Prevention of falls in the elderly in the home: promoting active ageing

Objective: To determine the frequency of falls and identify risk factors in the homes of the elderly under the Home Care Service of a village in Alentejo (Portugal). Method: Exploratory, descriptive study. The target group were elderly persons under the Home Care Service (23). The questionnaire consists of open and closed questions, and was based on the Jefferson Area Board for Aging Safety in the Home Assessment; Instrument to Assess the Risk of Falls and Adaptations to Prevent Falls at Home. Results: Of the 23 seniors, 13 were men; the mean age was 85; 10 widowers; 11 live alone; 12 cannot read or write; 17 have experienced falls, loss of balance being the main cause. They report changes in vision (21), hearing (14) and rheumatic diseases (14); hypertension (19); they use 4 or more drugs on a daily basis (16). Conclusion: The physiological changes associated with ageing may increase the risk of falls. Due to the consequences, it is a priority field in community intervention.

Prevention of falls in the elderly in the home: promoting active ageing

To determine the frequency of falls and identify risk factors in the homes of the elderly under the Home Care Service of a village in Alentejo (Portugal). Method: Exploratory, descriptive study. The target group were elderly persons under the Home Care Service (23). The questionnaire consists of open and closed questions, and was based on the Jefferson Area Board for Aging Safety in the Home Assessment; Instrument to Assess the Risk of Falls and Adaptations to Prevent Falls at Home. Results: Of the 23 seniors, 13 were men; the mean age was 85; 10 widowers; 11 live alone; 12 cannot read or write; 17 have experienced falls, loss of balance being the main cause. They report changes in vision (21), hearing (14) and rheumatic diseases (14); hypertension (19); they use 4 or more drugs on a daily basis (16). Conclusion: The physiological changes associated with ageing may increase the risk of falls. Due to the consequences, it is a priority field in community intervention.

Prevenção do tabagismo: um caminho na prestação de cuidados de saúde

Esta tese é constituída por dois estudos. O estudo de prevenção primária é experimental, ensaio clínico randomizado, cujo programa de intervenção “Para- Par sem Tabaco” é baseado na metodologia da formação pelos pares, com o objectivo de avaliar a sua eficácia. A amostra é constituída por 310 estudantes que frequentam o 7º e 8º Anos das Escolas Básicas e Secundárias de Oliveira de Azeméis por amostragem aleatória em conglomerados (turmas). 153 estudantes constituíram o grupo de controlo e 157 o grupo experimental. A observação foi feita antes, no final e passado um ano da intervenção. Foram construídas e validadas três escalas, que apresentaram bons argumentos de fidelidade e validade. Dos resultados ressaltam os benefícios na redução do consumo de cigarros por semana, a perspectiva futura menos associada ao consumo de tabaco; uma evolução na concordância sobre o alto risco face à auto-estima, comportamentos e tabaco; e alguma consistência nas suas percepções sobre o tabaco e as motivações dos fumadores. Verificou-se uma maior eficácia no sexo masculino. Nos dois grupos, com o aumento da idade, aumentou a idade de experimentação tabágica, o número de cigarros consumidos semanalmente e o número de amigos fumadores. No grupo experimental, constata-se que os adolescentes filhos de pais fumadores consomem mais cigarros por semana e têm mais amigos fumadores. O estudo de prevenção secundária e terciária do tabagismo foi efectuado com o objectivo de avaliar a eficácia e identificar os factores que interferem nas consultas de cessação tabágica. Tratando-se de um estudo descritivocorrelacional retrospectivo e de coorte. A amostra (probabilística aleatória – K=4) foi constituída por 395 elementos inscritos na consulta de cessação tabágica de 12 Centros de Saúde do Distrito de Aveiro entre 2004 a 2009 (pesquisa de arquivo). A avaliação foi feita em três momentos: na última consulta, aos três e seis meses de seguimento. Conclui-se que os elementos com mais habilitações académicas, que consomem menos cigarros e com menor grau de dependência tabágica, são os que apresentam maior sucesso na cessação tabágica aos três meses de seguimento. Os sujeitos que referem, na primeira consulta, conseguir reduzir menos cigarros e os que apresentam maior motivação, na primeira consulta, são os que apresentam mais sucesso na cessação tabágica na última consulta e aos três meses de seguimento. Os elementos com mais idade, sem apoio familiar, que apresentam um maior tempo sem fumar, em tentativas anteriores e os que mais utilizaram as consultas, foram os que conseguiram mais sucesso na cessação tabágica aos três e seis meses de seguimento. Os elementos que não fizeram tratamento específico não têm sucesso. Os elementos da amostra obtiveram ganho ponderal com redução nos valores da pressão arterial sistólica e diastólica. Destes estudos foram retiradas algumas linhas orientadoras para a prestação de cuidados de saúde nesta complexa área de intervenção.

During pregnancy, recreational drug-using women stop taking ecstasy (3,4-methylenedioxy-N-methylamphetamine) and reduce alcohol consumption but continue to smoke tobacco and cannabis

While recreational drug use in UK women is prevalent, to date there is little prospective data on patterns of drug use in recreational drug-using women immediately before and during pregnancy. A total of 121 participants from a wide range of backgrounds were recruited to take part in the longitudinal Development and Infancy Study (DAISY) study of prenatal drug use and outcomes. Eighty-six of the women were interviewed prospectively while pregnant and/or soon after their infant was born. Participants reported on use immediately before and during pregnancy and on use over their lifetime. Levels of lifetime drug use of the women recruited were high, with women reporting having used at least four different illegal drugs over their lifetime. Most users of cocaine, 3,4-methylenedioxy-N-methylamphetamine (MDMA) and other stimulants stopped using these by the second trimester and levels of use were low. However, in pregnancy, 64% of the sample continued to use alcohol, 46% tobacco and 48% cannabis. While the level of alcohol use reduced substantially, average tobacco and cannabis levels tended to be sustained at pre-pregnancy levels even into the third trimester (50 cigarettes and/or 11 joints per week). In sum, while the use of ‘party drugs’ and alcohol seems to reduce, levels of tobacco and cannabis use are likely to be sustained throughout pregnancy. The data provide polydrug profiles that can form the basis for the development of more realistic animal models.

Searching biocompounds in marine natural extracts with potential use in tumor prevention and treatment

Cancer is a multistage process characterized by three stages: initiation, promotion and progression; and is one of the major killers worldwide. Oxidative stress acts as initiator in tumorigenesis; chronic inflammation promotes cancer; and apoptosis inactivation is an issue in cancer progression. In this study, it was investigated the antioxidant, antiinflammatory and antitumor properties of hexane, ether, chloroform, methanol and water extracts of five species of halophytes: A. macrostachyum, P. coronopus, J. acutus, C. edulis and A. halimus. Antioxidant activity was assessed by DPPH• and ABTS•+ methods, and the total phenolics content (TPC) was evaluated by the Folin-Ciocalteau method. The anti-inflammatory activity of the extracts was determined by the Griess method, and by evaluating the inhibition of NO production in LPS-stimulated RAW- 264.7 macrophages. The cytotoxic activity of the extracts against HepG2 and THP1 cell lines was estimated by the MTT assay, and the results obtained were further compared with the S17 non-tumor cell line. The induction of apoptosis of J. acutus ether extract was assessed by DAPI staining. The highest antioxidant activities was observed in C. edulis methanol and the J. acutus ether extracts against the DPPH• radical; and J. acutus ether and A. halimus ether extracts against the ABTS•+ radical. The methanol extracts of C. edulis and P. coronopus, and the ether extract of J. acutus revealed a high TPC. Generally the antioxidant activity had no correlation with the TPC. The A. halimus chloroform and P. coronopus hexane extracts demonstrated ability to reduce NO production in macrophages (> 50%), revealing their anti-inflammatory capacity. The ether extract of J. acutus showed high cytotoxicity against HepG2 cancer cells, with reduced cellular viability even at the lowest concentrations. This outcome was significantly lower than the obtained with the non-tumor cells (S17). This result was complemented by the induction of apoptosis.

South Carolina tobacco directory

This tobacco directory lists tobacco products sold in South Carolina by name, company name, original certification date, action type and agreement type.

Alcohol, Tobacco and Drugs : What they can do to you and your family

This sheet written in English and Spanish tells of the dangers of alcohol, tobacco and drug use during pregnancy and how you can get help in quitting these habits.

New approaches for the diagnosis of human papillomavirus infection:relevance for clinical practice and cancer prevention

Tese de doutoramento, Biologia (Microbiologia), Universidade de Lisboa, Faculdade de Ciências, 2014

Study of predictive biomarkers of manganese toxicity : control and prevention of neurotoxicity associated with parenteral nutrition

Tese de doutoramento, Farmácia (Toxicologia), Universidade de Lisboa, Faculdade de Farmácia, 2014

Comportamentos autolesivos em adolescentes : características epidemiológicas e análise de fatores psicopatológicos, temperamento efetivo e estratégias de coping

Tese de doutoramento, Medicina (Psiquiatria e Saúde Mental), Universidade de Lisboa, Faculdade de Medicina, 2014

Pharmacotherapy follow-up in the prevention of cardiovascular disease

Cardiovascular diseases are the leading cause of death in Portugal, alike what is verified in the remaining western countries. There are factors that increase the risk of its occurrence, that do not usually emerge isolated, tending to group in the individual. This coexistence results in a combined effect which is larger than the one expected from the sum of its individual effects. The global cardiovascular risk is defined as the percentage change of developing a cardiovascular event over a given period of time (generally 10 years). The purpose of global cardiovascular risk assessment is to identify the individuals who should be counseled and receive treatment to prevent a cardiovascular disease, as well as to establish the therapeutics aggressiveness level.

Translating proteomics into environmental health : biomarkers discovery for tobacco smoke-induced biological damage

Tese de doutoramento, Biologia (Biologia Molecular), Universidade de Lisboa, Faculdade de Ciências, 2015

The effect of acute alcohol exposure on hepatic oxidative stress and function: prevention by micronutrients

Alcohol binge drinking, especially in teenagers and young adults is a major public health issue in the UK, with the number of alcohol related liver disorders steadily increasing. Understanding the mechanisms behind liver disease arising from binge-drinking and finding ways to prevent such damage are currently important areas of research. In the present investigation the effect of acute ethanol administration on hepatic oxidative damage and apoptosis was examined using both an in vivo and in vitro approach; the effect of micronutrient supplementation prior and during ethanol exposure was also studied. The following studies were performed: (1) ethanol administration (75 mmol/kg body weight) and cyanamide pre-treatment followed by ethanol to study elevated acetaldehyde levels with liver tissue analysed 2.5, 6 and 24 hours post-alcohol; (2). Using juvenile animals, 2% betaine supplementation followed by acute ethanol with tissue analysed 24 hrs post ethanol; and (3). Micronutrient supplementation during concomitant ethanol exposure to hepG2 cells. It was found that a single dose of alcohol caused oxidative damage to the liver of rats at 2.5 hr post-alcohol as evidenced by decreased glutathione levels and increased malondialdehyde levels in both the cytosol and mitochondria. Liver function was also depressed but there were no findings of apoptosis as cytochrome c levels and caspase 3 activity was unchanged. At 6 hours, the effect of ethanol was reduced suggesting some degree of recovery, however, by 24 hours, increased mitochondrial oxidative stress was apparent. The effect of elevated acetaldehyde on hepatic damage was particularly evident at 24 hours, with some oxidative changes at earlier time points. At 24 hours, acetaldehyde caused a profound drop in glutathione levels in the cytosol and hepatic function was still deteriorating. Studies examining ethanol exposure to juvenile livers showed that glutathione levels were increased, suggesting an overtly protective response not seen in with older animals. It also showed that despite cytochrome c release into the cytosol, caspase-3 levels were not increased. This suggests that ATP depletion is preventing apoptosis initiation. Betaine supplementation prevented almost all of the alcohol-mediated changes, suggesting that the main mechanism behind alcohol-mediated liver damage is oxidative stress. Results using the hepG2 cell line model showed that micronutrients involved in glutathione synthesis can protect against hepatocyte damage caused by alcohol metabolism, with reduced reactive oxygen species and increased/maintained glutathione levels. In summary, these results demonstrate that both acute alcohol and acetaldehyde can have damaging effects to the liver, but that dietary intervention may be able to protect against ethanol induced oxidative stress.

The effect of smoking nicotine tobacco versus smoking deprivation on motion sickness

BACKGROUND: The experienced smoker maintains adequate nicotine levels by 'puff-by-puff self-control' which also avoids symptomatic nauseating effects of nicotine overdose. It is postulated that there is a varying 'dynamic threshold for nausea' into which motion sickness susceptibility provides an objective toxin-free probe. Hypotheses were that: (i) nicotine promotes motion sickness whereas deprivation protects; and (ii) pleasurable effects of nicotine protect against motion sickness whereas adverse effects of withdrawal have the opposite effect. METHODS: Twenty-six healthy habitual cigarette smokers (mean±SD) 15.3±7.6cigs/day, were exposed to a provocative cross-coupled (coriolis) motion on a turntable, with sequences of 8 head movements every 30s. This continued to the point of moderate nausea. Subjects were tested after either ad-lib normal smoking (SMOKE) or after overnight deprivation (DEPRIV), according to a repeated measures design counter-balanced for order with 1-week interval between tests. RESULTS: Deprivation from recent smoking was confirmed by objective measures: exhaled carbon monoxide CO was lower (P<0.001) for DEPRIV (8.5±5.6ppm) versus SMOKE (16.0±6.3ppm); resting heart rate was lower (P<0.001) for DEPRIV (67.9±8.4bpm) versus SMOKE (74.3±9.5bpm). Mean±SD sequences of head movements tolerated to achieve moderate nausea were more (P=0.014) for DEPRIV (21.3±9.9) versus SMOKE (18.3±8.5). DISCUSSION: Tolerance to motion sickness was aided by short-term smoking deprivation, supporting Hypothesis (i) but not Hypothesis (ii). The effect was was approximately equivalent to half of the effect of an anti-motion sickness drug. Temporary nicotine withdrawal peri-operatively may explain why smokers have reduced risk for postoperative nausea and vomiting (PONV).

Occupational exposure to environmental tobacco smoke in hospitality venues: are genetic- or proteomics-based biomarkers predictive of respiratory diseases?

Environmental tobacco smoke (ETS) is recognized as an occupational hazard in the hospitality industry. Although Portuguese legislation banned smoking in most indoor public spaces, it is still allowed in some restaurants/bars, representing a potential risk to the workers’ health, particularly for chronic respiratory diseases. The aims of this work were to characterize biomarkers of early genetic effects and to disclose proteomic signatures associated to occupational exposure to ETS and with potential to predict respiratory diseases development. A detailed lifestyle survey and clinical evaluation (including spirometry) were performed in 81 workers from Lisbon restaurants. ETS exposure was assessed through the level of PM 2.5 in indoor air and the urinary level of cotinine. The plasma samples were immunodepleted and analysed by 2D-SDSPAGE followed by in-gel digestion and LC-MS/MS. DNA lesions and chromosome damage were analysed innlymphocytes and in exfoliated buccal cells from 19 cigarette smokers, 29 involuntary smokers, and 33 non-smokers not exposed to tobacco smoke. Also, the DNA repair capacity was evaluated using an ex vivo challenge comet assay with an alkylating agent (EMS). All workers were considered healthy and recorded normal lung function. Interestingly, following 2D-DIGE-MS (MALDI-TOF/TOF), 61 plasma proteins were found differentially expressed in ETS-exposed subjects, including 38 involved in metabolism, acute-phase respiratory inflammation, and immune or vascular functions. On the other hand, the involuntary smokers showed neither an increased level of DNA/chromosome damage on lymphocytes nor an increased number of micronuclei in buccal cells, when compared to non-exposed non-smokers. Noteworthy, lymphocytes challenge with EMS resulted in a significantly lower level of DNA breaks in ETS-exposed as compared to non-exposed workers (P<0.0001) suggestive of an adaptive response elicited by the previous exposure to low levels of ETS. Overall, changes in proteome may be promising early biomarkers of exposure to ETS. Likewise, alterations of the DNA repair competence observed upon ETS exposure deserves to be further understood. Work supported by Fundação Calouste Gulbenkian, ACSS and FCT/Polyannual Funding Program.