielding a positive result to Chlamydia trachomatis (CT). All considered samples were retrieved from the clinician activity, through swabbing and urine analysis and CT infection diagnosis was obtained using real-time PCR. Results: During the period studied 16 279 CT diagnostics tests were employed, with a striking increase from 2016 (n = 467) to 2019 (n = 9362). A total of 1602 diagnoses of CT were established, from which 168 (10.5%) corresponded to LGV, with both infections showing a rising evolution, between 2016 and 2019, of 2.9 and 2.7 times, respectively. The majority of the LGV strains were genotyped as L2/434 (67.3%; n = 113). LGV predominantly affected MSM and men who have sex with men and women (97.0%; n = 163). Anorectal infection was the most prevalent one (90.5%; n = 152), being proctitis the main clinical presentation (76.2%; n = 128). Absence of symptoms was reported in almost 15% of the cases (n = 24). The presence of concomitant infection with human immunodeficiency virus was dominant (73.2%; n = 123) and the prevalence of one or more STI co-infections was about 60.1% (n = 99). Conclusions: An increasing evolution of CT and LGV testing and diagnosing was observable throughout the studied period. Characteristics of the population are similar with those described within LGV epidemics. In accordance with recent European studies, predominance towards L2 genotype was identified.
- The 1918-1919 Influenza Pandemic in Portugal: a Regional Analysis of Death ImpactPublication . Nunes, Baltazar; Silva, Susana; Rodrigues, Ana; Roquette, Rita; Batista, Inês; Rebelo-de-Andrade, HelenaAlthough the impact of deaths occurring during the 1918-1919 influenza pandemic has been assessed in many archeo-epidemiologic studies, detailed estimates are not available for Portugal. We applied negative binomial models to monthly data on respiratory-related and all-cause deaths at the national and district levels from Portugal for 1916-1922. Influenza-related excess mortality was computed as the difference between observed and expected deaths. Poisson regression was used to estimate the association of geographic and sociodemographic factors with excess mortality. Two waves of pandemic influenza-July 1918 to January 1919 and April to May 1919-were identified, for which the excess all-cause death rate was 195.7 per 10,000 persons. All districts of Portugal were affected. The pandemic hit earlier in southeastern districts and the main cities, but excess mortality was highest in the northeast, in line with the high death burden experienced by northern Spanish provinces. During the period of intense excess mortality (fall/winter 1918-1919), population density was negatively associated with pandemic impact. This pattern changed during the March 1919 to June 1920 wave, when excess mortality increased with population density and in northern and western directions. Portuguese islands were less and later affected. Given the geographic heterogeneity evidenced in our study, subnational sociodemographic characteristics and connectivity should be integrated in pandemic preparedness plans.