RESUMO
The goal of the present study was to propose a set of preliminary regional diagnostic reference levels (DRLs) for pediatric interventional cardiology (IC) procedures in Latin America and the Caribbean countries, classified by age and weight groups. The study was conducted in the framework of the Optimization of Protection in Pediatric Interventional Radiology in Latin America and the Caribbean program coordinated by the World Health Organization and the Pan American Health Organization in cooperation with the International Atomic Energy Agency. The first step of the program was focused on pediatric IC. Dose data from diagnostic and therapeutic procedures were collected between December 2020 and December 2021. Regional DRLs were set as the third quartile of patient dose data (kerma area product) collected in 18 hospitals from 10 countries in an initial sample of 968 procedures. DRLs were set for four age bands and five weight ranges. The values obtained for the four age bands (<1 yr, 1 to <5 yr, 5 to <10 yr and 10 to <16 yr) were 2.9, 6.1, 8.8 and 14.4 Gy cm2for diagnostic procedures, and 4.0, 5.0, 10.0 and 38.1 Gy cm2for therapeutic procedures, respectively. The values obtained for the five weight bands (<5 kg, 5 to <15 kg, 15 to <30 kg, 30 to <50 kg and 50 to <80 kg) were 3.0, 4.5, 8.1, 9.2 and 26.8 Gy cm2for diagnostic procedures and 3.7, 4,3, 7.3, 16.1 and 53.4 Gy cm2for therapeutic procedures, respectively. While initial data were collected manually as patient dose management systems (DMSs) were not available in most of the hospitals involved in the program, a centralized automatic DMS for the collection and management of patient dose indicators has now been introduced and is envisaged to increase the sample size. The possibility of alerting on high dose values and introducing corrective actions will help in optimization.
Assuntos
Cardiologia , Níveis de Referência de Diagnóstico , Cardiologia/métodos , Criança , Fluoroscopia , Humanos , América Latina , Doses de Radiação , Radiografia Intervencionista/métodos , Radiologia Intervencionista , Valores de ReferênciaRESUMO
BACKGROUND: Bone and joint infections (BJI) are relatively common in children, and community -acquired methicillin resistant Staphylococcus aureus (CA-MRSA) is the leading cause in some countries. AIM: To evaluate epidemiological data, clinical and microbiological features and outcome of BJI. METHODS: A prospective descriptive study was conducted. RESULTS: 40 patients (p) completed the study. Bacterial cultures were positives in 30 p (75%): CA-MRSA was found in 19 p, methicillin-sensitive S. aureus in 6 p, and others in 5 p. Cultures were negatives in 10 p (25%). Median treatment duration was 28 days (r: 21-40 d); Analyzing patients with CA-MRSA positive cultures separately, initial CRP was higher (Md 76 vs 50 mg/L, p < 0.02), normalization occurred later (Md 14 days vs 7days, p < 0.03), and duration of treatment (Md 32 days vs 23, p < 0.004) as well as hospital stay (Md 9 days vs 7, p = 0.12) were longer. Sequelae were present in 3 p and 1 relapsed: All of them with CA-SAMR. CONCLUSION: CA-MRSA was the leading cause of BJI and was associated with higher CRP on admission, later normalization and longer treatment duration. Complications as drainage requirement, and sequelae were common in those p.
Assuntos
Antibacterianos/uso terapêutico , Artrite Infecciosa/microbiologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Osteomielite/microbiologia , Infecções Estafilocócicas/microbiologia , Adolescente , Antibacterianos/farmacologia , Artrite Infecciosa/tratamento farmacológico , Criança , Pré-Escolar , Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecções Comunitárias Adquiridas/microbiologia , Feminino , Humanos , Lactente , Masculino , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Testes de Sensibilidade Microbiana , Osteomielite/tratamento farmacológico , Estudos Prospectivos , Infecções Estafilocócicas/tratamento farmacológicoRESUMO
A simple and rapid headspace solid-phase microextraction (HS SPME) based method is presented for the determination of Persistent Organic Pollutants (POPs) in human serum by gas chromatography (GC) coupled to mass detector (MS) with electron impact ionization (EI). As an outcome of the assessment of several polymer phases; the one with the best result was the PDMS fiber (100 µm). A multivariate analysis of variance by permutations (PERMANOVA) was performed to establish the optimal extraction conditions as a function of temperature and time variables. The results were 1 mL serum+200 µL H2SO4 9M+1 mL of deionized water at 600 rpm with a temperature of 80°C for 50 min to expose the fiber. The limits of detection (LOD) for POPs pesticides fell within the 0.22-5.41 ng/mL interval, and within 0.07-1.79 ng/mL for PCBs; a linear method was used with correlation coefficients (r) higher than 0.99. Recovery percentages at low concentrations (15 ng/mL) were 67.8-120.2%, and at high concentrations (75 ng/mL) 80.2-119.2%. Evaluated precision as percentage Relative Standard Deviation (RSD%) of repeatability and reproducibility was within a range of 0.5-9% and 0.3-21%, respectively. This analytical method prevents some of the main problems for quantifying POPs in human serum, such as the elimination of the solvents, sample handling, integration of extraction steps, pre-concentration and introduction of samples; consequently, the time and cost of analyzing the sample can be significantly reduced. The method developed was applied to determine exposure to POPs in samples of children living in different polluted sites in Mexico. In children living in indigenous communities results show exposure to DDE (median 29.2 ng/mL range 17.4-52.2 ng/mL) and HCB (median 2.53 ng/mL range 2.50-2.64 ng/mL); whereas in the industrial scenario, exposure to HCB (median 2.81 ng/mL range 2.61-3.4 ng/mL) and PCBs (median Σ-PCBs 22.2 ng/ml range 8.2-74.6 ng/mL) and finally in petrochemical scenario was demonstrated exposure to HCB (median 2.81 ng/mL range 2.61-3.4 ng/mL) and PCBs (Σ-PCBs median 7.9 ng/mL range 5.4-114.5 ng/mL).
Assuntos
Poluentes Ambientais/análise , Cromatografia Gasosa-Espectrometria de Massas/métodos , Praguicidas/análise , Microextração em Fase Sólida/métodos , Criança , Monitoramento Ambiental/métodos , Poluentes Ambientais/sangue , Humanos , Análise Multivariada , Compostos Orgânicos/análise , Compostos Orgânicos/sangue , Praguicidas/sangue , Bifenilos Policlorados/análise , Reprodutibilidade dos Testes , Fatores de TempoRESUMO
Humans may be exposed to arsenic (As) and fluoride (F) through water consumption. However, the interaction between these two elements and gene expression in apoptosis or inflammatory processes in children has not been thoroughly investigated. Herein, the expression of cIAP-1, XIAP, TNF-α, ENA-78, survivin, CD25, and CD40 was evaluated by RT-PCR. Additionally, the surface expression of CD25, CD40, and CD40L on peripheral blood mononuclear cells was analyzed by flow cytometry, and TNF-α was measured by Western blotting. This study examined 72 children aged 6-12 years who were chronically exposed to As (154.2µg/L) and F (5.3mg/L) in drinking water and in food cooked with the same water. The urine concentrations of As (6.9-122.4µg/L) were positively correlated with the urine concentrations of F (1.0-8.8mg/L) (r(2)=0.413, p<0.0001). The CD25 gene expression levels and urine concentrations of As and F were negatively correlated, though the CD40 expression levels were negatively correlated only with the As concentration. Age and height influenced the expression of cIAP-1, whereas XIAP expression was correlated only with age. Additionally, there was a lower percentage of CD25- and CD40-positive cells in the group of 6- to 8-year-old children exposed to the highest concentrations of both As and F when compared to the 9- to 12-year-old group (CD25: 0.7±0.8 vs. 1.1±0.9, p<0.0014; CD40: 16.0±7.0 vs. 21.8±5.8, p<0.0003). PHA-stimulated lymphocytes did not show any changes in the induction of CD25, CD69, or CD95. In summary, high concentrations of As and F alter the expression patterns of CD25 and CD40 at both the genetic and protein levels. These changes could decrease immune responses in children exposed to As and F.
Assuntos
Apoptose/efeitos dos fármacos , Arsênio/toxicidade , Exposição Ambiental , Fluoretos/toxicidade , Expressão Gênica/efeitos dos fármacos , Imunidade Ativa/efeitos dos fármacos , Leucócitos Mononucleares/efeitos dos fármacos , Poluentes Químicos da Água/toxicidade , Apoptose/genética , Proteínas Reguladoras de Apoptose/genética , Proteínas Reguladoras de Apoptose/metabolismo , Arsênio/urina , Criança , Feminino , Fluoretos/urina , Humanos , Inflamação/genética , Inflamação/metabolismo , Leucócitos Mononucleares/metabolismo , Ativação Linfocitária/efeitos dos fármacos , Masculino , Fator de Necrose Tumoral alfa/genética , Fator de Necrose Tumoral alfa/metabolismo , Poluentes Químicos da Água/urinaRESUMO
The aim of this study was to develop a methodology for identifying and quantifying Fipronil and its degradation products in soil by gas chromatography-electron capture detector previously extracted using a focused ultrasound probe. This methodology was obtaining a range of recovery between 85% and 120%, decreasing approximately solvent used time and cost, respect to other methodologies such as bath ultrasonic, solid-phase extraction, liquid-liquid extraction and soxhlet. The method was validated in fortified matrix, presented linearity in the range of 25-400 µg kg(-1), and limit of detection for Fipronil and their products desulfinyl, sulfide and sulfone was 14.7, 9.8, 8.9 and 10.7 µg kg(-1), respectively. This process was applied to samples of agricultural soils, where two degradation products desulfinyl and sulfone were found.
Assuntos
Monitoramento Ambiental/métodos , Inseticidas/análise , Pirazóis/análise , Poluentes do Solo/análise , Agricultura , Inseticidas/química , Pirazóis/química , Solo/química , Poluentes do Solo/químicaRESUMO
The frequency of alleles, intragenic (intron 18) and extragenic (DXS52) Bcl I RFLPs was investigated in a sample of the Mexican population. Altogether 33 X chromosomes at R8c locus and 30 at DXS52 locus were studied. The allele frequencies found at the F8c locus were similar to those reported in the majority of other populations. The observed heterozygosity for the intragenic and extragenic markers were 0.57 and 0.64, respectively. By using these two RFLPs 15 females at risk in five independent families with hemophilia A were investigated; ten of them could be identified and five excluded as carriers.
Assuntos
Triagem de Portadores Genéticos , Hemofilia A/genética , Alelos , Feminino , Frequência do Gene , Hemofilia A/epidemiologia , Humanos , Masculino , México/epidemiologia , Linhagem , Polimorfismo de Fragmento de RestriçãoRESUMO
Nesse trabalho sao apresentados os resultados de levantamentos de enteroparasitoses realizados no Municipio de Campo Florido (MG), em areas que apresentam diferentes condicoes sanitarias, e os obtidos em amostras de individuos portadores de ancilostomideos, submetidos a tratamento especifico e a educacao sanitaria
Assuntos
Humanos , Masculino , Feminino , Ancilostomíase , Helmintíase , Infecções por Protozoários , Brasil , Inquéritos EpidemiológicosRESUMO
Säo descritos 15 casos de transplante renal, nos quais foi utilizada a técnica de ureteroneocistostomia externa. Os resultados säo analisados e comparados com a literatura. Houve um caso de estenose da metade distal de ureter, que foi submetido a ureteropielostomia, e um caso de fístula ureteral. Nos demais casos, o seguimento clínico e o controle, atravé de urografia excretora e uretrocistografia miccional, demonstram ausência de fístula e refluxo vésico-ureteral, assim como uma boa permeabilidade na anastomose. Säo ressaltadas as vantagens da utilizaçäo desta técnica: facilidade de execuçäo, pouco tempo de permanência da sonda vesical no pós-operatório e a sua realizaçäo sem abertura da bexiga
Assuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Cistostomia , Ureter/cirurgia , Bexiga Urinária/cirurgia , Transplante de RimRESUMO
Os autores apresentam uma nova maneira de colocaçäo do molde ureteral, sem utilizar a nefrostomia na pieloplastia desmembrada. Um cateter ureteral, com múltiplas perfuraçöes, é deixado desde o bacinete até a bexiga. Um fio de nylon transfixa o cateter na porçäo intrapiélica, penetra através da parênquima renal e é exteriorizado através da pele, onde é amarrado. Isto permite que se tenha um molde ureteral sem nefrostomia e sem exteriorizaçäo do cateter através da pele e, portanto, com menos risco de infecçäo. Säo apresentados os resultados de seis casos operados
Assuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Moldes Cirúrgicos/normas , Cirurgia Plástica/métodos , Hidronefrose/terapia , Pelve Renal/cirurgia , Cateterismo Urinário , UreterRESUMO
The results of a parasitological survey, emphasizing particularly schistosomiasis mansoni, are presented. The area under study was the district of Cajati, situated in the "município" of Jacupiranga (State of São Paulo, Brazil) near schistosomiasis-endemic areas in Vale do Ribeira. Though the presence of parasitized people by Schistosoma mansoni has been reported and focuses of Biomphalaria tenagophila, the species responsible for the spreading of the parasites through great areas of the state, has been localized, it has not been reported any autochthonous case nor the presence of schistosoma-infected planorbidian snails. As a contribution to the planorbidical chart of the State, it is reported as original the discovery of the species Drepanotrema cimex and D. depressissimum in that area. The detection of antitoxoplasmic antibodies in a sample of the studied population showed a significant prevalence rate corresponding to 76,4%.