Browsing by Issue Date, starting with "2017-08"
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- Necessidades não satisfeitas de cuidados de saúde dos portugueses em 2014Publication . Martins, João Luís Vieira; Dias, Carlos MatiasIntrodução: As necessidades não satisfeitas de cuidados de saúde (NNSCS) ocorrem quando um indivíduo não obtém cuidados de saúde necessários para a resolução do seu problema. O estudo das NNSCS permite identificar barreiras de acesso aos serviços de saúde como razões financeiras, tempo de espera e distância. A identificação destas iniquidades de acesso é o primeiro passo para a redução das mesmas. Este trabalho visa identificar as necessidades NNSCS em Portugal, e a sua relação com os fatores demográficos e socioeconómicos. Métodos: O Inquérito Nacional de Saúde 2014 usou uma amostra representativa nacional de 18 204 indivíduos com 15 ou mais anos. Foram selecionados os casos que reportavam uma necessidade de cuidados de saúde nos 12 meses prévios para avaliar as NNSCS por motivos financeiros, de distância ou tempo de espera. As prevalências de NNSCS foram calculadas e determinadas as Razões de Prevalência ajustadas (RP) através da Regressão de Poisson. Resultados: Estima-se que 83% dos portugueses tenham tido pelo menos uma necessidade de cuidados de saúde nos 12 meses que antecederam o INS 2014. Embora as mesmas tenham sido satisfeitas num grande número de indivíduos, 23% do total dos portugueses teve pelo menos uma necessidade de cuidados de saúde não satisfeita, por dificuldade financeira, distância ou por tempo de espera. Discussão/Conclusão: Em Portugal ser mulher, divorciado, desempregado, ter uma doença crónica, ter uma limitação das AVD, um nível de escolaridade completo inferior ou pertencer a um quintil mais baixo são fatores de risco para ter uma NNSCS. Há uma variação regional entre as NNSCS que necessita de uma investigação mais detalhada. É premente uma intervenção política transversal com vista à redução das iniquidades em saúde e das iniquidades socioeconómicas
- Relatório de atividades 2016Publication . Instituto Nacional de Saude Doutor Ricardo Jorge, IP; Correia, Ângela; Sanches, SusanaO presente instrumento de gestão do Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA) relativo a ano de 2016: tem três grandes objetivos: 1) Averiguar a concretização do Quadro de Avaliação e Responsabilização (QUAR) e do Plano de Ação (PA) de 2016, nomeadamente, avaliar a estratégia assumida através dos seus objetivos estratégicos, verificando o grau de realização dos programas e dos objetivos operacionais que foram propostos nestes documentos; 2) Disponibilizar informação institucional relativa à execução do orçamento, à alocação de recursos humanos, financeiros e técnicos; 3) Demonstrar quantitativa, e qualitativamente, a informação relativa às funções essenciais do Instituto, aos Departamentos Técnico Científicos (DTC), ao Museu da Saúde e aos Serviços de Suporte.
- Relatório mensal ICARO (Importância do CAlor: Repercussões sobre os Óbitos) - Julho 2017Publication . Silva, Susana PereiraApesar do IPMA ter identificado o mês de julho de 2017 como seco e quente, o Sistema ICARO não identifi cou nenhum período de calor extremo com possíveis impactes na mortalidade, pelo que não eram expectáveis quaisquer excessos de mortalidade potencialmente associados ao calor extremo.
- Population genetic structure of Helicobacter pylori strains from Portuguese-speaking countriesPublication . Oleastro, Mónica; Rocha, Raquel; Vale, Filipa F.The human gastric colonizer Helicobacter pylori is useful to track human migrations given the agreement between the bacterium phylogeographic distribution and human migrations. As Portugal was an African and Brazilian colonizer for over 400 years, we hypothesized that Portuguese isolates were likely genetically closer with those from countries colonized by Portuguese in the past. We aimed to characterize the population structure of several Portuguese-speaking countries, including Portugal, Brazil, Angola, and Cape Verde.
- Effects of positive airway pressure therapy on cardiovascular and metabolic markers in males with obstructive sleep apneaPublication . Feliciano, A.; Oliveira, M.J.; Cysneiros, A.; Martinho, C.; Reis, R.P.; Penque, D.; Pinto, P.; Bárbara, C.Introduction: Obstructive sleep apnea syndrome (OSAS) is associated with cardiovascular/ metabolic complications. Some analytical parameters (homocysteine, glycemic and lipidic profiles) are recognized markers of these consequences. Limited data is available on the association of these markers and OSAS’s severity/response to positive airway pressure therapy (PAP). Material and methods: In this prospective study we analyzed polysomnographic and analytical data of male patients admitted to sleep laboratory. The aim was to evaluate metabolic/cardiovascular markers in snorers and OSAS patients, to relate with sleep parameters and PAP response. One-hundred and three patients were included, and 73 (71%) were OSAS patients. OSAS patients were similar to snorers except for higher body mass index (BMI) and dyslipidemia. Severe OSAS patients showed higher glycemia, HbA1c, insulin, and insulin resistance, and lower HDL cholesterol in comparison to mild---moderate (p < 0.05, p < 0.05, p < 0.001, p < 0.001, p < 0.05, respectively). Glycemic profile and triglycerides were slightly correlated with OSAS severity. 46 OSAS patients were submitted to 6 months of PAP, with a statistical decrease in mean values of homocysteine, glycemia, total and LDL cholesterol(p < 0.05, p < 0.05, p < 0.05, respectively), and in glycemia and LDL cholesterol in severe grouponly (p < 0.05, p < 0.05, respectively).Results: This study demonstrated an association between glucose metabolism parameters andtriglycerides with OSAS severity underlying the complexity of the process leading to cardiovas-cular/metabolic complications in this disorder. Moreover, homocysteine, glycemic and lipidicprofiles changed significantly after 6 months of PAP therapy in OSAS, supporting its cardiovas-cular and metabolic protective effect.Conclusion: Our study has reinforced the importance of analytical cardiovascular/metabolicevaluation as complementary tool of diagnosis/treatment response in OSAS.
- Survival of lichens on the ISS-II: ultrastructural and morphological changes of Circinaria gyrosa after space and Mars-like conditionsPublication . Noetzel, Rosa de la Torre; Miller, B.; Cubero, A.Z.; Sancho, L.G.; Jordao, Luisa; Rabbow, E.; Meessen, J.; Vera, J.P.Lichens are extremophile organisms, they live in the most extreme conditions, colonizing areas with extreme temperatures, high aridity condition and high UV-radiation. Therefore they have been by far the most successful settlers of the Antarctic continent. Also in the laboratory they survive temperatures near the absolute cero and absolute dryness without difficulty. Lichen species have distinct likes and dislikes when it come to the physico-chemical properties of the substrate while the group of lichens as a whole is pretty adaptable to various substrata (from rocks to glass). The main feature/aspect of their evolutionary/ecological success of this capacity is the close symbiotic relation between two organisms, a fungi and a cyanobacteria or an algae [1], allowing them to survive at real space [2] and at Mars conditions [3, 4, 5], such as that on the ISS. At the exposure platform EXPOSE-R2 on ISS (2014-2016), samples of the lichen species Circinaria gyrosa belonging to the BIOMEX experiment (Biology and Mars Experiment, ESA) [5], were exposed during 18 months to real space and to a Mars simulated environment to study Mars habitability and resistance to real space conditions. Also the identification of biomarkers was done to include them as reference for future space missions to Mars (Exo Mars). After the return of the mission at June 2016, the first preliminary analysis were performed, showing the metabolic activity a quick and complete recovery of the dark space control samples exposed to space vacuum and Mars-like atmosphere. In contrast, the samples directly exposed to space radiation showed slow recovery in reference to their observed original activity. Electron and fluorescence microscopy techniques also revealed that the viability of C. gyrosa exposed to space conditions decreased in comparison to those exposed to Mars-like environment. Moreover, differences were observed between samples positioned at level 1 and level 2. In general, TEM and FESEM observations showed that samples at level 2 (basal samples) were slightly affected in their morphology/ultrastructure by the exposure conditions. In contrast, cellular ultrastructure alterations were clearly evident for samples exposed to space radiation, which led to a shrinkage process. The cell walls were irregularly shaped and debris of the major organelles were visible. Now, the biomolecular changes of the DNA are in study by PCR and sequencing techniques. In contrast to these studies, the biogeochemical variations will be examined with spectroscopic analyses (Raman) to look for possible degradation of cell surfaces and pigments which were in contact with terrestrial rocks, and Martian analogue regolith. These experiments will contribute to answer questions on the habitability of Mars, on the likelihood of the Lithopanspermia HYPOTHESIS y [8] and will be of relevance for planetary protection issues.
- Unrecognized Fibrinogen A α-Chain Amyloidosis: Results From Targeted Genetic TestingPublication . Tavares, Isabel; Oliveira, João Paulo; Pinho, Ana; Moreira, Luciana; Rocha, Liliana; Santos, Josefina; Pinheiro, Joaquim; Costa, Paulo Pinho; Lobato, LuísaFibrinogen A α-chain (AFib) amyloidosis results from autosomal-dominant mutations in the gene encoding AFib (FGA). Patients with this disorder typically present with proteinuria. Isolated cases of AFib amyloidosis, carrying the FGA p.Glu545Val variant, were identified in the district of Braga, in northwest Portugal. This observation led us to hypothesize that this disorder might be an unrecognized cause of kidney disease in that region and prompted us to carry out targeted genetic testing for the p.Glu545Val variant in the local hemodialysis population and family members of identified cases.
- The expression of Helicobacter pylori tfs plasticity zone cluster is regulated by pH and adherence, and its composition is associated with differential gastric IL-8 secretionPublication . Silva, Bruno; Nunes, Alexandra; Vale, Filipa F; Rocha, Raquel; Gomes, João Paulo; Dias, Ricardo; Oleastro, MónicaBackground: Helicobacter pylori virulence is associated with different clinical outcomes. The existence of an intact dupA gene from tfs4b cluster has been suggested as a predictor for duodenal ulcer development. However, the role of tfs plasticity zone clusters in the development of ulcers remains unclear. We studied several H. pylori strains to characterize the gene arrangement of tfs3 and tfs4 clusters and their impact in the inflammatory response by infected gastric cells. Methods: The genome of 14 H. pylori strains isolated from Western patients, pediatric (n=10) and adult (n=4), was fully sequenced using the Illumina platform MiSeq, in addition to eight pediatric strains previously sequenced. These strains were used to infect human gastric cells, and the secreted interleukin-8 (IL-8) was quantified by ELISA. The expression of virB2, dupA, virB8, virB10, and virB6 was assessed by quantitative PCR in adherent and nonadherent fractions of H. pylori during in vitro co-infection, at different pH values. Results: We have found that cagA-positive H. pylori strains harboring a complete tfs plasticity zone cluster significantly induce increased production of IL-8 from gastric cells. We have also found that the region spanning from virB2 to virB10 genes constitutes an operon, whose expression is increased in the adherent fraction of bacteria during infection, as well as in both adherent and nonadherent fractions at acidic conditions. Conclusions: A complete tfs plasticity zone cluster is a virulence factor that may be important for the colonization of H. pylori and to the development of severe outcomes of the infection with cagA-positive strains.
- Plano estratégico 2017-2019Publication . Instituto Nacional de Saude Doutor Ricardo Jorge, IP; Correia, Ângela; Sanches, SusanaPlano Estratégico do Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA) para 2017-2019. O INSA é um organismo público integrado na administração indireta do Estado, sob a tutela do Ministério da Saúde. Enquanto Laboratório do Estado, o Instituto tem por missão contribuir para ganhos em saúde pública através de atividades de investigação e desenvolvimento tecnológico, atividade laboratorial de referência, observação da saúde e vigilância epidemiológica, bem como coordenar a avaliação externa da qualidade laboratorial, difundir a cultura científica, fomentar a capacitação e formação e ainda assegurar a prestação de serviços diferenciados, nos referidos domínios. Este instrumento tem como objetivo apresentar a visão, os valores institucionais e as linhas estratégicas a adotar neste triénio.
- Plano de atividades 2017Publication . Instituto Nacional de Saude Doutor Ricardo Jorge, IP; Sanches, Susana; Correia, ÂngelaPlano de atividades do Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA) para o ano de 2017. O INSA é um organismo público integrado na administração indireta do Estado, sob a tutela do Ministério da Saúde. Enquanto Laboratório do Estado, o Instituto tem por missão contribuir para ganhos em saúde pública através de atividades de investigação e desenvolvimento tecnológico, atividade laboratorial de referência, observação da saúde e vigilância epidemiológica, bem como coordenar a avaliação externa da qualidade laboratorial, difundir a cultura científica, fomentar a capacitação e formação e ainda assegurar a prestação de serviços diferenciados, nos referidos domínios. Este instrumento constitui um referencial para a atividade a desenvolver pelo Instituto durante este ano, baseado nas estratégias objetivos e metas institucionalmente consensualizados.