Characterization of language disorders in children with lead poisoning

Background: lead poisoning can have a negative impact on the neuropsychological functions, including language, due to the damage it causes to the developthent of the Central Nervous System. Aim: to verify the occurrence of language disorders in children who suffered from led poisoning and to verify the correlation between the lead concentration level in the blood and the language disorders presented by the children. Method: language evaluation of 20 preschoolers, with lead concentration level in the blood above 10μg/dl. Results: 13 children presented language impairment involving only phonology or more than one language subsystem. The statistical analysis indicated that no correlation exists between the severity of the language impairment and the concentration levels of lead. Conclusion: the number of children with language impairment indicates lead poisoning as a risk factor for the present alterations, even though other risk factors for language disorders were found and the absence of correlation between the investigated variables.

Brachiaria spp. poisoning of ruminants in Brazil

Brachiaria spp. são as forrageiras mais importantes para a pecuária brasileira. Entretanto, um fator limitante para sua utilização é a sua toxicidade. A maioria dos surtos de fotossensibilização hepatógena é causada por Brachiaria decumbens; porém, B. brizantha, B. humidicola e B. ruziziensis podem também causar intoxicação. A intoxicação afeta bovinos, ovinos, caprinos e bubalinos. Os ovinos são mais susceptíveis que as outras espécies, e os animais jovens são mais susceptíveis que os adultos. Existem diferenças na susceptibilidade entre animais da mesma espécie e tem sido sugerido que esta resistência é genética. Sugere-se, também, que búfalos e provavelmente alguns ovinos são resilientes (quando intoxicados apresentam lesões histológicas e aumento das concentrações séricas de GGT, mas não apresentam sinais clínicos). Em geral, a concentração de saponinas é maior nas plantas em crescimento, mas surtos ocorrem durante todo o ano, provavelmente por aumento da concentração de saponinas na planta por alguma causa ainda desconhecida. Uma síndrome clínica com progressiva perda de peso e morte, sem fotossensibilização, tem sido descrita em bovinos intoxicados por B. decumbens. As principais medidas preventivas são baseadas na seleção de animais resistentes ou resilientes e o desenvolvimento de espécies ou variedades de Brachiaria com menores concentrações de saponinas.

Adequações tecnológicas no beneficiamento do caranguejo-uçá Ucides cordatus (Linnaeus, 1763) desenvolvido na comunidade de Caratateua, município de Bragança, estado do Pará, Brasil

No Estado do Pará, o beneficiamento do caranguejo-uçá ocorre de forma totalmente artesanal, sendo o seu produto frequentemente associado a eventos de intoxicação alimentar. Neste trabalho o autor tem por finalidade propor adequações tecnológicas no processamento deste crustáceo desenvolvido na comunidade de Caratateua, município de Bragança/Pará. Foram realizadas excursões mensais à comunidade de abril/2008 a maio/2009 com aplicação de 120 entrevistas direcionadas aos principais atores sociais envolvidos na atividade, constando de aspectos econômicos, sociais e tecnológicos, além de análises laboratoriais (composição química e microbiologia), observações de campo e revisão de literatura. Constatou-se que a quantidade de caranguejo desembarcada e o tamanho médio dos indivíduos vêm diminuindo nos últimos anos. A captura é realizada exclusivamente por indivíduos do sexo masculino, sendo o gancho o principal apetrecho utilizado. O beneficiamento é praticado principalmente por mulheres e crianças, porém homens eventualmente também o fazem. Não há uma padronização do processamento e as condições higiênico-sanitárias dos locais de beneficiamento são na grande maioria das vezes inadequadas, podendo este ser realizado no interior da residência, em “puxadinhas” ou nos quintais, geralmente na presença de animais domésticos, insetos e sem a adequada assepsia de manipuladores, equipamentos e superfícies de contato. Desta forma, conclui-se que tal realidade é ocasionada principalmente pelo desordenamento da pescaria e falta de preocupação dos catadores quanto à qualidade do produto, sendo de fundamental importância a criação de uma legislação específica para a carne de caranguejo e a adoção de boas práticas de fabricação levando em consideração a realidade local visando agregação de valor ao produto e maior segurança alimentar aos consumidores.

Conditioned food aversion to control poisoning by Ipomoea carnea subsp. fistulosa in goats

Para testar a técnica de aversão alimentar condicionada como método de controle para a intoxicação por I. carnea, foram realizados 3 experimentos administrando cloreto de lítio (LiCl) na dose de 175-200mg kg-1 após a ingestão da planta por caprinos. No primeiro, foram induzidos à aversão 10 caprinos que tinham o hábito de ingerir a planta e com sinais clínicos da intoxicação. Apesar da realização de diversos tratamentos aversivos, após os animais ingerirem a planta, a aversão não foi eficiente, demonstrando que a técnica não é eficiente em caprinos que já estão habituados a ingerir a planta. No segundo experimento, 14 caprinos foram adaptados a ingerir a planta na pastagem e, após ingerirem a planta a campo, foram induzidos à aversão com LiCl. Neste grupo, a aversão persistiu até o fim do Experimento, 2 anos e 8 meses após a aversão. Em outro experimento, 20 caprinos foram adaptados a consumir I. carnea e, em seguida, induzidos à aversão com LiCl. Esses animais foram transferidos para uma propriedade na Ilha de Marajó, onde foram realizadas 9 visitas com intervalos de 2-3 meses para verificar a duração da aversão. Após 2 anos de observações, nenhum animal voltou a ingerir a planta na pastagem e não foram observados casos de intoxicação, enquanto que, em 6 propriedades vizinhas, a doença foi observada com uma prevalência de até 60%. Esses resultados demonstram a eficiência da aversão alimentar condicionada para evitar a ingestão de I. carnea em caprinos recém adaptados a ingerir a planta, nas regiões invadidas por esta planta e nas condições naturais da Ilha de Marajó.

Lead poisoning in cattle and chickens in the state of Pará, Brazil

O presente estudo descreve a ocorrência de intoxicação por chumbo em bovinos e galinhas no Pará, Brasil. Em um lote composto de 80 bezerros de um rebanho leiteiro, 10 animais ficaram doentes e nove morreram, e um animal se recuperou após ser removido do piquete. Após a inspeção deste piquete, foi observada a presença de baterias de caminhões usados para armazenar a energia captada por painéis solares. Os sinais clínicos observados nos bezerros incluíam dificuldade respiratória, corrimento nasal, salivação excessiva, opacidade da córnea, pressão da cabeça contra objetos e decúbito. As galinhas tinham diminuída oviposição e os ovos produzidos eram com cascas malformadas ou tinham a casca mais fina. Os achados de necropsia e as alterações histopatológicas observadas nos bovinos eram de pouco significado, com exceção de um animal que mostrou leve astrocitose no córtex cerebral. Em uma das galinhas, na histopatologia renal observou-se leve necrose tubular aguda multifocal. As concentrações de chumbo médios nos fígados e rins dos bovinos eram 93,91mg/kg e 209,76mg/kg, respectivamente, e a concentração média no fígado de galinhas foi 105,02mg/ kg. Concluiu-se que a fonte de contaminação por chumbo nesses bezerros e galinhas eram placas de bateria de caminhão, aos quais os animais tiveram acesso na pastagem.

Poisoning after ingestion of pufferfish in Brazil: report of 11 cases

In this brief communication the authors report eleven cases of human poisoning caused by ingestion of pufferfish meat. Three patients (two children and one adult) were seriously affected. The circumstances that precipitated the poisoning are discussed as well as the clinical aspects observed. No deaths were registered and the patients did not present sequelae after the episode.

Spontaneous poisoning by Hovenia dulcis in dairy cattle in Southwest Parana, Brazil

Livestock poisoning by plants is a frequent occurrence which determines severe losses, such as the fall in the milk and meat production, the cost of expensive treatments, the state of immunosuppression, or even the animal's death. Cattle ingest toxic plants only when there is food shortage, when they cannot select what they eat, or when they ingest food for preference, which is the case of Hovenia dulcis fruits, very rich in sucrose. This plant is widely distributed in the southern and southeastern Brazilian regions. In literature, there are some cases of severe human liver injury associated with a long-term of H. dulcis leaf and fruit tea intake, and only one report regarding spontaneous poisoning of goats caused by this plant ingestion. However, its toxic effects associated with spontaneous ingestion by cattle have never been reported. This paper reports the first case of spontaneous poisoning in cattle by H. dulcis, which occurred in a dairy farm in southwest Paraná, Brazil. Three cattle individuals showed anorexia, ruminal atony, severe diarrhea and neurological tournament, head pressing, blindness, ataxia, and circling. The necropsy of the animals was done, and the remaining alterations were restricted to the digestive system and brain. The clinical signs presented by the animals are characteristic of polioencephalomalacia (PEM), caused by changes in the thiamine metabolism. Furthermore, clinical signs, gross, and microscopic lesions as well as the large amount of the plant throughout the digestive segment led to a diagnosis.

Effects of Maternal Pb2+ poisoning during pregnancy on the development of the jaw (Meckel´s Cartilage) of rat fetus

The purpose of this study was to investigate the effects of maternal lead poisoning during pregnancy on the development of the jaw (Meckel's cartilage) of rat fetuses by histologic and morphometric methods. Pregnant rats received a single intraperitoneal injection of 2.5 mg of lead acetate/100g body weight on the 10th day of pregnancy. Meckel's cartilage of fetuses of the lead-treated group showed smaller volume density and size of the lacunae, as well as modification of the lacunae shape. Moreover, the number density of lacunae and the volume density of the matrix increased significantly in the Meckel's cartilage in treated group fetuses. The results suggest that lead poisoning during the period of organogenesis can induce disturbances in the development and differentiation of the fetal stomatognathic system. Reducing the consumption of alcoholic beberages and smoking cessation by women in childbearing age, along with a strict policy of control of the environmental lead exposure can bring great benefits to the future generations of children.

Mineral element and heavy metal poisoning in animals

Mineral elements are essential to animal health, survival and production because they are part of physiological, structural, catalytic and regulatory organism functions. Therefore, they should be present in diet. However, these minerals when ingested in excessive doses due to errors in balancing mineral supplements and/or complete ration, intake of plants with high mineral concentration, resulting from addition of fertilizers, herbicides, insecticides and fungicides in pasture or tillage where plants and/or grains will be used to feed animals, decomposition of urban and industrial wastes, leaks and accidental spills of pollutants may result in accumulation of toxic mineral elements in the environment poisoning the animals and may lead them to death. However, toxic doses, physiological changes during poisoning, symptoms and mineral concentration in tissues of poisoned animals to confirm diagnosis are not completely known. Thus, this study reviews mineral element doses that some authors considered toxic for animals intake, as its concentration in tissues of poisoned animals and its physiological effects, symptoms, diagnostic procedures and treatment for poisoning by cadmium, lead, copper, chromium, iodine, manganese, molybdenum, selenium and zinc.

Assessment of the risk of raw milk consumption related to staphylococcal food poisoning

This study aimed to identify the risks of staphylococcal food poisoning due to the consumption of raw milk. Fifty-one farms in Londrina (PR) and 50 in Pelotas (RS) were analyzed, to determine the population of coagulase-positive staphylococci (UFC/ mL), as well as to verify the ability of producing Staphylococcal Enterotoxin A (SEA) by immunodifusion (OSP), the presence of the gene for the production of SEA (PCR) in the cultures, and the research of enterotoxin (SEA to SEE) in milk samples using ELISA commercial kit. Considering the 101 farms analyzed, 19 (18.8%) presented coagulase-positive staphylococci count above 105 UFC/mL. For the evaluation of the enterotoxigenic ability (SEA) by the OSP technique, six cultures coagulase-positive (5.5%) were positive to the test and identified as S. aureus. From the coagualse-negative sample, one (5.5%) was OSP positive. For the evaluation of the presence of the gene for EEA synthesis, 51 cultures of staphylococci were tested. From this total, 14 (27.45%) presented the gene, and from that, only 5 (9.81%) cultures were capable of expressing it in the technique of the OSP. The morphologic characteristic of the evaluated cultures that had enterotoxigenic capacity, from the 14 (33,3%) cultures that presented the gene for EEA production, 05 (11.9%) were characterized as typical cultures of S.aureus in Baird Parker agar. All the 12 milk samples studied for the presence of EEA to EEE in milk were negative. Thus, it can be concluded that there is extensive contamination of raw milk for staphylococci coagulase, however, most of the isolated strains were not enterotoxigenic or did not express such a characteristic. Only 9.81% of the tested colonies expressed the gene and effectively produced SEA. None of the samples had sufficient counts to produce detectable amounts of SEA. The milk samples did not present risk to cause staphylococcal food poisoning if consumed in natura until the collection moment.

Environmental lead poisoning among children in Porto Alegre state, Southern Brazil

OBJECTIVE: To estimate the prevalence of lead poisoning in children and to identify associated factors, as well as possible local sources of contamination. METHODS: A cross-sectional prevalence study conducted in 2006 with a random sample of 97 children age zero to five years from a neighborhood in Porto Alegre, Southern Brazil. Blood lead levels were measured and a questionnaire administered to collect information on sociodemographics, recycling and dwelling. A preliminary environmental evaluation was carried out with direct analysis of soil and indirect analysis of air pollution with bioindicators to identify possible sources of contamination. To analyze lead concentrations from the different collection sites, for each type of material studied, ANOVA was performed with a Brown-Forsythe adjustment for heteroscedasticity and with Dunnett's T3 procedure for multiple comparisons of unequal variances. RESULTS: Blood lead levels >= 10.0 mu g/dL was found in 16.5% of children. Recycling of waste at home, low father's education level, and increased age of children were associated with increase blood lead levels. High lead levels were found in soil, and there was little indication of lead air pollution. CONCLUSIONS: A high prevalence of lead poisoning was identified, and the potential sources of contamination in this community appear related to waste recylcing activities. Studies should be conducted with other populations of Brazilian children and evaluate potential sources of local and general contamination, to accurately characterize this issue in Brazil.

The EXTRIP (EXtracorporeal TReatments In Poisoning) workgroup: Guideline methodology

Extracorporeal treatments (ECTRs), such as hemodialysis and hemoperfusion, are used in poisoning despite a lack of controlled human trials demonstrating efficacy. To provide uniform recommendations, the EXTRIP group was formed as an international collaboration among recognized experts from nephrology, clinical toxicology, critical care, or pharmacology and supported by over 30 professional societies. For every poison, the clinical benefit of ECTR is weighed against associated complications, alternative therapies, and costs. Rigorous methodology, using the AGREE instrument, was developed and ratified. Methods rely on evidence appraisal and, in the absence of robust studies, on a thorough and transparent process of consensus statements. Twenty-four poisons were chosen according to their frequency, available evidence, and relevance. A systematic literature search was performed in order to retrieve all original publications regardless of language. Data were extracted on a standardized instrument. Quality of the evidence was assessed by GRADE as: High = A, Moderate = B, Low = C, Very Low = D. For every poison, dialyzability was assessed and clinical effect of ECTR summarized. All pertinent documents were submitted to the workgroup with a list of statements for vote (general statement, indications, timing, ECTR choice). A modified Delphi method with two voting rounds was used, between which deliberation was required. Each statement was voted on a Likert scale (1-9) to establish the strength of recommendation. This approach will permit the production of the first important practice guidelines on this topic.

Correlation analysis of the long latency auditory evoked potential N2 and cognitive P3 with the level of lead poisoning in children

Introduction: The effects of lead on children’s health have been widely studied. Aim: To analyze the correlation between the long latency auditory evoked potential N2 and cognitive P3 with the level of lead poisoning in Brazilian children. Methods: This retrospective study evaluated 20 children ranging in age from 7 to 14 years at the time of audiological and electrophysiological evaluations. We performed periodic surveys of the lead concentration in the blood and basic audiological evaluations. Furthermore, we studied the auditory evoked potential long latency N2 and cognitive P3 by analyzing the absolute latency of the N2 and P3 potentials and the P3 amplitude recorded at Cz. At the time of audiological and electrophysiological evaluations, the average concentration of lead in the blood was less than 10 ug/dL. Results: In conventional audiologic evaluations, all children had hearing thresholds below 20 dBHL for the frequencies tested and normal tympanometry findings; the auditory evoked potential long latency N2 and cognitive P3 were present in 95% of children. No significant correlations were found between the blood lead concentration and latency (p = 0.821) or amplitude (p = 0.411) of the P3 potential. However, the latency of the N2 potential increased with the concentration of lead in the blood, with a significant correlation (p = 0.030). Conclusion: Among Brazilian children with low lead exposure, a significant correlation was found between blood lead levels and the average latency of the auditory evoked potential long latency N2; however, a significant correlation was not observed for the amplitude and latency of the cognitive potential P3

Personal and Social Performance (PSP) scale for patients with schizophrenia: translation to Portuguese, cross-cultural adaptation and interrater reliability

INTRODUCTION: Schizophrenia is a chronic mental disorder associated with impairment in social functioning. The most widely used scale to measure social functioning is the GAF (Global Assessment of Functioning), but it has the disadvantage of measuring at the same time symptoms and functioning, as described in its anchors. OBJECTIVES:Translation and cultural adaptation of the PSP, proposing a final version in Portuguese for use in Brazil. METHODS: We performed five steps: 1) translation; 2) back translation; 3) formal assessment of semantic equivalence; 4) debriefing; 5) analysis by experts. Interrater reliability (Intraclass correlation, ICC) between two raters was also measured. RESULTS: The final version was applied by two independent investigators in 18 adults with schizophrenia (DSM-IV-TR). The interrater reliability (ICC) was 0.812 (p < 0.001). CONCLUSION: The translation and adaptation of the PSP had an adequate level of semantic equivalence between the Portuguese version and the original English version. There were no difficulties related to understanding the content expressed in the translated texts and terms. Its application was easy and it showed a good interrater reliability. The PSP is a valid instrument for the measurement of personal and social functioning in schizophrenia.