RESUMO
Use of water for leisure activities has long been prevalent in human societies, especially where the climate is favorable. Water resources with appealing conditions for primary contact recreational activities include rivers, waterfall plunge pools, dams and lakes, as well as sea coasts. Recreational use has specific demands for water quality, particularly as regards risks to human health such as exposure to pathogenic organisms, toxic substances, and submerged hazards. In Brazil, there is insufficient monitoring of bathing water conditions and currently used methodology has some limitations particularly the lack of guidance on interpretation of variables other than faecal bacterial indicators. The objectives of this study were: (1) to establish variables contributing to assessment of freshwater bathing conditions in Brazil; (2) to develop an integrated index of suitability-for-use for bathing in Brazil; and (3) to improve the methodology for assessing bathing water quality in Brazil. Based on a metadata analysis and consultation with Brazilian water professionals, a water quality index was developed incorporating the variables: Escherichia coli, cyanobacterial density, turbidity (visual clarity) and pH. This index should advance the management of recreational waters in Brazil, by improving the evaluation of freshwater bathing conditions and protecting the health of frequent users.
Assuntos
Monitoramento Ambiental/métodos , Água Doce/análise , Água Doce/microbiologia , Qualidade da Água , Brasil , Cianobactérias/isolamento & purificação , Escherichia coli/isolamento & purificação , Água Doce/química , Humanos , Concentração de Íons de Hidrogênio , Nefelometria e TurbidimetriaRESUMO
Treatment of non-thyroidal illness by intravenous triiodothyronine (T3) after cardiac surgery causes a disproportional elevation of hormone levels. The administration of oral T3, which has never been studied in this context, could cause physiological hormone levels. The aim of this study was to test oral T3 for the prevention of T3 reduction during the postoperative period of valvular cardiac surgery in adults. Eighteen patients who underwent cardiac surgery for valvular disease with invasive hemodynamic monitoring were randomly assigned to 2 groups: the T group received oral T3 (N = 8), 25 microg three times/day, initiated 24 h before surgery and maintained for 48 h and the NT group (N = 10) received placebo. Serum T3, thyroxine and thyrotropin were determined at baseline, 1 h before surgery, within 30 min of cardiopulmonary bypass and 6, 12, 24, and 48 h after removal of the aortic cross-clamp. Baseline T3 was similar in both groups (T: 119 +/- 13; NT: 131 +/- 9 ng/dL). Serum T3 increased during the first 24 h in the T group compared to the NT group (232 +/- 18 vs 151 +/- 13 ng/dL; P < 0.001). In the NT group, T3 was reduced by 24% (P = 0.007) 6 h after removal of the aortic cross-clamp, confirming the non-thyroidal illness syndrome. There were no differences in clinical or hemodynamic parameters between groups. Administration of oral T3 prevented its serum reduction after valvular cardiac surgery in adults, with normal serum levels for 48 h without disproportional elevations.
Assuntos
Procedimentos Cirúrgicos Cardíacos , Síndromes do Eutireóideo Doente/prevenção & controle , Doenças das Valvas Cardíacas/cirurgia , Tri-Iodotironina/administração & dosagem , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica/métodosRESUMO
Treatment of non-thyroidal illness by intravenous triiodothyronine (T3) after cardiac surgery causes a disproportional elevation of hormone levels. The administration of oral T3, which has never been studied in this context, could cause physiological hormone levels. The aim of this study was to test oral T3 for the prevention of T3 reduction during the postoperative period of valvular cardiac surgery in adults. Eighteen patients who underwent cardiac surgery for valvular disease with invasive hemodynamic monitoring were randomly assigned to 2 groups: the T group received oral T3 (N = 8), 25 æg three times/day, initiated 24 h before surgery and maintained for 48 h and the NT group (N = 10) received placebo. Serum T3, thyroxine and thyrotropin were determined at baseline, 1 h before surgery, within 30 min of cardiopulmonary bypass and 6, 12, 24, and 48 h after removal of the aortic cross-clamp. Baseline T3 was similar in both groups (T: 119 ± 13; NT: 131 ± 9 ng/dL). Serum T3 increased during the first 24 h in the T group compared to the NT group (232 ± 18 vs 151 ± 13 ng/dL; P < 0.001). In the NT group, T3 was reduced by 24 percent (P = 0.007) 6 h after removal of the aortic cross-clamp, confirming the non-thyroidal illness syndrome. There were no differences in clinical or hemodynamic parameters between groups. Administration of oral T3 prevented its serum reduction after valvular cardiac surgery in adults, with normal serum levels for 48 h without disproportional elevations.