Salvador Massano Cardoso

O VIH constitui um dos principais problemas de saúde pública nos países da EU/EEE. Os novos casos continuam a aumentar em homens que têm sexo com homens, que representam 42 % dos novos casos diagnosticados. 47% dos novos diagnósticos ocorrem em fase avançada da infeção. O tratamento como prevenção, a profilaxia préexposição e a indicação de tratamento independentemente das T CD4+, alteraram o paradigma de abordagem da infeção. Os programas dos últimos dez anos devem-se às Declarações de Dublin e Vílnius. A intensificação da prevenção e do tratamento nos próximos 5 anos são essenciais para atingirmos o objetivo “90-90-90”.http://dx.doi.org/10.14195/1647-6336_14_6

OBJECTIVE To evaluate the exploratory relationship between determinants of health, life satisfaction, locus of control, attitudes and behaviors and health related quality of life in an adult population. METHODS Observational study (analytical and cross-sectional) with a quantitative methodological basis. The sample was composed oy 1,214 inhabitants aged ≥ 35 in 31 civil parishes in the County of Coimbra, Portugal, 2011-2012. An anonymous and voluntary health survey was conducted, which collected the following information: demographic, clinical record, health and lifestyle behaviors; health related quality of life (Medical Outcomes Study, Short Form-36); health locus of control; survey of health attitudes and behavior, and quality of life index. Pearson’s Linear Correlation, t-Student, Wilcoxon-Mann-Whitney; One-way ANOVA; Brown-Forsythe’s F; Kruskal-Wallis; Multiple Comparisons: Tukey (HSD), Games-Howell and Conover were used in the statistical analysis. RESULTS Health related quality of life was shown to be lower in females, in older age groups, in obese/overweight individuals, widows, unassisted, those living alone, living in rural/suburban areas, those who did not work and with a medium-low socioeconomic level. Respondents with poor/very poor self-perceived health (p < 0.0001), with chronic disease (p < 0.0001), who consumed < 3 meals per day (p ≤ 0.01), who were sedentary, who slept ≤ 6 h/day and had smoked for several years revealed the worst health results. Health related quality of life was positively related with a bigger internal locus, with better health attitudes and behaviors (physical exercise, health and nutritional care, length of dependence) and with different areas of life satisfaction. CONCLUSIONS Better health related quality of life was associated with certain social, psychological, family and health characteristics, a satisfactory lifestyle, better socioeconomic conditions and a good internal locus of control over health attitudes and behaviors.

This study aimed to assess the treatment patterns and prevalence of persistent lipid abnormalities in Portuguese hypertensive patients concomitantly treated with statins. Only 25% of the 656 hypertensive patients achieved the blood pressure goals in use during the study period. Similarly, only 33% and 37% attained the recommended levels of total cholesterol<4.5 mmol/L and LDL cholesterol<2.5 mmol/L, respectively. Relatively low doses of medium potency statins were the mainstay of therapy. There seems to be considerable room for improvement through the use of more potent statins, dose up-titration, and/or addition of other lipid-modifying therapies.

O impacto ambiental dos transportes é evidente em qualidade do ar urbano. Urbanização traz consigo muitas transformações da natureza incluindo a poluição. Cada cidade terá um papel crucial a desempenhar na minimização das atividades que contribuem para a destruição da camada de ozônio e do aquecimento global. A poluição atmosférica constitui um problema de saúde com reflexos a longo prazo. O aumento das preocupações com a economia de energia, conduziram à necessidade de reduzir as infiltrações de ar, de forma a diminuir os consumos energéticos na climatização. Esta diminuição, associada à entrada de novos materiais e técnicas de construção, foi tornando os edifícios mais estanques, o que se traduziu em problemas na qualidade do ar interior quando os meios de ventilação não são adequados. O presente trabalho pretendeu avaliar no outono/inverno e na primavera/verão a associação entre a qualidade do ar interior, em escolas localizadas em diferentes locais, da cidade de Coimbra e a prevalência de patologia alérgica e respiratória nas crianças que as frequentam. Os resultados vêm reforçar o interesse da exposição aos poluentes do ar em crianças, que frequentam escolas localizadas em meios predominantemente urbanas ou mediamente urbanas, relativamente às que frequentam escolas localizadas em meios predominantemente rurais.

OBJETIVO : Analisar a qualidade do ar em escolas de educação básica e suas condições estruturais e funcionais. MÉTODOS : Foi avaliada a qualidade do ar de 51 escolas (81 salas de aula) de educação básica da cidade de Coimbra, Portugal, tanto na parte interior das salas como na exterior, durante as quatro estações do ano, de 2010 a 2011. Foram avaliadas a temperatura (Tº), umidade relativa (Hr), concentrações de monóxido de carbono (CO), dióxido de carbono (CO 2 ), ozona (O 3 ), dióxido de nitrogênio (NO 2 ), dióxido de enxofre (SO 2 ), compostos orgânicos voláteis (COV), formaldeído e material particulado (PM 10 ), de novembro de 2010 a fevereiro de 2011 (outono/inverno) e de março de 2011 a junho de 2011 (primavera/verão). Procedeu-se ao preenchimento de uma grelha de caracterização das condições estruturais e funcionais das escolas. Aplicaram-se os testes estatísticos t- Student para amostras emparelhadas e o teste t de Wilcoxon. RESULTADOS : Em 47 escolas, as concentrações médias de CO 2 encontravam-se acima da concentração máxima de referência (984 ppm) mencionada na legislação portuguesa. Os valores máximos de concentração encontrados no interior das salas foram críticos, principalmente no outono/inverno (5.320 ppm). As concentrações médias de COV e de PM 10 no interior ultrapassaram a concentração máxima de referência legislada em algumas escolas. Não foram detetados valores relevantes (risco) de CO, formaldeído, NO 2 , SO 2 e O 3 . CONCLUSÕES : Houve maior concentração de poluentes no interior das salas, comparativamente com o exterior. A inadequada ventilação está associada à elevada concentração de CO 2 nas salas de aula

Background/Aims: Chronic kidney disease (CKD) is a growing public health problem. However, data on risk factors and prevalence of CKD exist only in a small number of countries. Portugal has the highest incidence of end-stage renal disease (ESRD) among European countries, but there are huge disparities among countries. Whether these disparities reflect differences in risk factors, prevalence of CKD or other factors is currently unknown. Methods: We analyzed data from a nationally representative sample of 5,167 subjects, and estimated the prevalence of CKD and associated risk factors, and combined these prevalence estimates with available data on ESRD. Results: The prevalence of risk factors such as diabetes (11.7%), obesity (33.7%), and metabolic syndrome (41.5%) was similar to that in the US, but greater than in most European countries. The prevalence of CKD stages 3–5 was 6.1%, which is similar to that in other Western countries. The risk of ESRD was greater than in other European countries, but lower than in the US. Conclusion: The high incidence of ESRD among the Portuguese population is not due to a greater prevalence of CKD. A higher rate of progression associated with the high prevalence of risk factors may account for the high incidence of ESRD. The role of unmeasured factors needs to be evaluated in further studies.

Diabet. Med. 27, 879–881 (2010) Aims  Diabetes is a growing worldwide problem. Ascertaining its prevalence is vital as a starting point to establish and measure the success of health interventions. This study aimed to determine the prevalence of Type 2 diabetes and ‘pre‐diabetes’, defined as impaired fasting glucose and impaired glucose tolerance, in the Portuguese population aged between 20 and 79 years.Methods  Considering the number of inhabitants between 20 and 79 years old, statistical units were selected that were representative regionally and nationally. The total sample comprised 5167 subjects. National prevalence was calculated. Analyses were performed on all those without previously known diabetes using World Health Organization reference diagnostic criteria.Results  We found a diabetes prevalence of 11.7% (95% confidence interval 10.8–12.6%), with a significant difference between men (14.2%; 95% confidence interval 12.5–15.5%) and women (9.5%; 95% confidence interval 8.5–10.6%). While 6.6% of the subjects had previously been diagnosed with diabetes, 5.1% were undiagnosed. By age groups, 2.4% of the population between 20 and 39 years, 12.6% of people from 40 to 59 years old and 26.3% of those aged between 60 and 79 years had diabetes. Prevalence of ‘pre‐diabetes’ (impaired fasting glucose, impaired glucose tolerance or both) in the population was 23.3%.Conclusions  Diabetes has a high prevalence in Portugal. If ‘pre‐diabetes’ is also considered, about one‐third (34.9%) of the population aged 20–79 years is affected. A greater number of males were found to have diabetes. We detected a high percentage of people with undiagnosed diabetes (43.6%).

Little is known about what patients think of the medicines they take. Such knowledge could be of importance for health results. In a primary care setting, the knowledge about pharmacokinetics, pharmacodynamics and about how medicines work in the body were addressed through a validated questionnaire for self fulfillment, in anonymity, to be returned by mail. 272 questionnaires were received representing the population in study in gender and age. As main results knowledge about pharmacokinetics, pharmacodynamics is scarce and there is good knowledge about drug adverse events even though patients don't know how it is medicines work in the body and show very good knowledge about safety medicine's issues. As main conclusions there is little knowledge about how medicines work in the body, much information work being needed to upgrade what patients know in order to ameliorate health results, when medicines are needed.