District Of Coimbra Research Articles

Are sun exposure time, dietary patterns, and vitamin D intake related to the socioeconomic status of Portuguese children?

To investigate the association among sun exposure time, vitamin D intake, dietary patterns, and socioeconomic status in Portuguese children. Participants aged 3-11 years (50.1% females) were recruited from public and private schools (n = 118) in the districts of Coimbra (n = 2980), Lisbon (n = 3066), and Porto (n = 2426). Parents reported their children's daily sun exposure time during the summer season and reported children's food consumption, including vitamin D food sources, using standardized questionnaires. Parents' education level was used as a proxy measure to the socioeconomic status (SES). The principal component factor analysis (PCA) method was used to identify dietary patterns. The eight dietary patterns identified were labeled in: "fast food", "rich in vitamin D", "sugary drinks", "vitamin D", "candies", "supplements", "rich in calcium" and "vegetables/healthy". Linear regression analyses were performed to investigate the association between sun exposure time and dietary patterns according to SES. A total of 4755 children were included. Children from high SES had significantly longer sun exposure time (p < .001) and more frequently consumed vitamin D supplements (p < .001). "Fast food" pattern showed a negative association with sun exposure time in medium and high SES (p = .014 and p < .001, respectively). Children with lower SES spend less time exposed to the sun, consume fewer dietary sources of vitamin D, and consume more foods rich in fat and sugar.

Loss to follow-up: Understand its determinants among tuberculosis patients, in Coimbra District (2005–2017)

IntroductionTuberculosis patients who abscond from treatment are more likely to contribute to ongoing transmission. This growing concern has led to the development of this study in order to assess risk factors among Tuberculosis patients lost to follow up (LTFU) notified in the Coimbra District between 2005 and 2017. Material and methodsA case-control study was designed to compare Tuberculosis patients LTFU (cases) to those successfully treated (controls). Forty-two LTFU cases were compared to 712 controls. Social and demographic data, co-morbidities, disease location, previous treatment history, drug resistance pattern and time period related to economic crisis were analyzed. In order to determine independent risk factors, numeric data was compared by one sample t-test; categorical data compared by the chi-square test or the fisher exact test, and included in a logistic regression analysis, in order to analyze their association to LTFU as a dependent variable. ResultsUnivariate analysis found that LTFU patients were more likely to be immigrants (OR:2,54; 95%CI,1,36-4,75;p < 0,01); unemployed (OR:1,99; 95%CI, 1,08-3,69;p = 0,03); civil construction workers (OR:2,53; 95%CI,1,22-5,27;p = 0,01), have a history of drug (OR:3,29; 95%CI,1,57-6,91;p < 0,01), alcohol (OR:2,16; 95%CI,1,41-3,32; p < 0,01), and tobacco abuse (OR:1,60; 95%CI,1,12-2,30; p=0,02), HIV (OR:4,15; 95%CI,2,12-8,13; p < 0,01), Hepatitis C (OR:4,51; 95%CI,1,95-10,45; p < 0,01) and Hepatitis B (OR:12,97; 95%CI,3,00–56,02; p < 0,01) virus infection. Multivariate analysis found immigrants (aOR:3,08; 95% CI, 1,20-7,93; p = 0,02) and alcohol abuse (aOR:2,81; 95% CI, 1,22-6,47; p = 0,01) to be the strongest LTFU predictor. ConclusionsLTFU likelihood was strongly associated to addictive behaviours and immigrants. It is important that the medical teams prioritize these patients for intensive follow-up care. It is recommended stronger coordination with other support services such as mental health and substance abuse programs. Multidrug-resistant tuberculosis makes necessary to highlight all of the strategies available to its prevention and management; those, should include legislative responses towards recalcitrant patients, particularly when all other less restrictive measures fail.

Mental health and post-traumatic stress disorder in firefighters: an integrated analysis from an action research study.

The presence of post-traumatic stress disorder (PTSD) symptomatology in firefighters is an ever-pressing issue that requires close attention for adequate interventions. The present study investigated PTSD and global psychopathology prevalence in a sample of highly risk-exposed Portuguese firefighters, collected after the widespread deadly wildfires in 2017 that ravaged the country. Following an action research approach, the aim of this study was to depict this sample and examine the impact of cumulative adverse experiences on their mental health, which is a phenomenon worth attention. From an initial sample of 283 firefighters who manifested interest in participating, a total of 139 firefighters from the Coimbra District, of whom 130 unequivocally experienced a potentially traumatic/adverse event as a firefighter, completed BSI (to obtain indicators on psychopathology), QEPAT (an inventory of adverse events possibly experienced as a firefighter), and PCL-5 (a measure of PTSD symptomatology) through an online survey during the year 2018 by the Regional Medical Organization, as proposed and supervised by the local Centre for Prevention and Treatment of Psychological Trauma (CPTTP). We found a global prevalence of 8.6% of possible PTSD and 14.4% of possible psychopathology (n = 139). When considering only firefighters who unequivocally reported a potentially traumatic/adverse event as a firefighter (n = 130), 9.2% present possible PTSD, and 13.8% present possible global psychopathology. This sample experienced a mean of 28 adverse events during firefighting work. Linear regressions (n = 118) demonstrated that the perceived severity of the most traumatic event reported and the experience of more adverse events were both related to an increase in PTSD symptomatology. Global psychopathology was associated with PCL-5 scores, with an emphasis on paranoid ideation, hostility, depression, anxiety, and phobic anxiety. The severe wildfires of 2017 did not impact PTSD scores in this sample (collected the year after), suggesting that cumulative adverse events are more important than particular episodes. However, the number of reported events was related to PTSD scores. These results can be used to develop interventions that target all firefighters by addressing risk and protective factors. This action research study motivated specialized aid for firefighters involved in this study.

MisuMedPT - Morbi-mortality consequences of misuse of psychoactive prescription drugs in Portugal

Abstract Background In Portugal, there are no published data on the health-related consequences of prescription drug misuse, which is therefore a public health issue of unknown dimension in our country. Poison control centres and other pharmacoepidemiological sources can be part of a surveillance system for monitoring medicine's use and misuse. Methods Retrospective observational study of intentional exposures to opioid analgesics, antiepileptics, antidepressants, anxiolytics, hypnotics and sedatives reported to the Portuguese Poison Information Centre (CIAV) between 2014 and 2018. Variables studied were demographic characteristics of individuals, geographic distribution of calls, co-exposure to alcohol or illicit drugs, call origin, case evaluation and guidance. Results CIAV received 24624 calls reporting 34203 intentional exposures to any medicine, 31169 (91.1%) of which involving one of the studied psychoactive medicines and 20906 exposures having emergency room advice or effective hospitalisation. The most frequently involved medicines were benzodiazepines (62.0%) - alprazolam (15.4%) and diazepam (12.0%) - with trazodone ranking fifth (6.0%). Combination with non-medicinal products was seen in 2169 calls (9.4%), 2052 (94.6%) of which with alcohol. Conclusions There is female predominance in the poisonings reported involving any of the medicines studied. Benzodiazepines and antidepressants are the top classes reported. The rate of intentional exposures to psychoactive medicines is higher in Coimbra district, whose significant university student population requires further analysis of data. To adjust for the variability in the level of medicines' use in the population, work is undergoing to include rates of intentional poisonings in patients prescribed the studied medicines. To better characterise the potential consequences of misuse of psychoactive prescription drugs in Portugal, additional data on deaths involving these medicines will also be included in the project. Key messages First published Portuguese data on prescription drug poisoning reported to CIAV. First Portuguese project to analyse prescription drug poisoning, forensic and hospitalisation data.

MRSA/MSSA causing infections: prevalence of mecA gene

Abstract Introduction Staphylococcus aureus is part of the human flora, present in the skin and mucous membranes but can become pathogenic, causing a wide spectrum of infections that were initially treated with penicillin. However, were observed some strains with resistance to this antibiotic and, therefore was developed a new antibiotic, the methicillin. After its introduction, arose the first S. aureus with resistance to methicillin (MRSA) due to the presence of a gene known as mecA that encodes an altered penicillin binding protein (PBP2a). In Europe, it is estimated that MRSA are associated to 44% of hospital acquired infections and its mortality rate is around 20%. Objectives Prevalence of MRSA strains in different types of infection in Coimbra district. Methodology Were analysed a total of 539 isolates of S. aureus previously characterized to the antibiotic susceptibility profile in the Hospital and University Center of Coimbra. Through the minimum inhibitory concentration (MIC) of oxacillin we classified our strains into MRSA and S. aureus methicillin-sensitive (MSSA); simultaneously, the mecA gene was detected by Polymerase Chain Reaction (PCR). Results Of the 539 isolates, 49% were considered MRSA and 51% MSSA. All MRSA isolates express the mecA gene, but from the total of 276 MSSA, 191 show this gene but do not express it. MRSA isolates were mostly from respiratory tract samples (48%) and blood cultures (21%) while MSSA were isolated in skin and soft tissue samples (35%). Conclusion MRSA are considered one of the primary pathogens for the development of pneumonia and septicaemia due to its highly virulent potential and the increasing expression of genetic determinants of antimicrobial resistance. Therefore, infections caused by MRSA continue with highly representability in the clinical context and their dissemination is a public health problem.

Wildfire effects on two freshwater producers: Combining in-situ and laboratory bioassays.

Mediterranean forests are highly susceptible to wildfires, which can cause several impacts not only within burnt areas but also on downstream aquatic ecosystems. The ashes' washout from burnt areas by surface runoff can be a diffuse source of toxic substances, such as metals, when reaching the nearby aquatic systems, and can be noxious to aquatic organisms. The present work aimed at assessing the ecotoxicological effects of post-fire contamination on two aquatic producers (the microalgae Raphidocelis subcapitata and the macrophyte Lemna minor) through in-situ bioassays, validating the obtained results with the outcomes of laboratory bioassays with surface water collected simultaneously. Four distinct sites were selected in a basin partially burnt (Ceira river basin; Coimbra district, Portugal) for bioassay deployment: one site upstream the burnt area in the Ceira river (RUS); three sites located under the influence of the burnt area, one immediately downstream of the burnt area in the Ceira river (RDS) and the other two in tributary streams within the burnt area (BS1 and BS2). The in-situ bioassays lasted for 13 days and began following the first post-fire major rain events. Results showed that the microalgae growth rate was able to distinguish the three sites within and downstream of the burnt area (BS1, BS2, RDS) from the site upstream (RUS). By contrast, the macrophytes growth rate only allowed to differentiate between the sites within the burnt area (BS1 and BS2) and those up- and downstream of the burnt area (RUS and RDS). The in-situ results for both species were corroborated with the results of the laboratory experiments, supporting the use of laboratory surrogates for a screening assessment of wildfire impacts in aquatic ecosystems. Direct causal relationships between the observed ecotoxicological effects on R. subcapitata and L. minor and the physical-chemical parameters of the water samples were difficult to establish, although the results suggest (i) a role of differential major and trace metal load in explaining species growth variation; (ii) interaction between metals and/or between metals and other field parameters are likely to modulate the biological responses to the challenges deriving from wildfire runoff.

Perfil de Sensibilidade aos Antibióticos na Infeção Urinária em Ambulatório no Distrito de Coimbra: Um Estudo Transversal

Urinary tract infections in the community setting are quite common. It is necessary to be aware of antibiotic susceptibility patterns in order to provide rational empirical therapy. The aim of this study is to determine the frequency and antimicrobial susceptibility of the strains responsible for urinary tract infections in primary health care, in the district of Coimbra, Portugal. In this observational and cross-sectional study, we analyzed 7134 positive urine cultures of outpatient laboratories in the district of Coimbra, over one year. In most cases, a positive culture was defined by a threshold of 105 colony-forming units per milliliter and was conducted by the automated system VITEK® 2, by bioMérieux. We used descriptive and inferential statistics to determine the prevalence and antimicrobial susceptibility of bacteria and to ascertain whether there were differences associated with sex and age. From the total of positive cultures, 83.4% pertained to females and 41.0% to individuals over 75 years old. Escherichia coli was the most frequent strain (63.9%), although its prevalence was lower (p < 0.001) in males and individuals over 75 years old. Its susceptibility to fosfomycin and nitrofurantoin was higher than 95% and with ciprofloxacin and trimethoprim/sulfamethoxazole it was lower than 80%. Resistances were more frequent (p < 0.001) in males and in the elderly. Escherichia coli was the most frequent strain, revealing less resistance to fosfomycin and nitrofurantoin. Antimicrobial susceptibility was lower in the elderly and in males, populations in whom empirical therapy may be less successful. In order to improve clinical results, we recommend periodic surveillance of antimicrobial susceptibility, which could enable the provision of efficient information to clinicians, namely those who prescribe empirically for such infections, as well as standardization of identification methods of bacterial strains diagnosis and of the antibiotic kits to be tested.

Life span disparities between rural and urban residents in the Portuguese district of Coimbra

Life span disparities between rural and urban residents in the Portuguese district of Coimbra

Environmental and Socio-demographic Factors Associated with 6–10-Year-Old Children’s School Travel in Urban and Non-urban Settings

Walking or bicycling to school is an important source of physical activity and may help prevent childhood obesity. However, active commuting has been declining in recent decades. The purposes of this study were to explore travel characteristics in children and examine factors associated with active commuting in children living in urban and non-urban setting. Participants were 834 parents and corresponding children aged 6-10years, living in the district of Coimbra, Portugal. Data were collected during April-June of 2013 and 2014. Anthropometric measures (height, weight, waist circumference) were taken in children. Mode shift and child/family demographics were assessed by a parental questionnaire. School and home addresses were geocoded and the shortest route (meters) was taken in consideration. Although car is the most common way of travel to school, active transportation is significantly more prevalent in children living in the non-urban setting. Different determinants were found associated with active travel according to the level of urbanization. The adjusted logistic regression revealed that, independently of the urbanization, children whose mothers actively commute to work, whose parents reported their neighbor as safe to walk, and children living less than 2000m from school were significantly more likely to walk to school. Present findings highlight the need to consider models with different levels, including individual, social, and environmental characteristics, when developing interventions and policies to promote active transport to school.

O licenciamento dos estabelecimentos insalubres, incómodos ou perigosos no século XIX e as plantas dos processos do distrito de Coimbra

Neste artigo traça-se a origem e a transformação jurídica da lei portuguesa criada para regular a instalação dos estabelecimentos industriais insalubres, incómodos ou perigosos, no século XIX. Evidencia-se, ainda, a importância deste regulamento para a história dos procedimentos administrativos de licenciamento, dada a obrigatoriedade dos impetrantes entregarem junto com o requerimento as plantas dos edifícios. Como exemplo da sua aplicação prática usam-se as plantas dos processos do distrito de Coimbra, existentes no Arquivo da Universidade de Coimbra.

Conhecimento das mães acerca do uso da chupeta, amamentação e desenvolvimento da criança

O uso de chupeta é actualmente considerado um problema de Saúde Pública ao se constituir um dos determinantes principais que conduzem as mães a interromper precocemente a amamentação e pelo impacto negativo no desenvolvimento infantil. Objetivos: Explorar o conhecimento das mães sobre o efeito do uso da chupeta no processo da amamentação e desenvolvimento da criança; Identificar os factores que levaram as mães que amamentam ou amamentaram na introdução da chupeta aos filhos; Caracterizar o peso relativo evocado pelas mães que levam ao uso da chupeta no processo de amamentação e no desenvolvimento da criança; Relacionar o conhecimento das mães que amamentam ou amamentaram e cujos filhos usaram ou não chupeta sobre a sua influência no processo de amamentação e desenvolvimento da criança. Participantes e Métodos: Estudo descritivo-correlacional, segundo a metodologia quantitativa, junto de mães de crianças que amamentaram ou que ainda se encontravam a amamentar, cujos filhos frequentavam creches públicas ou privadas, situadas em meio urbano ou rural do distrito de Coimbra, através da aplicação de um Questionário, entre Abril e Junho/2016. Tratou-se os dados por computador e utilizou-se a estatística descritiva no tratamento da informação. Resultados: Grande percentagem de mães referiu que os filhos usaram chupeta, com início no primeiro dia de vida, por opção própria ou aconselhamento de um profissional de saúde. Percentagem elevada tomou a decisão da sua introdução por opção própria, para acalmar o filho. Houve grande dispersão de respostas relativamente à idade adequada para a retirar. Pequena percentagem revelou conhecimento sobre o impacto negativo no desmame precoce, processo de amamentação e desenvolvimento infantil.Conclusões: As mães não possuem uma globalidade de conhecimentos essenciais sobre a influência da chupeta no processo de amamentação e desenvolvimento infantil. É necessário apostar na formação dos profissionais de saúde para a transmissão de informações às mães.

ALEITAMENTO MATERNO EXCLUSIVO: DA TEORIA À REALIDADE

Antecedentes: O aleitamento materno exclusivo até aos meses do bebé, e a sua manutenção com alimentos complementares até aos dois anos (OMS e UNICEF, 1995).Objectivos: Conhecer a opinião das mães de lactentes sobre o período de aleitamento materno exclusivo, identificar se as mães foram informadas sobre a importância do aleitamento materno exclusivo durante o período pré-natal, identificar o motivo para amamentar, avaliar a taxa de aleitamento materno exclusivo durante os primeiros 6 meses de vida e identificar as causas para a introdução de outro tipo de alimentos;Método: Estudo quantitativo, descritivo, numa amostra não probabilística intencional de 39 mães de lactentes, que tenham amamentado ou ainda se encontravam a amamentar, cujos filhos frequentavam creches públicas ou privadas, situadas em meio urbano e rural do distrito de Coimbra, com aplicação de um questionário, de Outubro a Dezembro de 2015.Resultados: 17.9% das crianças tinha 9 meses de idade, 51.3% das mães tinha entre 31-35 anos, 87.2% eram trabalhadoras, 59.9% referiu o período de 6 meses como o período ideal de duração do aleitamento materno exclusivo, a 87.2% foram-lhes transmitidos conhecimentos sobre a importância do aleitamento materno exclusivo durante o período pré-natal, 22.6% referiu “a saúde do bebé” para amamentar, 48.7% introduziu outros alimentos aos 5 meses tendo 53.8% invocado o trabalho fora de casa o motivo para essa introdução.Conclusões: A maioria das mães de lactentes identificou correctamente o período de aleitamento materno exclusivo sendo maioritariamente informadas sobre a importância do aleitamento materno exclusivo durante o período pré-natal. Foi identificado o motivo para amamentar e avaliada a taxa de aleitamento materno exclusivo durante os primeiros 6 meses de vida. O trabalho fora de casa foi identificado o principal motivo para a introdução precoce de outro tipo de leites ou alimentos.

Critical analysis on legal capacity of the mentally retarded: The Portuguese reality in the European context

IntroductionAlmost 50 years after the mental health reform in Europe and the deinstitutionalization of the mentally ill, there seems to be a slow change in the social concept of mental disorder. However, in the case of mental retardation, little progress has been made, since the social approach to these patients does not seem to involve the promotion of their autonomy. This is a reality with implications in medical, social and forensic psychiatry settings.ObjectiveWe will present a statistical analysis on interdiction/inhabilitation processes in two districts of Portugal followed by a comparative analysis between Portuguese and other European countries’ civil law concerning the regulation of legal capacity.AimsCritical analysis of the means by which the concept of legal incapacity has been applied in the Portuguese social setting.MethodsDescriptive and retrospective analyses of 500 expert reports in the districts of Coimbra and Viseu regarding interdiction/disqualification processes. Research on Pubmed and legal databases; keywords used: mental disability, mental retardation, civil law, mental incapacity, legal incapacity, legal capacity, interdiction, curator.ResultsThe number of forensic psychiatric examinations has suffered a significant increase in the last years. The majority of these expertise concern interdiction/inhabilitation processes. Mental retardation is the more prevalent diagnosis, and the great majority of the cases were interdicted.ConclusionsIn Portugal, the law has been applied in order to safeguard the economic assets of mentally retarded individuals, but not in order to promote their social integration and autonomy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Desigualdades sociais em saúde: o exemplo da obesidade infantil

O aumento da prevalência de obesidade tem sido explicado por mecanismos ambientais obesogénicos, possivelmente associados ao estatuto socioeconómico: indivíduos de baixo estatuto socioeconómico são mais propensos a viver em áreas desfavorecidas, onde escasseiam os recursos e as oportunidades que poderiam propiciar e apoiar uma vida saudável. Esta associação constitui a ideia central dos modelos de “amplificação da privação”, uma versão particular dos modelos de “injustiça ambiental”. Neste estudo observam-se 1885 crianças em idade escolar residentes no distrito de Coimbra. Utilizando modelos logísticos ordenados, analisam-se as associações entre o seu índice de massa corporal, a sua atividade desportiva, o ambiente construído e social dos seus locais de residência – avaliado pela perceção dos pais – com o seu estatuto socioeconómico. Os resultados mostram que crianças de menor estatuto socioeconómico são mais propensas a ser obesas e têm menor probabilidade de participar em atividades desportivas extracurriculares do que as de elevado estatuto socioeconómico. Revelam, ainda, que estas crianças têm menor probabilidade de viver numa área cujo ambiente construído seja percecionado de forma positiva pelos seus pais. Estes resultados evidenciam um gradiente socioeconómico no acesso a recursos e facilidades materiais locais, que se sobrepõe ao estatuto socioeconómico individual, originando clusters de fatores prejudicais à saúde, concluindo-se pela existência (e relevância) de um modelo ambiental de amplificação da privação que penaliza as crianças mais vulneráveis.

Leadership and nurses’ satisfaction with supervision

Objective: The main objectives of this study were to evaluate the performance of leadership roles and the nurses’ satisfaction with supervision and to examine the relationship between the performance of leadership roles and nurse satisfaction.Methods: A quantitative, descriptive, correlational and transversal study was conducted, with a sample made up of 79 nurses practicing in two public health institutions in the district of Coimbra in Portugal. Data collected included demographic characteristics, eight leadership roles and five levels of supervision satisfaction. The Munson’s Supervision Satisfaction Scale and the Quinn’s Leadership Scale were used. The instruments adaptation and validation study revealed adequate psychometric properties being considered as valid instruments for the quantitative study pursuance.Results: The results indicate an acknowledgement of all roles of leadership, having a tendency towards the roles of producer (4.73) and director (4.64) indicating leadership centered on the rational goals model, revealing a greater concern with efficiency and productivity. The role of innovator was the one least perceived (4.16). Most nurses (83.50%) were satisfied with the supervision. The relationships between all the leadership roles and nurse satisfaction were positive, with the roles of facilitator (r = .842; p &lt; .001) and mentor (r = .871; p &lt; .001) with the strongest correlation.Conclusions: The investigation revealed that the leader who plays all roles of leadership raises the level of supervision satisfaction of the nurses he/she leads. A poor performance of the facilitator role suggests the need for head nurses to acquire leadership skills which help them manage interpersonal conflicts and promote cohesion and teamwork within the current context of health care restructuring and decreased nurse staffing levels.

Hypertensive patients in a general practice setting: Comparative analysis between controlled and uncontrolled hypertension

ObjectivesTo study the differences between controlled and not controlled hypertensive patients. MethodsThis was a cross-sectional observational study of the hypertensive population on the lists of three general practitioners in the district of Coimbra in central Portugal in 2013, with a margin of error of 6% and 95% confidence interval in each sample, organized in ascending order of health care user numbers. Data were gathered electronically by the investigators after approval by the Regional Health Authority's ethics committee. ResultsA sample of 201 individuals was studied, of whom 104 (51.7%) were male and 86 (42.8%) were aged under 65 (p=0.127 for gender and age-group). Hypertension was controlled in 130 (64.7%). We found significant differences in target organ damage, more frequent in those with controlled hypertension (33.1% vs. 19.7%, p=0.031), in hypertension control, better in those taking at least one anti-hypertensive drug at night (56.9% vs. 29.6%, p=0.001), and in prescription of non-steroidal anti-inflammatory drugs, more frequent in those with uncontrolled hypertension (11.3% vs. 3.8%, p=0.043). ConclusionHypertension control is significantly associated with target organ damage, taking at least one anti-hypertensive drug at night and not taking non-steroidal anti-inflammatory drugs simultaneously.

Pacientes com hipertensão arterial em ambiente de medicina geral e familiar: análise comparativa entre controlados e não controlados

ObjectiveTo study the differences between controlled and uncontrolled hypertensive patients. MethodsThis was a cross‐sectional observational study of the hypertensive population on the lists of three general practitioners in the district of Coimbra in central Portugal in 2013, with a margin of error of 6% and 95% confidence interval in each sample, organized in ascending order of health care user numbers. Data were gathered electronically by the investigators after approval by the Regional Health Authority's ethics committee. ResultsA sample of 201 individuals was studied, of whom 104 (51.7%) were male and 86 (42.8%) were aged under 65 (p=0.127 for gender and age‐group). Hypertension was controlled in 130 (64.7%). We found significant differences in target organ damage, more frequent in those with controlled hypertension (33.1% vs. 19.7%, p=0.031), in hypertension control, better in those taking at least one anti‐hypertensive drug at night (56.9% vs. 29.6%, p<0.001), and in prescription of non‐steroidal anti‐inflammatory drugs, more frequent in those with uncontrolled hypertension (11.3% vs. 3.8%, p=0.043). ConclusionHypertension control is significantly associated with target organ damage, taking at least one anti‐hypertensive drug at night and not taking non‐steroidal anti‐inflammatory drugs simultaneously.

Prevalence of asthma and rhinitis symptoms among children living in Coimbra, Portugal

Asthma is the most common chronic disease in pediatrics. Most data on the prevalence of childhood allergic diseases come from the International Study of Asthma and Allergies in Childhood (ISAAC) phase II held in 1995 and phase III from 2002. ISAAC created a methodology for studying two age groups 6--7 and 13--14 years old. In 2002, according to the data gathered in the phase III of ISAAC, the prevalence of asthma among Portuguese children from 6 to 7 years old was 9.4%, 29.1% for rhinitis and 28.1% for wheezing. In the last decade, little information on the prevalence of childhood asthma and rhinitis in Portugal has been documented, and to the best of our knowledge, none in Coimbra. In 2002, 5 centers from 5 Portuguese cities joined the ISAAC project: Lisbon, Oporto, Coimbra, Portimao and Funchal. The Coimbra research center only studied 13--14 years old adolescents. The district of Coimbra, with a total area of 3974 km, is located in central Portugal and has 434,311 inhabitants. Coimbra is the biggest city in the central region, and the 6th largest in Portugal. The most recent published data on childhood asthma prevalence in Portugal come from the Lisbon 2008 study where the prevalence of asthma, allergic rhinitis and wheezing was 5.6%, 43.0% and 43.3%, respectively, and from

Y -chromosome diversity in central Portugal reveals signatures of ancient maritime expansions

The genetic diversity of human populations in Portugal results from several different demographic events that occurred in distinct prehistorical and historical periods. The main objective of this study was to examine if patterns of Y-chromosome diversity explained by ancient maritime Mediterranean expansions can be observed in Coimbra district (central-west region of Portugal). A total of 125 male DNA samples were typed for 16 Y-SNPs and eight Y-STRs using standard molecular methodologies. Thirteen different haplogroups were identified, being the typical Western European haplogroup R1b1b2-M269 the most common (57.6%), followed by J-M304 (16%) and E1b1b1-M35 (12%). Haplogroup J-M304, whose origin maps to the Middle East, showed significant differences when comparisons were made between Coimbra district and the innermost region of Beira Interior (p = 0.022), in the same geographic area of the country, but not with the Portuguese regions of Alentejo (p = 0.165) and Algarve (p = 0.254), with known evidences of Mediterranean influence. Y-STR analysis revealed in Coimbra district several haplotypes previously associated with ancient maritime Mediterranean expansions. These findings suggest that maritime routes in the first millennium B.C. may have been important for introduction of new male lineages in Central Portugal.

Motivos de consulta em Medicina Geral e Familiar no distrito de Coimbra no ano de 2010

Objectives: To characterize the reasons for consultation in primary care as coded by family physicians. Study design: Descriptive, cross-sectional. Setting: District of Coimbra, Portugal. Participants: Patients visiting health centres in the Coimbra district in 2010. Methods: This study examined 453,388 reasons for consultation recorded in primary care in the district of Coimbra during the year 2010. They were coded using the International Classification for Primary Care, second edition (ICPC-2). Descriptive statistics were obtained using PAWS v19 statistical software. Results: The most frequent reasons for consultation recorded were “general and unspecified” (39.8%), “musculoskeletal system” (9, 9%) and “circulatory system” (8.7%). The most commonly recorded components were “signs and symptoms” (30.8%), “diagnostic and preventive procedures” (20.0%) and “test results” (19.3%). The most frequent signs and symptoms symptoms recorded were “cough” (5.6%), “signs and symptoms in the lumbar region” (4.2%), “signs/symptoms of the throat” (3.5%) and “fever” (3.5%). Conclusions: General and unspecified conditions were found to be the most common reason for consultation in this population