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1.
JMIR Form Res ; 8: e46151, 2024 May 17.
Article in English | MEDLINE | ID: mdl-38758585

ABSTRACT

BACKGROUND: Digital patient-centered interventions may be important tools for improving and promoting social interaction, health, and well-being among older adults. In this regard, we developed a mobile app called DigiAdherence for an older adult population, which consisted of easy-to-access short videos and messages, to improve health-related knowledge among them and prevent common health conditions, such as falls, polypharmacy, treatment adherence, nutritional problems, and physical inactivity. OBJECTIVE: This study aimed to assess the usability and utility of the DigiAdherence app among Portuguese older adults 65 years or older. METHODS: In this pilot noncontrolled quasi-experimental study, older adults who were patients at the primary health care center in Portimão, Portugal, and owned a smartphone or tablet were recruited. Participants were assessed at baseline, given access to the DigiAdherence app for 1 month, and assessed again immediately after 30 days (first assessment) and 60 days after stopping the use of the app (second assessment). App usability and utility (primary outcomes) were analyzed in the first follow-up assessment using a structured questionnaire with 8 items. In the second follow-up assessment, our focus was on knowledge acquired through the app. Secondary outcomes such as treatment adherence and health-related quality of life were also assessed. RESULTS: The study included 26 older adults. Most participants rated the different functionalities of the app positively and perceived the app as useful, attractive, and user-friendly (median score of 6 on a 7-point Likert scale). In addition, after follow-up, participants reported having a sense of security and greater knowledge in preventing falls (16/24, 67%) and managing therapies and polypharmacy (16/26, 62%). CONCLUSIONS: The DigiAdherence mobile app was useful and highly accepted by older adults, who developed more confidence regarding health-related knowledge. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/29675.

2.
Lancet Reg Health Am ; 30: 100671, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38259252

ABSTRACT

As a developing region, Latin America faces unique cancer control and prevention challenges, which are intensified when considering rare cancers, including sarcomas. Sarcomas are a group of malignancies that arise in the connective tissues of the body-such as muscle, fat, nerves, blood vessels, and bones-accounting for a diverse range of tumours that, although rare, require specialized attention. Sarcoma care and research in Latin America require a comprehensive approach that includes deeper epidemiologic knowledge, diagnostic capacity building, access to innovative treatments, increased patient advocacy, and strengthening of clinical research capacity. This article will review current challenges and opportunities for treating patients with sarcoma in Latin America and outline a pathway toward improvement for regional collaborative groups.

3.
JCO Glob Oncol ; 9: e2300070, 2023 09.
Article in English | MEDLINE | ID: mdl-37856732

ABSTRACT

PURPOSE: Mutations of the KIT gene are the molecular hallmark of most GI stromal tumors (GISTs). Imatinib has revolutionized GIST treatment. Adjuvant imatinib for 3 years is the standard of care for high-risk resected GIST. However, the GIST molecular biologic profile has found different responses to this approach. Despite this, genetic testing at diagnosis is not a routine and empirical adjuvant imatinib remains the rule. Barriers to genetic profiling include concerns about the cost and utility of testing. This analysis aims to determine whether targeted genetic testing reduces costs as an ancillary tool for a limited-resource scenario instead of adjuvant empirical imatinib in patients with resected high-risk GIST. METHODS: The cost evaluation analysis of molecular testing for GIST was based on the Cost of Preventing an Event (COPE), considering the Number Needed to Treat and the costs of each test compared with the cost of 3-year empirical adjuvant imatinib and real treatment costs (median number of cycles) from the public and private Brazilian Healthcare System's perspective. The analysis compared the costs of the molecular tests (broad next-generation sequencing [NGS], GS Infinity DNA/RNA assay, and targeted NGS: GS Focus GIST and the Fleury GIST Tumor DNA sequencing panel), costs of drug acquisition, considering discounts (imatinib mesylate and Glivec), and the costs of supportive care. RESULTS: In both scenarios, public and private, regardless of the use of imatinib or Glivec, tailoring adjuvant treatment reduced costs, irrespective of the number of cycles. The only exception was the combination of the broad NGS test and imatinib in the Public Healthcare System. CONCLUSION: The molecularly tailored adjuvant imatinib reduced costs considering the COPE of available NGS tests for both the public and private Brazilian health care systems.


Subject(s)
Antineoplastic Agents , Gastrointestinal Stromal Tumors , Humans , Imatinib Mesylate/therapeutic use , Gastrointestinal Stromal Tumors/drug therapy , Gastrointestinal Stromal Tumors/genetics , Antineoplastic Agents/therapeutic use , Brazil , Chemotherapy, Adjuvant , Genetic Testing
4.
BMC Public Health ; 23(1): 1564, 2023 08 17.
Article in English | MEDLINE | ID: mdl-37592343

ABSTRACT

INTRODUCTION: The population in Portugal is ageing due to increased life expectancy and reduced fertility rates. We aimed to estimate the health trajectories of Portuguese older adults (60 + years old) in a 10-year period and to assess associated sociodemographic, lifestyle factors and multimorbidity status. METHODS: Using the population-based EpiDoC cohort, we estimated the trajectories of health-related quality of life and physical function of 4135 Portuguese older adults over 10 years using linear mixed models. Factors associated to health-related quality of life and physical function were assessed using linear mixed models and random intercept tobit regression, respectively. RESULTS: The physical disability of participants increased by 0.263 (0.240, 0.286), and health-related quality of life declined by 0.074 (-0.084, -0.063), over 10 years. With advancing age, older adults reported a faster reduction in health-related quality of life and faster increase in physical disability. In general, women were in worse health than men at baseline, albeit with a similar rate of change throughout the follow-up. Higher education and regular exercise were associated with better health-related quality of life and physical function while multimorbidity and excess weight were associated with worse reporting of these outcomes. CONCLUSIONS: These findings, based on longitudinal data with 10 years of follow-up, are essential to effectively plan resource allocation, plan better healthcare and design informed public health policies in Portugal. This study characterizes ageing in Portugal showing increased physical disability and decreased health-related quality of life with advancing age older adults, helping to develop public health policies.


Subject(s)
Aging , Quality of Life , Male , Humans , Female , Aged , Middle Aged , Portugal/epidemiology , Life Expectancy
5.
Insects ; 14(7)2023 Jul 14.
Article in English | MEDLINE | ID: mdl-37504640

ABSTRACT

The effect of flower strips on ecosystem services (ESs) and disservices (EDs) is routinely assessed following changes in service provider densities without measuring the associated levels of ES/EDs. By using the sentinel approach (i.e., exposing a plant, seeds, and prey models in a standardized way), we tested how coriander (Coriandrum sativum) strips planted in mixed orchards on Terceira Island (Azores, Portugal) affected herbivory on lettuce plants, seed predation on wheat and weed seeds, and predation on artificial caterpillars. Vertebrates had more influence than invertebrates on ESs/EDs. Herbivory (ED) after 2 weeks was similar in the coriander and the control plots (mean ± SD; 2.3% ± 3.3% vs. 2.2% ± 2.9%, n = 32 for both). Seed predation was higher in the control than in the coriander plots for both grain (ED; 30.8% ± 38.9% vs. 15.3% ± 10.8%, n = 18 for both) and weed seeds (ES; 2.5% ± 4.1% vs. 0.4% ± 0.5%, n = 18 for both). Vertebrate predation (ES) rates after 48 h were significantly higher in the control (estimate 9%, 95% CI: 4-20%) than in the coriander plots (3%, 1-8%), while no difference was observed for invertebrate predation. Coriander strips did not support increased ES/reduced ED levels in this setting. The tools used can be effective to quantitatively compare multiple ESs/EDs under different farming management strategies.

6.
BMC Public Health ; 23(1): 1407, 2023 07 21.
Article in English | MEDLINE | ID: mdl-37480019

ABSTRACT

OBJECTIVE: To identify long-term trajectories of physical function and health-related quality of life (HRQoL) among people with hip and/or knee osteoarthritis (HKOA) and the sociodemographic, lifestyle, and clinical factors associated with different trajectories. METHODS: Participants with HKOA from the EpiDoC study, a 10-year follow-up (2011-2021) population-based cohort, were considered. Sociodemographic, lifestyle, and clinical variables were collected at baseline in a structured interview and clinical appointment. Physical function and HRQoL were evaluated with the Health Assessment Questionnaire (HAQ) and EuroQoL, respectively, at baseline and the three follow-ups. Group-based trajectory modeling identified physical function and HRQoL trajectories. Multinomial logistic regression analyzed the associations between the covariates of interest and trajectory assignment (p < 0.05). RESULTS: We included 983 participants with HKOA. We identified three trajectories for each outcome: "consistently low disability" (32.0%), "slightly worsening moderate disability" (47.0%), and "consistently high disability" (21.0%) for physical function; "consistently high HRQoL" (18.3%), "consistently moderate HRQoL" (48.4%) and "consistently low HRQoL" (33.4%) for HRQoL. Age ≥ 75 years, female sex, multimorbidity, and high baseline clinical severity were associated with higher risk of assignment to poorer physical function and HRQoL trajectories. Participants with high education level and with regular physical activity had a lower risk of assignment to a poor trajectory. Unmanageable pain levels increased the risk of assignment to the "consistently moderate HRQoL" trajectory. CONCLUSION: Although the trajectories of physical function and HRQoL remained stable over 10 years, approximately 70% of people with HKOA maintained moderate or low physical function and HRQoL over this period. Modifiable risk factors like physical activity, multimorbidity and clinical severity were associated with poorer physical function and HRQoL trajectories. These risk factors may be considered in tailored healthcare interventions.


Subject(s)
Osteoarthritis, Hip , Osteoarthritis, Knee , Female , Humans , Aged , Quality of Life , Osteoarthritis, Knee/epidemiology , Life Style , Osteoarthritis, Hip/epidemiology , Lower Extremity , Iron
7.
Biol Trace Elem Res ; 201(12): 5861-5870, 2023 Dec.
Article in English | MEDLINE | ID: mdl-36943550

ABSTRACT

Cereals and cereal-based foods continue to be basic foods in all diets. Despite being known for their high nutritional value; they can also contain contaminants (hazards) such as toxic metals. This study assesses the Cd, Pb and Hg dietary exposure from cereals and derivatives marketed in Madeira and the Azores and characterizes the risks by evaluating the Cd and Hg intake contributions to the tolerable intakes and by estimating the Margin of Exposure (MOE) in the case of Pb. In Madeira, metals follow the descending order of Cd > Pb > Hg. Cd stands out as having the highest levels (0.307 mg Cd/kg in oats; 0.237 mg/kg in rye). High levels of Pb (0.347 mg/kg) were also detected in rye. Regarding total mercury, rice stands out (0.0013 mg/kg) followed by wheat (0.001 mg/kg). While all cereals and derivatives except maize consumed in Madeira exceed the maximum value of Cd allowed by the EU, 50.0% of the rye and 25.0% of the corn flour samples exceeded the European Pb limit. The daily consumption of 100 g of oats, rye flour and rye represent high contributions to the TWI of Cd (93.2 - 120%). The MOE values of Pb from the consumption of rye (100 g/day) are 1,294 (nephrotoxic effects) and 3,082 (cardiotoxic effects). In the Azores, corn flour (0.72 mg Pb/kg) stands out with 85.7% of the samples exceeding the maximum Pb EU limit and MOE values of 626 (nephrotoxic effects) and 1,490 (cardiotoxic effects). Regular daily consumption of corn flour makes a low (< 10%) contribution to the Cd TDI. In conclusion, the Pb exposure from the consumption of cereals and derivatives could have toxic effects such as nephrotoxicity or cardiotoxicity in adults. The results highlight the need to set up monitoring and surveillance programs for the safety of cereals and their derivatives in Madeira and the Azores in terms of lead and cadmium.


Subject(s)
Mercury , Metals, Heavy , Cadmium/toxicity , Cadmium/analysis , Dietary Exposure , Edible Grain/chemistry , Lead/toxicity , Azores , Food Contamination/analysis , Mercury/toxicity , Mercury/analysis , Metals, Heavy/analysis
8.
Toxics ; 11(3)2023 Feb 28.
Article in English | MEDLINE | ID: mdl-36976997

ABSTRACT

Silica aerogels are a class of materials that can be tailored in terms of their final properties and surface chemistry. They can be synthesized with specific features to be used as adsorbents, resulting in improved performance for wastewater pollutants' removal. The purpose of this research was to investigate the effect of amino functionalization and the addition of carbon nanostructures to silica aerogels made from methyltrimethoxysilane (MTMS) on their removal capacities for various contaminants in aqueous solutions. The MTMS-based aerogels successfully removed various organic compounds and drugs, achieving adsorption capacities of 170 mg⋅g-1 for toluene and 200 mg⋅g-1 for xylene. For initial concentrations up to 50 mg⋅L-1, removals greater than 71% were obtained for amoxicillin, and superior to 96% for naproxen. The addition of a co-precursor containing amine groups and/or carbon nanomaterials was proven to be a valuable tool in the development of new adsorbents by altering the aerogels' properties and enhancing their adsorption capacities. Therefore, this work demonstrates the potential of these materials as an alternative to industrial sorbents due to their high and fast removal efficiency, less than 60 min for the organic compounds, towards different types of pollutants.

10.
BMC Musculoskelet Disord ; 24(1): 60, 2023 Jan 23.
Article in English | MEDLINE | ID: mdl-36683031

ABSTRACT

BACKGROUND: Pain due to knee and / or hip osteoarthritis (HKOA) is the most common symptom for seeking healthcare. Pain interferes on daily activities, social and occupational participation in people with HKOA. The goal of this study is to estimate the prevalence of unmanageable pain levels (UPL) among people with HKOA), characterize this population and identify factors associated with UPL, and compare therapeutic strategies used by people with UPL versus manageable pain levels (MPL). METHODS: We analysed data from the EpiReumaPt study (n = 10,661), that included a representative sample of the Portuguese population. Among these, 1081 participants had a validated diagnosis of HKOA by a rheumatologist.. Sociodemographic, lifestyle and health-related data were collected in a structured interview. Pain intensity (NPRS) data were collected in a medical appointment. Painmedication (last month), physiotherapy and surgery were considered as therapies for pain management. UPL was defined as a mean pain intensity in the previous week of ≥5 points on 11-point numeric pain rating scale. The factors associated with UPL were analyzed with logistic regression (p < 0.05, 95%CI). The effect of unmanageable pain levels was assessed by the HOOS/KOOS activities of daily living and quality of life subscales. Symptoms of anxiety and depression were assessed by the Hospital Anxiety and Depression Scale (HADS). Analysis was completed with linear and logistic regression. All analysis were weighted. RESULTS: The estimated prevalence of UPL among people with HKOA was 68.8%. UPL was associated with being female (odds ratio (OR) = 2.36, p < 0.001), being overweight (OR = 1.84, p = 0.035) or obese (OR = 2.26, p = 0.006), and having multimorbidity (OR = 2.08, p = 0.002). People with UPL reported worse performance in activities of daily living and lower quality of life (ß = - 21.28, p < 0.001 and ß = - 21.19, p < 0.001, respectively) than people with MPL. People with UPL consumed more NSAIDs (22.0%, p = 0.003), opioids (4.8%, p = 0.008), paracetamol (2.7%, p = 0.033), and overall analgesics (7.3%, p = 0.013) than people with MPL. A higher proportion of people with UPL underwent physiotherapy (17.5%, p = 0.002) than people with MPL. CONCLUSION: Two-thirds of people with HKOA in Portugal have poor management of their pain levels. Clinical and lifestyle factors, that are highly presented in individuals with HKOA, are associated with unmanageable pain. Our results highlighting the need for further research and implementation of effective interventions to improve pain, function and quality of life in people with HKOA.


Subject(s)
Osteoarthritis, Hip , Osteoarthritis, Knee , Humans , Female , Male , Osteoarthritis, Hip/diagnosis , Osteoarthritis, Hip/epidemiology , Osteoarthritis, Hip/complications , Osteoarthritis, Knee/diagnosis , Osteoarthritis, Knee/epidemiology , Osteoarthritis, Knee/complications , Activities of Daily Living , Quality of Life , Cross-Sectional Studies , Prevalence , Pain/diagnosis , Pain/epidemiology
11.
Arthritis Res Ther ; 25(1): 14, 2023 01 26.
Article in English | MEDLINE | ID: mdl-36703210

ABSTRACT

Hip and knee osteoarthritis (HKOA) is a chronic disease characterized by joint pain that leads to reduced physical function and health-related quality of life (HRQoL). At present, no cure is available. Clinical trials indicate that people with HKOA benefit from physical activity in several health-related outcomes. However, few studies have evaluated the long-term positive effect of regular physical activity. This study analyzed participants with HKOA from a nationwide population-based cohort (EpiDoC Cohort) to assess the impact of physical activity on patients' physical function and HRQoL over a long-term follow-up. The regular weekly frequency of intentional physical activity was self-reported as non-frequent (0 times/week), frequent (1-2 times/week), or very frequent (≥ 3 times/week). This study followed 1086 participants over a mean period of 4.7 ± 3.4 years, during which 6.3% and 14.9% of participants reported frequent and very frequent physical activity, respectively. Using linear mixed models, we found that frequent (ß = - 0.101 [- 0.187, - 0.016]; ß = 0.039 [- 0.002, 0.080]) and very frequent physical activity (ß = - 0.061 [- 0.118, - 0.004]; ß = 0.057 [0.029, 0.084]) were associated with improved physical function and HRQoL over time, respectively, when compared with non-frequent exercise, adjusting for years to baseline, sex, age, years of education, body mass index, multimorbidity, hospitalizations, clinical severity, and unmanageable pain levels. These findings raise awareness of the importance of maintaining exercise/physical activity long term to optimize HRQoL and physical function. Further studies must address barriers and facilitators to improve the adoption of regular physical activity among citizens with HKOA.


Subject(s)
Osteoarthritis, Hip , Osteoarthritis, Knee , Humans , Osteoarthritis, Knee/epidemiology , Osteoarthritis, Hip/therapy , Quality of Life , Exercise Therapy , Exercise
13.
Biodivers Data J ; 11: e100942, 2023.
Article in English | MEDLINE | ID: mdl-38327366

ABSTRACT

Background: The data we present are part of the CUARENTAGRI project, which involves all archipelagos of the Macaronesia (Azores, Madeira, Canary Islands and Cabo Verde). The project aims to: i) identify and evaluate the risks associated with the introduction of new arthropod pests; ii) study the population dynamics of selected arthropod pest species currently responsible for the damage of key target crops and iii) develop monitoring systems, based on prediction and/or population dynamics of the crop pests, creating warnings and a phytosanitary prevention system. In this contribution, we compile data for three Azorean Islands (Terceira, São Jorge and São Miguel Islands), where pheromone-baited traps were placed in pastures, potato fields and several orchards' types (apples, banana, chestnuts, olives, orange and strawberry), during three consecutive years (2020, 2021 and 2022). New information: A total of 114,827 specimens of insects (Arthropoda, Insecta) were collected, belonging to four orders, six families and ten recorded pest species. A total of eight species are considered introduced (Cosmopolitessordidus (Germar, 1824), Drosophilasuzukii (Matsumura, 1931), Bactroceraoleae (Rossi, 1790), Ceratitiscapitata (Wiedemann, 1824), Phthorimaeaoperculella (Zeller, 1873), Cydiapomonella (Linnaeus, 1758), Cydiasplendana (Hübner, 1799) and Grapholitamolesta (Busck, 1916); n = 84,986 specimens) and two native non-endemic (Mythimnaunipuncta (Haworth, 1809) and Spodopteralittoralis (Boisduval, 1833); n = 17,465 specimens). This study intended to contribute to a better knowledge of the arthropods pests that can affect the Azorean crops and will serve as a baseline for future monitoring actions, pest risk assessments and prevention systems.

15.
Crit Rev Oncol Hematol ; 174: 103685, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35460913

ABSTRACT

Bone sarcoma are infrequent diseases, representing < 0.2% of all adult neoplasms. A multidisciplinary management within reference centers for sarcoma, with discussion of the diagnostic and therapeutic strategies within an expert multidisciplinary tumour board, is essential for these patients, given its heterogeneity and low frequency. This approach leads to an improvement in patient's outcome, as demonstrated in several studies. The Sarcoma European Latin-American Network (SELNET), aims to improve clinical outcome in sarcoma care, with a special focus in Latin-American countries. These Clinical Practice Guidelines (CPG) have been developed and agreed by a multidisciplinary expert group (including medical and radiation oncologist, surgical oncologist, orthopaedic surgeons, radiologist, pathologist, molecular biologist and representatives of patients advocacy groups) of the SELNET consortium, and are conceived to provide the standard approach to diagnosis, treatment and follow-up of bone sarcoma patients in the Latin-American context.


Subject(s)
Bone Neoplasms , Osteosarcoma , Sarcoma , Soft Tissue Neoplasms , Adult , Bone Neoplasms/diagnosis , Bone Neoplasms/pathology , Bone Neoplasms/therapy , Humans , Osteosarcoma/diagnosis , Osteosarcoma/pathology , Osteosarcoma/therapy , Practice Guidelines as Topic , Sarcoma/diagnosis , Sarcoma/pathology , Sarcoma/therapy , Soft Tissue Neoplasms/pathology
17.
Biodivers Data J ; 9: e77548, 2021.
Article in English | MEDLINE | ID: mdl-34924799

ABSTRACT

BACKGROUND: The data we present are part of the AGRO-ECOSERVICES project (Assessing ecosystem services and disservices provided by arthropod species in Azorean agroecosystems). The project aims to evaluate the relative importance of native and non-native organisms as ecosystem services (ES) and disservices (ED) providers, by combining novel, direct and quantitative tools for monitoring agro-biodiversity. Ecosystem services include evaluation of natural pest control by predation, seed predation on weed plants, pollination, decomposition and ecosystem disservices, herbivory and seed predation on crop plants. Active Aerial Searching (AAS) (only in maize-fields) and pitfall traps were used to sample the arthropod biodiversity (predatory spiders, true-bugs and beetles and main insect pests) on four agricultural habitats of Terceira Island, namely citrus orchards, low and high elevation maize fields and vineyards. NEW INFORMATION: We provided an inventory of all arthropods recorded in four Azorean agroecosystems (citrus orchards, low and high elevation maize fields and vineyards) from Terceira Island. A total of 50412 specimens were collected, belonging to four classes, 20 orders, 81 families and 200 identified species of arthropods. A total of 127 species are considered introduced (n = 22646) and 69 native non-endemic (n = 24117). Four endemic species were recorded with very few specimens (n = 14) and 3635 specimens belong to unidentified taxa recorded only at genus or family level. Five species are new records for Terceira Island, with Lagriahirta (Linnaeus, 1758) (Coleoptera, Tenebrionidae) being also a new record for the Azores. This publication contributes to a better knowledge of the arthropods communities present in agro-ecosystems of Terceira Island and will serve as a baseline for future monitoring schemes targeting the long-term change in arthropod diversity and abundance.

18.
Bone Rep ; 15: 101139, 2021 Dec.
Article in English | MEDLINE | ID: mdl-34754887

ABSTRACT

INTRODUCTION: Multimorbidity is a worldwide health problem, especially in elderly patients who have a higher risk of fragility fracture. Currently, there is insufficient knowledge about the burden of multimorbidity in patients with previous fragility fracture. The aim of this study was to evaluate the association between multimorbidity and previous fragility fracture, and to assess the effect of fragility fracture and/or multimorbidity in the perception of quality-of-life and physical function, in women 50 years of age and older. METHODS: Women aged ≥50 years from the EpiReumaPt study (2011-2013), a nationwide population-based study, were evaluated. Self-reported data regarding sociodemographics, health-related quality of life, physical functioning, fragility fracture, and multimorbidity were collected using a semi-structured questionnaire. Multimorbidity was defined as 2 or more chronic non-communicable diseases. Descriptive exploratory analysis of the data was performed using hypothesis testing. Multiple logistic regression modelling was used to assess the association between multimorbidity and fragility fractures, and linear regression was used for the quality-of-life and physical function outcomes. RESULTS: The estimated prevalence of fragility fracture in women older than 50 years was 17.5%. A higher prevalence of multimorbidity (74.6%) was found in the group of women with previous fragility fracture than in those without previous fragility fracture. Multivariate logistic regression analysis revealed that women with multimorbidity had a higher odds of fragility fracture (adjusted odds ratio, 1.38; 95% confidence interval, 1.12-1.69), compared with women with 1 or no self-reported non-communicable chronic diseases. In women with previous fragility fracture, rheumatic diseases (62.7%) and hypertension (58.6%) were the most frequently self-reported non-communicable chronic diseases. The combination of fragility fracture and multimorbidity was associated with a lower quality of life and higher degree of disability. CONCLUSIONS: Women 50 years and older with multimorbidity had a significantly increased odds of fragility fracture. Fragility fracture combined with multimorbidity was negatively associated with quality of life and positively associated with disability. This study emphasizes the need to redesign health services to care for patients to prevent non-communicable chronic diseases and fragility fracture, particularly in women 50 years and older, in whom these diseases are likely to potentiate the risk of fragility fracture.

19.
BMC Pregnancy Childbirth ; 21(1): 632, 2021 Sep 17.
Article in English | MEDLINE | ID: mdl-34535094

ABSTRACT

BACKGROUND: Immunological protection via breastfeeding is well known. The immunological profile of human milk changes during lactation. No clinical trials have been conducted in lactating women with the newest mRNA vaccines against SARS- CoV-2. A Few studies have shown the presence of antibodies in breastmilk after vaccination. The aim of this work is to study possible antibodies transfer via breastmilk and also the immunological characteristics of lactating women compared to non-lactating women, after using the BNT162b2 Pfizer vaccine. METHODS: This is a prospective cohort study with a convenience homogenous sample of 24 healthcare workers (14 lactating and 10 non-lactating women) enrolled at the time of COVID-19 vaccination. Clinical data was registered in a questionnaire. Titers of SARS-CoV-2 spike IgG, IgA and IgM were quantified in post vaccination blood and human milk. Antibody quantification was performed by an in-house ELISA to SARS-CoV-2 trimeric spike protein. RESULTS: All women showed immunity after vaccination with positive antibodies for IgM, IgA and IgG antibodies. The dominant serum antibody response was IgG. Modest levels of antibodies in breastmilk of lactating mothers were observed in this study, especially IgG in 42.9%. There was a moderate association between higher titers of IgG and a longer duration of breastfeeding (R= 0.55, p=0.041). CONCLUSIONS: Evidence of antibody transfer in human milk after COVID-19 vaccination is scarce. The presence of antibodies in human milk is reported, but immunization through breastfeeding is still to be established.


Subject(s)
Antibodies, Viral/metabolism , Breast Feeding , COVID-19 Vaccines/immunology , COVID-19/prevention & control , Lactation/immunology , Milk, Human/immunology , SARS-CoV-2/immunology , Adult , BNT162 Vaccine , Biomarkers/metabolism , COVID-19/immunology , Case-Control Studies , Enzyme-Linked Immunosorbent Assay , Female , Humans , Immunization, Passive , Prospective Studies
20.
Front Public Health ; 9: 689919, 2021.
Article in English | MEDLINE | ID: mdl-34222187

ABSTRACT

Background: In response to rapid global spread of the newly emerged coronavirus disease 2019 (COVID-19), universities transitioned to online learning and telework to decrease risks of inter-person contact. To help administrators respond to the COVID-19 pandemic and better understand its impacts, we surveyed SARS-CoV-2 seroprevalence among NOVA University employees and assessed community mental health. Methods: Data were collected from voluntary participants at six NOVA University locations, in the Lisbon metropolitan area, from June 15-30, 2020. All subjects provided written informed consent. Of 1,627 recruited participants (mean age 42.0 ± 12.3 years), 1,624 were tested. Prior to blood collection, participants completed a questionnaire that assessed: COVID-19 symptoms during the previous 14 days, chronic non-communicable diseases, chronic medication, anxiety, and depression symptoms. SARS-CoV-2 serology tests were then performed, and results communicated approximately 4 days after blood draw. Participants with positive serology tests were contacted to assess COVID-19 symptoms since February. Results: Estimated prevalence of SARS-CoV-2 IgG antibodies was 3.1% (n = 50), of which 43.5% reported symptoms in the previous 4 months. The Medical School had the highest seroprevalence (6.2%). Participants reported having at least one chronic disease (63.7%), depression-like symptoms (2.1%), and anxiety symptoms (8.1%). Rates of depression and anxiety symptoms were significantly higher in women, with sleep hours and occasional alcohol consumption negatively associated with depression. Male gender, older age, and sleep hours negatively associated with anxiety symptoms. School of employment and presence of comorbidities positively associated with anxiety. Conclusion: By measuring seroprevalence of SARS-CoV-2 antibodies among NOVA employees and assessing subjects' mental health, we aim to help administrators at European public universities in urban areas, such as Lisbon, Portugal, better understand the needs of their communities. This study resulted in implementation of a stricter contingency plan in the Medical School, while other schools continued to follow Government mitigation guidelines. These findings may also guide the development of tailored strategies to ensure physical and mental health of the academic community during this pandemic crisis. We conclude that, together with COVID-19 contingency plans, psychological support services and facilities to help people effectively face pandemic-associated challenges and minimise anxiety and depression should be implemented.


Subject(s)
COVID-19 , Pandemics , Adult , Aged , Female , Humans , Male , Mental Health , Middle Aged , Portugal , SARS-CoV-2 , Seroepidemiologic Studies , Universities
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