Contaminação por nitrato no Aquífero Adamantina: o caso do município de Monte Azul Paulista - SP

Pós-graduação em Geociências e Meio Ambiente - IGCE

A experiência da saúde coletiva na formação profissional: retrato da extensão universitária

The guidelines of National Curriculum for Dental courses highlights the necessity in providing for the professional the ability to analyze and assess community’s problems and needs, and to create solutions for the society. The continuing education may be considered a useful tool for the teaching and learning because it favors the diversification of learning environments, which allows the insertion of undergraduate and graduate students into the real scenarios. This current study aimed to assess the Public Health projects and programs of the UNESP – Araçatuba Dental School, by describing the interaction experiences between faculty and health services in the professional career development. Historical, documentary and descriptive searches were performed based on the faculty archives such as official documents, reports, databases from the Pro-rector of continuing education and published papers in the period between 1964 and 2011. The following experiences were noted: the Extra-Muro Dental Service (SEMO), established in 1964, that focused in providing dental treatment to the rural population, highlighted the social inclusion of discriminated society groups since that time. In 1972, this service was expanded to several specific populations living in the urban areas. In the '60s, many educational campaigns were performed as homemade water filter and construction of wells and septic tanks which demonstrate the concern with the determinants of healthdisease process. At that time, the campaign of fluoridation of public water supplies in several counties started as Araçatuba, Birigui, Penápolis, Guararapes, Valparaíso and so on. The Campaign of “Good Teeth” from the '70s became wider over time and it was transformed in the "Oral Health Education Program" and it was continuously developed in all public schools of Araçatuba and some neighboring towns, benefiting children aged from 6 to 10 years-old. Several epidemiological studies of caries, periodontal diseases, malocclusion and fluorosis were conducted in cooperation with local governments, and counted with the participation of undergraduate and graduate students. Pereira Barreto – SP was the precursor city in Brazil to carry out fluorosis study. Currently, 12 projects of Public Health from the Institution of Higher Education in the Pro-rector of continuing education are being developed. The concern in qualifying the human resources in health is confirmed with the development of training courses and workshops for professionals, highlighting the training for people enrolled in the Family Health program; Community Health Agent training - Solidarity University, and Municipal Health Counselors training. The Graduate Program in Social and Preventive Dentistry, created in 1993, has an important role to train several professionals for the Unified Health System, and provides education to create researchers, professors and administrators, and enucleates research groups in several Brazilian states. In all activities showed herein, a dynamic participation of undergraduate and graduate students has been observed, and several books, guidelines, articles, brochures and booklets have been published as a result of the continuing education activities.. It was concluded that different projects and programs have been developed by the Public Health of UNESP –Araçatuba Dental School, which allow the exchange of experience between the university and health services, and benefit all participants enrolled in these activities.

Prove di ozonolisi sui fanghi biologici prodotti da impianti di depurazione delle acque reflue urbane

La tecnica di ozonolisi viene applicata ai fanghi biologici derivanti da impianti di depurazione acque reflue urbane, e consiste nell'ottenere, grazie all'ozono, una minor massa fangosa da smaltire e una miglior trattabilità del fango residue. In questo elaborato si prendono in esame le sperimentazioni effettuate a Marina di Ravenna e si estraggono le prime conclusioni gestionali, economiche e ambientali sull'applicabilità del metodo a questo tipo di fango.

Study of water use and supply in the district of Independencia, Peru

Peru is a developing country with abundant fresh water resources, yet the lack of infrastructure leaves much of the population without access to safe water for domestic uses. The author of this report was a Peace Corps Volunteer in the sector of water & sanitation in the district of Independencia, Ica, Peru. Independencia is located in the arid coastal region of the country, receiving on average 15 mm of rain annually. The water source for this district comes from the Pisco River, originating in the Andean highlands and outflowing into the Pacific Ocean near the town of Pisco, Peru. The objectives of this report are to assess the water supply and sanitation practices, model the existing water distribution system, and make recommendations for future expansion of the distribution system in the district of Independencia, Peru. The assessment of water supply will be based on the results from community surveys done in the district of Independencia, water quality testing done by a detachment of the U.S. Navy, as well as on the results of a hydraulic model built in EPANET 2.0 to represent the distribution system. Sanitation practice assessments will be based on the surveys as well as observations from the author while living in Peru. Recommendations for system expansions will be made based on results from the EPANET model and the municipality’s technical report for the existing distribution system. Household water use and sanitation surveys were conducted with 84 families in the district revealing that upwards of 85% store their domestic water in regularly washed containers with lids. Over 80% of those surveyed are drinking water that is treated, mostly boiled. Of those surveyed, over 95% reported washing their hands and over 60% mentioned at least one critical time for hand washing when asked for specific instances. From the surveys, it was also discovered that over 80% of houses are properly disposing of excrement, in either latrines or septic tanks. There were 43 families interviewed with children five years of age or under, and just over 18% reported the child had a case of diarrhea within the last month at the time of the interview. Finally, from the surveys it was calculated that the average water use per person per day is about 22 liters. Water quality testing carried out by a detachment of the U.S. Navy revealed that the water intended for consumption in the houses surveyed was not suitable for consumption, with a median E. coli most probable number of 47/100 ml for the 61 houses sampled. The median total coliforms was 3,000 colony forming units per 100 ml. EPANET was used to simulate the water delivery system and evaluate its performance. EPANET is designed for continuous water delivery systems, assuming all pipes are always flowing full. To account for the intermittent nature of the system, multiple EPANET network models were created to simulate how water is routed to the different parts of the system throughout the day. The models were created from interviews with the water technicians and a map of the system created using handheld GPS units. The purpose is to analyze the performance of the water system that services approximately 13,276 people in the district of Independencia, Peru, as well as provide recommendations for future growth and improvement of the service level. Performance evaluation of the existing system is based on meeting 25 liters per person per day while maintaining positive pressure at all nodes in the network. The future performance is based on meeting a minimum pressure of 20 psi in the main line, as proposed by Chase (2000). The EPANET model results yield an average nodal pressure for all communities of 71 psi, with a range from 1.3 – 160 psi. Thus, if the current water delivery schedule obtained from the local municipality is followed, all communities should have sufficient pressure to deliver 25 l/p/d, with the exception of Los Rosales, which can only supply 3.25 l/p/d. However, if the line to Los Rosales were increased from one to four inches, the system could supply this community with 25 l/p/d. The district of Independencia could greatly benefit from increasing the service level to 24-hour water delivery and a minimum of 50 l/p/d, so that communities without reliable access due to insufficient pressure would become equal beneficiaries of this invaluable resource. To evaluate the feasibility of this, EPANET was used to model the system with a range of population growth rates, system lifetimes, and demands. In order to meet a minimum pressure of 20 psi in the main line, the 6-inch diameter main line must be increased and approximately two miles of trench must be excavated up to 30 feet deep. The sections of the main line that must be excavated are mile 0-1 and 1.5-2.5, and the first 3.4 miles of the main line must be increased from 6 to 16 inches, contracting to 10 inches for the remaining 5.8 miles. Doing this would allow 24-hour water delivery and provide 50 l/p/d for a range of population growth rates and system lifetimes. It is expected that improving the water delivery service would reduce the morbidity and mortality from diarrheal diseases by decreasing the recontamination of the water due to transport and household storage, as well as by maintaining continuous pressure in the system to prevent infiltration of contaminated groundwater. However, this expansion must be carefully planned so as not to affect aquatic ecosystems or other districts utilizing water from the Pisco River. It is recommended that stream gaging of the Pisco River and precipitation monitoring of the surrounding watershed is initiated in order to begin a hydrological study that would be integrated into the district’s water resource planning. It is also recommended that the district begin routine water quality testing, with the results available to the public.

Handbook, septage treatment and disposal.

"EPA-625/6-84-009."

Determination if distribution boxes can be eliminated without inducing increased failure to disposal fields /

Mode of access: Internet.

Industrial Discharges of Metals in Kigali, Rwanda, and the Impact on Drinking Water Quality

Rwanda is a landlocked country located in Africa's Central-East Great Lakes region. It has a population of 7.5 million which occupies 26,338 km'. Its population density (285/km') is one of the highest in the world and has prompted fear of a rapid degradation of the ecosystem. There are no central sewer systems in Rwanda. The use of pit latrines and septic tanks is common in urban and rural areas. People still defecate in the fields (World Bank, 1989). Less than half of the urban population is served by a central water supply. The majority of people get their water untreated from rivers that have been polluted by chemicals and human excreta. In and around the capital city of Kigali, there is a concentration of people, farms, and industries which discharge wastewater into the Nyabarongo River and its tributaries. The Nyabarongo River, a tributary of the Nile, empties into the Akagera River which flows into Lake Victoria. Nyabarongo River water is used for drinking water, cooking, bathing, and agriculture in the Kigali area. There has been very little monitoring of the water quality of the Nyabarongo River and of industrial outfalls located on tributaries of the Nyabarongo River. As a first step in understanding the water quality of the Nyabarongo River, wastewater samples were collected in 1993 from industrial outfalls located on tributaries of the Nyabarongo River. Most of the facilities sampled had no wastewater treatment. The impact of these discharges on the water quality of the Nyabarongo River was evaluated.

Tanques sépticos seguidos de leitos cultivados com diferentes espécies de macrofitas no tratamento de esgoto

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Agronomia e Medicina Veterinária, Programa de Pós-Graduação em Agronomia, 2016.

Induction of a gloverin-like antimicrobial polypeptide in the sugarcane borer Diatraea saccharalis challenged by septic injury

Diatraea saccharalis (Fabricius, 1794) (Lepidoptera: Crambidae) is an important pest for Brazilian sugarcane. In the present study, we detected two distinct spots in hemolymph from septic injured larvae (HDs1 and HDs2), which are separated by 2DE gel electrophoresis. Both spots were subjected to in-gel tryptic digestion and MALDI-TOF/TOF analysis, which revealed the sequence VFGTLGSDDSGLFGK present in both HDs1 and HDs2. This sequence had homology and 80% identity with specific Lepidoptera antimicrobial peptides called gloverins. Analyses using the ImageMaster 2D software showed pI 8.94 of the HDs1 spot, which is similar to that described to Hyalophora gloveri gloverin (pI 8.5). Moreover, the 14-kDa molecular mass of the spot HDs1 is compatible to that of gloverins isolated from the hemolymph of Trichoplusia ni, Helicoverpa armigera and H. gloveri. Antimicrobial assays with partially purified fractions containing the HDs1 and HDs2 polypeptides demonstrated activity against Escherichia coli. This is the first report of antimicrobial polypeptides in D. saccharalis, and the identification of these peptides may help in the generation of new strategies to control this pest.

Comparison of C-reactive protein and serum amyloid A protein in septic shock patients

Septic shock is a severe inflammatory state caused by an infectious agent. Our purpose was to investigate serum amyloid A (SAA) protein and C-reactive protein (CRP) as inflammatory markers of septic shock patients. Here we evaluate 29 patients in postoperative period, with septic shock, in a prospective study developed in a surgical intensive care unit. All eligible patients were monitored over a 7-day period by sequential organ failure assessment (SOFA) score, daily CRP, SAA, and lactate measurements. CRP and SAA strongly correlated up to the fifth day of observation but were not good predictors of mortality in septic shock. Copyright (C) 2008.

Sampling study in milk storage tanks by INAA

This study investigated the representativeness of samples for assessing chemical elements in milk bulk tanks. Milk samples were collected from a closed tank in a dairy plant and from an open top tank in a dairy farm. Samples were analyzed for chemical elements by instrumental neutron activation analysis (INAA). For both experiments, Br, Ca, Cs, K, Na, Rb and Zn did not present significant differences between samples thereby indicating the appropriateness of the sampling procedure adopted to evaluate the analytes of interest.

Gene expression reprogramming protects macrophage from septic-induced cell death

Sepsis induces a systemic inflammatory response leading to tissue damage and cell death. LPS tolerance affects inflammatory response. To comprehend potential new mechanisms of immune regulation in endotoxemia, we examined macrophage mRNA expression by macroarray affected by LPS tolerance. LPS tolerance was induced with subcutaneous administration of 1 mg/kg/day of LPS over 5 days. Macrophages were isolated from the spleen and the expression of 1200 genes was quantitatively analyzed by the macroarray technique. The tolerant group displayed relevant changes in the expression of 84 mRNA when compared to naive mice. A functional group of genes related to cell death regulation was identified. PARP-1, caspase 3, FASL and TRAIL genes were confirmed by RT-PCR to present lower expression in tolerant mice. In addition, reduced expression of the pro-inflammatory genes TNF-alpha and IFN-gamma in the tolerant group was demonstrated. Following this, animals were challenged with polymicrobial sepsis. Flow cytometry analysis showed reduced necrosis and apoptosis in macrophages from the tolerant group compared to the naive group. Finally, a survival study showed a significant reduction in mortality in the tolerant group. Thus, in the current study we provide evidence for the selective reprogramming of the gene expression of cell death pathways during LPS tolerance and link these changes to protection from cell death and enhanced survival rates. (C) 2010 Elsevier Ltd. All rights reserved.

FUNCTIONAL COMPARISON BETWEEN SEPTIC AND ASEPTIC KNEE ARTHROPLASTY REVIEW

Introduction: Total knee arthroplasty (TKA) imposes many risks. TKA infection is not the most frequent complication, but is probably the most serious one. Two-step review is the procedure of choice in deep knee prosthesis infection. On the other hand, aseptic prosthesis detachment represents almost half of the primary arthroplasty review indications, Patient`s satisfaction level might diminish after reviews. Objective: The objective of this study was to compare the quality of life and final result of TKA review for septic and aseptic failures. Methods: The patients were assessed using the HSS and SF-36 scores. The patients were divided in two groups: one group submitted to two-step review (septic) and the other to one-step review (aseptic). The analysis of the data obtained shows better scores for the second group in HSS and in 06 of 08 domains of SF-36 classification. Conclusions: The on-step review of total knee arthroplasty leads to better functional outcomes.

Time- and Fluid-Sensitive Resuscitation for Hemodynamic Support of Children in Septic Shock Barriers to the Implementation of the American College of Critical Care Medicine/Pediatric Advanced Life Support Guidelines in a Pediatric Intensive Care Unit in a Developing World

Objectives: To analyze mortality rates of children with severe sepsis and septic shock in relation to time-sensitive fluid resuscitation and treatments received and to define barriers to the implementation of the American College of Critical Care Medicine/Pediatric Advanced Life Support guidelines in a pediatric intensive care unit in a developing country. Methods: Retrospective chart review and prospective analysis of septic shock treatment in a pediatric intensive care unit of a tertiary care teaching hospital. Ninety patients with severe sepsis or septic shock admitted between July 2002 and June 2003 were included in this study. Results: Of the 90 patients, 83% had septic shock and 17% had severe sepsis; 80 patients had preexisting severe chronic diseases. Patients with septic shock who received less than a 20-mL/kg dose of resuscitation fluid in the first hour of treatment had a mortality rate of 73%, whereas patients who received more than a 40-mL/kg dose in the first hour of treatment had a mortality rate of 33% (P < 0.05.) Patients treated less than 30 minutes after diagnosis of severe sepsis and septic shock had a significantly lower mortality rate (40%) than patients treated more than 60 Minutes after diagnosis (P < 0.05). Controlling for the risk of mortality, early fluid resuscitation was associated with a 3-fold reduction in the odds of death (odds ratio, 0.33; 95% confidence interval, 0.13-0.85). The most important barriers to achieve adequate severe sepsis and septic shock treatment were lack of adequate vascular access, lack of recognition of early shock, shortage of health care providers, and nonuse of goals and treatment protocols. Conclusions: The mortality rate was higher for children older than years, for those who received less than 40 mL/kg in the first hour, and for those whose treatment was not initiated in the first 30 Minutes after the diagnosis of septic shock. The acknowledgment of existing barriers to a timely fluid administration and the establishment of objectives to overcome these barriers may lead to a more successful implementation of the American College of Critical Care Medicine guidelines and reduced mortality rates for children with septic shock in the developing world.

Changes in plasma free fatty acid levels in septic patients are associated with cardiac damage and reduction in heart rate variability

Free fatty acids (FFAs) have been shown to produce alteration of heart rate variability (HRV) in healthy and diabetic individuals. Changes in HRV have been described in septic patients and in those with hyperglycemia and elevated plasma FFA levels. We studied if sepsis-induced heart damage and HRV alteration are associated with plasma FFA levels in patients. Thirty-one patients with sepsis were included. The patients were divided into two groups: survivors(n = 12) and nonsurvivors (n = 19). The following associations were investigated: (a) troponin I elevation and HRV reduction and (b) clinical evolution and HRV index, plasma troponin, and plasma FFA levels. Initial measurements of C-reactive protein and gravity Acute Physiology and Chronic Health Evaluation scores were similar in both groups. Overall, an increase in plasma troponin level was related to increased mortality risk. From the first day of study, the nonsurvivor group presented a reduced left ventricular stroke work systolic index and a reduced low frequency (LF) that is one of HRV indexes. The correlation coefficient for LF values and troponin was r(2) = 0.75 (P < 0.05). All patients presented elevated plasma FFA levels on the first day of the study (5.11 +/- 0.53 mg/mL), and this elevation was even greater in the nonsurvivor group compared with the survivors (6.88 +/- 0.13 vs. 3.85 +/- 0.48 mg/mL, respectively; P < 0.05). Cardiac damage was confirmed by measurement of plasma troponin I and histological analysis. Heart dysfunction was determined by left ventricular stroke work systolic index and HRV index in nonsurvivor patients. A relationship was found between plasma FFA levels, LFnu index, troponin levels, and histological changes. Plasma FFA levels emerged as possible cause of heart damage in sepsis.