Vigilância laboratorial da infeção a Enterovirus entre 2010 e 2013

Objetivo: Analisar os resultados do diagnóstico laboratorial de casos suspeitos de infeção a Enterovirus recebidos no INSA ao abrigo do Programa de Erradicação da Poliomielite (Vigilância Laboratorial da PFA e de Enterovirus) entre 2010 e 2013

Citomegalovírus: análise retrospetiva de casos suspeitos de infeção do sistema nervoso central, diagnosticados entre 2010 e 2014

Este estudo tem como objetivo descrever as características demográficas e o quadro clínico e imunitário de doentes com suspeita de infeção viral neurotrópica e analisar a frequência das infeções por CMV nas patologias do SNC, cujo diagnóstico foi confirmado no Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA) entre janeiro de 2010 e abril de 2014

Rubéola congénita em Portugal entre 2009 e 2015

Objetivo: Analisar os resultados do diagnóstico laboratorial de casos suspeitos de rubéola congénita recebidos no Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA) entre 2009 e 2015, ao abrigo do Programa de Eliminação do Sarampo, da Rubéola e da Rubéola Congénita na Região Europeia da Organização Mundial da Saúde (OMS)

Diagnóstico laboratorial do sarampo em Portugal, 2011-2013

Objetivo: Este estudo tem como objetivo descrever os casos prováveis de sarampo enviados ao INSA para confirmação laboratorial entre 2011 e 2013 em Portugal

Seroprevalence to cytomegalovirus in the Portuguese population, 2002-2003

The prevalence of cytomegalovirus (CMV) infections ranges between 50% and 85% in adults in the United States, and its epidemiology varies in different regions of the world and between socioeconomic and age groups. In Portugal, no study has been carried out to date to determine the prevalence of CMV in the general population. Under the second National Serological Survey conducted in continental Portugal in 2001–2002, we estimated the prevalence of individuals with antibodies to CMV using indirect immunofluorescence to detect virus-specific IgG. The population sample included 2,143 individuals of both sexes and different ages from all 18 districts in Portugal. The national seroprevalence of CMV was determined as 77%. We analysed the proportion of CMV IgG by sex, age group and district of residence. This was the first nationally representative study of seroprevalence of CMV in Portugal. The results of the study indicate that CMV infection is highly prevalent in the population and occurs mainly in the first years of life.The project ‘Evaluation of National Vaccination Programme and improving their cost-effectiveness’ is responsibility of the Directorate General of Health and was funded by Health XXI Programme, under the III Community Support Framework. The planning of the protocol, the fieldwork and analysis of data were done by technicians of the National Observatory of Health (currently the Department of Epidemiology) in the National Institute of Health. Monitoring and review of all phases of the project was the responsibility of a group of experts in the clinical, laboratory and epidemiologic area

El sílex como recurso mineral en la Prehistoria de Asturias

Until 2000 in Asturias we have little information about the silica raw material sources related with the prehistoric lithic industries. Since that time some work has been done trying to identify the origin and exploitation of those sources. We expose what is known from the geological and archaeological point of view, and we show the novelties relating the incoming area of one kind of flint, and the characterisation of a new type used in the prehistory of Asturias, whose movement through the region is really important and, also, it is present in other Cantabrian and bordering areas.Hast el año 2000 en Asturias había poca información sobre las fuentes de materias primas silíceas relacionadas con las industrias líticas prehistóricas. Desde esa fecha contamos con varios trabajos que profundizan en la ubicación, identificación y explotación de esas materias primas. Se expondrá lo conocido desde el punto de vista geológico y arqueológico, al tiempo que se mostrarán las novedades relativas al hallazgo del lugar de procedencia de algunas variedades de sílex, y la caracterización de un nuevo tipo explotado en la prehistoria asturiana, siendo el que más circula en la región e, incluso, se encuentra en otras áreas cantábricas y limítrofes

Report of simultaneous measles outbreaks in two different health regions in Portugal, February to May 2017: lessons learnt and upcoming challenges

In Portugal, measles vaccination coverage and population immunity are high, and no endemic measles cases had been reported since 2004. The World Health Organization classified measles as eliminated in the country in 2015 and 2016, based on data from the previous 3 years. However, in a context of increasing incidence in several European countries in 2016 and 2017, Portugal experienced two simultaneous measles outbreaks with a total of 27 laboratory-confirmed cases (0.3 cases/100,000 population) in two health regions between February and May 2017. Nineteen cases (70.1%) were adults, of whom 12 were healthcare workers. Overall, 17 cases (63.0%) were not vaccinated, of whom five were infants younger than 12 months of age. One unvaccinated teenager died. Genotype B3 was identified in 14 cases from both regions. Measles virus sequencing identified different possible origins of the virus in each region affected. Although measles transmission was stopped in less than 2 months from the first case being notified, these outbreaks represent an opportunity to reinforce awareness of measles diagnosis. We highlight the intensity of the control measures taken and their impact on the rapid control of the outbreaks and also the fact that high vaccination coverage was crucial to stop transmission.info:eu-repo/semantics/publishedVersio

Is the reason to switch relevant?

57763]. AS is supported by a doctoral grant from “Fundação para a Ciência e Tecnologia” (SFRH/BD/108246/2015).Background: To investigate whether the reason to discontinue the first TNF inhibitor (TNFi) affects the response to the second TNFi in axial spondyloarthritis (axSpA). Methods: Patients with axSpA from the Rheumatic Diseases Portuguese Register (ReumaPt), who discontinued their first TNFi and started the second TNFi between June 2008 and May 2018, were included. Response was assessed by the Ankylosing Spondylitis Disease Activity Score (ASDAS) clinically important improvement (ASDAS-CII), major important improvement (ASDAS-MI), low disease activity (ASDAS-LDA), and inactive disease (ASDAS-ID). The reason for discontinuation of the first TNFi was defined, according to ASDAS-CII as primary failure (no response ≤ 6 months), secondary failure (response ≤ 6 months but lost thereafter), adverse events, and others. The association between the reason for discontinuation of the first TNFi and response to the second TNFi over time was assessed in multivariable generalized equation (GEE) models. Results: In total, 193 patients were included. The reason for discontinuation of the first TNFi did not influence the response to the second TNFi, according to the ASDAS-CII. However, a difference was found with more stringent outcomes, e.g., there was a higher likelihood to achieve ASDAS-ID with the second TNFi for patients discontinuing the first TNFi due to secondary failure (OR 7.3 [95%CI 1.9; 27.7]), adverse events (OR 9.1 [2.5; 33.3]), or other reasons (OR 7.7 [1.6; 37.9]) compared to primary failure. Conclusion: Patients with axSpA with secondary failure to their first TNFi, compared to those with primary failure, have a better response to the second TNFi according to stringent outcomes.publishersversionpublishe

going beyond BASDAI

This work was supported by a Research Grant from the InvestigatorInitiated Studies program of Merck Sharp & Dohme (Grant No. 56078). The sponsor did not interfere with the study question, analysis or interpretation of results. AS is supported by a doctoral grant from Fundação para a Ciência e Tecnologia (Foundation for Science and Technology) (SFRH/BD/108246/2015).OBJECTIVES: To compare definitions of high disease activity of the Ankylosing Spondylitis Disease Activity Score (ASDAS) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in selecting patients for treatment with biologic disease-modifying antirheumatic drugs (bDMARDs). METHODS: Patients from Rheumatic Diseases Portuguese Register (Reuma.pt) with a clinical diagnosis of axial spondyloarthritis (axSpA) were included. Four subgroups (cross-tabulation between ASDAS (≥2.1) and BASDAI (≥4) definitions of high disease activity) were compared regarding baseline characteristics and response to bDMARDs at 3 and 6 months estimated in multivariable regression models. RESULTS: Of the 594 patients included, the majority (82%) had both BASDAI≥4 and ASDAS ≥2.1. The frequency of ASDAS ≥2.1, if BASDAI<4 was much larger than the opposite (ie, ASDAS <2.1, if BASDAI≥4): 62% vs 0.8%. Compared to patients fulfilling both definitions, those with ASDAS ≥2.1 only were more likely to be male (77% vs 51%), human leucocyte antigen B27 positive (79% vs 65%) and have a higher C reactive protein (2.9 (SD 3.5) vs 2.1 (2.9)). Among bDMARD-treated patients (n=359), responses across subgroups were globally overlapping, except for the most 'stringent' outcomes. Patients captured only by ASDAS responded better compared to patients fulfilling both definitions (eg, ASDAS inactive disease at 3 months: 61% vs 25% and at 6 months: 42% vs 25%). CONCLUSION: The ASDAS definition of high disease activity is more inclusive than the BASDAI definition in selecting patients with axSpA for bDMARD treatment. The additionally 'captured' patients respond better and have higher likelihood of predictors thereof. These results support using ASDAS≥2.1 as a criterion for treatment decisions.publishersversionpublishe