957 resultados para Adverse


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In the management of solid waste, pollutants over a wide range are released with different routes of exposure for workers. The potential for synergism among the pollutants raises concerns about potential adverse health effects, and there are still many uncertainties involved in exposure assessment. In this study, conventional (culture-based) and molecular real-time polymerase chain reaction (RTPCR) methodologies were used to assess fungal air contamination in a waste-sorting plant which focused on the presence of three potential pathogenic/toxigenic fungal species: Aspergillus flavus, A. fumigatus, and Stachybotrys chartarum. In addition, microbial volatile organic compounds (MVOC) were measured by photoionization detection. For all analysis, samplings were performed at five different workstations inside the facilities and also outdoors as a reference. Penicillium sp. were the most common species found at all plant locations. Pathogenic/toxigenic species (A. fumigatus and S. chartarum) were detected at two different workstations by RTPCR but not by culture-based techniques. MVOC concentration indoors ranged between 0 and 8.9 ppm (average 5.3 ± 3.16 ppm). Our results illustrated the advantage of combining both conventional and molecular methodologies in fungal exposure assessment. Together with MVOC analyses in indoor air, data obtained allow for a more precise evaluation of potential health risks associated with bioaerosol exposure. Consequently, with this knowledge, strategies may be developed for effective protection of the workers.

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Although numerous studies have been conducted on microbial contaminants associated with various stages related to poultry and meat products processing, only a few reported on fungal contamination of poultry litter. The goals of this study were to (1) characterize litter fungal contamination and (2) report the incidence of keratinophilic and toxigenic fungi presence. Seven fresh and 14 aged litter samples were collected from 7 poultry farms. In addition, 27 air samples of 25 litters were also collected through impaction method, and after laboratory processing and incubation of collected samples, quantitative colony-forming units (CFU/m3) and qualitative results were obtained. Twelve different fungal species were detected in fresh litter and Penicillium was the most frequent genus found (59.9%), followed by Alternaria (17.8%), Cladosporium (7.1%), and Aspergillus (5.7%). With respect to aged litter, 19 different fungal species were detected, with Penicillium sp. the most frequently isolated (42.3%), followed by Scopulariopsis sp. (38.3%), Trichosporon sp. (8.8%), and Aspergillus sp. (5.5%). A significant positive correlation was found between litter fungal contamination (CFU/g) and air fungal contamination (CFU/m3). Litter fungal quantification and species identification have important implications in the evaluation of potential adverse health risks to exposed workers and animals. Spreading of poultry litter in agricultural fields is a potential public health concern, since keratinophilic (Scopulariopsis and Fusarium genus) as well as toxigenic fungi (Aspergillus, Fusarium, and Penicillium genus) were isolated.

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The assessment of patient dose has gained increased attention, still being an issue of concern that arises from the use of digital systems. The development of digital technology offers the possibility for a reduction of radiation dose around 50% without loss in image quality when compared to a conventional screen–film system. Digital systems give an equivalent or superior diagnostic performance and also several other advantages, but the risk of overexposure with no adverse effect on image quality could be present. This chapter refers to the management of patient dose and provides an explanation of dose-related concepts. In this chapter, exposure influence in dose and image representation and the effects of radiation exposure are also discussed.

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Introdução – Numa era em que os tratamentos de Radioterapia Externa (RTE) exigem cada vez mais precisão, a utilização de imagem médica permitirá medir, quantificar e avaliar o impacto do erro provocado pela execução do tratamento ou pelos movimentos dos órgãos. Objetivo – Analisar os dados existentes na literatura acerca de desvios de posicionamento (DP) em patologias de cabeça e pescoço (CP) e próstata, medidos com Cone Beam Computed Tomography (CBCT) ou Electronic Portal Image Device (EPID). Metodologia – Para esta revisão da literatura foram pesquisados artigos recorrendo às bases de dados MEDLINE/PubMed e b-on. Foram incluídos artigos que reportassem DP em patologias CP e próstata medidos através de CBCT e EPID. Seguidamente foram aplicados critérios de validação, que permitiram a seleção dos estudos. Resultados – Após a análise de 35 artigos foram incluídos 13 estudos e validados 9 estudos. Para tumores CP, a média (μ) dos DP encontra-se entre 0,0 e 1,2mm, com um desvio padrão (σ) máximo de 1,3mm. Para patologias de próstata observa-se μDP compreendido entre 0,0 e 7,1mm, com σ máximo de 7,5mm. Discussão/Conclusão – Os DP em patologias CP são atribuídos, maioritariamente, aos efeitos secundários da RTE, como mucosite e dor, que afetam a deglutição e conduzem ao emagrecimento, contribuindo para a instabilidade da posição do doente durante o tratamento, aumentando as incertezas de posicionamento. Os movimentos da próstata devem-se principalmente às variações de preenchimento vesical, retal e gás intestinal. O desconhecimento dos DP afeta negativamente a precisão da RTE. É importante detetá-los e quantificá-los para calcular margens adequadas e a magnitude dos erros, aumentando a precisão da administração de RTE, incluindo o aumento da segurança do doente. - ABSTRACT - Background and Purpose – In an era where precision is an increasing necessity in external radiotherapy (RT), modern medical imaging techniques provide means for measuring, quantifying and evaluating the impact of treatment execution and movement error. The aim of this paper is to review the current literature on the quantification of setup deviations (SD) in patients with head and neck (H&N) or prostate tumors, using Cone Beam Computed Tomography (CBCT) or Electronic Portal Image Device (EPID). Methods – According to the study protocol, MEDLINE/PubMed and b-on databases were searched for trials, which were analyzed using selection criteria based on the quality of the articles. Results – After assessment of 35 papers, 13 studies were included in this analysis and nine were authenticated (6 for prostate and 3 for H&N tumors). The SD in the treatment of H&N cancer patients is in the interval of 0.1 to 1.2mm, whereas in prostate cancer this interval is 0.0 to 7.1mm. Discussion – The reproducibility of patient positioning is the biggest barrier for higher precision in RT, which is affected by geometrical uncertainty, positioning errors and inter or intra-fraction organ movement. There are random and systematic errors associated to patient positioning, introduced since the treatment planning phase or through physiological organ movement. Conclusion – The H&N SD are mostly assigned to the Radiotherapy adverse effects, like mucositis and pain, which affect swallowing and decrease secretions, contributing for the instability of patient positioning during RT treatment and increasing positioning uncertainties. Prostate motion is mainly related to the variation in bladder and rectal filling. Ignoring SD affects negatively the accuracy of RT. Therefore, detection and quantification of SD is crucial in order to calculate appropriate margins, the magnitude of error and to improve accuracy in RTE and patient safety.

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Dissertação de Mestrado em Finanças Empresariais

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A crioterapia é prática comum na medicina esportiva, pela praticidade, facilidade de acesso e baixo custo, possuindo vantajoso uso na Saúde Pública. No entanto, os efeitos analgésicos do gelo tem pouca base objetiva e sistematizada em termos de técnicas, duração e frequência. O objetivo deste estudo foi sintetizar através da revisão sistemática (RS) as evidências relativas à efetividade da crioterapia para o tratamento das entorses de tornozelo de atletas. A RS é um método de pesquisa observacional e retrospectivo, pelo qual se tratam artigos, preferencialmente Ensaios Clínicos Aleatórios – ECA, como sujeitos da investigação, com rigorosos critérios de inclusão e exclusão e, quando possível, realiza-se uma macro estatística dos resultados – metaanálise. No presente RS, foram consultados cinco bancos de dados - Medline, Embase, Cochrane, Lilacs e PEDro para buscar ECA sobre crioterapia com os desfechos dor, edema, rigidez e função. Resultados: 289 estudos foram identificados inicialmente, dos quais nove com tratamentos isolados ou associados à crioterapia, porém apenas um preencheu aos critérios de inclusão, cujo N era 121 atletas, dos quais 64 receberam a crioterapia (funcional) e 57 no grupo controle (imobilização). Maior probabilidade para o evento dor foi observada no grupo controle, após 3 e 12 meses. A RS revelou uma lacuna em ECA dentro do tema, mas não encontrou efeito adverso na prática da crioterapia, sendo um princípio analgésico importante, sobretudo em lesões de tecidos moles.

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Farmers are occupationally exposed to many respiratory hazards at work and display higher rates of asthma and respiratory symptoms than other workers. Dust is one of the components present in poultry production that increases risk of adverse respiratory disease occurrence. Dust originates from poultry residues, molds, and feathers and is biologically active as it contains microorganisms. Exposure to dust is known to produce a variety of clinical responses, including asthma, chronic bronchitis, chronic airways obstructive disease (COPD), allergic alveolitis, and organic dust toxic syndrome (ODTS). A study was developed to determine particle contamination in seven poultry farms and correlate this with prevalence rate of respiratory defects and record by means of a questionnaire the presence of clinical symptoms associated with asthma and other allergy diseases by European Community Respiratory Health Survey. Poultry farm dust contamination was found to contain higher concentrations of particulate matter (PM) PM5 and PM10. Prevalence rate of obstructive pulmonary disorders was higher in individuals with longer exposure regardless of smoking status. In addition, a high prevalence for asthmatic (42.5%) and nasal (51.1%) symptoms was noted in poultry workers. Data thus show that poultry farm workers are more prone to suffer from respiratory ailments and this may be attributed to higher concentrations of PM found in the dust. Intervention programs aimed at reducing exposure to dust will ameliorate occupational working conditions and enhance the health of workers.

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Several studies have shown that human exposures to airbome dust and microorganisms, such as bacteria and fungi, can cause respiratory diseases. Agricultural workers have been found to be at high risk of exposures to airborne particles. From a human health perspective dust exposure in pig farming is the most important risk because of the large number of workers needed in pig production and the increasing number of working hours inside enclosed buildings. In the pig buildings, particulate matters like dust play a role in not only deteriorating indoor air quality but also can cause an adverse health effect on workers. Generally, dust is recognized to adsorb and transport odorous compounds and biological agents. The aim of this study was to determine particles contamination in 7 swine farms located in Lisbon district, Portugal.

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Animal confinement tends to increase the overall microbial load in the production environment caused by high amounts of feed and organic residuals (manure and wastewater) present in those environments. The number of animais and the handling and management required to work in these settings also contribute to enhance that microbial ioad. Animal housing typically exposes workers to substantial concentrations of bioaerosols, such as fungi and their metabolites. Therefore, agricultural workers, and especially pig and poultry farmers, are at increased risk of occupational respiratory diseases. Exposure to bioaerosols in poultries and swines may vary depending upon the stage of the animals' growth, density, manure management procedures, litter type and used floor coverage, among others. Gathering temporal information about the quantity and the composition of fungal load is necessary to better understand the relationship between these factors and adverse health symptoms of workers. This study aimed to characterize and compare fungal contamination between these two different settings.

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OBJECTIVE: To compare the reactogenicity of three yellow fever (YF) vaccines from WHO-17D and Brazilian 17DD substrains (different seed-lots) and placebo. METHODS: The study involved 1,087 adults eligible for YF vaccine in Rio de Janeiro, Brazil. Vaccines produced by Bio-Manguinhos, Fiocruz (Rio de Janeiro, Brazil) were administered ("day 0") following standardized procedures adapted to allow blinding and blocked randomization of participants to coded vaccine types. Adverse events after immunization were ascertained in an interview and in diary forms filled in by each participant. Liver enzymes were measured on days 0, 4-20 and 30 of the study. Viremia levels were measured on days 4 to 20 of follow-up. The immune response was verified through serologic tests. RESULTS: Participants were mostly young males. The seroconversion rate was above 98% among those seronegative before immunization. Compared to placebo, the excess risk of any local adverse events ranged from 0.9% to 2.5%, whereas for any systemic adverse events it ranged from 3.5% to 7.4% across vaccine groups. The excess risk of events leading to search for medical care or to interruption of work activities ranged from 2% to 4.5%. Viremia was detected in 3%-6% of vaccinees up to 10 days after vaccination. Variations in liver enzyme levels after vaccination were similar in placebo and vaccine recipients. CONCLUSIONS: The frequency of adverse events post-immunization against YF, accounting for the background occurrence of nonspecific signs and symptoms, was shown for the first time to be similar for vaccines from 17D and 17DD substrains. The data also provided evidence against viscerotropism of vaccine virus.

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A existência de estações de tratamentos de águas residuais (ETAR) é, nos dias de hoje, fundamental na medida em que permite, reduzir a poluição ambiental associada às águas e, também, a reutilização da água tratada para diversos fins. A constante necessidade de cumprir os limites de descargas nos meios recetores conduziu a um melhoramento nas técnicas e processos de tratamento de efluentes, nomeadamente, nos processos biológicos. O processo por lamas ativadas é um processo amplamente utilizado para a remoção de poluentes orgânicos presentes nas águas residuais, pelo que um estudo mais intensivo sobre estes tratamentos resultou na publicação de uma série de conceitos e pressupostos, através de modelos numéricos. A modelação numérica de processos de tratamento de águas residuais e a utilização de ferramentas de simulação numérica têm sido largamente utilizadas, a nível mundial, por exemplo em investigação, desenvolvimento de processos, atividade de consultoria e igualmente por entidades reguladoras, na medida em que os auxiliam no planeamento, dimensionamento e análise do comportamento de infraestruturas de tratamento. No presente trabalho, recorreu-se ao software de simulação GPS-X (versão 6.0) para implementar o esquema de tratamento da ETAR de Beirolas. O objetivo deste trabalho é verificar a aplicabilidade de modelos numéricos na simulação de unidades de tratamento de efluentes e avaliar a resposta dos diferentes modelos, assim como a influência na alteração de características das águas afluentes no comportamento dos modelos. Os resultados obtidos permitiram concluir que os modelos numéricos podem ser utilizados para prever a resposta dos sistemas biológicos e as suas perturbações. Conclui-se ainda que o comportamento, dos modelos estudados (ASM1, ASM2d, ASM3 e mantis), é semelhante, contudo deve-se referir que devido à complexidade do modelo e a falta de informação experimental sobre as características do efluente, não permitiram efetuar uma completa caracterização e calibração do caso de estudo, e toda a informação disponível sobre as características físico-químicas da água foram baseadas em estimativas de concentrações de carências de oxigénio e sólidos suspensos.

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Liver transplantation is nowadays the only effective answer to adjourn the outcome of functional limitations associated with familial amyloidotic polyneuropathy (FAP), a neurodegenerative disease characterized by sensory and motor polyneuropathies. Nevertheless, there is a detrimental impact associated with the after-surgery period on the fragile physical condition of these patients. Exercise training has been proven to be effective on reconditioning patients after transplantation. However, the effects of exercise training in liver transplanted FAP patients have not been scrutinized yet.

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Valproic acid (2-propyl pentanoic acid) is a pharmaceutical drug used for treatment of epileptic seizures absence, tonic-clonic (grand mal), complex partial seizures, and mania in bipolar disorder [1]. Valproic acid is a slightly soluble in water and therefore as active pharmaceutical ingredient it is most commonly applied in form of sodium or magnesium valproate salt [1].However the list of adverse effects of these compounds is large and includes among others: tiredness, tremor, sedation and gastrointestinal disturbances [2]. Ionic liquids (ILs) are promising compounds as Active Pharmaceutical Ingredients (APIs)[3]. In this context, the combinations of the valproate anion with appropriate cation when ILs and salts are formed can significantly alter valproate physical, chemical and thermal properties.[4] This methodology can be used for drug modification (alteration of drug solubility in water, lipids, bioavailability, etc)[2] and therefore can eliminate some adverse effect of the drugs related to drug toxicity due for example to its solubility in water and lipids (interaction with intestines). Herein, we will discuss the development of ILs based on valproate anion (Figure 1) prepared according a recent optimized and sustainable acid-base neutralization method [4]. The organic cations such as cetylpyridinium, choline and imidazolium structures were selected based on their biocompatibility and recent applications in pharmacy [3]. All novel API-ILs based on valproate have been studied in terms of their physical, chemical (viscosity, density, solubility) and thermal (calorimetric studies) properties as well as their biological activity.