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- WHO European Childhood Obesity Surveillance Initiative: COSI Portugal 2013Publication . Rito, Ana; Graça, PedroApresentação pública dos resultados do Relatório COSI 2013. O Childhood Obesity Surveillance Initiative (COSI)/World Health Organization Regional Office for Europe é o sistema europeu de vigilância nutricional infantil coordenado pelo Gabinete Regional Europeu da Organização Mundial da Saúde (OMS). Tem como principal objetivo criar uma rede sistemática de recolha, análise, interpretação e divulgação de informação descritiva sobre as caraterísticas do estado nutricional infantil de crianças dos 6 aos 8 anos, que se traduz num sistema de vigilância que produz dados comparáveis entre países da Europa e que permite a monitorização da obesidade infantil a cada 2-3 anos.
- Surveillance of norovirus in Portugal and the emergence of the Sydney variant, 2011-2013Publication . Costa, Inês; Mesquita, J.R.; Veiga, E.; Oleastro, Mónica; Nascimento, M.J.This report presents the results of the national surveillance system of diarrhea etiology of the National Institute of Health of Portugal concerning norovirus (NoV) during a two-year period, May 2011-2013. Of the total 580 stool samples collected from patients hospitalized for acute diarrhea in 13 Hospitals of Portugal, 67 (11.6%) tested positive for NoV. From May 2011 to March 2012 the GII.4 variant New Orleans 2009 was the most predominant strain having been replaced by the new GII.4 variant Sydney 2012 since then till the end of the survey. To our knowledge this is the first study showing the circulation of GII.4 as the norovirus strain most commonly associated to gastroenteritis and the first to report the replacement of GII.4 New Orleans by GII.4 Sydney 2012 variant in Portugal.
- Detection of Dientamoeba fragilis in Portuguese children with acute gastroenteritis between 2011 and 2013Publication . Júlio, C.; Furtado, Cristina; Rocha, R.; Escobar, C.; Brito, M.J.; Oleastro, MónicaDientamoeba fragilis is an inhabitant of human gastrointestinal tract with a worldwide distribution. The first description considered this protozoan a rare and harmless commensal, since then it has struggled to gain recognition as a pathogen. Commercial multiplex real-time PCR was used to detect D. fragilis in fecal samples from hospitalized children (⩽18 years) with acute gastrointestinal disease, admitted to two hospitals of Lisbon area, with different demographic characteristics. A total of 176 children were studied, 103 (58·5%) male, 144 (81·8%) children between 0 and 5 years and 32 (18·2%) above 6 years old. The overall protozoa frequency considering the four tested microorganisms were 8·5% (15/176), and the most frequently found protozoan was D. fragilis, 6·3% (11/176). Dientamoeba fragilis frequency was higher among older children (21·9%), than younger children (2·8%), and greater in boys (6·8%) than in girls (5·5%). All positive children presented with diarrhoea associated with vomiting, fever and abdominal pain. Infection was associated with the age of children (P < 0·001), school attendance (P = 0·002) and consumption of certain foods (P = 0·014), e.g. cakes with crème and ham. The frequency of diantamoebiasis found in a cohort of hospitalized Portuguese children, with acute gastrointestinal disease, could be considered a very high value when compared with the protozoan frequency normally associated with this pathology.
- Dormant phages of Helicobacter pylori reveal distinct populations in EuropePublication . Vale, F.F; Vadivelu, J.R.; Oleastro, Mónica; Breurec, S.; Engstrand, L.; Perets, T.T.; Mégraud, F.; Lehours, P.Prophages of Helicobacter pylori, a bacterium known to co-evolve in the stomach of its human host, were recently identified. However, their role in the diversity of H. pylori strains is unknown. We demonstrate here and for the first time that the diversity of the prophage genes offers the ability to distinguish between European populations, and that H. pylori prophages and their host bacteria share a complex evolutionary history. By comparing the phylogenetic trees of two prophage genes (integrase and holin) and the multilocus sequence typing (MLST)-based data obtained for seven housekeeping genes, we observed that the majority of the strains belong to the same phylogeographic group in both trees. Furthermore, we found that the Bayesian analysis of the population structure of the prophage genes identified two H. pylori European populations, hpNEurope and hpSWEurope, while the MLST sequences identified one European population, hpEurope. The population structure analysis of H. pylori prophages was even more discriminative than the traditional MLST-based method for the European population. Prophages are new players to be considered not only to show the diversity of H. pylori strains but also to more sharply define human populations.
- Risk assessment of multiple mycotoxins in infant food consumed by Portuguese children – the contribute of the MYCOMIX projectPublication . Alvito, Paula; Assunção, Ricardo; Borges, T.; Leal, S.; Loureiro, S.; Louro, Henriqueta; Nunes, Baltazar; Silva, M.J.; Tavares, A.; Martins, Carla; Vasco, Elsa; Calhau, Maria AntóniaThere is a growing concern within public health about mycotoxin involvement in human diseases, namely those related to children. Scarce data are available in the literature concerning the occurrence of multiple mycotoxins in infant food and their combined toxicity, and no data exists in Portugal concerning this issue. In order to contribute to fill this gap, the MycoMix project, funded by the Portuguese Foundation for Science and Technology, gathered a multidisciplinary team aiming at answering several questions: 1) Are Portuguese children exposed daily to one or several mycotoxins through food? 2) Can this co-exposure affect children´s health? and 3) Are there interaction effect between mycotoxins? Within this project, Portuguese children (< 3 years old, n=103) food consumption data were obtained using a 3 days food diary in a pilot study performed at a Primary Health Care Unit. The main declared infant foods were purchased from the Lisbon market along 2014-15 and analyzed by means of HPLC and LC-MS/MS analytical techniques for multiple mycotoxins co-occurrence. Toxicological studies including bioaccessibility and cyto and genotoxic interactions between detected mycotoxins were also performed using in vitro approaches. Preliminary results showed that 96 % of the analyzed breakfast cereals (BC) were contaminated with one to six different mycotoxins in the same sample and children exposure to single mycotoxins present in BC were well below the tolerable daily intake (TDI) although the margin of exposure (MOS) values for multiple mycotoxins were near one. Bioaccessibility values for single mycotoxins ranged between 42-106% for patulin and aflatoxin M1 in cereal based foods and in infant formulae. Cito and genotoxicity studies on the detected mycotoxins provided evidence on the interaction effect between some binary mixtures of mycotoxins. The assessment of all data is expected to contribute to a more accurate risk assessment of multiple mycotoxins in infant foods consumed by Portuguese children, warranting the safety of infant health. Results obtained within MYCOMIX highlight the challenges posed by the occurrence of multiple chemicals co-occurring in foods.
- Mucopolysaccharidoses in Tunisia: a molecular portrait of allelic heterogeneity and consanguinityPublication . Coutinho, Maria Francisca; Ouesleti, Souad; Ribeiro, Isaura; Miled, A.; Mosbahi, D.S.; Alves, SandraThere are 11 different enzymes involved in the stepwise degradation of glycosaminoglycans (GAGs). Deficiencies in each of those enzymes result in eight different Mucopolysaccharidoses (MPSs), all sharing a series of clinical features, though in variable degrees. Typical symptoms include organomegally, dysostosys multiplex and coarse facies. CNS, hearing, vision and cardiovascular function may also be compromised. Traditionally, MPSs are recognized through analysis of urinary GAGs. Still, initial screenings of urinary GAGs allow discrimination between broad classes of MPSs but cannot distinguish subgroups. In fact, a definitive diagnosis may only be accessed through a combination of enzymatic assays and molecular analyses. Currently, there are countless laboratories in Europe where those biochemical and genetic tests are carried out. Nevertheless, developing countries often lack the necessary resources/expertise for proper diagnosis of rare genetic diseases. Being one of the labs where molecular genetic testing for virtually all MPSs is available for research purposes, we receive several samples from other countries, whose clinicians and/or centers struggle to get a molecular characterization of affected individuals. Here we present our results on the molecular characterization of MPS patients we have been receiving from Tunisia. Nine families suffering from five different diseases were studied so far: 3 MPS II; 2 MPS IIIA; 2 MPS IIIB; 1 MPS IIIC and 1 MPS VI. We have identified 9 different mutations, 5 of which were novel: 1 in the IDS gene (c.1333delC); another in the SGSH gene (p.D477N); 2 in the NAGLU gene (p.L550P and p.E153X) and yet another in the ARSB gene (p.L82P). All detected mutations were further analyzed with the most suitable approaches. Special attention was paid to the novel alterations, particularly to the missense ones, whose impact on protein structure and function was evaluated in silico. In general, there was a strong correlation between the observed clinical phenotype and the genotype assessed through molecular analysis. Also noteworthy is the astonishing level of homozygosity in our sample (100%), with each family presenting its own molecular defect, a pattern consistent with the occurrence of consanguineous matings in Tunisia, where such marriages are thought to provide social, economic and cultural benefits. Altogether, our results provide a preliminary overview of the molecular basis, enzymatic defects and clinical manifestations of MPSs in Tunisia, further supporting previous reports on the high impact of inbreeding and regional endogamy on the occurrence of autosomal recessive disorders in that country. Hopefully, these results will not only contribute to improve genetic counseling for affected families, but also to highlight the need for reinforced and continuous information of general public and health professionals on the potential negative medical impact of intra-family marriages, particularly in Northern Africa, Middle East and South Asia.
- Mercury content in foods a contribution to food risk assessmentPublication . Santiago, Susana; Santos, Mariana; Calhau, M. AntóniaFood risk assessment takes account of both toxicological information and estimates of dietary exposure of a population to the chemical substances in order to evaluate risks for public health (EFSA, FAO, & WHO 2011). To estimate dietary exposure accurately, it is essential to analyse foods as consumed for the presence and levels of chemical substances. Mercury is a metal that is released into the environment from both natural and anthropogenic sources. Once released, mercury undergoes a series of complex transformations and cycles between atmosphere, ocean and land. The three chemical forms of mercury are (i) elemental or metallic mercury (Hg0), (ii) inorganic mercury (mercurous (Hg2 2+) and mercuric (Hg2+) cations) and (iii) organic mercury. Methylmercury is by far the most common form of organic mercury in the food chain. The European Food Safety Authority (EFSA) has established Tolerable Weekly Intakes (TWIs), or ‘safe levels’, intended to protect consumers from adverse health effects posed by the possible presence of the main forms of mercury found in food: methylmercury and inorganic mercury.On this basis, Member States, research institutions, academia and any other stakeholders are invited to submit occurrence data on these contaminants. Following these Commission Recommendations, Member States are requested to encourage the active involvement of food and feed business operators on the submission of available data on contaminants in food/feed to EFSA. In this study 117 different samples from 10 food groups according to the FoodEx Level 1, a pan- European food classification system, were analyse to determine the amount of total mercury. The samples were collected during October 2013-May 2015. Determination was carried in compliance with ISO standard 17025. Total mercury (Hg) was determined in a Direct Mercury Analyser DMA 80 (Milestone Inc.; CT, USA), according to United States Environmental Protection Agency test method 7473 (USEPA, 2007) [2]. We obtained different limits of quantification, according matrices, in a range 0.5 μg/Kg (grapes and fruit salad) to 13.8 μg/Kg (popcorn). Analytical quality control was achieved using certified reference material NIST 1566b oyster tissue and BCR 151 skim milk powder. More than 72 % of the results were below the limit of quantification (LOQ). However, 27.4% of the results revealed measurable concentration of mercury. Fish and other seafood and a composite food containing fish had the highest values of total mercury (between 2.9 and 574 μg/Kg of sample) in comparison to all other food categories. Analysis of this data indicated that the average intake of mercury from fish and seafood products can be near the tolerable weekly intakes established by JECFA (1.6 μg/kg body weight). This study provide baseline information on the analytical data on the chemical substances of interest to performed, a dietary exposure assessment to determine whether this substance pose a risk to the public health, i.e. whether intakes exceed the toxicological limits.
- Prevenção primária dos Defeitos do Tubo Neural: dados do Registo Nacional de Anomalias CongénitasPublication . Braz, Paula; Machado, Ausenda; Dias, Carlos MatiasIntrodução: Os defeitos do tubo neural (DTN) são anomalias congénitas que ocorrem devido ao deficiente encerramento do tubo neural que deve estar concluído até ao 28º dia de vida. Estudos internacionais mostram que a utilização do ácido fólico previne cerca de 70% dos DTN, quando administrado antes da gravidez até ao fim do primeiro trimestre. Em Portugal é recomendado o uso pre-concepcional do ácido fólico desde 1998 A literatura mostra que características maternas como a idade e a escolaridade têm influência na utilização pre-concepcional de ácido fólico. É objetivo deste estudo avaliar a utilização de ácido fólico na prevenção primária dos DTN, para os anos de 2004 a 2013.
- Effects of Trihalomethanes on Liver MitochondriaPublication . Faustino-Rocha, A.I.; Rodrigues, D.; Gil da Costa, R.M.; Dinis, C.; Talhada, D.; Aragão, S.; Botelho, M.; Colaço, A; Pires, M.J.; Oliveira, M.M.; Peixoto, F; Oliveira, P.A.Introduction: Trihalomethanes (THMs), namely dibromochloromethane (DBCM) and bromodichloromethane (BDCM), are disinfection byproducts of chlorinated water. This experiment aimed to evaluate the mitochondrial dysfunction induced by THMs at low levels in a mouse model.
- Nutritional quality of natural and processed nutsPublication . Albuquerque, T.G.; Oliveira, M.B.; Sanches-Silva, A.; Costa, H.S.Total fat and salt contents are crucial factors for the nutritional quality of nuts. In the last years, several studies have reported the importance of nuts consumption to promote health benefits, especially those related with the prevention of cardiovascular diseases. The overall objective of this study was to compare the total fat and salt contents of 21 samples of natural and processed nuts (walnuts, pistachios, broad beans, corn, hazelnuts, cashews, almonds, peanuts and mixtures of different nuts). Natural nuts have nothing added, while processed have honey, salt and/or other ingredients. The selected nuts were analysed regarding their moisture, fat and salt contents. Moisture content was determined by gravimetric method. For total fat, acid hydrolysis followed by Soxhlet extraction with petroleum ether was used, while for salt determination Charpentier-Volhard’s titration was performed. The results are expressed in g/100 g of edible portion. Total fat content varied between 12.3 ± 0.3 and 72.9 ± 0.3 g/100 g, for corn and walnuts, respectively. With respect to salt content a range from 0.0291 ± 0.0 (natural walnuts) to 2.65 ± 0.0 g/100 g (pistachio) was obtained. The analysed natural nuts presented the lowest salt content (0.0291 – 0.105 g/100 g). World Health Organization recommends a daily salt intake below 5 g. Therefore, it is of utmost importance to increase the variety of natural nuts available in the market, since these have much lower contents of salt than the processed nuts, and at the same time provide significant amounts of unsaturated fatty acids.