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- ABO blood system: infection risk and severity in COVID 19Publication . Caldeira, Maria João; Pereira, Tifany; Rodrigues, Ângela; Gonçalves, Viviane; Montanha, Maria José; Rodrigues, CarinaAssociation studies between ABO blood group and COVID 19 risk and severity have shown differences depending on blood group From the serological study, carried out at CIMO in collaboration with the ULSNE, for 343 individuals the ABO phenotype was 40 2 5 0 8 6 and 46 2 for groups A, AB, B and O, respectively No significant differences were found between blood groups and infection These are preliminary results of a study on genetic determinants of susceptibility to SARS CoV 2 infection
- Alelos do grupo sanguíneo do sistema ABO e suscetibilidade para a doença COVID-19: revisão sistemáticaPublication . Amorim, Ana; Caldeira, Maria João; Pereira, Tifany; Vaz, Josiana A.; Rodrigues, CarinaA COVID-19 é uma doença causada pelo vírus SARS-COV-2 que recentemente teve um grande impacto mundial pela sua evolução pandémica. O sistema ABO tem sido associado a certas doenças ao longo do tempo, e mais recentemente iniciaram estudos sobre a sua associação com a doença da COVID-19. Acredita-se a genética dos hospedeiros podem contribuir nas diversas manifestações clinicas e na severidade da doença apresentadas de individuo para individuo. Como tal, este estudo teve o objetivo de perceber se as variações genéticas encontradas cromossoma 9 do locus do gene ABO podem ter influência na suscetibilidade dos indivíduos para a doença COVID-19.
- Anti-SARS-COV-2 humoral immunity in ULSNE healthcare professionalsPublication . Pereira, Tifany; Caldeira, Maria João; Rodrigues, Ângela; Gonçalves, Viviane; Montanha, Maria José; Rodrigues, CarinaThe detection of specific antibodies can provide information on the immunity achieved against SARS-CoV-2 infection. The new coronavirus-2 S protein is the main target used in COVID-19 vaccine development. Infection and vaccination in COVID-19 induce an antibody response against the Spike (S) glycoprotein. The administration of the vaccine appears to be an effective prophylactic strategy and there is scientific data showing that vaccination is responsible for reducing the number of infections, severe symptoms and COVID-19 associated deaths.
- Antibody response among portuguese healthcare workers prior to sars-cov-2 vaccine booster administrationPublication . Pereira, Tifany; Caldeira, Maria João; Rodrigues, A.; Alves, Madalena; Gonçalves, Viviane; Pinto, S.; Montanha, Maria José; Teixeira, Cristina; Rodrigues, CarinaPrioritizing healthcare workers (HCWs) for vaccination against the coronavirus disease 2019 (COVID-19) allowed to study the vaccine effectiveness in this professional group. The quantification of antibodies levels after vaccination among HCWs could give insights about SARS-CoV-2 protection. The aim of this study is to investigate SARS-CoV-2 immune response based on quantitation of antibodies against the spike receptor binding domain (RBD) of the S protein (anti-SRBD) and nucleocapside (anti-N) after the first vaccination stage in HCWs from the Local Health Unit of the Northeast of Portugal. Methods: Serum samples from 427 vaccinated HCW were tested for anti-SARS-CoV-2 immunoglobulin with chemiluminescent microparticle SARS-CoV-2 2 IgG I (anti-N) and IgG II (anti-SRBD) immunoassays detected by using ARCHITECT i1000SR (Abbot) equipment. Blood samples were collected between November and December of 2021, before the administration of 3rd vaccine dose. The chemiluminescent reaction anti-N immunoassay was expressed as an index classified as positive for values higher than 0.6. Anti-SRBD was quantified between 21.0 and 40,000.0 arbitrary units per ml (AU/mL) and values ≥ 50 AU/ml were considered positive. We obtained data about age, gender), infection with SARS-CoV-2 (PCR+), smoking habits and number of days between complete vaccination and blood sample collection Median, interquartile interval IIQ) and frequencies were obtained. Multivariate regression linear model was conducted to assess the factors affecting the values of anti-SRBD (logarithmized variable). Results: From all 427 HCW with median age 45.7 years [IIQ: 37.8-55.0], 89 (20.8%) were males, 89 (20.8%) had PCR+, 422 (98.8%) and 46 (21%) tested positive for IgG anti-SRBD and anti-N, respectively. The median of anti- SRBD was 737.3 (IIQ: 376.2-2270.1). According to the multivariate regression analysis, anti-SRBD values decrease as increase age (p = 0.004) and number of days since vaccination (p =0.004). Also, be a smoker decreases but a PCR+ increases anti-SRBD values. Conclusions/Recommendations: The SARS-CoV-2 antibody measurements suggested that quantitative anti-SRBD responses fall over the time (from days of complete immunization) and are lower among older vaccinated HCW.
- Associação entre os polimorfismos do gene abo e risco de infeção e severidade da COVID-19: estudo em profissionais de saúde da ULSNEPublication . Amorim, Ana; Caldeira, Maria João; Pereira, Tifany; Vaz, Josiana; Rodrigues, Ângela; Gonçalves; Viviana; Montanha, Maria José; Rodrigues, Carina; Vaz, Josiana A.Vários estudos epidemiológicos têm sido realizados com o propósito de compreender as diferentes suscetibilidades à infeção pelo novo coronavírus, bem como as diferentes manifestações da doença do novo coronavírus 19 (COVID-19) (1,2). Estudos de associação entre os grupos sanguíneos do sistema ABO e o risco e severidade da COVID-19 têm vindo a corroborar o facto da presença do grupo sanguíneo O conferir proteção enquanto a presença do grupo A parece conferir maior suscetibilidade à infeção e a uma sintomatologia mais grave da doença, no entanto há estudos com resultados contraditórios (3). Está estabelecido que determinados grupos do sistema ABO está associado a um maior risco para várias doenças infeciosas, incluindo hepatite B e dengue hemorrágico. Os mecanismos que podem explicar esta associação carecem de investigação mais aprofundada. Com este trabalho pretendeu-se contribuir para elucidar esta possível associação entre o genótipo ABO e o risco de infeção e severidade da doença COVID-19 na nossa opulação e estabelecer frequências genótipicas do gene ABO.
- Association between bilirubin and lipid profile in Portuguese elderly individualsPublication . Gomes, Ana; Rodrigues, Carina; Fernandes, Adília; Vaz, Josiana A.; Rebelo, IreneSeveral studies showed that mildly elevated bilirubin blood concentration is inversely associated with coronary artery disease (CAD). The most commonly mechanism contributing to CAD prevention is the bilirubin antioxidant effect, protecting several macromolecules from oxidation. Recently, other studies have found that higher serum bilirubin levels (BL) are associated with beneficial effects improving lipid profile and that might contribute to decrease cholesterol and triacylglycerol. In the meantime, a consistently negative association between BL and body mass index (BMI) was observed. The aim of this study was evaluate the cardiovascular risk protection by bilirubin analyzing the association between bilirubin levels and lipid profile in elderly. Clinical data, anthropometric measurements (BMI, Visceral Fat and Body Fat Percentage), lipid profile (total cholesterol-TC; triglycerides-TG; high-density lipoprotein cholesterol-HDL-c; low-density lipoprotein cholesterol-LDL-c; apoliprotein A-Apo-A; apoliprotein B-Apo-B) were evaluated in 70 institutionalized elderly, 43 females (mean age= 88.2±5.5 years old) and 27 males (mean age= 87.7±7.7 years old). Anthropometric measurements were obtained by bioimpedance, using specific scale (Tanita BC Model: 545). The lipid parameters were performed in autoanalyzer (Cobas Mira S, Roche, Switzerland) using available commercial kits. Correlation analysis revealed positive associations between BL and the HDL-c in males (total bilirubin: r=0.51; p<0.007) and no association in females (r=0.40; p<0.50). Positive associations were also found to TB levels and Apo-A (males: r=0.40; p<0.50 and females: r=0.270; p<0.013). Interestingly, the conjugated bilirubin present a stronger positive association with this two parameters (male: r=0.64; p<0.000; female: r=0.29; p<0.052). No associations were found between bilirubin and triglycerides; total cholesterol and anthropometric measurements. Low levels of HDL-c are a risk factor for coronary heart disease. A similar association has been shown for Apo-A1. These results suggest higher bilirubin is associated with higher cardioprotective agents, which indicates that the determination of total bilirubin should be included for more accurate cardiovascular disease risk assessment.
- Association between bilirubin and lipid profile in Portuguese elderly individualsPublication . Gomes, Ana; Rodrigues, Carina; Fernandes, Adília; Vaz, Josiana A.; Rebelo, IreneSeveral studies showed that mildly elevated bilirubin blood concentration is inversely associated to coronary artery disease (CAD). The most commonly mechanism contributing to CAD prevention is the bilirubin antioxidant effect, protecting several macromolecules from oxidation. Recently, other studies have found that higher serum bilirubin levels (BL) are associated with beneficial effects improving lipid profile and that might contribute to decrease cholesterol and triacylglycerol. In the meantime, a consistently negative association between BL and body mass index (BMI) was observed. The aim of this study was evaluate the cardiovascular risk protection by bilirubin analyzing the association between bilirubin levels and lipid profile in elderly. Clinical data, anthropometric measurements (BMI, Visceral Fat and Body Fat Percentage), lipid profile (total cholesterol-TC; triglycerides-TG; high-density lipoprotein cholesterol-HDL-c; low-density lipoprotein cholesterol-LDL-c; apoliprotein A-Apo-A; apoliprotein B-Apo-B) were evaluated in 70 institutionalized elderly, 43 females (mean age= 88.2±5.5 years old) and 27 males (mean age= 87.7±7.7 years old). Anthropometric measurements were obtained by bioimpedance, using specific scale (Tanita BC Model: 545). The lipid parameters were performed in autoanalyzer (Cobas Mira S, Roche, Switzerland) using available commercial kits. Correlation analysis revealed positive associations between BL and the HDL-c in males (total bilirubin: r=0.51; p<0.007) and no association in females (r=0.40; p<0.50). Positive associations were also found to TB levels and Apo-A (males: r=0.40; p<0.50 and females: r=0.270; p<0.013). Interestingly, the conjugated bilirubin present a stronger positive association with this two parameters (male: r=0.64; p<0.000; female: r=0.29; p<0.052). No associations were found between bilirubin and triglycerides; total cholesterol and anthropometric measurements. Low levels of HDL-c are a risk factor for coronary heart disease. A similar association has been shown for Apo-A1. These results suggest higher bilirubin is associated with higher cardioprotective agents, which indicates that the determination of total bilirubin should be included for more accurate cardiovascular disease risk assessment.
- Associaton between anthropometric indicators of adiposity and risk factors for cardiovascular disease in elderlyPublication . Gomes, Ana; Rodrigues, Carina; Rebelo, IreneAccording to the World Health Organization (WHO). Portugal remains one of the European countries with the highest rates of children and adults with overweight/obesity and it is estimated that 24% of the adult Portuguese population is obese. Dyslipidemias are the main risk factors for cardiovascular diseases, which are the leading cause of death in developed countries. Numerous studies have been conducted to establish the anthropometric measures as screening tools in clinical practice instead of using laboratory tests. The use of body mass index (BMI) as indicator of nutritional and metabolic status in elderly has difficulties due to the decrease in height, lean body mass, amount of body water and fat accumulation and the presence of certain conditions age-related that can cause bias in body composition (1,2). Some authors state that, in the absence of specific cutoff points for BMI according to age and gender limits the use of this indicator (3). This study aims to investigate the association between anthropometric measurements and the cardiovascular risk factors (lipid profile) in the elderly. A random sample of 70 elderly subjects, 43 women (mean age= 88.2 + 5.5) and 27 men (mean age = 87.7 + 7.7) institutionalized in 3 different nursing homes of Braganza was studied. The lipid profile was estimated from fasting blood samples of all participants. The selected parameters were Total Cholesterol (TC), High Density Lipoprotein Cholesterol(HDL-c), Low Density Lipoprotein Cholesterol (LDL-c), triglycerides (TRG), apolipoprotein - A. (APO-A) and apolipoprotein B (APO-B). Lipids and lipoproteins plasma concentration were determinate using a biochemical autoanalyzer (Cobas 400 plus, Roche). Some anthropometric parameters (metabolic age, visceral fat, muscle mass, body fat percentage -% BF) were performed by bioimpedance, using a specific scale (Tanita BC model: 545). The height (to calculate BMI) was considered according to the identity card. After performing descriptive analysis of anthropometric and lipid profile variables, comparing the elderly values according the gender, we used Spearman correlation coefficient to determine the relationship between biochemical and anthropometric parameters. In the analyzed sample, 4.2% of subjects had an underweight BMI (≤18.4), 35.2% of subjects normal BMI (18.5-24.9) and 59.2% overweight (25-29.9) and obesity (≥30). As expected, statistically significant differences between men and women were found in regard to muscle mass (50.6 + 5.9 vs. 39.6 + 6; p <0.000), visceral fat (17.5 + 3.4 vs. 10.9 + 2.2, p <0.000) and % BF (26.5 + 6.4 vs. 33.3 + 6.5; p = 0.002). It was found that in the women group there is a strong positive correlation between BMI and % BF (men = 0.73; p <0.000 and women = 0.85; p <0.000). Correlation analysis between anthropometric measurements and lipid profile parameters showed a positive association between BMI and TRG concentration (r = 0:26; p = 0.03) and a negative association between BMI and HDL-c concentration (r = -0.24; p = 0.048). The same results were observed in other studies, the main lipid/lipoprotein abnormalities related to obesity were a decrease in serum HDL-c concentration and an increase in serum TRG concentration (4). As described in the literature, the average in % BF difference, between men and women, increases with age, where women accumulate more body fat than men. In this context, it would be important to define new limits to anthropometric indicators, according to age and gender, which allows them to replicate more accurately the metabolic and nutritional status. In this study, there were no significant correlations between anthropometric parameters and lipid parameters. However, we can confirm, despite the limitations of BMI already mentioned, this was the anthropometric indicator with the highest correlation with lipid profile parameters. Keywords: BMI, anthropometric measurements, cardiovascular risk factors, lipid profile, dyslipidemias
- Avaliação da dor em utentes internados com atroplastia total da anca: Intervenções dos enfermeirosPublication . Quina, Ema; Rodrigues, Kátia; Sousa, Filomena; Rodrigues, CarinaA dor é um sintoma com grande prevalência no internamento hospitalar, sendo responsável pelo sofrimento e incapacidade dos doentes. Lidar com as vivências de dor de um doente é uma das particularidades do trabalho diário dos enfermeiros. É portanto a estes que cabe uma observação contínua dos doentes, adoção de medidas para alívio da dor, assim como deteção e despiste de efeitos secundários que possam aparecer. Objetivos: Identificar quais as dificuldades dos enfermeiros na observação/avaliação da dor e conhecer as atitudes tomadas pelos mesmos para o alívio da dor no pós-operatório em doentes submetidos a atroplastia total do joelho e da anca. Metodologia: Através de um estudo quantitativo observacional descritivo transversal tendo sido aplicado um questionário a 18 enfermeiros que exercem a sua atividade no serviço de ortopedia no Hospital de São Pedro de Vila Real. Resultados: Constatou-se que quanto à adoção de medidas para o alívio da dor a totalidade dos enfermeiros não sente dificuldade. Dos inquiridos, 50% usa frequentemente medidas farmacológicas, 44% usa medidas não farmacológicas frequentemente. Apenas 11% dos inquiridos respondeu que usava sempre medidas não farmacológicas, tais como massagem, exercícios, relaxamento, distração, posicionamento e termoterapia. Conclusão: A adoção das medidas não farmacológicas no controlo da dor apresentam bastante eficácia, principalmente como adjuvantes a medidas farmacológicas. A aplicação destas medidas trás resultados positivos e têm como principal vantagem serem pouco dispendiosas.
- Avaliação da imunidade humoral em profissionais de saúde e utentes em lares de idosos em Bragança antes da administração das duas primeiras doses de reforço da vacina COVID-19Publication . Teixeira, Catarina; Caldeira, Maria João; Pereira, Tifany; Teixeira, Cristina; Rodrigues, Ângela; Gonçalves, Viviane; Montanha, Maria José; Rodrigues, CarinaVacinação surge como uma estratégia profilática eficaz, muitos estudos corroboram a sua capacidade de reduzir a incidência da infeção por COVID-19, bem como a gravidade dos sintomas e a mortalidade associada a esta doença. Tanto a infeção natural pelo vírus SARS-CoV-2 quanto a imunização por meio da vacinação induzem uma resposta imunitária caracterizada pela produção de anticorpos direcionados contra a glicoproteína viral Spike (IgG anti-S). Nos indivíduos que foram vacinados com vacinas de mRNA é possível identificar aqueles que estiveram infetados recentemente pela deteção de anticorpos anti-Nucleocápside (IgG anti-N) uma vez que o segmento relativo à nucleocapside não é o alvo na formulação destas vacinas. O principal objetivo deste estudo foi avaliar a imunidade humoral gerada pela vacinação e infeção em profissionais de saúde da Unidade Local de Saúde do Nordeste de Bragança e em lares da terceira idade do distrito de Bragança, em dois momentos distintos, o primeiro antes da administração da primeira dose de reforço da vacina COVID-19 (T1), e a segunda antes da 2ª dose de reforço (T2) através de uma quantificação de anticorpos específicos anti-SARS-CoV-2, no soro dos participantes.