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- Infeção por VIH em Portugal – 2025Publication . Direção-Geral da Saúde; Instituto Nacional de Saúde Doutor Ricardo JorgeRelatório anual Infeção VIH em Portugal – 2025. Este relatório conjunto DGS/INSA apresenta os dados mais recentes da vigilância epidemiológica da infeção por VIH em Portugal, bem como resultantes de iniciativas de prevenção e rastreio desenvolvidas no âmbito do Programa Nacional para as Infeções Sexualmente Transmissíveis e Infeção pelo VIH (PNISTVIH). Dos resultados e conclusões apresentados no documento, destaca-se o seguinte: (1) Vigilância epidemiológica: - Em Portugal, segundo os dados recolhidos a 30 de junho de 2025, foram notificados 997 casos de infeção por VIH com diagnóstico em 2024, dos quais 951 com diagnóstico em Portugal; - Registou-se uma redução de 35% no número de novos casos de infeção por VIH e de 43% em novos casos de SIDA entre 2015 e 2024; - A maioria (72,3%) dos novos casos de infeção VIH em adolescentes e adultos (≥ 15 anos) registou-se em homens. A taxa de novos diagnósticos mais elevada registou-se no grupo etário dos 25-29 anos (28,5 casos/105 habitantes) e em 25,2% dos novos casos a idade ao diagnóstico foi igual ou superior a 50 anos. Foram notificados 3 casos de infeção VIH em crianças com idade <15 anos; - A transmissão heterossexual mantém-se como a mais frequente (52,5%), mas os casos em homens que têm sexo com homens (HSH) corresponderam à maioria dos novos diagnósticos em homens (60,6%); - Apresentaram-se tardiamente aos cuidados de saúde 53,9% das pessoas com novo diagnóstico de VIH e 65,4% das pessoas com 50 ou mais anos; - Foram comunicados 194 casos de SIDA com diagnóstico do estádio em 2024 e 108 óbitos em pessoas que viviam com VIH. Em 46,3% dos óbitos o diagnóstico VIH tinha ocorrido há mais de 20 anos; - Em Portugal, ao longo das quatro décadas da epidemia VIH, foram diagnosticados 66 421 casos de infeção por VIH, 23 946 atingiram o estádio de SIDA e foram notificados 16 080 óbitos. Estima-se que viviam em Portugal, em 2023, 49 699 pessoas com infeção por VIH (PVVIH), 94,2% destas já diagnosticadas; - Foi possível obter dados completos do "continuum of care" de 26 hospitais nacionais, relativos a 36 184 PVVIH, constatando-se que 97,8% estavam em tratamento e, destas, 95,9% atingiram a supressão virológica; - O relatório apresenta ainda uma análise das causas de morte reportadas nos certificados dos óbitos de pessoas que viviam com VIH, constatando-se que desde 2021 predominam as causas de morte não associadas à infeção por VIH; - São também apresentadas as características dos casos com diagnóstico entre 2014 e 2023 e residência nas 12 cidades portuguesas que aderiram à iniciativa Fast-track cities. As estimativas realizadas revelaram que em cinco destas cidades mais de 95% das PVVIH que conheciam a sua infeção. (2) Prevenção, rastreio e estigma: - O PNISTVIH prosseguiu e/ou monitorizou as atividades referentes à prevenção da infeção por VIH efetuadas em 2024, com destaque para a distribuição de materiais preventivos, o Programa de Troca de Seringas, a profilaxia pré-exposição ao VIH (PrEP) e a profilaxia pós-exposição (PPE). É apresentado um balanço positivo, tendo aumentado significativamente o número de pessoas que tiveram acesso à PrEP, incluindo fora do contexto hospitalar. O número de testes de rastreio e diagnóstico para VIH realizados no país, em diferentes contextos, mostrou um ligeiro decréscimo face aos anos precedentes.
- Registo Nacional de Anomalias Congénitas: relatório 2020-2021Publication . Braz, Paula; Machado, Ausenda; Aniceto, Carlos; Dias, Carlos MatiasRelatório do Registo Nacional de Anomalias Congénitas (RENAC) referente aos anos 2020 e 2021, elaborado pelo Departamento de Epidemiologia, que apresenta um panorama atualizado da prevalência das Anomalias Congénitas (AC) em Portugal. Os dados presentes no relatório resultam de notificações reportadas até setembro de 2024. O RENAC, é um registo nosológico de base populacional que recebe notificações da ocorrência de Anomalias Congénitas (AC) em Portugal, com dados disponíveis desde 1997. Este instrumento de monitorização e vigilância das AC recebe notificações de casos diagnosticados nos recém-nascidos, fetos-mortos e nos fetos submetidos a interrupção médica da gravidez, após o diagnóstico de malformação grave. Os objetivos essenciais deste registo são: i) Epidemiologia - fornecer informação essencial sobre a epidemiologia das AC em Portugal; ii) Vigilância - manter um sistema de vigilância ativo que permita detetar novas exposições teratogénicas; iii) Investigação - manter uma base de dados acessível para a investigação; iv) Rede Europeia – colaborar com a rede europeia de registos de AC.
- Vaccine effectiveness against influenza A in older adults and the effect of chronic conditions: results from the I-MOVE and VEBIS multicentre European hospital case-control studies, 2015/16-2023/24Publication . Rose, Angela Mary Catherine; Nicolay, Nathalie; Mazagatos, Clara; Martínez-Baz, Iván; Launay, Odile; De Mot, Laurane; Bella, Antonino; Lazar, Mihaela; Machado, Ausenda; Kuliešė, Monika; Abela, Stephen; Vučina, Vesna Višekruna; van Gageldonk-Lafeber, Rianne; Bino, Silvia; Dürrwald, Ralf; Paradowska-Stankiewicz, Iwona; Horváth, Judit Krisztina; Duffy, Róisín; Husa, Petr; McMenamin, Jim; Pozo, Francisco; Howard, Jennifer; Latorre-Millán, Miriam; Castilla, Jesús; Nguyen, Liem Binh Luong; Dauby, Nicolas; Riccardo, Flavia; Ivanciuc, Alina; Gomez, Verónica; Jančorienė, Ligita; Xuereb, Gerd; Petrović, Goranka; Marbus, Sierk; Vasili, Adela; Tolksdorf, Kristin; Bogusz, Joanna; Oroszi, Beatrix; Domegan, Lisa; Součková, Lenka; Marsh, Kimberley; Bacci, Sabrina; Kissling, Esther; I-MOVE & VEBIS Hospital Network teamsBackground: The Influenza - Monitoring Vaccine Effectiveness in Europe (I-MOVE/I-MOVE+) and Vaccine Effectiveness, Burden and Impact Studies (VEBIS) hospital networks have conducted seasonal multicentre, test-negative, case-control studies in Europe to measure influenza vaccine effectiveness (IVE) since 2015/16. We measured the effect of chronic conditions on VE of influenza A subtypes among older adults (≥ 65 years) using pooled-season data (2015/16-2023/24). Methods: Hospital teams swabbed patients with severe acute respiratory infection (SARI) within 7 days of symptom onset. Cases were RT-PCR positive for influenza A(H1N1)pdm09 or A(H3N2); controls negative for any influenza virus. We calculated overall pooled-season IVE against influenza A(H1N1)pdm09 and A(H3N2), adjusted for study site, sex, age and onset date; and stratified by number of and by each chronic condition (diabetes, heart disease, lung disease/asthma, immunosuppression, kidney disease, liver disease, cancer, obesity). We investigated interaction between vaccination and each condition. Results: We included 1805 A(H1N1)pdm09 cases with 16,329 controls; 2590 A(H3N2) cases with 14,920 controls, from 13 study sites (12 countries). Over all seasons, 63-67% cases and 70% controls had ≥ 2 chronic conditions. Against A(H1N1)pdm09, pooled-season IVE was 37% (95%CI: 29-44) overall; 49% (95%CI: 9-72), 30% (95%CI: 12-44) and 38% (95%CI: 29-46) in those with 0, 1, ≥ 2 chronic conditions. Most IVE point estimates were 34-45%, apart from immunosuppression (-7%), kidney disease (17%) and liver disease (54%), but 95% CIs overlapped. Significant interaction was observed for kidney disease (p = 0.02) and immunosuppression (p = 0.01). Against A(H3N2), pooled-season IVE was 17% (95%CI: 8-25) overall; 15% (95%CI: -26-42), 11% (95%CI: -8-27) and 18% (95%CI: 7-28) in those with 0, 1, ≥ 2 chronic conditions. Here, IVE point estimates ranged 13-25%, apart from immunosuppression (5%), kidney disease (6%) and liver disease (31%), although 95% CIs overlapped. There were no significant interactions. Conclusions: Pooled-season results suggest low-moderate VE against influenza A subtypes among older SARI patients; higher against A(H1N1)pdm09 than A(H3N2), with little evidence of chronic condition modifying effect, apart from kidney disease and immunosuppression. We stress the importance of developing improved influenza vaccines for specific populations, and encourage further research into the effect of chronic conditions on IVE in older adults.
- Systematic review on toxicological effects of platinum nanoparticles: towards their use as safe biomedical toolsPublication . Touzani, Assia; Ramos-Pan, Lucía; Fraga, Sónia; Fernández-Bertólez, Natalia; Laffon, Blanca; Valdiglesias, VanessaPlatinum nanoparticles (PtNP) have received considerable attention in the nanomedicine field due to their magnetic, catalytic, and optical properties. However, the potential toxicity of PtNP has not been properly evaluated yet, and current information on the possible risks related to their use is still limited. On this basis, the main objective of this systematic review was to gather available data on PtNP biological behaviour and potential harmful effects, as well as to highlight the gaps of knowledge that need to be filled in to progress in their use in clinical practice. A total of 441 studies were obtained and reviewed from the initial search; 108 fulfilled the selection criteria and were included in the revision. Mainly in vitro but also in vivo studies were reported using a variety of biological systems and animal models, with no data from human epidemiological studies published so far. All these studies were extensively evaluated to provide useful information on the PtNP biocompatibility and their potential to be employed for medical purposes. In particular, information on the physicochemical features of the PtNP influencing their biological behaviour, methods employed for toxicity evaluation, biological systems used, and outcomes addressed were analysed and discussed. In general, the results obtained showed a good biocompatibility of these NP, although some of them detected significant toxicity highly dependent of size, concentration/dose, coating, or exposed biological system. Furthermore, anticancer or protective effects were also described for PtNP in several revised studies. These findings encourage to continue exploring the benefits of PtNP for clinical practice.
- Long-term cardiovascular events in individuals hospitalised with COVID-19: a retrospective cohortPublication . Soares, Patricia; Ruivinho, Carolina; Silva, Joana; Lobão, Maria João; Santos, Lelita; Paixão, Joana; Ramalho, Ana Rita; Henriques, Adriana; Simões, Inês; Guimarães, Luísa Eça; Moça, Rita; Costa, Andreia; Atanásio, Gabriel; Nóbrega, Sofia; Brazão, Maria da Luz; Goes, Ana Rita; Leite, Andreia; LOCUS groupBackground: Post-COVID condition encompasses a spectrum of persistent or emerging symptoms affecting multiple organ systems, including a heightened risk of cardiovascular complications. Despite growing recognition of this phenomenon, there remains a lack of comprehensive data regarding the incidence and risk factors associated with cardiovascular events during the post-acute phase in patients previously hospitalised for COVID-19. Thus, we aimed to estimate the incidence of cardiovascular events among patients hospitalised for COVID-19 in Portugal and assess the association between patient and infection characteristics and cardiovascular events in the COVID-19 post-acute phase. Methods: We conducted a registry-based retrospective cohort study from seven hospitals across Portugal. Data was retrospectively collected from the electronic medical record of each patient. We included individuals hospitalised due to COVID-19 between March 2020 and March 2021. Our outcome of interest was cardiovascular events in the post-acute phase of COVID-19, occurring at least 30 days after a positive SARS-CoV-2 test. The variables of interest considered were the severity of the episode, existing cardiovascular risk and vaccination status before the SARS-CoV-2 test. Person-years was estimated for each individual, and incidence rates were estimated. A Cox proportional hazard regression model was employed to assess risk factors. Results: We included 1,803 patients in the analysis, of which 143 (7.9%) experienced at least one cardiovascular event following COVID-19 hospitalisation. The overall incidence rate of having at least one cardiovascular event was 34.65 per 1,000 person-years (95% confidence interval (CI): 29.20; 40.82). We found higher risk of cardiovascular events for individuals with pre-existing cardiovascular risk (adjusted hazard ratio (aHR): 3.76, 95% CI: 1.53; 9.24) and lower risk for individuals with at least one vaccine dose before the SARS-CoV-2 test (partial vaccination - aHR: 0.44, 95%CI: 0.30; 0.64, complete vaccination - aHR: 0.46, 95%CI: 0.2; 0.80). We did not find a significant difference between the severity of the COVID-19 episode and the risk of having cardiovascular events post-COVID-19. Conclusion: Our findings suggest a substantial burden of cardiovascular complications post-COVID-19, underscoring the need for health services to be prepared and commence screening and preventive measures for individuals at higher risk.
- Second-hand smoke exposure modulates plasma proteins linked to detoxification, inflammation and atherothrombosisPublication . Neves, Sofia; Pacheco, Solange A.; Vaz, Fátima; Valentim-Coelho, Cristina; Saraiva, Joana; James, Peter; Simões, Tânia; Penque, DeborahChronic exposure to second-hand smoke (SHS) contributes to the development of health issues, including cancer and cardiovascular diseases. Molecular mechanisms underlying SHS-related diseases remain poorly understood, highlighting the need for reliable risk assessment biomarkers. Herein, we demonstrate that the plasma proteome of individuals exposed to SHS undergoes significant modulation. Butyrylcholinesterase (BChE) and Vitamin D-binding protein (GC) that are involved in the physiological response to circulating toxic substances, as well as key mediators of systemic inflammation, including Complement C1r subcomponent (C1R), Complement C1q subcomponent subunit C (C1QC), Histidine-rich glycoprotein (HRG), and Vitamin K-dependent protein S (PROS1), were found to be significantly modulated in SHS-exposed individuals. Moreover, strong indicators of a pro-atherothrombotic response such Apolipoprotein A-IV (APOA4) and Alpha-2-antiplasmin (SERPINF2), were also differentially expressed. These findings provide novel insights into the biological pathways linking SHS-exposure to cardiovascular risks, and suggest a panel of candidate proteins with potential utility as SHS-risk assessment biomarkers.
- Risk of stroke or myocardial infarction hospitalisation following hospitalisation for community-acquired pneumonia in Portugal: a self-controlled case series studyPublication . Carneiro, Joana; Leite, Andreia; Lahuerta, Maria; Catusse, Julie; Ali, Mohammad; Teixeira, Rita; Lopes, SílviaObjectives: We aimed to assess the risk of cardiovascular hospitalisations (stroke or myocardial infarction (MI)) following a community-acquired pneumonia (CAP) hospitalisation in a large Portuguese administrative dataset. Design: Self-controlled case series study. Setting: We used hospitalisation data from National Health Service hospitals across Portugal between 2010 and 2018. Participants: Adults hospitalised for both CAP and stroke/MI in Portugal during the 2010-2018 period (n=13 494, of which 10 400 with stroke and 3094 with MI). Primary and secondary outcome measures: We considered CAP hospitalisation as the exposure (14-, 28- and 91-day exposure periods) and acute cardiovascular (stroke or MI) hospitalisations as the outcome. Incidence rate ratios (IRR) were computed using a conditional Poisson regression (overall and by sex and age subgroups). Results: Patients were mostly male and above 75 years. Stroke/MI hospitalisation incidence was higher following CAP, compared with the baseline period. Largest differences were observed in the 14-day period after discharge (IRR for stroke: 2.55, 95% CI: 2.33-2.80; IRR for MI: 3.23, 2.78-3.75), compared with the 28-day (IRR for stroke: 2.06, 1.92-2.22; IRR for MI: 2.62, 2.32-2.95) and 91-day periods (IRR for stroke: 1.37, 1.30-1.44; IRR for MI: 1.75, 1.60-1.91). A similar trend was observed for sex and age subgroups. Conclusions: Our study shows an increased risk of stroke/MI for CAP patients, particularly during the first 2 weeks after being discharged. Effective postdischarge monitoring and follow-up, combined with efforts to prevent CAP occurrence, could improve patient outcomes.
- Optimizing MS Parameters for Data-Independent Acquisition (DIA) to Enhance Untargeted MetabolomicsPublication . Pinto, Frederico G.; Giddey, Alexander D.; Almarri, Rouda S. B.; Alkhnbashi, Omer S.; Garrett, Timothy J.; Uddin, Mohammed J.; Soares, Nelson C.Data-Independent Acquisition (DIA) has emerged as a powerful mass spectrometry (MS) strategy for comprehensive metabolomics. This study presents a novel short gradient (13 min) nanosensitive analytical method for human plasma analysis using DIA LC-MS/MS, focusing on in-depth optimization of MS parameters to maximize data quality and metabolite coverage. Key MS parameters, including scan speed, isolation window width, resolution, automatic gain control, and collision energy, were systematically tuned to balance the sensitivity and specificity while minimizing interferences. The optimized method enabled the detection of 2,907 features with 675 annotated compounds, leveraging recent progress in nano-LC-MS/MS for multiomics applications and showcasing the possibility of combining proteomics and metabolomics within a single chromatographic system. Ultimately, a comparison was performed between the data acquired through the DIA and DDA MS approaches in the context of untargeted metabolomics. This optimized analytical method yields more robust and reproducible results, thereby expanding the potential for meaningful discoveries across diverse biological fields.
- Effectiveness of long-acting monoclonal antibodies against laboratory-confirmed RSV in children aged < 24 months and hospitalised for severe acute respiratory infection, European pilot study, 2024 to 2025Publication . Savulescu, Camelia; Ganser, Iris; Nicolay, Nathalie; Lajot, Adrien; Campos, Sandra; Martínez-Baz, Iván; Rodrigues, Ana Paula; Vandromme, Mathil; Cara-Rodríguez, Marta; Echeverría, Aitziber; Gaio, Vânia; Parsy, Marie-Pierre; Garrido, Ana Roldan; Castilla, Jesús; Guiomar, Raquel; Bacci, Sabrina; Rose, Angela Mc; VEBIS hospital network RSV IE groupWe measured effectiveness of nirsevimab against laboratory-confirmed respiratory syncytial virus (RSV) infection in a test-negative case-control study among children aged < 24 months hospitalised for severe acute respiratory infection in three European countries. The overall effectiveness in the 2024/25 season among 2,201 children was 79% (95% CI: 58 to 89) and 85%, 78% and 69% at < 30, 30-89 and 90-215 days since immunisation. Immunisation was effective for preventing RSV-related hospitalisation in children, but effectiveness by time since immunisation needs monitoring in future seasons.
- A scoping review of the health effects of fermented foods in specific human populations and their potential role in precision nutrition: current knowledge and gapsPublication . Humblot, Christèle; Alvanoudi, Panagiota; Alves, Emilia; Assunção, Ricardo; Belovic, Miona; Bulmus-Tuccar, Tugce; Chassard, Christophe; Derrien, Muriel; Fevzi Karagöz, Mustafa; Karakaya, Sibel; Laranjo, Marta; Th Mantzouridou, Fani; Rosado, Catarina; Pracer, Smilja; Saar, Helen; Tap, Julien; Treven, Primož; Vergères, Guy; Pertziger, Eugenia; Savary-Auzeloux, IsabelleBackground: Diets and specific foods have a significant impact on health, and individual responses to nutritional factors vary. This variability among humans can be considered a basis for developing personalized or precision nutrition. Fermented foods (FF) contain a wide range of macro- and micronutrients, bioactive compounds, and live or dead microorganisms. FF represent a diverse range of products and have garnered significant interest due to their potential health benefits. However, consistent evidence remains limited, possibly due to heterogeneity in individual responses. Objectives: The objective of this review is to assess and compile existing evidence on the variable responses of populations to FF and to determine whether FF could be integrated into a precision nutrition strategy. Design: Interventional and observational human studies were systematically collected. The publication identified the main factors likely to contribute to variable responses to FF across all health outcomes. The question was systematically addressed to assess the available evidence and identify knowledge gaps, guiding future research. A pragmatic approach was employed, following EFSA health claim guidelines, which require an assessment of food characteristics and mechanisms of action, as well as conducting a systematic search of human interventional studies. A similar approach was used to analyze data extracted from observational studies. The population included all humans (healthy and non-healthy, of all ages), encompassing both observational and interventional studies. The intervention consisted of the ingestion of any FF, while the control was defined as the absence or lower consumption of FF or consumption of a corresponding non-FF. Outcomes included all markers of the population's health status. Results: The main factors contributing to variable responses to FF across all health outcomes were related to initial phenotypic characteristics (biological sex, geographical origin, hormonal status, and age), baseline health status [metabolic syndrome [MetS], chronic metabolic pathologies, cancer, and psychological disorders], and genetic background. Additionally, since the gut microbiota is person-specific and influences metabolic responses, particular attention was paid to its functions and role in the variability of population responses to FF. Conclusion: Collectively, this review represents a first step toward evaluating the feasibility of using FF in tailored nutritional strategies.
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