Higher plasma lipopolysaccharide concentrations are associated with less favorable phenotype in overweight/obese men.

PURPOSE: Lipopolysaccharide (LPS) from the outer membrane of gram-negative bacteria might be an inflammation trigger in adipose tissue. It has recently been proposed that there is a link between adipose tissue distribution and blood LPS. However, the number of studies on this topic is scarce, and further investigation in humans is required. In this study, we explored the association between plasma LPS concentrations and body fat distribution, as well as the biochemical parameters that may indicate the presence of metabolic disorders. METHODS: Sixty-seven young adult men with body mass index of 26-35 kg/m(2) were evaluated. Anthropometry, body composition and body fat distribution, blood pressure, energy expenditure, physical activity level, dietary intake, and biochemical parameters were assessed. RESULTS: Men with median plasma LPS ≥ 0.9 EU/mL presented higher sagittal abdominal diameter, trunk fat percentage, and android fat percentage, and mass, insulin and alanine aminotransferase concentrations, homeostasis model assessment of insulin resistance (HOMA-IR), and beta cell dysfunction (HOMA-B) than those with lower plasma LPS. LPS correlated positively with the trunk fat percentage, and android fat percentage, and mass, insulin, aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase concentrations, as well as HOMA-IR and HOMA-B. CONCLUSION: Our results suggest that a higher plasma LPS concentration is associated with a less favorable phenotype as characterized by higher central adiposity, higher values of HOMA-IR, and beta cell function impairment in overweight/obese men.

Ventilator-associated pneumonia risk factors in patients with severe COVID-19 in southern Brazil: A retrospective observational study.

BACKGOUND: During the SARS-CoV-2 pandemic, a significant number of critical patients required ventilatory assistance in health institutions. In this context, Ventilator-Associated Pneumonia (VAP) was the most prevalent nosocomial infection among critically ill patients. We aimed to analyze the occurrence of VAP in critically ill patients with SARS-CoV-2 and the risk factors associated with the outcome. METHOD: This is a multicenter, retrospective cohort study which included patients ≥18 years old, diagnosed with COVID-19, admitted to intensive care units (ICU) and who received invasive mechanical ventilation (MV) for >2 consecutive days. The associations between the variables were initially tested, and those that showed potential associations (p<0.05) were included in the multivariate logistic regression model. RESULTS: One third of patients had an episode of VAP, with an incidence density of 34.97 cases per 1000 MV days. In addition, 42.37% (50) of the microorganisms causing VAP were multidrug-resistant, predominantly gram-negative bacteria (61.32%). More than 50% of participants developed healthcare-associated infections and 243 (73.64%) died. The factors associated with greater chances of VAP were: prone position (OR= 3.77), BMI 25-29.9 kg/m2 (OR= 4.76), pressure injury (OR= 4.41), length of stay in the ICU (OR= 1.06), positive tracheal aspirate before VAP (OR= 5.41) and dyspnea (OR= 3.80). CONCLUSIONS: Patients with COVID-19 are at high risk of VAP, which leads to an increased risk of death (OR = 2.18). Multiple factors increase the chances of VAP in this population, namely: work overload in health institutions, prone position, prolonged ICU time, infusion of multiple drugs, invasive devices, and in particular, immobility in bed.

Pulmonary and Renal Toxoplasmosis in an Immunocompetent Adult Patient.

Toxoplasmosis is caused by the protozoan parasite Toxoplasma gondii (T. gondii), which is one of the most widespread zoonotic pathogens known today. It is a global health hazard as they infect 30-50% of the world's human population. Acute toxoplasmosis is usually asymptomatic and self-limited in immunocompetent people, recovering without treatment and do not require specific therapy. Therefore, rare complications are associated with infection in the individuals with normal immune systems. However, we present a rare case of an immunocompetent man with acute T. gondii infection confirmed by serology, subsequently presented with two life-threatening organ dysfunctions: severe renal and pulmonary involvement, requiring hospitalization and anti-parasitic treatment.

Doxycycline for Multidrug-Resistant Gram-Negative Bacterial Infection Treatment: A Scoping Review.

Introduction: Multidrug-resistant bacterial infections limit available therapeutic options. Doxycycline is an old antibiotic from the tetracycline class that exhibits a wide antibacterial action, including Gram-negative bacteria (GNB), and could be an alternative for the treatment of multidrug-resistant (MDR) Enterobacteriaceae. The study aimed to systematically identify, evaluate, and summarize the results of studies related to outcomes of treatments for MDR-GNB infections in patients treated with doxycycline. Methods: This review was conducted in four databases during weeks 41-52 of 2022: PubMed, Medline, Scopus, and Web of Science, from the earliest year available on each database to December 2022. Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines were followed in conducting this study, and PICO was used for the research question of this review. Results: This scoping review found 8 retrospective studies that included 59 patients. Of these, 69% were treated for ventilator-associated pneumonia (VAP), 27% for urinary tract infections, 2% for bloodstream infections, and 2% for wound infections, both of which were associated with VAP. The usual dosage of doxycycline was 100 mg intravenously or orally. Clinical and microbiologic improvements were achieved in 81.3% and 87% of all patients, respectively. The mortality rate was 17.3% and was exclusively due to VAP. Conclusions: Doxycycline showed promising results in this review; however, randomized clinical trials or prospective cohorts are recommended to demonstrate the efficacy of doxycycline in the treatment of MDR infections with GNB.

The health facility as a risk factor for multidrug-resistant gram-negative bacteria in critically ill patients with COVID-19.

BACKGROUND: The relationship between Multidrug Resistant-Gram Negative Bacteria (MDR-GNB) infection and colonization in critically ill COVID-19 patients has been observed, however, it is still poorly understood. This study evaluated the risk factors for acquiring MDR-GNB in patients with severe COVID-19 in Intensive Care Units (ICU). METHODS: This is a nested case-control study in a cohort of 400 adult patients (≥ 18 years old) with COVID-19, hospitalized in the ICU of 4 hospitals in the city of Curitiba, Brazil. Cases were critical COVID-19 patients with one or more MDR GNB from any surveillance and/or clinical cultures were taken during their ICU stay. Controls were patients from the same units with negative cultures for MDR-GNB. Bivariate and multivariate analyses were done. RESULTS: Sixty-seven cases and 143 controls were included. Independent risk factors for MDR bacteria were: male gender (OR = 2.6; 95% CI 1.28‒5.33; p = 0.008); the hospital of admission (OR = 3.24; 95% CI 1.39‒7.57; p = 0.006); mechanical ventilation (OR = 25.7; 95% CI 7.26‒91; p < 0.0001); and desaturation on admission (OR = 2.6; 95% CI 1.27‒5.74; p = 0.009). CONCLUSIONS: Male gender, desaturation, mechanical ventilation, and the hospital of admission were the independent factors associated with MDR-GNB in patients in the ICU with COVID-19. The only modifiable factor was the hospital of admission, where a newly opened hospital posed a higher risk. Therefore, coordinated actions toward a better quality of care for critically ill COVID-19 patients are essential.

Nontuberculous Mycobacterial Infections after Aesthetic Procedures: Comparison of Clinical Features and Treatment.

Nontuberculous mycobacteria (NTM) have been increasingly identified as causative of numerous cosmetic procedure related infections worldwide. This manuscript reports clinical aspects and antimicrobial resistance profiles of NTM infections associated with aesthetic procedures diagnosed in a private infectious disease clinic in the Brazilian Amazon. Four patients developed skin and soft tissue infections between August 2015 and August 2019. Clinical, microbiological, and epidemiological data were collected. M. conceptionense, M. abscessus and M. fortuitum were isolated. The histopathology showed dermal granulomatous inflammation. All patients were treated with a combination of antimycobacterial regimens, mainly with moxifloxacin and clarithromycin.

Assessment of the biological effects of exposure to toxicants among workers at a metallurgical company in Caxias do Sul, RS, Brazil.

BACKGROUND: Metallurgical workers are a high-risk population as a function of their occupational exposure to toxicants, such as heavy metals, aromatic hydrocarbons and silicate. OBJECTIVE: To investigate the occurrence of biological effects among workers exposed to toxicants in various areas of a metallurgical company in Caxias do Sul, Rio Grande do Sul, Brazil. METHODS: Cross-sectional study with 31 workers from 10 areas who responded a questionnaire on occupational and lifestyle habits. Blood and toxicology tests were compared to the questionnaire results. RESULTS: About 19.4% (n=6) of the sample did not use all the required personal protective equipment (PPE). Reduction of red blood cell parameters and leukocyte abnormalities were found, including leukocytosis, neutrophilia and eosinophilia, as well as in the blood lead levels. The following significant associations were found on analysis per work area: smoking and neutrophilia (p=0.000); work in the mold section and leukocytosis (p=0.023) and eosinophilia (p=0.007); and more than 10 years of work and leukocytosis (p=0.008). CONCLUSIONS: The data suggest that length of work, type of exposure and use of PPE might cause changes in the results of laboratory tests.

INTRODUÇÃO: Metalúrgicos compõem uma população de risco pela sua exposição ocupacional a toxicantes, como metais pesados, gases, hidrocarbonetos aromáticos e silicato. OBJETIVO: Avaliar a existência de efeitos biológicos em trabalhadores expostos a toxicantes de vários setores de uma metalúrgica de Caxias do Sul, Rio Grande do Sul. MÉTODO: Foi realizado um estudo transversal com 31 trabalhadores de 10 setores em que foi aplicado um questionário sobre hábitos ocupacionais e de vida. Exames hematológicos e toxicológicos foram comparados com os resultados do questionário. RESULTADOS: 19,4% (n=6) dos trabalhadores não usaram todos os equipamentos de proteção individual (EPIs). Foi possível observar diminuição dos parâmetros do eritrograma e alterações na série branca, como leucocitose, neutrofilia e eosinofilia, e no chumbo sérico. Evidenciaram-se valores diminuídos na série vermelha e leucocitose dos trabalhadores que não faziam uso adequado dos EPIs. Quando avaliado o setor de trabalho, pôde-se evidenciar as seguintes associações significativas: fumantes e neutrofilia (p=0,000); setor da moldagem e leucocitose (p=0,023) e eosinofilia (p=0,007); mais de 10 anos de trabalho e leucocitose (p=0,008). CONCLUSÕES: Os dados sugerem que o tempo de trabalho, o tipo de exposição e o uso de EPIs podem alterar exames laboratoriais.

Occurrence of the bacteria in a hospital environment and their sensitivity profile to the main antimicrobials in a reference general hospital in Curitiba, Brazil / Ocorrência de bactérias em ambiente hospitalar, e seu perfil de sensibilidade aos principais antimicrobianos em um hospital de referência em Curitiba, Brasil / Ocurrencia de bacterias en ambiente hospitalario y su perfil de sensibilidad a los principales antimicrobianos en un hospital de referencia en Curitiba, Brasil

Introduction: Antimicrobial resistance rates are increasing in both hospital and community settings, creating a favorable environment for the development of superbacteria. Therefore, local studies are necessary for the proper management of current antimicrobial arsenals and for addressing the current bacteriological scenario. Aim: The aim of this study is to profile bacterial epidemiology in a hospital in Curitiba, Brazil and associate it with the effectiveness of antimicrobial therapy. Methodology: Data from 2019 to 2021 were collected by the Center for Epidemiology and Hospital Infection Control (CEHIC), and this was a quantitative single-center study. Results: The most commonly detected microorganisms were Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Staphylococcus epidermidis, Pseudomonas aeruginosa, Enterococcus faecalis, Acinetobacter baumannii, Staphylococcus haemolyticus, Staphylococcus hominis, and Enterobacter cloacae. A. baumannii and K. pneumoniae had the lowest mean sensitivity coefficients, while S. aureus was the most sensitive. Erythromycin was the least effective antimicrobial agent, while daptomycin was the most effective. Conclusion: These results are consistent with the literature and can be used to optimize empiric therapies, as there are already important therapeutic failures associated with antimicrobial resistance.

Introdução: As taxas de resistência antimicrobiana estão em ascensão tanto em ambientes hospitalares como comunitários, criando um cenário propício para o desenvolvimento de superbactérias e, assim, torna-se necessário estudos locais para uma gestão adequada dos arsenais antimicrobianos atuais e frente ao cenário bacteriológico atual. Objetivo: O escopo desse estudo visa traçar o perfil epidemiológico bacteriano num hospital em Curitiba, Brasil e associá-lo à eficácia da terapia antimicrobiana. Metodologia: Os dados de 2019 a 2021 foram recolhidos pelo Centro de Epidemiologia e Controle de Infecções Hospitalares (CECIH), sendo este um estudo unicêntrico quantitativo. Resultados: Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Staphylococcus epidermidis, Pseudomonas aeruginosa, Enterococcus faecalis, Acinetobacter baumannii, Staphylococcus haemolyticus, Staphylococcus hominis, e Enterobacter cloacae foram os microrganismos mais comuns detectados. A. baumannii e K. pneumoniae tinham as médias de coeficiente de sensibilidade mais baixas, enquanto S. aureus era o mais sensível. A eritromicina era o agente antimicrobiano menos eficaz, enquanto a daptomicina era o mais eficaz. Conclusão: Estes resultados estão de acordo com a literatura e podem ser utilizados para otimizar as terapias empíricas, visto que já há falhas terapêuticas importantes associadas a resistência antimicrobiana.

Introducción: Las tasas de resistencia antimicrobiana están en aumento tanto en el ámbito hospitalario como en el comunitario, creando un escenario propicio para el desarrollo de superbacterias, por lo que son necesarios estudios locales para una gestión adecuada de los actuales arsenales antimicrobianos y hacer frente al escenario bacteriológico actual. Objetivo: El alcance de este estudio pretende trazar el perfil epidemiológico bacteriano en un hospital de Curitiba, Brasil y asociarlo a la eficacia de la terapia antimicrobiana. Metodología: Los datos de 2019 a 2021 fueron recogidos por el Centro de Epidemiología y Control de Infecciones Hospitalarias (CECIH), siendo un estudio cuantitativo unicéntrico. Resultados: Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Staphylococcus epidermidis, Pseudomonas aeruginosa, Enterococcus faecalis, Acinetobacter baumannii, Staphylococcus haemolyticus, Staphylococcus hominis y Enterobacter cloacae fueron los microorganismos más frecuentes detectados. A. baumannii y K. pneumoniae presentaron los coeficientes medios de sensibilidad más bajos, mientras que S. aureus fue el más sensible. La eritromicina fue el agente antimicrobiano menos eficaz, mientras que la daptomicina fue el más eficaz. Conclusión: Estos resultados concuerdan con la literatura y pueden ser utilizados para optimizar las terapias empíricas, pues ya existen importantes fracasos terapéuticos asociados a la resistencia antimicrobiana.

The health facility as a risk factor for multidrug-resistant gram-negative bacteria in critically ill patients with COVID-19

Abstract Background The relationship between Multidrug Resistant-Gram Negative Bacteria (MDR-GNB) infection and colonization in critically ill COVID-19 patients has been observed, however, it is still poorly understood. This study evaluated the risk factors for acquiring MDR-GNB in patients with severe COVID-19 in Intensive Care Units (ICU). Methods This is a nested case-control study in a cohort of 400 adult patients (≥ 18 years old) with COVID-19, hospitalized in the ICU of 4 hospitals in the city of Curitiba, Brazil. Cases were critical COVID-19 patients with one or more MDR GNB from any surveillance and/or clinical cultures were taken during their ICU stay. Controls were patients from the same units with negative cultures for MDR-GNB. Bivariate and multivariate analyses were done. Results Sixty-seven cases and 143 controls were included. Independent risk factors for MDR bacteria were: male gender (OR = 2.6; 95% CI 1.28‒5.33; p = 0.008); the hospital of admission (OR = 3.24; 95% CI 1.39‒7.57; p = 0.006); mechanical ventilation (OR = 25.7; 95% CI 7.26‒91; p < 0.0001); and desaturation on admission (OR = 2.6; 95% CI 1.27‒5.74; p = 0.009). Conclusions Male gender, desaturation, mechanical ventilation, and the hospital of admission were the independent factors associated with MDR-GNB in patients in the ICU with COVID-19. The only modifiable factor was the hospital of admission, where a newly opened hospital posed a higher risk. Therefore, coordinated actions toward a better quality of care for critically ill COVID-19 patients are essential.

High-oleic peanuts increase diet-induced thermogenesis in overweight and obese men.

BACKGROUND: Evidences suggest that nuts consumption can improve energy metabolism. PURPOSE: This study aimed to compare the effects of acute ingestion of high-oleic and conventional peanuts on appetite, food intake, and energy metabolism in overweight and obese men. METHODS: Seventy one subjects (29.8 ± 2.4 kg/m2) were assigned to the groups: control (CT, n = 24); conventional peanuts (CVP, n = 23); high-oleic peanuts (HOP, n = 24). Subjects consumed 56 g of peanuts (CVP and HOP) or control biscuits (CT) after overnight fasting. Thereafter, energy metabolism was evaluated over 200 minutes, during which diet-induced thermogenesis (DIT) and substrate oxidation were analyzed. Appetite sensation was recorded for 3 hours. Statistical analyses were performed using the SAS software considering 5% as the significance level. RESULTS: Postprandial energy expenditure and DIT were significantly higher in HOP than in CVP. Substrate oxidation did not differ between groups. Only HOP presented score below 100 indicating incomplete compensation. CT and CVP showed a complete caloric compensation (scores > 100). Regarding appetite sensation, CVP group felt less "full" than HOP and CT. After 3 hours, satiety score of CVP returned to baseline, whereas HOP and CT remained significantly higher. Hunger scores returned to baseline in CVP and CT and they were maintained significantly lowered in HOP. CONCLUSION: High-oleic peanuts contributed to higher DIT, higher sensation of fullness and incomplete compensation for energy intake compared to conventional peanuts and may be useful to dietary intervention to reduce body weight.

Antecedentes: Las pruebas sugieren que el consumo de frutos secos puede mejorar el metabolismo energético. Propósito: Este estudio tenía por finalidad comparar los efectos de la ingesta aguda de cacahuetes con alto contenido en oleico y cacahuetes convencionales sobre el apetito, el consumo de alimentos y el metabolismo energético in hombres con sobrepeso y obesos. Métodos: Se distribuyó a 71 individuos (29,8 ± 2,4 kg/m2) a los grupos: control (CT, n = 24); cacahuetes convencionales (CVP, n = 23); cacahuetes con alto contenido en oleico (HOP, n = 24). Los individuos consumieron 56 g de cacahuetes (CVP y HOP) o control (CT) tras un ayuno nocturno. Posteriormente, se evaluó el metabolismo energético a lo largo de 200 minutes, durante los cuales se analizaron la termogénesis inducida por la dieta (TID) y la oxidación de sustratos. La sensación de apetito se registró durante 3 horas. Se realizaron los análisis estadísticos con el programa SAS considerando un nivel de significación del 5%. Resultados: El consumo de energía posprandial y la TID fueron significativamente superiores en el HOP que el CVP. La oxidación de sustratos no difirió entre los grupos. Sólo el HOP presentó una puntuación por debajo de 100, lo que indicaba una compensación incompleta. El CT y el CVP mostraron una compensación calórica completa (puntuaciones > 100). Con respecto a la sensación de apetito, el grupo CVP se mostró menos "lleno" que los grupos HOP y CT. A las 3 horas, la puntuación de saciedad del CVP volvió a la situación basal, mientras que en los grupos HOP y CT permanecía significativamente superior. Las puntuaciones de hambre volvieron a la situación basal in los grupos CVP y CT y se mantuvieron significativamente por debajo a las del grupo HOP. Conclusión: Los cacahuetes con alto contenido en oleico contribuyen a una mayor TID, mayor sensación de plenitud y una compensation incompleta del consumo de energía en comparación con los cacahuetes convencionales y pueden ser de ayuda como intervention dietética para disminuir el peso corporal.

High-oleic peanuts: new perspective to attenuate glucose homeostasis disruption and inflammation related obesity.

OBJECTIVE: To evaluate the effects of acute and daily consumption of high-oleic peanuts (HOP) on inflammation and glucose homeostasis in overweight/obese men. METHODS: In a 4-week randomized clinical trial, males with body mass index of 29.8 ± 2.3 kg/m(2) and aged 18-50 years were assigned to the groups: control (CT, n = 22); conventional peanuts (CVP, n = 22); or HOP (n = 21). They followed a hypocaloric-diet with or without 56 g/day of CVP or HOP. Main outcomes were changes in fasting blood biomarkers and postprandial insulin, glucose, tumor necrosis factor-alfa (TNF-α), and interleukin-10 (IL-10) responses after acute peanut intake. RESULTS: At baseline, HOP showed significantly lower postprandial responses of glucose, insulin, and TNF-α than CVP and CT. Changes in fasting blood biomarkers did not differ between groups after the 4-week intervention. However, within groups, total cholesterol decreased in CT, and all groups reduced High-density lipoprotein (HDL-c). Triglycerides were reduced in HOP and CVP. IL-10 increased significantly in all groups while only the CT and CVP showed increased TNF-α after intervention. CONCLUSION: Acute high-oleic peanut consumption leads to stronger moderation of postprandial glucose, insulin, and TNF-α concentrations than CVP and control meal intake. Whether daily intake of high-oleic peanuts has additional benefits to CVP remains uncertain.

Regular intake of high-oleic peanuts improves fat oxidation and body composition in overweight/obese men pursuing a energy-restricted diet.

OBJECTIVE: Evaluate the effect of high-oleic and conventional peanuts within a hypocaloric-diet on energy metabolism and body composition. METHODS: This 4-week randomized clinical trial included males with BMI of 29.7 ± 2.4 kg m(-2) and aged between 18 and 50 years. Participants were assigned to the groups: control (CT, n = 22) that followed a hypocaloric-diet; conventional peanuts (CVP, n = 22) or high-oleic peanuts (HOP, n = 21) that received the hypocaloric-diet including (not adding) 56 g day(-1) of peanuts. Glucose, fat oxidation, and body fatness and lean mass were the main outcomes. RESULTS: Body weight and composition did not differ between groups. However, within group total body fat (kg) reduced with CVP and HOP, with a significant decrease in body fat percentage in HOP. While total lean mass (kg) decreased in CT, total lean mass (%) increased in HOP. Truncal lean mass decreased in the CT. At baseline, HOP had greater postprandial fat oxidation than the CVP. After 4-weeks, fasting fat oxidation increased in CVP and HOP. Fat oxidation increased in CT and HOP during the 200 min after meal intake compared to the fasting condition. CONCLUSION: Regular peanut consumption, especially the high-oleic type, within a hypocaloric-diet increased fat oxidation and reduced body fatness in overweigh and obese men.

Avaliação dos efeitos biológicos da exposição a toxicantes em trabalhadores de uma metalúrgica de Caxias do Sul, RS / Assessment of the biological effects of exposure to toxicants among workers at a metallurgical company in Caxias do Sul, RS, Brazil

Introdução: Metalúrgicos compõem uma população de risco pela sua exposição ocupacional a toxicantes, como metais pesados, gases, hidrocarbonetos aromáticos e silicato. Objetivo: Avaliar a existência de efeitos biológicos em trabalhadores expostos a toxicantes de vários setores de uma metalúrgica de Caxias do Sul, Rio Grande do Sul. Método: Foi realizado um estudo transversal com 31 trabalhadores de 10 setores em que foi aplicado um questionário sobre hábitos ocupacionais e de vida. Exames hematológicos e toxicológicos foram comparados com os resultados do questionário. Resultados: 19,4% (n=6) dos trabalhadores não usaram todos os equipamentos de proteção individual (EPIs). Foi possível observar diminuição dos parâmetros do eritrograma e alterações na série branca, como leucocitose, neutrofilia e eosinofilia, e no chumbo sérico. Evidenciaram-se valores diminuídos na série vermelha e leucocitose dos trabalhadores que não faziam uso adequado dos EPIs. Quando avaliado o setor de trabalho, pôde-se evidenciar as seguintes associações significativas: fumantes e neutrofilia (p=0,000); setor da moldagem e leucocitose (p=0,023) e eosinofilia (p=0,007); mais de 10 anos de trabalho e leucocitose (p=0,008). Conclusões: Os dados sugerem que o tempo de trabalho, o tipo de exposição e o uso de EPIs podem alterar exames laboratoriais

Background: Metallurgical workers are a high-risk population as a function of their occupational exposure to toxicants, such as heavy metals, aromatic hydrocarbons and silicate. Objective: To investigate the occurrence of biological effects among workers exposed to toxicants in various areas of a metallurgical company in Caxias do Sul, Rio Grande do Sul, Brazil. Methods: Cross-sectional study with 31 workers from 10 areas who responded a questionnaire on occupational and lifestyle habits. Blood and toxicology tests were compared to the questionnaire results. Results: About 19.4% (n=6) of the sample did not use all the required personal protective equipment (PPE). Reduction of red blood cell parameters and leukocyte abnormalities were found, including leukocytosis, neutrophilia and eosinophilia, as well as in the blood lead levels. The following significant associations were found on analysis per work area: smoking and neutrophilia (p=0.000); work in the mold section and leukocytosis (p=0.023) and eosinophilia (p=0.007); and more than 10 years of work and leukocytosis (p=0.008). Conclusions: The data suggest that length of work, type of exposure and use of PPE might cause changes in the results of laboratory tests

Recuperação da desnutrição em ratos mediante rações adicionadas ou não de suplemento alimentar e de vitaminas e minerais durante o período de crescimento / Recovery from malnutrition in rats with or without the addition of dietary food supplements, vitamins and minerals during the growth period

OBJETIVOS: O propósito deste estudo foi analisar experimentalmente a eficiência da suplementação alimentar da dieta do Município de Quissamã, RJ, em recuperar a desnutrição durante o período de crescimento. MÉTODOS: Foram utilizados 42 Rattus norvegicus, desmamados ao 26º dia e induzidos à desnutrição por 21 dias (ração hipoprotéica 2 por cento, ad libitum). Os animais foram distribuídos em sete grupos, alimentados com suas respectivas dietas, todas isoprotéicas (10 por cento) e isoenergéticas (350Kcal/100g). Foi registrado o peso dos animais e, após o sacrifício, foram coletados e pesados fígado, rins, baço e intestino. RESULTADOS: O ganho ponderal médio no 28º dia do controle suplemento alimentar (75,33g) foi significativamente inferior aos demais grupos, e o do controle suplemento alimentar e vitaminas+minerais foi o mais elevado (213,17). Quase todos os grupos diferenciaram-se estatisticamente no peso médio de fígado, rins e baço; os órgãos do controle suplemento alimentar apresentaram o menor peso (respectivamente 3,34g; 0,97g; 0,24g) sendo significativamente inferior aos demais grupos. O controle suplemento alimentar e vitaminas+minerais apresentou o maior peso médio do fígado (13,85g). O Controle vitaminas+minerais apresentou o maior peso médio dos rins (1,88g) e do baço (0,87g). O número de placas de Peyer/animal variou de nove a treze, sem diferenças entre os grupos; o tamanho das placas de Peyer do controle suplemento alimentar (2,6mm) foi significativamente inferior aos demais grupos. O Quissamã suplemento alimentar apresentou as maiores placas de Peyer (4,4mm). O controle suplemento alimentar apresentou sempre valores inferiores para todos os parâmetros estudados comparativamente, já que não foram adicionados à sua ração vitaminas e minerais. CONCLUSAO: A dieta de Quissamã, RJ experimentalmente alcança as necessidades mínimas para promover a recuperação da desnutrição, sendo desnecessária a adição de vitaminas e minerais e/ou suplemento alimentar.

Poliangiíte microscópica com hemorragia pulmonar / Microscopic polyangiitis with lung hemorrhage

Os autores relatam um caso de Poliangiíte Microscópica em paciente idosa, diabética, que apresentou quadro agudo de dor abdominal, edema dos membros inferiores, dor nas panturrilhas e poliartralgia. Evoluiu com insuficiência renal aguda, sendo dializada. Surgiram púrpuras não palpáveis generalizadas. Enquanto se submetia a hemodialíse, sofreu dispnéia súbita, sendo entubada e aspirado grande quantidade de sangue vivo, falecendo em seguida. A necropsia no Serviço de Patologia do HUAP-UFF revelou aspectos de Poliangiíte Microscópica.

The autors present one fatal case lung hemorrhage caused by microscopic polyangiitis, that was confirmed by postmortem examination. She was a diabetic old woman who complained of acute abdominal pain, purpuric cutaneous lesions myalgia and arthralgia followed by acute renal failure requiring hemodialysis. She had a sudden death in respiratory failure and through the tracheal tube a lange volume of blood was aspirated.