Bruno Peixoto

Iodine status and iodised salt consumption in portuguese school-aged children: The iogeneration study

The World Health Organization promotes salt iodisation to control iodine deficiency. In Portugal, the use of iodised salt in school canteens has been mandatory since 2013. The present study aimed to evaluate iodine status in school-aged children (6–12 years) and to monitor the use of iodised salt in school canteens. A total of 2018 participants were randomly selected to participate in a cross-sectional survey in northern Portugal. Children’s urine and salt samples from households and school canteens were collected. A lifestyle questionnaire was completed by parents to assess children’s eating frequency of iodine food sources. Urinary iodine concentration (UIC) was measured by inductively coupled plasma-mass spectrometry. The median UIC was 129 µg/L which indicates the adequacy of iodine status and 32% of the children had UIC < 100 µg/L. No school canteen implemented the iodised salt policy and only 2% of the households were using iodised salt. Lower consumption of milk, but not fish, was associated with a higher risk of iodine deficiency. Estimation of sodium intake from spot urine samples could be an opportunity for adequate monitoring of population means. Implementation of iodine deficiency control policies should include a monitoring program aligned with the commitment of reducing the population salt intake.

Emotional distress in Angolan patients with several types of tuberculosis

BACKGROUND There is growing evidence that emotional distress expressed in terms of anxiety and depression is very high among tuberculosis (TB) patients. OBJECTIVES This study aims to determine levels of anxiety, depression and emotional distress in patients with several types of TB and to determine the association between social-demographic and economical factors, clinical variables and anxiety, depression and emotional distress. METHODS A cross-sectional study was performed in a sample of 81 TB patients. A social-demographic and economical questionnaire was used, followed by the hospital anxiety and depression scale. RESULTS 38.3% and 49.4% of our sample presented significant levels of anxiety and depression. 44.4% of patients had significant levels of emotional distress.Married subjects, a diagnosis of extra-pulmonary TB and multidrug resistant TB were related to higher risk for anxiety. Gender, extra-pulmonary and multidrug resistant TB were associated to depression. Female gender and cases of extra-pulmonary TB presented a 1.5 times risk for emotional distress. CONCLUSIONS Our study found high rates of anxiety, depression and emotional distress among TB patients. Marital status, gender, type and treatment of TB were related to higher levels of emotional disorder. Mental health services should be an integral part of programs against tuberculosis.

Validation of the Portuguese version of Addenbrooke’s Cognitive Examination III in mild cognitive impairment and dementia

BACKGROUND Cognitive assessment is central to the diagnosis of cognitive impairment and dementia, and it should be performed in all patients in the early stages of the disease. Recently, the 3rd version of Addenbrookes Cognitive Examination (ACE-III) has been developed in order to improve the previous versions. OBJECTIVES The aim of this study was to determine the psychometric properties of the Portuguese version of ACE-III, namely: reliability and discriminative validity (sensitivity and specificity) in the identification of mild cognitive impairment (MCI) and dementia, in comparison to other neuropsychological screening tests, as well as to establish its concurrent and divergent validity. MATERIAL AND METHODS The study encompassed a sample of 90 participants distributed into 3 groups: Control (n = 30), MCI (n = 30) and Dementia (n = 30). In addition to ACE-III, Clinical Dementia Rating (CDR) and Montreal Cognitive Assessment (MoCA) were also used. RESULTS The reliability of ACE-III was very good (α = 0.914). ACE-III significantly differentiated the 3 groups. The receiver operating characteristic (ROC) curves significantly favored ACE-III in comparison to another screening test - MoCA. ACE-III presented higher levels of sensitivity and specificity. Its total score correlated positively with the results on MoCA (ρ = 0.912; p < 0.001) and negatively with a depression scale (ρ = -0.505; p < 0.001). CONCLUSIONS The Portuguese version of ACE-III has very good reliability and high diagnostic capacity in the context of MCI and dementia. ACE-III also holds concurrent and divergent validity.

Neurocognitive impairment after acute coronary syndrome: Prevalence and characterization in a hospital-based cardiac rehabilitation program sample

Introduction: Prospective studies have shown the relation between acute coronary syndrome (ACS) and neurocognitive dysfunction with prevalence ranging between 10.51% and 66.8%. The present study aims to determine the prevalence level of neurocognitive dysfunction; the relations between sociodemographic, clinical and emotional variables and neurocognitive functioning in a sample of ACS patients. Methods: The sample comprised of 53 patients engaged in cardiac rehabilitation within 3 months after an ACS. Patients with any medical history of neuropsychiatric problems prior to the ACS and illiterate subjects were not included in the study. Results: The majority of the sample (85%) exhibits some degree of cognitive impairment, with 84.8% showing verbal fluency impairment, 60.3% memory impairment and only 26,4% had language compromised. Neurocognitive general functioning was correlated with age. Memory domain was negatively correlated with the number of daily smoked cigarettes before the ACS. Verbal fluency was influenced by schooling. Language domain was correlated with mean diastolic pressure and with the type of profession, visuospatial domain was correlated with schooling, number of cardiovascular risk factors, distress, anxiety levels and type of ACS. Conclusion: Prevalence rate of neurocognitive dysfunction is considerably high. Besides global neurocognitive functioning, verbal fluency and memory are the most affected domains. Several variables were related to neurocognitive performance: sociodemographic; cardiovascular risk factors; clinical; psychological. The underlying mechanisms of neurocognitive dysfunction should be further explored.

GANDRA-BARTA FOR THE ASSESSMENT OF FACIAL EMOTION RECOGNITION IN ACQUIRED BRAIN INJURY

Patients with acquired brain injury (ABI) may experience social difficulties more specifically in the emotional recognition of faces. The present research aims to test the discriminative validity of GandraBARTA to the changes in the emotional recognition of faces after ABI and to perceive its connection with the general cognitive functioning, executive functioning and other variables associated with ABI. The sample consists of two groups, the Clinical Group (n=20, ABI participants) and the Control Group (n=16, healthy participants). All participants underwent a global cognitive assessment through the Montreal Cognitive Assessment (MoCA), executive functioning was measured by INECO Frontal Screening and the evaluation of emotional recognition of faces through Gandra-BARTA. The results demonstrate that Gandra-BARTA presents discriminative capacity for the evaluation of the emotional recognition of faces in patients with acquired brain injury. We observed differences between the two groups in the capacity of emotional recognition especially in the identification of emotions such as anger, disgust, happiness and surprise. The study also shows the existence of a decline in the identification of emotions with age, in the recognition of the disgusting stimuli presents a deficit related to the age and executive functioning, while with the rage the decline is related to the age and schooling. The emotional recognition of faces presents improvements with time after injury. Identification of the neutral expression demonstrates an improvement over time after injury. The discriminative ability of Gandra-BARTA allows it to be an instrument to be used in the evaluation of the emotional recognition of faces in patients with acquired brain injury. Individuals with brain injury have difficulties in identifying anger, disgust, happiness and surprise. Emotional recognition differs in relation to age, executive functioning, schooling, and time after injury.

Emotional distress patients with several types of tuberculosis. A pilot study with patients from the Sanatorium Hospital of Huambo.

Background: There is growing evidence that emotional distress expressed in terms of anxiety and depression it is very high among tuberculosis (TB) patients. Objectives: This study aims to determine levels of anxiety, depression and emotional distress in patients with several types of TB and to determine the association between social-demographic and economical factors, clinical variables and anxiety, depression and emotional distress. Methods: A cross-sectional study was performed in a sample of 81 TB patients. A social-demographic and economical questionnaire was used, followed by the Hospital Anxiety and Depression Scale. Results: 38.3% and 49.4% of our sample presented significant levels of anxiety and depression. 44.4% of patients had significant levels of emotional distress. Married subjects, a diagnosis of extra-pulmonary TB and multidrug resistant TB were related to higher risk for anxiety. Gender, extra-pulmonary and multidrug resistant TB were associated to depression. Female gender and cases of extra-pulmonary TB presented a 1,5 times risk for emotional distress. Conclusions: Our study found high rates of anxiety, depression and emotional distress among TB patients. Marital status, gender, type and treatment of TB were related to higher levels of emotional disorder. Mental health services should be an integral part of programs against tuberculosis.

Versão angolana do IneCo Frontal Screening: IndICadores psICométrICos e CapaCIdade dIsCrImInatIVa na perturbação de stress pós-traumátICo

Introducao: O INECO Frontal Screening (IFS) e um teste de rastreio das funcoes do lobo frontal, utilizado no contexto das demencias e de diversas patologias psiquiatricas. O presente trabalho tem como objetivo determinar as caracteristicas psicometricas da versao angolana do IFS: aceitabilidade, validade de constructo e capacidade discriminativa no contexto da perturbacao de stress pos-traumatico (PTSD). Metodos: O IFS foi aplicado a dois grupos: grupo controlo (n=51), constituido por participantes sem historial de perturbacao neuropsiquiatrica, e um grupo de pacientes com PTSD (n=35), composto por utentes da consulta externa do Hospital Central do Huambo. Resultados Os efeitos de piso e de teto no total do IFS e em suas diferentes subprovas foram inferiores a 80%. O alfa de Cronbach obtido foi 0,791. As correlacoes entre as subprovas e entre estas e o total do IFS foram significativas. O grupo PTSD obteve resultados significativamente inferiores no total do IFS e nas subprovas de instrucoes conflituosas e memoria de trabalho espacial. Para um ponto de corte de 13 pontos, o IFS apresenta uma sensibilidade de 100% e uma especificidade de 87% na identificacao de participantes com PTSD. O IFS correlaciona-se de forma negativa com o total da IES-R. Conclusao: O IFS revela excelentes niveis de aceitabilidade. O valor de consistencia interna obtido e muito proximo ao da versao original e da versao portuguesa da prova. IFS e sensivel (100%) e especifico (87%) na identificacao dos participantes com PTSD, posicionando-se como um instrumento valido para uso clinico. Tanto quanto e do nosso conhecimento, este sera o primeiro instrumento de avaliacao frontal a ser adaptado e validado para uso em Angola

Frontal functioning alterations in chronic hepatitis C virus infected patients

Background The neuropsychological implications of severe liver dysfunction have been widely discussed in recent neuropsychological literature. However, research has only just begun on the harmful effects of mild liver dysfunction on neurocognitive processes, as well as the direct action of the hepatitis C virus (HCV) on the central nervous system. The purpose of this study was to investigate the possible existence of alterations in the executive functions of HCV patients.