http://hdl.handle.net/10174/29513 2026-07-30T01:41:34Z http://hdl.handle.net/10174/41772 Title: Environmental status of TBT pollution in the Portuguese coastline: insights into persistence and regulatory implementation challenges Authors: Galante-Oliveira, S; Coelho, S; Pereira, D; Oliveira, I B; Laranjeiro, F; Sousa, Ana Catarina; Potes, ML; Batista, R; Fillmann, G; Barroso, CM Abstract: This study constitutes the most comprehensive assessment of imposex along the Portuguese coast. It is based on a 22-year biomonitoring program using Nucella lapillus and Tritia reticulata, comparing new measurements from 2022 with historical data collected at the same locations. Since the EU ban on organotin (OT) antifouling (AF) systems in 2003, the intensity of imposex and OT tissue concentrations have declined in both species; however, in 2022, imposex remained widespread, with moderate to high levels still recorded in several areas. N. lapillus met the OSPAR Ecological Quality Objective (EcoQO) at all sampled sites, whereas T. reticulata failed to meet this target at 44% of the locations. This contrast reflects species distribution: T. reticulata inhabits a broader range of habitats, including more contaminated areas, making it a more effective bioindicator of OT pollution along the entire coast. Despite OT-based AF systems being banned on small vessels in 1993 by the Directive 89/677/EEC – nearly three decades before the current survey – and banned on all vessels in 2003 by the Regulation (EC) No. 782/2003, TBT continues to cause imposex, particularly in areas dominated by small-boat activity. These findings indicate spatially heterogeneous recovery patterns and suggest that vessel-size-dependent management and monitoring frameworks may influence post-ban environmental outcomes. Strengthened monitoring strategies targeting small-vessel-dominated areas may therefore support more effective long-term recovery. 2026-03-31T23:00:00Z http://hdl.handle.net/10174/41549 Title: The burden of breast, cervical, and colon and rectum cancer in the Balkan countries, 1990–2019 and forecast to 2030 Authors: Todorovic J, J; Stamenkovic Z, Z; Stevanovic A, A; Terzic N, N; Kissimova-Skarbek K, K; Tozija F, F; Mechili, E A; Devleesschauwer, B; Terzic-Supic, Z; Vasic, M; Bjegovic-Mikanovic, M; Santric-Milicevic, M; Liew, A; Mentis, AF; Mereke, A; Sousa, Ana Catarina; Manda, AL; Gkitakou, A; Adam, B; Oancea, B; Socea, B; Unim, B; Smarandache, CG; Ngwa, CH; Santoso CMA, CMA; Sur, D; Plass, D; Pallari, E; Nena, E; Gazzelloni, F; Fisher, F; Mulita, F; Collatuzzo, G; Lewison, G; Wyper, G; Samouda, H; Negoi, I; Penalvo, JL; Gonzalez, JMG; Haagsma, J; Dokova, K; Lorenzovici, L; Monasta, L; Ortiz, MR; Hostiuc, M; Gissler, M; Speybroeck, N; Varga, O; Gaal, P; Kostoulas, P; O’Caoimh, R; Cuscieri, V; Namorado, S; Mestrovic, s; Gorasso, V; Zadnik, V; Mevsim, V; Kabir, Z Abstract: the second leading cause of mortality, closely following circulatory system diseases. Objective To describe trends in the burden of breast, cervical, and colon and rectum cancer in the Balkan region and per country between 1990 and 2019, including a forecast to 2030. Methods We described the 2019 Global Burden of Disease (GBD) estimates for breast, cervical, and colon and rectum cancers in eleven Balkan countries over the period 1990–2019, including incidence, years lived with disability (YLD), years of life lost (YLL), and disability-adjusted life years (DALYs) rates per 100,000 population and accompanied 95% uncertainty interval. With the Autoregressive Integrated Moving Average, we forecasted these rates per country up to 2030. Results In the Balkan region, the highest incidence and DALYs rates in the study period were for colon and rectum, and breast cancers. Over the study period, the DALYs rates for breast cancer per 100,000 population were the highest in Serbia (reaching 670.84 in 2019) but the lowest in Albania (reaching 271.24 in 2019). In 2019, the highest incidence of breast cancer (85 /100,000) and highest YLD rate (64 /100,000) were observed in Greece. Romania had the highest incidence rates, YLD rates, DALY rates, and YLL rates of cervical cancer, with respective 20.59%, 23.39% 4.00%, and 3.47% increases for the 1990/2019 period, and the highest forecasted burden for cervical cancer in 2030. The highest incidence rates, YLD rates and DALY rates of colon and rectum cancers were continuously recorded in Croatia (an increase of 130.75%, 48.23%, and 63.28%, respectively), while the highest YLL rates were in Bulgaria (an increase of 63.85%). The YLL rates due to colon and rectum cancers are forecasted to progress by 2030 in all Balkan countries. Conclusion As most of the DALYs burden for breast, cervical, and colon and rectum cancer is due to premature mortality, the numerous country-specific barriers to cancer early detection and quality and care continuum should be a public priority of multi-stakeholder collaboration in the Balkan region. 2023-01-01T00:00:00Z http://hdl.handle.net/10174/41253 Title: Pharmaceutical consultation on patients receiving oral antineoplastic agents: a systematic review Authors: Fernandes, João; Advinha, Ana Margarida; Oliveira-Martins, Sofia Abstract: The management of oncological treatment has evolved substantially with the increasing use of oral antineoplastic agents, which are self-administered by patients or caregivers at home, and require careful monitoring and support. The aim of this study was to evaluate the impact of pharmaceutical consultations on oncology patients undergoing therapy with oral antineoplastic agents. A systematic literature review was conducted using the PubMed, Scopus and Web of Science databases with the last search on 5 June 2025. Primary observational or experimental studies were sought for inclusion. Eligible studies assessed the outcomes of pharmaceutical consultations for oncology patients receiving oral antineoplastic therapy in a hospital setting, compared with a conventional medication dispensing model. The risk of bias in the included studies was evaluated using the Cochrane risk-of-bias tools, RoB-2 and ROBINS-I. The review was developed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 Statement, and the protocol for the systematic literature review was registered with PROSPERO under the reference CRD42024533367. From the 881 records initially identified, 16 studies were included. A backward reference search led to the inclusion of two additional publications, bringing the total to 18 studies in this systematic review. The main interventions performed by pharmacists during pharmaceutical consultations included patient education on their treatment, management of adverse reactions and drug interactions, and monitoring of adherence to therapy. The studies evaluated a total of 10 variables, demonstrating the benefits of pharmaceutical consultation in all of them. Significant benefits were observed in terms of progression-free survival and quality of life, both of which are crucial in cancer treatment. However, further research is required, particularly involving larger patient samples and studies spanning multiple institutions and countries. To facilitate a comprehensive and comparative evaluation of different pharmaceutical consultation models in oncology, it would be advantageous to standardise methods for assessing their impact. 2025-01-01T00:00:00Z http://hdl.handle.net/10174/41252 Title: Pharmacovigilance teaching and learning: a mixed cross-sectional analysis of the Portuguese public higher education system Authors: Perdigão, Margarida; Afonso, Anabela; Oliveira-Martins, Sofia; Lopes, Manuel José; Advinha, Ana Margarida Abstract: Pharmacovigilance stands out for its importance in obtaining existing knowledge about medicine and patient safety and should be recognized as a continuous line of study. It constitutes a highly relevant component in the activities of health professionals, with spontaneous notification of suspected adverse drug reactions being its main emphasis. The underreporting that persists can be overcome through continuous professional development programs, reinforcing theoretical and practical knowledge in the curricular plans of health courses. As a result, more educated professionals will also allow citizens to recognize the importance of pharmacovigilance. The main objective of this study was to describe and characterize the teaching-learning process of pharmacovigilance in Portugal, analyzing the knowledge, perceptions and attitudes of students and health professionals. In total, ninety-three curricular unit forms of the seventeen healthcare courses included were analyzed, among which only three referred to pharmacovigilance as mandatory and thirty-nine did not address any keywords. The questionnaire applied was answered by 650 participants, both students (62%) and professionals (38%). Approximately 84.4% of the students and 54.7% of the professionals affirmed that they had never spontaneously reported an adverse drug reaction. Only 24.6% of the students and 17.8% of professionals referred to the existence of specific course content dedicated to pharmacovigilance in their coursework. In view of these results, it is evident that there is a need for a wider reflection regarding the further training and constant update of practicing professionals as well as in diverse health institutions, investing in the creation of an academic curriculum that integrates pharmacovigilance in healthcare courses. 2024-01-01T00:00:00Z