Seroprevalence for hepatitis E virus (HEV) infection among volunteer blood donors of the Regional Blood Bank of Londrina, State of Paraná , Brazil

A cross-sectional study was carried out among 996 volunteer blood donors enrolled from May 1999 to December 1999 to determine the seroprevalence of hepatitis E virus (HEV) infection among volunteer blood donors of the Regional Blood Bank of Londrina, State of Paraná, Brazil, and to evaluate whether the rate of seroprevalence of IgG anti-HEV antibodies is associated with sociodemographic variables and with seropositivity for hepatitis A virus (HAV) infection. All participants answered the questionnaire regarding the sociodemographic characterisitcs. Serum samples were tested for IgG antibodies to HEV (anti-HEV) by an enzyme linked immunoassay (ELISA). All serum samples positive for anti-HEV IgG and 237 serum samples negative for anti-HEV were also assayed for IgG anti-HAV antibodies by ELISA. Anti-HEV IgG was confirmed in 23/996 samples, resulting in a seroprevalence of 2.3% for HEV infection, similar to previous results obtained in developed countries. No significant association was found between the presence of anti-HEV IgG antibodies and the sociodemographic variables including gender, age, educational level, rural or urban areas, source of water, and sewer system (p > 0.05). Also, no association with seropositivity for anti-HAV IgG antibodies was observed (p > 0.05). Although this study revealed a low seroprevalence of HEV infection in the population evaluated, the results showed that this virus is circulating among the population from Londrina, South Brazil, and point out the need of further studies to define the clinical and epidemiological importance of HEV infection and to identify additional risk factors involved in the epidemiology and pathogenesis of this infection in this population.

First report of an accident with the speckled forest pit viper (Bothriopsis taeniata) in Brazil

The first reported case of an accident with Bothriopsis taeniata in Brazil is described. The victim, a 43-year-old man, was bitten just above his right heel and presented a clinical condition compatible with mild Bothrops poisoning: local edema with hemorrhage at the bite site and pain, although without coagulopathy.

Report of a human accident caused by Conus regius (Gastropoda, Conidae)

Conus regius is a venomous mollusc in the Conidae family, which includes species responsible for severe or even fatal accidents affecting human beings. This is the first report on a clinical case involving this species. It consisted a puncture in the right hand of a diver who presented paresthesia and movement difficulty in the whole limb. The manifestations disappeared after around twelve hours, without sequelae.

Accident caused by Centruroides testaceus (DeGeer, 1778) (Scorpiones, Buthidae), native to the Caribbean, in Brazilian airport

Describes the case of a 6-year-old girl who was stung by a Centruroides testaceus, a scorpion native to the Lesser Antilles, in the Guarulhos International Airport, São Paulo, Brazil, as she disembarked from a flight coming from the Caribbean. The patient presented only local symptoms (a small area of erythema and pain at the sting site), which were resolved after a few hours with analgesics, without the need for antivenom. Physicians who treat patients stung by scorpions should be alert to the possibility of such accidents being caused by non native species, especially those cases that occur near airports or ports.

Pulmonary artery catheter complications: report on a case of a knot accident and literature review

A particular event concerning a Swan-Ganz catheter complication is reported. A 41-year-old woman was admitted at the emergency room of our hospital with massive gastrointestinal bleeding. A total gastrectomy was performed. During the postoperative period in the intensive care unit , the patient maintained hemodynamic instability. Invasive hemodynamic monitoring with a pulmonary artery catheter was then indicated. During the maneuvers to insert the catheter, a true knot formation was identified at the level of the superior vena cava. Several maneuvers by radiological endovascular invasive techniques allowed removal of the catheter. The authors describe the details of this procedure and provide comments regarding the various techniques that were employed in overcoming this event. A comprehensive review of evidence regarding the benefits and risks of pulmonary artery catheterization was performed. The consensus statement regarding the indications, utilization, and management of the pulmonary artery catheterization that were issued by a consensus conference held in 1996 are also discussed in detail.

Communication Strategies Of The Nursing Team In The Aphasia After Cerebrovascular Accident

This is an exploratory, cross-sectional study of quantitative design that aimed to identify the communication strategies used and reported by the nursing staff in the care of aphasic patients after a stroke. The techniques used were the participant observation and interviews with 27 subjects of the nursing staff of neurological units in a general hospital. The most frequently mentioned strategies were gestures (100%), verbal communication (33.3%), written communication (29.6%) and the touch (18.5 %). Among the observed strategies, the gestures reached 40.7% and the touch was present in all situations, given its instrumental character essential to care. The findings show lack of knowledge of nonverbal, proxemics , kinesics and tacesics communication. No significant differences were observed among the professional categories depending on the length of experience with respect to the strategies reported by members of the nursing staff in the care for aphasic patients.


Trauma in the elderly caused by traffic accident: integrative review

OBJECTIVE To describe the scientific knowledge produced about trauma in the elderly caused by traffic accidents in healthcare area studies. METHODS Integrative review of studies from 2003 to 2013 searched in LILACS, SciELO, PubMed and CINHAL databases. We used combination of the descriptors injuries, wounds and accidents, in English, Portuguese and Spanish languages. RESULTS 32 studies were selected. In the thematic analysis, three categories emerged: epidemiological data from traffic accidents involving elderly; traffic accidents with elderly pedestrians; and trauma care in the elderly. We observed increased incidence of trauma in most countries and pedestrians represented a large part of the victims. Among these, the elderly are the most vulnerable group. CONCLUSION Studies showed that trauma care in the elderly need protocols and professionals with training in gerontology specialized in trauma care services.

Quantifying seed production by volunteer canola (Brassica napus) and Sinapis arvensis

Volunteer canola (Brassica napus) and Sinapis arvensis are well identified weeds of different cropping systems. Quantitative information on regarding seed production by them is limited. Such information is necessary to model dynamics of soil seed banks. The aim of this work was to quantify seed production as a function of the size of those weeds. A wide range of plant size was produced by using a fan seeding system performed at two sowing dates (environments). Plant size varied from 3 to 167 g per plant for canola and from 6 to 104 g per plant for S. arvensis. Seed production ranged from 543 to14,773 seeds per plant for canola, and from 264 to 10,336 seeds per plant for S. arvensis. There was a close relationship between seed production per plant and plant size which was well-described by a power function (y = 130.6x0.94; R² = 0.93 for canola and y = 28x1.27; R² = 0.95 for S. arvensis). There was also strong relationships among the number of pods produced in individual plants and the quantity of seeds produced (g per plant) with the size of the plant. The relationships found in this study can be used in dynamic seed bank models of volunteer canola and S. arvensis.

Seed bank modelling of volunteer oil seed rape: from seeds fate in the soil to seedling emergence

Studies were conducted to estimate parameters and relationships associated with sub-processes in soil seed banks of oilseed rape in Gorgan, Iran. After one month of burial, seed viability decreased to 39%, with a slope of 2.03% per day, and subsequently decreased with a lower slope of 0.01 until 365 days following burial in the soil. Germinability remained at its highest value in autumn and winter and decreased from spring to the last month of summer. Non-dormant seeds of volunteer oilseed rape did not germinate at temperatures lower than 3.8 ºC and a water potential of -1.4 MPa ºd. The hydrothermal values were 36.2 and 42.9 MPa ºd for sub- and supra-optimal temperatures, respectively. Quantification of seed emergence as influenced by burial depth was performed satisfactorily (R² = 0.98 and RMSE = 5.03). The parameters and relationships estimated here can be used for modelling soil seed bank dynamics or establishing a new model for the environment.

Glyphosate tolerant volunteer corn control at two development stages

The loss of grains during the harvest of glyphosate tolerant corn may generate volunteer plants, which can interfere in the conventional or glyphosate crop in succession. The current work aim to evaluate the control of the volunteer corn glyphosate tolerant under two weed stages. Aimed to evaluate the control of volunteer glyphosate tolerant corn in two stages of development. There were conducted two experiments with hybrid 2B688 HR (lepidoptera and glyphosate tolerant), the application were at V5 and V8 stage. The experiment was randomized block design with four replicates, using the treatments: haloxyfop at 25, 50 and 62 g ha-1 alone and associated with 2,4-D at 670 g ha-1 or fluroxypyr at 200 g ha-1. The standard was clethodim at 84 g ha-1 with 2,4-D and fluroxypyr at same rates. The applications of haloxyfop and clethodim both isolated or in a mixture with 2,4-D and fluroxypyr at V5 stage showed total control (100%) at 32 and 39 days after the application, except for haloxyfop + 2,4-D (25 + 670 g ha-1) mixture, which did not provided adequate control. At V8 stage, haloxyfop + 2,4-D (50 + 670 g ha-1) and haloxyfop + 2,4-D (62 + 670 g ha-1) mixtures took up to 6 and 10 days or longer to reach adequate to excellent control, when compared to haloxyfop isolated applications in the same doses, respectively. Either isolated clethodim or mixed with 2, 4-D and fluroxypyr did not show adequate control. The treatments showed efficient control on volunteer corn plants at V5 stage, except for haloxyfop + 2, 4-D (25 + 670 g ha-1) mixture. At V8 stage applications, haloxyfop either isolated or mixture with fluroxypyr demonstrated excellent control on every evaluated dose. The mixture with 2, 4-D can reduce haloxyfop efficiency at low doses. Clethodim alone or mixed with 2,4-D or furoxypyr did not provide acceptable level of control.

Volunteer RR® corn management in roundup ready® soybean-corn succession system

The present study evaluated the effects of cover crops (Pennisetum glaucum, Crotalaria spectabilis and Urochloa ruziziensis) associated with the application of herbicides {glyphosate; (glyphosate + haloxyfop-R); (glyphosate + fluazifop-p-butyl); (glyphosate + imazethapyr) and (glyphosate + imazaquin)} in soybean desiccation management for volunteer RR® corn control. The experiment was conducted under field conditions at Sinop-MT, during the 2013/2014 crop season, in a randomized complete blocks design with factorial scheme and four replications. The following parameter were evaluated: dry matter of cover crops and ground coverage rate, control of volunteer RR® corn present at the time of desiccation, dry matter, height and intoxication level on soybean plants caused by herbicides at 7, 14 and 28 days after emergence (DAE), control of volunteer RR® corn derived from emergence fluxes subsequent to desiccation management and soybean yield. The joint application of (glyphosate + haloxyfop-R) provided the best level of volunteer RR® corn control present at the time of desiccation. Satisfactory control (80%) of volunteer corn was obtained with the application of (glyphosate + imazethapyr). This treatment displayed an additional residual effect of imazethapyr, which efficiently controled volunteer RR® corn derived from fluxes subsequent to desiccation management, especially in treatments performed under U. ruziziensis straw. None of the herbicides used in desiccation management caused any significant effect on dry matter, height and phytotoxicity of soybean plants at 7, 14 and 28 DAE nor on grain yield.

Hippuric acid in urine: reference values

OBJECTIVE: To establish reference values for hippuric acid (HA) excreted in the urine, and to evaluate the impact of age, gender, alcohol, and tobacco, on these levels in a population nonexposed to toluene. METHODS: Reference values for hippuric acid in urine were determined in 115 toluene nonexposed healthy volunteers, from Alfenas city, Southeastern Brazil. A questionnaire was applied to each volunteer and data on occupational and personal habits were collected. Biochemical and hematological analyses were used to confirm the volunteers' good health condition. Reference values were expressed in g HA/g urine creatinine, as mean ± standard deviation (x ± SD), median, 95% confidence interval (95%CI), 95th percentile, and upper reference value (URV, mean +2 SD). RESULTS: Reference values of hippuric acid in urine were: mean ± standard deviation =0.18±0.10; median =0.15; 95% confidence interval =0.16±0.20; 95th percentile = 0.36 and upper reference value (URV, mean +2 SD) =0.38. Statistically significant differences in urinary HA (Wilcoxon - Mann/Whitney, p<0.05) were observed for different genders and age groups. Alcohol ingestion and smoking habit did not significantly affect the results. CONCLUSIONS: The reference values of hippuric acid in urine can be used in biomonitoring programs of workers occupationally exposed to toluene, especially in the southern region of the state of Minas Gerais. Age and gender may affect the HA reference values.

Sleep, stress and compensatory behaviors in Australian nurses and midwives

OBJECTIVE: To describe sleep, stress and compensatory behaviors in nurses and midwives. METHODS: The study included 41 midwives and 21 nurses working in Australian hospitals between 2005 and 2009. Participation was voluntary. All participants recorded on a daily basis their work and sleep hours, levels of stress and exhaustion, caffeine intake and use of sleep aids for a month (1,736 days, 1,002 work shifts). RESULTS: Participants reported moderate to high levels of stress and exhaustion on 20-40% of work days; experienced sleep disruption on more than 50% of work days; struggled to remain awake on 27% of work days; and suffered extreme drowsiness or experienced a near accident while travelling home on 9% of workdays. Age, perceived sleep duration and work hours were significant predictors of caffeine intake. About 60% of participants reported using sleep aids (about 20% reported taking prescription medications and 44% of nurses and 9% of midwives reported alcohol use as a sleep aid at least once during the study). Stress and workdays were significant predictors of sedative use. Overall, 22% reported being indifferent or mildly dissatisfied with their job. CONCLUSIONS: Sleep problems, high levels of stress and exhaustion and low job satisfaction are prevalent among nurses and midwives. The use of alcohol and sleeping pills as sleep aids, and the use of caffeine to help maintain alertness is also common. Nurses and midwives may use caffeine to compensate for reduced sleep, especially on workdays, and sleeping pills to cope with their daily work-related stress.

Human risk assessment of benzene after a gasoline station fuel leak

OBJECTIVE: To assess the health risk of exposure to benzene for a community affected by a fuel leak. METHODS: Data regarding the fuel leak accident with, which occurred in the Brasilia, Federal District, were obtained from the Fuel Distributor reports provided to the environmental authority. Information about the affected population (22 individuals) was obtained from focal groups of eight individuals. Length of exposure and water benzene concentration were estimated through a groundwater flow model associated with a benzene propagation model. The risk assessment was conducted according to the Agency for Toxic Substances and Disease Registry methodology. RESULTS: A high risk perception related to the health consequences of the accident was evident in the affected community (22 individuals), probably due to the lack of assistance and a poor risk communication from government authorities and the polluting agent. The community had been exposed to unsafe levels of benzene (> 5 µg/L) since December 2001, five months before they reported the leak. The mean benzene level in drinking water (72.2 µg/L) was higher than that obtained by the Fuel Distributer using the Risk Based Corrective Action methodology (17.2 µg/L).The estimated benzene intake from the consumption of water and food reached a maximum of 0.0091 µg/kg bw/day (5 x 10-7 cancer risk per 106 individuals). The level of benzene in water vapor while showering reached 7.5 µg/m3 for children (1 per 104 cancer risk). Total cancer risk ranged from 110 to 200 per 106 individuals. CONCLUSIONS: The population affected by the fuel leak was exposed to benzene levels that might have represented a health risk. Local government authorities need to develop better strategies to respond rapidly to these types of accidents to protect the health of the affected population and the environment.

Lack of access and continuity of adult health care: a national population-based survey

OBJECTIVE To describe the lack of access and continuity of health care in adults.METHODS A cross-sectional population-based study was performed on a sample of 12,402 adults aged 20 to 59 years in urban areas of 100 municipalities of 23 states in the five Brazilian geopolitical regions. Barriers to the access and continuity of health care and were investigated based on receiving, needing and seeking health care (hospitalization and accident/emergency care in the last 12 months; care provided by a doctor, by other health professional or home care in the last three months). Based on the results obtained by the description of the sample, a projection is provided for adults living in Brazilian urban areas.RESULTS The highest prevalence of lack of access to health services and to provision of care by health professionals was for hospitalization (3.0%), whilst the lowest prevalence was for care provided by a doctor (1.1%). The lack of access to care provided by other health professionals was 2.0%; to accident and emergency services, 2.1%; and to home care, 2.9%. As for prevalences, the greatest absolute lack of access occurred in emergency care (more than 360,000 adults). The main reasons were structural and organizational problems, such as unavailability of hospital beds, of health professionals, of appointments for the type of care needed and charges made for care.CONCLUSIONS The universal right to health care in Brazil has not yet been achieved. These projections can help health care management in scaling the efforts needed to overcome this problem, such as expanding the infrastructure of health services and the workforce.