Prevalence In Portugal Research Articles

Assessing boar taint in Portuguese pork: A small-scale study of prevalence and classification via established detection thresholds

Aim of study: To assess the boar taint prevalence in the Portuguese pork industry through an observational study model by measuring skatole and androstenone levels in fat and to compare it with the estimated thresholds for these compounds among Portuguese consumers. Area of study: Portugal. Material and methods: Adipose tissue samples from 140 animals (102 entire males and 38 females) were collected in three Portuguese abattoirs for boar taint quantification. Cut-off limits were determined using best-estimate thresholds (BET) for skatole and androstenone. Main results: Boar taint quantification for the 140 animals revealed levels of 36.0±4.7 ng/g of skatole and 64.5±21.3 ng/g of androstenone, and values were significantly higher in males. Group BET values were 35.4 ng/g and 566.3 ng/g for skatole and androstenone, respectively. BET values were exceeded in 28.8% of the samples for skatole and 0.7% for androstenone. Research highlights: The investigation revealed a generally low level of boar taint in the samples of this small-scale study on skatole and androstenone prevalence in Portugal's pork supply chain. However, occasionally a significantly elevated boar taint levels suggest that relying solely on slaughtering sexually immature males might not fully resolve this issue.

The socioeconomic epidemiology of inherited retinal diseases in Portugal

BackgroundInherited retinal diseases (IRDs) are a group of rare degenerative disorders of the retina that can lead to blindness from birth to late middle age. Knowing the target population and its resources is essential to better plan support measures. The aim of this study was to evaluate the socioeconomic characteristics of regions in Portugal where IRD patients reside to inform the planning of vision aid and rehabilitation intervention measures.ResultsThis study included 1082 patients from 973 families, aged 3 to 92 years, with a mean age of 44.8 ± 18.1 years. Patients living with an IRD were identified in 190 of the 308 municipalities. According to this study, the estimated IRD prevalence in Portugal was 10.4 per 100,000 inhabitants, and by municipalities, it ranged from 0 to 131.2 per 100,000 inhabitants. Overall, regions with a higher prevalence of IRD have a lower population density (r=-0.371, p < 0.001), a higher illiteracy rate (r = 0.404, p < 0.001) and an overall older population (r = 0.475, p < 0.001). Additionally, there is a lower proportion of doctor per capita (r = 0.350, p < 0.001), higher social security pensions beneficiaries (r = 0.439, p < 0.001), worse water quality for human consumption (r=-0.194, p = 0.008), fewer audiences at the cinema (r=-0.315, p < 0.001) and lower proportion of foreign guests in tourist accommodations (r=-0.287, p < 0.001).ConclusionThe number of identified patients with IRD varied between regions. Using data from national statistics (PORDATA), we observed differences in socioeconomic characteristics between regions. Multiple targeted aid strategies can be developed to ensure that all IRD patients are granted full clinical and socioeconomic support.

Forecasted Dementia Prevalence in Portugal (2020-2080).

Dementia is a global public health challenge, and its impact on Portugal is yet unclear. This study forecasts dementia prevalence in Portugal until 2080. Using the Gonçalves-Pereira et al (2021) method, we estimated dementia cases among older adults (≥65 years) in the community. Applying age-sex specific prevalence rates of the Gonçalves-Pereira study to population projections for Portugal between 2020-2080, based on the 10/66 Dementia Research Group criteria (10/66 DRG) and the Diagnostic and Statistical Manual of Mental Disorders IV criteria (DSM-IV), to Portugal's population projections (2020-2080) under various growth scenarios (low, medium, and high). We anticipate a more than 2-fold increase in dementia prevalence from 2020 to 2080, both for 10/66 DRG [2.1%-5.0%] and DSM-IV [.8%-2.0%]. By 2080, those aged ≥80 years are projected to constitute 75.0% (vs 59.0% in 2020) of all dementia cases, particularly affecting women. Addressing dementia growth in Portugal calls for a comprehensive global response, while country-level estimates facilitate informed public health planning, policy-making, and resource allocation.

Diversity of Human T-Lymphotropic Virus Type 1 Cosmopolitan Subtype (HTLV-1a) Circulating in Infected Residents in Portugal.

Human T-cell lymphotropic virus type 1 (HTLV-1) prevalence in Portugal is low and mainly affects immigrants from endemic areas where human immunodeficiency virus (HIV) infection represents a public health problem. Despite the majority of HTLV-1-infected individuals remains asymptomatic, severe pathologies may develop after prolonged viral persistence, namely an aggressive form of leukemia. An increased mortality rate and faster progression to death is often related to HTLV-1/HIV coinfection. Nevertheless, studies showed that some antiretrovirals used in HIV treatment lead to a positive immune response against HTLV-1. This study aimed to analyze epidemiological and clinical data, and to assess the diversity of HTLV-1 strains circulating in infected residents diagnosed in the Portuguese national reference laboratory between 2010 and 2021. Long terminal repeat and env proviral sequences derived from 20 individuals were used to generate phylogenetic trees along with multiples reference sequences from different geographic origins retrieved from the database. Three samples belong to Portuguese natives and 17 belong to immigrants: 15 from several countries of Africa, 1 from South America, and 1 from Europe; 6 patients (30%, mean age 40.3 years) showed HTLV-1-related diseases, and 6 (30%, mean age 45.2 years) were coinfected with HIV/AIDS. The results show that the Cosmopolitan subtype is circulating in Portugal, with 10 sequences being classified as subgroup A, that include Portuguese and natives from S. Tomé and Príncipe with a mean age of 39.4 years, and 10 sequences that segregated into the Senegal cluster derived from natives born in Guinea-Bissau with a mean age of 43.5 years. A high proportion of HTLV-1-related diseases and HIV/AIDS coinfection was observed. Risk behavior practices and the absence of specific control measures, including diagnostic and treatment, may contribute to a silent dissemination of a broad diversity of HTLV-1 strains and, therefore, the increased rate of progression to debilitating diseases. In this manner, an early diagnostic and a molecular surveillance of HTLV-1 transmission remains necessary in Portugal.

Time trend prevalence of helicobacter pylori infection and endoscopic findings in symptomatic children in Portugal: A retrospective study based on three time points in 2009, 2014, and 2019.

Helicobacter pylori infection acquisition occurs mainly in childhood and may be a critical factor in developing long-term complications. In contrast to other developed countries, previous studies have reported a relatively high H.pylori infection prevalence in Portugal, both in children and adults. However, there are no recent data concerning pediatric population. We performed a retrospective observational study concerning an 11 years period (2009, 2014, 2019), that included patients under 18 years old who underwent upper endoscopy at a pediatric tertiary center. Demographic, clinical-pathological, and microbiological data were collected. Four hundred and sixty one children were included. The average age was 11.7± 4.4 years. In total, H.pylori infection was confirmed in 37.3% of cases (histology and/or culture) and a decreasing infection trend was observed (p= .027). The most common indication for endoscopy was abdominal pain, which was a good predictor of infection. Antral nodularity was present in 72.2% of the infected children (p< .001). In the oldest age groups, moderate/severe chronic inflammation, H.pylori density and lymphoid aggregates/follicles were positive predictors for the presence of antral nodularity. For all ages, the presence of antral nodularity, neutrophilic activity in the antrum and corpus and lymphoid follicles/aggregates in the antrum were positive predictors for the presence of H.pylori infection. Among the 139 strains tested for antibiotic susceptibility, 48.9% were susceptible to all tested antibiotics. Resistance to clarithromycin, metronidazole, and both was detected in 23.0%, 12.9%, and 6.5% of the strains, respectively; furthermore, resistance to ciprofloxacin and to amoxicillin was observed in 5.0% and 1.4% of the strains, respectively. The present study reports (for the first time in Portugal) a significant decreasing trend in the prevalence of pediatric H.pylori infection, although it remains relatively high compared to the recently reported prevalence in other South European countries. We confirmed a previously recognized positive association of some endoscopic and histological features with H.pylori infection, as well as a high prevalence rate of resistance to clarithromycin and to metronidazole. The clinical relevance of these findings requires confirmation with further studies at a national level, taking into account the high incidence rate of gastric cancer in Portugal and the potential need for country-specific intervention strategies.

Geographical Distribution of Periodontitis Risk and Prevalence in Portugal Using Multivariable Data Mining and Modeling.

We aimed to estimate the geographical distribution of periodontitis prevalence and risk based on sociodemographic and economic data. This study used sociodemographic, economic, and health services data obtained from a regional survey and governmental open data sources. Information was gathered for all 308 Portuguese municipalities and compiled in a large set of 52 variables. We employed principal component analysis (PCA), factor analysis (FA) and clustering techniques to model the Portuguese nationwide geographical distribution of the disease. Estimation of periodontitis risk for each municipality was achieved by calculation of a normalized score, obtained as an adjusted linear combination of six independent factors that were extracted through PCA/FA. The municipalities were also classified according to a quartile-based risk grade in each cluster. Additionally, linear regression was used to estimate the periodontitis prevalence within the peri-urban municipality clusters, accounting for 30.5% of the Portuguese population. A total of nine municipality clusters were obtained with the following characteristics: mainly rural/low populated, including small villages (one), partly rural, including small cities (two), mainly urban/peri-urban, including medium-sized to large cities (4), and urban/large cities (2). Within the clusters, a higher periodontitis risk was identified for municipalities with lower income, older populations. The estimated periodontitis prevalence for the 18 municipalities included in the four peri-urban clusters ranged from 41.2% to 69.0%. Periodontitis prevalence estimates range from 41.2% to 69.0% for the municipalities characterized as peri-urban and mainly urban, most of them located in the Lisbon Metropolitan Area, the tenth largest in Europe.

Prevalence of refractive error in Portugal – A systematic review and meta-analysis

PurposeThe aim of this study was to systematically review and meta-analyse epidemiological data of refractive error prevalence in Portugal. MethodsA structured search strategy and systematic literature review was applied to multiple databases, such as MEDLINE/PubMed, Web of Science, Scopus, Google Scholar, official organizations and academic repositorium's, to identify all relevant epidemiological studies in Portugal until February 2021. The outcome measure was the prevalence of refractive error among the Portuguese population. The events and sample size were entered as raw data and the effect size parameters were computed by Comprehensive Meta-Analysis Software. ResultsA total of 9 studies were pooled for the meta-analysis. The fixed effects model points to an estimated effect size of 43% (95% CI: 41.9–44.1%). However, the statistics of heterogeneity (Q-value p < 0.001; I-squared =99.344) showed very high heterogeneity among studies and recommends using a random-effects model. The random effects model points to an estimated effect size of 31.9% (95% CI: 19.8–47.0%) prevalence of refractive error in the Portuguese population. ConclusionsA prevalence of refractive error in Portugal of 31.9% (95% CI: 20.0–47.0%) can be considered as a conservative approach to the real burden of this condition. However, it translates into at least 2 to 4.5 million Portuguese individuals with a refractive error. The high heterogeneity between studies, the wide estimate and the random effects involved demonstrate the need for more studies and consistent sources to obtain narrower estimates.

The Prevalence, Directionality, and Dyadic Perpetration Types of Intimate Partner Violence in a Community Sample in Portugal: a Gender-Inclusive Inquiry.

Intimate partner violence (IPV) is a major concern across the world, and its prevalence assessment has been a priority in numerous countries. However, data about IPV prevalence in Portugal is scarce and not up-to-date. This study aims to estimate IPV prevalence in Portugal. A community sample of 1392 adults (77.4% female, mean age = 34.95 years, SD = 12.80) was collected through a web-based survey, between March and June of 2020. Participants completed a sociodemographic questionnaire and the Conflict Tactic Scales-2 (CTS-2). Accounting for all forms of IPV, a past-year prevalence of 64.4% and 64.6% were found, for victimization and perpetration, respectively. Regarding gender or sexual orientation, no significant differences were found in the past-year or the lifetime prevalence, neither concerning frequency. Directionality and dyadic concordance types were analyzed and showed that most violence was bidirectional. Having perpetrated violence in previous intimate relationships was the most influential factor when predicting past-year perpetration or victimization. Other significant predictors were age, being victimized before 15 years old, cohabitation with the intimate partner, and drug use, but the last two were only significant for victimization. Findings support the idea that IPV is a relevant phenomenon, regardless of gender and sexual orientation. It is the first nationwide, gender-inclusive study to do so in Portugal. Studies based on different samples might provide important evidence to prevent hasty conclusions about IPV prevalence and patterns and to guide empirically driven policies.

Prevalence and incidence of iron deficiency in European community-dwelling older adults: an observational analysis of the DO-HEALTH trial

Background and aimIron deficiency is associated with increased morbidity and mortality in older adults. However, data on its prevalence and incidence among older adults is limited. The aim of this study was to investigate the prevalence and incidence of iron deficiency in European community-dwelling older adults aged ≥ 70 years.MethodsSecondary analysis of the DO-HEALTH trial, a 3-year clinical trial including 2157 community-dwelling adults aged ≥ 70 years from Austria, France, Germany, Portugal and Switzerland. Iron deficiency was defined as soluble transferrin receptor (sTfR) > 28.1 nmol/L. Prevalence and incidence rate (IR) of iron deficiency per 100 person-years were examined overall and stratified by sex, age group, and country. Sensitivity analysis for three commonly used definitions of iron deficiency (ferritin < 45 μg/L, ferritin < 30 μg/L, and sTfR–ferritin index > 1.5) were also performed.ResultsOut of 2157 participants, 2141 had sTfR measured at baseline (mean age 74.9 years; 61.5% women). The prevalence of iron deficiency at baseline was 26.8%, and did not differ by sex, but by age (35.6% in age group ≥ 80, 29.3% in age group 75–79, 23.2% in age group 70–74); P < 0.0001) and country (P = 0.02), with the highest prevalence in Portugal (34.5%) and the lowest in France (24.4%). As for the other definitions of iron deficiency, the prevalence ranged from 4.2% for ferritin < 30 µg/L to 35.3% for sTfR–ferritin index > 1.5. Occurrences of iron deficiency were observed with IR per 100 person-years of 9.2 (95% CI 8.3–10.1) and did not significantly differ by sex or age group. The highest IR per 100 person-years was observed in Austria (20.8, 95% CI 16.1–26.9), the lowest in Germany (6.1, 95% CI 4.7–8.0). Regarding the other definitions of iron deficiency, the IR per 100 person-years was 4.5 (95% CI 4.0–4.9) for ferritin < 45 µg/L, 2.4 (95% CI 2.2–2.7) for ferritin < 30 µg/L, and 12.2 (95% CI 11.0–13.5) for sTfR–ferritin index > 1.5.ConclusionsIron deficiency is frequent among relatively healthy European older adults, with people aged ≥ 80 years and residence in Austria and Portugal associated with the highest risk.

PBI46 Cost-Effectiveness of Treatment Sequences Initiating with Risankizumab for the Treatment of Moderate to Severe Psoriasis in Portugal

Risankizumab is a new IL-23 inhibitor approved by EMA (April 2019), currently reimbursed in Portugal to treat adult patients with moderate-to-severe psoriasis. Psoriasis is a chronic inflammatory, immune mediated disease characterized by erythematous plaques covered with silvery-white scales, with a 2% prevalence in Portugal. Managing psoriasis is still challenging due to its chronicity and ability to relapse, being needed to assess the most cost-effective treatment sequences. The aim of this study was to evaluate the cost-effectiveness of therapeutic sequences initiating with risankizumab against other biologic treatment sequences used in clinical practice (biosimilars included), among the approved population in Portugal. An excel-based Markov model was adapted to simulate a cohort of patients over a lifetime horizon. The Portuguese NHS perspective was adopted, with a 4% annual discount rate for costs and effects. All the mathematically possible therapeutic sequences were analysed, being clinically plausible sequences subsequently identified through an expert panel for risankizumab and comparators. The model considered three lines of treatment, each one with induction and maintenance phases. Within each treatment-related state, patients were distributed by level of PASI response. Patients with PASI90 at the induction phase went through to the maintenance phase and continued receiving the same treatment. Remaining patients switched to the next treatment line. Discontinuation and effectiveness rates were assumed to vary by treatment and therapeutic line. Results suggest that risankizumab sequence is dominant versus all the sequences identified by the expert panel, allowing QALY gains between 0.01-0.45 and savings between 4,518€ and 21,965€ per patient. The probabilistic sensitivity analysis and the scenario analysis confirmed the dominance of risankizumab sequence across all the others. Risankizumab is expected to provide clinically meaningful benefit and quality of life increase, while allowing for expressive economic savings in the treatment of adults with moderate-to-severe psoriasis.

RENA Study: Cross-Sectional Study to Evaluate CKD Prevalence in Portugal

Introduction: Chronic kidney disease (CKD) is a major global public health problem associated with increased risk of cardiovascular morbidity, premature mortality, and decreased quality of life. In Portugal, the PREVADIAB study showed a prevalence of CKD stages 3–5 of 6.1%. To overcome the limitations of the PREVADIAB study, the RENA study aimed to provide an estimate of the prevalence of CKD at a national level and to characterize CKD patients. Methods: This was a cross-sectional study including users of Primary Health Care Units aged 18 or more. After obtaining written informed consent, sociodemographic and clinical data were recorded through a structured questionnaire, anthropometric measurements were taken, and blood and urine samples were collected. All participants initially meeting the criteria for CKD were contacted at least 3 months after the initial assessment for confirmation of the analytical results. Results: A total of 3,135 individuals were included, 65.4% were female, and the mean age was 56.7 ± 15.9 years. The prevalence of hypertension, dyslipidemia, and diabetes was 38, 32, and 16%, respectively, and 31% were obese. After data adjustment by gender, age group, and geographical region, the global prevalence of CKD was 20.9% (95% CI: 6.5–35.3%), with no differences between genders and a significant increase with the advance of the age groups. Conclusion: Our study showed a CKD prevalence above the worldwide and Europe average. Despite the study limitations, it has become clear that it is urgent to identify CKD patients earlier and to develop awareness and educational programs to prevent CKD and its associated diseases.

Estimating Amyotrophic Lateral Sclerosis and Motor Neuron Disease Prevalence in Portugal Using a Pharmaco-Epidemiological Approach and a Bayesian Multiparameter Evidence Synthesis Model

Background: Amyotrophic lateral sclerosis (ALS) is a rare and progressive neurodegenerative disease involving the upper and lower motor neurons. It is also the most common and the one with the worst prognosis among the motor neuron diseases (MND). ALS invariably progresses to respiratory failure, which is an essential factor affecting the prognosis of this disease. Its prevalence in the world is heterogeneous and, in many countries, is even unknown, since national registries are not mandatory or comprehensive enough. Worldwide, the ALS/MND prevalence is estimated between 4 and 8 cases per 100,000 inhabitants, but in Portugal the prevalence was never studied. Because ALS and MND are rare diseases, population-based studies are very difficult to perform. In Portugal, there are no systematic patient registries. Objective: We aimed to obtain the best available indirect estimates of ALS/MND prevalence, using a pharmaco-epidemiological approach. Method: We developed a Bayesian multiparameter evidence synthesis model based on nationwide data of riluzole consumption, a drug highly specific for ALS/MND, combined with data from a nationwide hospital administrative database, data from the national institute of statistics, and data from other scientific articles focused on ALS/MND epidemiology, to estimate ALS/MND prevalence in Portugal. Results: We found an estimated ALS/MND prevalence in Portugal steadily increasing from 6.74 per 100,000 inhabitants (Bayesian 95% Credible Interval [95% CI] 5.39–9.37) in 2009 to 10.32 (95% CI 8.27–14.27) in 2016. In 2016, the estimated ALS/MND prevalence was higher in men, 12.08 per 100,000 (9.66–17.15), than in women, 8.56 (6.84–12.32). Regarding age groups, the estimated prevalence per 100,000 inhabitants were, in 2016 for women, 1.19 (0.78–1.85) for the <50 years’ group, 8.48 (6.00–12.76) for the 51–60 group, 23.47 (18.05–33.88) for the 61–70 group, 28.77 (22.02–41.31) for the 71–80 group, and 14.45 (9.97–21.63) for the >80 group. For men, the prevalence estimates were 1.90 (1.32–2.84), 12.89 (9.44–19.16), 32.18 (24.91–45.74), 48.85 (38.72–71.40), and 31.27 (21.73–46.41), respectively, for each age group. We also observed a relevant variability across the country, with prevalence estimates, in 2016, of 9.31 cases per 100,000 inhabitants (7.45–12.86) in the Northern region of Portugal, 11.15 (8.9–15.34) in the Centre region, 10.74 (8.6–14.82) in Lisbon and Alentejo regions, and 5.55 (4.35–7.83) in the Algarve region. Conclusion: Overall, and even though we must account for the limitations of the indirect methods and models used for prevalence estimation, we probably have a very high ALS/MND prevalence in Portugal. It would be important to create registries, particularly in rare diseases, for better organization and distribution of healthcare services and resources, particularly at the level of ventilatory support.

Tradução e adaptação do Pediatric Cardiac Quality of Life Inventory para a população portuguesa

Background: Congenital heart diseases have a high prevalence in Portugal in the pediatric age. Understanding the quality of life of children with congenital heart diseases will allow to know its impact and the adaptive process involved. We lack, however, measurement instruments adapted to the Portuguese population. Objective: Translate and adapt the Pediatric Cardiac Quality of Life Inventory (PCQLI) for the Portuguese population. Methodology: The original questionnaire was translated according to international recommendations. The final version of the instrument was applied in a non-probability sample comprised 59 children, 80 adolescents and their parents, totaling 278 respondents. The facial validity analysis was performed with the pre-test and internal consistency analysis using Cronbach’s Alpha. Results: In the pre-test it was verified that the items are comprehensible, useful with a simple and colloquial language. The internal consistency for the total score varied for the different versions between 0.834 and 0.932. Conclusion: The Portuguese version of PCQLI allowed us to evaluate the quality of life of children with congenital heart disease in a satisfactory way. However, a larger sample is needed to develop the validation process

Prevalence of recurrent wheezing during the first year of life in Setúbal district, Portugal

BackgroundRecurrent wheezing during the first year of life is a major cause of respiratory morbidity worldwide, yet there are no studies on its prevalence in Portugal. ObjectiveDetermine the prevalence and severity of recurrent wheezing, treatments employed and other related aspects, in infants during their first year of life in Setúbal, Portugal. MethodsThis is a cross-sectional study of a random sample of infants aged 12–15 months living in Setúbal district. It uses a validated questionnaire answered by parents/caregivers at local healthcare facilities where infants attend for growth/development monitoring and/or vaccine administration. ResultsAmong the 202 infants surveyed, 44.6% (95% CI 37.7–51.4) had at least one episode of wheezing; and 18.3% (95% CI 12.9–23.6) had recurrent wheezing. There was significant morbidity associated to recurrent wheezing in terms of severe episodes (17.3%–95% CI 12–22.5), visits to the emergency department (26.2%–95% CI 20.1–32.2) and hospital admissions (5.4%–95% CI 2.2–8.5); 10.4% (95% CI 6.1–14.6) used inhaled corticosteroids and 7.9% (95% CI 4.1–11.6) used a leukotriene receptor antagonist. ConclusionsThe prevalence of recurrent wheezing in infants during the first year of life is high and is associated with significant morbidity, presenting as a relevant public health problem. An important proportion of infants’ progress with a more severe condition, resulting in high use of health resources (visits to emergency department and hospitalisations). The prevalence of recurrent wheezing in this district of Portugal stays between those related in other European and Latin American Centres, suggesting that maybe some of the well-known risk factors are shared with affluent countries.

Tuberculose na grávida: um relato de caso

Introduction: Tuberculosis is an infectious disease with a declining prevalence in Portugal, with more cases reported in urban centres. Most cases are diagnosed by passive screening but there are reports of increasing delay between the onset of the symptoms and diagnosis. Although this disease is rare in pregnant women, early diagnosis is important, because of the risk of vertical transmission to the fetus. Case Description: We present the case of a 32 year-old woman who began follow-up of her pregnancy with her family doctor at eight weeks gestation. Her partner was diagnosed with pulmonary tuberculosis during the 26th week of gestation. She was referred for contact screening which was negative. Two weeks later she presented with fever and thoracic pain with a tubercular pleural effusion. She started tuberculostatic therapy. Delivery was at 39 weeks without complications. The infant received immediate chemoprophylaxis that was stopped after confirming the absence of disease. The mother was followed by a pneumologist with good clinical and laboratory resolution, and was discharged from care without active disease. Comments: This case report demonstrates the importance of early diagnosis of tuberculosis in pregnancy. The first contact with the patient may occur in primary care.

Hepatitis B and C prevalence in Portugal: disparity between the general population and high-risk groups.

The prevalence of anti-HCV and HBsAg in Portugal has been shown to be elevated in high-risk groups, such as intravenous drug-users and incarcerated individuals. However, in the general population, prevalence remains largely unknown. The aims of this study were to estimate the prevalence of anti-HCV and HBsAg in the general Portuguese population and identify associated risk factors. We carried out a nationwide, population-based cross-sectional study of adults resident in mainland Portugal. Serology for HBsAg, anti-HBc, anti-HBs, and anti-HCV was performed. Anti-HCV-positive individuals were tested for HCV RNA by PCR. Of 1685 participants, 50.6% were men, mean age 50.2±18.3 years. In terms of hepatitis C, the prevalence of anti-HCV was 0.54% [95% confidence interval (CI): 0.2-0.9] and 0.12% (95% CI: 0.0-0.3) were viremic, with peak prevalence among individuals 35-64 years of age (0.8%), men (0.8%), and individuals from Lisbon and Tagus Valley region (1.9%).In terms of hepatitis B, the estimated prevalence of HBsAg was 1.45% (95% CI: 0.9-2.0). A higher prevalence was found in individuals who were 35-64 years old (2.2%), in men (2.5%), and in the Northern region (2.6%).The presence of positive serological markers of hepatitis C virus and hepatitis B virus infection did not correlate with elevated aminotransferases, race, place of birth, and alcohol consumption. These results suggest a low endemicity for both hepatitis B and hepatitis C in the general population, in contrast to a very high prevalence in risk groups, thus suggesting that targeted screening to high-risk groups may be more cost-effective than general population screening.

Epidemiology of transthyretin familial amyloid polyneuropathy in Portugal

Background Transthyretin Familial Amyloid Polyneuropathy (TTRFAP) is a rare, progressive, debilitating and life-threatening neurodegenerative disease. TTR-FAP is a rare disease worldwide. In Europe a disease is defined as rare when it affects less than 1 in 2000 inhabitants. Portugal has the largest cluster worldwide nonetheless recent Portuguese epidemiologic data is lacking. The purpose of this study is to estimate TTR-FAP prevalence in Portugal.

Transthyretin Proteins Regulate Angiogenesis by Conferring Different Molecular Identities to Endothelial Cells

Familial amyloidotic polyneuropathy (FAP) has a high prevalence in Portugal, and the most common form of hereditary amyloidosis is caused by an amyloidogenic variant of transthyretin (TTR) with a substitution of methionine for valine at position 30 (V30M). Until now, the available efficient therapy is liver transplantation, when performed in an early phase of the onset of the disease symptoms. However, transplanted FAP patients have a significantly higher incidence of early hepatic artery thrombosis compared with non-FAP transplanted patients. Because FAP was described as an independent risk factor for early hepatic artery thrombosis, more studies to understand the underlying mechanisms involved in this outcome are of the utmost importance. Knowing that the liver is the major site for TTR production, we investigated the biological effects of TTR proteins in the vasculature and on angiogenesis. In this study, we identified genes differentially expressed in endothelial cells exposed to the WT or V30M tetramer. We found that endothelial cells may acquire different molecular identities when exposed to these proteins, and consequently TTR could regulate angiogenesis. Moreover, we show that V30M decreases endothelial survival by inducing apoptosis, and it inhibits migration. These findings provide new knowledge that may have critical implications in the prevention of early hepatic artery thrombosis in FAP patients after liver transplantation.

Relação do Tabagismo com Ansiedade e Depressão nos Cuidados de Saúde Primários

Smoking prevalence in Portugal is estimated to be 19.7% (2005). Smoking is prevalent in anxiety disorders. Studies report that 60% of smokers have a history of depression. The Fagerström scale can be used to assess smoke dependence. The Hospital Anxiety and Depression Scale allows an estimate of anxiety and depression. Our goal was to find whether there is a relationship between smoking and anxiety / depression in eight clinics within primary care practice. We designed an observational, descriptive, cross-sectional, analytical study. Anonymous survey. We considered as inclusion criteria the over 18 years of age and literate clinic users and as exclusion criteria the under 18 years old users or incomplete surveys. We defined as variables: Fagerström, Hospital Anxiety and Depression Scale, age, marital status, gender, profession, schooling. We obtained a total of 608 valid surveys of which there were 64% women and 21% smokers. We found no differences in the prevalence of anxiety or depression when comparing non-smokers, ex-smokers and smokers. We found that the degree of nicotine addiction varies directly with anxiety and depression, however, the only statistically significant relationship observed was in women, even after correcting the effect of age. There is a relationship between nicotine dependence and the severity of symptoms of anxiety and depression, most relevant in women. selection bias. This study supplies information regarding psychological factors associated with tobacco consumption, allowing for its inclusion in treatment options for nicotine dependence.

Prevalência da exposição ao fumo ambiental do tabaco em casa e do tabagismo na população Portuguesa – o estudo INAsma

BackgroundWe aimed to: 1) estimate the prevalence of exposure to environmental tobacco smoke (ETS) at home in the Portuguese population; 2) estimate tobacco smoking prevalence in Portugal; 3) identify social and personal characteristics associated with smoking or exposure to ETS. MethodsNationwide, cross-sectional, population-based telephone survey. Overall, 6003 individuals completed the interview. ETS exposure at home was defined as exposure to at least one current smoker at home. A smoker was defined as someone with 15 years or older, smoking at least 1 cigarette per day during a year; a current smoker (CS) smoked in the last month. ResultsExposure to ETS at home was reported by 26.6% (95%CI 25.5-27.7) of the participants. Living in households with ≥4 persons (OR=2.31; 95%CI[1.81-2.96]), being a current smoker (OR=7.29; 95%CI[5.74-9.26]) or having current asthma (OR=2.06; 95%CI[1.45-2.94]) were factors positively associated with ETS exposure. When analyzed by gender, the effect of current asthma was only relevant to females.Currently 19.0% (95%CI 18.0-20.0) of the Portuguese population smokes tobacco and 17.2% (95%CI 16.2-18.2) are ex-smokers. CS prevalence is higher in males than females (26.5%versus 12.2%, p<0,001). The odds of being a CS were higher for males, the more educated, and those exposed to ETS at home. When analyzed by gender, school education only affected females. ConclusionExposure to ETS at home was higher than previously reported. Children/adolescents and asthma patients may have a higher risk of exposure. This report endorses a decreasing trend in the prevalence of tobacco smoking in Portuguese males, but a tendency to increase in females.