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- Empirical evaluation of the potential of low-cost and open source “on-the-person” ECG for cardiopathy pre-screeningPublication . Reis, Manuel José Cabral dos Santos; Silva, Hugo P.; Barros, Francisco; Ala, Sílvia Maria Fernandes; Sanfins, Víctor; Lourenço, Hélio B.M.Electrocardiographic (ECG) data analysis can reveal crucial information about the cardiovascular physiologi- cal phenomenon, which is modulated by the Autonomic Nervous System. Hereupon, beyond cardiovascular diagnosis, ECG markers can also reflect workload levels, or even physical and mental performance, through Heart Rate Variability (HRV) analysis. Building upon previous work found within the state-of-the-art, this pilot research explores the potential of using a low-cost device for cardiopathy pre-screening, through ECG signal analysis. With the aim of performing the rhythmical analysis, we performed empirical tests from a population of 21 control subjects in a resting position, and an additional 2 subjects, one of them in dynamic condition, in the scope of an exploratory research, using ECG wave segments analysis and HRV features extraction for nu- merical analysis. Results have demonstrated that the signal quality allows reliable ECG acquisition for further rhythmical and HRV analysis, in stationary and dynamic monitoring, for the bipolar leads applied. There was also evidence to suggest a benefit from including ECG morphological analysis with this hardware and software setup for prevention and diagnosis of cardiovascular disorders, although requiring further investigation.
- Heart rhythm qualitative analysis using low-cost and open source electrocardiography: a study based on atrial fibrillation detectionPublication . Lourenço, Hélio B.M.; Sanfins, Víctor; Torgal, Fernando; Ala, Sílvia Maria Fernandes; Reis, Manuel José Cabral dos Santos; Silva, Hugo P.; Barros, FranciscoIn the current digital era, cardiovascular activity analysis is becoming ubiquitous with the increasing availability of embedded systems, and, in some cases, these systems are even endowed with the capabili- ties of detecting health risk factors identified through electrocardiographic (ECG) markers. Aligned with this trend, and inspired by the results from our pilot study, we focus this research on exploring the potential of a low- cost and open source device for heart rhythm analysis, with emphasis on Atrial Fibrillation (AF). AF is the most common cardiac arrhythmia, defined as a complex cardiac disease which is highly correlated to stroke and heart failure, and its prevalence is especially high in elderly popula- tion. Given the importance and impact of such cardiovascular disease, we performed ECG acquisitions in a hospital setting to evaluate the poten- tial of this device to identify heart rhythms. These ECG acquisitions were performed in 10 patients, accomplished simultaneously with the low-cost device and the gold standard devices used in the clinical routine of the hospital. The data collected from the low-cost device was analysed by the cardiologist specialized in rhythmology, along with the conventional ECG exam analysis, whom suggested 100% accuracy of the low-cost device in differentiating a sinus rhythm from AF. The results also present great accu- racy in the detection of atypical cardiac events through ECG analysis, as well as a good agreement for the corroboration of the numerical data from the devices used for this study, as the RR intervals and QTc intervals values suggest.
- Levels of urinary 1- hydroxypyrene in firemen from the Northeast of PortugalPublication . Oliveira, Marta; Slezakova, Klara; Pereira, Maria do Carmo; Fernandes, Adília; Alves, Maria José; Delerue-Matos, Cristina; Morais, SimonePolycyclic Aromatic Hydrocarbons (PAHs) are ubiquitous environmental pollutants that are mostly formed during incomplete combustion of organic materials (e.g. coal, oil, wood, and tobacco). Many PAHs and their epoxides are highly toxic, mutagenic and carcinogenic to humans. Thus, the present study assesses the total exposure to PAHs by the determination of 1-hydroxypyrene (1OHPy) in the urine of (non-smoking and smoking) firemen serving at four Portuguese fire corporations from the Northeast of Portugal. The global median concentrations of 1OHPy ranged between 8.0 × 10 -3 to 6.3 × 10 -2 µmol/ mol creatinine in subjects. Urinary 1OHPy levels were always below the benchmark of 0.5 µmol/mol creatinine proposed by the American Conference of Governmental Industrial Hygienists for occupational exposure to PAHs. Moderate to strong correlations were found between the urinary levels of 1OHPy and the number of cigarettes consumed per individual for some fire stations, seeming to reflect the impact of tobacco consumption in firemen’ total exposure to PAHs. © 2017 Taylor & Francis Group, London.
- Levels of urinary biomarkers of exposure and potential genotoxic risks in firefightersPublication . Oliveira, Marta; Delerue-Matos, Cristina; Morais, Simone; Slezakova, Klara; Pereira, Maria do Carmo; Fernandes, Adília; Costa, Solange; Teixeira, João Paulo FernandesThis study characterizes the levels of six urinary monohydroxyl-polycyclic aromatic hydrocarbons in Portuguese firefighters directly involved in firefighting activities. Median concentrations of urinary total monohydroxyl-PAHs were predominantly higher in exposed subjects comparatively with non-exposed firefighters (3.12 versus 1.59 mu mol/mol creatinine, respectively). Urinary 1-hydroxynaphthalene and 1-hydroxyacenaphthene were the most predominant metabolites (87-90% of total monohydroxyl-PAHs), being followed by 2-hydroxylfluorene (2.4-6.3%), 1-hydroxyphenanthrene (4.1-5.4%), and 1-hydroxypyrene (2.0-2.6%). Firefighters who were directly involved in fire combat activities presented increased percentages of DNA damage (9.85 versus 10.9%; p <= 0.01) and oxidative stress (0 versus 2.14% TDNA; p <= 0.01) comparatively with non-exposed subjects, thus revealing the impact of fires on the health of exposed firefighters.
- Maternal care, pregnancy complications and birth outcomes among native and migrant women in PortugalPublication . Teixeira, Cristina; Muralova, Ana; Cancela, Marilyne; Barros, HenriqueMigrants can experience inequalities in care and health outcomes even in countries with universal access to care, regardless of legal status, as it is the case in Portugal. Thus, we assessed the prevalence of late antenatal care, pregnancy complications, obstetric interventions and birth outcomes considering the country of origin of women delivering in Portugal Methods: As part of an ongoing population-based study, enrolling native and foreign-born women recruited in 32 Portuguese public hospitals at delivery, 3884 women were classified in groups according to their country of origin and native country language as Portuguese (PT), Portuguese speaking Latin American Countries (BR), Portuguese speaking African countries (PALOP) and other countries (PNSC) Results: The prevalence (%) varies for late antenatal care (p<0.001), from 14.5 (PT) to 29.8 (PALOP); pre-eclampsia/eclampsia (p = 0.031), from 0.8 (BR) to 2.4 (PALOP); instrumental vaginal birth (p<0.001), from 8.6 (PALOP) to 18.1 (PNSC); C-section before labour (p<0.001), from 11.5 (PNSC) to 15.2 (BR); and C-section during labour (p<0.001), from 15.5 (PNSC) to 21.7 (PALOP). No differences were found for twin pregnancy (p = 0.128), gestational diabetes (p = 0.283), placental disorders (p = 0.743), induced labour (p = 0.138), preterm delivery (p = 0.897) or admission to Neonatal Intensive Care Unit (p = 0.918). Conclusions: Health inequalities in care of migrant pregnant women are particularly evident for those born in African countries with Portuguese as the official language. Key messages: In Portugal women coming from different countries converge in regards to indicators of perinatal health. Speaking the language of the host country does not overcome inequalities of care among migrants.
- Exercise in patients admitted for decompensated heart failure - cardiac rehabilitationPublication . Delgado, Bruno; Novo, André; Gomes, BárbaraHeart failure (HF) is characterized by dyspnea, fatigue and edema that leads to decreased exercise tolerance, functional dependence and impairment of performance in activities of daily living (ADL). Exercise is a well stablish intervention, for patients with stable cronic HF, which leads to improvement of symptoms, promotes functional capacity and decrease exercise intolerance. Exercise its not yet tested for patients during the phase of stabilization. Purpose: To evaluate the safety and feasibility of an aerobic exercise training program for patients admitted due to decompensated HF: the ERIC program. Methods: Patients are randomized in training group (TG) or control (CG). Data includes cardiovascular history, HF history and two functional tools: London Chest of Daily Living Activities (LCADL) and Barthel Index (BI). TG patients perform the ERIC program twice a day, 6 days a week. ERIC program is a supervised aerobic exercise program, with increasing levels of intensity, divided into 5 stages: respiratory raining, gait training and climbing stairs, for progressive duration periods. In all sessions are valuated vital signs before and after the exercise, as well as Borg Modified Perceived Exertion scale. CG patients are supervised too and perform freely physical activity. At discharge, all patients perform a 6 minute walking test (6MWT), and evaluation of LCADL scale and BI. Results: Until now, 47 patients are randomized (24 in TG - 275 sessions) with an average age of 71 (11) years old. 31 are male, 80% are in NHYA class III and 20% are class IV. At admission both groups (training vs control) of patients have the same level of functional dependence. At discharge, TG present lower LCADL and Borg score and higher BI score. Those differences are statistically significant (p=0,038 LCADL; p=0,024 Barthel). The average distance on 6MWT by TG is 72 meters higher, which is a statistically significant (p=0,031). No adverse events had occurred, like precordial pain, falls or worsening of clinical state. Conclusions: ERIC program can safely lead patients to a better functional capacity state.
- Firefighters's occupational exposure to PM2.5 and polycyclic aromatic hydrocarbonsPublication . Oliveira, Beatriz; Slezakova, Klara; Pereira, Maria do Carmo; Fernandes, Adília; Vaz, Josiana A.; Delerue-Matos, Cristina; Morais, SimoneThis study collected the personal PM2.5 air fraction in fifteen healthy and no-smoking firefighters during their normal shift inside four Portuguese fire stations. Indoor PM2.5 levels varied between 0.05 to 1.04 µg/m3. Polycyclic Aromatic Hydrocarbons (PAHs) are known for their ubiquity and toxicity, being some of them classified as carcinogenic and possible carcinogens to humans. Firefighters’ personal PM2.5-bound total PAH concentrations ranged between 35.8 to 294 ng/m3 with total carcinogenic PAHs accounting with 12% to the total PAHs. Benzo[a]pyrene, the PAH biomarker of carcinogenicity, was detected in levels ranging from 6.74 × 10-2 to 1.00 ng/m3
- Effect of mode of delivery on early oral colonization and childhood dental caries: a systematic reviewPublication . Antão, Celeste; Teixeira, Cristina; Gomes, Maria JoséBackground: Oral colonization starts at birth by vertical transmission. Objective: To determine whether mode of delivery influences the oral colonization of infants and contributes to the risk of childhood dental caries. Methods: A systematic review was conducted in the electronic database Web of Science for articles published from January 1995 to December 2015 by using a set of keywords. Results: From 2,644 citations identified through electronic search, ten studies met the inclusion criteria. According to the studies mode of delivery influences oral microbial density, oral microbial profile and the timing of oral colonization by cariogenic microbiota. However, there are no consistent results concerning either the prevalence of children harboring cariogenic microbiota or the prevalence of early childhood caries by mode of delivery. Conclusion: Mode of delivery influences early oral colonization. However, it seems that other determinants rather than mode of delivery could be major contributors to the development of early childhood caries. Keywords: Early childhood caries, early oral colonization, acquisition of oral microflora, mode of delivery
- Effect of chaethomellic acid on renal function in rat model of chronic renal failurePublication . Nogueira, António José M.; Mega, Carmén; Fonte, Elizabete; Oliveira, Paula A.; Colaço, Bruno Jorge; López-Novoa, Jose; Colaço, Aura; Pires, Maria JoãoTo study the effect of chronic treatment with chaethomellic acid (CA), a highly specific inhibitor of ras farnesyl-protein transferase, on the renal function of rats with renal failure induced by renal mass reduction. Male Wistar rats were subjected to 5/6 nephrectomy (RMR) or sham-operated (SO). One week after surgery, rats have been placed in four experimental groups: RMR: rats without treat- ment (n=13); RMR+CA: rats treated with CA (n=13); SO: rats without treatment (n=13); SO+AC: rats treated with CA (n=13). CA was intraperitoneally administered in a dose of 0.23 g/Kg three times a week for 6 months. Creatinine, blood urea nitrogen (BUN) and protein were measured in serum and/or urine by routine laboratory techniques. BUN, creatinine, and proteinuria were significantly lower and creatinine clearance was significantly higher in SO and SO+AC groups when compared with RMR and RMR+AC groups. There were no differ- ences in creatinine, proteinuria and creatinine clearance between RMR and RMR+AC groups. Anyway, RMR+AC group showed significant lower BUN and lower creatinine and proteinuria, and higher creatinine clearance than RMR group. In a model of renal failure induced by RMR, 6 months of treatment with CA may have some beneficial effect on renal function.
- Effects of a strength exercise program during hemodialysisPublication . Novo, André; Domingues, Ânia; Preto, Leonel; Sousa, Tânia; Mendes, Eugénia; Baptista, Gorete; Vaz, Josiana A.Introduction and Aims: The present study aims to investigate the effects of an intradialytic program of strength exercises in patients with Chronic Kidney Disease. Individuals who undergo hemodialysis are faced with multiple catabolic processes, including protein and energy level, characterized by loss of muscle mass and decreased visceral proteins. Its pathophysiology becomes so complex, multifactorial and few explanations are encountered. However, it is clear that irregularities in muscle function, exercise performance and physical activity initiated in the early stages of CKD will progressively worsening. Methods: Of the 45 participants, 29 were randomly chosen to join the training group (TG) and 16 control group (CG). The TG conducted a program of strength training during hemodialysis sessions for 8 weeks, 3 times per week, while the CG remained with the usual routine. At the beginning of the program was conducted an assessment period: the Sit-to-Stand Test, the Up-and-Go Test, the Hand Grip Test, the Pinch Gauge© and anthropometric and laboratory tests, culminating in the application of SF-36 version 2. We repeated this evaluation procedure after completion of training protocol. Results: Taking into account the results obtained, the TG significantly increased the number of repetitions of the Sit-to-Stand Test (12,22±5,37 initials; 15,4±3,27 final), and improved runtime Up-and-Go Test (16,74±17,38s initials; 11,33±6,26s end). Regarding the right handgrip, this group improved significantly (18,79±11,32Kg/f initials; 21,92±11,73Kg/f end), not even checking the left side (18,5±11,60Kg/f initials; 18,46±11,63Kg/f final). As for digital right grip strength (5,68±2,14Kg/f initial; 6,04±2,88Kg/f end) and left (5,21±2,53Kg/f initial; 4,88±2,31Kg/f end) there is the same situation as in handgrip strength. After completion of training program, in TG the physical component of the SF-36 (version 2) improved significantly (34,178±10,83 initials; final 41,52±8,14), and the same happened with the mental component (51,43±7,33 initial; 52,74±8,47 final). Conclusions: It's visible an increase in the number of repetitions of the Sit-to-Stand Test in GT, declaring statistically significant changes. Through these results, it can be said that the program was beneficial, improving the ability of participants to perform a higher number of repetitions in comparison with the results obtained by many authors; It's clear that the GT had a reduction in the time of execution of the up and go test, with significant statistical differences. These values indicate an improvement in the physical condition of the patients. These results suggest that a program of strength training intradialytic improves functional capacity and quality of life in this debilitated population.