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  • Avaliação do desempenho dos Participantes do PNAEQ em Micobacteriologia 2016-2020 e comparação com resultados anteriores (2007-2015)
    Publication . Pereira, Edna; Santos Silva, Anabela; Correia, Helena; Silva, Susana; Faria, Ana Paula
    A Organização Mundial da Saúde (OMS) declarou a tuberculose como emergência mundial, pois 1/3 da população mundial encontra-se infetada pelo bacilo Mycobacterium tuberculosis (MTB) ou bacilo de Koch. Os exames diretos para pesquisa de bacilos álcool ácido resistentes (BAAR) continuam a ser um método rápido e económico para o diagnóstico dos casos infeciosos e para a monitorização do tratamento. O Programa Nacional de Avaliação Externa da Qualidade (PNAEQ) inserido no Departamento de Epidemiologia do Instituto Nacional de Saúde Doutor Ricardo Jorge, tem implementado entre outros, o Programa de Avaliação Externa da Qualidade em Micobacteriologia-Microscopia, desde 1997 contemplando a avaliação microscópica de bacilos álcool ácido resistentes.
    2022-04Conference object Open access Show more
  • Prospective observational study on the role of catheter colonization and multidrug-resistance associated with catheter-related bloodstream infections
    Publication . Pinto, Miguel; Borges, Vitor; Nascimento, Maria; Martins, Filomena; Pessanha, Maria Ana; Faria, Isabel; Rodrigues, Joao; Matias, Rui; Joao Paulo, Gomes; Jordao, Luisa
    Background: Central venous catheter (CVC)-related bloodstream infection (CRBSI) is a huge public health consern with considerable impact on mortality and health costs. The emergence of antimicrobial resistant microorganisms associated or not with CVC colonization by biofilms makes the treatment of CRBSI even more challeging. Methods:A 3-year observational study enrolling 3 tertiary hospitals located in Lisbon (Portugal) was designed to identify the major etiological agent of 58 CRBSI, their ability to colonize CVCs and their antimicrobial resistance profiles. Etiological agents of CRBSI were idebtified by VITEK-2. Whole-genome sequencing was used to confirm CRBSI by the most prevalent etiological agents and characteriza their resistome. CVC's colonization (namely by biofilm assembly) was monitored by scanning electron microscopy. Results: Staphylococci were the most prevalent causative agent (36/58, 62%), with S. aureus and coagulase negative S. epidermidis accounting for 24.1% and 36.2% of CRBSIs, respectively. Comparative genomic analysis of CVCs/hemoculture pairs of isolates revealed genomic matches for 35/36 pairs and a good correlation between antibiotic susceptibility phenotype and the presence of antimicrobials resistance genetic determinants. CVCs colonization was observed mainly in the catheter lumen and presented different phenotypes ranging from isolated attached microorganisms to mature biofilms. The latest phenotype, mature biofilms of S. epidermidis and S. aureus were found for 50.0% and 48.6% of the CVCs, respectively. Nevertheless, no statistical significant association was established between biofilm assembly and CRBSI highlighting the need for further studies to elucidate biofilms' role on this HAI. Conclusion: WGS proved to be a valuable tool to confirm CRBSI. Despite staphylococci biofilms identification on a considerable number of CVCs, no statistically significant association was found between CRBSI and biofilms.
    2022-04Conference object Open access Show more
  • Intervention Services for Autistic Adults: An ASDEU Study of Autistic Adults, Carers, and Professionals’ Experiences
    Publication . Micai, Martina; Ciaramella, Antonio; Salvitti, Tommaso; Fulceri, Francesca; Fatta, Laura Maria; Poustka, Luise; Diehm, Robert; Iskrov, Georgi; Stefanov, Rumen; Guillon, Quentin; Rogé, Bernadette; Staines, Anthony; Sweeney, Mary Rose; Boilson, Andrew Martin; Leósdóttir, Thora; Saemundsen, Evald; Moilanen, Irma; Ebeling, Hanna; Yliherva, Anneli; Gissler, Mika; Parviainen, Tarja; Tani, Pekka; Kawa, Rafal; Vicente, Astrid; Rasga, Célia; Budişteanu, Magdalena; Dale, Ian; Povey, Carol; Flores, Noelia; Jenaro, Cristina; Monroy, Maria Luisa; Primo, Patricia García; Charman, Tony; Cramer, Susanne; Warberg, Christine Kloster; Canal-Bedia, Ricardo; Posada, Manuel; Scattoni, Maria Luisa; Schendel, Diana
    The Autism Spectrum Disorders in the European Union (ASDEU) survey investigated local services' use experiences of autistic adults, carers and professionals with interventions for autistic adults. The majority of the 697 participants experienced recommended considerations prior to deciding on intervention and during the intervention plan and implementation. Psychosocial interventions were the most commonly experienced interventions, while pharmacological interventions NOT recommended for core autistic symptoms were reported by fairly large proportions of participants. Family interventions were experienced slightly more commonly by carers than adults or professionals. Less than the 26% of autistic adult responders who had experienced challenging behaviors reported receiving an intervention to change them. These results provide insights for improving gaps in service provision of interventions among autistic adults.
    2022-04Journal article Open access Show more
  • Overview of PNAEQ clinical participants during COVID-19 pandemic
    Publication . Faria, Ana Paula; Correia, Helena; Ventura, Catarina; Cardoso, Ana; Pereira, Edna; Aldeia, Claudia; Júlio, Claudia; Miranda, Armandina; Silva, Cândido; Barreira, Rui; Miranda, Ana; Reis, Ana; Silva, Susana
    External Quality Assessment Schemes are a crucial tool to identify and evaluate laboratory performance. COVID 19 pandemic poses a challenge for laboratories, since they own a critical role in the diagnosis, prognosis and therapeutic monitoring The laboratory practice in stressful conditions may increase errors due to several factors. The main objective of this study was to evaluate and compare the performance of clinical participants in Portuguese External Quality Assessment Programme (PNAEQ) during the pandemic period (2020) and previous schemes (2019 or 2018) for different parameters of Haematology Chemistry Endocrinology Immunology and Microbiology
    2022-04Conference object Open access Show more
  • Epidemiology of Clostridioides difficile Infection in Portugal: A Retrospective, Observational Study of Hospitalized Patients
    Publication . Nazareth, Cláudia; Leitão, Inês; Reis, Ernestina; Inácio, Hugo; Martins, Filomena; Ramalheira, Elmano; Cunha, Flávia; Santos, Carla; Lino, Sara; Moreira, Hugo; Kruptsala, Nadiya; Santos, Andrea; Paixão, Laura; Pássaro, Leonor; Oleastro, Mónica
    Introduction: Clostridioides difficile is the main cause of healthcare-associated diarrhea in Europe and North America. The aim of this study was to characterize the epidemiology and clinical burden of Clostridioides difficile infection among hospitalized patients in Portugal. Material and methods: Retrospective study conducted in six public hospital centers in Portugal. All primary Clostridioides difficile infection episodes and related recurrences occurring in 2017, as well as episodes developing two to eight weeks after the last episode diagnosed in that year, were documented. The National Reference Laboratory (National Institute of Health Dr. Ricardo Jorge) provided national surveillance data on Clostridioides difficile infection. Results: A total of 385 inpatients with at least one primary episode diagnosed in 2017 were included. Most patients were aged over 70 years-old (73.2%). The included patients developed 451 episodes during the observation period. Approximately 44% of primary episodes were community-associated. Most episodes (94.9%) occurred in patients with one or more risk factors, with recent antibiotic exposure being particularly common (86.0%). All-cause in-hospital mortality was 19.5%, being significantly higher in patients aged over 65 years-old versus those aged 18 to 64 years-old (22.4% vs 7.8%, respectively). Over 50 different ribotypes were observed among 206 Clostridioides difficile strains received by the National Reference Laboratory. Conclusion: In Portugal, hospitalized patients with Clostridioides difficile infection are mostly older patients presenting risk factors for the development of this infection, particularly recent antibiotic exposure. Mortality is disproportionately high among the older population. Community-associated Clostridioides difficile infection is common among inpatients with this infection.
    2022-04-01Journal article Open access Show more
  • Gestational Exercise Increases Male Offspring’s Maximal Workload Capacity Early in Life
    Publication . Beleza, Jorge; Stevanović-Silva, Jelena; Coxito, Pedro; Rocha, Hugo; Santos, Paulo; Ascensão, António; Ramon Torrella, Joan; Magalhães, José
    Mothers' antenatal strategies to improve the intrauterine environment can positively decrease pregnancy-derived intercurrences. By challenging the mother-fetus unit, gestational exercise (GE) favorably modulates deleterious stimuli, such as high-fat, high-sucrose (HFHS) diet-induced adverse consequences for offspring. We aimed to analyze whether GE alters maternal HFHS-consumption effects on male offspring's maximal workload performance (MWP) and in some skeletal muscle (the soleus-SOL and the tibialis anterior-TA) biomarkers associated with mitochondrial biogenesis and oxidative fitness. Infant male Sprague-Dawley rats were divided into experimental groups according to mothers' dietary and/or exercise conditions: offspring of sedentary control diet-fed or HFHS-fed mothers (C-S or HFHS-S, respectively) and of exercised HFHS-fed mothers (HFHS-E). Although maternal HFHS did not significantly alter MWP, offspring from GE dams exhibited increased MWP. Lower SOL AMPk levels in HFHS-S were reverted by GE. SOL PGC-1α, OXPHOS C-I and C-IV subunits remained unaltered by maternal diet, although increased in HFHS-E offspring. Additionally, GE prevented maternal diet-related SOL miR-378a overexpression, while upregulated miR-34a expression. Decreased TA C-IV subunit expression in HFHS-S was reverted in HFHS-E, concomitantly with the downregulation of miR-338. In conclusion, GE in HFHS-fed dams increases the offspring's MWP, which seems to be associated with the intrauterine modulation of SM mitochondrial density and functional markers.
    2022-04-01Journal article Open access Show more
  • Análise do teor de contaminantes químicos em alimentos provenientes de áreas ardidas na região Centro
    Publication . Sequeira, Maria Catarina Gil; Dias, Deodália Maria Antunes; Namorado, Sónia
    Os incêndios florestais são fenómenos que impactam o meio natural. Durante um incêndio, a combustão da matéria orgânica e subsequente deposição de cinzas, induz alterações nos solos. Especificamente, o aumento da temperatura nas camadas superficiais promove a quebra de ligações em compostos organometálicos, favorável à libertação e acréscimo de metais nos solos ardidos. Através da absorção radicular, as espécies vegetais acumulam teores elevados destes e, caso se destinem ao consumo humano, tornam-se numa fonte de exposição a contaminantes. Sendo Portugal um dos países europeus com elevada incidência de incêndios florestais, o presente trabalho teve como objetivos quantificar o teor de contaminantes químicos inorgânicos em alimentos colhidos em 2019 nas áreas afetadas pelos incêndios de 2017 na região Centro, averiguar o risco de exposição das populações locais associado ao consumo desses alimentos e avaliar a evolução dos teores de contaminantes químicos entre 2017 e 2019. Foram analisados alimentos frequentemente consumidos pelas populações locais. Foi efetuada a quantificação de crómio (Cr), cobalto (Co), arsénio (As), cádmio (Cd) e chumbo (Pb), em amostras de batata, cebola, couve e ovos, colhidas em 2019, utilizando espectrometria de massa acoplada a plasma indutivo. Analisando os resultados obtidos, verificou-se que nenhuma amostra apresentou teores superiores à legislação em vigor. A ingestão dos alimentos analisados não parece contribuir de forma significativa para a exposição humana aos contaminantes químicos analisados, não evidenciando riscos para a saúde das populações locais. Comparando com amostras controlo, as amostras de couve analisadas apresentam teores superiores de Cr e Pb para a maioria dos produtores, e em alguns casos, teores superiores de Co, As e Cd. Entre 2017 e 2019, verificou-se um aumento na média do teor de Cr e uma diminuição na média do teor de As para as amostras de batata e couve. Ainda, nas amostras de batata observou-se uma redução na média do teor de Cd, enquanto nas amostras de couve, se verificou um aumento na média do teor de Pb.
    2022-04-05Master thesis Restricted access Show more
  • Chemical characterization and bioactive potential of Thymus × citriodorus (Pers.) Schreb. preparations for anti-acne applications: Antimicrobial, anti-biofilm, anti-inflammatory and safety profiles
    Publication . Oliveira, Ana S.; Rolo, Joana; Gaspar, Carlos; Cavaleiro, Carlos; Salgueiro, Lígia; Palmeira-de-Oliveira, Rita; Ferraz, Celso; Coelho, Susana; Pastorinho, M. Ramiro; Sousa, Ana Catarina; Teixeira, João Paulo; Martinez-de-Oliveira, José; Palmeira-de-Oliveira, Ana
    Ethnopharmacological relevance: Thymus × citriodorus (Pers.) Schreb. is an interspecific hybrid between Thymus pulegioides and Thymus vulgaris, known for its pharmacological activities as diaphoretic, deodorant, antiseptic and disinfectant, the last mostly related with its antimicrobial activity. The folk use of other extracts, as hydrolates, have also been disseminated, as regulators of oily skin with anti-acne effect. Aim of the study: We aimed to evaluate the anti-acne potential of two Thymus x citriodorus (TC) preparations, the essential oil (EO) and the hydrolate, to be used as active ingredients for skin applications. Specifically, we intend to validate their anti-acne potential by describing their activity on acne related bacteria, bacterial virulence, anti-oxidant and anti-inflammatory potential, and biocompatibility on inflammatory cells. Additionally, we aimed to report their ecotoxicity under the Globally Harmonized System of Classification and Labelling of Chemicals (GHS), thus focusing not only on the consumer, but also on environmental safety assessment. Materials and methods: Minimum inhibitory concentration (MIC) against C. acnes, S. aureus and S. epidermidis was evaluated. Minimum lethal concentration (MLC) was also determined. The effect on C. acnes biofilm formation and disruption was evaluated with crystal violet staining. Anti-inflammatory activity was investigated on LPS-stimulated mouse macrophages (RAW 264.7), by studying nitric oxide (NO) production (Griess reagent) and cellular biocompatibility through MTT assay. In-vitro NO and 2,2-Diphenyl-1-picrylhydrazyl (DPPH) scavenging potential were also evaluated. The ecotoxicity was evaluated using Daphnia magna acute toxicity assays. Results: EO presented direct antimicrobial activity, with visual MICs ranging from 0.06% for S. epidermidis and C. acnes to 0.125% for S. aureus. MLCs were higher than the obtained MICs. Hydrolate revealed visual MIC only for C. acnes. TC essential oil was effective in preventing biofilm formation and disrupting preformed biofilms even at sub-inhibitory concentrations. Hydrolate showed a more modest anti-biofilm effect. Regarding anti-inflammatory activity, TC hydrolate has a higher cellular biocompatibility. Still, both plant preparations were able to inhibit at least 50% of NO production at non-cytotoxic concentrations. Both EO and hydrolate have poor anti-oxidant activities. Regarding the ecotoxicity, TC essential oil was classified under acute 3 category, while the hydrolate has proved to be nontoxic, in accordance to the GHS. Conclusions: These results support the anti-acne value of different TC preparations for different applications. TC hydrolate by presenting higher biocompatibility, anti-inflammatory potential and the ability to modulate C. acnes virulence, can be advantageous in a product for everyday application. On the other hand, EO by presenting a marked antimicrobial, anti-biofilm and anti-inflammatory activities, still with some cytotoxicity, may be better suited for application in acute flare-ups, for short treatment periods.
    2022-04-06Journal article Restricted access Show more
  • Carcinogenicity of cobalt, antimony compounds, and weapons-grade tungsten alloy
    Publication . Karagas, Margaret R.; Wang, Amy; Dorman, David C.; Hall, Amy L.; Pi, Jingbo; Sergi, Consolato M.; Symanski, Elaine; Ward, Elizabeth M.; Arrandale, Victoria H.; Azuma, Kenichi; Brambila, Eduardo; Calaf, Gloria M.; Fritz, Jason M.; Fukushima, Shoji; Gaitens, Joanna M.; Grimsrud, Tom K.; Guo, Lei; Lynge, Elsebeth; Marinho-Reis, Amélia P.; McDiarmid, Melissa A.; Middleton, Daniel R.S.; Ong, Thomas P.; Polya, David A.; Quintanilla-Vega, Betzabet; Roberts, Georgia K.; Santonen, Tiina; Sauni, Riitta; Silva, Maria João; Wild, Pascal; Zhang, Changwen W.; Zhang, Qunwei; Grosse, Yann; Benbrahim-Tallaa, Lamia; de Conti, Aline; DeBono, Nathan L.; Ghissassi, Fatiha El; Madia, Federica; Reisfeld, Bradley; Stayner, Leslie T.; Suonio, Eero; Viegas, Susana; Wedekind, Roland; Ahmadi, Shukrullah; Mattock, Heidi; Gwinn, William M.; Schubauer-Berigan, Mary K.
    In March, 2022, a Working Group of 31 scientists from 13 countries met remotely at the invitation of the International Agency for Research on Cancer (IARC) to finalise their evaluation of the carcinogenicity of nine agents: cobalt metal (without tungsten carbide or other metal alloys), soluble cobalt(II) salts, cobalt(II) oxide, cobalt(II,III) oxide, cobalt(II) sulfide, other cobalt(II) compounds, trivalent antimony, pentavalent antimony, and weapons-grade tungsten (with nickel and cobalt) alloy. For cobalt metal and the cobalt compounds, particles of all sizes were included in the evaluation.
    2022-04-07Journal article Restricted access Show more
  • Effect of Dietary Laminaria digitata with Carbohydrases on Broiler Production Performance and Meat Quality, Lipid Profile, and Mineral Composition
    Publication . Costa, Mónica M.; Pestana, José M.; Osório, Diogo; Alfaia, Cristina M.; Martins, Cátia F.; Mourato, Miguel; Gueifão, Sandra; Rego, Andreia M.; Coelho, Inês; Coelho, Diogo; Lemos, José P.C.; Fontes, Carlos M.G.A.; Lordelo, Madalena M.; Prates, José A. M.
    Simple Summary: Seaweeds represent promising alternatives to unsustainable conventional feed sources, such as cereals, incorporated in poultry diets. Brown macroalgae (e.g., Laminaria digitata) correspond to the largest cultured algal biomass worldwide and are rich in bioactive polysaccharides, minerals, and antioxidant pigments. However, their utilization as feed ingredients is limited due to the presence of an intricate gel-forming cell wall composed of indigestible carbohydrates, mainly alginate and fucose-containing sulfated polysaccharides. Therefore, supplementation with carbohydrate-active enzymes is required to disrupt the cell wall and allow seaweed nutrients to be digested and absorbed in poultry gut. The present study aimed to evaluate if the dietary inclusion of 15% L. digitata, supplemented or not with carbohydrases, could improve the nutritional value of poultry meat without impairing growth performance of broiler chickens. The results show that L. digitata increases antioxidant pigments and n-3 long-chain polyunsaturated fatty acids in meat, thus improving meat nutritional and health values. On the other hand, feeding algae at a high incorporation level impaired growth performance. Feed enzymatic supplementation had only residual effects, although alginate lyase decreased intestinal viscosity caused by dietary L. digitata with potential benefits for broiler digestibility.
    2022-04-13Journal article Open access Show more