Avaliação ecotoxicológica de solos contaminados por ibuprofeno

Os produtos farmacêuticos são substâncias químicas muito utilizados em medicina, veterinária e ainda na agricultura. Nos anos 90, foi descoberta a presença de fármacos em meio aquático, verificando-se que a sua remoção nas Estações de Tratamento de Águas Residuais (ETAR) não era completa. Durante as duas últimas décadas foi identificada a presença de mais de oitenta compostos no meio ambiente e actualmente são considerados poluentes emergentes. Podem contaminar solos e águas, depois de serem usados e excretados (inalterados ou metabolizados) por humanos e animais, ou quando são indevidamente lançados directamente no meio ambiente. Os estudos ecotoxicológicos efectuados com estes poluentes têm sido direccionados, sobretudo, para as águas, existindo uma ausência de trabalhos sobre solos. O Ibuprofeno (IB) é um anti-inflamatório não esteróide, utilizado também como analgésico e antipirético, sendo um dos produtos farmacêuticos mais vendidos em todo o mundo, o que justifica a sua forte presença no meio ambiente. Por isso, e dada a ausência de trabalhos ecotoxicológicos de solos contaminados por fármacos, o IB foi o produto farmacêutico selecionado para a realização deste trabalho. A ecotoxicidade pode ser avaliada através de bioensaios. Estes têm a capacidade de avaliar a toxicidade de uma determinada substância de forma global, usando organismos vivos que funcionam como bio-indicadores. O presente trabalho tem como objectivos avaliar o impacte causado nos solos pelo IB, testar a toxicidade de dois processos de descontaminação para remover o referido fármaco dos solos assim como avaliar a toxicidade provocada por águas residuais, de três unidades hospitalares e de uma indústria farmacêutica. Esta avaliação foi efectuada através de ensaios de toxicidade aguda de germinação e de alongamento de raiz de sementes de alface, variedade bola de manteiga (Lactuca sativa), em solo arenoso. Os ensaios de ecotoxicidade aguda em solos contaminados por IB foram realizados para uma gama de concentrações entre 0,1 e 1000 μg/L. Verificou-se uma redução do número de sementes germinadas e do comprimento médio da planta no solo contaminado com 0,5 e 20 μg/L de IB. No solo contaminado com 1000 μg/L de IB observou-se uma redução da germinação, acompanhada por uma indução de crescimento da raiz da espécie Lactuca sativa. Os dois tratamentos de descontaminação de solos, reagente de Fenton e Nanopartículas de ferro zero valente, revelaram toxicidade, tendo-se obtido uma percentagem de germinação entre 32,2 ± 3,5 e 48,5 ± 6,2 e inibição do crescimento da raiz do organismo teste em cerca de 85,0 %. Em relação às águas residuais hospitalares verificou-se uma redução da percentagem de germinação entre 31,1 ± 5,0 e 72,3 ± 12,4 e uma inibição do crescimento da raiz situada entre 13,0 ± 6,4 e 20,2 ± 10,0 %. Para a água residual industrial ocorreu uma inibição da percentagem de germinação de 60,5 ± 13,1, contudo nas plantas germinadas observou-se uma indução do crescimento da raiz de 14,9 ± 7,7 %.

Processos de purificação/ valorização do glicerol proveniente da produção de biodiesel

Mestrado em Engenharia Química - Ramo optimização energética na indústria química

Fatores associados à amamentação na primeira hora de vida

OBJETIVO: Identificar fatores associados à amamentação na primeira hora de vida (Passo 4 da Iniciativa Hospital Amigo da Criança). MÉTODOS: Foi realizado estudo transversal com amostra representativa de parturientes em maternidades do Rio de Janeiro, RJ, entre 1999 e 2001. Foram excluídos recém-nascidos ou mães com restrição ao aleitamento materno, resultando em amostra de 8.397 binômios. Foi adotado modelo Poisson com efeitos aleatórios ao nível das maternidades, em abordagem hierarquizada com três níveis: distal, intermediário e proximal para características maternas, do recém-nascido, e de assistência ao pré-natal e hospitalar. RESULTADOS: Amamentaram na primeira hora de vida 16% das mães. O aleitamento materno nesse período foi menos prevalente entre os recém-nascidos com intercorrências imediatas após o parto (RP = 0,47; IC99% 0,15;0,80); entre as mães que não tiveram contato com os recém-nascidos na sala de parto (RP = 0,62; IC99% 0,29;0,95), as que tiveram parto cesariano (RP = 0,48; IC99% 0,24;0,72); e cujo parto ocorreu em maternidade privada (RP = 0,06; IC99% 0,01;0,19) ou conveniada com o Sistema Único de Saúde (RP = 0,16; IC99% 0,01;0,30). O efeito de contexto das maternidades foi estatisticamente significativo. CONCLUSÕES: Em nível individual, a amamentação na primeira hora de nascimento foi prejudicada por práticas inadequadas nas maternidades, em particular as privadas e conveniadas com o Sistema Único de Saúde. O efeito de grupo das maternidades e a ausência de fatores individuais maternos que expliquem o desfecho sugerem que as mães têm pouco ou nenhum poder de decisão sobre essa amamentação e dependem das práticas institucionais vigentes nas maternidades.

Óbitos evitáveis até 48 meses de idade entre as crianças da Coorte de Nascimentos de Pelotas de 2004

OBJETIVO: Descrever óbitos evitáveis de crianças pertencentes à Coorte de Pelotas, RS, de 2004. MÉTODOS: O óbito de 92 crianças entre 2004-2008 da Coorte de Pelotas 2004 foi identificado e classificado conforme a Lista de Causas de Mortes Evitáveis por Intervenções do Sistema Único de Saúde. Os Sistemas de Informação sobre Mortalidade (SIM) municipal e estadual foram rastreados para localizar mortes ocorridas fora de Pelotas e as causas após o primeiro ano vida. O óbito de menores de um ano foi avaliado e comparado entre um subestudo e o SIM. Foram calculados coeficientes de mortalidade: 1.000 nascidos vivos (NV), mortalidade proporcional por causas evitáveis e conforme tipo de unidade básica de saúde (tradicional ou Estratégia Saúde da Família). RESULTADOS: O coeficiente de mortalidade foi de 22,2:1.000 NV, 82 óbitos ocorreram no primeiro ano de vida (19,4:1.000 NV), dos quais 37 (45%) na primeira semana. Mais de ¾ dos óbitos (70/92) eram evitáveis. No primeiro ano de vida, a maioria (42/82) das mortes seriam evitadas pela adequada atenção à mulher durante a gestação; de acordo com o SIM, a maioria (n = 32/82), pela adequada atenção ao recém-nascido. Não houve diferença entre o tipo de Unidade Básica de Saúde quanto à proporção de óbitos evitáveis. CONCLUSÕES: É alta a proporção de óbitos infantis que podem ser evitados. Para que os óbitos evitáveis possam ser utilizados como indicadores no monitoramento da qualidade da atenção à saúde materno-infantil, é necessário aprimorar a qualidade dos os registros das Declarações de Óbito.

Cause-specific mortality and income inequality in São Paulo, Brazil

OBJECTIVE: To analyze cause-specific mortality rates according to the relative income hypothesis. METHODS: All 96 administrative areas of the city of São Paulo, southeastern Brazil, were divided into two groups based on the Gini coefficient of income inequality: high (>0.25) and low (<0.25). The propensity score matching method was applied to control for confounders associated with socioeconomic differences among areas. RESULTS: The difference between high and low income inequality areas was statistically significant for homicide (8.57 per 10,000; 95%CI: 2.60;14.53); ischemic heart disease (5.47 per 10,000 [95%CI 0.76;10.17]); HIV/AIDS (3.58 per 10,000 [95%CI 0.58;6.57]); and respiratory diseases (3.56 per 10,000 [95%CI 0.18;6.94]). The ten most common causes of death accounted for 72.30% of the mortality difference. Infant mortality also had significantly higher age-adjusted rates in high inequality areas (2.80 per 10,000 [95%CI 0.86;4.74]), as well as among males (27.37 per 10,000 [95%CI 6.19;48.55]) and females (15.07 per 10,000 [95%CI 3.65;26.48]). CONCLUSIONS: The study results support the relative income hypothesis. After propensity score matching cause-specific mortality rates was higher in more unequal areas. Studies on income inequality in smaller areas should take proper accounting of heterogeneity of social and demographic characteristics.

Fontes de fósforo total e o estado trófico de albufeiras em Portugal continental

O estudo realizado incidiu sobre 260 albufeiras, identificadas em diferentes fontes de informação e localizadas em Portugal continental. De entre as massas de água identificadas procedeu-se à classificação do estado trófico de 92 albufeiras, todas para as quais se dispõe de dados de qualidade da água para o efeito. Destas, de acordo com o critério de classificação adoptado em Portugal, 60 foram classificadas como eutróficas, em resultado principalmente das concentrações de fósforo total. Após a delimitação das bacias drenantes de 194 albufeiras, foram implementadas metodologias de quantificação de fósforo total afluente a essas massas de água. Com recurso a um modelo de balanço de massas foram simuladas as concentrações de fósforo total em 80 albufeiras, tendo sido considerados adequados os resultados obtidos em 42 albufeiras. Com base nos resultados obtidos concluiu-se que as metodologias de quantificação de fósforo total de origem urbana e de origem difusa são adequadas ao desenvolvimento de estudos de planeamento e de identificação das principais fontes de fósforo total, em águas doces superficiais.

Características contextuais de vizinhança e atividade física de lazer: Estudo Pró-Saúde

OBJETIVO Estimar a associação entre variáveis contextuais de vizinhança e prática de atividade física de lazer. MÉTODOS Foram analisados dados de 2.674 participantes adultos de estudo longitudinal no Rio de Janeiro, RJ, em 1999. A atividade física de lazer, avaliada de forma dicotômica, referiu-se às duas semanas prévias à pesquisa. Sexo, idade, renda, escolaridade e situação conjugal foram analisados como variáveis individuais. Características contextuais referentes às vizinhanças (bairros) foram índice de desenvolvimento social, índice de Theil e proporção de área de parques, praças e jardins, categorizadas em quintis. Foram estimadas razões de chances brutas e ajustadas e intervalos de confiança de 95% por meio de regressão logística multinível. RESULTADOS As prevalências de atividade física de lazer foram maiores entre residentes de bairros com maiores índices de desenvolvimento social (entre 32,3% e 55,4%) e proporção de área de parques, praças e jardins (entre 35,8% e 53,1%). Para o índice de desenvolvimento social, quando comparados aos residentes de bairros do primeiro quintil, as razões de chances ajustadas de atividade física de lazer para variáveis individuais foram 1,22 (IC95% 0,93;1,61), 1,44 (IC95% 1,09;1,89), 1,75 (IC95% 1,31;2,34) e 2,25 (IC95% 1,70; 3,00) entre residentes de bairros do segundo, terceiro, quarto e quinto quintis. As razões de chances relativas à proporção de área de parques, praças e jardins foram 0,90 (IC95% 0,69;1,19), 1,41 (IC95% 1,04;1,90), 1,63 (IC95% 1,24;2,14) e 1,05 (IC95% 0,80;1,38) entre residentes de bairros dos segundo, terceiro, quarto e quinto quintis. Após ajuste para as demais variáveis contextuais, somente o índice de desenvolvimento social permaneceu associado à atividade física de lazer, com razões de chances de 1,41 (IC95% 1,02;1,95), 1,54 (IC95% 1,12;2,12); 1,65 (IC95% 1,14;2,39) e 2,13 (IC95% 1,40;3,25) para residentes de bairros dos segundo, terceiro, quarto e quinto quintis. CONCLUSÕES A atividade física de lazer foi mais frequente entre residentes de bairros com maiores índices de desenvolvimento social. Não foram observadas associações com acesso a espaços de lazer e desigualdade de renda.

Disability in instrumental activities of daily living among older adults: gender differences

OBJECTIVE To analyze gender differences in the incidence and determinants of disability regarding instrumental activities of daily living among older adults. METHODS The data were extracted from the Saúde, Bem-Estar e Envelhecimento (SABE – Health, Wellbeing and Ageing) study. In 2000, 1,034 older adults without difficulty in regarding instrumental activities of daily living were selected. The following characteristics were evaluated at the baseline: sociodemographic and behavioral variables, health status, falls, fractures, hospitalizations, depressive symptoms, cognition, strength, mobility, balance and perception of vision and hearing. Instrumental activities of daily living such as shopping and managing own money and medication, using transportation and using the telephone were reassessed in 2006, with incident cases of disability considered as the outcome. RESULTS The incidence density of disability in instrumental activities of daily living was 44.7/1,000 person/years for women and 25.2/1,000 person/years for men. The incidence rate ratio between women and men was 1.77 (95%CI 1.75;1.80). After controlling for socioeconomic status and clinical conditions, the incidence rate ratio was 1.81 (95%CI 1.77;1.84), demonstrating that women with chronic disease and greater social vulnerability have a greater incidence density of disability in instrumental activities of daily living. The following were determinants of the incidence of disability: age ≥ 80 and worse perception of hearing in both genders; stroke in men; and being aged 70 to 79 in women. Better cognitive performance was a protective factor in both genders and better balance was a protective factor in women. CONCLUSIONS The higher incidence density of disability in older women remained even after controlling for adverse social and clinical conditions. In addition to age, poorer cognitive performance and conditions that adversely affect communication disable both genders. Acute events, such as a stroke, disables elderly men more, whereas early deficits regarding balance disable women more.

Serological and infection statuses of dogs from a visceral leishmaniasis-endemic area

OBJECTIVE This study investigated the serological status of dogs living in a visceral leishmaniasis-endemic area and its correlation with the parasitological condition of the animals.METHODS Canine humoral response was evaluated using the sera of 134 dogs by enzyme-linked immunosorbent assay and immunohistochemistry to detect parasites in the skin, lymph node, and spleen of the animals. The specific antibodies investigated were IgG, IgG1, IgG2, and IgE.RESULTS According to the parasitological, laboratory, and clinical findings, the dogs were placed into one of four groups: asymptomatic with (AP+, n = 21) or without (AP-, n = 36) Leishmania tissue parasitism and symptomatic with (SP+, n = 52) or without (SP-, n = 25) parasitism. Higher IgG and IgE levels were positively correlated with the infection condition and parasite load, but not with the clinical status. In all groups, total IgG was the predominant antibody, which occurred at the expense of IgG2 instead of IgG1. Most of the infected dogs tested positive for IgG (SP+, 98.1%; AP+, 95.2%), whereas this was not observed with IgE (SP+, 80.8%; AP+, 71.2%). The most relevant finding was the high positivity of the uninfected dogs for Leishmania-specific IgG (SP-, 60.0%; AP-, 44.4%), IgE (SP-, 44.0%; AP-, 27.8%), IgG1 (SP-, 28.0%; AP-, 22.2%), and IgG2 antibodies (SP-, 56.0%; AP-, 41.7%).CONCLUSIONS The serological status of dogs, as determined by any class or subclass of antibodies, did not accurately distinguish dogs infected with L. (L.) infantum chagasifrom uninfected animals. The inaccuracy of the serological result may impair not only the diagnosis, but also epidemiological investigations and strategies for visceral leishmaniasis control. This complex serological scenario occurring in a visceral leishmaniasis-endemic area highlights the challenges associated with canine diagnosis and points out the difficulties experienced by veterinary clinicians and coordinators of control programs.

Gender differences in social support and leisure-time physical activity

OBJECTIVE To identify gender differences in social support dimensions’ effect on adults’ leisure-time physical activity maintenance, type, and time.METHODS Longitudinal study of 1,278 non-faculty public employees at a university in Rio de Janeiro, RJ, Southeastern Brazil. Physical activity was evaluated using a dichotomous question with a two-week reference period, and further questions concerning leisure-time physical activity type (individual or group) and time spent on the activity. Social support was measured with the Medical Outcomes Study Social Support Scale. For the analysis, logistic regression models were adjusted separately by gender.RESULTS A multinomial logistic regression showed an association between material support and individual activities among women (OR = 2.76; 95%CI 1.2;6.5). Affective support was associated with time spent on leisure-time physical activity only among men (OR = 1.80; 95%CI 1.1;3.2).CONCLUSIONS All dimensions of social support that were examined influenced either the type of, or the time spent on, leisure-time physical activity. In some social support dimensions, the associations detected varied by gender. Future studies should attempt to elucidate the mechanisms involved in these gender differences.

Evaluation of maternal and neonatal hospital care: quality index of completeness

OBJECTIVE Develop an index to evaluate the maternal and neonatal hospital care of the Brazilian Unified Health System.METHODS This descriptive cross-sectional study of national scope was based on the structure-process-outcome framework proposed by Donabedian and on comprehensive health care. Data from the Hospital Information System and the National Registry of Health Establishments were used. The maternal and neonatal network of Brazilian Unified Health System consisted of 3,400 hospitals that performed at least 12 deliveries in 2009 or whose number of deliveries represented 10.0% or more of the total admissions in 2009. Relevance and reliability were defined as criteria for the selection of variables. Simple and composite indicators and the index of completeness were constructed and evaluated, and the distribution of maternal and neonatal hospital care was assessed in different regions of the country.RESULTS A total of 40 variables were selected, from which 27 single indicators, five composite indicators, and the index of completeness of care were built. Composite indicators were constructed by grouping simple indicators and included the following variables: hospital size, level of complexity, delivery care practice, recommended hospital practice, and epidemiological practice. The index of completeness of care grouped the five variables and classified them in ascending order, thereby yielding five levels of completeness of maternal and neonatal hospital care: very low, low, intermediate, high, and very high. The hospital network was predominantly of small size and low complexity, with inadequate child delivery care and poor development of recommended and epidemiological practices. The index showed that more than 80.0% hospitals had a low index of completeness of care and that most qualified heath care services were concentrated in the more developed regions of the country.CONCLUSIONS The index of completeness proved to be of great value for monitoring the maternal and neonatal hospital care of Brazilian Unified Health System and indicated that the quality of health care was unsatisfactory. However, its application does not replace specific evaluations.

Social capital, social participation and life satisfaction among Chilean older adults

OBJECTIVE To examine factors associated with social participation and their relationship with self-perceived well-being in older adults. METHODS This study was based on data obtained from the National Socioeconomic Characterization (CASEN) Survey conducted in Chile, in 2011, on a probability sample of households. We examined information of 31,428 older adults living in these households. Descriptive and explanatory analyses were performed using linear and multivariate logistic regression models. We assessed the respondents’ participation in different types of associations: egotropic, sociotropic, and religious. RESULTS Social participation increased with advancing age and then declined after the age of 80. The main finding of this study was that family social capital is a major determinant of social participation of older adults. Their involvement was associated with high levels of self-perceived subjective well-being. We identified four settings as sources of social participation: home-based; rural community-based; social policy programs; and religious. Older adults were significantly more likely to participate when other members of the household were also involved in social activities evidencing an intergenerational transmission of social participation. Rural communities, especially territorial associations, were the most favorable setting for participation. There has been a steady increase in the rates of involvement of older adults in social groups in Chile, especially after retirement. Religiosity remains a major determinant of associativism. The proportion of participation was higher among older women than men but these proportions equaled after the age of 80. CONCLUSIONS Self-perceived subjective well-being is not only dependent upon objective factors such as health and income, but is also dependent upon active participation in social life, measured as participation in associations, though its effects are moderate.

Resistance of Aedes aegypti to temephos and adaptive disadvantages

OBJECTIVE To evaluate the resistance of Aedes aegypti to temephos Fersol 1G (temephos 1% w/w) associated with the adaptive disadvantage of insect populations in the absence of selection pressure. METHODS A diagnostic dose of 0.28 mg a.i./L and doses between 0.28 mg a.i./L and 1.40 mg a.i./L were used. Vector populations collected between 2007 and 2008 in the city of Campina Grande, state of Paraíba, were evaluated. To evaluate competition in the absence of selection pressure, insect populations with initial frequencies of 20.0%, 40.0%, 60.0%, and 80.0% resistant individuals were produced and subjected to the diagnostic dose for two months. Evaluation of the development of aquatic and adult stages allowed comparison of the life cycles in susceptible and resistant populations and construction of fertility life tables. RESULTS No mortality was observed in Ae. aegypti populations subjected to the diagnostic dose of 0.28 mg a.i./L. The decreased mortality observed in populations containing 20.0%, 40.0%, 60.0%, and 80.0% resistant insects indicates that temephos resistance is unstable in the absence of selection pressure. A comparison of the life cycles indicated differences in the duration and viability of the larval phase, but no differences were observed in embryo development, sex ratio, adult longevity, and number of eggs per female. CONCLUSIONS The fertility life table results indicated that some populations had reproductive disadvantages compared with the susceptible population in the absence of selection pressure, indicating the presence of a fitness cost in populations resistant to temephos.

Legal and health variations in drug litigation injunctions granted in Minas Gerais

OBJECTIVE To investigate the factors related to the granting of preliminary court orders [injunctions] in drug litigations. METHODS A retrospective descriptive study of drug lawsuits in the State of Minas Gerais, Southeastern Brazil, was conducted from October 1999 to 2009. The database consists of 6,112 lawsuits, out of which 6,044 had motions for injunctions and 5,167 included the requisition of drugs. Those with more than one beneficiary were excluded, which totaled 5,072 examined suits. The variables for complete, partial, and suppressed motions were treated as dependent and assessed in relation to those that were independent – lawsuits (year, type, legal representation, defendant, court in which it was filed, adjudication time), drugs (level five of the anatomical therapeutic chemical classification), and diseases (chapter of the International Classification of Diseases). Statistical analyses were performed using the Chi-square test. RESULTS Out of the 5,072 lawsuits with injunctions, 4,184 (82.5%) had the injunctions granted. Granting varied from 95.8% of the total lawsuits in 2004 to 76.9% in 2008. Where there was legal representation, granting exceeded 80.0% and in lawsuits without representation, it did not exceed 66.9%. In public civil actions (89.1%), granting was higher relative to ordinary lawsuits (82.8%) and injunctions (80.1%). Federal courts granted only 68.6% of the injunctions, while the state courts granted 84.8%. Diseases of the digestive system and neoplasms received up to 87.0% in granting, while diseases of the nervous system, mental and behavioral disorders, and diseases of the skin and subcutaneous tissue received granting below 78.6% and showed a high proportion of suspended injunctions (10.9%). Injunctions involving paroxetine, somatropin, and ferrous sulfate drugs were all granted, while less than 54.0% of those involving escitalopram, sodium diclofenac, and nortriptyline were granted. CONCLUSIONS There are significant differences in the granting of injunctions, depending on the procedural and clinical variances. Important trends in the pattern of judicial action were observed, particularly, in the reduced granting [of injunctions] over the period.

Public school teachers’ perceptions about mental health

OBJECTIVE To examine public school teachers’ perceptions about general health and mental health, and the way in which they obtained this information. METHODS Qualitative research was conducted with 31 primary and secondary school teachers at a state school in the municipality of Sao Paulo, SP, Southeastern Brazil, in 2010. The teachers responded to a questionnaire containing open-ended questions about mental health and general health. The following aspects were evaluated: Teachers’ understanding of the terms “health and “mental health,” the relevance of the need for information on the subject, the method preferred for obtaining information, their experience with different media regarding such matters, and perceptions about the extent to which this available information is sufficient to support their practice. The data were processed using the Qualiquantisoft software and analyzed according to the Discourse of the Collective Subject technique. RESULTS From the teachers’ perspective, general health is defined as the proper physiological functioning of the body and mental health is related to the balance between mind and body, as a requirement for happiness. Most of the teachers (80.6%) showed great interest in acquiring knowledge about mental health and receiving educational materials on the subject. For these teachers, the lack of information creates insecurity and complicates the management of everyday situations involving mental disorders. For 61.3% of the teachers, television is the medium that provides the most information on the topic. CONCLUSIONS The data indicate that there is little information available on mental health for teachers, showing that strategies need to be developed to promote mental health in schools.