ABSTRACT
Abstract Introduction: Monitoring water quality in mobile dialysis (MD) services, assessing critical points and characterizing the risks inherent in the process, is essential to avoid risks to the patient's health. This study evaluated the microbiological quality of water in the MD of 36 hospitals with intensive treatment in the city of Rio de Janeiro. Methods: 204 water samples were collected from the points of entry to the network (NET), post-osmosis (PO) and dialysis solution (DS). The samples were evaluated for heterotrophic bacteria count, pathogen search, presence of endotoxins and aluminum content. Results: Bacterial contamination at 3 collection points in 36 hospitals was 30% (32/108); 42% from DS, 31% from PO and 17% from NET, with the presence of Pseudomonas aeruginosa, Stenotrophomonas maltophilia , Burkholderia cepacia and Ralstonia pickettii in the 3 points. Endotoxin concentrations above 0.25 EU/mL occurred in 77% of the samples (17/22) analyzed in the PO. In the aluminum content, values above 0.01 mg/L were presented in 47% (7/15) of PO samples and 27% (4/15) of NET samples. There is no specific legislation for water used in the MD; therefore, the limits of the RDC of the National Health Surveillance Agency (Anvisa) 11/2014 were used; which regulates conventional hemodialysis services. Conclusion: The results highlight the importance of evaluating water quality in MD services to ensure patient safety and support the sanitary monitoring of this process as a healthcare promoter.
Resumo Introdução: Monitorar a qualidade da água nos serviços de diálise móvel (DM), avaliando os pontos críticos e caracterizando os riscos inerentes ao processo, é fundamental para evitar riscos à saúde do paciente. Este estudo avaliou a qualidade microbiológica da água na DM de 36 hospitais com tratamento intensivo no município do Rio de Janeiro. Métodos: Foram coletadas 204 amostras de água dos pontos de entrada da rede (REDE), pós-osmose (PO) e solução de diálise (SD). As amostras foram avaliadas quanto à contagem de bactérias heterotróficas, pesquisa de patógenos, presença de endotoxinas e teor de alumínio. Resultados: A contaminação bacteriana, em 3 pontos de coleta nos 36 hospitais, foi de 30% (32/108), sendo 42% provenientes da SD, 31% da PO e 17% da REDE, com presença de Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Burkholderia cepacia e Ralstonia pickettii nos 3 pontos. Concentrações de endotoxina acima de 0,25 EU/mL ocorreram em 77% das amostras (17/22) analisadas na PO. No teor de alumínio, os valores acima de 0,01 mg/L foram apresentados em 47% (7/15) das amostras da PO e 27% (4/15) das amostras da REDE. Não existe uma legislação específica para água utilizada na DM; logo, foram utilizados os limites da RDC da Agência Nacional de Vigilância Sanitária (Anvisa) 11/2014, que regulamenta os serviços de hemodiálise convencional. Conclusão: Os resultados ressaltam a importância da avaliação da qualidade da água nos serviços de DM para garantir a segurança do paciente e subsidiar o monitoramento sanitário desse processo como um promotor de saúde.
ABSTRACT
Abstract The increasing number of reports of web-based experiences on the success of Cannabis-based therapies in controlling seizures in children suffering from refractory epilepsy have led to efforts by governments and associations to a recent change in legislation. The Brazilian Health Regulatory Agency (ANVISA) allowed the import of Cannabis extracts in 2015 and the registration of the first industrialized drug in 2017. In 2019, ANVISA approved procedures for the granting of a Sanitary Authorization for manufacturing and imports, establishing marketing requirements, prescribing, dispensing, monitoring and surveillance of cannabis products for medicinal purposes. Similar to other consumer products of health concern, is necessary to ensure the quality and health safety of these products worldwide. The aim of the present study to evaluate the presence of As, Cd, Pb, Ni, Cu, Co, Cr and Mn present in Cannabis extracts and resins used in the treatment of pediatric patients with neurological diseases. Samples (48 national and 24 imported) were analyzed by Inductively Coupled Plasma Mass Spectrometry - ICP-MS. The imported extracts presented more homogeneous inorganic element values, while national extracts showed varied levels, thus indicating the highest health risk.
Subject(s)
Patients/classification , Cannabis/adverse effects , Plant Extracts/administration & dosage , Medical Marijuana , Mass Spectrometry/methods , Pharmaceutical Preparations , Health , Disease , Elements , Brazilian Health Surveillance Agency , Resins , Drug Resistant Epilepsy/drug therapy , MethodsABSTRACT
ABSTRACT: "Mate" or "Yerba Mate" (Ilex paraguariensis) is a native South American plant, commonly consumed in Argentina, Paraguay, Uruguay and southern Brazil. Recent research has detected the presence of many vitamins and metals in this plant. Theses metals are also part of yerba mate's mineral composition, due to soil and water contamination by pesticides and fertilizers, coal and oil combustion, vehicle emissions, mining, smelting, refining and the incineration of urban and industrial waste. Regardless of their origin, some inorganic elements, such as arsenic, cadmium and lead, are considered toxic, since they accumulate in all plant tissues and are, thus, introduced into the food chain. In this context, the aim of the present study was to determine and compare arsenic, cadmium, lead concentrations in 104 samples of yerba mate (Ilex paraguariensis) marketed, and consumed in three southern Brazilian States, namely Paraná (PR), Santa Catarina (SC) and Rio Grande do Sul (RS). Each element was determined by inductively coupled plasma mass spectrometry (ICP-MS), on a Nexion 300D equipment (Perkin Elmer). As, Cd and Pb concentrations in yerba mate leaves ranged from 0.015 to 0.15mg kg-1, 0.18 to 1.25mg kg-1 and 0.1 to 1.20mg kg-1, respectively. Regarding Cd, 84% of the samples from RS, 63% from PR and 75% from SC showed higher concentrations than the maximum permissible limit of 0.4mg kg-1 established by the Brazilian National Sanitary Surveillance Agency (ANVISA), while 7% of the samples from RS and 5% from PR were unsatisfactory for Pb. Concentrations were below the established ANVISA limit of 0.6mg kg-1 for all samples.
RESUMO: A erva-mate (Ilex paraguariensis) é uma planta originária da América do Sul, consumida habitualmente na Argentina, Paraguai, Uruguai e no sul do Brasil. Pesquisas, recentes, detectaram na erva-mate a presença de muitas vitaminas e metais. Esses metais podem fazer parte da composição mineral da planta ou por contaminação dos solos e águas pelo uso de fertilizantes, pesticidas, combustão de carvão e óleo, emissões veiculares, mineração, fundição, refinamento e incineração de resíduos urbanos e industriais. Independente da sua origem, os metais são acumulados em todos os tecidos das plantas, sendo desta forma introduzidos na cadeia alimentar. Alguns desses elementos inorgânicos são considerados tóxicos, como arsênico, cádmio e chumbo. O objetivo deste trabalho foi determinar e comparar as concentrações de metais na erva-mate (Ilex paraguariensis) comercializadas e consumidas nos diferentes estados do sul do Brasil. 104 amostras foram coletadas em supermercados no sul do Brasil: Paraná (PR), Santa Catarina (SC) e Rio Grande do Sul (RS). A determinação da concentração de As, Cd, Pb foi feita por espectrometria de massa por plasma indutivamente acoplado (ICP-MS), modelo Nexion 300D (Perkin Elmer). As concentrações de As, Cd e Pb em folhas de erva-mate variaram de 0,015-0,15mg kg-1; 0,18-1,25mg kg-1 e 0,1-1,20mg kg-1. 84% do RS, 63% do PR e 75% do SC, a concentração de Cd na erva mate foi superior ao limite estabelecido (0,4mg kg-1), pela Agência Nacional de Vigilância Sanitária (ANVISA), 7% do RS, 5% do PR foram insatisfatórias para Pb e a concentração de As ficou abaixo do limite estabelecido (0,6mg kg-1).