Qualidade da água para consumo humano e concentração de fluoreto

O artigo visa analisar a concentração de fluoreto na água para consumo humano, considerando o balanço entre benefícios e riscos à saúde, e produzir subsídios para atualização da legislação brasileira. Estudos de revisão sistemática, documentos oficiais e dados meteorológicos foram examinados. As temperaturas nas capitais brasileiras indicam que o fluoreto deveria variar de 0,6 a 0,9 mg/L para prevenir cárie dentária. Concentração de fluoreto natural de 1,5 mg/L é tolerável para consumo no Brasil se não houver tecnologia de custo-benefício aceitável para ajuste/remoção do seu excesso. A ingestão diária de água com fluoreto em concentração > 0,9 mg/L representa risco à dentição em menores de oito anos de idade e os consumidores deveriam ser expressamente informados desse risco. Considerando a expansão do programa nacional de fluoretação da água para regiões de clima tipicamente tropical, deve-se revisar a Portaria 635/75, relacionada ao fluoreto adicionado às águas de abastecimento público.

Cobertura vacinal em menores de dois anos a partir de registro informatizado de imunização em Curitiba, PR

OBJETIVO: Avaliar o programa de imunização de crianças de 12 e de 24 meses de idade, com base no registro informatizado de imunização. MÉTODOS: Estudo descritivo em amostra probabilística de 2.637 crianças nascidas em 2002 e residentes em Curitiba, PR. As fontes de dados foram: registro informatizado de imunização do município, Sistema de Informação de Nascidos Vivos e inquérito domiciliar para casos com registro incompleto. As coberturas foram estimadas aos 12 e aos 24 meses de vida e analisadas segundo características socioeconômicas de cada distrito sanitário e o vínculo das crianças aos serviços de saúde. Foram analisadas a abrangência, completude e duplicidades do registro informatizado de imunização. RESULTADOS: A cobertura do esquema de imunização foi de 95,3% aos 12 meses sem diferenças entre os distritos e de 90,3% aos 24 meses, tendo sido mais elevada em um distrito com piores indicadores socioeconômicos (p = 0,01). A proporção de vacinas, segundo o tipo, aplicadas antes e após a idade recomendada foi de até 0,9% e até 32,2%, respectivamente. A cobertura do registro informatizado de imunização foi de 98% na amostra estudada, o sub-registro de doses de vacinas foi de 11% e a duplicidade de registro foi de 20,6%. Os grupos que apresentaram maiores coberturas foram: crianças com cadastro definitivo, aquelas com três ou mais consultas pelo Sistema Único de Saúde e as atendidas em Unidades Básicas de Saúde que adotam plenamente a Estratégia de Saúde da Família. CONCLUSÕES: A cobertura vacinal em Curitiba mostrou-se elevada e homogênea entre os distritos, e o vínculo com os serviços de saúde foi fator importante para tais resultados. O registro informatizado de imunização mostrou-se útil no monitoramento da cobertura vacinal; no entanto, é importante a prévia avaliação do seu custo-efetividade para que seja amplamente utilizado pelo Programa Nacional de Imunização.

Análise TG-ROC de testes de imunofluorescência no diagnóstico de leishmaniose visceral canina

OBJETIVO: Analisar a acurácia do diagnóstico de dois protocolos de imunofluorescência indireta para leishmaniose visceral canina. MÉTODOS: Cães provenientes de inquérito soroepidemiológico realizado em área endêmica nos municípios de Araçatuba e de Andradina, na região noroeste do estado de São Paulo, em 2003, e área não endêmica da região metropolitana de São Paulo, foram utilizados para avaliar comparativamente dois protocolos da reação de imunofluorescência indireta (RIFI) para leishmaniose: um utilizando antígeno heterólogo Leishmania major (RIFI-BM) e outro utilizando antígeno homólogo Leishmania chagasi (RIFI-CH). Para estimar acurácia utilizou-se a análise two-graph receiver operating characteristic (TG-ROC). A análise TG-ROC comparou as leituras da diluição 1:20 do antígeno homólogo (RIFI-CH), consideradas como teste referência, com as diluições da RIFI-BM (antígeno heterólogo). RESULTADOS: A diluição 1:20 do teste RIFI-CH apresentou o melhor coeficiente de contingência (0,755) e a maior força de associação entre as duas variáveis estudadas (qui-quadrado=124,3), sendo considerada a diluição-referência do teste nas comparações com as diferentes diluições do teste RIFI-BM. Os melhores resultados do RIFI-BM foram obtidos na diluição 1:40, com melhor coeficiente de contingência (0,680) e maior força de associação (qui-quadrado=80,8). Com a mudança do ponto de corte sugerido nesta análise para a diluição 1:40 da RIFI-BM, o valor do parâmetro especificidade aumentou de 57,5% para 97,7%, embora a diluição 1:80 tivesse apresentado a melhor estimativa para sensibilidade (80,2%) com o novo ponto de corte. CONCLUSÕES: A análise TG-ROC pode fornecer importantes informações sobre os testes de diagnósticos, além de apresentar sugestões sobre pontos de cortes que podem melhorar as estimativas de sensibilidade e especificidade do teste, e avaliá-los a luz do melhor custo-benefício.

Ansiedade no climatério: prevalência e fatores associados

Este estudo estimou a prevalência de ansiedade e caracterizou os possíveis fatores associados em 749 mulheres no climatério, cadastradas no Programa de Saúde da Família e integrantes do Projeto de Saúde de Pindamonhangaba (PROSAPIN). Trata-se de um estudo observacional transversal; o método consistiu na aplicação de um questionário auto-referido, contendo variáveis sócio-demográficas, de ansiedade e antropometria. A análise estatística foi feita pela distribuição de freqüências e Odds Ratio (intervalo de confiança de 95%), considerando o nível de significância em p< 0,05. Os resultados mostraram que a prevalência de ansiedade foi de 49,8% (IC 95%: 46,2 a 53,4) e, entre os principais fatores associados à ansiedade destacaram-se a escolaridade (OR:1,20 p=0,005), atividade remunerada (OR:0,68 p=0,001) e o período da transição menopausal (OR:1,21 p=0,003). Em conclusão, a ansiedade foi muito prevalente, atingindo quase metade da população estudada e os principais fatores associados à ansiedade foram os hábitos de vida e as condições socioeconômicas

Tendência da incidência e da mortalidade por Aids em mulheres na transição menopausal e pós-menopausa no Brasil, 1996-2005

Objetivo: Descrever a incidência e a mortalidade por Aids no Brasil e mulheres na fase menopausal e pós-menopausa. Métodos: Estudo retrospectivo de 1996 a 2005, utilizando dados secundários do Sistema de Informações de Saúde do DATASUS - Ministério da Saúde. Buscou-se por população residente em dados "Demográficos e Socioeconômicos, incidência no Sistema de Informação de Agravos de Notificação (SINAN) e mortalidade no Sistema de Informação sobre Mortalidade (SIM). Os coeficientes específicos de incidência e de mortalidade por Aids/100.000 mulheres foram calculados para cada década da faixa etária de 30 a 69 anos (30-39, 40-49, 50-59, 60-69), pois inclui a população de interesse; isto é, mulheres na transição menopausal e pós-menopausa, dos 35 aos 65 anos, Resultados: Houve aumento da incidência de Aids entre os anos de 1996 e 1998, a partir daí, observa-se tendência à ligeira queda até 2000 e posterior incremento até 2004. Em 2005, o coeficiente retorna a valores próximos dos encontrados em 1997. A mortalidade apresentou queda em todas as faixas etárias nos anos de 1996 e 1997, a partir de então, os coeficientes mantêm-se praticamente estáveis até 1999, exceto na faixa etária de 30 a 39 anos que continua estável até 2005. Já entre mulheres acima de 40 anos, o coeficiente de mortalidade apresentou aumento entre os anos 1999 a 2005. conclusão: Houve aumento no número de casos novos de Aids entre mulheres acima de 30 anos e o mesmo processo se repetiu com relação à mortalidade. O aumento e "envelhecimento" da epidemia entre brasileiras, sinalizam que medidas de promoção à saúde, prevenção da doença, diagnóstico precoce e tratamento efetivo devem ser oferecidos de maneira apropriada às mulheres de 30 a 69 anos, considerando as características pessoais, o contexto familiar e o papel social do sexo feminino nestas idades

Tendências da mortalidade em mulheres brasileiras no climatério

Há poucos estudos sobre mortalidade feminina durante o climatério, em especial no Brasil. O objetivo deste estudo foi analisar a tendência de mortalidade em mulheres de 35 a 64 anos no Brasil nos últimos anos. Para tanto, foram coletados os dados de mortalidade do Sistema de Informações de Mortalidade do Datasus, Ministério da Saúde, para o período de 1979 a 2004. Para análise, foram calculados os coeficientes específicos de mortalidade por idade e causa para os dez capítulos da Classificação Internacional de Doenças mais freqüentes como causa de morte por década da faixa etária do climatério, nas regiões do Brasil. No Brasil, três capítulos da Classificação Internacional de Doenças predominaram: doenças do aparelho circulatório; neoplasias e causas mal definidas. As regiões Sudeste, Sul e Centro-Oeste acompanharam o mesmo padrão do país, em relação à posição das três primeiras causas de morte, contudo, as doenças do aparelho circulatório e as causas mal definidas descresceram e as neoplasias aumentaram. Na região Norte, apesar das mesmas causas apresentarem coeficientes próximos, as doenças circulatórias prevaleceram na maior parte do período estudado, mas as causas mal definidas foram mais freqüentes que as neoplasias. Já no Nordeste, as principais causas foram as mal definidas, embora tenham descrecido de 1979 a 2004. As doenças do aparelho circulatório e neoplasias ocuparam a segunda e terceira posições, respectivamente, e aumentaram no período de estudo

Template-based fluoroethylenepropylene piezoelectrets with tubular channels for transducer applications

We describe the concept, the fabrication, and the most relevant properties of a piezoelectric-polymer system: Two fluoroethylenepropylene (FEP) films with good electret properties are laminated around a specifically designed and prepared polytetrafluoroethylene (PTFE) template at 300 degrees C. After removing the PTFE template, a two-layer FEP film with open tubular channels is obtained. For electric charging, the two-layer FEP system is subjected to a high electric field. The resulting dielectric barrier discharges inside the tubular channels yield a ferroelectret with high piezoelectricity. d(33) coefficients of up to 160 pC/N have already been achieved on the ferroelectret films. After charging at suitable elevated temperatures, the piezoelectricity is stable at temperatures of at least 130 degrees C. Advantages of the transducer films include ease of fabrication at laboratory or industrial scales, a wide range of possible geometrical and processing parameters, straightforward control of the uniformity of the polymer system, flexibility, and versatility of the soft ferroelectrets, and a large potential for device applications e.g., in the areas of biomedicine, communications, production engineering, sensor systems, environmental monitoring, etc.

The variability and predictors of quality of AIDS care services in Brazil

Background: Since establishing universal free access to antiretroviral therapy in 1996, the Brazilian Health System has increased the number of centers providing HIV/AIDS outpatient care from 33 to 540. There had been no formal monitoring of the quality of these services until a survey of 336 AIDS health centers across 7 Brazilian states was undertaken in 2002. Managers of the services were asked to assess their clinics according to parameters of service inputs and service delivery processes. This report analyzes the survey results and identifies predictors of the overall quality of service delivery. Methods: The survey involved completion of a multiple-choice questionnaire comprising 107 parameters of service inputs and processes of delivering care, with responses assessed according to their likely impact on service quality using a 3-point scale. K-means clustering was used to group these services according to their scored responses. Logistic regression analysis was performed to identify predictors of high service quality. Results: The questionnaire was completed by 95.8% (322) of the managers of the sites surveyed. Most sites scored about 50% of the benchmark expectation. K-means clustering analysis identified four quality levels within which services could be grouped: 76 services (24%) were classed as level 1 (best), 53 (16%) as level 2 (medium), 113 (35%) as level 3 (poor), and 80 (25%) as level 4 (very poor). Parameters of service delivery processes were more important than those relating to service inputs for determining the quality classification. Predictors of quality services included larger care sites, specialization for HIV/AIDS, and location within large municipalities. Conclusion: The survey demonstrated highly variable levels of HIV/AIDS service quality across the sites. Many sites were found to have deficiencies in the processes of service delivery processes that could benefit from quality improvement initiatives. These findings could have implications for how HIV/AIDS services are planned in Brazil to achieve quality standards, such as for where service sites should be located, their size and staffing requirements. A set of service delivery indicators has been identified that could be used for routine monitoring of HIV/AIDS service delivery for HIV/AIDS in Brazil (and potentially in other similar settings).

The Effects of Commercially Available Preservative-Free FDA-Approved Triamcinolone (Triesence (R)) on Retinal Cells in Culture

Purpose: To evaluate the effects of Triesence (R) (TRI), a new preservative-free triamcinolone approved by the U. S. Food and Drug Administration (FDA) for intraocular use, on human retina pigment epithelial (ARPE-19) and rat neurosensory (R28) cells in culture. Methods: ARPE-19 and R28 cell cultures were treated 24 h with 1,000, 500, 200, or 100 mu g/mL of crystalline (cTRI) or 1,000, 500, or 200 mu g/mL of solubilized (sTRI). TRI was solubilized by centrifuging the drug, discarding the supernatant containing the vehicle and then resuspending the drug pellet in an equivalent amount of Dimethyl sulfoxide to achieve the same concentration as the commercial preparation. Percentage of cell viability (CV) was evaluated by a trypan blue dye-exclusion assay. The mitochondrial membrane potential (Delta Psi m) was analyzed with the JC-1 assay. The caspase-3/7 activity was measured by a fluorochrome assay. Results: In the ARPE-19 cultures, the cTRI caused a decrease in CV at 1,000 mg/mL (13.03 +/- 6.51; P < 0.001), 500 mu g/mL (28.87 +/- 9.3; P < 0.001), 200 mu g/mL (54.93 +/- 5.61; P < 0.001), and 100 mu g/mL (82.53 +/- 0.65; P < 0.005) compared with the untreated controls (96.98 +/- 0.16). In R28 cultures, the cTRI treatment also reduced CV values significantly (P < 0.001) for the 1,000 mu g/mL (22.73 +/- 2.44), 500 mu g/mL (34.63 +/- 1.91), 200 mu g/mL (58.70 +/- 1.39), and 100 mu g/m (75.33 +/- 2.47) compared with the untreated controls (86.08 +/- 3.54). Once the TRI was solubilized (sTRI), the CV and Delta Psi m remained similar to the untreated controls for both ARPE-19 and R28 cells. The sTRI treatment with 1,000, 500, and 200 mu g/mL increased in caspase-3/7 activity in ARPE-19 cells (P < 0.01) and in R28 cells (P < 0.05) compared with dimethyl sulfoxide equivalent controls. Conclusion: The crystalline form of TRI (cTRI) can cause a significant decrease in CV to cultured retinal cells. Once the TRI is solubilized (sTRI), at the same concentrations, the cells remain viable with no decrease in CV or Delta Psi m. The sTRI can, however, increase caspase-3/7 activity, thus suggesting some degree of apoptosis.

SMALL MAMMAL PREY SELECTION BY TWO OWL SPECIES IN SOUTHEASTERN BRAZIL

A variety of factors influence prey selection by predators. Because Barn Owls (Tyto alba) and Burrowing Owls (Athene cunicularia) differ in size and foraging tactics, we expected differential predation on small mammal prey. We hypothesized that the Barn Owl, all active predator, would prey on smaller and younger individuals than the Burrowing Owl, a sit-and-wait predator. We used pellet analyses to evaluate selection of small mammals by the two owls in relation to prey), species, age, and size at the Ecological Station of Itirapina, state of Sao Paulo, in southeastern Brazil. Small mammals constituted most of the prey individuals and biomass in the diet of Barn Owls. Although Burrowing Owls consumed a wider range of taxa, small mammals represented one-third of all biomass consumed. With respect. to small mammals, Barn Owls foraged selectively relative to prey species, size, and age. Burrowing Owls foraged opportunistically relative to prey species, but selectively relative to prey size and age. Barn Owls selected smaller and younger (juvenile and subadult) individuals of the delicate vesper mouse (Calomys tener) and Burrowing Owls preyed more oil larger and older (subadult only) individuals. morphology and behavior of both prey and predators may explain this differential predation. Our data suggest that the active predator feeds oil smaller and younger prey, and the sit-and-wait predator took relatively larger and older prey.

Human Dental Pulp Cells: A New Source of Cell Therapy in a Mouse Model of Compressive Spinal Cord Injury

Strategies aimed at improving spinal cord regeneration after trauma are still challenging neurologists and neuroscientists throughout the world. Many cell-based therapies have been tested, with limited success in terms of functional outcome. In this study, we investigated the effects of human dental pulp cells (HDPCs) in a mouse model of compressive spinal cord injury (SCI). These cells present some advantages, such as the ease of the extraction process, and expression of trophic factors and embryonic markers from both ecto-mesenchymal and mesenchymal components. Young adult female C57/BL6 mice were subjected to laminectomy at T9 and compression of the spinal cord with a vascular clip for 1 min. The cells were transplanted 7 days or 28 days after the lesion, in order to compare the recovery when treatment is applied in a subacute or chronic phase. We performed quantitative analyses of white-matter preservation, trophic-factor expression and quantification, and ultrastructural and functional analysis. Our results for the HDPC-transplanted animals showed better white-matter preservation than the DMEM groups, higher levels of trophic-factor expression in the tissue, better tissue organization, and the presence of many axons being myelinated by either Schwann cells or oligodendrocytes, in addition to the presence of some healthy-appearing intact neurons with synapse contacts on their cell bodies. We also demonstrated that HDPCs were able to express some glial markers such as GFAP and S-100. The functional analysis also showed locomotor improvement in these animals. Based on these findings, we propose that HDPCs may be feasible candidates for therapeutic intervention after SCI and central nervous system disorders in humans.

Comparison Between Single-Diode Low-Level Laser Therapy (LLLT) and LED Multi-Diode (Cluster) Therapy (LEDT) Applications Before High-Intensity Exercise

Background Data and Objective: There is anecdotal evidence that low-level laser therapy (LLLT) may affect the development of muscular fatigue, minor muscle damage, and recovery after heavy exercises. Although manufacturers claim that cluster probes (LEDT) maybe more effective than single-diode lasers in clinical settings, there is a lack of head-to-head comparisons in controlled trials. This study was designed to compare the effect of single-diode LLLT and cluster LEDT before heavy exercise. Materials and Methods: This was a randomized, placebo-controlled, double-blind cross-over study. Young male volleyball players (n = 8) were enrolled and asked to perform three Wingate cycle tests after 4 x 30 sec LLLT or LEDT pretreatment of the rectus femoris muscle with either (1) an active LEDT cluster-probe (660/850 nm, 10/30mW), (2) a placebo cluster-probe with no output, and (3) a single-diode 810-nm 200-mW laser. Results: The active LEDT group had significantly decreased post-exercise creatine kinase (CK) levels (-18.88 +/- 41.48U/L), compared to the placebo cluster group (26.88 +/- 15.18U/L) (p < 0.05) and the active single-diode laser group (43.38 +/- 32.90U/L) (p<0.01). None of the pre-exercise LLLT or LEDT protocols enhanced performance on the Wingate tests or reduced post-exercise blood lactate levels. However, a non-significant tendency toward lower post-exercise blood lactate levels in the treated groups should be explored further. Conclusion: In this experimental set-up, only the active LEDT probe decreased post-exercise CK levels after the Wingate cycle test. Neither performance nor blood lactate levels were significantly affected by this protocol of pre-exercise LEDT or LLLT.

Continuous monitoring of ascorbate transport through neuroblastoma cells with a ruthenium oxide hexacyanoferrate modified microelectrode

The uptake of ascorbate by neuroblastoma cells using a ruthenium oxide hexacyanoferrate (RuOHCF)-modified carbon fiber disc (CFD) microelectrode (r = 14.5 mu m) was investigated. By use of the proposed electrochemical sensor the amperometric determination of ascorbate was performed at 0.0 V in minimum essential medium (MEM, pH = 7.2) with a limit of detection of 25 mu mol L(-1). Under the optimum experimental conditions, no interference from MEM constituents and reduced glutathione (used to prevent the oxidation of ascorbate during the experiments) was noticed. The stability of the RuOHCF-modified electrode response was studied by measuring the sensitivity over an extended period of time (120 h), a decrease of around 10% being noticed at the end of the experiment. The rate of ascorbate uptake by control human neuroblastoma SH-SY5Y cells, and cells transfected with wild-type Cu,Zn-superoxide dismutase (SOD WT) or with a mutant typical of familial amyotrophic lateral sclerosis (SOD G93A), was in agreement with the level of oxidative stress in these cells. The usefulness of the RuOHCF-modified microelectrode for in vivo monitoring of ascorbate inside neuroblastoma cells was also demonstrated.

Evaluation of grinding methods for pellets preparation aiming at the analysis of plant materials by laser induced breakdown spectrometry

It has been demonstrated that laser induced breakdown spectrometry (LIBS) can be used as an alternative method for the determination of macro (P, K. Ca, Mg) and micronutrients (B, Fe, Cu, Mn, Zn) in pellets of plant materials. However, information is required regarding the sample preparation for plant analysis by LIBS. In this work, methods involving cryogenic grinding and planetary ball milling were evaluated for leaves comminution before pellets preparation. The particle sizes were associated to chemical sample properties such as fiber and cellulose contents, as well as to pellets porosity and density. The pellets were ablated at 30 different sites by applying 25 laser pulses per site (Nd:YAG@1064 nm, 5 ns, 10 Hz, 25J cm(-2)). The plasma emission collected by lenses was directed through an optical fiber towards a high resolution echelle spectrometer equipped with an ICCD. Delay time and integration time gate were fixed at 2.0 and 4.5 mu s, respectively. Experiments carried out with pellets of sugarcane, orange tree and soy leaves showed a significant effect of the plant species for choosing the most appropriate grinding conditions. By using ball milling with agate materials, 20 min grinding for orange tree and soy, and 60 min for sugarcane leaves led to particle size distributions generally lower than 75 mu m. Cryogenic grinding yielded similar particle size distributions after 10 min for orange tree, 20 min for soy and 30 min for sugarcane leaves. There was up to 50% emission signal enhancement on LIBS measurements for most elements by improving particle size distribution and consequently the pellet porosity. (C) 2011 Elsevier B.V. All rights reserved.

Evaluation of laser induced breakdown spectroscopy for the determination of micronutrients in plant materials

Laser induced breakdown spectroscopy (LIBS) has been evaluated for the determination of micronutrients (B, Cu, Fe, Mn and Zn) in pellets of plant materials, using NIST, BCR and GBW biological certified reference materials for analytical calibration. Pellets of approximately 2 mm thick and 15 mm diameter were prepared by transferring 0.5 g of powdered material to a 15 mm die set and applying 8.0 tons cm(-2). An experimental setup was designed by using a Nd:YAG laser operating at 1064 nm (200 mJ per pulse, 10 Hz) and an Echelle spectrometer with ICCD detector. Repeatability precision varied from 4 to 30% from measurements obtained in 10 different positions (8 laser shots per test portion) in the same sample pellet. Limits of detection were appropriate for routine analysis of plant materials and were 2.2 mg kg(-1) B, 3.0 mg kg(-1) Cu, 3.6 mg kg(-1) Fe, 1.8 mg kg(-1) Mn and 1.2 mg kg(-1) Zn. Analysis of different plant samples were carried out by LIBS and results were compared with those obtained by ICP OES after wet acid decomposition. (C) 2009 Elsevier B.V. All rights reserved.