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- Medicines and medication literacy : social practices and use of informationPublication . Lopes, Noémia; Pegado, Elsa; Egreja, Catarina; Rodrigues, Carla; Fernandes, Ana IsabelThis article discusses results from a sociological study on (i) the sources and use of information on medicines and/or supplements and (ii) the self-assessment of how informed participants were about the last medicine or supplement they purchased. It seeks to demonstrate the plurality of information sources (expert and lay) that individuals call upon—with which they build up their medication literacy—and their perception of the information they have. While these social components of literacy are scarcely visible in available studies, the need to produce knowledge on them is a requisite for a more laypeople-centred approach in public policies seeking to promote medication literacy. A questionnaire was applied in-person (n = 1107) in urban pharmacies in Lisbon and Porto (Portugal). Results show expert information (medical and pharmaceutical) as the dominant reference, followed by lay sources (family/friends/colleagues), while digital sources were less valued than interpersonal ones. This interpersonal dimension was a relevant factor in the building of trust in information. The self-assessment of the information on medication was higher in functional literacy and lower in comprehensive literacy. Studies on medication literacy are particularly relevant in the current context of the expansion and diversification of medicines’ use and of individuals’ growing autonomy in their consumption habits.
- Meat consumption and availability for its reduction by health and environmental concerns : a pilot studyPublication . Turnes, Andrea; Pereira, Paula; Cid, Helena; Valente, Ana(1) Background: Excessive meat consumption has raised multiple health and environmental concerns; however, there are no data on the population’s willingness to reduce its intake for these reasons. The current study aims to assess the frequency of meat intake and readiness to limit consumption due to concern about the impact on health and the environment in residents of the Lisbon metropolitan region. (2) Methods: This analytical cross-sectional observational study was carried out in 197 residents in the metropolitan region of Lisbon. The participants were divided into two groups by age (GI: 20–29 years; GII: 40–64 years). Meat consumption and willingness to reduce it were assessed through a questionnaire. (3) Results: Most participants (67%) reported not having knowledge about the ecological footprint of meat. Being a less frequent meat consumer (<1 time per day) is associated with a willingness 3.6 times higher (p < 0.001) to reduce meat consumption due to sensitivity to the impact on health and 4.0 times higher (p < 0.001) due to environmental reasons. (4) Conclusions: Lower meat consumption frequency was associated with reductions in this consumption for environmental and health reasons.
- Mass spectrometry imaging of in vitro Cryptosporidium parvum-infected cells and host tissuePublication . Anschütz, Nils H.; Gerbig, Stefanie; Ghezellou, Parviz; Silva, Liliana M. R.; Vélez, Juan Diego; Hermosilla, Carlos R.; Taubert, Anja; Spengler, BernhardCryptosporidium parvum is a zoonotic-relevant parasite belonging to the phylum Alveolata (subphylum Apicomplexa). One of the most zoonotic-relevant etiologies of cryptosporidiosis is the species C. parvum, infecting humans, cattle and wildlife. C. parvum-infected intestinal mucosa as well as host cells infected in vitro have not yet been the subject of extensive biochemical investigation. Efficient treatment options or vaccines against cryptosporidiosis are currently not available. Human cryptosporidiosis is currently known as a neglected poverty-related disease (PRD), being potentially fatal in young children or immunocompromised patients. In this study, we used a combination of atmospheric pressure scanning microprobe matrix-assisted laser desorption/ionization (AP-SMALDI) mass spectrometry imaging (MSI) and liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) to determine and locate molecular biomarkers in in vitro C. parvum-infected host cells as well as parasitized neonatal calf intestines. Sections of C. parvum-infected and non-infected host cell pellets and infected intestines were examined to determine potential biomarkers. Human ileocecal adenocarcinoma cells (HCT-8) were used as a suitable in vitro host cell system. More than a thousand different molecular signals were found in both positive- and negative-ion mode, which were significantly increased in C. parvum-infected material. A database search in combination with HPLC-MS/MS experiments was employed for the structural verification of markers. Our results demonstrate some overlap between the identified markers and data obtained from earlier studies on other apicomplexan parasites. Statistically relevant biomarkers were imaged in cell layers of C. parvum-infected and non-infected host cells with 5 µm pixel size and in bovine intestinal tissue with 10 µm pixel size. This allowed us to substantiate their relevance once again. Taken together, the present approach delivers novel metabolic insights on neglected cryptosporidiosis affecting mainly children in developing countries.
- Malnutrition, cancer stage and gastrostomy timing as markers of poor outcomes in gastrostomy-fed head and neck cancer patientsPublication . Sousa-Catita, Diogo; Ferreira-Santos, Cláudia; Mascarenhas, Paulo; Oliveira, Cátia; Madeira, Raquel; Santos, Carla Adriana; André, Carla; Godinho, Catarina; Antunes, Luís; Fonseca, JorgeFor percutaneous endoscopic gastrostomy (PEG)-fed head and neck cancer (HNC) patients, risk markers of poor outcomes may identify those needing more intensive support. This retrospective study aimed to evaluate markers of poor outcomes using TNM-defined stages, initial anthropometry [body mass index (BMI), mid-upper arm circumference (MUAC), tricipital skinfold (TSF), mid-arm muscle circumference (MAMC)] and laboratory data (albumin, transferrin, cholesterol), with 138 patients, 42–94 years old, enrolled. The patients had cancer, most frequently in the larynx (n = 52), predominantly stage IV (n = 109). Stage IVc presented a four times greater death risk than stage I (OR 3.998). Most patients presented low parameters: low BMI (n = 76), MUAC (n = 114), TSF (n = 58), MAMC (n = 81), albumin (n = 47), transferrin (n = 93), and cholesterol (n = 53). In stages I, III, IVa, and IVb, MAMC and PEG-timing were major survival determinants. Each MAMC unit increase resulted in 16% death risk decrease. Additional 10 PEG-feeding days resulted in 1% mortality decrease. Comparing IVa/IVb vs. IVc, albumin and transferrin presented significant differences (p = 0.042; p = 0.008). All parameters decreased as severity of stages increased. HNC patients were malnourished before PEG, with advanced cancer stages, and poor outcomes. Initial MAMC, reflecting lean tissue, significantly increases survival time, highlighting the importance of preserving muscle mass. PEG duration correlated positively with increased survival, lowering death risk by 1% for every additional 10 PEG-feeding days, signaling the need for early gastrostomy.
- Lower calcium and iron intake in adolescent gymnasts : a case of concern for youth sports nutritionPublication . Vicente, Filipa; Holanda, Marcela; Ramalho, Renata; Mendes, João; Marques-Vidal, Pedro; Pereira, PaulaObjectives: Diet is important for the appropriate development and maturation of young amateur athletes. The aim of this study was to determine whether young gymnasts were consuming adequate amounts of nutrients, particularly calcium and iron. Methods: This cross-sectional survey was conducted in Portugal's Almada and Lisbon regions in 2020. To determine if participants’ diet was adequate, weight, height, and skinfold measurements were taken. Dietary consumption was examined using two 24-h recalls. We collected data from 66 participants (60% females, 12–18 y of age), of whom 82% had normal weight and 39% had ideal body fat. Results: The daily total energy intake (TEI) was1605 ± 601 kcal. Of the TEI, 19%, 31%, and 50% were comprised of protein, fat, and carbohydrates, respectively. The most often consumed protein sources were poultry and ultra-processed meat products (52% and 45%, respectively). The average daily consumption of calcium and iron was 626 ± 293 and 9 ± 3 mg, respectively. Only 2 of the 66 participants had calcium intake within recommended levels, and 1of 5 had iron intake within recommended levels, the percentage of which was lower in girls than boys (7.5% versus 38.5%, P < 0.05). Conclusions: Despite having a sufficient macronutrient distribution, Portuguese gymnasts consume a high amount of ultra-processed items and a low amount of calcium and iron. The low proportion of female gymnasts with adequate iron consumption is cause for worry in sports nutrition.
- Long-term intestinal failure and home parenteral support : a single center experiencePublication . Brito, Mariana; Padinha, Mafalda; Carlos, Sandra; Oliveira, Cátia; Santos, Ana Paula; Nunes, Gonçalo; Santos, Carla Adriana; Fonseca, JorgeIntroduction: Home parenteral nutrition (HPN) and/or home parenteral hydration (HPH) are the gold-standard treatment for patients with long-term intestinal failure (IF). The authors aimed to assess the impact of HPN/HPH on nutritional status and survival of long-term IF patients, as well as HPN/HPH-related complications. Methods: This was a retrospective study including IF patients under HPN/HPH followed in a single large tertiary Portuguese hospital. The data collected included demographics, underlying conditions, anatomical characteristics, type and duration of parenteral support, IF functional, pathophysiological, and clinical classifications, body mass index (BMI) at the beginning and end of follow-up, complications/hospitalizations, current patient status (deceased, alive with HPN/HPH, and alive without HPN/HPH), and cause of death. Survival after HPN/HPH beginning, until death or August 2021, was recorded in months. Results: Overall 13 patients were included (53.9% female, mean age 63.46 years), and 84.6% of patients presented type III IF and 15.4% type II. Short bowel syndrome caused 76.9% of IF. Nine patients received HPN and 4 HPH. Eight patients (61.5%) were underweight at the beginning of HPN/HPH. At the end of follow-up, 4 patients were alive without HPN/HPH, 4 maintained HPN/HPH, and 5 died. All patients improved their BMI (mean initial BMI 18.9 vs. 23.5 at the end, p < 0.001). Eight patients (61.5%) were hospitalized due to catheter-related complications, mainly infectious (mean hospitalization episodes 2.25, mean hospital stay of 24.5 days). No deaths were related to HPN/HPH. Conclusion: HPN/HPH significantly improved IF patients’ BMI. HPN/HPH-related hospitalizations were common, however causing no deaths, reinforcing that HPN/HPH is an adequate and safe therapy for long-term IF patients.
- Lisbon Intensive Falls Trampoline Training (LIFTT) Program for people with Parkinson’s for balance, gait, and falls : study protocol for a randomized controlled trialPublication . Domingos, Josefa; Dean, John; Fernandes, Júlio Belo; Ramos, Catarina; Grunho, Miguel; Proença, Luís; Vaz, João R.; Godinho, CatarinaFalling and gait difficulties in people with Parkinson’s disease (PD) are associated with impaired reactive postural adjustments and impairments in attentional resources. Combined intensive balance motor and cognitive exercise can be beneficial. However, uncertainties persist regarding the true effects and safety when applying such training. Using trampoline beds may be a favorable safe environment for a highly intensive, cognitive, and balancing training approach. The primary goal of this randomized controlled trial is to assess the effects of an intensive cognitive-motor training program in a safe trampoline environment in addition to usual care on balance impairment, gait, physical capacity, fear of falling, falls frequency and severity, cognition, and clinical impairments in people with mild or moderate PD.
- Landing wise program : feasibility study protocol for Parkinson’s diseasePublication . Fernandes, Júlio Belo; Domingos, Josefa; Família, Carlos; Santos, Cátia; Santana, Diana; Gregório, Francisco; Costa, Inês; Afonso, Joana; Matos, Lúcia; Marques, Solange; Santos, Tânia; Fernandes, Sónia; Santos, Isabel; Sousa, Natacha; Ramos, Catarina; Godinho, CatarinaRegardless of the benefits of fall prevention programs, people with Parkinson’s disease (PD) will still fall. Therefore, it is crucial to explore novel therapeutic approaches that are well-accepted and effective for addressing fall risk and the fear of falls among this population. The present study aims to assess the feasibility of the Landing Wise program as a therapeutic intervention for reducing the fear of falling in people with PD. A mixed-methods study will be conducted using convenience sampling to recruit 20 people with PD with a moderate concern of falling from a Parkinson’s Patients Association. In addition to usual care, participants will attend 2 days per week, 90 min group sessions for 8 weeks. The intervention combines group cognitive behavioral intervention with the training of safe landing strategies. Feasibility will be assessed by six key domains (recruitment strategy and rates, enrollment, retention, acceptability, reasons for decline/withdrawal, and adverse events). Quantitative data will be analyzed using descriptive statistics to characterize the sample, followed by inferential statistics to evaluate differences in the Short Falls Efficacy Scale-International Scale, Movement Disorder Society Unified Parkinson’s Disease Rating Scale, Timed Up Go, 6-Minutes Walking Distance, and fall frequency and severity scores between baseline and final assessment. Qualitative data will be analyzed using an inductive thematic analysis process. There is a growing interest in developing new effective therapeutic approaches for people with PD. If proven program feasibility, this study precedes a randomized controlled trial to establish the effectiveness of the Landing Wise program.
- Kinetics of torque teno virus viral load is associated with infection and de novo donor specific antibodies in the first year after kidney transplantation : a prospective cohort studyPublication . Querido, Sara; Martins, Catarina; Gomes, Perpétua; Pessanha, Maria Ana; Arroz, Maria Jorge; Adragão, Teresa; Casqueiro, Ana; Oliveira, Regina; Costa, Inês; Azinheira, Jorge; Paixão, Paulo; Weigert, AndréTorque teno virus (TTV) was recently identified as a potential biomarker for the degree of immunosuppression, and potentially as a predictor of rejection and infection in solid organ transplant patients. We evaluated TTV viral load in kidney transplant (KT) patients during the first year post-transplant to examine overall kinetics and their relationships with deleterious events, including episodes of infection and the formation of de novo donor-specific antibodies (DSAs). In a single-center, prospective observational cohort study, 81 KT patients were monitored at baseline, week 1, and month 1, 3, 6, 9 and 12, post-KT, and whenever required by clinical events. Kidney function, plasma TTV load, immunoglobulins and lymphocyte subpopulations were assessed at each time point. Twenty-six patients (32.1%) presented a total of 38 infection episodes post-KT. Induction immunosuppression with thymoglobulin, compared to basiliximab, was not associated with more infections (p = 0.8093). Patients with infectious events had lower T-cells (p = 0.0500), CD8+ T-cells (p = 0.0313) and B-cells (p = 0.0009) 1 month post-KT, compared to infection-free patients. Patients with infection also showed higher increases in TTV viral loads between week 1- month 1, post-KT, with TTV viral load variations >2.65 log10 cp/mL predicting the development of infectious events during the 12-month study period (p < 0.0001; sensitivity 99.73%; specificity 83.67%). Patients who developed de novo DSAs had lower TTV DNA viral loads at month 12 after KT, compared to patients who did not develop DSA (3.7 vs. 5.3 log10 cp/mL, p = 0.0023). Briefly, evaluating early TTV viremia is a promising strategy for defining infectious risk in the 1st year post-KT. The availability of standardized commercial real-time PCR assays is crucial to further validate this as an effective tool guiding immunosuppression prescription.
- Irish dancing injuries and associated risk factors : a systematic reviewPublication . Póvoa, Ana Rita; Costa, Cláudia Maria; Simões, Sérgio; Azevedo, Ana Morais; Oliveira, RaulIrish dance is growing in popularity, evolving to a more athletic and demanding dance style. The aim of this study is to conduct a systematic review, previously registered with PROSPERO, to identify the prevalence, incidence, and the injury pattern among Irish dancers and analyse the associated risk factors. Six online databases and two dance-specific science publications were searched systematically. Studies were included if the patterns of injuries among Irish dancers were evaluated or the factors associated with injury were analysed, published in English or Portuguese, in peer-reviewed scientific journals. Four reviewers assessed the quality and level of evidence using the Downs and Black criteria and a modified Oxford Centre of Evidence-Based Medicine 2009 model, respectively. Eleven articles were included, eight of Level 3c (cross-sectional) and three of Level 3b (prospective). Mean DB percentage score was 63% ± 7.2%. Prevalence ranged from 72.2% to 92.6%, affecting mostly the foot/ankle complex. Only two articles reported incidence, which ranged from 3.4 to 10.6 injuries/1000 h danced depending on injury definition. Psychological factors, elite level, and insufficient/poor sleep were associated with musculoskeletal injury. Injury prevalence and incidence is high in Irish dancers, with the foot and ankle being more affected. Due to heterogeneity in injury definitions, methods, and populations, along with the need for improvement in studies quality, recommendations were made for future research.