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OBJECTIVE: To evaluate the follow-up of children diagnosed with deafness in neonatal hearing screening and risk factors for hearing loss. METHODS: Quantitative, cross-sectional, and retrospective study to evaluate factors associated with hearing loss and the follow-up of cases of children diagnosed with audiological dysfunction, by analyzing electronic medical records of 5,305 children referred to a Specialized Center in Type I Rehabilitation, from January/2016 to February/2020, in the city of Manaus, Amazonas. The statistical study used Pearson's chi-square test and binary logistic regression in which odds ratio scans were obtained with reliability intervals of 95%. RESULTS: Of the 5,305 children referred for the otoacoustic emission retest, 366 (6.9%) failed the retest. Children diagnosed with sensorineural hearing loss continued in the study, totaling 265 (72.4%). Only 58 (21.9%) children continued in the study to its end, of these 39 had received hearing aids at that point; and 16 (41%) had surgical indication for cochlear implants, of which only 3 (18.7%) had undergone surgery. Among the risk factors for hearing loss, we found 2.6 times more chance of failure in the otoacoustic emissions retest in those children who had a family history of hearing loss and ICU stay. CONCLUSION: Although the screening flow reaches a large part of live births, the dropout rates during the process are high, therefore, the socioeconomic and geographic characteristics of regions such as the Amazon should be considered as relevant factors to the evasion of rehabilitation programs of these children. Hospitalization in the neonatal ICU and family history of hearing loss in the investigations could be identified as the main and most important factors for alteration of the otoacoustic emissions retests.

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Inhalation of xenobiotics during manufacture process in chrome plating bath produce hazards to workers' health. Chromium (Cr) is a metal widely used by industry, and its hexavalent (VI) form has been classified as mutagenic and carcinogenic. This study aimed to evaluate the occupational risk of exposure to metals in chrome plating workers. Biological monitoring was performed through quantification of Cr, Pb, As, Ni, and V in blood by ICP-MS in 50 male chrome-plating workers from the exposed group and 50 male non-exposed workers. The inflammatory parameters assessed were ß-2 integrin, intercellular adhesion molecule-1 (ICAM-1), and L-selectin expression in lymphocytes. The genotoxicity was evaluated with comet and micronucleus (MN) assays and as a biomarker of oxidative damage the lipid peroxidation (MDA) and protein carbonyl (PCO). The results demonstrated that Cr levels in blood and urine were increased in the exposed group compared to the non-exposed group. Although the biomarkers of exposure proved to be within the levels considered safe in exposed individuals, chrome plating workers presented significantly increase in the percentage of lymphocytes expressing ß-2 integrin, ICAM-1, and L-selectin as well as DNA damage (comet assay) and plasmatic MDA and PCO levels. Therefore, it is possible also assign the injuries caused to lipids, proteins, and DNA assessed due to the increased presence of other metals such as Pb, As, Ni, and V in exposed subjects. These results suggest that exposure to xenobiotics present in the occupational environment in chrome plating industry could play a crucial role toward the inflammation, genetic, and oxidative damage.

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ABSTRACT OBJECTIVE To evaluate the follow-up of children diagnosed with deafness in neonatal hearing screening and risk factors for hearing loss. METHODS Quantitative, cross-sectional, and retrospective study to evaluate factors associated with hearing loss and the follow-up of cases of children diagnosed with audiological dysfunction, by analyzing electronic medical records of 5,305 children referred to a Specialized Center in Type I Rehabilitation, from January/2016 to February/2020, in the city of Manaus, Amazonas. The statistical study used Pearson's chi-square test and binary logistic regression in which odds ratio scans were obtained with reliability intervals of 95%. RESULTS Of the 5,305 children referred for the otoacoustic emission retest, 366 (6.9%) failed the retest. Children diagnosed with sensorineural hearing loss continued in the study, totaling 265 (72.4%). Only 58 (21.9%) children continued in the study to its end, of these 39 had received hearing aids at that point; and 16 (41%) had surgical indication for cochlear implants, of which only 3 (18.7%) had undergone surgery. Among the risk factors for hearing loss, we found 2.6 times more chance of failure in the otoacoustic emissions retest in those children who had a family history of hearing loss and ICU stay. CONCLUSION Although the screening flow reaches a large part of live births, the dropout rates during the process are high, therefore, the socioeconomic and geographic characteristics of regions such as the Amazon should be considered as relevant factors to the evasion of rehabilitation programs of these children. Hospitalization in the neonatal ICU and family history of hearing loss in the investigations could be identified as the main and most important factors for alteration of the otoacoustic emissions retests.

RESUMO OBJETIVO Avaliar o seguimento das crianças com diagnóstico de surdez na triagem auditiva neonatal e fatores de risco para deficiência auditiva. MÉTODOS Estudo quantitativo, transversal e retrospectivo para avaliação de fatores associados à perda auditiva e o seguimento dos casos de crianças diagnosticadas com disfunção audiológica, por meio da análise de prontuários eletrônicos de 5.305 crianças encaminhadas a um Centro Especializado em Reabilitação Tipo I, no período de janeiro/2016 a fevereiro/2020, na cidade de Manaus, Amazonas. O estudo estatístico utilizou o teste qui-quadrado de Pearson e por regressão logística binária nos quais foram obtidos odds ratio com intervalos de confiabilidade de 95%. RESULTADOS Das 5.305 crianças encaminhadas para realização do reteste da orelhinha, 366 (6,9%) falharam no reteste. Prosseguiram no estudo as crianças com diagnóstico de perda auditiva neurossensorial, totalizando 265 (72,4%). Permanecendo, no final da pesquisa, apenas 58 (21,9%) crianças, destas 39 receberam aparelho auditivo até o presente estudo; e 16 (41%) já tinham indicação cirúrgica para implante coclear, sendo que apenas três (18,7%) haviam realizado a cirurgia. Dentre os fatores de risco para deficiência auditiva encontramos 2,6 vezes mais chance de falha no reteste da orelhinha naquelas crianças que tinham história familiar de perda auditiva e internação em UTI. CONCLUSÕES Embora o fluxo de triagem alcance boa parte dos nascidos vivos, as taxas de evasão durante o processo são altas, portanto, as características socioeconômicas e geográficas de regiões como a Amazônia devem ser consideradas como fatores relevantes à evasão dos programas de reabilitação dessas crianças. Foi possível identificar que a internação em UTI neonatal e o histórico familiar de perda auditiva presentes nas investigações compõem os principais e mais importantes fatores para alteração dos retestes da orelhinha.

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OBJECTIVE: Describe the sociodemographic profile of mothers of children with congenital Zika syndrome. METHODS: This is a descriptive, cross-sectional, quantitative study. The 39 mothers of live born babies among the cases notified in 2015 and 2016 with confirmed diagnosis of congenital Zika syndrome in the state of Espírito Santo, Brazil, were invited to participate. Of these, 25 mothers were enrolled. Data were collected using a socioeconomic questionnaire and a field diary. RESULTS: Skin color was self-reported as non-white by 19/25 mothers (74.0%), and 16 (64.0%) reported having a partner. Regarding schooling, 12 (48.0%) had completed high school. Per capita income varied from no income to US$ 1 111.11, and ranged from none to US$ 61.72 for 12 women (48.0%). Seventeen women (68.0%) lived in underprivileged periphery areas with poor living conditions. Of the 25 women, 16 (64.0%) had a job prior to the pregnancy; and of these, 12 (75.0%) were fired or quit after the baby was born. CONCLUSIONS: The profile of mothers shows that the Zika epidemics was not equanimous and preferentially affected women with low income and lower social class. In this sense, we believe that congenital Zika syndrome may be determined by social inequalities in Brazil. The data described in the present study may be useful for the planning of effective actions to ensure a social protection network for children with congenital Zika syndrome and their families.

OBJETIVO: Describir el perfil sociodemográfico de las madres de niños con síndrome congénito por el virus del Zika. MÉTODOS: Estudio descriptivo, transversal, de abordaje cuantitativo. Se invitó a participar en el estudio a 39 madres de niños nacidos vivos pertenecientes al grupo de casos notificados entre 2015 y 2016 con diagnóstico confirmado de síndrome congénito por el virus del Zika en el estado de Espírito Santo. De las 39 mujeres, 25 aceptaron participar. Para la recolección de datos se utilizó un formulario para identificar el perfil sociodemográfico y un diario de campo. RESULTADOS: Se identificaron 107 estudios. Al final del proceso de clasificación se incluyeron 18 artículos que presentaban datos sobre la asociación entre el péptido C y el riesgo cardiovascular. Cinco estudios proporcionaron datos sobre la relación entre el péptido C y la mortalidad cardiovascular y general. El péptido C presentó una asociación positiva con el índice de masa corporal en población china, y una asociación inversa con el colesterol HDL en muestras poblacionales de Asia, Oriente Medio y Estados Unidos. Sin embargo, no fue posible realizar un metanálisis para los componentes de riesgo cardiovascular. Por otro lado, el péptido C se asoció con la mortalidad cardiovascular (RR = 1,62, IC95%: 0,99 a 2,66) y general (RR = 1,39, IC95%: 1,04 a 1,84). CONCLUSIONES: De las 25 madres, 19 (74,0%) manifestaron no ser blancas y 16 (64,0%) tener una pareja. En cuanto a la escolaridad, 12 (48,0%) poseían eduación media completa. El ingreso domiciliario per cápita varió desde ningún ingreso hasta US$ 1 111,11; 12 mujeres (48,0%) reportaron desde no tener ingresos hasta un ingreso de US$ 61,72. En cuanto a la vivienda, 17 (68,0%) vivían en zonas periféricas con condiciones precarias. De las 25 mujeres, 16 (64,0%) presentaban vínculo laboral antes de la gestación, y de estas 12 (75,0%) fueron despedidas o renunciaron después del nacimiento del niño. Conclusiones. El perfil de las madres reveló que la epidemia no fue equitativa y alcanzó mayormente a mujeres de bajos ingresos y de estratos sociales desfavorecidos. En ese sentido, la enfermedad podría ser determinada por las desigualdades sociales de salud presentes en el país. Los datos encontrados son útiles para planificar acciones efectivas enfocadas a garantizar una red de protección social para niños con síndrome congénito por el virus del Zika y sus familias.

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[RESUMO]. Objetivo. Descrever o perfil sociodemográfico de mães de crianças com síndrome congênita do Zika. Métodos. Trata-se de um estudo descritivo, transversal, de abordagem quantitativa. Foram convidadas a participar todas as 39 mães de bebês nascidos vivos entre os casos notificados em 2015 e 2016 com diagnóstico confirmado de síndrome congênita do Zika no Estado da Saúde do Espírito Santo. Dessas 39 mulheres, 25 concordaram em participar. Para a coleta de dados foram utilizados um formulário para identificar o perfil sociodemográfico e um diário de campo. Resultados. Das 25 mães, 19 (74,0%) se declararam não brancas e 16 declararam (64,0%) possuir companheiro. Quanto à escolaridade, 12 (48,0%) possuíam ensino médio completo. A renda domiciliar per capita variou de nenhuma renda até US$ 1 111,11; 12 mulheres (48,0%) tinham entre nenhuma renda e renda de US$ 61,72. Quanto à moradia, 17 (68,0%) residiam em áreas de periferia com condições precárias. Das 25 mulheres, 16 (64,0%) apresentavam vínculo empregatício antes da gestação; e dessas 16 com vínculo, 12 (75,0%) foram demitidas ou pediram demissão após o nascimento do bebê. Conclusões. O perfil das mães revelou que a epidemia não foi equânime e atingiu preferencialmente mulheres de baixa renda e de estratos sociais desfavorecidos. Nesse sentido, acredita-se que a doença possa ser determinada pelas desigualdades sociais de saúde presentes no país. Os dados descritos podem fornecer subsídios para o planejamento de ações efetivas para garantir uma rede de proteção social para crianças com síndrome congênita do Zika e suas famílias.

[ABSTRACT]. Objective. Describe the sociodemographic profile of mothers of children with congenital Zika syndrome. Method. This is a descriptive, cross-sectional, quantitative study. The 39 mothers of live born babies among the cases notified in 2015 and 2016 with confirmed diagnosis of congenital Zika syndrome in the state of Espírito Santo, Brazil, were invited to participate. Of these, 25 mothers were enrolled. Data were collected using a socioeconomic questionnaire and a field diary. Results. Skin color was self-reported as non-white by 19/25 mothers (74.0%), and 16 (64.0%) reported having a partner. Regarding schooling, 12 (48.0%) had completed high school. Per capita income varied from no income to US$ 1 111.11, and ranged from none to US$ 61.72 for 12 women (48.0%). Seventeen women (68.0%) lived in underprivileged periphery areas with poor living conditions. Of the 25 women, 16 (64.0%) had a job prior to the pregnancy; and of these, 12 (75.0%) were fired or quit after the baby was born. Conclusions. The profile of mothers shows that the Zika epidemics was not equanimous and preferentially affected women with low income and lower social class. In this sense, we believe that congenital Zika syndrome may be determined by social inequalities in Brazil. The data described in the present study may be useful for the planning of effective actions to ensure a social protection network for children with congenital Zika syndrome and their families.

[RESUMEN]. Objetivo. Describir el perfil sociodemográfico de las madres de niños con síndrome congénito por el virus del Zika. Métodos. Estudio descriptivo, transversal, de abordaje cuantitativo. Se invitó a participar en el estudio a 39 madres de niños nacidos vivos pertenecientes al grupo de casos notificados entre 2015 y 2016 con diagnóstico confirmado de síndrome congénito por el virus del Zika en el estado de Espírito Santo. De las 39 mujeres, 25 aceptaron participar. Para la recolección de datos se utilizó un formulario para identificar el perfil sociodemográfico y un diario de campo. Resultados. De las 25 madres, 19 (74,0%) manifestaron no ser blancas y 16 (64,0%) tener una pareja. En cuanto a la escolaridad, 12 (48,0%) poseían eduación media completa. El ingreso domiciliario per cápita varió desde ningún ingreso hasta US$ 1 111,11; 12 mujeres (48,0%) reportaron desde no tener ingresos hasta un ingreso de US$ 61,72. En cuanto a la vivienda, 17 (68,0%) vivían en zonas periféricas con condiciones precarias. De las 25 mujeres, 16 (64,0%) presentaban vínculo laboral antes de la gestación, y de estas 12 (75,0%) fueron despedidas o renunciaron después del nacimiento del niño. Conclusiones. El perfil de las madres reveló que la epidemia no fue equitativa y alcanzó mayormente a mujeres de bajos ingresos y de estratos sociales desfavorecidos. En ese sentido, la enfermedad podría ser determinada por las desigualdades sociales de salud presentes en el país. Los datos encontrados son útiles para planificar acciones efectivas enfocadas a garantizar una red de protección social para niños con síndrome congénito por el virus del Zika y sus familias.

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Objetivo: compreender a percepção do enfermeiro sobre a relevância dos registros de Enfermagem na prestação da assistência ao cliente. Método: trata-se de estudo descritivo, exploratório de natureza qualitativa, que foi desenvolvido em um hospital do município do norte do estado do Espírito Santo. Participaram deste estudo sete enfermeiros. A coleta de dados se deu por meio de entrevista semiestruturada. Utilizou-se a análise de conteúdo. Resultados: foram organizados em categorias analíticas empíricas, a saber: definição e relevância dos registros de Enfermagem, dificuldades encontradas para a realização dos registros de Enfermagem e melhoria da qualidade dos registros de Enfermagem no cotidiano de trabalho. Observou-se que a Enfermagem se preocupa com o fazer, em detrimento aos registros sistemáticos de sua assistência. Conclusão: considerando que os registros de Enfermagem contribuem para a melhoria da qualidade da assistência, evidencia-se a necessidade de um acompanhamento mais rigoroso dos registros efetuados nos serviços de saúde. Destaca-se a necessidade de uma educação continuada no que concerne aos aspectos técnicos, éticos e legais dos registros de Enfermagem.(AU)

Objective: to understand the nurse's perception on the relevance of the Nursing records when providing customer care. Method: this is a descriptive and exploratory study of a qualitative nature, developed in a hospital in a municipality in the North of the state of Espírito Santo. Seven nurses participated in this study. Data was collected through semi-structured interviews. Content analysis was used. Results: the results were organized into empirical analytical categories, namely: definition and relevance of the Nursing records, difficulties encountered in the realization of the Nursing records and improvement of the quality of the Nursing records in daily work. It was observed that Nursing is concerned with the doing, to the detriment of the systematic records of its care. Conclusion: considering that Nursing records contribute to improve the quality of care, there is a need for a more rigorous monitoring of the records made in the health services. The need for continuing education regarding the technical, ethical and legal aspects of Nursing records is highlighted.(AU)

Objetivo: comprender la percepción de los enfermeros sobre la relevancia de los registros de enfermería en la atención al cliente. Método: estudio descriptivo, exploratorio de naturaleza cualitativa, llevdo a cabo en un hospital del norte del estado de Espírito Santo. Siete enfermeros participaron en este estudio. Los datos fueron recogidos a través de entrevistas semiestructuradas. Se utilizó el análisis de contenido. Resultados: se organizaron en categorías analíticas empíricas, a saber: definición y relevancia de los registros de enfermería, dificultades encontradas en la realización de los registros de enfermería y mejora de la calidad de los registros de enfermería en el trabajo diario. Se observó que la enfermería se preocupa por ejecutar tareas, perjudicando los registros sistemáticos de las mismas. Conclusión: teniendo en cuenta que los registros de enfermería contribuyen a mejorar la calidad de la atención, existe la necesidad del seguimiento más riguroso de los registros realizados en los servicios de salud. Destacamos la necesidad de la educación continua en lo referente a los aspectos técnicos, éticos y legales de los registros de enfermería.(AU)

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The most commonly used solution in chrome plating bath is chromic acid (hexavalent Cr), and a considerable amount of mists is released into the air and consequently produce hazards to workers. Thus, the aim of this study was to evaluate whether the biomarker of exposure to metals, specially Cr levels, presents associations with hematological and biochemical parameters and if they can alter the activity of enzymes that contain thiol groups such as pyruvate kinase, creatine kinase, adenylate kinase, and δ-aminolevulinate dehydratase. Fifty male chrome plating workers were used for exposed group and 50 male non-exposed workers for control group. For that, biological monitoring was performed through quantification of metals on total blood and urine by inductively coupled plasma mass spectrometry (ICP-MS) and enzyme activity was performed by spectrometry in erythrocytes. In addition, chromium levels in water was quantified and ecotoxicology assay was performed with Allium cepa test. The results demonstrated that blood and urinary chromium levels in exposed group were higher than the control group (p < 0.0001). Furthermore, decreased activity of enzymes was found in those that contain thiol groups from exposed group when compared with the control group (p < 0.001). The water analysis did not present a statistical difference between control and exposed groups (p > 0.05), demonstrating that water did not seem to be the source of contamination. In summary, our findings indicated some toxicology effects observed in the exposed group, such as thiol enzyme inhibition, mainly associated with occupational exposure in chrome plating and besides the presence of other metals, and Cr demonstrated to influence the activity of the enzymes analyzed in this research.

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Bancos de alimentos (BA) atuam no recebimento de alimentos considerados impróprios à comercialização, mas que são adequados ao consumo humano. Neste estudo foram avaliadas as práticas higiênicas em um BA, objetivando a construção de um manual que orientasse os colaboradores acerca das boas práticas de manipulação (BPM). Trata-se de um estudo transversal, no qual a amostra foi um BA localizado no município de Belo Horizonte. O levantamento dos dados primários deu-se por meio de um instrumento de coleta de dados - checklist. Os resultados mostraram que a higiene ambiental é o quesito com a menor porcentagem de conformidades, seguido da higiene pessoal e por último a higiene operacional. Concluiu-se que a capacitação de manipuladores de alimentos e a implementação do manual de BPM desenvolvido neste estudo promoveu a conscientização dos manipuladores de alimentos, otimizando a aplicação das BPM além de contribuir para manutenção da qualidade dos alimentos que são distribuídos à população.(AU)

Food banks (FB) act in the receipt of food considered improper to the commercialization, but that are adapted to the human consumption. This study evaluated the food handling practices in a FB, aiming at the construction of a manual to guide employees about good practices of handling (GMP). It is a crosssectional study, in which the sample was a BA located in the city of Belo Horizonte. The primary data were collected through a data collection instrument - checklist. The results showed that environmental hygiene is the item with the lowest percentage of conformities, followed by personal hygiene and finally operational hygiene. It was concluded that the training of food handlers and the implementation of the GMP manual developed in this study promoted the awareness of food handlers, optimizing the application of GMP and contributing to the maintenance of the quality of food distributed to the population.

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O "ciúme" frequentemente é associado, na literatura, à violência contra a mulher cometida por seus parceiros, supondo-se uma relação causal entre ambos. Partindo do enfoque da Análise do Comportamento, buscou-se investigar se existe relação entre esses comportamentos ("ciúme" e violência) por meio dos relatos de 10 mulheres, abrigadas em uma instituição de proteção a vítimas de violência, que consideravam seus parceiros ciumentos. Criaram-se categorias de análise para as definições de "ciúme" e para os antecedentes às respostas emocionais ciumentas, além da elaboração de relações de contingências tríplices para cada exemplo de "ciúme" fornecido pelas participantes. Todas as participantes entrevistadas relataram comportamentos violentos do parceiro ao descrever uma situação de "ciúme" e todas citaram a suspeita de envolvimento com outra pessoa como situação antecedente ao "ciúme". As análises levaram a propor uma forma diferente de tratar a relação entre "ciúme" e violência, considerando os comportamentos agressivos dos parceiros como um tipo (topografia) de "ciúme".(AU)

"Jealousy" is often associated in literature to violence against women perpetrated by their partners, presuming a causal relationship between them. Based on Behavior Analysis, a possible relation between these behaviors ("jealousy" and violence) was investigated through reports of 10 women sheltered in an institution of protection of violence victims who considered their partners jealous. Categories of analysis for the definitions of "jealousy" and the antecedents to the jealousy emotional responses were created, and contingency relations for each example of "jealousy" provided by the participants were drafted. One hundred percent of participants reported partner's violent behavior when describing a situation of "jealousy" and all cited the suspicion of involvement with another person as antecedent to "jealousy". The analysis led to the proposal of a different way of dealing with the relationship between "jealousy" and violence, considering the aggressive behavior of partners as a type (topography) of "jealousy".(AU)

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O "ciúme" frequentemente é associado, na literatura, à violência contra a mulher cometida por seus parceiros, supondo-se uma relação causal entre ambos. Partindo do enfoque da Análise do Comportamento, buscou-se investigar se existe relação entre esses comportamentos ("ciúme" e violência) por meio dos relatos de 10 mulheres, abrigadas em uma instituição de proteção a vítimas de violência, que consideravam seus parceiros ciumentos. Criaram-se categorias de análise para as definições de "ciúme" e para os antecedentes às respostas emocionais ciumentas, além da elaboração de relações de contingências tríplices para cada exemplo de "ciúme" fornecido pelas participantes. Todas as participantes entrevistadas relataram comportamentos violentos do parceiro ao descrever uma situação de "ciúme" e todas citaram a suspeita de envolvimento com outra pessoa como situação antecedente ao "ciúme". As análises levaram a propor uma forma diferente de tratar a relação entre "ciúme" e violência, considerando os comportamentos agressivos dos parceiros como um tipo (topografia) de "ciúme"...

"Jealousy" is often associated in literature to violence against women perpetrated by their partners, presuming a causal relationship between them. Based on Behavior Analysis, a possible relation between these behaviors ("jealousy" and violence) was investigated through reports of 10 women sheltered in an institution of protection of violence victims who considered their partners jealous. Categories of analysis for the definitions of "jealousy" and the antecedents to the jealousy emotional responses were created, and contingency relations for each example of "jealousy" provided by the participants were drafted. One hundred percent of participants reported partner's violent behavior when describing a situation of "jealousy" and all cited the suspicion of involvement with another person as antecedent to "jealousy". The analysis led to the proposal of a different way of dealing with the relationship between "jealousy" and violence, considering the aggressive behavior of partners as a type (topography) of "jealousy"...

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Lead (Pb(2+)) is a heavy metal that has long been used by humans for a wide range of technological purposes, which is the main reason for its current widespread distribution. Pb(2+) is thought to enter erythrocytes through anion exchange and to remain in the cell by binding to thiol groups. Pyruvate kinase (PK) is a thiol-containing enzyme that plays a key role in erythrocyte cellular energy homeostasis. δ-aminolevulinic acid dehydratase (δ-ALAD) is the second enzyme in the heme biosynthetic pathway and plays a role in the pathogenesis of Pb poisoning. Our primary objective was to investigate the effect of Pb(2+) on the activity of the thiolenzymes δ-ALAD and PK and on the concentration of glutathione (GSH), a nonenzymatic antioxidant defense, in erythrocytes from Pb-exposed workers. The study sample comprised 22 male Pb workers and 21 normal volunteers (15 men and 6 women). The Pb-exposed workers were employed in manufacturing and recycling of automotive batteries. Basic red-cell parameters were assayed and total white blood cell counts performed. PK and δ-ALAD activity and blood Pb (BPb) concentrations were determined in all subjects. Pb-exposed individuals had significantly greater BPb levels than controls. Both PK and δ-ALAD activity levels were significantly lower in Pb-exposed individuals than in controls. Pb significantly inhibited PK and δ-ALAD activity in a dose-dependent manner. We found that erythrocyte GSH levels were lower in Pb-exposed individuals than normal volunteers. Pb-exposed individuals had lower values than controls for several red cell parameters (hemoglobin, hematocrit, red blood cell count, mean corpuscular volume). These results suggest that Pb inhibits δ-ALAD and PK activity by interacting with their thiol groups. It is therefore possible that Pb disrupts energy homeostasis and may be linked with decreased glucose metabolism because it affects the heme synthesis pathway in erythrocytes, contributing to the cell dysfunction observed in these in Pb-exposed individuals. These results indicate an apparent dose-effect relationship between PK activity and BPb. PK activity in human erythrocytes can be used for biological monitoring of Pb exposure. Study of the mechanisms by which Pb acts may contribute to greater understanding of the symptoms caused by Pb.

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