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- Aetiology of Acute Gastroenteritis in Hospitalized Children from Lisbon AreaPublication . Costa, Inês; Júlio, Cláudia; Rodrigues, João; Machado, Jorge; Correia, Cristina; Oliveira, Maria Marisa; Escobar, Carlos; Costa, Beatriz; Brito, Maria João; Correia, Paula; Ferreira, Gonçalo Cordeiro; Simões, Maria João; Oleastro, MónicaGastroenteritis is a major cause of morbidity and mortality worlwide. Aim: Determine the etiology of gastroenteritis in a cohort of children hospitalized Methods: From May 2011 to January 2012, stool samples were collected from children (4.2 ± 4.8 years). Viral agents (enteric and enterovirus) were detected by RT-PCR. Stool specimens were also tested for bacteria and parasites, by conventional methods. Results: From the 82 stool samples, 42(51.2%) were positive for virus, 22 (26.8%) for bacteria and 35.6% (26/73) for parasites. An association between viral infection and age<3 years (OR=4.92, p<0.01) was observed. Distribution of viral agents was NorovirusII (33.3%), Enterovirus (31%), Rotavirus (23.8%), Adenovirus (9.5%), NorovirusI (2.4%). Simultaneous detection of two viral agents was observed in seven cases (16.7%) - NorovirusII and Enterovirus was the most frequent (57.1%); association with another agent was detected in 33.3% samples. Eight of 22 samples (36.4%) were positive for Campylobacter jejuni, 5 (22.7%) for Salmonella spp, 7 (31.8%) for E. coli, although always in co-infection with another agent, and 1 (4.5%) for Shigella spp. 38.5% of the samples were positive for Cryptosporidium spp., 23.1% for Giardia sp. and 3.8% for Entamoeba histolytica. 69.2% of the parasites were co-detected with other agents. Conclusion: Results suggest that viral agents are the most common among children with acute gastroenteritis, although co-infections with bacteria and parasites are frequent. The most common viral agent associated with acute diarrhea was NorovirusII. An important percentage of cases with no infectious aetiology identified, suggesting that other emergent agents are probably implicated.
- Childhood Obesity Surveillance Initiative: COSI Portugal 2010Publication . Rito, Ana Isabel; Paixão, Eleonora; Carvalho, Maria Ana; Ramos, CarlosA obesidade infantil apresenta-se como um dos mais sérios problemas de saúde pública, quer no espaço Europeu, quer no resto do mundo. A taxa de crescimento desta doença tem-se mantido constante, acrescentando 400000 crianças por ano, aos já existentes 40-50 milhões de crianças com excesso de peso. A Organização Mundial da Saúde (OMS), no seguimento da aprovação da Carta Europeia de Luta Contra a Obesidade, lançou uma iniciativa a pedido dos Estados-Membros da Região Europeia com a intenção de instalar um sistema de vigilância da obesidade infantil. O WHO - European Childhood Obesity Surveillance Initiative, constitui o primeiro Sistema Europeu de Vigilância Nutricional Infantil. Portugal assumiu a coordenação Europeia desta iniciativa em 2007 e a nível nacional este estudo denomina-se “COSI – Portugal". Sendo Portugal um dos países com maior prevalência de obesidade infantil com a morbilidade e mortalidade associada e ainda os elevados custos que a determinam, o combate a esta doença e a sua prevenção constituem-se como uma prioridade política, nomeadamente do Ministério da Saúde. Neste contexto, houve a necessidade de se estabelecer a implementação de um sistema de vigilância simples, padronizado, harmonizado e sustentável constituindo uma medida claramente importante para corrigir a lacuna que existe na obtenção de informação sobre o estado nutricional e avaliação e monitorização da prevalência de obesidade em crianças, permitindo também identificar grupos em risco. O COSI-Portugal tem como principal objetivo criar uma rede de informação sistemática, comparável entre os países da Europa, sobre as características do estado nutricional infantil de crianças dos 6 aos 8 anos de idade. No primeiro ano de avaliação (2007/2008) participaram 13 países dos 22 inscritos. No segundo ano de avaliação (2009/2010) juntaram-se quatro novos países aos 13 já participantes: Grécia, Hungria, Macedónia e Espanha. Em Portugal este projeto foi articulado com as Administrações Regionais de Saúde do Norte, Centro, Lisboa e Vale do Tejo, Algarve, Alentejo e com as Direcções Regionais de Saúde dos Açores e da Madeira. De acordo com a listagem oficial das escolas do 1º ciclo do Ensino Básico (2007/2008) do Ministério de Educação, foi seleccionada uma amostra representativa nacional, na qual a unidade amostral é a escola. O estudo em questão baseia-se no modelo da epidemiologia descritiva, com amostras transversais repetidas de avaliação do estado nutricional de crianças do 1º ciclo do ensino básico português. As escolas seleccionadas constituem a “Rede de Escolas Sentinelas” onde decorre o COSI-Portugal a cada 2-3 anos. Foram avaliadas 4064 crianças dos 6 aos 8 anos (média de idades: 6,97 anos ± 0,72) do 1º e 2º ano de 176 escolas. A metodologia aplicada seguiu o protocolo comum a todos os países participantes. As crianças foram avaliadas através de parâmetros antropométricos (peso e estatura) por 164 examinadores que receberam o mesmo treino de uniformização e qualidade de procedimentos. Para a classificação do estado nutricional foram utilizados os 3 critérios internacionalmente reconhecidos (IOTF, CDC e OMS). Foram ainda aplicados mais dois questionários compreendo variáveis relativas à família e ao ambiente escolar. É de notar que a participação neste estudo foi de 78,6% das crianças inicialmente inscritas, 93,1% de escolas e 84,2% de famílias.
- Necessidades energéticas em criançasPublication . Rito, Ana Isabel; Carvalho, Maria AnaAs crianças em idade escolar (6-10 anos) encontram-se em crescimento contínuo, sendo essencial a adopção de um padrão alimentar equilibrado e adequado às suas necessidades que deve compreender uma distribuição, em termos de aporte energético e nutricional, de acordo com os princípios de uma alimentação saudável – completa, variada e equilibrada. As necessidades de energia da criança dependem das necessidades impostas pelas funções do organismo, pelo crescimento e também pelo dispêndio de energia inerente à prática de atividade física que, no período escolar, pode ser muito intensa. O total de alimentos, ingeridos ao longo do dia, deve respeitar as proporções da roda dos alimentos, bem como distribuir-se pelo menos em cinco refeições diárias, optimizando assim todas as funções do organismo e evitando o cansaço e a falta de concentração. Em Portugal, não existem até à data dados actualizados do consumo alimentar individual, dado que o último e único Inquérito Alimentar Nacional data de 1980. Contudo, através de dados de estudos internacionais no âmbito da monitorização do consumo alimentar infantil, verifica-se que o padrão alimentar das crianças em idade escolar é hiperproteico e hiperlípidico, com uma diminuição marcada no consumo de polissacáridos, fibra alimentar e hortofrutícolas, em paralelo com o aumento do consumo de refrigerantes que parece estar associado ao aumento do risco para desenvolver obesidade. A revogabilidade desta situação justifica a prioridade atribuível à formulação e ao desenvolvimento de programas de acção que estimulem a adopção de estilos de vida mais saudáveis e criem condições estruturais e ambientais favoráveis à saúde quer em ambiente escolar, familiar e comunitário. Neste contexto, é necessário recorrer a estratégias diversificadas e complementares de monitorização e intervenção, de que são exemplo a monitorização do consumo alimentar infantil, o “empoderamento” dos cidadãos, o desenvolvimento de competências pessoais, a criação de ambientes favoráveis à saúde e o delineamento de políticas saudáveis.
- Effect of cooking on hydrossoluble vitamin content on two fish speciesPublication . Flores, Cristina; Santos, MarianaThis work intended to evaluate the effect of Portuguese fish cooking methods, in riboflavin, pyridoxine and niacin content and produce data for the Food Composition Table. Two samples of European seabass (Dicentrarchus labrax) and three of Nile perch (Lates niloticus) were obtained, from the local seafood market, in three different dates. The first step of sample preparation was equal for all samples; each sample was gutted, scaled, headed, washed and drained. Seabass was grilled and perch samples grilled or boiled according to local recipes. Cooked and raw samples were reduced to the edible portion and frozen at -80 ºC, before testing. All analytical methodologies included RP-HPLC separation with fluorescent detection, and were based in European standards. Vitamin content was calculated in mg/100g of primary raw samples (after the common preparation step), to evaluate vitamin loss due to cooking procedures. Vitamin concentration in mg/100g of edible portion was also calculated. Vitamin content of cooked samples were compared with raw samples content (ANOVA, p<0,05), in terms of mg/100g of primary raw samples and mg/100g of edible portion. In seabass, a loss of pyridoxine is verified in the grilled vs. raw samples. For riboflavin and niacin, no significant differences were found. When edible fraction concentrations, were compared, no differences were found. For perch, vitamin loss was not verified but, niacin concentration in the grilled sample is significantly higher than in the other two, in terms of edible fraction concentration. In the present study vitamin loss due to cooking, in most cases, was not verified.
- To have or not to have familial hypercholesterolaemia, that is the question: genetic and different clinical criteriaPublication . Alves, A.C.; Medeiros, A.M.; Berguete, S.; Bourbon, M.Familial hypercholesterolaemia (FH) is an inherited disorder of cholesterol metabolism with increased cardiovascular risk. The molecular basis of FH is well understood and the molecular diagnosis is extensively applied. There are several clinical criteria for the clinical diagnosis of FH. The three criteria most applied worldwide have been proposed by the Simon Broome Register Group, the USA Make Early Diagnosis to Prevent Early Death (MEDPED) Program, and the Dutch MEDPED Program. The clinical diagnosis of FH is usually obtained by combining evidence from clinical history, physical signs, biochemical markers and family history. The Dutch MEDPED criteria (DMP) is more specific and is based on a score system, the Simon Broome criteria (SB) and the USA MEDPED criteria (MP) are more broad. Although all of them are based on clinical personal and family history of premature coronary artery disease (CAD) and plasma cholesterol levels, they use different specifications. SB and DMP criteria are the most used worldwide. The AIM of this work was to compare both methods and examine the relationship between phenotype and genotype to determine which one is more accurate for the clinical identification of FH patients that should be further characterized.
- Computerized dietary interviews: defining guidelines for the contruction of food consumption assessment software for European populationsPublication . Cruz, C.; Rodrigues, T.; Vilela, S.; Guiomar, S.; Lopes, C.; Torres, D.
- Identification of microorganisms that may contribute to the safety and quality of traditional foods and beverages consumed in the Black Sea regionPublication . Boyko, N.; Levchuk, O.; Mudryk, M.; Kutchak, I.; Dolgikh, A.; Bati, V.; Jorjadze, M.; Karpenko, D.; Sapundzhieva, T.; Alexieva, I.; Hayran, O.; Kocaoglu, B.; Kroon, P.; Costa, H.S.The main aim of the EU-funded BaSeFood project is to invesitgate the healthy properties of traditional foods and beverages of plant origin. Quality and safety of foods are largely dependent of the level of microbial contamination. For this study the majority of plants, as ingredients, of prioritized foods and drinks was obtained and collected from Georgia, Bulgaria, Russia, Turkey and Ukraine. The microbial species (strains) potentially belong to three different categories: (A) beneficial; (B1) detrimental of environment, and (B2) dangerous to human origin (classical “foodborne” pathogens) among all the variety of microbial contaminants that were determined. All isolated microorganisms have been identified with semi-automatic biochemical and serological tests and MULDY techniques. Beneficial species isolated from fresh green parts of plants included mainly Streptococcus lactis (carrot); enterococci, Enterococcus faecalis/faecium (hot pepper) in Bulgarian samples; Actinomyces israeli (kale, Turkey); Bifidobacterium longum (parsley), and Lactobacillus acidophilus (elderly flowers) in Ukrainian samples. The dominating opportunistic pathogenic bacteria (the category B1) belong mainly to species of Klebsiella pneumoniae and oxytoca (rose petals), Enterobacter cloacae (carrot), Proteus vulgaris/mirabilis (sorrel, dill, parsley, Ukraine and Bulgaria), and Str. agalactiae (nettle, corn, Georgia, and Turkey). Isolation of some bacteria (for example Serratia odorifera biogroup 1 and Pantoea agglomerans ) are plant specific. Salmonella typhi were obtained from sorrel (Ukraine), Shigella flexneri ABC from kale, crop and green beans (Turkey), and Listeria monocytogenes from bread (Georgia). The amount of bacteria with potential beneficial properties is significantly increased when selected traditional fermented foods and drinks are assessed: L. fermentum, B. breve and L. acidophylus (in boza), B. dentinum (in fermented beans, Turkey), A. israeli, L. plantarum and casei (kvass, Russia). We have concluded that the amount of beneficial bacteria was significantly less compared with the main dominating group of potentially pathogenic bacteria and foodborne pathogens were rarely found.
- Relation between triglycerides associated polymorphisms and lipid profile in Familial Combined HyperlipidaemiaPublication . Santos, T.; Rato, Q.; Gaspar, I.M.; Bourbon, M.Familial Combined Hyperlipidaemia (FCHL) is a genetic disorder characterized by highly atherogenic profile with prevalence of sdLDL particles, hyperlipidaemia (hypertriglyceridaemia and/or hypercholesterolaemia) and high apoB levels (>120 mg/dL), with different lipid profiles in members of the same family. Some polymorphisms in several genes (LPL -93T>G/D9N, APOAIV Q360H and V13M, APOAV -1131T>C and S19W, APOCIII 3238C>G, USF1s1 and USF1s2) have been associated with higher levels of triglycerides (TG) or FCHL. Hypertriglyceridaemia (HTG) has also been suggested by some authors as an independent risk factor for cardiovascular diseases (CVD).
- Analysis of Genetic Markers for Cardiovascular Disorders in a Portuguese Population with Familial HypercholesterolaemiaPublication . Gomes, A.; Santos, T.; Costa, L.; Bourbon, M.Familial Hypercholesterolaemia (FH) is a genetic disorder that leads to an increase in levels of total and low density lipoprotein cholesterol promoting atherosclerosis (ATH) and premature cardiovascular disease (CVD). ATH and CVD are multifactorial disorders depending on both genetic and environmental factors and inflammation has been considered to be involved in the pathogenesis of ATH and CVD, namely the activity of pro-inflammatory cytokines and acute phase proteins. Also, there are other risk factors contributing to the development and progression of ATH and CVD as genetic and oxidative stress markers.
- Harmonization of dietary quantification methods: can quantification common based picture book cover specific needs of a country?Publication . Rodrigues, T.; Cruz, C.; Vilela, S.; Lopes, C.; Torres, D.; Guiomar, S.