Instituto de Saúde Ambiental (ISAMB)
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O Instituto de Saúde Ambiental (ISAMB) é uma nova unidade de investigação, multidisciplinar e autónoma, que reunirá contribuições de vários Centros de Investigação e Unidades Estruturais da Faculdade de Medicina. O seu objectivo é realizar investigação, divulgação e intervenção social na área das Ciências da Saúde, na sua dimensão psicossocial, ambiental e económica, contribuindo para a constituição de um Núcleo de Intervenção Científica e Profissional no âmbito das Ciências da Vida e da Saúde na Universidade de Lisboa.
The Instituto de Saúde Ambiental (ISAMB) is a research centre established by FMUL (Faculdade de Medicina da Universidade de Lisboa), entirely devoted to Environmental Health. Through funding contract with the Fundação para a Ciência e a Tecnologia (FCT), ISAMB will also be a FCT Research Unit. As a structural FMUL unit, ISAMB has privileged association with the country’s largest university hospital (Hospital de Santa Maria), associated and partner institutions and most hospitals and health centres of the Lisbon Region, which gives it the competitive advantage of a team encompassing a wide array of renowned academics and health professionals.
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Instituto de Saúde Ambiental (ISAMB)
Faculdade de Medicina da Universidade de Lisboa
Av. Professor Egas Moniz,Edifício Egas Moniz, Piso 0, Ala C
1649-028 Lisboa - Portugal
http://isamb.medicina.ulisboa.pt/
isamb-coord@medicina.ulisboa.ptTel. +(351) 217 999 489
Fax +(351) 217 999 487
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- 24-h movement guidelines and overweight and obesity indicators in toddlers, children and adolescents: a systematic review and meta-analysisPublication . Marques, Adilson; Ramirez-Campillo, Rodrigo; Gouveia, Elvio; Ferrari, Gérson; Tesler, Riki; Marconcin, Priscila; Loureiro, Vânia; Peralta, Miguel; Sarmento, HugoBackground: Engaging in physical activity increases energy expenditure, reducing total body fat. Time spent in sedentary behaviours is associated with overweight and obesity, and adequate sleep duration is associated with improved body composition. This systematic review aimed to analyse the relationship between compliance with the 24-h movement guidelines and obesity indicators in toddlers, children and adolescents. Methods: A systematic review and meta-analysis was conducted. PubMed, Web of Science and Scopus were searched from inception to December 2021. Cross-sectional and prospective studies that analysed the relationship between 24-h movement guidelines and overweight and obesity written in English, French, Portuguese or Spanish were included. PROSPERO registration number is CRD42022298316. Results: The associations between meeting the 24-h movement guidelines and standardised body mass index were null in the two studies for toddlers. Seven studies analysed the relationship between compliance with the 24-h movement guidelines and overweight and obesity among preschool children. Of these seven studies, six found no association between compliance with 24-h movement guidelines and body composition. Among children and adolescents, 15 articles were analysed. Of these 15 studies, in seven, it was found that children and adolescents who meet the 24-h movement guidelines were more likely to have lower risks of overweight and obesity. The meta-analysis yielded a pooled OR = 0.80 (95% CI = 0.68 to 0.95, p = 0.012, I2 = 70.5%) in favour of compliant participants. Regarding participants' age groups, compliance with 24-h movement guidelines seems to exert greater benefits on overweight and obesity indicators among children-adolescents (OR = 0.62, p = 0.008) compared to participants at preschool (OR = 1.00, p = 0.931) and toddlers (OR = 0.91, p = 0.853). Conclusion: Most included studies have not observed a significant relationship between compliance with the 24-h movement guidelines and overweight and obesity in toddlers, children and adolescents.
- ABCA1 polymorphism R1587K in chronic hepatitis C Is gender-specific and modulates liver disease severity through its influence on cholesterol metabolism and liver function: a preliminary studyPublication . Ferreira, Joana; Bicho, Manuel; Serejo, FátimaChronic hepatitis C (CHC) progression is highly variable and can be influenced by lipid metabolism. The ATP-binding cassette transporter A1 (ABCA1) is involved in lipid metabolism and mediates cholesterol efflux from liver cells. ABCA1 gene polymorphism rs2230808 (R1587K) modulates lipid levels as it is located in an ABCA1 protein domain, which is essential for cholesterol efflux. We aimed to analyze the role of ABCA1 polymorphism R1587K (rs2230808) in modulating the biochemical parameters of lipid metabolism and liver function and its association with liver disease severity, according to gender. A total of 161 CHC patients were clinically, histologically, and biochemically evaluated. Genotyping was performed by melting-curve analysis and statistical analysis by SPSS 24.0. There were significant differences between ABCA1_rs2230808 genotypes and total cholesterol, γGT (γ-glutamyl-transpeptidase), and HCV-RNA. Gender differences: in females, ABCA1_rs2230808 (GG or GA) was associated with higher HCV-RNA serum levels; in males, ABCA1_rs2230808 (GG or GA) was associated with higher γGT, lower total cholesterol, increased risk for γGT ≥ 38 UI/L, and total cholesterol < 4.92 mmol/L. Only in the case of males were higher γGT and lower total cholesterol associated with severe fibrosis and steatosis. Total cholesterol < 4.92 mmol/L also associates with severe necroinflammation. We conclude that ABCA1_rs2230808 is gender-specific. ABCA1_rs2230808 Allele G was associated with different clinical and biochemical parameters, which are related to more severe liver disease.
- Abundance and updated distribution of Aedes aegypti (Diptera: Culicidae) in Cabo Verde Archipelago : a neglected threat to public healthPublication . Da Veiga Leal, Silvânia; Fernandes Varela, Isaías Baptista; Gonçalves, Adéritow; Sousa Monteiro, Davidson Daniel; Ramos de Sousa, Celivianne Marisia; Lima Mendonça, Maria da Luz; DePina, Adilson; Alves, Maria João; Osório, HugoBackground: Mosquito-borne viruses, such as Zika, dengue, yellow fever, and chikungunya, are important causes of human diseases nearly worldwide. The greatest health risk for arboviral disease outbreaks is the presence of the most competent and highly invasive domestic mosquito, Aedes aegypti. In Cabo Verde, two recent arbovirus outbreaks were reported, a dengue outbreak in 2009, followed by a Zika outbreak in 2015. This study is the first entomological survey for Ae. aegypti that includes all islands of Cabo Verde archipelago, in which we aim to evaluate the actual risk of vector-borne arboviruses as a continuous update of the geographical distribution of this species. Methods: In order to assess its current distribution and abundance, we undertook a mosquito larval survey in the nine inhabited islands of Cabo Verde from November 2018 to May 2019. Entomological larval survey indices were calculated, and the abundance analyzed. We collected and identified 4045 Ae. aegypti mosquitoes from 264 positive breeding sites in 22 municipalities and confirmed the presence of Ae. aegypti in every inhabited island. Results: Water drums were found to be the most prevalent containers (n = 3843; 62.9%), but puddles (n = 27; 0.4%) were the most productive habitats found. The overall average of the House, Container, and Breteau larval indices were 8.4%, 4.4%, and 10.9, respectively. However, 15 out of the 22 municipalities showed that the Breteau Index was above the epidemic risk threshold. Conclusion: These results suggest that if no vector control measures are considered to be in place, the risk of new arboviral outbreaks in Cabo Verde is high. The vector control strategy adopted must include measures of public health directed to domestic water storage and management.
- Accelerometer-measured daily step counts and adiposity indicators among Latin American adults : a multi-country studyPublication . Ferrari, Gerson; Marques, Adilson; Barreira, Tiago; Kovalskys, Irina; Gómez, Georgina; Rigotti, Attilio; Cortés, Lilia; García, Martha; Pareja, Rossina; Herrera-Cuenca, Marianella; Guajardo, Viviana; Leme, Ana; Guzmán Habinger, Juan; Valdivia-Moral, Pedro; Suárez-Reyes, Mónica; Ihle, Andreas; Gouveia, Elvio; Fisberg, MauroThe aim of the present study was to examine the sex-related associations between accelerometer-measured daily step counts and adiposity indicators in adults from eight Latin American countries. We analyzed data from 2524 adults (aged 18-65 years) from the Latin American Study of Nutrition and Health. Device-measured daily step counts were measured by accelerometers (ActiGraph GT3X). The outcomes were body mass index (BMI; (kg/m2), waist and neck circumference (in cm). Overall, the mean of daily steps counts, BMI, waist and neck circumference were 10699.8, 27.3, 89.6, and 35.8. Weak and negative associations were observed between daily steps counts and BMI (r = -0.17; p < 0.05) and waist circumference (r = -0.16; p < 0.05); however, step counts was not associated with neck circumference. Daily steps counts were negatively associated with BMI (β: -0.054; 95%CI: -0.077; -0.012) and waist circumference (-0.098; -0.165; -0.030) independently of age and socioeconomic level. In men, there were significant negative associations between daily steps counts with BMI (-0.075; -0.119; -0.031) and waist circumference (-0.140; -0.233; -0.048), and in women, there was no significant association with either of the body composition indicators. The findings from this study need to be examined in prospective settings that use device-measured from Latin America.
- Accuracy of the new rapid test for monitoring adalimumab levelsPublication . Rocha, Cátia; Afonso, Joana; Lago, Paula; Arroja, Bruno; Vieira, Ana I.; Dias, Cláudia C.; Magro, FernandoBackground: The loss of response to adalimumab (ADL) has been related to low serum concentrations at trough. Currently, most methods commercially available for the quantification of ADL are enzyme-linked immunosorbent assay (ELISA) based, with a turnaround time of approximately 8 h, delaying the target dosage adjustment to the subsequent infusion. In this study, we aimed to evaluate the performance of the newly available rapid-test ADL quantification assay by comparing it with three established ELISA methods, using spiked samples and a set of clinical samples. Methods: Spiked samples from control donors and 120 serum samples from inflammatory bowel disease (IBD) patients undergoing ADL therapy were quantified using lateral flow Quantum Blue® Adalimumab and, the ELISA formats from Immundiagnostik, R-Biopharm and an in-house assay. Results: The rapid-test assay had intraclass correlation coefficients of 0.590, 0.864 and 0.761 when comparing with the Immundiagnostik, R-Biopharm and in-house assays, respectively. For the five therapeutic windows, the accuracy was high: ADL rapid test compared with the Immundiagnostik (58–88%); R-Biopharm, 68–89%; and in house, 60–88%; and kappa statistics revealed 0.492–0.602, 0.531–0.659 and 0.545–0.682, respectively. Conclusions: The Quantum Blue® Adalimumab assay can replace the commonly used ELISAbased ADL quantification kits and it is a reliable alternative to these methods. This rapidtest assay enables the quantitative determination of ADL serum trough level in only 15 min. The developed assay allows measurement of ADL over a wide range. Hence, it represents a valuable tool for the clinician to assess the ADL trough level.
- Acidentes, violência e lesões nos adolescentes portugueses : resultados do estudo HBSC de 2018Publication . Gaspar, Susana; Peralta, Miguel; Guedes, Fábio Botelho; Ferreira, Carlos; Matos, Margarida Gaspar deThe aim of this study was to analyse the occurrence of unintentional lesions in Portuguese adolescents. 8215 Portuguese adolescents (52,7% girls), from 6th, 8th, 10th and 12th grades were inquired. The occurrence of injuries, the involvement in violent behaviours and the level of satisfaction with life were analysed. The Student’s t-test and chi-square test were used to analyse differences between genders. A logistic regression model stratified by gender were conducted to analyse the associations between injuries and violence. 41,3% of the adolescents had at least one injury event. Boys reported more injuries (55%) and more injuries with need of hospitalization (61,6%). The youngest boys who attend the 6th and 8th grades, the girls of the 8th and 10th years, from Alentejo, with Portuguese nationality, with low life satisfaction are those who had more injuries. For both genders, the occurrence of injuries is positively associated with fight’s involvement. For boys, it is also positively associated with the carrying of weapons and, for girls, with being bullied and cyberbullied and with Portuguese nationality. Involvement in violence, male gender, and younger age are risk factors to injury occurrence in Portuguese adolescents. Portuguese adolescents frequently involved in fights, boys who carried weapons and girls with Portuguese nationality, who were bullied and cyberbullied had more injuries. Preventive strategies should be developed considering the specificities for each gender. Adolescents need to recognise risk factors for injuries occurrence. Intervention need to be developed to promote adolescent’s safety.
- Aconselhamento em atividade física : uma proposta de fluxograma de intervenção clínicaPublication . Gamboa Madeira, Sara; Sousa, Patrícia Alexandra; Envia, Gonçalo; Marques, Sérgio; Moreira, Tiago Martins
- Active aging awareness and well-being among older adults in PortugalPublication . Costa, Andreia; Henriques, Joana; Alarcão, Violeta; Henriques, Adriana; Madeira, Teresa; Virgolino, Ana; Sousa, Joana; Feteira-Santos, Rodrigo; Arriaga, Miguel; Rocha, Jorge; Nogueira, Paulo JorgeObjective: This study aims to assess the active aging awareness of older adults in mainland Portugal and their levels of overall well-being and to identify social and health-related factors. Methods: A cross-sectional study was conducted with a representative sample of 613 older adults, aged 65 or older, who participated in the PROKnos – Knowing Social Prescribing needs of the elderly study in Portugal. The questionnaire consisted of the Active Ageing Awareness Questionnaire and the World Health Organization – Five Well-Being Index, as well as sociodemographic, economic, and health status questions. Correlation coefficients, t-tests for independent samples, and one-way ANOVA were used to explore potential associations between variables. Results: The active aging awareness levels were significantly higher for women (p = 0.031), and those who were younger (p = 0.011), more educated (p < 0.001), had a better financial situation (p < 0.001), and had better health (p < 0.001). The same pattern was found for well-being, except in relation to gender, as men had higher levels (p = 0.016). These variables were found to be correlated. Discussion: Even though active aging is an important strategy to implement, it is indispensable to consider the perceptions and conditions that need to be in place before that. This study reveals that several social and health-related factors are associated with well-being and active aging awareness, as well as the differences between groups that exist in mainland Portugal in relation to that. This emphasizes how vital it is to address social inequalities in active aging efforts, which are not necessarily uncovered when only considering actual active aging measures.
- Active and healthy aging after COVID-19 pandemic in Portugal and other European countries: time to rethink strategies and foster actionPublication . Costa, Andreia; Câmara, Gisele; Arriaga, Miguel Telo de; Nogueira, Paulo Jorge; Pereira Miguel, JoséThe population aging in Europe imposes challenges to societies that require adaptations and responses at various levels to minimize impacts and figuring out opportunities. Portugal has been committed to the World Health Organization and European Union’s values and policy frameworks concerning active and healthy aging. In 2017, an inter-ministerial working group developed the National Strategy for Active and Healthy Aging. In the face of the COVID-19 pandemic that exposed the vulnerabilities of older populations, the launch of the Decade of Healthy Aging 2021–2030 and its baseline report and the 2018 Active Aging Index Analytical Report may constitute an opportunity to strategically think about the aging of the population as a national purpose in Portugal and in the other European countries that face similar challenges.
- Active commuting and depression symptoms in adults : a systematic reviewPublication . Marques, Adilson; Peralta, Miguel; Henriques-Neto, Duarte; Frasquilho, Diana; Gouveia, Elvio; Gómez-Baya, DiegoPhysical activity (PA) is suggested to have a protective effect against depression. One way of engaging in PA is through active commuting. This review summarises the literature regarding the relationship between active commuting and depression among adults and older adults. A systematic review of studies published up to December 2019, performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, was conducted using three databases (PubMed, Scopus, and Web of Science). A total of seven articles were identified as relevant. The results from these studies were inconsistent. Only two presented a significant relationship between active commuting and depression symptoms. In those two studies, switching to more active modes of travel and walking long distances were negatively related to the likelihood of developing new depressive symptoms. In the other five studies, no significant association between active travel or active commuting and depression was found. The relationship between active commuting and depression symptoms in adults is not clear. More studies on this topic are necessary in order to understand if active commuting can be used as a public health strategy to tackle mental health issues such as depression.