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- Asthma is more frequently associated with non-allergic than allergic rhinitis in Portuguese patientsPublication . Lourenço, Olga; Fonseca, AM; Barata, Luis TabordaBackground: Rhinitis prevalence is increasing worldwide and is frequently associated with asthma, for which it is a risk factor. The aims of the study were to characterise the adult population with rhinitis attending the Cova da Beira Hospital Allergy Clinic, and to assess the relationship between rhinitis and asthma. Methods: In total, 686 patients were characterised by clinical history and anterior rhinoscopy, and classified according to international guidelines. Atopy was determined by skin prick testing to aeroallergens and quantification of specific IgE. Results: Seventy two percent of patients had allergic rhinitis (AR), and 28% had non-allergic rhinitis (NAR). NAR was more frequently associated with older age, perennial symptoms and female gender. NAR patients more frequently had bronchial asthma. In addition, more NAR than AR patients also had drug allergy, pharyngitis, sinusitis and urticaria. AR patients with nasal polyps more frequently had asthma. Grass pollen and mites were the major sensitisers for AR patients. Sensitisation profiles were not significantly different between urban- and ruralbased AR patients. Conclusions: Asthma was more frequently associated with non-allergic than with allergic rhinitis. The two types of rhinitis did not differ in clinical severity. Although sensitisation profiles were not different between the urban and rural patients, allergic rhinitis prevalence was higher in urban patients.
- Promoting players’ safety and welfare through the sharing of scientific knowledge with sports agents: the new reality of Portuguese rugby sevensPublication . Ferreira, António Miguel da Cruz; Ferreira, Eduardo Cruz; Barata, Luis Taborda; Santiago, Luiz Miguel de Mendonça SoaresAs the authors of the recently published article “Epidemiology of injuries in senior male rugby union sevens: a systematic review”, we would like to share with you its impact on the Portuguese rugby community and our achievements since then. [...]
- Epidemiology of Time-Loss Injuries in Senior and Under-18 Portuguese Male Rugby PlayersPublication . Ferreira, António Miguel da Cruz; Ferreira, Eduardo Cruz; Ribeiro, Pedro Barbosa; Santiago, Luiz Miguel de Mendonça Soares; Barata, Luis TabordaRugby union has one of the highest injury incidence rates in team sports, however, most of the available data focus on the epidemiology of injuries in countries where rugby is popular. We aimed to report the incidence rate and relevant epidemiological aspects of injuries occurred in a group of Portuguese male rugby players. A prospective cohort study was conducted with a group of 45 senior and 32 under-18 male players (total of 77 players). Outcome measures included injury incidence, position, type, location and severity of injuries. The match injury incidence for all players was 55.84 per 1000 player match-hours (66.66 for seniors, 42.85 for under-18), while mean time-loss for injury was 20.79 days. No statistical differences were found between groups. Lower limb injuries accounted for 60.5% of all injuries, while joint/ligament injuries were the most prevalent type. Contact events were responsible for 65.1% of injuries. Despite the limitations, the obtained data are consistent with the literature. Time-loss injuries seem highly prevalent in rugby union and the incidence rates found in this Portuguese-based study were lower than the reported for international and senior men's professional rugby union, but higher than those occurring in community rugby in tier-1 countries. The authors believe these data reinforce the need to develop and implement effective injury surveillance and prevention programs.
- Five-year follow-up of participants diagnosed with chronic airflow obstruction in a South African Burden of Obstructive Lung Disease (BOLD) surveyPublication . Allwood, Brian; Gillespie, R; Bateman, Mary; Olckers, Helena; Barata, Luis Taborda; Calligaro, Gregory L; van Zyl-Smit, Richard; Cooper, Christopher B; Beyers, N; Bateman, EricBackground. A community-based prevalence survey performed in two suburbs in Cape Town, South Africa (SA), in 2005, using the international Burden of Obstructive Lung Disease (BOLD) method, confirmed a prevalence of chronic airflow obstruction (CAO) in 23.1% of adults aged >40 years. Objectives. To study the clinical course and prognosis over 5 years of patients with CAO identified in the 2005 survey. Methods. Patients with CAO in 2005 were invited to participate. Standard BOLD and modified questionnaires were completed. Spirometry was performed using spirometers of the same make as in 2005. Results. Of 196 eligible participants from BOLD 2005, 45 (23.0%) had died, 8 from respiratory causes, 10 from cardiovascular causes and 6 from other known causes, while in 21 cases the cause of death was not known. On multivariate analysis, only age and Global initiative for Obstructive Lung Disease (GOLD) stage 4 disease at baseline were significantly associated with death. Of the 151 survivors, 11 (5.6% of the original cohort) were unavailable and 33 (16.8%) declined or had medical exclusions. One hundred and seven survivors were enrolled in the follow-up study (54.6%, median age 63.1 years, 45.8% males). Post-bronchodilator spirometry performed in 106 participants failed to confirm CAO, defined as a forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) ratio of <0.7, in 16 participants (15.1%), but CAO was present in 90. The median decline in FEV1 was 28.9 mL/year (interquartile range –54.8 - 0.0) and was similar between GOLD stages. The median total decline in FVC was 75 mL, and was significantly greater in GOLD stage 1 (–350 mL) than in stages 2 or 3 (–80 mL and +140 mL, respectively; p<0.01). Fifty-eight participants with CAO in 2005 (64.4%) remained in the same GOLD stage, while 21 (23.3%) deteriorated and 11 (12.2%) improved by ≥1 stage. Only one-third were receiving any treatment for chronic obstructive pulmonary disease (COPD). Conclusions. The prevalence, morbidity and mortality of CAO and COPD in SA are high and the level of appropriate treatment is very low, pointing to underdiagnosis and inadequate provision of and access to effective treatments and preventive strategies for this priority chronic non-communicable disease.
- Demographic, laboratory and clinical characterisation of adult portuguese asthmatic patientsPublication . Lourenço, Olga; Fonseca, A. M.; Barata, Luis TabordaAsthma is a heterogeneous chronic inflammatory condition characterised by reversible airway obstruction and hyperresponsiveness associated with underlying bronchial inflammation and structural changes. It represents an increasing health problem and is a huge burden on the patients, their families and society. The aim of the study was to characterise the adult asthmatic population attending a Hospital Allergy Clinic between the years of 2003 and 2006.
- Prevalence and risk factors for food allergy in older people: protocol for a systematic reviewPublication . Dias, Inês Laia; Lozoya-Ibáñez, Carlos; Skypala, Isabel; Gama, Jorge; Nurmatov, Ulugbek; Lourenço, Olga; Barata, Luis TabordaStudies suggest that the prevalence of food allergy may be increasing worldwide. Results regarding the prevalence and features of adverse food reactions older people have, however, scarcely been analysed in the literature. Thus, the objective of the present systematic review will be to describe the prevalence of food allergy in older individuals, its risk factors, clinical features, as well as the most frequently and commonly involved foods.
- Inhaler training and asthma knowledge are associated with a higher proportion of patients with correct inhaler technique in young but not in elderly asthmatic patientsPublication . Ferreira, Eduardo Freitas; Pascoal, Adriana dos Santos; Silva, Patrícia; Lourenço, Olga; Valente, Maria La Salete; Valente, Maria de Jesus; Loureiro, Marli; Gama, Jorge; Fonseca, Joao A; Taborda Barata, LuisObjective: Incorrect inhaler usage is frequent, particularly in elderly asthmatic patients. This study aimed at comparing inhaler technique errors and their determinants, as well inhaler technique self-perception versus real performance, between elderly and non-elderly asthmatics. Methods: Cross-sectional assessment of 92 elderly and 100 non-elderly asthmatics followed at specialty clinics. A standardized questionnaire was applied and inhaler technique demonstration was requested. Errors were assessed using checklists based on manufacturers’ instructions and inhaler technique was graded as correct, acceptable or incorrect. Chi-Square Test and Fischer’s Exact Test were used for comparative analysis of nominal variables. A p value equal to or less than 0.05 was considered statistically significant. Results: Inhaler technique was correct in a minority of elderly and young patients, without significant differences between study groups. Only 11.1% of the elderly who classified their inhaler as easy and 12.7% who stated their technique was correct had no errors. Previous regular inhaler training was associated with better actual performance in young but not in elderly patients. Conclusion: Our study showed that in spite of regular follow up at specialized outpatient clinics, inhaler devices are associated with a high frequency of errors in elderly and non-elderly asthmatics. In addition, most patients tend to overestimate their technique as correct. Finally, previous, frequent training was associated with a significantly higher percentage of patients showing correct or acceptable technique but only in non-elderly asthmatics, which suggests that elderly asthmatics may need specifically tailored inhaler education programs.
- Quantificação de mercúrio em amostras de pó doméstico recolhidas na cidade da Covilhã (Portugal) - Resultados preliminares do projeto 6x60x6Publication . Neves, Sara M.; Pastorinho, Manuel Ramiro Dias; Barata, Luis Taborda; Patto, Maria Da Assunção Vaz; Monteiro, Marisa Rodrigues; Nepomuceno, Miguel; Lanzinha, João; Sousa, Ana Catarina AlmeidaA 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.
- Patient‐centered digital biomarkers for allergic respiratory diseases and asthma: The ARIA‐EAACI approach – ARIA‐EAACI Task Force ReportPublication . Bousquet, Jean; Shamji, Mohamed; Anto, Josep M.; Schünemann, Holger; Canonica, Giorgio Walter; Jutel, Marek; Del Giacco, Stafano; Zuberbier, Torsten; Pfaar, Oliver; Fonseca, Joao A; Pinto, Bernardo Sousa; Pétré, Benoit; Pham‐Thi, Nhân; Puggioni, Francesca; Quirce, Santiago; Roche, Nicolas; Rouadi, Philip; Sousa, Ana Sá; Sagara, Hironori; Sastre, Joaquin; Scichilone, Nicola; Sheikh, Aziz; Sova, Milan; Ulrik, Charlotte Suppli; Taborda Barata, Luis; Todo-Bom, Ana; Torres, María Jose; Tsiligianni, Ioanna; Usmani, Omar; Valovirta, Erkka; Vasankari, Tuula; Vieira, Rafael José; Wallace, Dana; Waserman, Susan; Zidarn, Mihaela; Yorgancıoglu, Arzu; Zhang, Luo; Chivato, Tomás; Ollert, Markus; Klimek, Ludger; Czarlewski, Wienczyslawa; Bedbrook, Anna; Amaral, Rita; Ansotegui Zubeldia, Ignacio Javier; Bosnic-Anticevich, Sinthia; Braido, Fulvio; Loureiro, Cláudia Chaves; Gemicioglu, Bilun; Haahtela, Tari; Kulus, Marek; Kuna, Piotr; Kupczyk, Maciej; Matricardi, Paolo Maria; Regateiro, Frederico S.; Samoliński, Bolesław; Sofiev, Mikhail; Toppila-Salmi, Sanna; Valiulis, Arunas; Ventura, Maria Teresa; Bárbara, Cristina; Bergmann, Karl-Christian; Bewick, Michael; Blain, Hubert; Bonini, Matteo; Boulet, Louis-Philippe; Bourret, Rodolphe; Brusselle, Guy; Brussino, Luisa; Buhl, Roland; Cardona, Victoria; Casale, Thomas; Cecchi, Lorenzo; Charpin, Denis; Cherrez Ojeda, Ivan; Chu, Derek K; Cing, Cemal; Costa, Elísio; Cruz, Álvaro A.; Devillier, Philippe; Dramburg, Stephanie; Fokkens, Wytske; Gotua, Maia; Heffler, Enrico; Ispayeva, Zhanat; Ivancevich, Juan Carlos; Joos, Guy; Kaidashev, Igor; Kraxner, Helga; Kvedarienė, Violeta; Larenas Linnemann, Désirée; Laune, Daniel; Lourenço, Olga; Louis, Renaud; Mäkelä, Mika J.; Makris, Michael; Maurer, Marcus; Melén, Erik; Micheli, Yann; Almeida, Mário Morais; Mullol, Joaquim; Niedoszytko, Marek; O'Hehir, Robyn; Okamoto, Yoshitaka; Olze, Heidi; Papadopoulos, Nikolaos G.; Papi, Alberto; Patella, VincenzoBiomarkers for the diagnosis, treatment and follow-up of patients with rhinitis and/ or asthma are urgently needed. Although some biologic biomarkers exist in specialist care for asthma, they cannot be largely used in primary care. There are no validated biomarkers in rhinitis or allergen immunotherapy (AIT) that can be used in clinical practice. The digital transformation of health and health care (including mHealth) places the patient at the center of the health system and is likely to optimize the practice of allergy. Allergic Rhinitis and its Impact on Asthma (ARIA) and EAACI (European Academy of Allergy and Clinical Immunology) developed a Task Force aimed at proposing patient-reported outcome measures (PROMs) as digital biomarkers that can be easily used for different purposes in rhinitis and asthma. It first defined control digital biomarkers that should make a bridge between clinical practice, randomized controlled trials, observational real-life studies and allergen challenges. Using the MASK-air app as a model, a daily electronic combined symptom-medication score for allergic diseases (CSMS) or for asthma (e-DASTHMA), combined with a monthly control questionnaire, was embedded in a strategy similar to the diabetes approach for disease control. To mimic real-life, it secondly proposed quality-of- life digital biomarkers including daily EQ-5D visual analogue scales and the bi-weekly RhinAsthma Patient Perspective (RAAP). The potential implications for the management of allergic respiratory diseases were proposed.
- Toxic metals in indoor dust collected from houses included in the “6x60x6” Project (Covilhã, Portugal) during the cooling seasonPublication . Pastorinho, Ramiro; Lanzinha, João; Barata, Luis Taborda; Patto, Maria Da Assunção Vaz; Monteiro, Marisa Rodrigues; Nepomuceno, Miguel; Sousa, Ana Catarina AlmeidaWe 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.