Percorrer por autor "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.
- Current advances, research needs and gaps in mycotoxins biomonitoring under the HBM4EU : lessons learned and future trendsPublication . Alvito, Paula; Assunção, Ricardo; Bajard, Lola; Martins, Carla; Mengelers, Marcel J. B.; Mol, Hans; Namorado, Sónia; van den Brand, Annick D.; Vasco, Elsa; Viegas, Susana; Silva, Maria JoãoMycotoxins are natural metabolites produced by fungi that contaminate food and feed worldwide. They can pose a threat to human and animal health, mainly causing chronic effects, e.g., immunotoxic and carcinogenic. Due to climate change, an increase in European population exposure to mycotoxins is expected to occur, raising public health concerns. This urges us to assess the current human exposure to mycotoxins in Europe to allow monitoring exposure and prevent future health impacts. The mycotoxins deoxynivalenol (DON) and fumonisin B1 (FB1) were considered as priority substances to be studied within the European Human Biomonitoring Initiative (HBM4EU) to generate knowledge on internal exposure and their potential health impacts. Several policy questions were addressed concerning hazard characterization, exposure and risk assessment. The present article presents the current advances attained under the HBM4EU, research needs and gaps. Overall, the knowledge on the European population risk from exposure to DON was improved by using new harmonised data and a newly derived reference value. In addition, mechanistic information on FB1 was, for the first time, organized into an adverse outcome pathway for a congenital anomaly. It is expected that this knowledge will support policy making and contribute to driving new Human Biomonitoring (HBM) studies on mycotoxin exposure in Europe.
- earlyMYCO : a pilot mother-child cohort study to assess early-life exposure to mycotoxins : challenges and lessons learnedPublication . Martins, Carla; Assunção, Ricardo; Costa, Ana; Serrano, Débora; Visintin, Lia; De Boevre, Marthe; Lachat, Carl; Vidal, Arnau; De Saeger, Sarah; Namorado, Sónia; Vidigal, Cristina; Almeida, Elisabete; Alvito, Paula; Nunes, CarlaEarly-life exposure occurs during gestation through transfer to the fetus and later, during lactation. Recent monitoring data revealed that the Portuguese population is exposed to mycotoxins, including young children. This study aimed to develop a pilot study to assess the early-life exposure to mycotoxins through a mother–child cohort, and to identify the associated challenges. Participants were recruited during pregnancy (1st trimester) and followed-up in three moments of observation: 2nd trimester of pregnancy (mother), and 1st and 6th month of the child’s life (mother and child), with the collection of biological samples and sociodemographic and food consumption data. The earlyMYCO pilot study enrolled 19 mother–child pairs. The analysis of biological samples from participants revealed the presence of 4 out of 15 and 5 out of 18 mycotoxins’ biomarkers of exposure in urine and breast milk samples, respectively. The main aspects identified as contributors for the successful development of the cohort were the multidisciplinary and dedicated team members in healthcare units, reduced burden of participation, and the availability of healthcare units for the implementation of the fieldwork. Challenges faced, lessons learned, and suggestions were discussed as a contribution for the development of further studies in this area.
- Editorial : human biomonitoring (HBM) as a tool to support policy and regulatory action to prevent chemicals exposurePublication . Viegas, Susana; Martins, Carla; Assunção, Ricardo
- Exposure assessment of the European adult population to deoxynivalenol – results from the HBM4EU Aligned StudiesPublication . Namorado, Sónia; Martins, Carla; Ogura, Joana; Assunção, Ricardo; Vasco, Elsa; Appenzeller, Brice; Halldorsson, Thorhallur I.; Janasik, Beata; Kolossa-Gehring, Marike; Nieuwenhuyse, An Van; Ólafsdóttir, Kristin; Rambaud, Loïc; Riou, Margaux; Silva, Susana; Wasowicz, Wojciech; Weber, Till; Esteban-López, Marta; Castaño, Argelia; Gilles, Liese; Martin, Laura Rodríguez; Govarts, Eva; Schoeters, Greet; Viegas, Susana; Silva, Maria João; Alvito, PaulaMycotoxins are natural toxins produced by fungi that may cause adverse health effects thus constituting a public health concern. Deoxynivalenol (DON), a mycotoxin affecting the immune system and causing intestinal disorders, was selected as a priority under the European Human Biomonitoring Initiative (HBM4EU). Urinary total DON levels (tDON) of 1270 participants from six countries were used to characterize the internal exposure of the adult European population and identify the most relevant determinants of exposure. tDON concentrations’ P50 and P95 were in the range of 0.41–10.16 µg/L (0.39–9.05 µg/g crt) and 3.25–46.58 µg/L (2.12–33.50 µg/g crt) respectively. Higher tDON levels were observed for (i) male participants from France and Germany, (ii) samples collected in spring and summer, (iii) participants with a lower educational level, (iv) participants living in rural areas, (v) individuals without a job in France and Luxembourg, while in Portugal higher exposure was observed in working individuals, (vi) individuals with higher consumption of cereals and bread. The proportion of individuals with exposure levels exceeding the HBM-GV of 23 µg/L was 12.3 %, ranging from 0.8 % to 20.7 % in the individual countries. This study on mycotoxins exposure has used post harmonized questionnaire data and validated analytical methodologies for analysis and covered countries representing the four geographical regions of Europe, having produced much needed knowledge on the exposure of the European adult population to deoxynivalenol.
- Mortality burden of cardiovascular disease attributable to ambient PM2.5 exposure in Portugal, 2011 to 2021Publication . Corda, Mariana O.; Charalampous, Periklis; Haagsma, Juanita A.; Assunção, Ricardo; Martins, CarlaBackground: Exposure to high levels of environmental air pollution causes several health outcomes and has been associated with increased mortality, premature mortality, and morbidity. Ambient exposure to PM2.5 is currently considered the leading environmental risk factor globally. A causal relationship between exposure to PM2.5 and the contribution of this exposure to cardiovascular morbidity and mortality was already demonstrated by the American Heart Association. Methods: To estimate the burden of mortality attributable to environmental risk factors, a comparative risk assessment was performed, considering a “top-down” approach. This approach uses an existing estimate of mortality of the disease endpoint by all causes as a starting point. A population attributable fraction was calculated for the exposure to PM2.5the overall burden of IHD and stroke was multiplied by the PAF to determine the burden attributable to this risk factor. The avoidable burden was calculated using the potential impact fraction (PIF) and considering the WHO-AQG 2021 as an alternative scenario. Results: Between 2011 and 2021, the ambient exposure to PM2.5 resulted in a total of 288,862.7 IHD YLL and a total of 420,432.3 stroke YLL in Portugal. This study found a decreasing trend in the mortality burden attributable to PM2.5 exposure, for both males and females and different age-groups. For different regions of Portugal, the same trend was observed in the last years. The mortality burden attributable to long-term exposure to PM2.5 was mainly concentrated in Lisbon Metropolitan Area, North and Centre. Changes in the exposure limits to the WHO recommended value of exposure (WHO-AQG 2021) have a reduction in the mortality burden due to IHD and stroke attributable to PM2.5 exposure, in Portugal. Conclusion: Between 2011 and 2021, approximately 22% and 23% of IHD and stroke deaths were attributable to PM2.5 exposure. Nevertheless, the mortality burden attributable to cardiovascular diseases has been decreasing in last years in Portugal. Our findings provide evidence of the impact of air pollution on human health, which are crucial for decision-making, at the national and regional level.