Neonatal hearing screening in a low-risk maternity in São Paulo state

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Barriers related to non-adherence in a mammography breast-screening program during the implementation period in the interior of São Paulo State, Brazil

Mammography is the best exam for early diagnosis of breast cancer. Developing countries frequently have a low income of mammography and absence of organized screening. The knowledge of vulnerable population and strategies to increase adherence are important to improve the implementation of an organized breast-screening program. A mammography regional-screening program was implemented in a place around 54.238 women, aged 40-69 years old. It was proposed to perform biannual mammography free of cost for the women. We analyze the first 2 years of the implementation of the project. Mammography was realized in 17.964 women. 42.1% of the women hadn't done de mammography in their lives and these women were principally from low socio-economic status (OR=2.99), low education (OR=3.00). The best strategies to include these women were mobile unit (OR=1.43) and Family Health Program (OR=1.79). The incidence of early breast tumors before the project was 14.5%, a fact that changed to 43.2% in this phase. Multivariate analysis showed that the association of illiterate and the mobile unit achieve more women who had not performed mammography in their lives. The strategies to increase adherence to mammography must be multiple and a large organization is necessary to overpass the barriers related to system health and education.

The occurrence of UV filters in natural and drinking water in São Paulo State (Brazil)

Ultraviolet (UV) filters are widely used in the formulation of personal care products (PCPs) to prevent damage to the skin, lips, and hair caused by excessive UV radiation. Therefore, large amounts of these substances are released daily into the aquatic environment through either recreational activities or the release of domestic sewage. The concern regarding the presence of such substances in the environment and the exposure of aquatic organisms is based on their potential for bioaccumulation and their potential as endocrine disruptors. Although there are several reports regarding the occurrence and fate of UV filters in the aquatic environment, these compounds are still overlooked in tropical areas. In this study, we investigated the occurrence of the organic UV filters benzophenone-3 (BP-3), ethylhexyl salicylate (ES), ethylhexyl methoxycinnamate (EHMC), and octocrylene (OC) in six water treatment plants in various cities in Southeast Brazil over a period of 6 months to 1 year. All of the UV filters studied were detected at some time during the sampling period; however, only EHMC and BP-3 were found in quantifiable concentrations, ranging from 55 to 101 and 18 to 115 ng L(-1), respectively. Seasonal variation of BP-3 was most clearly noticed in the water treatment plant in Araraquara, São Paulo, where sampling was performed for 12 months. BP-3 was not quantifiable in winter but was quantifiable in summer. The levels of BP-3 were in the same range in raw, treated and chlorinated water, indicating that the compound was not removed by the water treatment process.

Chicken meat consumer profile in northwestern São Paulo State, Brazil

Brazil is the world’s first chicken meat exporter nowadays. The maintenance of this position requires a constant quality attributes evolution. This work evaluated the chicken meat consumer profile in the northwest region of São Paulo state, the most important Brazilian poultry meat consumer market, in order to provide information to the productive sector. The data were collected using 482 interviews and questionnaires that were answered by e-mail. The questionnaires involved questions related to the consumer identification, habits and preferences and their knowledge about food safety, production system, sustainability and animal welfare. Most of the consumers, 62%, were female, with ages ranging from 20 to 50 years. Beef was preferred by the majority of the answerers and chicken and pork meat were together the second choice. Only 2% of the interviewed consumers mentioned not enjoying poultry meat. The main part of consumers, 67%, prefer to buy breast and leg cuts and only 11% are used to buy the whole poultry carcass. More than 60% of the interviewed have already eaten free range chicken meat, but the majority of them, 89%, are used to consume regular industrialized poultry. About 75% of the consumers believe hormones are used to grow the birds. Over 80% of people observe the expiration date before buying the product, but only 55% check if it has the stamp of the official inspection service. Color and appearance of meat are the most important factors that influence the consumer’s choice. The amount of water that drips on the tray is a rejection factor to 88% of answerers. Most of them, 66%, prefer lighter colored meat. Only 27% of them believe that chicken meat causes an environmental impact and 48% do not know the meaning of animal welfare. More than half of the interviewed do not consider animal welfare aspects before consuming any kind of meat. From these results obtained, it is possible to conclude that any effort to improve the product quality, mainly concerned to animal welfare and sustainability aspects, requires prior educational initiatives.

A comparative analysis of caries and fluorosis among cities with and without public water supply fluoridation in São Paulo State, Brazil

Purpose: This population-based, cross-sectional study aimed to record the DMFT index for 12 year-old children with dental caries and fluorosis levels in cities with and without public water supply fluoridation. Methods: From the 101 municipalities belonging to the Health Regional Department XV (DRSXV-SJRP) of the São Paulo state in the Southeast region of Brazil, 85 cities were selected after exclusion of those with incomplete data and less than ten years of fluoridation treatment in 2004. The criteria adopted for the assessment of dental caries and fluorosis levels were based on the guidelines published in the WHO Manual 4th edition. The data were analyzed using Fisher’s exact tests at a significance level of 5%. Results: The prevalence of caries in 12 year-old children had no significant association with fluoridated water, and was considered “moderate” and “high” in cities without fluoridation and “low” and “moderate” in cities with fluoridation. A significant association was found between water fluoridation and fluorosis (P=0.001), but not between water fluoridation and the DMFT index (P=0.119). Conclusion: The prevalence of fluorosis was related to water fluoridation in this study. However, fluorosis was also observed in non-fluoridated cities, which may result from fluoride intake through other sources.

Medicinal plants in pregnancy and lactation: perception of the health risk and practical educational group in Araraquara, São Paulo State, Brazil

The use of medicinal plants among pregnant women and lactating is a common practice in diverse countries. However, many medicinal plants are contraindicated during pregnancy and lactating, due to various adverse effects, such as teratogenic, embryotoxic and abortive effects, exposing these women, their fetus and babies to health unknown risks. Thus, the purpose of this commentary, was to analyze the perception about the use of medicinal plants by pregnant women and lactating registered in the "baby on board" NGO, Araraquara, São Paulo state, Brazil, between 2010 at 2013. The group was constituted by 48 women, between the first and last trimester of pregnancy or whilst breastfeeding. Information was collected during group meetings by oral interview, using a questionnaire, as script. The nature of the study was a qualitative analysis. The results were based on reports about the use of medicinal plants by pregnant women during group meetings: use, indication of use, knowledge about risks. All participants received written and oral information about the study and they gave a written informed consent. The use of medicinal plants is a reality among pregnant and lactating women of the "baby on board" NGO. They reported that they feel that "natural" products are not harmful for their health. The primary information sources for the majority of women about medicinal plants during pregnancy are family, neighbors and herbalists. The plants most cited (in popular name in Brazil) were: senna, chamomile, boldo, lemon balm, lemon grass. They were used mainly for: nausea, heartburn, indigestion, flatulence, intestinal and abdominal pain, anxiety, intestinal constipation and low milk production. The pregnant and lactating women lacked knowledge about the health risks of the use of medicinal plants and herbal medicines in pregnancy and lactation. They also reported difficulties in clarifying some questions about the use of medicinal plants with their doctors. The results of the present study showed that educative actions about the rational use of medicinal plants in pregnancy and breastfeeding could be part of the operating protocols to promote the maternal and child health programs in Araraquara. Thus, our results also suggest the importance of creating institutionalized places, to the implementation of continued education programs about rational use of medicinal plants in pregnancy and lactation. These targeted programs are not only for health professionals, but also for community members, pregnant women and breastfeeding. Our results pointed out the importance of guidance of doctors and healthcare professionals on the scientific studies about medicinal plants and herbal medicines and the risk/benefit of using herbs during pregnancy. Finally, it is noted the importance of the health professionals to inform women of childbearing on risks to their health, as well as on possibilities of utilization of herbs during fertile period, giving special attention to the potential risk of self-medication.

Selecting for rust (Puccinia psidii) reistance in Euclyptus grandis in São Paulo state, Brazil

In Brazil, Eucalyptus grandis is a key species for wood production. However, some genotypes are susceptible to rust (Puccinia psidii), mainly in São Paulo State, where climatic conditions are favorable for its development. Rust represents a high economic risk to forest companies because of the high potential of damage to commercial eucalypt plantations. The aims of the present study were (i) to select progenies of E. grandis for stability and adaptability regarding resistance to rust at different locations; (ii) compare the selections under these different climatic conditions; and (iii) compare rust severity in the field with the theoretical model. We observed that climatic conditions were extremely influential factors for rust development, but even under favorable conditions for disease development, we found rust-resistant progenies. In sites unfavorable for rust development, we detected highly susceptible progenies. We found significant correlation among the genetic material, environmental conditions and disease symptoms, however, we observed a simple genotype-environmental interaction and significant genetic variability among the progenies. The average heritability was high among the progenies in all sites, indicating substantial genetic control for rust resistance. We also observed a good relationship between rust severity in the field and the theoretical model that considered annual average temperature and leaf wetness.

Factors associated with physical-activity performance by older individuals in a medium-sized city in São Paulo State, Brazil

Physical activity has been scientifically discussed as fundamental in the process of healthy ageing. Hence, this study aimed at determining the factors that influence older people to perform physical activities. The complete IPAQ (International Physical Activity Questionnaire) was applied to a population-based sample consisting of 364 elderly persons in the city of Botucatu, São Paulo, Brazil. Days of physical activity performed by the older people were considered by taking into account household and leisure activities. Models for count data were fitted by including socio-demographic variables as well as those related to life satisfaction. It was shown that housework physical-activity performance is associated with female, who predominantly showed to be more active in all levels. Male seemed to be more predisposed to perform lighter recreation, sports and leisure-time physical activities, such as walking. Additionally, poor schooling showed to be decisive for not performing physical activities both at home and during leisure.

Magmatism and fenitization in the Cretaceous potassium-alkaline-carbonatitic complex of Ipanema So Paulo State, Brazil

The Ipanema alkaline-carbonatitic complex is part of the Meso-Cenozoic alkaline magmatism located within the southeastern part of the Brazilian Platform. Drill-core and field sampling have indicated the occurrence of glimmerites, with subordinate shonkinites (mela-syenites), clinopyroxene-bearing glimmerites, diorites and syenites. The glimmerites are cross-cut by lamprophyric dykes and calciocarbonatites. Fenitization has deeply affected the country rocks, originating dioritic and syenitic rocks. The Ipanema rocks show a distinct potassic affinity. The initial Sr-Nd- isotopic composition of the Ipanema rocks ((87)Sr/(86)Sr = 0.70661-0.70754 and (143)Nd/(144)Nd = 0.51169-0.51181) is similar to that of tholeiitic and potassium-rich-alkaline rocks of the Eastern Paraguay. Stable isotope data for the Ipanema calciocarbonatite suggest interaction with fluids at temperatures typical of hydrothermal stages, as hypothesized for other carbonatite complexes from southeastern Brazil. The chemical differences between the lamprophyre, glimmerites, carbonatites, apatitites and magnetitites, and the absence of marked REE enrichment in the evolved lithologies, all indicate that fractional crystallization and accumulus of liquidus phases in a magma reservoir, likely coupled with liquid immiscibility processes, may have played an important role in the genesis of the Ipanema rocks.

Biomonitoring of coastal regions of So Paulo State, Brazil, using mussels Perna perna

The marine environment is constantly affected by anthropic actions, with causes consequent degradation of the waters and marine biota by various discharges of xenobiotics. In the present study, the focus was the study of a region of the marine coast of the State of So Paulo (city of Santos), which is one of the most industrialized parts of Brazil and suffers also from a strong impact of domestic effluents. The mussel Perna perna, very abundant in the coast of the State of So Paulo, Brazil, was selected as the biomonitoring organism for the determination of inorganic elements and a passive biomonitoring was performed. The organisms were collected at two sites in So Paulo State coast: Cocanha beach in Caraguatatuba (mussel farm) and Santos Bay (Itaipu and Palmas). Seasonally, the Perna perna were collected between September/08 and July/09 in each study sites. After removal and sample preparation, the elements As, Co, Cr, Fe, Se and Zn were determined by instrumental neutron activation analysis (INAA) and Cd, Pb and Hg were determined by atomic absorption spectroscopy (AAS) in this organism.

Spectral behavior of some modal soil profiles from São Paulo State, Brazil

Remote sensing has a high potential for environmental evaluation. However, a necessity exists for a better understanding of the relations between the soil attributes and spectral data. The objective of this work was to analyze the spectral behavior of some soil profiles from the region of Piracicaba, São Paulo State, using a laboratory spectroradiometer (400 to 2500 nm). The relations between the reflected electromagnetic energy and the soil physical, chemical and mineralogical attributes were analyzed, verifying the spectral variations of soil samples in depth along the profiles with their classification and discrimination. Sandy soil reflected more, presenting a spectral curve with an ascendant form, opposite to clayey soils. The 1900 nm band discriminated soil with 2:1 mineralogy from the 1:1 and oxidic soils. It was possible to detect the presence of kaolinite, gibbsite, hematite and goethite in the soils through the descriptive aspects of curves, absorption features and reflectance intensity. A relation exists between the weathering stage and spectral data. The evaluation of the superficial and subsuperficial horizon samples allowed characterizing and discriminating the analytical variability of the profile, helping to soil distinguishing and classification.

Association between particulate matter air pollution and monthly inhalation and nebulization procedures in Ribeirão Preto, São Paulo State, Brazil

The study was designed to investigate the impact of air pollution on monthly inhalation/nebulization procedures in Ribeirão Preto, São Paulo State, Brazil, from 2004 to 2010. To assess the relationship between the procedures and particulate matter (PM10) a Bayesian Poisson regression model was used, including a random factor that captured extra-Poisson variability between counts. Particulate matter was associated with the monthly number of inhalation/nebulization procedures, but the inclusion of covariates (temperature, precipitation, and season of the year) suggests a possible confounding effect. Although other studies have linked particulate matter to an increasing number of visits due to respiratory morbidity, the results of this study suggest that such associations should be interpreted with caution.

Space-time cluster analysis of American visceral leishmaniasis in Bauru, São Paulo State, Brazil

A space-time analysis of American visceral leishmaniasis (AVL) in humans in the city of Bauru, São Paulo State, Brazil was carried out based on 239 cases diagnosed between June 2003 and October 2008. Spatial analysis of the disease showed that cases occurred especially in the city's urban areas. AVL annual incidence rates were calculated, demonstrating that the highest rate occurred in 2006 (19.55/100,000 inhabitants). This finding was confirmed by the time series analysis, which also showed a positive tendency over the period analyzed. The present study allows us to conclude that the disease was clustered in the Southwest side of the city in 2006, suggesting that this area may require special attention with regard to control and prevention measures.