Análise da hemoglobina glicada na expressão de risco cardiovascular e renal em população acompanhada na atenção primária

Indivíduos com hemoglobina glicada (HbA1c) &#8805;6,5% e níveis normais de glicemia têm maior risco de complicações relacionadas ao diabetes, em médio e longo prazo. Estas evidências foram importantes na recomendação de que HbA1c &#8805;6,5% fosse aceita como critério diagnóstico de diabetes. Diferenças raciais/ étnicas tem sido encontradas quanto aos níveis de HbA1c. Níveis elevados de HbA1c em indivíduos sem diabetes e com níveis normais de glicemia em jejum tem sido associados a alterações micro e macrovasculares, entre elas alterações da filtração glomerular. Diversos marcadores inflamatórios, em especial a MCP-1 (proteína quimiotática de macrófagos-1), estão envolvidos no mecanismo de lesão glomerular descrito em casos de nefropatia diabética No entanto, a HbA1C ainda não foi amplamente incorporada a rotina de diagnóstico e de acompanhamento na atenção primária brasileira. O objetivo deste estudo foi o de investigar a associação entre a alteração da HbA1c e da glicemia e fatores étnicos/ raciais e de risco cardiovascular e renal em adultos assistidos pelo Programa Médico de Família de Niterói, sem diagnóstico prévio de diabetes. Trata-se de um estudo transversal, onde foram reunidas informações de participantes do Estudo Cardio Metabólico Renal (CAMELIA), colhidas entre os meses de julho de 2006 a dezembro de 2007. Observou-se que o perfil de risco cardiovascular foi mais acentuado em indivíduos com alterações simultâneas da glicemia e da HbA1c. A alteração isolada da glicemia indicou ser condição de maior risco que a alteração isolada da HbA1c. Indivíduos com HbA1c &#8805; 6,5% eram em sua maioria mulheres de pele preta e apresentavam maiores níveis de LDL e creatinina sérica. Verificamos associação independente entre a alteração da HbA1c (&#8805; 5,7 e < 6,5% versus < 5,7%) e diminuição da taxa de filtração glomerular estimada. A HbA1c mostrou ser um marcador subclinico de alterações metabólicas em pacientes nao diabéticos e com glicemia de jejum < 126 mg/dL, em especial na população de mulheres e de indivíduos com a cor da pele preta. Os resultados apontam para a possibilidade de se utilizar a HbA1c como marcador de risco cardiovascular e renal visando propor estratégias de intervenção precoce e assim promover a prevenção de condições de agravos relacionados as alterações do metabolismo da glicose.

Evidências de necessidades de autocuidado de militares com hipertensão arterial sistêmica da Marinha do Brasil: contribuição da Enfermagem

Este estudo refere-se às evidências de necessidades de autocuidado de militares com hipertensão sistêmica da Marinha do Brasil. A hipertensão arterial é uma das doenças crônicas mais frequentes, de maior prevalência no mundo e a sua evolução leva a complicações que comprometem todos os sistemas orgânicos. Neste sentido o problema apresentado é: como se caracterizam as necessidades de autocuidado de militares hipertensos da Marinha do Brasil. Para tanto, o objetivo geral da pesquisa foi: Discutir as necessidades de cuidado no processo saúde/adoecimento do militar da Marinha do Brasil e os objetivos específicos: Descrever as características sociodemográficas e de autocuidado dos militares atendidos no ambulatório de cardiologia do HNMD; Identificar através dos depoimentos dos militares, as necessidades de autocuidado e; Propor estratégias de autocuidado em saúde aos militares. O referencial teórico utilizado foi o Modelo de Promoção de Saúde de Nola J Pender. Trata-se de um estudo misto de caráter exploratório e descritivo, realizado no ambulatório de Cardiologia do Hospital Naval Marcilio Dias, no município do Rio de Janeiro, no período de julho a agosto de 2014. Os sujeitos do estudo foram 20 militares hipertensos da Marinha do Brasil com idade acima dos 25 anos. Os dados foram coletados por meio de entrevista semiestruturada, em seguida, submetidos à análise de conteúdo de Bardin, emergindo três categorias e subcategorias assim denominadas: Primeira: Evidências de necessidades de autocuidado. Segunda: Identificação situacional da saúde dos militares com a subcategoria: A experiência do autocuidado para o militar com HAS. Terceira: Interesse pelo autocuidado com duas subcategorias: Interesse pelo aprendizado e Estratégias para o aprendizado do autocuidado. O perfil dos participantes caracterizou-se da seguinte maneira: Dos 20 militares, 19 são homens e 1 mulher, sendo 3 da ativa e 17 da reserva, a maioria são casados, idosos, de etnia parda e crença religiosa cristã, possuem ensino médio completo, com remuneração acima de 4 salários mínimos, residindo em local com saneamento básico. Quanto ao autocuidado referido pelos participantes: a maioria controla o uso de sal, ingesta hídrica adequada, utilizam alimentação balanceada, praticam algum tipo de exercício diário, a maioria referiu uso regular de anti-hipertensivos, e procura pelos serviços de saúde, quando necessário. Conclui-se que apesar do autocuidado referido, estes estão aquém às necessidades de saúde e não atendem às demandas de autocuidado necessária à manutenção da vida. Apesar de diversos fatores contribuírem para desmotivar os militares em relação ao autocuidado, eles apresentam interesse em aprender novas tecnologias de cuidar para adequação de sua saúde atual e melhora da qualidade de vida. Para atender às necessidades de autocuidado identificadas, sugere-se planejamento das ações estratégicas de promoção à saúde conjunta, com a equipe multiprofissional, instituindo a consulta de enfermagem, avaliação do autocuidado, prevenção dos fatores de risco e acompanhamento regular para análise das mudanças efetivas dos hábitos de vida saudáveis.

Harmful algal blooms in coastal waters: options for prevention, control and mitigation

This report is the product of a panel of experts in the science of blooms of unicellular marine algae which can cause mass mortalities in a variety of marine organisms and cause illness and even death in humans who consume contaminated seafood. These phenomena are collectively termed harmful algal blooms or HABs for short. As a counterpart to recent assessments of the priorities for scientific research to understand the causes and behavior of HABs, this assessment addressed the management options for reducing their incidence and extent (prevention), actions that can quell or contain blooms (control), and steps to reduce the losses of resources or economic values and minimize human health risks (mitigation). This assessment is limited to an appraisal of scientific understanding, but also reflects consideration of information and perspectives provided by regional experts, agency managers and user constituencies during three regional meetings. The panel convened these meetings during the latter half of 1996 to solicit information and opinions from scientific experts, agency managers and user constituencies in Texas, Washington, and Florida. The panel's assessment limited its attention to those HABs that result in neurotoxic shellfish poisoning, paralytic shellfish poisoning, brown tides, amnesic shellfish poisoning, and aquaculture fish kills. This covers most, but certainly not all, HAB problems in the U.S.

Ciguatera Fish Poisoning: treatment, prevention and management

Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world, and it causes substantial physical and functional impact. It produces a myriad of gastrointestinal, neurologic and/or cardiovascular symptoms which last days to weeks, or even months. Although there are reports of symptom amelioration with some interventions (e.g. IV mannitol), the appropriate treatment for CFP remains unclear to many physicians. We review the literature on the treatments for CFP, including randomized controlled studies and anecdotal reports. The article is intended to clarify treatment options, and provide information about management and prevention of CFP, for emergency room physicians, poison control information providers, other health care providers, and patients.

Phosphate treatment of frozen prawns. Pt. 1. Screening of various phosphates for prevention of drip loss

Various phosphates and their mixtures were screened for their efficiency of preventing drip loss in frozen prawns. The effectiveness of the phosphates decreased in the following order: Sodium tripolyphosphate — Sodium pyrophosphate — Sodium hexametaphosphate Sodium metaphosphate — Sodium dihydrogen phosphate; the last two being ineffective. Even though thaw drip loss was reduced by the above treatments the organoleptic quality of the thawed as well as cooked products was unsatisfactory, discoloration being the major defect. A solution of a mixture of 12% sodium tripolyphosphate and 8.6% sodium dihydrogen phosphate or 2% citric acid in water when used as dip prevented thaw drip loss, improved cooked yield and organoleptic quality without adversely affecting the biochemical characteristics. Commercial scale trials showed that the results are highly reproducible.

Blackening of canned prawn and its prevention

The paper gives an account of the types of blackening associated with canned prawn in brine and their control. It was found that blackening caused by iron sulphide could be controlled by maintaining proper titratable acidity of fill brine in cans. The paper also elaborates on the factors responsible for or governing this critical titratable acidity. In regard to copper sulphide blackening, control was found to be difficult by maintaining the acidity or by additives such as EDTA when the copper content in the material went above the critical level.

FATIGUE CRACK GROWTH - THE COMPLICATIONS.

A vast body of experimental data has been accumulated on the constant amplitude crack growth response of structural metals in moist laboratory air. Usually the data is presented as plots of crack growth rate, da/dN, against stress intensity range, DELTA K. In order to extrapolate this data to fatigue crack growth in more active or more inert environments, to crack growth under variable amplitude loading, or to crack growth under multi-axial or mixed mode loading, the mechanisms of crack advance and crack closure should be considered. This paper briefly reviews the crack closure phenomenon and discusses the dominant causes of accelerated and retarded growth under changes in environment or type of loading. It is argued that simple constant amplitude data is often surprisingly accurate when used to predict crack growth in more complex situations. However, there are some cases where constant amplitude data lead to dangerously non-conservative predictions of fatigue life.

Removal of fungus and prevention of fungal reinfestation in stored dry salted fish

A simple and effective method is described for converting dry fish products infested with fungus and red halophilic bacteria to acceptable ones. Washing, drying and then smearing with a mixture of 3% sodium propionate in dry, refined salt in a ratio of 1 part mixture: 10 parts dry fish resulted in the fish having a shelf life of 5 months.

Prevention of infestation by Dermestes maculatus Degeer in east African dried fish by solar treatment

East African sun-dried fish infested by Dermestes maculatus were exposed to tropical sunlight at ambient temperature and analysed for insect mortality and weight losses. Solar treatment for 6 to 8 lo was highly effective for one layer of split sun-dried fish and 100% insect mortality was toted, while pest species were still present in the four layer batch. Weight losses between 1.2% and 10.2% were recorded, the top layer suffering the highest loss. The high surface temperature of 60°C caused fish to become brittle and quality losses occurred. A reduction in length of exposure/temperature is probably a presupposition for application of the method to local conditions.

Prevention of infestation by Dermestes maculatus Degeer in east African dried fish using pyrethrum and piperonyl butoxide

East African sun-dried fish dipped for 4 seconds in different solutions of pyrethrum and piperonyl butoxide were analysed for insecticide residue limits. All analyses showed residues above the FAO/WHO MRL; exceeding factors of between 7.6 (22.9 ppm) and 1.6 (5.3 ppm) were found for pyrethrum while exceeding factors between 5.1 (102 ppm) and 1.7 (33.1 ppm) were common for piperonyl butoxide after 6 months storage at ambient temperature. All insecticide treated fish, regardless of dip concentration, were observed to be less susceptible to infestation by Dermestes maculatus than samples of untreated fish. No dry weight losses due to insect infestation were recorded, however moisture evaporation caused weight losses between 6 and 8% during the period. Further investigations showed that careful handling and a dip concentration more in accordance with FAO/WHO MRL than the commercial practice will reduce the cost of insecticides from K.sh. 0.72 to K.sh. 0.23 per kg pyrethrum treated fish.

Indigenous traditional technical knowledge of disease cure and prevention through fish consumption

Our knowledge regarding ethno-medico zoology is scanty and scattered. The present work is an endeavour to collect information on indigenous traditional knowledge (ITK) of disease cure through fish consumption, prepare a consolidated report on this aspect and to document our ITK so that in the long run after due verification (by Medical experts), such ITK can be patented. We also suggest for the recognition of the age old tribal medicine and establishment of a national research institute for tribal medicines at suitable place for the welfare of all the human beings.

Evaluation and comparison of ozone, hydrogen peroxide and physical treatment on fungal infection prevention and hatching rate of Iranian sturgeon (Acipenser persicus)

Ozone due to having low half-life and devoid of environmental harmful effects is recognized as one of the most effective disinfectant and fungicide in aquaculture. The objective of this study is to consider the effects of periodicay ozonation, hydrogen peroxide treatment, and physical treatment capability in hatching rate enhancement. Three concentrations of 0.05, 0.1 and 0.15 ppm ozone (10 min) and peroxide hydrogen with dose of 500 and 1000 ppm in two procedures accompanied with physical treatment and without physical treatment were examined on hatching rate. In the first year, Egg ozonation (0.1 ppm) with physical treatment have been resulted the greatest hatching rate (81.4%). In the second year, egg treatment with 1000 ppm hydrogen peroxide with physical treatment have been showed the greatest hatching rate (78%). Average hatching rate for the blank control treatment (without disinfectin and physical treatment) was 32.7%. From the economic viewpoint, 0.05 ppm ozone with physical treatment, due to considerable minimizing at consumption energy and ozonation system retention costs, indicated as the best treatment than other ozone treatments for fungal control. Very low correlation (r=-0.14) have been observed between hatchery water temperature and fungal infection percentage in control treatment.