HB - Patologia Clínica
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- Etiology of bronchiolitis in a hospitalized pediatric population: prospective multicenter studyPublication . Antunes, H; Rodrigues, H; Silva, N; Ferreira, C; Carvalho, F; Ramalho, H; Gonçalves, A; Branca, FBACKGROUND: In 2006, bronchiolitis due to adenovirus nosocomial infections resulted in the closure of a pediatric department in northern Portugal. OBJECTIVES: To determine the etiology of bronchiolitis in northern Portugal. STUDY DESIGN: It was a prospective multicenter study on the etiology of bronchiolitis during the respiratory syncytial virus (RSV) season (November-April). Children < or = 24 months of age admitted for a first wheezing episode were included. Nasopharyngeal specimens were analyzed by an indirect immunofluorescent-antibody assay (IFA) for RSV, adenovirus (HAdV), parainfluenza (PIV) 1-3 and influenza (IV) A and B and by polymerase chain reaction (PCR) or reverse transcription-PCR for the same viruses and for human metapneumovirus (hMPV), bocavirus (HBoV), rhinovirus (HRV), coronaviruses (229/E; NL63; OC43; HKU1) and enterovirus. RESULTS: During this period, 253 children were included, 249 IFA analyses and 207 PCRs were performed. IFA detected RSV in 58.1%; PCR increased it to 66.7%. IFA detected HAdV in 3.2%, PCR 10.0%. PCR detected IV A in 5; IV B in 2; PIV 1 in 6, PIV 2 in 4 and PIV 3 in 11 cases. HBoV, as single agent in 2 cases, and HRV were positive in 8 samples and hMPV in 11. With this virus panel, 19.7% remained without etiology. CONCLUSIONS: The most frequent agent was RSV, followed by HAdV. PCR can be cost-effective and more accurate than IFA, which is crucial for HAdV that may be associated with significant mortality (IFA alone did not detect 2/3 of the cases).
- G2P[4] the most prevalent rotavirus genotype in 2007 winter season in an European non-vaccinated populationPublication . Antunes, H; Afonso, A; Iturriza, M; Martinho, I; Ribeiro, C; Rocha, S; Magalhães, C; Carvalho, L; Branca, F; Gray, JBACKGROUND: Recently, a high prevalence of G2P[4] rotavirus (RV) infection was reported from Brazil, and linked with the universal RV vaccination programme that used the G1P[8] live oral RV vaccine. OBJECTIVE: To determine the genotypes of RV co-circulating in a non-vaccinated population, in northern Portugal in the winter season of 2007. STUDY DESIGN: Prospective multicenter study of the genotypes circulating in the northwest region of Portugal during January to March 2007. Children with acute gastroenteritis, who attended the Pediatric Emergency Services of five Hospitals, were included in the study. The parents of the children completed a clinical and epidemiological data questionnaire and stool samples were collected. Stool samples positive in a RV enzyme immunoassay (EIA) were genotyped by reverse transcriptase-polymerase chain reaction. RESULTS: Stool samples were collected from 424 children. Two hundred and thirty-four (55.2%) stool samples were RV-positive. G2P[4] was the predominant RV type (68.6%), followed by G9P[8] (14.0%). CONCLUSIONS: Because our population was naïve for RV vaccine, the G2P[4] predominance cannot be explained by vaccination. Rather, this high prevalence of G2P[4] may be within the normal fluctuation of RV genotypes. RV strain surveillance programmes are important for informing RV vaccination programmes.
- O polimorfismo C/T-13910 como teste genético para o diagnóstico de hipolactasia tipo adulto em criançasPublication . Nascimento, J; Gonçalves, P; Branca, F; Antunes, H
- Prevalência do vírus da hepatite A: primeiros resultados de baixa endemicidade em PortugalPublication . Antunes, H; Macedo, M; Estrada, AThe prevalence of the hepatitis A virus in a population determines the degree of morbidity associated with this illness, that is, the higher the morbidity, the lower the prevalence. This study aims to obtain the prevalence of total antibody to the hepatitis A virus in children, 5 and 8 years of age, and in adolescents, 14 years of age. The study was based on two samples: the serum of 64 healthy five-year-olds and 76 healthy eight-year-olds living in the proximity of the São Marcos Hospital in Braga and the serum of 311 adolescents, aged 14, from a total population of 536 adolescents attending schools in Braga, North of Portugal. The samples were collected in 1999 for the adolescent group, in 2000 and 2001 for the group of the five-year-olds and in 2002 and 2003 for the group of the eight-year-olds. None of the persons involved had been vaccinated with the hepatitis A virus vaccine. The Enzyme Linked Fluorescent Assay method was used to measure the serum total antibody to the hepatitis A virus. The prevalence of total antibody to the hepatitis A virus was 1.6% at 5 years of age, [95% confidence intervals (CI), 0-4.7%]; 3.9% at 8 years of age, [95% CI, 0-8,4%]; and 32.5% at 14 years of age +/- 6 months, [95% CI, 27.3-37.7%]. The prevalence of total antibody to the hepatitis A virus in this population revealed lower natural immunity. The results obtained for the five and eight-year-olds were the first Portuguese results of low endemicity to the hepatitis A virus.
- Primeira determinação de prevalência de doença celíaca numa população portuguesaPublication . Antunes, H; Abreu, I; Nogueira, A; Sá, C; Gonçalves, C; Cleto, P; Garcia, F; Alves, A; Lemos, DThe prevalence of celiac disease is unknown in Portugal. In European countries the prevalence is between 1:200 and 1:400. The incidence obtained through diagnosed cases in the paediatric gastroenterology units in Portugal was 1:3648. To determine the best current celiac disease screening method and its prevalence in a portuguese population, 536 sera of teenagers with 14 years +/- 6 months from Braga town schools were tested as follows: a) total IgA, b) anti-tissue transglutaminase antibodies c) anti-endomysium antibodies (AEA). One female adolescent, with negative AEA and anti-transglutaminase antibodies had a diagnosed celiac disease; this patient was under appropriate diet. Eleven adolescents had positive anti-transglutaminase antibodies and 4 of these had also positive AEA. A jejunal biopsy was carried out on the latter adolescents. Three presented intestinal villous atrophy, 2 a flat mucosa and 1 a moderate atrophy. One female adolescent had a normal mucosa. The prevalence was 1:134, [confidence interval at 95%, 1:53-1:500]. Conclusions: Presently, total IgA with determination of anti-tissue transglutaminase antibodies is apparently the best screening method; it is less expensive test and, given the use of ELISA, less dependent on the observer. The celiac disease prevalence found in the present study falls within the range of prevalence recently found in other European populations, which implies that the celiac disease is under-diagnosed in Portugal.
- Taxa de cobertura vacinal com imunização para o vírus da hepatite BPublication . Antunes, H; Macedo, M; Estrada, AThe hepatitis B virus is an important cause of morbidity and mortality in humans, thus making it a serious public health issue. The purpose of this study was to determine the hepatitis B virus vaccination rate with immunization, the risk of this population group becoming infected before vaccination and the prevalence of hepatitis B virus infection. The study involved randomly analyzing the serum of 311 adolescents of both sexes aged 14 from a total population of 536 adolescents attending schools in Braga, Portugal. A questionnaire was administered to the adolescents and asked them if they had received the Hepatitis B vaccine, how many doses they received, if they had a history of acute hepatitis, drug abuse, whether or not they had had sexual intercourse and if so, if they had used protection. The determination of the hepatitis B surface antigen (HbsAg), the antibody to HbsAg and the antibody to hepatitis B core antigen was carried out using the chemoluminiscence method. The vaccination rate with immunization was 85.8 %, [95% CI 81.9-89.7%]. The prevalence of hepatitis B virus infection was 0.6%, [95% CI 0-1.5%]. Conclusions: The prevalence of hepatitis B virus infection was low in this adolescent population of Braga. The vaccination rate with immunization is satisfactory, but does not reach 100%, which means that the risk of transmission is still present in this age group.