ESALD - Artigos em revistas com arbitragem científica
URI permanente para esta coleção:
Navegar
Entradas recentes
- Early cardiovascular risk indicators in school-aged children from inland Portugal: Elevated blood pressure at screening and the coexistence of underweight and excess weightPublication . Coelho, Patricia; Figueiredo, Ana; Mateus, Sónia; Furtado, Guilherme Eustáquio; Rodrigues, FranciscoBackground: Cardiovascular risk factors may emerge early in life and track into adulthood. Local data from inland and socioeconomically vulnerable regions remain limited. This study aimed to describe cardiovascular risk indicators in school-aged children from inland Portugal, focusing on body mass index (BMI), blood pressure (BP), and physical activity patterns. Methods: A cross-sectional school-based screening study was conducted in 101 children and adolescents aged 10–15 years. Anthropometric measurements and BP were obtained using standardized procedures. BMI categories were classified according to age- and sex-specific WHO references. BP was classified using European pediatric percentiles. Because measurements were obtained during a single visit, results were interpreted as elevated BP at screening. Associations between variables were explored using chi-square or Fisher’s exact tests and Spearman’s correlation. Results: The prevalence of underweight, normal weight, and overweight/obesity was 25.7%, 67.3%, and 6.9%, respectively. Overall, 24.8% of participants presented elevated BP at screening. The BMI category was significantly associated with BP classification (p = 0.003), and BMI correlated positively with systolic BP (ρ = 0.32; p = 0.001). Most children reported only school-based physical education. Conclusions: This school-based screening suggests a high proportion of elevated BP measurements and an unexpectedly high prevalence of underweight children, indicating the coexistence of different nutritional vulnerabilities. Findings should be interpreted cautiously due to the small, single-school sample and single-occasion BP assessment but support the importance of early cardiovascular risk monitoring in vulnerable settings.
- Prevalence, determinants, and temporal dynamics of multidrug-resistant Gram-negative bacilli in urinary tract infection patients from Central Portugal (2018–2022)Publication . Adnan, Muhammad; Coelho, Patricia; Castelo-Branco, Miguel; Rodrigues, FranciscoBackground: Multidrug-resistant (MDR) Gram-negative bacilli (GNBs) significantly compromisse the effective management of urinary tract infections (UTIs) worldwide. As antimicrobial resistance varies across regions, locally tailored data are essential to guide empirical therapy. This study investigated the prevalence, determinants, and temporal dynamics of MDR GNBs in UTI patients from Central Portugal between 2018 and 2022. Methods:We conducted a retrospective observational study at a hospital center in Central Portugal, analyzing data from 2018 to 2022. Data from 5194 UTI patients with GNB-positive cultures were analyzed. Binary logistic regression was used to identify determinants of MDR GNBs, defined as resistance to ≥1 agent in ≥3 antibiotic classes. Results: The study population had a mean age of 64.5 ± 25.3 years, and females represented two-thirds of the sample (67.0%). The overall prevalence of MDR GNBs was 35.8%. Advanced age (≥75 years), male sex, and specific treatment contexts—particularly day treatment and laboratory-only cases—were independently associated with MDR. SBL-producing Enterobacterales and non-fermenting GNBs showed the highest risk levels. Conclusions: MDR GNBs are highly prevalent among UTI patients in Central Portugal, and their increasing trend—particularly in 2022—highlights an urgent need for strengthened surveillance and updated empirical treatment strategies. The observed temporal increase highlights the urgent need for strengthened regional surveillance and updated empirical treatment guidelines.
- The influence of structured physical activity on vaccination response from adults to older individuals: a systematic review on the Immunoinflammatory crosstalk of COVID-19Publication . Ferreira, Bruna Maria Palotino; Rocha, Saulo Vasconcelos; Silva, Albená Nunes; Gomes, Antonio Felipe Souza; Rodrigues, Francisco; Coelho, Patricia; Bachi, André Luís Lacerda; Oliveira, Rodrigo Assunção de; Barros, Marcelo Paes de; Furtado, Guilherme EustáquioBackground: Amidst the ongoing COVID-19 pandemic, understanding factors that influence vaccine efficacy is crucial, particularly in older adults. Regular physical exercise and/or structured physical activity (SPA) has emerged as a potential modulator of immune responses, enhancing vaccine effectiveness. This systematic review aims to consolidate current evidence on the impact of SPA/exercise on both immune and inflammatory responses to COVID-19 vaccination in adults and older individuals. Methods: Most relevant studies were extracted from indexed databases using health subject terms in English, Portuguese, and Spanish. Studies that examined the impact of regular exercise or SPA on inflammatory and/or immunological responses in relation to COVID-19 immunization were selected. In particular, all chosen studies included individuals who received vaccinations either prior to or following the exercise regimen or SPA, and the main goal was to evaluate these effects on immunological and/or inflammatory reactions induced by vaccination. Results: Among the 7 studies included (n = 1149), the effects of regular exercise or PA on vaccine-induced imune responses while concurrently assessing inflammatory markers were examined. The findings suggest that moderate to high-intensity structured physical activity (50–70% of maximum heart rate for aerobic exercise and 60–80% of 1RM for resistance training), performed 3–5 times per week, was able to enhance immune responses to COVID-19 vaccination, particularly by mitigating chronic low-grade inflammation. Acute exercise can transiently boost immunity, whilst engagement in moderate SPA over a period of six months may contribute to sustained improvements in imune function, especially in older adults. However, these findings should be interpreted with caution due to variability in study design, sample characteristics, and potential confounding factors. Conclusion: Regular exercise and SPA play a significant role in improving immune/inflammatory responses to COVID-19 vaccination. Older adults, in particular, may benefit from regular SPA and exercise as a strategy to counteract immunosenescence and optimize vaccine efficacy. However, further research is needed to better refine exerciseprotocols and determine long-term benefits in different populations.
- Community surveillance of MRSA and Staphylococcus aureus in rural Portugal: The BI-STAPH Project—Phase 1: SertãPublication . Cordero, Ainhoa; Ferreira, Francisco; Coelho, Patricia; Belo, João; Metello, João; Santos, Carina; Mateus, Sónia; Miguel Castelo-Branco; Rodrigues, FranciscoIntroduction: Colonization by Staphylococcus aureus—including methicillin-resistant strains (MRSA)—represents a growing public health concern, particularly in community and rural settings. In Portugal, limited data are available regarding its prevalence in populations with agricultural or animal-related exposures. Objectives: To determine the prevalence of S. aureus and MRSA nasal colonization among adults residing in the municipality of Sertã, Portugal, and to explore potential sociodemographic and behavioral factors associated with colonization. Methods: A cross-sectional study was conducted with 292 adult participants from multiple parishes of Sertã. Nasal swabs were collected for microbiological identification of S. aureus and MRSA. Data on sociodemographic characteristics, occupational exposure, animal contact, and recent antibiotic use were collected via structured questionnaires. Descriptive statistics and inferential analyses (chi-square and Fisher’s exact tests) were performed, and odds ratios were estimated. Results: The overall prevalence of S. aureus colonization was 19.9% (58/292), with MRSA detected in 4.8% (14/292) of participants, representing 24.1% of all S. aureus carriers. Colonization by S. aureus was slightly more frequent among females (51.7%) and predominantly observed in individuals aged 35–59 years. MRSA was more frequent in participants aged ≥ 60 years and was equally distributed between sexes. 57% of MRSA cases reported recent antibiotic use and all MRSA cases reported daily contact with animals—primarily domestic species. No statistically significant associations were identified between colonization and the analyzed variables, although trends suggested increased risk among individuals with animal contact and moderate to high-risk occupations. Conclusions: This study revealed a notable prevalence of S. aureus and MRSA colonization in a rural Portuguese population. Although no statistically significant associations were found, with animal contact, occupational exposure, and recent antibiotic use emerged as relevant epidemiological factors. These findings highlight the need for strengthened surveillance and further investigation into zoonotic transmission and occupational risk in rural environments.
- The effects of terrestrial and aquatic activities on foot health: A comparative analysis of podiatric disordersPublication . Pérez Pico, Ana María; Villar Rodríguez, Julia; Belo, João; Cáceres-Madrid, María Victoria; Fontán-Jiménez, Marina; Mayordomo, RaquelBackground/Objectives: This study explores the prevalence of podiatric disorders in relation to factors such as gender, age, and the type of sports activity. Understanding these elements is crucial for implementing effective prevention strategies. Methods: The sample consisted of 70 participants, aged 12 to 30, with 71.4% youths and 28.6% adults, including 50 Portuguese and 20 Spanish individuals, who practiced either terrestrial or aquatic sports at varying training intensities. Statistical analyses were performed on data collected from athletes using chi-square tests and proportion tests. Variables such as exercise intensity and sport type (terrestrial vs. aquatic) were examined. Results: Skin disorders were more frequent in men (70.2%) compared to women (29.8%). Regarding age, 70% of individuals aged 19 to 30 years presented dermatoses, compared to 36% in the 12 to 18-year-old group. Exercise intensity also had an impact: 53.8% of athletes engaging in moderate activity exhibited keratoses, compared to 30.8% of those practicing intense activity. Additionally, athletes in terrestrial sports showed an average of 5.2 podiatric disorders, significantly higher than the 3.2 average in aquatic sports. Specifically, terrestrial athletes have a higher prevalence of pinch callus (84.6%) and hyperkeratosis on metatarsal heads (85.7%), while aquatic athletes have more onychomycosis (91.7%) and less hyperkeratosis. A higher prevalence of rotated toes (61.4%) and subungual hematoma (90.9%) was also observed in terrestrial athletes. Conclusions: The prevalence of podiatric disorders is significantly related to gender, age, and the type of physical activity. Men and Young adults are more prone to dermatoses, while athletes engaging in moderate intensity activity and those athletes in terrestrial sport face a higher risk of podiatric issues. These findings highlight the need for prevention and treatment strategies in relation to the specific characteristics of each group.
- Short-term high-intensity resistance training: A feasibility study on pulmonary, immune and physical-functional fitness benefits for older adults with metabolic syndromePublication . Santos, Juliana de Melo Batista dos; Furtado, Guilherme Eustáquio; Correa, Eviton Sousa; Rangel, Maysa Alves Rodrigues Brandao; Junior, Manoel Carneiro Oliveira; Cardoso, Katielle Rodrigues da Silva; Souza, Mariana Alvarez de; Rodrigues, Francisco; Coelho, Patricia; Oliveira, Luís Vicente Franco de; Bachi, André Luís Lacerda; Jorge, Luciana Malosa Sampaio; Martins, Patrícia Sardinha Leonardo Lopes; Albertini, Regiane; Vieira, Rodolfo P.The incidence of metabolic syndrome (MetS) is rising rapidly, particularly among older adults, and is associated with comorbidities that impair respiratory and immune functions. Physical exercise has proven effective in mitigating the adverse effects of both aging and MetS. However, evidence on the impact of high-intensity resistance training (HIRT) on the respiratory and immune systems in older adults with MetS remains limited. This study aimed to evaluate the effects of HIRT on respiratory function, skeletal muscle strength, and immune modulation in older adults with MetS, highlighting its potential as a complementary therapeutic approach. A total of 43 older adults with MetS were enrolled and divided into two groups: a HIRT intervention group (n = 23; mean age 66.71 ± 4.98 years) and a non-exercising control group (n = 20; mean age 66.91 ± 5.26 years). The HIRT protocol involved twice-weekly sessions (10 total) over 5 weeks, performed at 80–90% of one-repetition maximum. Results showed that HIRT significantly improved lung mechanics (R5Hz, R20Hz, Z5Hz, X5Hz), peripheral muscle strength, and both maximal expiratory and inspiratory pressures. Furthermore, HIRT increased antiinflammatory and anti-fibrotic cytokines in sputum (klotho, IL-10, adiponectin) and serum (klotho, relaxin-1, relaxin-3, IL-10), while reducing pro-inflammatory cytokines in sputum (IL-6, TNF-α) and serum (IL-1ra, IL-6, TNF-α, leptin). A decrease in total leukocyte, neutrophil, lymphocyte, and monocyte counts was also observed. In conclusion, HIRT effectively mitigates the effects of MetS on respiratory, muscular, and immune functions in older adults and may be recommended as a complementary strategy for managing MetS in this population.
- Rising threats and evolving trends: Five years of urinary tract infection prevalence in a Portuguese hospitalPublication . Rodrigues, Francisco; Patricia Coelho; Mateus, Sónia; Castelo BrancoMiguelBackground/Objective: Urinary tract infections (UTIs) are a significant public health concern worldwide, yet longitudinal data from Portuguese hospital settings remain limited. This study aimed to characterize epidemiological trends, microbial etiology, antimicrobial resistance patterns, and associated risk factors of UTIs over a five-year period (2018–2022) in a central Portuguese hospital. Methods: In this retrospective observational study, 23,682 positive urine cultures were analyzed from specimens collected between anuary 2018 and December 2022. Data were extracted from the laboratory information system and included patient demographics, clinical service of origin, isolated microorganisms, resistance profiles, and annual antibiotic consumption (Defined Daily Dose (DDD) per 1000 patient-days). UTI prevalence was calculated as the proportion of positive cultures among all urine samples processed annually. Results: The positivity rate increased from 18.7% in 2018 to 22.7% in 2022, with a peak in 2019. Women represented around 70% of cases throughout the study period. Most infections originated from inpatient wards, followed by emergency services. Escherichia coli remained the leading pathogen (≈62%), followed by Klebsiella pneumoniae (≈14%) and Enterococcus faecalis (≈8%). Risk factors included catheterization (37.2%), prior UTI history (22.1%), and diabetes mellitus (18.5%). Longer hospital stays (>7 days) were associated with increased positivity. For E. coli, resistance ranged from 2% (amikacin) to 41% (ampicillin), with increasing resistance to ertapenem and fosfomycin and decreasing resistance to several key antibiotics. K. pneumoniae showed 4–36% resistance across antimicrobials, with notable increases for fosfomycin, meropenem, and cefuroxime axetil. Antibiotic usage trends reflected these patterns, with declining use of amikacin and rising use of cefuroxime axetil and meropenem. Conclusions: Over the five-year period, both UTI prevalence and resistance to critical antimicrobials increased, reinforcing the need to update empirical treatment guidelines. Identified risk factors may inform targeted prevention strategies. Ongoing surveillance and antimicrobial stewardship are crucial to mitigate the rising burden of UTIs and resistance
- Epidemiological profile and antibiotic resistance in urinary tract infections among elderly womenPublication . Rodrigues, Francisco; Patricia Coelho; Mateus, Sónia; Metello, João; Castelo-Branco, MiguelUrinary tract infections (UTIs) are among the most prevalent infectious diseases in older women, especially those over 65 years of age. Physiological changes related to aging, comorbidities, and frequent use of medical devices such as urinary catheters increase susceptibility. Increasing antimicrobial resistance further complicates treatment strategies. This study aims to describe the epidemiological profile of UTI in women over 65 years of age, focusing on the characterization of etiological agents, observed antimicrobial resistance patterns, and commonly reported risk factors. We conducted a retrospective analysis of microbiological and clinical data from elderly women diagnosed with UTIs. Bacterial isolates were identified and antimicrobial susceptibility profiles were evaluated over a specified period. A statistical analysis was performed to determine the prevalence of different pathogens and antibiotic resistance trends. Escherichia coli was the predominant uropathogen, consistent across different clinical scenarios and patient conditions. The four most common bacterial strains—E. coli, Klebsiella pneumoniae, Proteus mirabilis, and Enterococcus faecalis—aligned with global epidemiological data. In Escherichia coli a significant increase in resistance to nitrofurantoin was observed, possibly indicating excessive empirical use, while resistance to other antibiotics, such as amoxicillin/clavulanic acid and ertapenem, remained stable or decreased. Institutional antibiotic stewardship programs likely contributed to this trend. The study highlights E. coli as the main etiological agent in elderly women with UTIs. The observed resistance patterns emphasize the need for localized antimicrobial surveillance and personalized therapeutic approaches. Continuous microbiological monitoring and rational use of antibiotics are crucial to optimize treatment outcomes and control the development of resistance.
- Rising trends of urinary infections among pregnant women: Insights from a Portuguese hospital (2018–2022)Publication . Rodrigues, Francisco; Patricia Coelho; Mateus, Sónia; Eideh, Hatem; Gonçalves, Teresa; Caseiro, Armando; Castelo Branco, MiguelThis study explores the prevalence and antibiotic resistance of urinary tract infections (UTIs) in pregnant women in central Portugal. A retrospective observational study was conducted on 201 positive urine cultures from pregnant women at a hospital center between January 2018 and December 2022. The data collected included age, hospital admission source, history of antibiotic therapy, catheterization status, identity of bacterial isolates, and their antibiotic profile. The most common bacterial strains were Escherichia coli (52.4%) and Streptococcus agalactiae (16.9%). In terms of antibiotic resistance, Escherichia coli demonstrated complete sensitivity to ertapenem, while Streptococcus agalactiae showed sensitivity to four antibiotics, including trimethoprim/sulfamethoxazole. Notably, most infections occurred in the third trimester, underscoring the need for continuous monitoring throughout pregnancy. This study emphasizes the importance of tailored treatment strategies to manage UTIs in pregnancy effectively, reducing the potential maternal and fetal complications. These findings contribute to regional data on UTI management in pregnant populations and aim to support improved healthcare practices. These regional data provide a solid foundation for optimizing healthcare practices in pregnant women, suggesting targeted approaches to combat antibiotic resistance and improve maternal–fetal safety during UTI treatment.
- Decoding urinary tract infection trends: A 5-year snapshot from Central PortugalPublication . Rodrigues, Francisco; Coelho, Patrícia; Patricia Coelho; Mateus, Sónia; Caseiro, Armando; Eideh, Hatem; Gonçalves, Teresa; Castelo Branco, MiguelIntroduction: This study analyzes urinary tract infections (UTIs) in a hospital in Central Portugal over a five-year period, focusing on bacterial prevalence, patient demographics, and antibiotic resistance patterns. This investigation aims to provide insights that can guide improved infection control and treatment strategies. Methods: A total of 6161 positive urine cultures collected over five years were examined, with particular emphasis on 2019 due to a peak in infection rates. The analysis explored bacterial prevalence, demographic factors such as sex and clinical service origin, and antibiotic resistance. Special attention was given to hospitalized patients, especially those undergoing invasive procedures, due to their increased vulnerability to infection. Results: This study found that UTIs were more prevalent in female patients, reflecting anatomical susceptibilities. Hospitalized individuals, particularly those requiring invasive procedures, were at greater risk. The predominant bacteria were Escherichia coli, Klebsiella pneumoniae, and Enterococcus faecalis, with differences in prevalence by patient sex and service origin. Resistance to Imipenem in E. coli increased, raising concerns about last-resort treatments. However, resistance to other antibiotics declined, suggesting improvements due to recent stewardship measures. During the COVID-19 pandemic, overall antibiotic consumption decreased due to changes in clinical practices. Conclusion: The findings highlight the importance of strict infection control, targeted prevention measures, and rational antibiotic use to combat resistance. Ongoing surveillance and personalized treatment approaches are essential to improve UTI management and outcomes.