Browsing by Author "Martins, Carla"
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- Adaptação do Endometriosis Health Profile Questionnaire (EHP-30) para a cultura portuguesaPublication . Martins, Carla; Gil, João; Pereira, José Pascoalinho
- Adverse outcome pathways associated with the ingestion of titanium dioxide nanoparticles : a systematic reviewPublication . Rolo, Dora; Assunção, Ricardo; Ventura, Célia; Alvito, Paula; Gonçalves, Lídia; Martins, Carla; Bettencourt, Ana; Jordan, Peter; Vital, Nádia; Pereira, Joana; Pinto, Fátima; Matos, Paulo; Silva, Maria João; Louro, HenriquetaTitanium dioxide nanoparticles (TiO2-NPs) are widely used, and humans are exposed through food (E171), cosmetics (e.g., toothpaste), and pharmaceuticals. The oral and gastrointestinal (GIT) tract are the first contact sites, but it may be systemically distributed. However, a robust adverse outcome pathway (AOP) has not been developed upon GIT exposure to TiO2-NPs. The aim of this review was to provide an integrative analysis of the published data on cellular and molecular mechanisms triggered after the ingestion of TiO2-NPs, proposing plausible AOPs that may drive policy decisions. A systematic review according to Prisma Methodology was performed in three databases of peer-reviewed literature: Pubmed, Scopus, and Web of Science. A total of 787 records were identified, screened in title/abstract, being 185 used for data extraction. The main endpoints identified were oxidative stress, cytotoxicity/apoptosis/cell death, inflammation, cellular and systemic uptake, genotoxicity, and carcinogenicity. From the results, AOPs were proposed where colorectal cancer, liver injury, reproductive toxicity, cardiac and kidney damage, as well as hematological effects stand out as possible adverse outcomes. The recent transgenerational studies also point to concerns with regard to population effects. Overall, the findings further support a limitation of the use of TiO2-NPs in food, announced by the European Food Safety Authority (EFSA).
- Analysis of the characteristics and cytotoxicity of titanium dioxide nanomaterials following simulated in vitro digestionPublication . Bettencourt, Ana; Gonçalves, Lídia M.; Gramacho, Ana C.; Vieira, Adriana; Rolo, Dora; Martins, Carla; Assunção, Ricardo; Alvito, Paula; Silva, Maria João; Louro, HenriquetaSeveral metallic nanomaterials (NMs), such as titanium dioxide nanomaterials (TiO2), present beneficial properties with a broad range of innovative applications. The human population is exposed to TiO2, particularly by ingestion, due to its increasing use as a food additive and inclusion in dietary supplements and food packaging materials. Whether this oral exposure may lead to adverse local or systemic outcomes has been the subject of research, but studies have generated contradictory results, reflecting differences in the physicochemical properties of the TiO2 studied, effects of the surrounding matrix, and modifications during digestion. This work aimed to investigate the toxic effects of three different TiO2 NMs (NM-103, NM-103 and NM-105) on the gastrointestinal tract cells, Caco-2 and HT29-MTX-E12, after the use of the standardized static INFOGEST 2.0 in vitro digestion method to mimic human digestion of TiO2, contributing to hazard assessment. The results show that, for one of the digested TiO2 NMs studied (NM-105), a more pronounced toxicity occurs after exposure of HT29-MTX-E12 intestinal cells, as compared to undigested NM, concomitantly with subtle changes in characteristics of the NM. Thus, the inclusion of the digestion simulation in the safety evaluation of ingested NMs through in vitro bioassays can better integrate the modifications that NMs suffer in the organism. It is expected that such an approach will reduce uncertainties in the hazard assessment of ingested NMs for human health.
- Contributos da formação na identificação de necessidades e desafios em controlo de infeçãoPublication . Silva, Márcio; Martins, Fábio; Ramos, Maria Joaquina; Martins, Carla; Fontes, JoanaIdentificação de áreas de intervenção prioritárias em controlo de infeção, com base nos resultados obtidos em teste teórico
- CRESCER NA CRECHE: QUALIDADE E AVALIAÇÃO NA PRIMEIRA INFÂNCIAPublication . Mendes, Ana; Antão, Bruno; Martins, Carla; Matias, Catarina; Aversa, Valentina; Sá, Susana Oliveira; Noronha-Sousa, DulceEste estudo é norteado pela questão de investigação: como construir uma grelha de avaliação prática, para o educador utilizar diariamente, validada na fase inicial do trabalho referente ao Mestrado em Creche. Faz o enquadramento da creche em Portugal, abordando as questões da qualidade e da avaliação. Apresenta como principal objetivo a importância do papel da observação na prática pedagógica do educador. A metodologia utilizada baseou-se na pesquisa científica sobre os indicadores de qualidade, a avaliação, e a análise de três grelhas de uma instituição. Conclui-se que a observação é um suporte fundamental da avaliação na creche, sendo essencial um registo escrito claro, compreensivo, sistemático e fácil de colocar em prática.
- Risk-benefit assessment of cereal-based foods consumed by Portuguese children aged 6 to 36 months : a case study under the RiskBenefit4EU projectPublication . Assunção, Ricardo; Boué, Géraldine; Alvito, Paula; Brazão, Roberto; Carmona, Paulo; Carvalho, Catarina; Correia, Daniela; Fernandes, Paulo; Lopes, Carla; Martins, Carla; Membré, Jeanne-Marie; Monteiro, Sarogini; Nabais, Pedro; Thomsen, Sofie T.; Torres, Duarte; Pires, Sara M.; Jakobsen, Lea S.Cereal-based foods, including breakfast (BC) and infant cereals (IC), are among the first solid foods introduced to infants. BC and IC are sources of macro and micronutrients that have beneficial effects on health, but can also be sources of harmful chemical and microbiological contaminants and nutrients that may lead to adverse health effects at high consumption levels. This study was performed under the RiskBenefit4EU project with the aim of assessing the health impact associated with consumption of BC and IC by Portuguese children under 35 months. Adverse effects associated with the presence of aflatoxins, Bacillus cereus, sodium and free sugars were assessed against the benefits of fiber intake. We applied a risk–benefit assessment approach, and quantified the health impact of changes in consumption of BC and IC from current to various alternative consumption scenarios. Health impact was assessed in terms of disability-adjusted life years. Results showed that moving from the current consumption scenario to considered alternative scenarios results in a gain of healthy life years. Portuguese children can benefit from exchanging intake of IC to BC, if the BC consumed has an adequate nutritional profile in terms of fiber, sodium and free sugars, with levels of aflatoxins reduced as much as possible.
- Use of the Control of Allergic Rhinitis and Asthma Test and pulmonary function tests to assess asthma control in pregnancyPublication . Amaral, Luís; Martins, Carla; Coimbra, AliceINTRODUCTION: Asthma is one of the most prevalent chronic medical conditions to complicate pregnancy. Similarly, active management strategies that prioritise asthma control in this vulnerable population can have a far-reaching impact. AIM: To describe lung function parameters and results of the Control of Allergic Rhinitis and Asthma Test (CARAT) questionnaire in pregnant asthmatics and to analyse correlations between lung function tests and CARAT results. METHODS: All pregnant asthmatics who performed spirometry and CARAT between September 2014 and August 2015 were included. A medical records review was performed and data regarding demographics, sensitisation and medical prescriptions were recorded. Control of asthma and rhinitis was defined by CARAT total score (CARAT (T)) ≥ 24; upper airways (U) control if CARAT (U) > 8; lower airways (L) control if CARAT (L) > 15. RESULTS: Forty-two pregnant asthmatics were included, with a median age (interquartile range)of 32 (27-34) years; all had a previous medical diagnosis of asthma and rhinitis, 76% were atopic, 94% sensitised to dust mites and 43% were polissensitised. More than 80% presented poor control (CARAT (T) < 24) in the first assessment and 15% had a percentage forced expiratory volume in the first second < 80%. There were significant negative correlations between CARAT (L) and CARAT (T) scores and step-up of controller medication, (correlation coefficients = -0.453 and -0.392, respectively). CONCLUSION: The use of tools such as spirometry and validated questionnaires to objectively assess asthma control during pregnancy should be routinely applied to assist in the management of these patients. These data reinforce the importance of close monitoring of pregnant asthmatics to achieve and maintain better disease control.