Development of a screening questionnaire for the study of food allergy in adults

Background & aims: As far as we know, no screening questionnaire has been developed and validated for identification of adverse food reactions in Portuguese-speaking adults, as an initial approach towards the investigation of cases of possible food allergy. Thus, the objective of this study was to develop and validate a screening questionnaire of food allergy in adult Portuguesespeaking patients. Methods: This was a multicentre, cross-sectional study using a simple random sample of 186 adults between 18 and 82 years old from various parts of the centre of Portugal. Intelligibility of the questionnaire was first assessed in 24 patients with confirmed IgE- or non-IgE-mediated food allergy, and in 24 volunteers without food allergies. The 17-item questionnaire was subsequently applied by phone to 78 food allergic patients (66 IgE-mediated and 12 non-IgE mediated) and to 60 non-food allergic volunteers, with subsequent reassessment (re-test). Face and content validity, intelligibility, construct validity, and test-retest reliability (temporal stability) were analysed. Results: Face and content validity allowed item reduction from 30 to 17 items with adequate content validity index >0.78. Construct validity was confirmed in the 66 confirmed IgE-mediated food allergic patients, 12 non-IgE-mediated food allergic patients, and 60 non-allergic patients. Test-Retest Reliability (general temporal stability) of the test had a Spearman correlation coefficient value of 0.845 for the retest. Cohen's Kappa values for the relevant questions were greater than 0.890 for almost all items. No differences were found when sex, age, and volunteers' recruitment origin were analysed. An inverse relationship was found between reliability and retest time interval. Conclusions: Due to the quick and easy implementation, confirmation of face, content and construct validity as well as high temporal reproducibility, this screening questionnaire may be a useful study tool for an initial approach to detection of food allergies in adults.info:eu-repo/semantics/publishedVersio

Toxic metals in indoor dust collected from houses included in the “6x60x6” Project (Covilhã, Portugal) during the cooling season

We spend more than 90 per cent of our daily lives indoors. Managing the indoor environment so that we feel comfortable and healthy is therefore very important. However, this management is only possible if rigorous data on both construction parameters and indoor environment exists. Moreover, the evolution of construction techniques and materials used modulates both aspects. As a consequence, it is necessary that the information obtained reflects a long period of time. That is the main driver for the project “Six by Sixty by Six” undertaken by the Civil Engineering and Architecture Department and the Faculty of Health Sciences of the University of Beira Interior. Six houses constructed in six different decades (1960’s-2010’s) were surveyed for sixty days regarding a set of parameters (e.g., temperature, humidity, CO2, CO, VOCs). Additionally, dust was collected by the vacuum cleaner bag and was analyzed for specific contaminants. This work presents the results obtained for the toxics metals mercury, arsenic, cadmium, and lead in dust samples. There is no legislation regulating maximum permissible levels for any of the studied metals in dust. A comparison with ”Portaria Nº 1450/2007” which regulates the maximum metal contents in dredged sediment that can be safely deposited in soils (here used as an action threshold) reveals that the values for As in all houses were transcended. For Cd and Hg they were only transcended in one house, whereas for lead all the values were below this threshold. Linear regression with age of construction used as independent variable revealed no relationship between this variable and metal concentrations with the exception of As (R2 adjusted= 0.41). Findings are discussed under the light of potential health outcomes upon the residents.info:eu-repo/semantics/publishedVersio

Mercury levels in biological matrices from inhabitants of Estarreja, Portugal

Humans are exposed to mercury trough several pathways including the consumption of contaminated seafood and ingestion of contaminated house dust. We have previously demonstrated that mercury levels in house dust samples from Estarreja region are amongst the highest reported in Portugal. Here we report the levels of total mercury in different biological matrices from 88 adult individuals from Estarreja (age: 37-83, median: 68). Mercury was detected in all samples analysed, with the highest levels being found in hair (range: 560-4540 ng/g, median: 1680 ng/g), followed by fingernails (range: 215-1740 ng/g, median: 844 ng/g), toenails (range: 144-1850 ng/g, median: 555 ng/g), blood (range: 0.97-18.4 ng/g, median: 6.70 ng/g) and urine (range: 0.15-5.14 ng/g, median: 0.61 ng/g). The hair to blood ratio (H:B) varied between 147 and 616, with a median value of 274, which is only 9% higher than the H:B ratio proposed by the Word Health Organization . The concentrations of mercury in hair were very strongly correlated with the concentrations in blood (p0.001). Such results suggest that a urine levels reflect the exposure to a different species of mercury, reinforcing previous studies that propose urine as a suitable matrix for inorganic mercury whereas blood, hair and nails are suitable matrices for methylmercury exposure.Ana C Sousa acknowledges the financial support from University of Aveiro, in the scope of the framework contract foreseen in the numbers 4, 5 and 6 of the article 23, of the Decree-Law 57/2016, of August 29, changed by Law 57/2017, of July 19 (A.C.A. Sousa)publishe

House dust fungal communities’ characterization: a double take on the six by sixty by six project (6x60x6)

Fungi are a group microbes, that are found with particular incidence in the indoor environment. Their direct toxicity or capability of generating toxic compounds has been associated with a large number of adverse health effects, such as infectious diseases, allergies and other toxic effects. Given that in modern society people spend a large part of their time indoors; fungal communities’ characterization of this environmental compartment assumes paramount importance in the comprehension of health effects. House dust is an easy to obtain, time-integrative matrix, being its use in epidemiological studies on human exposure to environmental contaminants highly recommended. Furthermore, dust can carry a great variety of fungal content that undergoes a large number of processes that modulate and further complexify human exposure. Our study aims to quantify and identify the fungal community on house dust samples collected using two different methodologies (an approach not often seen in the literature): active (vacuum cleaner bags) and passive sampling (dust settled in petri dishes). Sampling was performed as part of the ongoing 6x60x6 Project in which six houses from Covilhã (Portugal), with building dates representative of six decades, were studied for a period of sixty days.info:eu-repo/semantics/publishedVersio

Pi3k Inhibition Synergizes With Glucocorticoids But Antagonizes With Methotrexate In T-cell Acute Lymphoblastic Leukemia.

The PI3K pathway is frequently hyperactivated in primary T-cell acute lymphoblastic leukemia (T-ALL) cells. Activation of the PI3K pathway has been suggested as one mechanism of glucocorticoid resistance in T-ALL, and patients harboring mutations in the PI3K negative regulator PTEN may be at increased risk of induction failure and relapse. By gene expression microarray analysis of T-ALL cells treated with the PI3K inhibitor AS605240, we identified Myc as a prominent downstream target of the PI3K pathway. A significant association was found between the AS605240 gene expression signature and that of glucocorticoid resistance and relapse in T-ALL. AS605240 showed anti-leukemic activity and strong synergism with glucocorticoids both in vitro and in a NOD/SCID xenograft model of T-ALL. In contrast, PI3K inhibition showed antagonism with methotrexate and daunorubicin, drugs that preferentially target dividing cells. This antagonistic interaction, however, could be circumvented by the use of correct drug scheduling schemes. Our data indicate the potential benefits and difficulties for the incorporation of PI3K inhibitors in T-ALL therapy.613105-1311

Mercury levels in house dust samples from Covilhã, Portugal - Preliminary results from 6x60x6 Project

A avaliação da qualidade do ambiente interior, particularmente do ambiente doméstico, por ser aquele em que o ser humano passa a maior parte do seu tempo, reveste-se de particular importância. Esta qualidade é modulada por um conjunto de fatores entre os quais se encontram os contaminantes ambientais com potencial tóxico, que têm vindo a ser quantificados de forma consistente no pó doméstico, uma matriz com grande capacidade integradora. Este trabalho, que utiliza o mercúrio como caso de estudo, integra-se no âmbito de um projeto pioneiro e multidisciplinar, em que se pretende estudar por um período de sessenta dias, seis habitações particulares localizadas na cidade da Covilhã, para compreender de que forma as características do imóvel e os hábitos dos habitantes podem influenciar a qualidade do ambiente interior e consequentemente a saúde dos residentes. Os níveis de mercúrio total nas amostras de pó doméstico variaram entre 138,7 ppb e 1075,5 ppb, com um só dos imóveis a transcender o valor máximo permissível estabelecido pela Portaria Nº1450/2007. Estabelece-se uma comparação com os valores registados para outros estudos similares e traça-se um plano de ação para o pleno desenvolvimento do estudo.The evaluation of indoor environmental quality, particularly of households, is of paramount importance since modern humans spend most of their time indoors. Environmental contaminants with toxic potential play a central role in the modulation of indoor quality and recent trends have pointed towards their quantification in dust, which is a highly integrative matrix. The present work uses mercury as a case study integrated in a pioneering multidisciplinary study aiming to ascertain (by measuring a set of parameters for sixty days in six houses built in six different decades – 6x60x6) how the household characteristics and residents’ habits modulate indoor environmental quality and, in turn, drive impacts upon their health. Total mercury levels in house dust samples varied between 138.7 ppb and 1075.5 ppb, with a single house recording a value higher than the limit admissible by Portuguese law (Portaria Nº1450/2007). A comparison of the obtained values with similar studies worldwide is performed and an action plan for the full development of the study is drafted. Keywords: Indoor environment, Metals, Mercury, House dustinfo:eu-repo/semantics/publishedVersio

Patient-physician discordance in assessment of adherence to inhaled controller medication: a cross-sectional analysis of two cohorts

We aimed to compare patient's and physician's ratings of inhaled medication adherence and to identify predictors of patient-physician discordance.(SFRH/BPD/115169/2016) funded by Fundação para a Ciência e Tecnologia (FCT); ERDF (European Regional Development Fund) through the operations: POCI-01-0145-FEDER-029130 ('mINSPIRERS—mHealth to measure and improve adherence to medication in chronic obstructive respiratory diseases—generalisation and evaluation of gamification, peer support and advanced image processing technologies') cofunded by the COMPETE2020 (Programa Operacional Competitividade e Internacionalização), Portugal 2020 and by Portuguese Funds through FCT (Fundação para a Ciência e a Tecnologia).info:eu-repo/semantics/publishedVersio

Low Doses of Ionizing Radiation Promote Tumor Growth and Metastasis by Enhancing Angiogenesis

Radiotherapy is a widely used treatment option in cancer. However, recent evidence suggests that doses of ionizing radiation (IR) delivered inside the tumor target volume, during fractionated radiotherapy, can promote tumor invasion and metastasis. Furthermore, the tissues that surround the tumor area are also exposed to low doses of IR that are lower than those delivered inside the tumor mass, because external radiotherapy is delivered to the tumor through multiple radiation beams, in order to prevent damage of organs at risk. The biological effects of these low doses of IR on the healthy tissue surrounding the tumor area, and in particular on the vasculature remain largely to be determined. We found that doses of IR lower or equal to 0.8 Gy enhance endothelial cell migration without impinging on cell proliferation or survival. Moreover, we show that low-dose IR induces a rapid phosphorylation of several endothelial cell proteins, including the Vascular Endothelial Growth Factor (VEGF) Receptor-2 and induces VEGF production in hypoxia mimicking conditions. By activating the VEGF Receptor-2, low-dose IR enhances endothelial cell migration and prevents endothelial cell death promoted by an anti-angiogenic drug, bevacizumab. In addition, we observed that low-dose IR accelerates embryonic angiogenic sprouting during zebrafish development and promotes adult angiogenesis during zebrafish fin regeneration and in the murine Matrigel assay. Using murine experimental models of leukemia and orthotopic breast cancer, we show that low-dose IR promotes tumor growth and metastasis and that these effects were prevented by the administration of a VEGF receptor-tyrosine kinase inhibitor immediately before IR exposure. These findings demonstrate a new mechanism to the understanding of the potential pro-metastatic effect of IR and may provide a new rationale basis to the improvement of current radiotherapy protocols

Identification of clusters of asthma control: A preliminary analysis of the inspirers studies

This work was funded by ERDF (European Regional Development Fund) through the operations: POCI- -01-0145-FEDER-029130 (“mINSPIRERS—mHealth to measure and improve adherence to medication in chronic obstructive respiratory diseases - generalisation and evaluation of gamification, peer support and advanced image processing technologies”) co-funded by the COMPETE2020 (Programa Operacional Competitividade e Internacionalização), Portugal 2020 and by Portuguese Funds through FCT (Fundação para a Ciência e a Tecnologia).© 2020, Sociedade Portuguesa de Alergologia e Imunologia Clinica. All rights reserved. Aims: To identify distinct asthma control clusters based on Control of Allergic Rhinitis and Asthma Test (CARAT) and to compare patients’ characteristics among these clusters. Methods: Adults and adolescents (≥13 years) with persistent asthma were recruited at 29 Portuguese hospital outpatient clinics, in the context of two observational studies of the INSPIRERS project. Demographic and clinical characteristics, adherence to inhaled medication, beliefs about inhaled medication, anxiety and depression, quality of life, and asthma control (CARAT, >24 good control) were collected. Hierarchical cluster analysis was performed using CARAT total score (CARAT-T). Results: 410 patients (68% adults), with a median (percentile 25–percentile 75) age of 28 (16-46) years, were analysed. Three clusters were identified [mean CARAT-T (min-max)]: cluster 1 [27(24-30)], cluster 2 [19(14-23)] and cluster 3 [10(2-13)]. Patients in cluster 1 (34%) were characterised by better asthma control, better quality of life, higher inhaler adherence and use of a single inhaler. Patients in clusters 2 (50%) and 3 (16%) had uncontrolled asthma, lower inhaler adherence, more symptoms of anxiety and depression and more than half had at least one exacerbation in the previous year. Further-more, patients in cluster 3 were predominantly female, had more unscheduled medical visits and more anxiety symp-toms, perceived a higher necessity of their prescribed inhalers but also higher levels of concern about taking these inhalers. There were no differences in age, body mass index, lung function, smoking status, hospital admissions or specialist physician follow-up time among the three clusters. Conclusion: An unsupervised method based on CARAT--T, identified 3 clusters of patients with distinct, clinically meaningful characteristics. The cluster with better asthma control had a cut-off similar to the established in the validation study of CARAT and an additional cut-off seems to distinguish more severe disease. Further research is necessary to validate the asthma control clusters identified.publishersversionpublishe