Can cold weather be a cardiovascular determinant in warm countries?

In almost every temperate region of the world, the number of cardiovascular mortality increases significantly during winter months. This phenomenon has been considered as a public health issue in several countries as many of these deaths are considered to be avoidable. The cause for the excess of winter deaths can be attributed to a number of factors, such as diet, exercise and exposure to cold weather. Curiously, southern European countries, such as Portugal, seem to have the highest excess winter deaths that seem to be related to exposure of cold. However, very few studies have addressed this relationship in Portugal and no quantification of the role of cold weather on cardiovascular diseases has been published. The main goal of this study is to quantify the short effect of cold weather on the cardiovascular morbidity in Portugal Generalized additive Poisson regression models were used in order to obtain the influence of a thermal comfort index (PET) on daily hospitalizations for acute myocardial Infarction in the two most developed metropolitan areas of Portugal: Lisbon and Oporto. All models were adjusted for time and other environmental variables. Influenza was also considered as a confounder. The main results reveal an increase up to 2.2% (95% CI = 0,9%; 3,3%) of daily hospital admissions in winter per degree fall in PET. The increase in daily hospitalizations was greater for the entire population than when only the elderly (>65 years) were considered. View publicationinfo:eu-repo/semantics/publishedVersio

Objetos sustentáveis para um habitar sustentável

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North African dust intrusions and increased risk of respiratory diseases in Southern Portugal

The study of dust intrusions in Portugal is still a subject on which little investigation has been made, especially in terms of their effects. Thus, this work aims to achieve two goals: firstly, to characterize the dust intrusions in the study area; and secondly, to evaluate the possible statistical association between the dust intrusion days and hospital admissions due to respiratory diseases. Dust intrusions in Portugal are prevalent during the summer season. During this season, the dust plumes tend to cover broader areas than in the other seasons and they have origin in the North African countries. In the study area for the period between 2005 and 2015, the relative risk of urgent hospitalizations due to respiratory diseases was 12.6% higher during dust intrusion days. In order to obtain this statistical association, a Distributed Lag Nonlinear Model was developed. With this work, we expect to help the development of further studies regarding North African dust intrusions in Portugal, more precisely their effects on human health.info:eu-repo/semantics/acceptedVersio

Sustainability curricula in design education

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The influence of the Great Recession on perinatal health—an ecological study on the trend changes and regional differences in Portugal

Background: Few studies examine the relationship between socioeconomic factors and trends in mortality in high-income European countries. Due to the lack of regional-level data, most recent studies on social inequality in Portugal do not investigate regional differences. This study analyses time trends and regional disparities in the evolution of perinatal mortality (PMR) and infant mortality (IMR) associated with demographic and socioeconomic indicators following Portugal's 2008 economic and financial crisis. Methods: Associations were assessed using generalised linear models. A Poisson joinpoint regression model was applied to identify relevant PMR and IMR changes between 2000 and 2018. Country regional disparities were analysed using Mixed Effect Multilevel models. Findings: IMR and PMR significantly decreased in the pre-crisis period but not in the post-crisis period. The significant differences between regions in IMR and PMR in 2000 were followed by a different evolution of regional IMR after 2008. PMR and IMR were not significantly associated with socioeconomic indicators. A significant positive association with maternal age at first birth was identified. Interpretation: Results confirm the influence of the crisis on PMR and IMR trends in Portugal, taking into account recurring associations between macroeconomic cycles, variations in mortality trends, macroeconomic volatility, and stagnation of IMR and PMR. Regional inequalities confirm the internal variability of the crisis influence and persistent spatial inequalities affecting IMR patterns. Funding: FCT, under the Institute of Public Health of the University of Porto (ISPUP)– EPIUnit ( UIDB/04750/2020) and ITR ( LA/P/0064/2020), Maastricht University's external PhD programme under the Care and Public Health Research Institute ( CAPHRI), and the RECAP preterm project (grant agreement no 733280). © 2023 The Author(s)FCT, under the Institute of Public Health of the University of Porto (ISPUP)–EPIUnit (UIDB/04750/2020) and ITR (LA/P/0064/2020), Maastricht University's external PhD programme under the Care and Public Health Research Institute (CAPHRI), and the RECAP preterm project (grant agreement no 733280)

Condições climáticas e morbilidade/mortalidade: Contributos para uma melhoria da habitabilidade e para o planeamento urbano em Portugal

A exposição ao frio pode debilitar severamente o estado de saúde, nomeadamente ao desencadear doenças cardiovasculares e respiratórias. Através de inquéritos realizados em diversos Hospitais em Portugal foi feito um levantamento das características da habitação dos doentes internados com Síndroma Coronária Aguda. Foram identificados diversos elementos que caracterizam uma vulnerabilidade à exposição ao frio em Portugal, possivelmente contribuindo para o desencadear/agravar da doença.info:eu-repo/semantics/publishedVersio

LAMA2 gene mutation update: Toward a more comprehensive picture of the laminin-α2 variome and its related phenotypes

Congenital muscular dystrophy type 1A (MDC1A) is one of the main subtypes of early-onset muscle disease, caused by disease-associated variants in the laminin-α2 (LAMA2) gene. MDC1A usually presents as a severe neonatal hypotonia and failure to thrive. Muscle weakness compromises normal motor development, leading to the inability to sit unsupported or to walk independently. The phenotype associated with LAMA2 defects has been expanded to include milder and atypical cases, being now collectively known as LAMA2-related muscular dystrophies (LAMA2-MD). Through an international multicenter collaborative effort, 61 new LAMA2 disease-associated variants were identified in 86 patients, representing the largest number of patients and new disease-causing variants in a single report. The collaborative variant collection was supported by the LOVD-powered LAMA2 gene variant database (https://www.LOVD.nl/LAMA2), updated as part of this work. As of December 2017, the database contains 486 unique LAMA2 variants (309 disease-associated), obtained from direct submissions and literature reports. Database content was systematically reviewed and further insights concerning LAMA2-MD are presented. We focus on the impact of missense changes, especially the c.2461A > C (p.Thr821Pro) variant and its association with late-onset LAMA2-MD. Finally, we report diagnostically challenging cases, highlighting the relevance of modern genetic analysis in the characterization of clinically heterogeneous muscle diseases.info:eu-repo/semantics/publishedVersio

Vitrificación ovocitaria para posponer fecundidad: experiencia de la Unidad de Medicina Reproductiva de Clínica Monteblanco

Antecedentes: Múltiples variables médicas y sociales han llevado al desarrollo de técnicas que permitan a la mujer posponer su fertilidad; dentro de ellas la vitrificación ovocitaria surge como una técnica relativamente sencilla y muy promisoria en este campo. Objetivo: Presentar la experiencia del Centro de Medicina Reproductiva de Clínica Monteblanco, en mujeres que han vitrificado sus ovocitos y posteriormente han intentado embarazarse con ellos. Método: Se revisaron todos los casos de vitrificación ovocitaria con posterior intento de embarazo, realizados desde el año 2007 a la fecha. Resultados: Del total de ciclos de vitrificación ovoci-taria, 22 mujeres han intentado un embarazo posterior al procedimiento. La mediana de edad al momento de la vitrificación fue de 36 años. En 10 pacientes no hubo transferencia embrionaria, ya fuera por no fecundación (4 casos) o por detención del desarrollo embrionario (6 casos); 12 pacientes fueron transferidas, la mitad de ellas lograron embarazo. Discusión: En este trabajo se presenta la primera serie nacional de casos de vitrificación de óvulos con posterior intento de embarazo; 12 de 20 pacientes lograron ser transferidas y 6 de ellas lograron el embarazo. Las mujeres más jóvenes vitrificaron un mayor número de ovocitos, tuvieron más embriones y tuvieron una mayor posibilidad de lograr embarazo. Conclusión: Pese a que la vitrificación ovocitaria no es una solución definitiva a la postergación de la fertilidad, representa en estos casos una alternativa válida

Ten-year survival of ART restorations in permanent posterior teeth

This study evaluated the 10-year clinical performance of high-viscosity glass-ionomer cement placed in posterior permanent teeth by means of the Atraumatic Restorative Treatment (ART) approach. One operator placed 167 single- and 107 multiple-surface restorations in 43 high-risk caries pregnant women (mean decayed teeth = 9.8 ± 5.5). Examinations were performed at 1-, 2-, and 10-year intervals according to ART criteria. In the last evaluation, the US Public Health Service (USPHS) criteria were also used. After 10 years, 129 restorations (47.1%) were evaluated and achieved a cumulative survival rate of 49.0% (SE 7.2%). The 10-year survival of single- and multiple-surface ART restorations assessed using the ART criteria were 65.2% (SE 7.3%) and 30.6% (SE 9.9%), respectively. This difference was significant (jackknife SE of difference; p < 0.05). Using the USPHS criteria, the 10-year survival of single- and multiple-surface ART restorations were 86.5% and 57.6%, respectively. The primary causes of failure were total loss (9.3%) and marginal defects (5.4%). The survival rates observed, especially for the single-surface restorations, confirm the potential of the ART approach for restoring and saving posterior permanent teeth