Qualidade total: uma nova era para os supermercados

O autor apresenta um estudo, baseado em sua tese de doutorado, sobre a busca de qualidade total nos supermercados. Analisa um cenário de crescente competitividade, no qual os consumidores estão cada vez mais exigentes, induzindo os dirigentes de supermercados a buscar mais qualidade, eficiência e produtividade em suas operações.

Possible consequences of increasing life expectancy in Brazil: the perspective of a European historical demographer

Those over sixty years of age accounted for 6.6% of the total population of Brazil in 1985, in the Federal Republic of Germany this proportion was 20.3% in 1984. As early as 1950 it had been 14.5%. This proportion will not even be reached in Brazil in the year 2000 when persons aged sixty years and older are only projected to make up 8.8% of the total population. Similarly, in 1982/84 life expectancy at birth in the Federal Republic was 70.8 years for men and 77.5 for women; in Brazil the figures for 1980/85 were, by contrast, "only" 61.0 and 66.0. Against this background it is easy to understand why the discussion concerning an ageing society with its many related medical, economic, individual and social problems has been so slow in coming into its own in Brazil. As important as a more intensive consideration of these aspects may be in Brazil at present, they are, nevertheless, only one side of the story. For a European historical demographer with a long-term perspective of three of four hundred years, the other side of the story is just as important. The life expectancy which is almost ten years lower in Brazil is not a result of the fact that no one in Brazil lives to old age. In 1981 people sixty-five years and older accounted for 34.4% of all deaths! At the same time infants accounted for only 22.1% of total mortality. They are responsible, along with the "premature" deaths among youths and adults, for the low, "average" life expectancy figure. In Europe, by contrast, these "premature" deaths no longer play much of a role. In 1982/84 more than half of the women (52.8%) in the Federal Republic of Germany lived to see their eightieth birthdays and almost half of the men (47.3%) lived to see their seventy-fifth. Our biological existence is guaranteed to an extent today that would have been unthinkable a few generations ago. Then, the classic troika of "plague, hunger and war" threatened our forefathers all the time and everywhere. The radical transition from the formerly uncertain to a present-day certain lifetime, which is the result of the repression of "plague, hunger and war", led to unexpected consequences for our living together. Our forefathers were forced to live in closely knit Gemeinschaften in the interest of physical survival and to subordinate their egoistic goals to a common value, but now these pressures have, for the most part, fallen away. Correspondingly, this much more certain EGO has taken center stage. An ever greater number of us chooses to live life as single beings: the number of marriages is lower every year; the number of divorces is on the increase; in Berlin (West) more than half (sic! 52.3%) of all households are already composed on only one person. For the last dozen years the annual number of births in the Federal Republic has been insufficient to ensure population replacement. Not a population explosion but rather the opposite, a population implosion, is our problem. Human beings do not appear to be "social animals", as was axiomatically assumed for so long. They were only forced to behave as such for as long as "plague, hunger and war" forced them to do so. When these life endangering conditions no longer exist and life becomes certain even without their being integrated into a Gemeinschaft then humans suddenly show themselves more and more to be independent single beings. It is not the percentage of the population that is over sixty or sixty-five that is decisive in this context but rather how certain adults perceive their biological lives to be, since they are the ones who organize their lives, who build communities or who are ever more often willing only to enter into means-to-an-end personal unions without lasting or close ties and mutual responsibilities. There are many signs which seem to point to a development in this direction in Brazil as well. More and more adults in Brazil are caught up in the deep-seated transition from an uncertain to a certain lifetime. A third of them die after having reached their sixty-fifth birthday. It therefore seems to me to be high time that one began to give more consideration to the other side of the story in Brazil as well. And who is more suited intensively to consider the long-term perspectives than those engaged in the public health sector in whose competence, after all, such aspects, as "life certainty", "life expectancy" and "age at death" belong?

Determinação de mercúrio total em amostras de água, sedimento e sólidos em suspensão de corpos aquáticos por espectrofotometria de absorção atômica com gerador de vapor a frio

O emprego de mercúrio metálico nos processos de extração do ouro libera toneladas de mercúrio ao meio ambiente, provocando um aumento considerável nas concentrações presentes. Com a finalidade de prevenir a exposição humana a concentrações excessivas, o que poderá resultar em graves episódios de intoxicação mercurial, bem como avaliar a possibilidade de sedimentos tornarem-se fontes potenciais de contaminação para os seres vivos, é de fundamental importância a monitorização do mercúrio em diversos compartimentos ambientais. Efetuou-se a padronização de uma metodologia analítica para determinação de mercúrio total em amostras de água, sólidos em suspensão e sedimentos de corpos aquáticos para monitorização ambiental do xenobiótico. Posteriormente, foram analisadas amostras oriundas de regiões garimpeiras, com vistas a avaliar o desempenho do método em amostras reais e efetuar levantamento preliminar sobre a contaminação mercurial na área de estudo.

Complemento hemolítico total, C3 e taxa de conversão de C3 nas formas cardíaca e indeterminada da doença de Chagas

Os valores de complemento hemolítico total, C3 total (nativo + produtos de degradação) e o grau de conversão de C3 nativo foram estudados em dois subgrupos de pacientes chagásicos, nas formas cardíaca e indeterminada, e em um subgrupo de indivíduos não chagásicos, clinicamente sadios. Os níveis de C3 total e as taxas de conversão de C3 em seus produtos de degradação foram semelhantes nos três subgrupos. Os valores de complemento hemolítico total foram estatisticamente diferentes nos três subgrupos (nível de significância descritivo p = 0,0757), tendo sido observada média aritmética mais baixa no subgrupo de cardíacos e mais elevada no subgrupo de controles. Maior amplitude de variação dos níveis de complemento hemolítico total foi notada no subgrupo de cardíacos, no qual se encontraram os valores extremos (máximo e mínimo), considerando-se todos os subgrupos.

Utilidad de las muestras de sangre total desecada en papel de filtro en la detección de anticuerpos antitoxoplasma

Se compara la técnica de Aglutinación Directa (AD) utilizando muestras de sangre total desecada en papel de filtro, con la técnica de ELISA y la misma AD utilizando muestras de suero de los mismos pacientes, para la detección de anticuerpos antitoxoplasma. Los resultados muestran la validez del método de la sangre desecada en papel de filtro para la detección de anticuerpos antitoxoplasma con la técnica de AD, y se considera su utilidad en los estudios epidemiológicos de campo.

Total serum IgE and parasite: specific IgG and IgA antibodies in human strongyloidiasis

Total serum IgE, and Strongyloides - specific IgG and IgA antibodies were studied in 27 patients with parasitologically proven strongyloidiasis. Clinical manifestations in this case series were investigated by a restrospective study of the patient's records. Total serum IgE levels were elevated (greater than 250 IU/ml) in 59% of the patients (mean concentration = 1364 IU/ml). Parasite - specific IgG and IgA antibodies were detected by ELISA in the serum of 23 (85.2%) and 21 (77.8%) patients, respectively. Elevated serum IgE and clinical manifestations were not useful indexes of the presence of strongyloidiasis. On the other hand, our results support the view that serologic tests, particularly ELISA for detecting Strongyloides - specific IgG antibodies, can be usefully exploited for diagnostic purposes in strongyloidiasis.

Total IgE detection in paired cerebrospinal fluid and serum samples from patients with neurocysticercosis

Neurocysticercosis (NC), the presence of Taenia solium metacestodes in tissues, is the most frequent and severe parasitic infection of the central nervous system. We investigated the presence of total IgE by an automated chemiluminescence assay in 53 paired cerebrospinal fluid (CSF) and serum samples from patients with NC (P) and in 40 CSF samples from individuals with other neurological disorders as the control group (C). Total IgE concentration ranged from 1.2 to 6.6 IU/ml (mean = 1.4 IU/ml, standard deviation-sd = 1.1 IU/ml) in 28.3% of CSF samples from the P group, a value significantly higher than for the C group (£1.0 IU/ml). The serum samples from the P group showed concentrations ranging from 1.0 to 2330.0 IU/ml (mean = 224.1 IU/ml, sd = 452.1 IU/ml), which were higher than the normal value cited by the manufacturer (<100.0 IU/ml) in 32.1% of the samples. A significant difference was observed in CSF samples from the P and C groups (p = 0.005) and in serum samples from the P group compared to the normal value (p = 0.005), with sera showing more frequent abnormal results.

Treatment of chronic hepatitis C in non-responsive patients with pegylated interferon associated with ribavirin and thalidomide: report of six cases of total remission

Hepatitis C virus (HCV) infection is an important public health issue worldwide. It is estimated that over 170 million people are infected with the virus. The present study reports six cases in which patients did not respond to combination therapy with pegylated interferon and ribavirin. However, after the addition of thalidomide to the therapy, the patients presented negative RNA PCR. The use of thalidomide combined with pegylated interferon and ribavirin for the treatment of hepatitis C is described here for the first time in the related literature.

Skin lesions in envenoming by cnidarians (Portuguese man-of-war and jellyfish): etiology and severity of accidents on the Brazilian coast

This work attempts to establish dermatological identification patterns for Brazilian cnidarian species and a probable correlation with envenoming severity. In an observational prospective study, one hundred and twenty-eight patients from the North Coast region of São Paulo State, Brazil were seen between 2002 and 2008. About 80% of these showed only local effects (erythema, edema, and pain) with small, less than 20 cm, oval or round skin marks and impressions from small tentacles. Approximately 20% of the victims had long, more than 20 cm, linear and crossed marks with frequent systemic phenomena, such as malaise, vomiting, dyspnea, and tachycardia. The former is compatible with the common hydromedusa from Southeast and Southern Brazil (Olindias sambaquiensis). The long linear marks with intense pain and systemic phenomena are compatible with envenoming by the box jellyfish Tamoya haplonema and Chiropsalmus quadrumanus and the hydrozoan Portuguese man-of-war (Physalis physalis). There was an association between skin marks and probable accident etiology. This simple observation rule can be indicative of severity, as the Cubozoa Class (box jellyfish) and Portuguese man-of-war cause the most severe accidents. In such cases, medical attention, including intensive care, is important, as the systemic manifestations can be associated with death.

Avaliação da contaminação mercurial mediante análise do teor de Hg total em amostras de cabelo em comunidades ribeirinhas do Tapajós, Pará, Brasil

Este estudo avalia a contaminação mercurial em comunidades de pescadores em quatro localidades nas margens do rio Tapajós: Rainha, Barreiras, São Luís do Tapajós e Paraná-Mirim. Análises toxocológicas das amostras de cabelo foram realizadas por espectofotometria de absorção atômica. Os níveis de mercúrio total em amostras de cabelo variaram entre 2,9µg/g e 71,5µg/g. Os valores mais baixos foram encontrados na comunidade de Paraná-Mirim. Os mais elevados, em São Luís do Tapajós e Barreiras, cerca de seis a sete vezes superiores ao valor estabelecido. As diferenças entre as concentrações médias de mercúrio total nas amostras, coletadas em populações ribeirinhas, a montante e a jusante do rio Tapajós em Itaituba, não apresentaram significância estatística (p > 0,05). Conclui-se que a exposição humana ao mercúrio por ingestão de peixes contaminados constitui risco potencial para o aparecimento de sintomas e sinais da doença de Minamata, o que recomenda a manutenção de um programa de vigilância epidemiológica.

Alterações nos níveis de colesterol, triglicerídeo e fosfolipídeo total em plasma de Callithrix jacchus (sagüi) reinfectado por Schistosoma mansoni

Pouco se conhece a cerca de alterações nos lipídeos plasmáticos devido à reinfecção por Schistosoma mansoni. Neste trabalho, foram avaliadas alterações nos lipídeos plasmáticos decorrentes de uma reinfecção por Schistosoma mansoni no primata não humano Callithrix jacchus (sagüi). Amostras de sangue dos animais, antes e após serem infectados e reinfectados, foram coletadas por punção venosa, anticoaguladas com EDTA (1mg/mL) e centrifugadas a 2.500xg para obtenção do plasma. Os níveis plasmáticos de colesterol total, colesterol éster, fosfolipídeo total e triglicerídeo foram determinados por métodos espectrofotométricos. Os resultados mostraram haver redução significativa nas concentrações de colesterol total, colesterol esterificado, triglicerídeo e fosfolipídeo total em plasma de animais reinfectados por Schistosoma mansoni, em comparação com os mesmos animais antes da infecção e após uma infecção. Este estudo mostra que uma segunda infecção por Schistosoma mansoni causa alterações lipídicas plasmáticas significativamente mais acentuadas que as decorrentes de uma única infecção.