Injuries and envenoming by aquatic animals in fishermen of Coxim and Corumbá municipalities, state of Mato Grosso do Sul, Brazil: identification of the causative agents, clinical aspects and first aid measures

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Trauma and envenoming caused by stingrays and other fish in a fishing community in Pontal do Paranapanema, state of São Paulo, Brazil: epidemiology, clinical aspects, and therapeutic and preventive measures

INTRODUÇÃO: Os acidentes causados por peixes são comuns em comunidades de pescadores fluviais no Brasil, sendo acidentes ocupacionais na maioria das vezes. Estas populações não têm informações dos mecanismos de trauma e envenenamento. MÉTODOS: Através de um questionário aplicado aos pescadores, foram obtidos dados clínicos e epidemiológicos sobre acidentes em Rosana, Pontal do Paranapanema, Estado de São Paulo, Brasil. Estes dados foram analisados e convertidos em um programa de prevenção e tratamento de acidentes através de um folheto de fácil assimilação RESULTADOS: Trinta e nove pescadores responderam o questionário. Todos os pacientes apresentaram ferimentos causados por algum peixe. Dos peixes mencionados, mandijubas (Pimelodus maculatus) foram os mais associados aos ferimentos, mas outros também causaram traumas. em relação às arraias, seis pescadores tinham sido envenenados. Dor intensa e úlceras foram os principais sintomas. Aproximadamente metade dos acidentados usou apenas medidas de tratamentos populares. CONCLUSÕES: Os pescadores apresentaram acidentes múltiplos por mandis, que são peçonhentos e causam dor intensa, assim como traumas por outros peixes, como surubins, traíras, corvinas de água doce e piranhas. Cerca de 16% dos entrevistados apresentaram envenenamento por arraias. Nossos dados e experiência prévia permitiram a criação de um folheto de fácil assimilação pelas populações locais que pode ajudar os pescadores de forma efetiva, em uma área extremamente carente de serviços de saúde e prevenção de doenças. Esta iniciativa é aplicável a toda a bacia do Rio da Prata, área extensa e de fauna similar.

Assessment of Quality of Life and Psychologic Aspects in Patients with Gestational Trophoblastic Disease

OBJECTIVE: To assess quality of life (QoL) and psychological aspects in patients with gestational trophoblastic disease (GTD).METHODS: This cross-sectional self-report study was conducted among 54 women. Validated questionnaires assessed QoL (WHO-QOL-bref), symptoms of depression (Beck Depression Inventory [BDI]) and anxiety (State-Trait Anxiety Inventory [STAI]).RESULTS: Most patients rated overall QoL as good (44.44%) anti were satisfied with their health status (42.59%). Mean QoL domain score was lowest for psychologic health (53.86 +/- 21.46) and highest for social relationships (65.74 +/- 22.41). BDI mean was 15.81 +/- 11.15, indicating dysphoria. STAI means were 46 +/- 6.46 for trait-anxiety and 43.72 +/- 4.23 for state-anxiety, both evidencing medium-high anxiety. Among employed patients, environment domain mean was the highest (p = 0.024). Presence of children resulted in lowest means for physical health (p = 0.041) and environment (p = 0.045). Patients desiring children showed significantly higher means for physical health (p = 0.004), psychological health (p = 0.021) and environment (p = 0.003). Chemotherapy had no significant influence on QoL (p > 0.05).CONCLUSION: This study evidenced psychological impact on GTD patients, suggesting specialized care centers should provide psychological interventions during treatment and follow-up of GTD patients, highlighting the importance of a multidisciplinary approach. (J Reprod Med 2009;54:239-244)

Epidemiological Aspects in the Leptospira spp. and Toxoplasma gondii Infection in Horses from Botucatu, São Paulo, Brazil

Leptospirosis and toxoplasmosis are zoonoses with high importance because of the economic and public health impact. This study was aimed to determine the seroprevafence of leptospirosis and toxoplamosis in 714 serum samples of horses from different farms from Botucatu, São Paulo, Brazil. The samples were researched for Toxoplasma gondii antibodies by indirect immunofluorescence antibody test (IFAT) and for Leptospira spp. antibodies by microscopic agglutination test. of 714 serum samples, 128 (17.9%; 95% Cl: 15.3%-20.9%) were positive for one or more serovars of Leptospira spp., with icterohaemorrhagiae, canicola, and castellonis as the most prevalent serovars, whereas 42 (5.9%; 95% CI: 4.4%-7.9%) were positive for T gondii, of which 33 samples (78.57%; 95% CI: 64.0%-88.2%) presented a titer of 16, 7 (16.7%; 95% CI: 8.4%-30.7%) a titer of 64, and 1 (2.38%; 95% CI: 0.6%-12.3%) a titer of 256. No significant difference was found among the results obtained and the associated variables such as age and sex. (C) 2012 Elsevier B.V. All rights reserved.

Epidemiological aspects in leptospirosis. Research of anti-Leptospira spp antibodies, isolation and biomolecular research in bovines, rodents and workers in rural properties from Botucatu, SP, Brazil.

Leptospirosis is a worldwide infection, transmitted between man and animals that causes a decrease in the production of bovine flocks, and offer risks for public health, as an important zoonosis. The rodents are the main reservoirs of leptospires. It was studied 27 dairy farm properties located in or near from Botucatu-SP, Brazil. In these farms were collected blood and kidney samples from rodents, blood and urine samples from bovines and blood samples from the workers. The serology was performed with microscopic agglutination test (MAT). Samples of bovine urine and rodent kidneys were cultivated searching for leptospires isolation. The polymerase chain reaction (PCR) of the kidneys of the rodents was performed. In MAT, 46/ 140 (32.85%) bovine and 8/34 (23.53%) human sera samples were positive, respectively. In human samples, the serovar Brastilava (37.51%) presented the highest occurrence, while in bovines, the serovars Hardjo and Castellonis were most frequent, with 26.08% each one. All of the rodents were negatives in serology. No leptospire was isolated, and kidney samples were negative in PCR. In bovines, the dam water and the bad hygiene quality of milking process were considered important risks of infection in the affected properties (p<0.05), where other reproductive problems, except abortion, can be related. In other side, to human beings the drainage system was the most important risk factor in the studied properties. Thus, it was verified the necessity of an improvement in zoosanitary handling of the properties, mainly of water supply.

Leprosy control: perspectives & epidemiological and operational aspects

OBJETIVOS: A partir de acervo de 200 textos acadêmicos e de documentos de organismos nacionais e internacionais voltados ao controle da hanseníase publicados no período de 1999 a 2008, procurou-se estudar respectivas possibilidades evolutivas futuras, empregando-se os subsídios do recurso de análise de cenários. MÉTODOS: A reconstrução metodológica adotada foi de natureza qualitativa, fulcrada nas técnicas de revisão bibliográfica e análise de conteúdo. Esta última foi empregada na tipificação documental categorial frequencial contigencial, de acordo com devida fundamentação pertinente. RESULTADOS: Recuperaram-se elementos atuais importantes de natureza epidemiológica e operacional, bem como de respectivas perspectivas. CONCLUSÕES: Projeta-se que a manutenção dos coeficientes de incidência da doença coloca reptos econômicos e sanitários a desafiar desde o modelo neoliberal de organização societária mundial até competências específicas das ações das equipes de saúde em campo.

Functional and Morphological Reproductive Aspects in Male Rats Exposed to Di-n-Butyl Phthalate (DBP) in Utero and During Lactation

The potential adverse reproductive effects, with emphasis on the epididymis, of in utero and lactational exposure to 100 mg/kg/d di-n-butyl phthalate (DBP) in adult male rat offspring were investigated. The fetal testis histopathology was also determined. The selected endpoints included reproductive organ weights, sperm motility and morphology, sperm epididymal transit time, sperm quantity in the testis and epididymis, hormonal status, fetal testis and epididymal histopathology and stereology, and androgen receptor (AR), aquaporin 9 (AQP9), and Ki-67 immunoreactivities. Pregnant females were divided into two groups: control (C) and treated (T). The treated females received DBP (100 mg/kg/d, by gavage) from gestation day (GD) 12 to postnatal day (PND) 21, while control dams received the vehicle. Some pregnant dams were killed by decapitation on GD20, and testes from male fetuses were collected for histopathogy. Male rats from other dams were killed at PND 90. Fetal testes from treated group showed Leydig-cell clusters, presence of multinucleated germinative cells, and increase of the interstitial component. Testosterone levels and reproductive organ weights were similar between the treated and control adult groups. DBP treatment did not markedly affect relative proportions of epithelial, stromal, or luminal compartments in the epididymis; sperm counts in the testis and epididymis; sperm transit time; or sperm morphology and motility in adult rats. The AR and AQP9 immunoreactivities and proliferation index were similar for the two groups. These results showed that fetal testes were affected by DBP as evidenced by testicular histopathologic alterations, but reproductive parameters and epididymal structure/function were not significantly altered in the adult animals exposed to 100 mg/kg DBP in utero and during lactation.

Historical aspects of Belly Dance and its practice in Brazil

Dance is regarded as one of the oldest art forms, which is based on evidence from prehistoric paintings found in caves; man expressed himself through body language prior to the development of spoken and written forms of communication. Dance was then used during important events, common to their era and culture, and often in religious rituals, to ensure good harvests - their economic activity. Belly-dance appeared approximately eight thousand years B. C. E. as a sacred dance firstly practiced by priestesses, and after that, it was popularized amongst women from Mesopotamia. Virtually considered an ancient form of physical exercise, it is still practiced by Bedouin women as a preparation for spontaneous delivery. In Brazil, belly-dance is widely practiced and our corporal culture enables its learning and improvement, resulting in professional dancers.

Acerola: importance, culture conditions, production and biochemical aspects

Origin and importance. Acerola, or Malpighia emarginata D. C., is native to the Caribbean islands, Central America and the Amazonian region. More recently, it has been introduced in subtropical areas (Asia, India and South America). The vitamin C produced by acerola is better absorbed by the human organism than synthetic ascorbic acid. Exportation of acerola crops is a potential alternative source of income in agricultural businesses. In Brazil, the commercial farming of acerola is quite recent. Climatic conditions. Acerola is a rustic plant. It can resist temperatures close to 0 degrees C, but it is well adapted to temperatures around 26 degrees C with rainfall between (1200 and 1600) mm per year. Fruit characteristics. Acerola fruit is drupaceous, whose form can vary from round to conic. When ripe, it can be red, purple or yellow. The fruit weight varies between (3 and 16) g. Maturation. Acerola fruit presents fast metabolic activity and its maturation occurs rapidly. When commercialised in ambient conditions, it requires fast transportation or the use of refrigerated containers to retard its respiration and metabolism partially. Production and productivity. Flowering and fruiting are typically in cycles associated with rain. Usually, they take place in 25-day cycles, up to 8 times per year. The plant can be propagated by cuttings, grafting or seedlings. Harvest. Fruits produced for markets needs to be harvested at its optimal maturation stage. For distant markets, they need to be packed in boxes and piled up in low layers; transportation should be done in refrigerated trucks in relatively high humid conditions. Biochemical constituents. Acerola is the most important natural source of vitamin C [(1000 to 4500) mg.100(-1) g of pulp], but it is also rich in pectin and pectolytic enzymes, carotenoids, plant fibre, vitamin B, thiamin, riboflavin, niacin, proteins and mineral salts. It has also shown active anti-fungal properties. Products and market. Acerola is used in the production of juice, soft drinks, gums and liqueurs. The USA and Europe are great potential markets. In Europe, acerola extracts are used to enrich pear or apple juices. In the USA, they are used in the pharmaceutical industry. Conclusions. The demand for acerola has increased significantly in recent years because of the relevance of vitamin C in human health, coupled with the use of ascorbic acid as an antioxidant in food and feed. Acerola fruit contains other significant components, which are likely to lead to a further increase in its production and trade all over the world.

Desordens temporomandibulares e dor orofacial: estudo da qualidade de vida medida pelo Medical Outcomes Study 36 - Item Short Form Health Survey

JUSTIFICATIVA E OBJETIVOS: O conhecimento de indicadores de qualidade de vida (QV) relacionados à saúde bucal é especialmente relevante para a Odontologia considerando o impacto que as condições bucais podem provocar no bem estar psicológico e social. Estudos sobre aspectos psicossociais contribuem para maior integração da conduta clínica e assistencial, preocupação compartilhada com profissionais da saúde. Integrar as áreas de Psicologia e Odontologia quebrando paradigmas interdisciplinares e o interesse em conhecer os aspectos psicológicos dos pacientes, motivou a realização deste estudo. O objetivo deste estudo foi avaliar a QV dos pacientes com disfunção temporomandibular e/ou dor orofacial. MÉTODO: Foi aplicado o Questionário Genérico de Avaliação de Qualidade de Vida - Medical Outcomes Study 36 - Item Short Health Survey (SF-36) a 91 pacientes, que buscaram atendimento por apresentarem sinais e/ou sintomas de disfunção temporomandibular (DTM) e dor orofacial (DOF). O SF-36 avalia 8 domínios: capacidade funcional (CF), aspectos físicos (AF), dor, estado geral de saúde (EGS), saúde mental (SM), aspectos emocionais (AE), aspectos sociais (AS) e vitalidade (V). RESULTADOS: A análise estatística descritiva e inferencial pela Correlação de Pearson (p-valor < 0,05) demonstrou, com exceção da capacidade funcional (73,2), valores médios entre 50 e 64 para os demais domínios: AF - 57,6; Dor - 50; EGS - 54,5; V - 53,4; AS - 63,6; AE - 51,8; SM - 58. Considerando-se que a pontuação varia de 0 a 100, ou seja, do pior para o melhor estado de saúde, os valores médios foram baixos. Verificou-se correlação entre CF e EGS (p-valor 0,01), tendência de significância para dor e EGS (p-valor 0,07). CONCLUSÃO: Os aspectos dor e capacidade funcional interferem no estado geral de saúde; os pacientes com DTM e DOF sofreram impacto negativo na qualidade de vida pelo prejuízo dos aspectos físicos e mentais.

Breastfeeding knowledge and practice of health professionals in public health care services

Objetivou-se avaliar conhecimentos e práticas sobre aleitamento materno de profissionais que atendem lactentes em unidades de atenção básica, ou maternidades públicas, de município do interior paulista, Brasil. É estudo epidemiológico, sendo a população composta por 89 enfermeiros e médicos. Suas respostas a um questionário estruturado foram analisadas no total e segundo o local de trabalho, aplicando-se o teste de diferença de proporções (qui-quadrado), considerando-se p<0,05 como nível crítico. Como parâmetros de acertos foram consideradas as recomendações do Ministério da Saúde. As diferenças significativas para conhecimentos e práticas, segundo o local de trabalho, foram restritas a alguns aspectos, com resultados discretamente melhores dos escores médios de acertos dos profissionais das unidades de atenção básica. Independente do local de trabalho, verificou-se desempenho regular e ruim em diferentes aspectos estudados, indicando que possíveis intervenções para a capacitação nessa temática deverão incluir profissionais de todos os níveis de atenção à saúde.

TEACHING OF MEDICAL MICROBIOLOGY - COMMENTS ON BASIC VERSUS APPLIED ASPECTS RELATED TO PROFESSION

Comments about education and medicine teaching were made. The learning and the curriculum in according with the priorities of the country's health had special emphasis.Students and teachers of Botucatu considered that the improvement of the 2nd year medical microbiological course was good with predominantly basic contents. The students prefer a balanced content or predominantly applied to medicine.Three phases of the teaching of microbiological contents are proposed: 1st - in the basic cycly (2nd year); 2nd - into the course of Clinical Laboratory (3rd or 4th year); 3rd - into the clinical cycle, following a program of integration.

Evaluation of the performance of pharmacists in terms of providing health assistance at a university hospital

OBJETIVE: This study aimed to assess the practices of pharmacists in Hospital Care. Method - we interviewed 20 pharmacists from the Pharmacy Division by applying a structured instrument, in September 2005. This instrument addressed aspects related to the main activities at the Hospital Pharmacy, which were assessed according to indicators organized into five areas: sector management, hospital pharmacotechniques, committee activities, information and pharmacotherapeutic follow-up, as well as teaching and research activities.RESULTS: the Pharmacy Division considered all structural aspects under analysis as essential for the good development and application of its services. We found that some essential services, such as the Medication Information Service and Pharmacotherapeutic Follow-up, were absent. Pharmacist professionals were dissatisfied about human resource and physical structure dimensioning, and they presented as not very active in terms of Pharmaceutical Care.CONCLUSION: Results indicate that care is still centered on the drug, with few clinical activities. We suggest reformulations in service management, particularly in the management of pharmacists.

Blaming the victim: Aspects of the Brazilian case

This report describes the consequences and some aspects of the origin and development of victim blaming in accident analysis, and some methods for investigating such events, with particular emphasis on the situation in Brazil. In Brazil, the spread of this practice seems to have been helped by several factors. (1) the idea that occupational accidents are simple phenomena with a limited number of causal factors linked to unsafe actions and/or conditions. In the past, the theory of accident proneness had less influence than in other countries. (2) Government regulations that stipulate the hiring of health and safety officers, production of educational material, and preventive campaigns that emphasize the role of the victim's faulty behavior in the origin of an accident. (3) Mandatory implementation of standardized models for accident investigation directed toward searching for a single cause. Usually one conclusion, expressed in terms of unsafe acts or conditions, is formulated so that whoever performs an unsafe act is responsible for the accident. (4) Lack of knowledge, as shown in Brazilian publications on occupational accidents and in the evolution of studies on the nature of accident phenomena and of strategies adopted for their prevention.

Environmental education and the health risk question: how do we educate the educators working with this theme?

Our society is presently seeing a trend of continuous increase of risk with severe consequences, especially those linked to environmental aspects. It has obligated us to reflect on this production and its effects, either positive or negative, and, after a long reflection, to think about the adopted model of civilization and the possibilities of changing such a model. The educational institution is among the social departments responsible for this revision process, since it represents one possibility to promote a more critical vision from society, providing it with tools needed for a more responsible action. However, schools are dominated by a traditional work, which does not allow for enough and proper attention to these relevant and current questions, and which involve a critical analysis of the conceptions and values established by our civilization, resulting in the present patterns of science-technology-society relations and their influence on the environment and health. Several research works have indicated a diversity of barriers that obstruct this necessary change. Since formal education plays an important role in the education of society for this theme, in this paper the possibilities and difficulty dealing with this problem are discussed, focusing on the question of teacher education, based on investigations related to teacher education programs for environmental education. The data collected show the urgency for introducing this theme in teacher training programs, taking into account the fact that educators have their own conceptions, values and attitudes that should be considered in these programs.