Prevalência da exposição ao fumo ambiental do tabaco em casa e do tabagismo na população Portuguesa – o estudo INAsma

ResumoIntroduçãoNeste estudo, pretendemos: 1) estimar a prevalência, na população portuguesa, da exposição ao fumo ambiental do tabaco em casa; 2) estimar a prevalência de tabagismo em Portugal; 3) identificar as características sociais e pessoais associadas ao tabagismo ou à exposição ao fumo ambiental do tabaco.MétodosEstudo transversal consistindo na aplicação, à população, a nível nacional, de questionário telefónico. Completaram a entrevista 6 003 indivíduos. A exposição ao fumo ambiental do tabaco em casa foi definida como a exposição, em casa, ao fumo do tabaco de, pelo menos, um fumador atual. Por fumador entendeu-se um indivíduo com ≥ 15 anos que fumou, pelo menos, um cigarro por dia durante um período de um ano; um fumador atual fumou no último mês.ResultadosReferiram exposição ao fumo ambiental do tabaco em casa 26,6% dos participantes (IC 95%: 25,5-27,7). Viver num agregado familiar constituído por ≥ 4 pessoas (OR=2,31; IC 95%: [1,81-2,96]), ser fumador atual (OR=7,29; IC 95%: [5,74-9,26]) ou ter asma atual (OR=2,06; IC 95%: [1,45-2,94]) associaram-se positivamente à exposição ao fumo ambiental do tabaco. Na análise estratificada por sexo, o efeito da asma atual manteve-se apenas nas mulheres.Atualmente, 19,0% (IC 95%: 18,0-20,0) da população portuguesa é fumadora e 17,2% (IC 95%: 16,2-18,2) são ex-fumadores. A prevalência de fumadores atuais é mais elevada nos homens do que nas mulheres (26,5 versus 12,2%, p<0,001). A probabilidade de ser um fumador atual foi maior nos homens, nas pessoas mais instruídas e nos indivíduos expostos, em casa, ao fumo ambiental do tabaco. Na análise estratificada por sexo, o efeito da escolaridade manteve-se apenas nas mulheres.ConclusãoA exposição ao fumo ambiental do tabaco em casa foi mais elevada do que a anteriormente publicada. Crianças/adolescentes e doentes com asma podem ter um risco de exposição ambiental mais elevado. Este estudo apoia uma tendência decrescente da prevalência de tabagismo nos homens portugueses, mas uma tendência crescente nas mulheres.AbstractBackgroundWe aimed to: 1) estimate the prevalence of exposure to environmental tobacco smoke (ETS) at home in the Portuguese population; 2) estimate tobacco smoking prevalence in Portugal; 3) identify social and personal characteristics associated with smoking or exposure to ETS.MethodsNationwide, cross-sectional, population-based telephone survey. Overall, 6003 individuals completed the interview. ETS exposure at home was defined as exposure to at least one current smoker at home. A smoker was defined as someone with 15 years or older, smoking at least 1 cigarette per day during a year; a current smoker (CS) smoked in the last month.ResultsExposure to ETS at home was reported by 26.6% (95%CI 25.5-27.7) of the participants. Living in households with ≥4 persons (OR=2.31; 95%CI[1.81-2.96]), being a current smoker (OR=7.29; 95%CI[5.74-9.26]) or having current asthma (OR=2.06; 95%CI[1.45-2.94]) were factors positively associated with ETS exposure. When analyzed by gender, the effect of current asthma was only relevant to females.Currently 19.0% (95%CI 18.0-20.0) of the Portuguese population smokes tobacco and 17.2% (95%CI 16.2-18.2) are ex-smokers. CS prevalence is higher in males than females (26.5%versus 12.2%, p<0,001). The odds of being a CS were higher for males, the more educated, and those exposed to ETS at home. When analyzed by gender, school education only affected females.ConclusionExposure to ETS at home was higher than previously reported. Children/adolescents and asthma patients may have a higher risk of exposure. This report endorses a decreasing trend in the prevalence of tobacco smoking in Portuguese males, but a tendency to increase in females

N-terminal-pro-B type natriuretic peptide as a useful tool to evaluate pulmonary hypertension and cardiac function in CDH infants

Objective: In congenital diaphragmatic hernia (CDH) the severity of pulmonary hypertension (PH) is considered, by several authors, determinant of clinical outcome. Plasmatic N-terminal-pro-B type natriuretic peptide (NT-proBNP) might be useful in diagnosis and management of PH in newborns, although its interest in CDH infants remains to be defined. Early NT-proBNP levels were assessed in CDH infants and correlated with cardiovascular echocardiographic parameters. Patients and Methods: 28 newborns, CDH and age-matched controls were enrolled in a prospective study. Clinical condition, NT-proBNP plasmatic levels, echo parameters of PH and biventricular function were assessed at 24 h after delivery as well as survival outcome. Results: Estimated mean pulmonary pressure and NT-proBNP were significantly higher in CDH than control infants. NT-proBNP significantly correlated with estimated pulmonary artery pressure, right ventricular Tei index, and tricuspid E/A ratio. Additionally, we found that CDH infants with NT-proBNP >11,500 pg/ml experienced a worse prognosis. Conclusions: We demonstrated that PH is associated with NT-proBNP elevation and diastolic impairment in CDH infants. Early elevations in NT-proBNP levels seem to alert for a subset of CDH infants with worse prognosis. Copyrigh

Existence and stability of viscoelastic shock profiles

We investigate existence and stability of viscoelastic shock profiles for a class of planar models including the incompressible shear case studied by Antman and Malek-Madani. We establish that the resulting equations fall into the class of symmetrizable hyperbolic--parabolic systems, hence spectral stability implies linearized and nonlinear stability with sharp rates of decay. The new contributions are treatment of the compressible case, formulation of a rigorous nonlinear stability theory, including verification of stability of small-amplitude Lax shocks, and the systematic incorporation in our investigations of numerical Evans function computations determining stability of large-amplitude and or nonclassical type shock profiles.Comment: 43 pages, 12 figure

A novel enzymatically-mediated drug delivery carrier for bone tissue engineering applications: combining biodegradable starch-based microparticles and differentiation agents

In many biomedical applications, the performance of biomaterials depends largely on their degradation behavior. For instance, in drug delivery applications, the polymeric carrier should degrade under physiological conditions slowly releasing the encapsulated drug. The aim of this work was, therefore, to develop an enzymaticmediated degradation carrier system for the delivery of differentiation agents to be used in bone tissue engineering applications. For that, a polymeric blend of starch with polycaprolactone (SPCL) was used to produce a microparticle carrier for the controlled release of dexamethasone (DEX). In order to investigate the effect of enzymes on the degradation behavior of the developed system and release profile of the encapsulated osteogenic agent (DEX), the microparticles were incubated in phosphate buffer solution in the presence of a-amylase and/or lipase enzymes (at physiological concentrations), at 37 C for different periods of time. The degradation was followed by gravimetric measurements, scanning electron microscopy (SEM) and Fourier transformed infrared (FTIR) spectroscopy and the release of DEX was monitored by high performance liquid chromatography (HPLC). The developed microparticles were shown to be susceptible to enzymatic degradation, as observed by an increase in weight loss and porosity with degradation time when compared with control samples (incubation in buffer only). For longer degradation times, the diameter of the microparticles decreased significantly and a highly porous matrix was obtained. The in vitro release studies showed a sustained release pattern with 48% of the encapsulated drug being released for a period of 30 days. As the degradation proceeds, it is expected that the remaining encapsulated drug will be completely released as a consequence of an increasingly permeable matrix and faster diffusion of the drug. Cytocompatibility results indicated the possibility of the developed microparticles to be used as biomaterial due to their reduced cytotoxic effects

Evidence of contamination by oil and oil products in the Santos-Sao Vicente estuary, Sao Paulo, Brazil

Different components of the mixed function oxidase (MFO) system and the levels of fluorescent aromatic compounds in bile (FACs) were measured in Cathorops spixii in order to assess the impact of polycyclic aromatic hydrocarbons (PAHs). Fish were sampled in an estuary (Santos/Sao Vicente) with a history of contamination by PAHs, mainly due to the presence of the industrial complex of Cubatao city and of another of low anthropogenic influence (Cananeia) on the Brazilian coast. FACs were higher in fish from the polluted site, and the PAH 5 and 6-ring metabolites were the most frequent - with 14% and 15%, respectively. Levels of the different components of the MFO system showed the same variation profile as the FACs for both estuaries. Therefore, the values found for somatic indexes and biomarkers with data of bile PAH metabolites indicate the presence of organic contaminants, especially in the area subject to the influence of the industrial complex on the Santos/Sao Vicente estuary.CAPES (Brazilian Agency for Science and Technology); Oceanographic Institute of Sao Paulo University; Laboratory of Ecotoxicology and Environmental Chemistry of the University of Algarve; CAPES-PDEE [BEX 2176/07-6]info:eu-repo/semantics/publishedVersio