Browsing by Author "Duarte, Carlos Manuel Teixeira"
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- A case of transplacental transmission of EDTA-dependent pseudothrombocytopeniaPublication . Brandão, Carla; Abreu, Eduarda; Carvalho, Carmem; Iglésias, Isabel; Costa, Elísio; Duarte, Carlos Manuel Teixeira; Barbot, José
- Estudo do risco de diabetes mellitus do tipo 2 na comunidade do Instituto Politécnico de BragançaPublication . Duarte, Carlos Manuel Teixeira; Magalhães, PedroA doença da Diabetes Mellitus do tipo 2 (DM2) é considerada uma das doenças mais prevalentes a nível mundial, afetando aproximadamente 422 milhões de pessoas em todo mundo. A DM2 possui uma tendência exponencial tornando o diagnóstico precoce importante e fundamental para controlar a doença, evitar o aumento da mortalidade que lhe está associada, assim como estancar os custos cada vez maiores associados às complicações tardias e morbilidades associadas. Objetivos: 1) Quantificar o risco de desenvolver DM2 na comunidade do Instituto Politécnico de Bragança (IPB); 2) Perceber quais os fatores de risco da DM2 com maior peso dentro da população do IPB; 3) Sensibilizar a população do IPB, através do rastreio, para o risco de cada um de desenvolver DM2; Métodos: Realizou-se uma análise observacional, transversal e prospetiva com base na aplicação do questionário Finnish Diabetes Risk Test (FINDRISC), na comunidade do IPB. Foram avaliados 3021 indivíduos com idades compreendidas entre os 17 e os 68 anos, dos quais 2716 estudantes (21,4±4,2 anos) e 305 funcionários (44,0±11,7 anos). Os resultados foram analisados através da realização de um teste de Qui-quadrado, a fim de analisar a associação entre as diferentes variáveis de risco associadas à DM2, assim como o risco de desenvolver a doença. Foram ainda, adicionalmente, analisados os valores dos resíduos ajustados e os valores do teste Cramers’ V. Resultados: A prevalência do risco de desenvolver DM2 na população do IPB foi de aproximadamente 10%, sendo esta maior no grupo dos funcionários em comparação com o grupo dos estudantes. O valor do score referente ao risco médio obtido no presente estudo foi de 5 pontos ±3,4 pontos, sendo o valor médio do score de risco do grupo dos funcionários ligeiramente superior (7,3 pontos ±4,2 pontos). Dentro das variáveis sociodemográficas do presente estudo, as que registaram uma associação significativa com o risco de desenvolver DM2 (p < 0,05) foram o “estado civil”, “nível de escolaridade” e a “prática de exercício físico”. Dentro das variáveis contempladas no questionário FINDRISC as variáveis “IMC” e “perímetro da cintura” foram as variáveis, dentro desta população, que registaram uma associação mais forte através da análise dos valores do teste Cramers’ V (“0,585” e “0,492”) dentro das variáveis que registaram uma associação significativa com o risco de desenvolver DM2 (p < 0,001). A variável “consumo de frutas/vegetais” diverge das demais variáveis, uma vez que não registou uma associação significativa com o risco de desenvolver DM2 (p < 0,05). Conclusões: O presente estudo observou que o risco de desenvolver DM2 no seio da comunidade do IPB foi reduzido, em especial no grupo dos estudantes. Os fatores de risco com maior impacto no risco de desenvolver DM2 na população do IPB foram o perímetro da cintura e o IMC. O questionário FINDRISC demostrou-se assim uma ferramenta fundamental para a realização de um rastreio em larga escala e com um importante papel na sensibilização de uma população perante a doença de DM2 que se encontra num aumento exponencial.
- Physical activity, strength training and nutritional support in patients with metabolic syndrome from a Northeaster Portuguese primary health care: a pilot community intervention programPublication . Bragada, José A.; Teixeira, J.A.; Bragada, João P.; Duarte, Carlos Manuel Teixeira; Pontes, João H.; Saldanha, Laissa de Sousa; Magalhães, PedroThe prevalence of Metabolic Syndrome (MetS) has been increasing exponentially in the Portuguese population. Primary prevention using physical activity (PA), exercise and healthy lifestyles seems to be limited. Thus, current study aims to present the design and preliminary findings of a pilot community intervention for patients with MetS. Methods: A randomized controlled trial was conducted between April and July 2022 with patients with MetS, from a Northeaster Portuguese primary health care. Eight participants completed the three-month intervention program, 6 women (51.0±6.4 years) and 2 men (46.5±4.9 years). The program included: (1) evaluation and prescription of PA (steps/day and floors/day); (2) nutritional and dietary support; (3) strength training sessions; (3) blood testing; (4) anthropometric and body composition assessment. A pre- and post-intervention follow up was conducted. Garmin®F 745 were used for PA prescription and assessment. PA targets per day were: number of steps ≥10 000; uphill walking ≥10 floors; and minutes of intensity ≥150 per week. Nutritional and dietary evaluation was recorded by completing the food frequency questionnaire with subsequent recommendation of changes to healthy diet. The designed strength training program was: (i) frequency of 2x/week; (ii) 8 to 10 exercises, in order to work the main muscle groups; (iii) 2 sets of 10 to 12 repetitions; (iv) 60 to 70% of one maximum repetition. Blood samples evaluated glycated hemoglobin (HbA1c), fating glucose (FG), triglycerides (TG), high-density lipoprotein (HDL) cholesterol, total cholesterol (TC), systolic (SBP) and diastolic blood pressure (DBP). Body weight (kg), lean body mass (kg) and fat mass percentage (%) was evaluated by bio-impedance scale (Tanita MC 780-P MA®). MetS parameters was defined by joint interim statement (JIS) criteria (Alberti et al, 2009). Results: Regarding PA parameters at the end of the three-month program, the average number of daily steps was 11 818, the number of daily floors was 15.35 and moderate to vigorous PA was 253 minutes/week. An improvement in pre- and post-intervention blood concentrations and pressure was observed, namely in HbA1c (-7.4%±15.2), FG (-4.9%±14.4), HDL (-4.8%±9.7), TC (-1.9%±19.9), SBP (-15.6%±10.7) and DBP (-12.7%±9.3). All participants registered a weight loss (-3.4%±2.0), with an increase in lean mass (-4.5%±2.0) and a decrease in fat mass (-8.7%±6.3). Except for one participant, all improved in heart rate recovery after exercise (19.3%±28.2), suggesting an improvement in cardiovascular capacity. Conclusions: The effect of the implemented pilot community intervention program was greater in the participants who followed the program more rigorously. Additionally, the strength training may have been important in increasing lean body mass. The inclusion of PA, strength training and nutritional support in primary health care, through a supervised program, seems to be a key strategy to reduce the risk associated with MetS and delay the complications associated with cardiometabolic diseases.
- Prevalence of Type 2 Diabetes, impaired fasting glucose, and diabetes risk in an adult and older North-Eastern Portuguese populationPublication . Magalhães, Pedro; Teixeira, José Eduardo; Bragada, João P.; Duarte, Carlos Manuel Teixeira; Bragada, José A.The aims of this study were (1) to evaluate the prevalence of type 2 diabetes (T2D) in a middle-aged north-eastern Portuguese population, (2) to analyze the prevalence of impaired fasting glucose (IFG), and (3) to assess the risk of T2D in this community-based sample. An exploratory, retrospective, and cross-sectional study was conducted from a total of 6570 individuals aged 18–102 years, among which 3865 were women (57.4 18.1 years) and 2705 were men (60.0 16.8 years). T2D diagnosis, IFG, and the diabetes risk score (low to very high risk) were assessed. The prevalence of T2D in this adult and an older north-eastern Portuguese population was 17.4%. A higher prevalence of T2D was reported in men (22.2%) than in women (14.0%); however, this was without significant differences (p = 0.086). Otherwise, the prevalence of T2D was significantly different among the age groups and increased with age (p < 0.001). Regarding IFG, a higher percentage of cases was observed in men (14.1%) than in women (8.4%) (p < 0.001). The risk of developing T2D in the next 10 years showed an association with sex and age group (p < 0.001) with a small-to-moderate effect (V = 0.1–0.3). Men and the elderly had the highest percentage of cases in the moderate-to-very high-risk bands. The current research confirmed a higher prevalence of T2D, IFG, and diabetes risk than previous Portuguese epidemiological reports. The results also suggest potential prediabetes cases, which should be carefully monitored. The current research adds evidence to the worldwide trend of the increasing prevalence of T2D and intermediate hyperglycemia (i.e., prediabetes).
- Sensibility and specificity analysis for waist to height ratio, body mass index and waist circumference as a screening criterion for metabolic syndrome in an adult North East Portuguese populationPublication . Teixeira, José Eduardo; Bragada, José A.; Bragada, João P.; Coelho, Joana C.M.M.; Pinto, Isabel; Reis, Luís P.; Saldanha, Laissa de Sousa; Duarte, Carlos Manuel Teixeira; Magalhães, PedroObesity is a central component of Metabolic Syndrome (MetS) and a major public health concern. A harmonizing MetS definition was developed to aggregate the different criteria used by the umbrella organizations, however there is still controversy over the most sensitive and specific parameter to characterize each MetS component
- Sensibility and specificity analysis for waist-to-height ratio, body mass index and waist circumference as a screening criterion for metabolic syndrome in an adult North-East Portuguese populationPublication . Teixeira, José Eduardo; Bragada, José A.; Bragada, João P.; Coelho, Joana C.M.M.; Pinto, Isabel; Reis, Luís P.; Saldanha, Laissa de Sousa; Duarte, Carlos Manuel Teixeira; Magalhães, PedroObesity is a central component of Metabolic Syndrome (MetS) and a major public health concern. A harmonizing MetS definition was developed to aggregate the different criteria used by the umbrella organizations, however there is still controversy over the most sensitive and specific parameter to characterize each MetS component. The aim of this study was to compare the sensibility and specificity for waist-toheight ratio (WHtR), body mass index (BMI) and waist circumference (WC) to discriminate subjects with and without MetS in an adult North-East Portuguese population. Methods: A cross-sectional retrospective analysis was conducted between January 2019 and December 2020 from patients’ clinical records of two primary health care centers in a North-East Portuguese region. A total of 6570 individuals aged 18–102 years were included for analysis, among which 3865 women (57.37±18.67 years) and 2705 men (59.97±16.76 years). MetS was defined according to HARM2009 statement set by Alberti et al. (2009). Standardized cut-off points were used to measure WHtR (≥0.5), BMI (≥30 kg/m2) and WC (>88 cm in women and >102 cm in men). A binary logistic regression was performed for the areas under receiver operating characteristic curves (AUC) and adjusted odd ratios (OR) with a 95% confidence interval (CI). Results: MetS was present in 3,581 (54.51%) subjects, where 1,914 (49,52%) were women and 1,667 (61.63%) men. AUC demonstrated that WHtR was significantly more powerful than WC and BMI (p<0.05) for screening MetS (AUCWHtR = 0.785, 95% CI: 0.774–0.796; AUCWC = 0.768, 95% CI: 0.757–0.779; AUCBMI = 0.751, 95% CI: 0.703–0.796). Men are 1.53 (95% CI: 1.37–1.72, p<0.001) times more likely of having MetS compared to women. Also, the discriminative power of the three criteria for predicting MetS is higher in men (AUCWHtR = 0.795, 95% CI: 0.778–0.812; AUCWC = 0.783, 95% CI: 0.766–0.801; AUCBMI = 0.740, 95% CI: 0.722–0.759) than women (AUCWHtR = 0.782, 95% CI: 0.768–0.797; AUCWC = 0.760, 95% CI: 0.744–0.775; AUCBMI = 0.699, 95% CI: 0.683–0.716). However, WHtR is still the most powerfull screening criterion for MetS in both sexes. Conclusion: Adjusting individual’s waist circumference to height revealed a greater sensitivity and specificity for MetS screening than isolated WC and BMI. Current research suggests that WHtR is as a better predictor for MetS, specifically in its obesity component.