Análise das condições de saúde e de vida da população urbana de Botucatu, São Paulo (Brasil): IV - Morbidade referida em entrevistas domiciliárias, 1983-1984

Objetivou-se estudar a morbidade referida pela população urbana amostrada, no Município de Botucatu, SP, Brasil, em 1983/84, segundo sexo, idade, escolaridade e renda per capita. O método consistiu em entrevistas domiciliárias, com aplicação de dois formulários pré-codificados. Os entrevistadores eram leigos treinados e supervisionados, e a pessoa entrevistada foi quase sempre a mãe de família. O período recordatório estabelecido em relação aos eventos informados (queixas, sintomas, acidentes comuns e diagnósticos) foi de três semanas. Das 7.075 pessoas amostradas (12% da população), 56% apresentaram episódios mórbidos, totalizando 6.649 episódios. As mulheres, bem como o grupo etário de 50 e mais anos apresentaram maior freqüência de queixas. A escolaridade e a renda per capita não diferenciaram os entrevistados quanto à ocorrência maior ou menor de episódios. A prevalência de episódios mórbidos foi de 939/1.000 entrevistados. Predominaram queixas do aparelho respiratório (20% do total de queixas), principalmente as infecções respiratórias agudas. em segundo lugar, os sinais e sintomas mal definidos (19%) e, a seguir, as doenças do sistema osteo-muscular, do sistema nervoso e do sistema circulatório, com proporções similares (ao redor de 9%) e, finalmente, as do sistema digestivo e as lesões e envenenamentos (ao redor de 8%). Foram estimados os coeficientes de prevalência por grupos de doença (pela CID), segundo as variáveis estudadas. São comentadas as dificuldades de comparação dos resultados obtidos com os de trabalhos congêneres, face às diferenças nos métodos usados, apontando-se para a necessidade de uma padronização metodológica dos estudos de morbidade referida, cuja importância epidemiológica e para o planejamento em saúde vem sendo amplamente reconhecida.

Acidentes por lepidópteros (larvas e adultos de mariposas): estudo dos aspectos epidemiológicos, clínicos e terapêuticos

Os autores apresentam e discutem aspectos dos acidentes causados por larvas de lepidópteros (mariposas), enfatizando as manifestações dermatológicas e a dor intensa que caracterizam estes agravos. Além disso, são apresentadas larvas de mariposas que causam manifestações extracutâneas, tais como severos distúrbios de coagulação e artropatias anquilosantes, e ainda dermatites provocadas por insetos adultos. Os principais grupos de lepidópteros causadores de acidentes em humanos são demonstrados, e as medidas terapêuticas atualizadas são discutidas. O lepidopterismo e o erucismo são acidentes comuns, e é importante que o dermatologista saiba reconhecer e tratar esse tipo de envenenamento.

Leishmaniose cutânea acidental

Os autores relatam o 3º caso de Leishmaniose acidental em laboratório, ocorrido em aluna do curso de Biologia, que contaminou-se por ocasião da passagem de formas amastigotas de Leishmania (Viannia) braziliensis de hamster infectado para hamster são. Chamam atenção de que, apesar de usar toda proteção exigida, a aluna foi mordida pelo hamster são, havendo como conseqüência, ruptura da luva e contágio através do inóculo.

Clinical and epidemiological study of 27 poisonings caused by ingesting puffer fish (Tetrodontidae) in the states of Santa Catarina and Bahia, Brazil

Os baiacus ou peixes-bola podem ser venenosos devido à presença em seus tecidos corporais de Tetrodotoxina e/ou Saxitoxina, ambas potentes neurotoxinas. Os autores relatam 27 envenenamentos por ingestão da carne de baiacus. Os pacientes foram atendidos nos Centros de Toxicologia de Santa Catarina e da Bahia de 1984 a 2009. Os acidentes foram classificados em moderados (52%) e graves (33%), havendo dois óbitos. O diagnóstico precoce é fundamental no sentido de garantir suporte ventilatório aos pacientes.

Envenenamento fatal por baiacu (Tetrodontidae): relato de um caso em criança

É descrito um envenenamento pela ingestão de vísceras de um baiacu-pintado (Sphoeroides testudineus) por uma criança de dois anos, que apresentou sudorese fria, fraqueza muscular progressiva, parada cardiorrespiratória e morte. São discutidos os riscos do consumo da carne e vísceras de baiacus, fato comum em certas regiões do Brasil.

5-AMINOLEVULINIC ACID-INDUCED ALTERATIONS OF OXIDATIVE-METABOLISM IN SEDENTARY AND EXERCISE-TRAINED RATS

5-Aminolevulinic acid (ALA), a heme precursor that accumulates in acute intermittent porphyria patients and lead-exposed individuals, has previously been shown to autoxidize with generation of reactive oxygen species and to cause in vitro oxidative damage to rat liver mitochondria. We now demonstrate that chronically ALA-treated rats (40 mg/kg body wt every 2 days for 15 days) exhibit decreased mitochondrial enzymatic activities (superoxide dismutase, citrate synthase) in liver and soleus (type I, red) and gastrocnemius (type IIb, white) muscle fibers. Previous adaptation of rats to endurance exercise, indicated by augmented (cytosolic) CuZn-superoxide dismutase (SOD) and (mitochondrial) Mn-SOD activities in several organs, does not protect the animals against liver and soleus mitochondrial damage promoted by intraperitoneal injections of ALA. This is suggested by loss of citrate synthase and Mn-SOD activities and elevation of serum lactate levels, concomitant to decreased glycogen content in soleus and the red portion of gastrocnemius (type IIa) fibers of both sedentary and swimming-trained ALA-treated rats. In parallel, the type IIb gastrocnemius fibers, which are known to obtain energy mainly by glycolysis, do not undergo these biochemical changes. Consistently, ALA-treated rats under swimming training reach fatigue significantly earlier than the control group. These results indicate that ALA may be an important prooxidant in vivo.

Ocorrência e flutuação populacional de ácaros associados a seringais vizinhos de fragmentos de cerrado

The basic knowledge of the seasonal occurrence of mites can supply data for elaboration of programs of ecological management to be implanted with success in the future. The objective of this study was to determine the species richness and the seasonality of mites present in two areas of rubber tree crops neighboring to native areas in Itiquira, MT. Along one year, 25 quantitative samplings were accomplished in rubber tree crop neighboring to two fragments of Cerrado (Cerradao and Mata Riparia). There were registered 199,380 mites, of 48 species, belonging to 15 families. of those, 13 species are phytophagous, 18 predators and 17 mycophagous or of unknown alimentary habit. Three phytophagous species represented more than 97% of the mites collected: Phyllocoptruta seringueirae Feres (80.8%), Tenuipalpus heveae Baker (12.7%) and Calacarus heveae Feres (3.6%). Among the predators, the most abundant species were Agistemus sp., Scirula sp. and Euseius concordis (Chant). Twenty-eight species were common to both crops. The families that had the largest number of species collected in the neighboring area to Cerradao were Tydeidae (7), Tarsonemidae (6), Eriophyidae and Phytoseiidae (4), and in the area close to Mata Riparia, Tydeidae (9) and Phytoseiidae (8). The presence of vegetation near the crop should explain the great number of species of mites classified as accidental found in this study. The largest abundances and species richness occurred in the end of the rainy season and beginning of the dry season.

Caries resistance of lased human enamel with Er : YAG laser - morphological and ratio Ca/P analysis

Objective: In vitro analysis of caries resistance of dental enamel under caries simulation after irradiation with Er:YAG laser. Background Data: More susceptible to caries development spots at adjacent hard tissues from cavity preparations of dental tissues using burrs or lasers are quite common. Methods: Thirteen caries-free third permanent human molars were distributed as follows: G1: sound control and caries control; G2: Er:YAG 100, 200, 300, or 400 mJ/ 10 Hz/ 3 sec.; G3: the same parameters of G2 followed by artificial caries simulation, through dynamic model of demineralization and remineralization (DE/RE). Caries resistance analysis was evaluated through scanning electron microscopy (SEM) and Ca/P rate (X-Rays spectroscopy - EDX). Results: Photomicrographs showed that the Er:YAG laser created craters with rough aspect which became more evident as the energy per pulse was increased, but without change of regular morphology of enamel prisms. Significant statistical changes among the irradiated and control groups was observed considering the Ca/P ratio. Conclusion: Irradiated groups showed higher caries resistance than control groups. However, it is not possible to affirm that the enamel surface accidental irradiation could be a benefit to caries resistance for other situations can be considered, as biofilm deposit, which could increase the caries susceptibility.

Comparative genomics of two Leptospira interrogans serovars reveals novel insights into physiology and pathogenesis

Leptospira species colonize a significant proportion of rodent populations worldwide and produce life-threatening infections in accidental hosts, including humans. Complete genome sequencing of Leptospira interrogans serovar Copenhageni and comparative analysis with the available Leptospira interrogans serovar Lai genome reveal that despite overall genetic similarity there are significant structural differences, including a large chromosomal inversion and extensive variation in the number and distribution of insertion sequence elements. Genome sequence analysis elucidates many of the novel aspects of leptospiral physiology relating to energy metabolism, oxygen tolerance, two-component signal transduction systems, and mechanisms of pathogenesis. A broad array of transcriptional regulation proteins and two new families of afimbrial adhesins which contribute to host tissue colonization in the early steps of infection were identified. Differences in genes involved in the biosynthesis of lipopolysaccharide 0 side chains between the Copenhageni and Lai serovars were identified, offering an important starting point for the elucidation of the organism's complex polysaccharide surface antigens. Differences in adhesins and in lipopolysaccharide might be associated with the adaptation of serovars Copenhageni and Lai to different animal hosts. Hundreds of genes encoding surface-exposed lipoproteins and transmembrane outer membrane proteins were identified as candidates for development of vaccines for the prevention of leptospirosis.

Enamel caries resistance accidentally irradiated by the Nd : YAG laser

When the carious tissue is eliminated either by conventional methods (with burs) or with lasers, the risk of accidentally damage the surface of adjacent teeth may occur, which hypothetically could lead to a more susceptible surface for canes formation. This in vitro study aims to evaluate the caries resistance of the dental enamel surface irradiated by the Nd:YAG laser applied in conditions simulating accidental exposition. Thirteen third molars were used in this study. The experimental groups were: G1: sound control and control + carious; G2: contact Nd:YAG laser at 0.75, 1, 2, or 3 W; 10 Hz; 3 sec (27, 35, 71, and 106 J/cm(2)); G3: same parameters from G2 + caries artificial induction through the demineralization and demineralization (DES/RE) dynamic model. The caries resistance analysis was evaluated by the superficial morphological aspect through SEM images and also by Ca/P proportion through energy dispersive X-ray spectroscopy (EDX). The micrograph images showed that the Nd:YAG laser changed the normalmorphology of the enamel prisms resulting in a melted and re-solidified surface intensified with the power increase. Significant statistical differences were observed applying the Kruskal-Wallis statistical test (p <= 0.01) among the Nd:YAG laser irradiated groups and the control with caries regarding the Ca/P proportion. As an exception, this was not observed when 3 W; 10 Hz; 3 sec; 106 J/cm(2) was applied and posteriously submitted to a cariogenic challenge. The results indicate that the Nd:YAG laser accidental irradiation at low power settings did not represent risks to the enamel caries resistance.

Occurrence of severe and moderate traumatic brain injury in patients attended in a Brazilian teaching hospital - Epidemiology and dosage of alcoholemy

This study aimed at observing aspects of epidemiology in order to investigate the use of alcohol in patients older than 18 with severe and moderate traumatic brain injury, which were attended in the Clinics Hospital of the University of Uberlandia. Positive alcoholemy was found in 39.3% of the patients. of the 33 positive exams alcoholemy was found higher than 60 mg/dL in 28 (84.6%). There was not significant relation between alcoholemy levels and trauma severity. The major prevalence occurred on Saturdays nights. The most frequent types of external causes were transportation accidents (64.74) followed by accidental falls (17.27%) and physical aggression (16.55%). 93.9% of the patients with positive alcoholemy were men aged 20-29. 24.2% of the ones with positive alcoholemy died yet no significant difference was found in the study of the ones with negative alcoholemy (n=51) (p=0.93); RR= 0.9; IC95%=0.40-2.08.

STOMACH CONTENTS ANALYSIS of WHITE MARLIN (TETRAPTURUS ALBIDUS) CAUGHT OFF SOUTHERN and SOUTHEASTERN BRAZIL: A BAYESIAN ANALYSIS.

This study proposes to ascertain the importance of each alimentary category in the Tetrapturus albidus diet composition, as well as to propose the use of the Bayesian approach for analysis of these data. The stomachs were collected during fishing cruises carried out by the Santos-SP longliner from July 2007 to June 2008. For Bayesian model formulation, each alimentary item was clustered in four food categories as: teleost, cephalopod, crustaceans, and others. To estimate the proportion of each food category, the multinomial model with Dirichlet conjugate prior distribution was used. After the stomach contents analysis, 133 food items were identified, which belonged to 9 taxa. The most important food category is constituted by cephalopod molluscs, followed by teleost fishes. The food category comprised of crustaceans presents a low contribution and in this case it could be considered to be an accidental food item. The Bayesian approach means a distinct view in relation to traditional methods, as it permits one to incorporate information obtained from the literature. It should be useful to analyse great top predators, which are usually caught in small numbers.

Viral infections in workers in hospital and research laboratory settings: a comparative review of infection modes and respective biosafety aspects

Objectives: To compare modes and sources of infection and clinical and biosafety aspects of accidental viral infections in hospital workers and research laboratory staff reported in scientific articles. Methods: PubMed, Google Scholar, ISI Web of Knowledge, Scirus, and Scielo were searched (to December 2008) for reports of accidental viral infections, written in English, Portuguese, Spanish, or German; the authors' personal file of scientific articles and references from the articles retrieved in the initial search were also used. Systematic review was carried out with inclusion criteria of presence of accidental viral infection's cases information, and exclusion criteria of absence of information about the viral etiology, and at least probable mode of infection.Results: One hundred and forty-one scientific articles were obtained, 66 of which were included in the analysis. For arboviruses, 84% of the laboratory infections had aerosol as the source; for alphaviruses alone, aerosol exposure accounted for 94% of accidental infections. of laboratory arboviral infections, 15.7% were acquired percutaneously, whereas 41.6% of hospital infections were percutaneous. For airborne viruses, 81% of the infections occurred in laboratories, with hantavirus the leading causative agent. Aerosol inhalation was implicated in 96% of lymphocytic choriomeningitis virus infections, 99% of hantavirus infections, and 50% of coxsackievirus infections, but infective droplet inhalation was the leading mode of infection for severe acute respiratory syndrome coronavirus and the mucocutaneous mode of infection was involved in the case of infection with influenza B. For blood-borne viruses, 92% of infections occurred in hospitals and 93% of these had percutaneous mode of infection, while among laboratory infections 77% were due to infective aerosol inhalation. Among blood-borne virus infections there were six cases of particular note: three cases of acute hepatitis following hepatitis C virus infection with a short period of incubation, one laboratory case of human immunodeficiency virus infection through aerosol inhalation, one case of hepatitis following hepatitis G virus infection, and one case of fulminant hepatitis with hepatitis B virus infection following exposure of the worker's conjunctiva to hepatitis B virus e antigen-negative patient saliva. of the 12 infections with viruses with preferential mucocutaneous transmission, seven occurred percutaneously, aerosol was implicated as a possible source of infection in two cases, and one atypical infection with Macacine herpesvirus 1 with fatal encephalitis as the outcome occurred through a louse bite. One outbreak of norovirus infection among hospital staff had as its probable mode of infection the ingestion of inocula spread in the environment by fomites.Conclusions: The currently accepted and practiced risk analysis of accidental viral infections based on the conventional dynamics of infection of the etiological agents is insufficient to cope with accidental viral infections in laboratories and to a lesser extent in hospitals, where unconventional modes of infection are less frequently present but still have relevant clinical and potential epidemiological consequences. Unconventional modes of infection, atypical clinical development, or extremely severe cases are frequently present together with high viral loads and high virulence of the agents manipulated in laboratories. In hospitals by contrast, the only possible association of atypical cases is with the individual resistance of the worker. Current standard precaution practices are insufficient to prevent most of the unconventional infections in hospitals analyzed in this study; it is recommended that special attention be given to flaviviruses in these settings. (C) 2011 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.