Browsing by Author "Nunes, Carla"
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- 131I therapy in thyroid cancer and benign thyroid diseases: personal dose equivalent HP(10) assessment in patient’s close family membersPublication . Raminhas Carapinha, Maria João; Costa, Gracinda; Ferreira, Teresa C.; Salgado, Lucília; Vaz, Sofia; Ferreira, Rui; Isidoro, Jorge; Rézio, Teresa; Nunes, Carla; Tavares, António Barata; Vaz, PedroIntroduction - The aim is to quantify the personal dose equivalent HP(10) in the family members (FMs) of the patients (PATs) undergoing iodine-131 thyroid cancer (TC) therapy and benign thyroid diseases (BTD) and to compare the HP(10) values of children and adults. Methods - An observational study with convenience sampling was performed, including 83 FMs (59% ♂) of 48 PATs (72.9% ♀). All FMs wore a whole body TLD for 21 days and received instructions on radiation protection, based on Euratom recommendations. All FMs were provided with relevant instructions for TLD use and answered a questionnaire. Two groups were defined: Group-TC, included 65 FMs (5 children below the age of 10) of 37 PATs treated for TC with average (ᾱ) activity of 3434MBq (range 1110–5920MBq); Group-BTD included 18 FMs adults of 11 PATs treated for BTD with ᾱ activity of 336.4MBq (range 185–555MBq). The in-PATs of Group-TC were discharged 48h after therapy. All ethical principles of the investigation were respected. Results - When the PATs of Group-TC were discharged the ᾱ effective dose rate measured at a 1-metre distance was 10.4μSv/h (range 2–28μSv/h). The ᾱ value of HP(10) in FMs were: 0.14mSv (range 0.00-3.37mSv) for Group-TC and 0.37mSv (range 0.01-2.40mSv) for Group-BTD. The HP(10) value depended on the degree of relationship (p=0.008) and the age of the FMs (p=0.007). HP(10) of the FMs were moderately associated to administered activity (ρsp=-0.319; p=0.010) in Group-TC. No association was found between HP(10) FMs and the administered activity in Group-BTD (ρsp=0.139; p=0.583). Conclusions - The FMs of the PATs submitted 131I therapy for BTD received higher doses when compared to FMs of TC PATs. The HP(10) of the FMs depended to the degree of relationship and the age of the FMs. In the PATs submitted 131I therapy for BTD, the HP(10) of the FMs is not associated with the administered activity. The personal dose equivalent in these FMs does not reach the dose limits recommended by ICRP 97 and ICRP 94.
- Ability assessment of the elders to manage their own medication: a first step for the empowerment of the geriatric populationPublication . Advinha, Ana M.; Nunes, Carla; Lopes, Manuel J.; Oliveira-Martins, SofiaAbout 45% of older people are unable to take their medicines as prescribed. Adherence represents a complex behavior that involves both the intention and the ability to take medication. In this way, it is important to distinguish the intention to take medicine and the ability to do so. The daily consumption of medication is a methodical process, marked by routine and that can be affected by several systematic errors associated, not only due to ignorance and illiteracy, but also to its gradual loss of functional ability (physical, cognitive, and sensorial), in order to manage medication. Decreased cognitive skills, visual acuity, and manual dexterity have a significant impact on non-adherence (non-intentional), which may lead to health problems as a result of the absence or incorrect medication administration. This study presented as its main objective to assess the functional ability of community-dwelling elderly to manage their own medication, with recourse to specific tools, validated and adapted to Portugal.
- Assessment of iodine-131 in the urine of the patient’s family members after differentiated thyroid carcinoma therapyPublication . Raminhas Carapinha, Maria João; Costa, Gracinda; Ferreira, Teresa C.; Salgado, Lucília; Carvalho, Inês; Sofia, Monica; Isidoro, Jorge; Rézio, Teresa; Silva, Lidia; Reis, Mário; Santos, Marta; Nunes, Carla; Tavares, António Barata; Vaz, PedroIntroduction - The aim is to evaluate the internal exposure of the family members (FMs) of the patients (PATs) undergoing iodine-131 (131I) thyroid cancer (TC) therapy and quantify the amount of 131I in the FMs, excreted through the urinary. Methods - An observational study with convenience sampling was performed, including 25 PATs and 34 FMs. The PATs, who underwent 131I treatments for TC, were discharged from hospital 48h after therapy. All FMs received instructions on radiation protection, based on Euratom recommendations use and submitted to a questionnaire. A urine sample was collected from every FMs about 70h after discharge of the PAT. Samples of urine were analyzed by gamma spectrometry and counted for 24h. All ethical principles of the investigation were respected. Results - The average activity of 131I given to the PATs (52.9% ♀) was 3266.4 ±1120.2MBq. When the PATs have discharged the average (ᾱ) effective dose rate measured at a 1-metre distance was 7.9±5.8μSv/hr (range 1-25μSv/hr). In the 34 FMs (52.9% ♂) with ᾱ of 48.1±18.6years, only in 3FMs 131I wasn’t detected in the urine. In the other 31 samples urines, the specific activities of 131I have ᾱ of 97.4Bq/L (range 0.0-1146Bq/L). The specific activity of 131I in urine: it is not the same among the classes of the administered activity (p=0.019); don’t is the same on the different classes of FMs ages (p=0.470) and the different degree of relationship (p=0.744). We observed a moderate correlation between the specific activity of 131I in the urine and the activity administered to the PATs (ρsp=0.540; p=0.001) and also between the effective dose rate in the PATs (ρsp=0.730; p<0.001). With a CI of 95%. Conclusions - The PATs are a radioactive source that can cause exposure of the FMs to ionizing radiation. The specific activity of 131I in the urines of the FMs is related to the activity administered to the PAT. It is clear that FMs of PATs submitted to radioiodine therapy can be subject to internal contamination.
- Assessment the activity incorporated by the patient’s caregivers after Iodine-131 thyroid therapyPublication . Raminhas Carapinha, Maria João; Reis, M.; Silva, L.; Santos, M.; Costa, G.; Silva, M.; Isidoro, J.; Nunes, Carla; Tavares, A.; Teles, P.Aim of the study - Evaluate the activity incorporated by the caregivers of the patients undergoing thyroid cancer (TC) therapy with iodine-131 (131I), based on the amount of 131I excreted in the urine.
- Bullying escolar – Intervenientes, ações e sentimentos associados: um estudo com alunos do 2º e 3º ciclos da região do AlgarvePublication . Minghelli, Beatriz; Nunes, Carla; Abílio, FilipaIntrodução – O bullying pode ser definido como atitudes agressivas, intencionais e repetidas durante um período de tempo. Diversos estudos verificaram a prevalência de bullying entre estudantes de vários países e demonstraram que este é um problema internacional e que pelo menos um em cada dez estudantes está envolvido numa situação de bullying. Objetivos – Caracterizar as situações de bullying no ambiente escolar, o papel do estudante, os sentimentos associados a essas ações e identificar as características do agressor. Métodos – A amostra foi constituída por 519 alunos matriculados em duas escolas da região sul de Portugal que preencheram um questionário anónimo sobre uma situação de bullying que vivenciaram, descrevendo o papel do aluno e o que sentiram nesta situação. Resultados – Os resultados revelaram que em 61,7% dos casos se tratou de agressão física e 29,7% de agressão verbal. Desempenharam o papel de agressores 12,7% dos alunos, 21,8% foram vítimas e 63,6% foram testemunhas desta situação. 10,6% dos alunos relataram sentir bem, 11% mostraram indiferença e 78,4% dos alunos sentiram‑se mal com a situação de bullying. Verificou‑se que, com o avanço da idade, o estudante aumentava em 1,5 vezes a probabilidade de desempenhar o papel de agressor e os rapazes apresentavam 5,2 vezes mais probabilidades de vir a ser agressor numa situação de bullying. Conclusão – O presente estudo verificou que a maioria dos alunos participou de uma situação de bullying escolar como testemunha, sendo os casos mais comuns de agressão física. A maioria dos alunos sentiu‑se mal com essa situação. Os rapazes e os alunos com mais idade tiveram mais probabilidade de vir a desempenhar o papel de agressor numa situação de bullying.
- Exposição profissional a citostáticos: caracterização da exposição em unidades hospitalares portuguesasPublication . Prista, João; Suspiro, Alexandra; Veiga, Ana Costa; Ladeira, Carina; Nunes, Carla; Pedro, João de Almeida; Gomes, Mário; Pádua, Mário; Brito, Miguel; Gato, Sara; Viegas, SusanaOs citotóxicos constituem um grupo farmacoterapêutico que interfere por vários mecanismos de ação com o DNA, levando à destruição celular. Estes agentes terapêuticos são preparados diariamente em Unidades Hospitalares Portuguesas, e utilizados no tratamento de várias doenças, nomeadamente neoplasias. Dependendo do mecanismo de ação, estes fármacos podem ser agrupados em vários subgrupos: agentes alquilantes, antibióticos, antimetabolitos, geradores de radicais livres e inibidores mitóticos (Despacho nº 21 844/2004). Os agentes alquilantes interagem diretamente com o DNA de células tumorais; os antibióticos interferem com a transcrição de DNA; os antimetabolitos bloqueiam a síntese de DNA e RNA; os geradores de radicais livres produzem radicais livres reactivos que se ligam ao DNA e, finalmente, os inibidores mitóticos actuam no mecanismo mitótico necessário à cariocinese. Os fármacos antineoplásicos são cada vez mais utilizados quer na terapêutica de doenças malignas quer com intuitos profiláticos (terapêutica adjuvante) e num espetro crescente de patologia benigna (doenças autoimunes, doenças inflamatórias crónicas do foro gastroenterológico ou reumatológico, entre outras). Têm em comum o facto de poderem lesar o genoma celular (efeito genotóxico). Idealmente, deveriam afetar apenas as células neoplásicas; os fármacos disponíveis, no entanto, embora afetem preferencialmente as células malignas, são relativamente inespecíficos, afetando simultaneamente o genoma das células normais e condicionando assim efeitos adversos para a saúde quer dos doentes tratados quer dos profissionais de saúde a eles expostos. Neste contexto importa aprofundar o saber em 3 vertentes essenciais: a caracterização das exposições, os critérios de avaliação das repercussões sobre o organismo e os processos de organização dos programas preventivos. O estudo que se apresenta visou, assim, desenvolver conhecimento nas 3 vertentes assinaladas, designadamente, a exposição, a monitorização biológica e a programação da prevenção. Julgámos relevante o seu desenvolvimento face a dois grandes aspectos, designadamente a atualidade do estudo científico e a inexistência de estudos sobre esta realidade em hospitais portugueses. O estudo que se propôs pretendeu contribuir para a caracterização da exposição a citotóxicos num contexto profissional específico (salas limpas da Farmácia Hospitalar e Hospitais de Dia), identificando os fatores que a condicionam e os eventuais efeitos para a saúde dos trabalhadores decorrentes dessa exposição.
- Exposure and genotoxicity assessment methodologies: the case of formaldehyde occupational exposurePublication . Viegas, Susana; Ladeira, Carina; Gomes, Mário; Nunes, Carla; Brito, Miguel; Prista, JoãoFormaldehyde (FA) ranks 25th in the overall U.S. chemical production, with more than 5 million tons produced each year. Given its economic importance and widespread use, many people are exposed to FA occupationally. Recently, based on the correlation with nasopharyngeal cancer in humans, the International Agency for Research on Cancer (IARC) confirmed the classification of FA as a Group I substance. Considering the epidemiological evidence of a potential association with leukemia, the IARC has concluded that FA can cause this lymphoproliferative disorder. Our group has developed a method to assess the exposure and genotoxicity effects of FA in two different occupational settings, namely FAbased resins production and pathology and anatomy laboratories. For exposure assessment we applied simultaneously two different techniques of air monitoring: NIOSH Method 2541 and Photo Ionization Detection Equipment with simultaneously video recording. Genotoxicity effects were measured by cytokinesis-blocked micronucleus assay in peripheral blood lymphocytes and by micronucleus test in exfoliated oral cavity epithelial cells, both considered target cells. The two exposure assessment techniques show that in the two occupational settings peak exposures are still occurring. There was a statistical significant increase in the micronucleus mean of epithelial cells and peripheral lymphocytes of exposed individuals compared with controls. In conclusion, the exposure and genotoxicity effects assessment methodologies developed by us allowed to determine that these two occupational settings promote exposure to high peak FA concentrations and an increase in the micronucleus mean of exposed workers. Moreover, the developed techniques showed promising results and could be used to confirm and extend the results obtained by the analytical techniques currently available.
- Exposure assessment to mycotoxins in a Portuguese fresh bread dough company by analysis of dust and urine samplesPublication . Viegas, Susana; Assunção, Ricardo; Nunes, Carla; Osteresch, Bernard; Twaruzek, Magdalena; Kosicki, Robert; Grajewski, Jan; Alvito, Paula; Almeida, Ana; Viegas, CarlaOccupational exposure to mycotoxins can occur in many and different work environments. Critical workplaces for mycotoxins appearance have already been studied and nowadays it is possible to investigate that exposure to mycotoxins is likely through inhalation due to their presence in dust. This study aimed to assess occupational co-exposure to mycotoxins in a fresh bread dough company, an workplace not studied until now.
- Exposure assessment to mycotoxins in a Portuguese fresh bread dough company by using a multi-biomarker approachPublication . Viegas, Susana; Assunção, Ricardo; Nunes, Carla; Osteresch, Bernd; Twarużek, Magdalena; Kosicki, Robert; Grajewski, Jan; Martins, Carla; Alvito, Paula; Almeida, Ana; Viegas, CarlaMycotoxins are toxic mold metabolites that can persist in environment long after the fungi species responsible for their production disappear. Critical workplace for mycotoxins presence has already been studied and nowadays it is possible to recognize that exposure to mycotoxins through inhalation occurs due to their presence in dust. This study aimed to assess occupational co-exposure to multiple mycotoxins in a fresh bread dough company, an occupational setting not studied until now. Occupational exposure assessment to mycotoxins was done using a LC-MS/MS urinary multi-biomarker approach. Twenty-one workers and nineteen individuals that were used as controls participated in the study. Workers/controls (spot-urine) and environment (settled dust) samples were collected and analyzed. Concerning workers group, DON-GlcA, and OTA were the most prevalent biomarkers (>LOD), 66% and 90.5%, respectively. In the control group, OTA was also one of the most detected (68%) followed by CIT (58%) and DON-GlcA (58%). DON was the mycotoxin measured in high amounts in the settled dust sample (58.2 ng/g). Both workers and controls are exposed to several mycotoxins simultaneously. The workers group, due to their high contact with flour dust, revealed a higher exposure to DON. Considering these results, risk management measures must be applied including specific and adequate health surveillance programs in order to avoid exposure and consequently the associated health consequences.
- Genotoxic effects in occupational exposure to formaldehyde: A study in anatomy and pathology laboratories and formaldehyde-resins productionPublication . Viegas, Susana; Ladeira, Carina; Nunes, Carla; Malta-Vacas, Joana; Gomes, Mário; Brito, Miguel; Mendonça, Paula; Prista, JoãoBackground - According to the Report on Carcinogens, formaldehyde ranks 25th in the overall U.S. chemical production, with more than 5 million tons produced each year. Given its economic importance and widespread use, many people are exposed to formaldehyde environmentally and/or occupationally. Presently, the International Agency for Research on Cancer classifies formaldehyde as carcinogenic to humans (Group 1), based on sufficient evidence in humans and in experimental animals. Manyfold in vitro studies clearly indicated that formaldehyde can induce genotoxic effects in proliferating cultured mammalian cells. Furthermore, some in vivo studies have found changes in epithelial cells and in peripheral blood lymphocytes related to formaldehyde exposure. Methods - A study was carried out in Portugal, using 80 workers occupationally exposed to formaldehyde vapours: 30 workers from formaldehyde and formaldehyde-based resins production factory and 50 from 10 pathology and anatomy laboratories. A control group of 85 non-exposed subjects was considered. Exposure assessment was performed by applying simultaneously two techniques of air monitoring: NIOSH Method 2541 and Photo Ionization Detection equipment with simultaneously video recording. Evaluation of genotoxic effects was performed by application of micronucleus test in exfoliated epithelial cells from buccal mucosa and peripheral blood lymphocytes. Results - Time-weighted average concentrations not exceeded the reference value (0.75 ppm) in the two occupational settings studied. Ceiling concentrations, on the other hand, were higher than reference value (0.3 ppm) in both. The frequency of micronucleus in peripheral blood lymphocytes and in epithelial cells was significantly higher in both exposed groups than in the control group (p < 0.001). Moreover, the frequency of micronucleus in peripheral blood lymphocytes was significantly higher in the laboratories group than in the factory workers (p < 0.05). A moderate positive correlation was found between duration of occupational exposure to formaldehyde (years of exposure) and micronucleus frequency in peripheral blood lymphocytes (r = 0.401; p < 0.001) and in epithelial cells (r = 0.209; p < 0.01). Conclusions - The population studied is exposed to high peak concentrations of formaldehyde with a long-term exposure. These two aspects, cumulatively, can be the cause of the observed genotoxic endpoint effects. The association of these cytogenetic effects with formaldehyde exposure gives important information to risk assessment process and may also be used to assess health risks for exposed workers.
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