Biomedical subjects

H Barros

Publications and source records attributed to H Barros.

At least 19 recordsLinked to original sources

PubMed1999

Differences in behavior profile between normotensive subjects and patients with white-coat and sustained hypertension.

It has been hypothesized that white-coat hypertensives (WCHs) have lower cardiovascular risk than sustained hypertensives (HTs), but higher emotional reactivity. We evaluated 92 HT patients (clinic and daytime BP>140/90 mmHg), 52 WCHs (clinic BP>140190 and ambulatory daytime BP<134/ 85 mmHg), and 74 normotensive subjects (NTs, clinic BP<140/90 and ambulatory daytime BP<134/85 mmHg), aged between 24 and 72 years, and matched for educational level, age, gender, and weight for depression, psychopathology, well-being, and quality of life. HTs showed worse scores than WCHs and NTs on most of the psychological variables; no differences were found between WCHs and NTs except on physical mobility. Daytime BP variability was HTs>WCHs>NTs, whereas nighttime BP variability was HTs>WCHs=NTs. We conclude that HTs have worse psychological profiles than the other two groups. WCHs and NTs have similar psychological profiles, although WCHs have a higher daytime BP variability, which is not associated with higher emotional reactivity.

Adult↗

PubMed1999

Bone mineral density and depression: a community study in women.

In a community sample of 102 Portuguese white women we evaluated the relationship between osteoporosis and indexes of psychopathology and well-being. Depressive symptoms were assessed by the Beck Depression Inventory (BDI), psychopathology by the Hopkins Symptom Checklist-90 Revised (SCL-90-R), and quality of life using the Psychological General Well-Being Index. A questionnaire comprising social, demographic, clinical, and behavioral characteristics was also used. The sample prevalence of osteoporosis was 47.1%. Women with osteoporosis presented significantly higher scores on the total BDI (16+/-9 vs. 13+/-10, p=0.045) and lower scores in the hostility (0.8+/-0.6 vs. 1.2+/-0.7, p=0.012) and phobic anxiety (1.1+/-0.8 vs. 1.5+/-0.9, p=0.041) subscales of the SCL-90-R. No differences were found regarding mean general well-being scores (62+/-17 vs. 64+/-19, p=0.665). This study showed that women with osteoporosis have significantly higher levels of depressive symptoms and a corresponding higher prevalence of depression, independent of other factors strongly associated with osteoporosis, such as age or body mass index.

Adult↗

PubMed1998

Outcome of 88 pregnancies with absent or reversed end-diastolic blood flow (ARED flow) in the umbilical arteries.

OBJECTIVES: To investigate both perinatal and postneonatal morbidity and mortality in fetuses with absent or reversed end-diastolic flow (ARED flow) in the umbilical artery. STUDY DESIGN: A 5 year prospective follow-up of 88 fetuses with ARED flow. RESULTS: Sixteen stillbirths, 16 neonatal deaths, six postneonatal deaths and one death at 2 years of age were noted. Out of the 42 fetuses born alive, 36 showed a normal neurological development whereas six were mentally handicapped. Adverse prognosis was more frequently found in the group with absent end-diastolic flow at first examination and then reversed flow until delivery, compared to the groups of always absent or always reversed end-diastolic flows. CONCLUSIONS: Prompt delivery is recommended in these high-risk pregnancies in order to prevent long-term sequelae, obviously depending on the local limits of viability. Further studies appropriately designed for assessing long-term neurodevelopment of fetuses with ARED flow, although demanding, are mandatory.

Female↗

PubMed1998

Variation of embryonic/fetal heart rate at 6-13 weeks' gestation.

The aim of this study was to investigate changes in heart rate, namely the intraindividual variation, in normal embryos/fetuses between 6 and 13 weeks' gestation. A prospective study was performed of 41 singleton pregnancies undergoing routine ultrasound examination during the first trimester of pregnancy. For each case, the embryonic/fetal heart rate was measured on three consecutive occasions with a mean interval of 4 min. The difference in heart rate values between the serial measurements varied from 0 to 18 beats/min and was significantly associated with gestational age (Spearman r = 0.26, p < 0.01). In the group of 15 fetuses (examined before 10 weeks' gestation), the difference between measurements (median = 0 beats/min, range 0-8 beats/min) was significantly lower (z = 2.48, p < 0.05) than in fetuses assessed after 10 weeks of gestation (median = 3, range 0-18 beats/min). Reliable and reproducible information concerning embryonic/fetal heart rate may be obtained from a single measurement, especially when pregnancies are examined before 10 weeks of gestation.

Female↗

PubMed1998

[Risk factors for preterm labor].

OBJECTIVES: Most studies investigating preterm risk factors include medically induced preterm labor due to fetal or maternal complications and do not distinguish preterm labor from preterm premature rupture of membranes. Thus, the objective of this study was to determine the proportion of the three types of preterm birth and identify risk factors for spontaneous preterm labor in a sample of pregnant women who delivered at two level III units. STUDY DESIGN: From January to October 1996, we interviewed 385 women with live preterm newborns and, as controls, 357 mothers of term newborns. Preterm births were classified as preterm labor, preterm premature rupture of membranes and iathrogenic preterm. Independent associations between maternal sociodemographic, constitutional, nutritional and obstetric characteristics and preterm labor were identified using logistic regression analysis. RESULTS: In this sample of preterm births, 29% corresponded to preterm labor, 49% to preterm premature rupture of the membranes and 22% were iathrogenic preterm. The identified risk factors for preterm labor were multiple gestation, no paid work during pregnancy, less than six prenatal care visits, arm circumference less than 26 cm and previous preterm or low birth-weight. Gestational bleeding during the first or third trimester was significantly associated with preterm labor. CONCLUSIONS: As previously recognized, multiple gestation, prior preterm or low birthweight and gestational bleeding are established risk factors for preterm labor. However, prenatal care, maternal work and nutritional status have also been revealed as important issues in preterm risk, deserving special interest since they are susceptible to preventive intervention.

Adult↗

PubMed1998

[Prevalence of respiratory diseases in the textile industry. Relation with dust levels].

Many workers in the textile industry have respiratory symptoms that are related to their work environment. In this study we observed the dust level conditions of eleven textile industries of the North of Portugal. The dust levels determined were between 0.1 mg/m3 and 1.25 mg/m3, in many cases above the Portuguese standard levels of exposure (VLE). For these dust levels we found a prevalence of 23% of workers with respiratory symptoms with occupational characteristics in 10.8%, and 5.7% presenting byssinosis. Workers exposed to cotton fibres in spinning areas have the highest prevalence of symptoms, and reduction of the FEV1. These characteristics were related to dust levels and were higher in the initial phases of the spinning processes. We found no cases of byssinosis in workers exposed to synthetic fibres, or in workers from weaving areas. Smoking habits were related to the reduction of the FEV1, and severity of respiratory illness but not to the presence of byssinosis.

Dust↗

PubMed1998

[Diet and risk of myocardial infarction. A case-control community-based study].

OBJECTIVE: To evaluate diet as a risk factor for myocardial infarction. DESIGN: Community based case-control study. SETTING: University Hospital, Oporto. PARTICIPANTS: First time consecutive cases of acute myocardial infarction (n = 100) and 198 community controls, older than 39 years and living in Oporto, were compared. METHODS: Data were collected by trained interviewers using a structured questionnaire designed to obtain information on socio-demographic, medical and behavioural aspects, emphasising the description of diet and food habits (using a semi-quantitative food frequency questionnaire). Controls were selected by random digit dialing with a participation rate of 70%. Odds ratios and 95% confidence intervals (CI) according to quartiles of nutrient ingestion were calculated using unconditional logistic regression. RESULTS: Female controls presented significantly higher mean intakes of protein, omega-3 fatty acids, fiber, cholesterol and vitamin C. Male controls had a significantly higher mean daily intake of fiber, vitamin C, vitamin E, and carotenes. After adjusting for age, sex, education, body mass index, ethanol, smoking and total energy intake, there was a protective effect of vitamin C (OR = 0.2, 95% CI: 0.1-0.6, for the 4th quartile), vitamin E (OR = 0.3, 95% CI: 0.1-0.9 for the 4th quartile) and total fiber (OR = 0.3, 95% CI: 0.1-0.9) for the 4th quartile). No significant effect was found for trans-fatty acids, but there was a higher risk with increased energy intake. CONCLUSIONS: This study showed that diet has an important independent effect on myocardial infarction, a protective independent role for anti-oxidant vitamin C and E was verified.

Adult↗

PubMed1997

Sports-related ocular injuries. A three-year follow-up study.

PURPOSE: The authors performed a sports-related ocular injuries evaluation with periodic patient observation and follow-up, to outline the severity and long-term sequelae of eye injuries in sports. METHODS: A prospective study was conducted of 84 consecutive patients (85 injured eyes) with sports-related eye injuries examined at the Eye Emergency Department of Porto S. João Hospital, between April 1992 and March 1995. The ophthalmologic examination was recorded using the United States Eye Injury Registry report forms, and the follow-up ranged from 3 months to 3 years. RESULTS: Injuries occurred predominantly in young males (mean age, 24.8 +/- 9.6 years). The type of sport and the mechanism most frequently responsible for injuries were, respectively, outdoor and indoor soccer (72.6%) and ball trauma (64.3%). Of 45 patients presenting with hyphema, 24 (53.3%) had vitreous and/or retina (V/R) lesions (95% confidence interval [CI], 35.8-67.5) compared with 13 of 39 (33.3%) patients with no hyphema (95% CI, 20.0-49.1). Angle recession was significantly more common in the presence of hyphema (55.6%; 95% CI, 41.0-69.5 vs. 10.3%; 95% CI, 3.3-22.9; P < 0.00005), and retinal tears were more common in the presence of vitreous hemorrhage (P = 0.004). Nineteen of 58 (32.8%) patients with "normal" visual acuity (> or = 20/40) presented with V/R lesions. Hyphemas were significantly more frequent in soccer players (38/61 vs. 7/23, P = 0.018). CONCLUSION: These results highlighted the serious nature of outdoor and indoor soccer injuries. The severity of the anterior segment injury was not a good predictor of posterior segment damage. Ophthalmologists can help prevent delayed consequences by including regular gonioscopy and peripheral retinal examination in all cases of blunt trauma. The United States Eye Injury Registry report forms adapted to sports proved to be a useful tool for collecting detailed information and sharing a common database.

Adolescent↗

PubMed1997

Ductus venosus revisited: a Doppler blood flow evaluation in the first trimester of pregnancy.

The functional role of the fetal ductus venosus (DV) is still poorly established. Few reports are available in the literature concerning assessment of fetal venous return during the late first trimester of pregnancy. Our objective was to determine the normal Doppler blood velocity waveform in the human fetal DV as early as 10-13 weeks gestation. Adopting strict methodological concerns, 61 Doppler blood flow evaluations of the DV considered technically acceptable were selected. Using transvaginal Doppler ultrasound, several DV haemodynamic parameters were assessed: peak systolic and diastolic velocities, time-averaged velocity, maximum velocity during atrial contraction, pulsatility index and fetal heart rate (FHR). Except for the FHR, no significant variations were observed for the above mentioned parameters during this period, and no correlation could be established between FHR and the different flow velocity parameters. Further knowledge about DV haemodynamics in the early phases of pregnancy may make a valuable contribution to the understanding of fetal venus return to the heart and cardiac function.

Blood Flow Velocity↗

PubMed1997

Increased fetal nuchal translucency: possible involvement of early cardiac failure.

The ultrasonographic measurement of nuchal translucency thickness at 10-13 weeks of gestation is accepted as an efficient method of screening for chromosomal abnormalities. However, the underlying mechanism producing increased nuchal translucency thickness is still poorly understood. The purpose of this study was to investigate the possible contribution of impaired cardiac function to such an increase, by studying the venous return in the ductus venosus, using Doppler ultrasound. In a total of 65 fetuses, nuchal translucency thickness was measured at 10-13 weeks of gestation by means of a transvaginal probe. Color-coded and pulsed Doppler ultrasound were also used to evaluate different hemodynamic parameters in the ductus venosus: maximum systolic and diastolic velocities, pulsatility index, lowest forward velocity during atrial contraction and fetal heart rate. Fetal nuchal translucency thickness of > or = 3 mm was found in 17 cases; in five of them there were chromosomal anomalies: four trisomy 21 and one trisomy 18. Of interest is the finding that in the five chromosomally abnormal fetuses with increased nuchal translucency thickness, the forward velocity during atrial contraction was consistently less than 2 cm/s (p < 0.001). This impairment of atrial contraction may well implicate cardiac failure and/or heart defects in the pathogenesis of increased nuchal translucency thickness in the first trimester of pregnancy. Furthermore, nuchal translucency may prove to be a sensitive marker for the early identification of fetal cardiac anomalies.

Blood Flow Velocity↗

PubMed1997

[Life style and occupational risk factors in bladder carcinoma].

Bladder cancer is a useful model for the study of the relationship between lifestyle, occupation and cancer. In the present hospital based case-control study, performed in the north of Portugal, we evaluated the role of occupational exposure and the effect of different lifestyles as risk factors for bladder cancer. We inquired 98 incident cases of bladder cancer (70 men, 28 women) and 202 hospital controls (100 men, 102 women), selected based on the absence of cancer, urinary or lung diseases, and admitted for orthopedic or acute abdominal surgery. Demographic, and socio-economical variables were recorded. A detailed job history was obtained, and exposure to smoking, alcohol and coffee were assessed. Never married subjects and those with higher school degrees presented lower risk of bladder cancer. Smoking was significantly associated with cancer both in men (OR=2.7) and women (OR=5.7). Alcohol, in contrast, had a protective effect, even after adjusting for different confounders. In women, coffee and alcohol had a significant multiplicative effect. No particular industrial sector was associated with an increased risk of bladder cancer. However, those exposed to any of the substances usually considered as risk factors for bladder cancer presented higher risks (OR=1.7, 95% confidence intervals: 0.9-3.0). This study showed that lifestyles have an important role in the causality of bladder cancer, and that occupational exposure probably has less impact in the occurrence of the disease in the general population.

Aged↗

PubMed1997

[Mail questionnaires. A useful strategy for the follow-up of patients with a cerebrovascular stroke?].

Although not frequently used in Portugal, postal questionnaires allow the collection of information on patient's follow-up. In this study we assessed the rate of response and the usefulness of a postal questionnaire in a sample of patients with acute stroke. A prospective study was designed and analysed as a case-control: postal questionnaires were sent to 138 patients together with a randomly assigned stamped or post-free return envelope. The percentage of responders was 60% (n=78) and we found no significant differences in response rates according to the mailing strategy (58% for stamped and 62% for post-free return envelopes, p = 0.786). The time gap between hospital discharge and sending of the questionnaire had no significant influence in the response rate. Elder patients and women tend to respond more frequently, but these characteristics also do not change the response rate. Analysing socio-demographic variables reported at the acute phase, we only found differences in response rate for the smoking status: smoking was associated with a lower participation. In conclusion, the present study showed that a postal questionnaire is a useful method for the follow-up of stroke cases and that we must pay special attention to smokers for whom alternative strategies of contact or information should be used to increase compliance with postal questionnaire follow-up.

Aged↗

PubMed1997

[Familial infection by the hepatitis C virus].

The aim of this study was to evaluate the prevalence of the antibody to hepatitis C virus (HCV) in the relatives of cases of asymptomatic chronic hepatitis C infection, detected during routine blood donation, and determine risk factors for the presence of the infection in the family setting. Two hundred and eighty-five relatives (spouses, offspring, siblings and parents) of 87 index cases were studied. Anti-HCV was detected using second generation ELISA and RIBA tests. The overall prevalence of anti-HCV in the studied population was 6.7%, higher in spouses (11.7%) and lower in the offspring (2.1%). The presence of HCV RNA was detected in 12 of 45 index cases, using nested PCR. No increased risk of infection was found in the relatives of cases with HCV-RNA positivity. Using a logistic regression model, four factors were identified as significantly associated with an increased risk of hepatitis C in the relatives: the age of the index case, and, as characteristics of the relatives, male gender, past or ongoing hepatitis B virus infection, and being a spouse of an index case.

Adult↗

PubMed1997

[Respiratory symptoms in the textile industry. Their prevalence in the Vale do Ave].

Some workers in the textile industry have respiratory symptoms related to their occupation. This study is aimed at evaluating the frequency of respiratory symptoms in textile industries in the North of Portugal. We evaluated 3529 workers from 20 factories (19 deal with synthetic fibres and cotton and the other deals with sisal.) Among the workers, there were 34.5% with respiratory symptoms - 24,5% referred nasal symptoms, 22,6% with bronchial symptoms and 12,6% associated both. The workers who dealt with cotton presented a higher frequency of bronchial symptoms (25,0%) than the ones dealing with synthetic fibres (12,7% p < 0,000001). The same was noticed among the workers in the opening and spinning areas, who showed a higher frequency of bronchial symptoms (28,3%) than the ones in weaving areas (12,7% p < 0,000001). We did not find any differences concerning the frequency of symptoms among the workers handling both natural fibres (cotton and sisal). Individually all the symptoms were more frequent among the workers handling natural fibres. The most frequent symptom depended on the fibre. Cough was more frequently mentioned among the workers handling synthetic fibres (9.6%) and cotton (15.7%). Among the workers who handle sisal, dyspnea was the most frequently mentioned (16.9%). Productive cough was the most frequent association (7.2% sisal; 2.8% synthetic; 8.0% cotton), and the association between dyspnea and wheezing the least mentioned (6.4% sisal; 0.5% synthetic; 5.9% cotton). The workers with bronchial symptoms (synthetic fibre and cotton) have more years of exposure and greater smoking habits. In a covariance adjusted for age and smoking habits, the workers with bronchial symptoms, exposed to cotton have more years of exposure.

Adult↗

PubMed1997

[Unplanned pregnancy in Portugal].

This study was to determine the prevalence of unplanned pregnancy in a national sample of Portuguese puerperae and to define a risk profile for women with unplanned pregnancy. We also evaluated the independent effect of unplanned pregnancy in prenatal care utilisation and in the prevalence of preterm birth, low birth weight, and small for gestational age birth. Data was collected through a national survey proposed to the 50 major public Portuguese hospitals and answers were obtained from 41 hospitals, resulting in a sample of 1582 deliveries. Participants were classified as having a planned or unplanned pregnancy and were compared according to socio-demographic, behavioural, clinical, obstetric, and anthropometric characteristics. The prevalence of unplanned pregnancy was 39.4%. In the unplanned pregnancy group, single women aged less than 19 years and more than 34 years, those with one or more previous pregnancies, with 25% or less of the expected education for their age, and with the National Health Service as the source of were significantly more frequent. These characteristics, except the health provision, were significant and independently associated with an increased risk of unplanned pregnancy. Women with unplanned pregnancy were more likely to be unaware of prenatal care system, to have no prenatal care, late or inadequate prenatal care. Unplanned pregnancy was significantly associated with the risk of inadequate prenatal care (Odds ratio (OR) = 2.5; 95% Confidence interval (CI): 1.7-3.0), after adjusting for the effect of the confounding variables. Planning pregnancy was not significantly related with the prevalence of low birth weight or small for gestational age birth. However there was a significant relationship between unplanned pregnancy and preterm birth (Adjusted OR = 1.7; 95% CI:1.0-2.9). This study showed a high prevalence of unplanned pregnancy and that it was related with an under utilisation of prenatal care and with an independently increased risk of preterm birth, a major issue in perinatal health.

Adult↗

PubMed1997

[Prevalence, knowledge, treatment and control of arterial hypertension in Oporto, Portugal].

The aim of this study was to assess the prevalence, awareness, treatment and control of hypertension among subjects above the age of 39 years living in the urban area of Oporto, Portugal. One hundred and seventy seven individuals from the community were selected by random digit dialing. Each subject was asked about his/her personal history of hypertension, antihypertensive treatment and had his/her blood pressure measured. The prevalence of hypertension was 57.1%, defined by systolic blood pressure (SBP) > or = 140 mm Hg and/or diastolic blood pressure (DBP) > or = 90 mm Hg and/or administration of current the antihypertensive medication. If the values defining hypertension were SBP > or = 160 mm Hg, and DBP > or = 95 mm Hg the prevalence would be 37.9%. The overall prevalence of hypertension was higher in females, but a slightly higher non significant value was found in males in the fifth and sixth decades. Among hypertensives, 62.7% were aware of their condition, 56.7% were treated, 84.2% of hypertensives treated were controlled (SBP < 160 mm Hg and DBP < 95 mm Hg) and 44.7% were very well controlled (SBP < 140 mm Hg and DBP < 90 mm Hg). The question "Are you hypertensive?" had a sensitivity of 62.7%, a specificity of 83.6% and an accuracy of 75.7%. In the preliminary results of this study of an urban population with a high prevalence of hypertension, the awareness of hypertension is similar to that described in the United States of America twenty years ago, the percentage of hypertensives treated is similar to the American percentage fifteen years ago and the percentage of hypertensives treated and controlled is close to the current American percentage.

Adult↗

PubMed1997

[Risk factors for myocardial infarct: a case-control study in Oporto, Portugal].

A case-control study of coronary heart disease (CHD) was conducted in Oporto, Portugal. The cases series consisted of 100 consecutive patients with first time acute myocardial infarction who were admitted to the Coronary and Intermediate Care Units of a major teaching hospital. The community controls were 198 individuals without evidence of CHD by the Rose questionnaire and electrocardiography, selected by random digit dialing, with a participation rate of 70%. Data was collected by trained interviewers using a structured questionnaire and blood samples were obtained for selected laboratory data. The main analysis was made through unconditional logistic regression with calculations of odds ratios (OR). Age, OR: 1.5 (95% CI: 0.8-2.9), male gender, OR: 6.7 (3.6-12.3), family history of premature CHD, OR: 2.4 (1.4-4.3), diabetes, OR: 3.4 (1.6-7.4), antecedents of hypertension, OR:1.9 (1.1-3.1), history of high cholesterol levels, OR: 2.3 (1.4-3.9), high levels of physical activity, OR: 2.0 (0.9-4.1) and tobacco smoking, OR: 8.3 (3.8-18.5) were significant risk factors of acute myocardial infarction. After controlling for demographic variables and for the mutual confounding effects of the risk factors, the investigated factors that remained significantly associated with the risk of developing acute myocardial infarction were male gender, OR: 17.3 (4.8-62.3), family history of CHD, OR: 3.6 (1.4-9.6), diabetes, OR: 4.2 (1.0-18.1), high cholesterol levels OR: 2.7 (1.2-6.1) and smoking habits, OR: 7.7 (1.8-32.4). A negative association with high education levels was significant after controlling for all the variables, OR: 0.01 (0.01-0.5).

Adult↗

PubMed1997

Does pulmonary tuberculosis change with ageing?

SETTING: In most low prevalence countries, tuberculosis has become a disease of the aged; it has recently been suggested that the elderly may present a specific pattern. OBJECTIVE: To compare clinical, bacteriological and radiological features of pulmonary tuberculosis between young and elderly populations in a high incidence country. PARTICIPANTS AND METHODS: We retrospectively studied 337 consecutive pulmonary tuberculosis patients without confirmed HIV infection, hospitalised from 1989 to 1993. The clinical, bacteriological and radiological features of the two age groups considered, young adults (< 60 years) and elderly (> or = 60 years), were compared. RESULTS: Thoracic pain (16.3% vs 32.7%) and fever (27.2% vs 50.6%) were significantly less frequent in the elderly, while the frequency and duration of other symptoms before hospitalisation were similar. After admission, fever remained longer in young patients (P < 0.05). No significant differences were found regarding the general health status at hospitalisation, or associated illnesses (83.7% vs 73.5%; P = 0.068). Radiological lesions not related to the present diagnosis (14.1% vs 2.0%; P < 0.05), and a presumed diagnosis of tuberculosis (11.7% vs 4.1%; P = 0.02) were more frequent in the elderly. CONCLUSION: This study showed no specific clinical, bacteriological or radiological features between age groups, and does not support the hypothesis of any age-related patterns in pulmonary tuberculosis.

Adolescent↗