Gravimetric composition of the rejects coming from the segregation process of the municipal recyclable wastes.

Rejects from selective collection are municipal solid waste (MSW) not used for recycling and are, therefore, destined for the landfill in Brazil. Knowledge of the composition and generation of this waste is important for strategically planning public policies that minimize its generation and its negative environmental impacts. However, this portion of MSW is not very well known. Therefore, the aim of this study was to analyze the rejects from the sorting process of the selective waste collection in the municipality of Blumenau, in the State of Santa Catarina, southern Brazil. The studied rejects came from the largest cooperative in the city, and its composition was sorted into 17 categories of 101 samples over the course of one year, with a total of 3893 kg of analyzed rejects. The waste collected by the selective collection of the municipality was evaluated monthly to determine which part of this quantity became rejects and to determine the composition and seasonality of these rejects. The study found that 30.5% of the waste sorted by the cooperative was rejected. Among these rejects, the presence of materials that could be marketed by the cooperative was verified. Hazardous and/or legally prohibited waste were also identified, as were organics, construction and demolition waste, health care waste, electronics, textiles, footwear, batteries, and bulbs. Seasonal analysis indicated a concerning constant generation of health care waste. Aside from that, there was an increase in the generation of waste from electrical and electronic equipment (EEE) during the Christmas period, when a large part of the population discards their EEE. This information is important for the enforcement of the MSW management structure as well as for educational campaigns aimed at the correct separation of waste that should be sent for selective collection.

The diseases we cause: Iatrogenic illness in a department of internal medicine.

BACKGROUND: The aim of this study was to estimate the incidence, main causes, and risk factors of iatrogenic disease occurring in a department of internal medicine. METHODS: Over a 1-year period, physicians systematically filled out a 2-page questionnaire for all patients admitted to the ward. A database was created and the data were statistically analyzed. Patients undergoing immunosuppressive, chemo-, or radiation therapy were excluded. Missing data were completed by reviewing the patients' charts. The patients were then divided into two groups: those with and those without iatrogenic disease. The groups were compared using several parameters including gender, age, social features, days of hospitalization, associated illness, functional status, medical impression, prognosis, associated renal or liver function impairment, drugs taken daily, and outcome. In the group with iatrogenic disease, the type, severity, and predictability were also analyzed. RESULTS: Of the 879 patients admitted to the ward, 445 completed questionnaires and were included in the study. A total of 102 patients (22.9%) developed 121 iatrogenic events. Forty-four patients (43.1%) were admitted for iatrogenic illness, 10 (9.8%) developed life-threatening events, and in 3 (6.8%) it was the cause of death. Fifty-eight patients (56.8%) registered 77 episodes of iatrogenic disease during their hospital stay, 20 (19.6%) developed life-threatening events, and 9 (11.7%) died, 4 (5.2%) of an iatrogenic cause (nosocomial infections). Significant differences were found in 20 out of 26 parameters studied (p<0.005 for all cases; 95% confidence interval). Eighteen percent of all iatrogenic disease was severe, 61.9% predictable, 54.5% avoidable, and 59% drug-related, 80% of which was due to side effects or adverse reactions. Infection and metabolic and electrolyte disorders were the most frequent effects. CONCLUSIONS: It is possible to identify risk factors for iatrogenic events. Chronically ill elderly inpatients are the main target of iatrogenic events.

[Digital ulcers in systemic sclerosis: use of endotheline antagonists]. / Úlceras digitais na esclerodermia: papel dos antagonistas dos receptores da endotelina na terap êutica.

INTRODUCTION: Systemic sclerosis (SSc) is a systemic disease, characterized by fibrosis and vasculopathy, with variable internal organ involvement. Skin is very often involved, namely digital ulcers (DU), seldom treatment resistant, responsible for important functional limitation. The DU can evolve from sclerodactily with superficial ulcers, isquemic lesions, deep necrosis, gangrene, loss of tissue, and consequently, to finger amputation. METHODS: The authors describe the case of a 36 year old female patient, with SSc diagnosed 6 years previously, with skin, lung and gut manifestations. The patient showed uncontrolled Raynaud's phenomenon (RF), despite the adequate treatment using nifedidpine and general local warming measures, with progressively worsening DU and isquemia, especially in cold seasons. Bosentan, 62.5 mg twice daily was started, and a significant improvement in the peripheral isquemic lesions was achieved. The ulcers' healing was fast, the patient totally recovered function and regained quality of life, and no further lesions developed. CONCLUSION: The authors review the RF and DU in SSc, as well as the use of bosentan, an endotheline receptor antagonist, and its indications. Although it is not formally approved, the use of bosentan in SS has shown benefits in reducing the incidence of DU, and despite no influence in the healing process, this drug prevents the development of new lesions.

Rotavirus serotypes and electrophoretypes among children attending three paediatric hospitals in Belem, Brazil.

From March to September 1988 stool specimens of 101 hospitalized diarrhoeic infants and children, aged 1-24 months were examined by enzyme-linked immunosorbent assay (ELISA) for the presence of rotavirus antigen. This agent was found in 40 (40 per cent) of the 101 episodes of acute diarrhoea, and strains were both characterized by analysis of RNA in polyacrilamide gel and serotyped by ELISA using serotype-specific monoclonal antibodies. The highest frequency of rotavirus positivity was 80 per cent in the 16-18 month age group. All 11 (28 per cent) serotyped strains belonged to serotype 3 whereas absence of Vp7, the major outer capsid glycoprotein, did not allow serotyping in 29 (73 per cent) of the 40 rotavirus-positive specimens. Four distinct electrophoretypes were detected and the predominant one had the IbIIbIIIgIV a profile, accounting for 62 per cent of the classified strains. Unclear patterns did not allow us to determine the electrophoretype of six rotavirus strains. The clinical picture in study children was in general of moderate/severe nature.

USPIO-enhanced dynamic MRI: evaluation of normal and transplanted rat kidneys.

To evaluate first-pass renal perfusion with ultrasmall superparamagnetic iron oxide (USPIO) particles by MRI, 40 normal rats (20 Dark Agouti (DA) rats and 20 Brown Norway (BN) rats) and 16 transplanted rats (12 allografts and four isografts) were studied on day 4 post-transplantation with different USPIO doses (3.0-18.1 mg Fe/kg/body weight). All animals underwent 128 consecutive snapshot fast low-angle shot (FLASH) coronal dynamic studies in 43 s. In the normal rats, a larger maximum signal decrease (MSD) in the cortex and the outer medulla is observed with an increasing dose of USPIO particles (P < 0.01). No significant differences were observed between the right and left kidneys at all doses studied. Higher MSD, time of occurrence of MSD (tMSD), and wash-in slope appear with higher doses of USPIO particles. The dynamic curves for DA rats show similar shapes when compared to those for BN rats. In the transplanted rats, allograft kidneys show lower MSD, longer tMSD, and lower wash-in slope compared to those in the normal kidneys. Isograft kidneys show perfusion patterns similar to those of normal kidneys in the cortex and the outer medulla. Histopathology indicates acute vascular rejection in all allografts and normal kidney architecture in all isografts. The results clearly show good agreement between the renal graft perfusion measurements and histopathological changes associated with rejection. This work also introduces a new signal analysis methodology for the automatic detection of transplanted organ rejection. This method compares the dynamics of the intrarenal signal intensities for native and transplanted kidneys. A quantitative measurement to detect significant differences between these signals was developed, and showed that this technique exhibits good performance in identifying renal rejection.

The use of tissue expanders in extensive alopecias

The authors discuss the surgical approach in the treatment of alopecias using tissue expanders. Nine cases with extensive alopecias of varied etiologies are reported. Seven cases with good results using this technique are presented and complications observed in two cases are discussed, with the conclusion that this technique has a good indication in cases of extensive alopecia