The impact of urban configuration types on urban heat islands, air pollution, CO2 emissions, and mortality in Europe: a data science approach.

BACKGROUND: The world is becoming increasingly urbanised. As cities around the world continue to grow, it is important for urban planners and policy makers to understand how different urban configuration patterns affect the environment and human health. However, previous studies have provided mixed findings. We aimed to identify European urban configuration types, on the basis of the local climate zones categories and street design variables from Open Street Map, and evaluate their association with motorised traffic flows, surface urban heat island (SUHI) intensities, tropospheric NO2, CO2 per person emissions, and age-standardised mortality. METHODS: We considered 946 European cities from 31 countries for the analysis defined in the 2018 Urban Audit database, of which 919 European cities were analysed. Data were collected at a 250 m × 250 m grid cell resolution. We divided all cities into five concentric rings based on the Burgess concentric urban planning model and calculated the mean values of all variables for each ring. First, to identify distinct urban configuration types, we applied the Uniform Manifold Approximation and Projection for Dimension Reduction method, followed by the k-means clustering algorithm. Next, statistical differences in exposures (including SUHI) and mortality between the resulting urban configuration types were evaluated using a Kruskal-Wallis test followed by a post-hoc Dunn's test. FINDINGS: We identified four distinct urban configuration types characterising European cities: compact high density (n=246), open low-rise medium density (n=245), open low-rise low density (n=261), and green low density (n=167). Compact high density cities were a small size, had high population densities, and a low availability of natural areas. In contrast, green low density cities were a large size, had low population densities, and a high availability of natural areas and cycleways. The open low-rise medium and low density cities were a small to medium size with medium to low population densities and low to moderate availability of green areas. Motorised traffic flows and NO2 exposure were significantly higher in compact high density and open low-rise medium density cities when compared with green low density and open low-rise low density cities. Additionally, green low density cities had a significantly lower SUHI effect compared with all other urban configuration types. Per person CO2 emissions were significantly lower in compact high density cities compared with green low density cities. Lastly, green low density cities had significantly lower mortality rates when compared with all other urban configuration types. INTERPRETATION: Our findings indicate that, although the compact city model is more sustainable, European compact cities still face challenges related to poor environmental quality and health. Our results have notable implications for urban and transport planning policies in Europe and contribute to the ongoing discussion on which city models can bring the greatest benefits for the environment, climate, and health. FUNDING: Spanish Ministry of Science and Innovation, State Research Agency, Generalitat de Catalunya, Centro de Investigación Biomédica en red Epidemiología y Salud Pública, and Urban Burden of Disease Estimation for Policy Making as a Horizon Europe project.

The potential impact of PM2.5 on the covid-19 crisis in the Brazilian Amazon region.

OBJECTIVE: This study aims to assess covid-19 morbidity, mortality, and severity from 2020 to 2021 in five Brazilian Amazon states with the highest records of wildfires. METHODS: A distributed lag non-linear model was applied to estimate the potential exposure risk association with particulate matter smaller than 2.5-µm in diameter (PM2.5). Daily mean temperature, relative humidity, percentual of community mobility, number of hospital beds, days of the week, and holidays were considered in the final models for controlling the confounding factors. RESULTS: The states of Para, Mato Grosso, and Amazonas have reported the highest values of overall cases, deaths, and severe cases of covid-19. The worrying growth in the percentual rates in 2020/2021 for the incidence, severity, and mortality were highlighted in Rondônia and Mato Grosso. The growth in 2020/2021 in the estimations of PM2.5 concentrations was higher in Mato Grosso, with an increase of 24.4%, followed by Rondônia (14.9%). CONCLUSION: This study establishes an association between wildfire-generated PM2.5 and increasing covid-19 incidence, mortality, and severity within the studied area. The findings showed that the risk of covid-19 morbidity and mortality is nearly two times higher among individuals exposed to high concentrations of PM2.5. The attributable fraction to PM2.5 in the studied area represents an important role in the risk associated with covid-19 in the Brazilian Amazon region.

Sex Moderates the Relationship Between Social Support and Cardiovascular Prevention Behaviors in Middle-aged and Older Adults.

BACKGROUND: Most risk factors for cardiovascular disease (CVD) are modifiable, suggesting that the burden of CVD could be substantially reduced through cardiovascular screening and healthier lifestyle. People who have social support are more likely to adhere to cardiovascular prevention recommendations, but it is not clear whether the benefit of social support is equal for men and women. PURPOSE: We investigated whether sex moderates the relationship between social support and adherence to cardiovascular prevention recommendations in a nationally representative sample. METHODS: Participants were 17,287 adults (n = 10,264 middle-aged adults 40-64 years old and n = 7,023 older adults ≥ 65 years old) who participated in the National Health Survey of Spain in 2017. Social support was measured with the Functional Social Support Questionnaire of Duke-UNC. Adherence to cardiovascular screening recommendations was assessed based on self-reported testing of cholesterol, blood pressure, and blood sugar by a health professional in the past 12 months. Adherence to recommended health-related behaviors was assessed based on the guidelines of the European Society of Cardiology regarding diet, alcohol consumption, smoking, and physical activity. RESULTS: Multiple regression models adjusted for socio-demographic and cardiovascular history and risk variables showed that social support was more strongly associated with adherence to cardiovascular prevention recommendations in men than in women. In particular, low social support levels were especially detrimental for both middle-aged men (screening: B = 0.13, 95% CI [0.06-0.20], p < .001; behaviors: B = 0.33 [0.26-0.41], p < .001) and older men (screening: B = 0.10 [0.04-0.17], p = .001; behaviors: B = 0.16 [0.08-0.25], p < .001), whereas older women had comparatively high adherence, which was unrelated to social support (screening: B = 0.02 [-0.03 to 0.08], p = .433; behaviors: B = 0.03 [-0.03 to 0.10], p = .342). CONCLUSIONS: Social support is more strongly associated with cardiovascular prevention in men than in women, such that men who lack social support have the lowest adherence to cardiovascular screening and lifestyle recommendations.

To help prevent cardiovascular disease, experts recommend screening for cardiovascular risk factors and leading a healthy lifestyle. Previous research has found that people who have social support are more likely to adhere to such cardiovascular prevention recommendations. In this study, using data form a nationally representative survey, we investigated whether the relationship between social support and adherence to cardiovascular prevention recommendations is different for men and women. Participants were 17,287 adults from the National Health Survey of Spain, who reported their cardiovascular screening history (i.e., whether they had their cholesterol, blood pressure, and blood sugar levels tested by a health professional in the past 12 months) and their lifestyle habits regarding diet, alcohol consumption, smoking, and physical activity. Social support was more strongly associated with cardiovascular prevention in men than in women, such that men who lacked social support had the lowest adherence to cardiovascular screening and lifestyle recommendations.

The potential impact of PM2.5 on the covid-19 crisis in the Brazilian Amazon region

ABSTRACT OBJECTIVE This study aims to assess covid-19 morbidity, mortality, and severity from 2020 to 2021 in five Brazilian Amazon states with the highest records of wildfires. METHODS A distributed lag non-linear model was applied to estimate the potential exposure risk association with particulate matter smaller than 2.5-µm in diameter (PM2.5). Daily mean temperature, relative humidity, percentual of community mobility, number of hospital beds, days of the week, and holidays were considered in the final models for controlling the confounding factors. RESULTS The states of Para, Mato Grosso, and Amazonas have reported the highest values of overall cases, deaths, and severe cases of covid-19. The worrying growth in the percentual rates in 2020/2021 for the incidence, severity, and mortality were highlighted in Rondônia and Mato Grosso. The growth in 2020/2021 in the estimations of PM2.5 concentrations was higher in Mato Grosso, with an increase of 24.4%, followed by Rondônia (14.9%). CONCLUSION This study establishes an association between wildfire-generated PM2.5 and increasing covid-19 incidence, mortality, and severity within the studied area. The findings showed that the risk of covid-19 morbidity and mortality is nearly two times higher among individuals exposed to high concentrations of PM2.5. The attributable fraction to PM2.5 in the studied area represents an important role in the risk associated with covid-19 in the Brazilian Amazon region.

[Estimate of mean daily concentration of fine particulate matter in the Industrial and Port Complex area of Pecém, Ceará, Brazil]. / Estimativa da concentração média diária de material particulado fino na região do Complexo Industrial e Portuário do Pecém, Ceará, Brasil.

Exposure to fine particulate matter (PM2.5) is associated with numerous negative health outcomes. Thus, monitoring the environmental concentration of PM2.5 is important, especially in heavily industrialized areas, since they harbor potential emitters of PM2.5 and substances with the potential to increase the toxicity of already suspended particles. This study aims to estimate daily concentrations of PM2.5 in three areas under the influence of the Industrial and Port Complex of Pecém (CIPP), Ceará State, Brazil. A nonlinear regression model was applied to estimate PM2.5, using satellite-monitored optical depth data. Estimates were performed in three areas of influence (Ai) of the CIPP (São Gonçalo do Amarante - AiI, Paracuru and Paraipaba - AiII, and Caucaia - AiIII), from 2006 to 2017. Estimated mean annual concentrations were lower than established by Brazil's national legislation in all three Ai (8µg m-³). In all the Ai, the months of the dry season (September to February) showed the highest concentrations and a predominance of east winds, while the months of the rainy season (March to August) showed the lowest concentrations and less defined winds Weather conditions can play an important role in the removal, dispersal, or maintenance of concentrations of particulate matter in the region. Even at low estimated concentrations, it is important to assess the composition of fine participles in this region and their possible association with adverse health outcomes in the local population.

Multimorbidity and short-term overall mortality among colorectal cancer patients in Spain: A population-based cohort study.

BACKGROUND: Numerous studies have analysed the effect of comorbidity on cancer outcomes, but evidence on the association between multimorbidity and short-term mortality among colorectal cancer patients is limited. We aimed to assess this association and the most frequent patterns of multimorbidity associated with a higher short-term mortality risk among colorectal cancer patients in Spain. METHODS: Data were obtained from two Spanish population-based cancer registries and electronic health records. We estimated the unadjusted cumulative incidence of death by comorbidity status at 6 months and 1 year. We used a flexible parametric model to derive the excess mortality hazard ratios (HRs) for multimorbidity after adjusting for sex, age at diagnosis, cancer stage and treatment. We estimated the adjusted cumulative incidence of death by comorbidity status and identified multimorbidity patterns. RESULTS: Among the study participants, 1,048 cases were diagnosed with cancers of the colon and rectum, 2 cases with cancer of the anus with overlapping sites of the rectum and 11 cases with anal adenocarcinomas but treated as colorectal cancer patients. Among 1,061 colorectal cancer patients, 171 (16.2%) died before 6 months, 246 (23.3%) died before the 1-year follow-up, and 324 (30.5%) had multimorbidity. Patients with multimorbidity had two times higher mortality risk than those without comorbidities at 6 months (adjusted HR: 2.04; 95% confidence interval [CI]: 1.30-3.20, p = 0.002). The most frequent multimorbidity pattern was congestive heart failure + diabetes. However, patients with rheumatologic disease + diabetes had two times higher 1-year mortality risk than those without comorbidities (HR: 2.23; 95% CI: 1.23-4.07, p = 0.008). CONCLUSIONS: Multimorbidity was a strong independent predictor of short-term mortality at 6 months and 1 year among the colorectal cancer patients in Spain. The identified multimorbidity pattern was consistent. Our findings might help identify patients at a higher risk for poor cancer and treatment outcomes.

Estimativa da concentração média diária de material particulado fino na região do Complexo Industrial e Portuário do Pecém, Ceará, Brasil / Estimate of mean daily concentration of fine particulate matter in the Industrial and Port Complex area of Pecém, Ceará, Brazil / Estimación de la concentración media diaria de material particulado fino en la región del Complejo Industrial y Portuario de Pecém, Ceará, Brasil

A exposição ao material particulado fino (MP2,5) está associada a inúmeros desfechos à saúde. Desta forma, monitoramento da concentração ambiental do MP2,5 é importante, especialmente em áreas amplamente industrializadas, pois abrigam potenciais emissores do MP2,5 e de substâncias com potencial de aumentar a toxicidade de partículas já suspensas. O objetivo desta pesquisa é estimar a concentração diária do MP2,5 em três áreas de influência do Complexo Industrial e Portuário do Pecém (CIPP), Ceará, Brasil. Foi aplicado um modelo de regressão não linear para a estimativa do MP2,5, por meio de dados de profundidade óptica monitorados por satélite. As estimativas foram realizadas em três áreas de influência (Ai) do CIPP (São Gonçalo do Amarante - Ai I, Paracuru e Paraipaba - Ai II e Caucaia - Ai III, no período de 2006 a 2017. As médias anuais das concentrações estimadas foram inferiores ao estabelecido pela legislação nacional em todas as Ai (8µg m-3). Em todas as Ai, os meses referentes ao período de seca (setembro a fevereiro) apresentaram as maiores concentrações e uma predominância de ventos leste para oeste. Os meses que compreendem o período de chuva (março a agosto) apresentaram as menores concentrações e ventos menos definidos. As condições meteorológicas podem exercer um papel importante nos processos de remoção, dispersão ou manutenção das concentrações do material particulado na região. Mesmo com baixas concentrações estimadas, é importante avaliar a constituição das partículas finas dessa região, bem como sua possível associação a efeitos adversos à saúde da população local.

Exposure to fine particulate matter (PM2.5) is associated with numerous negative health outcomes. Thus, monitoring the environmental concentration of PM2.5 is important, especially in heavily industrialized areas, since they harbor potential emitters of PM2.5 and substances with the potential to increase the toxicity of already suspended particles. This study aims to estimate daily concentrations of PM2.5 in three areas under the influence of the Industrial and Port Complex of Pecém (CIPP), Ceará State, Brazil. A nonlinear regression model was applied to estimate PM2.5, using satellite-monitored optical depth data. Estimates were performed in three areas of influence (Ai) of the CIPP (São Gonçalo do Amarante - AiI, Paracuru and Paraipaba - AiII, and Caucaia - AiIII), from 2006 to 2017. Estimated mean annual concentrations were lower than established by Brazil's national legislation in all three Ai (8µg m-³). In all the Ai, the months of the dry season (September to February) showed the highest concentrations and a predominance of east winds, while the months of the rainy season (March to August) showed the lowest concentrations and less defined winds Weather conditions can play an important role in the removal, dispersal, or maintenance of concentrations of particulate matter in the region. Even at low estimated concentrations, it is important to assess the composition of fine participles in this region and their possible association with adverse health outcomes in the local population.

La exposición al material particulado fino (MP2,5) está asociada a innumerables problemas de salud. Por ello, la supervisión de la concentración ambiental del MP2,5 es importante, especialmente en áreas ampliamente industrializadas, puesto que albergan potenciales emisores de MP2,5 y de sustancias con potencial de aumentar la toxicidad de partículas ya suspendidas. El objetivo de esta investigación es estimar la concentración diaria del MP2,5 en tres áreas de influencia del Complejo Industrial y Portuario de Pecém (CIPP), Ceará, Brasil. Se aplicó un modelo de regresión no lineal para la estimación del MP2,5, mediante datos de profundidad óptica supervisados por satélite. Las estimaciones fueron realizadas en tres áreas de influencia (Ai) del CIPP (São Gonçalo do Amarante - Ai I, Paracuru y Paraipaba - Ai II y Caucaia - Ai III en el período de 2006 a 2017. Las medias anuales de las concentraciones estimadas fueron inferiores a lo establecido por la legislación nacional en todas las Ai (8µg m-³). En todas las Ai, los meses referentes al período de sequía (de setiembre a febrero) presentaron las mayores concentraciones y una predominancia de vientos este a oeste, los meses que comprenden el período de lluvia (marzo a agosto) presentaron las menores concentraciones y vientos menos definidos. Las condiciones meteorológicas pueden ejercer un papel importante en los procesos de eliminación, dispersión o mantenimiento de las concentraciones del material particulado en la región. Incluso con bajas concentraciones estimadas es importante que se evalúe la constitución de las partículas finas de esta región, así como su posible asociación con efectos adversos para la salud de la población local.

Nanoencapsulated Lecitase Ultra and Thermomyces lanuginosus Lipase, a Comparative Structural Study.

Two commercially available and widely used enzymes, the parent Thermomyces lanuginosus lipase (TLL) and the shuffled phospholipase A1 Lecitase (Lecitase Ultra), were encapsulated in AOT/isooctane reverse micelles and evaluated regarding their structure and activity. Preparations were also tested as effective biocatalysts. Small-angle X-ray scattering (SAXS), electronic paramagnetic resonance (EPR), and fluorescence spectroscopy were the techniques applied to assess the effects of enzyme incorporation to a reverse micellar nanostructure. SAXS analysis showed that the radius of gyration (Rg) changed from 16 to 38 Å, as the water content (w0) increased. Elongated shapes were more commonly observed than spherical shapes after enzyme encapsulation. EPR studies indicated that enzymes do not participate in the interface, being located in the aqueous center. Fluorescence energy transfer showed that TLL is located in the water core, whereas Lecitase Ultra is closer to the interface. Enzymatic activity toward a standard esterification reaction endured after the enzyme was incorporated into the micelles. The activity of TLL for systems with w0 15 showed the highest conversion yield, 38% in 2 h, while the system with w0 10 showed the highest initial velocity, 0.43 µM/min. This last system had a Rg of 19.3 Å, similar to that of the TLL monomer. Lecitase Ultra showed the highest conversion yields in systems with w0 10, 55% in 2 h. However, the initial rate was much lower than that of TLL, suggesting less affinity for the substrates, which is expected since Lecitase Ultra is a phospholipase. In summary, we here used several spectroscopic and scattering techniques to reveal the shape and stability of TTL and Lecitase Ultra encapsulated systems, which allowed the selection of w0 values to provide optimized enzymatic activity.

Stability and structural changes of horseradish peroxidase: microwave versus conventional heating treatment.

Effects of conventional heating (CH) and microwave (MW) on the structure and activity of horseradish peroxidase (HRP) in buffer solution were studied. CH incubation between 30 and 45 °C increased activity of HRP, reaching 170% of residual activity (RA) after 4-6 h at 45 °C. CH treatment at 50 and 60 °C caused HRP inactivation: RA was 5.7 and 16.7% after 12 h, respectively. Secondary and tertiary HRP structural changes were analyzed by circular dichroism (CD) and intrinsic fluorescence emission, respectively. Under CH, activation of the enzyme was attributed to conformational changes in secondary and tertiary structures. MW treatment had significant effects on the residual activity of HRP. MW treatment at 45 °C/30W followed by CH treatment 45 °C regenerated the enzyme activity. The greatest loss in activity occurred at 60 °C/60 W/30 min (RA 16.9%); without recovery of the original activity. The inactivation of MW-treated HRP was related to the loss of tertiary structure, indicating changes around the tryptophan environment.

[Indicator of socio-environmental vulnerability in the Western Amazon. The case of the city of Porto Velho, State of Rondônia, Brazil]. / Indicador de vulnerabilidade socioambiental na Amazônia Ocidental. O caso do município de Porto Velho, Rondônia, Brasil.

The accelerated process of urbanization in the State of Amazônia associated with changes in the patterns of exploitation of natural resources have resulted in several types of environmental impacts, such as urban air pollution produced by forest fires which alters the relationship between urban and rural areas and establishes new vulnerabilities. The scope of this study is to analyze the socio-environmental vulnerability in relation to forest fires and health effects in the urban area of Porto Velho, located in the Brazilian Amazon region. Data was analyzed using a synthetic indicator combining income and education aspects, housing infrastructure, environmental exposure and health effects. The findings indicate that 51% of the resident population, i.e. around 157,000 inhabitants, is exposed to conditions of high and extreme environmental vulnerability. Analysis of the dimensions used to construct the synthetic indicator reveals an intense heterogeneity in terms of socio-environmental vulnerability in the urban area of the city of Porto Velho. These results highlight the need for integrated actions from different government departments in order to enhance health promotion, ecological sustainability and also reduce social inequalities in health.

Indicador de vulnerabilidade socioambiental na Amazônia Ocidental. O caso do município de Porto Velho, Rondônia, Brasil / Indicator of socio-environmental vulnerability in the Western Amazon. The case of the city of Porto Velho, State of Rondônia, Brazil

O acelerado processo de urbanização na Amazônia associado às mudanças no padrão de exploração dos recursos naturais resultou em vários tipos de impactos ambientais, tal como a poluição do ar urbano produzido pelo incêndio florestal que altera a relação entre as áreas urbana e rural e reconfigura novas vulnerabilidades. O objetivo deste estudo é analisar a vulnerabilidade socioambiental em relação às queimadas e aos efeitos a saúde na área urbana do município de Porto Velho, região amazônica brasileira. Para tanto, utiliza como método a construção de um indicador síntese, que conjugou a dimensão social, de infraestrutura habitacional, exposição ambiental e de saúde. Dentre os resultados, destaca-se que 51% da população residente, 157 mil habitantes, estão sob condições de extrema e alta vulnerabilidade socioambiental. Ao final, discute-se que a análise integrada das dimensões estudadas permitiu identificar importante heterogeneidade em termos de vulnerabilidade socioambiental às queimadas no interior da área urbana de Porto Velho, apontando para a necessidade de ações integradas de diferentes setores governamentais de forma a potencializar a promoção da saúde, a sustentabilidade ecológica e a redução das iniquidades sociais em saúde.

The accelerated process of urbanization in the State of Amazônia associated with changes in the patterns of exploitation of natural resources have resulted in several types of environmental impacts, such as urban air pollution produced by forest fires which alters the relationship between urban and rural areas and establishes new vulnerabilities. The scope of this study is to analyze the socio-environmental vulnerability in relation to forest fires and health effects in the urban area of Porto Velho, located in the Brazilian Amazon region. Data was analyzed using a synthetic indicator combining income and education aspects, housing infrastructure, environmental exposure and health effects. The findings indicate that 51% of the resident population, i.e. around 157,000 inhabitants, is exposed to conditions of high and extreme environmental vulnerability. Analysis of the dimensions used to construct the synthetic indicator reveals an intense heterogeneity in terms of socio-environmental vulnerability in the urban area of the city of Porto Velho. These results highlight the need for integrated actions from different government departments in order to enhance health promotion, ecological sustainability and also reduce social inequalities in health.

Conformational dissection of Thermomyces lanuginosus lipase in solution.

Lipases are triacyl glycerol acyl hydrolases, which catalyze hydrolysis of esters, esterification and transesterification reactions, among others. Some of these enzymes have a large hydrophobic pocket covered by an alpha-helical mobile surface loop (the lid). Protein-protein interactions can occur through adsorption of two open lids of individual lipases. We investigated the conformation and oligomeric state of Thermomyces lanuginosus lipase (TLL) in solution by spectroscopic and mass spectrometry techniques. Information about oligomerization of this important industrial enzyme is only available for TLL crystals; therefore, we have done a throughout investigation of the conformation of this lipase in solution. SDS-PAGE and mass spectrometry analysis of size-exclusion chromatography eluted fractions indicated the presence of both monomeric and dimeric populations of TLL. The stability of the enzyme upon thermal and guanidine hydrochloride treatment was examined by circular dichroism and fluorescence emission spectroscopy. Small angle x-ray scattering and ion mobility mass spectrometry analysis revealed that TLL is found as a mixture of monomers and dimers at the assayed concentrations. Although previous x-ray diffraction data showed TLL as a dimer in the crystal (PDB: 1DT3), to our knowledge our report is the first evidencing that TLL co-exists as stable dimeric and monomeric forms in solution.

A comprehensive study on the activity and deactivation of immobilized Lecitase Ultra in esterifications of food waste streams to monoacylglycerols.

Lecitase Ultra was immobilized on Amberlites XAD2 and XAD4, through physical entrapping under conventional stirring or ultrasound irradiation, and characterized by standard techniques. The resulting immobilized biocatalysts were utilized in the valorization of an acidic food-derived residue from a palm oil refining process to produce monoacylglycerols from isopropylidene glycerol under batch and continuous flow conditions. Results indicated that the immobilized biocatalysts could moderately convert the food waste residue (max. conversion 50-60 %), exhibiting interesting stability under continuous flow conditions.

Local complications after industrial liquid silicone injection: case series.

OBJECTIVE: To analyze a case series of patients who underwent injection of industrial liquid silicone in a clandestine manner and by unauthorized persons. METHODS: We conducted a retrospective analysis of medical records of patients treated between September 2003 and December 2010. Data regarding gender, age, location and volume of silicone injected, time between application and clinical manifestations, complications, treatment and outcome were collected. Early manifestations were defined as occurring within 30 days of injection and late manifestations, the ones arising after this period. RESULTS: We treated 12 patients, eight were male, seven transsexuals. The volume injected ranged from 5 ml to 2000 ml, being unknown in three cases. The most often used injected sites were the thighs and buttocks. Eight patients had early manifestations, with inflammation and/or infection. Surgical debridement was necessary in five cases. Three patients with a history of injection in the breast region underwent adenomastectomy. There was one death due to refractory septic shock. CONCLUSION: The use of industrial liquid silicone should be completely contraindicated as a filling material and modification of body contouring, and may have serious complications, even death.

Complicações locais após a injeção de silicone líquido industrial: série de casos / Local complications after industrial liquid silicone injection: case series

OBJETIVO: analisar uma série de casos de pacientes submetidos à injeção de silicone líquido industrial de maneira clandestina e por pessoas não habilitadas. MÉTODOS: análise retrospectiva de prontuários de pacientes atendidos no período de setembro de 2003 a dezembro de 2010. Foram avaliados: sexo, idade, local e volume de silicone injetado, tempo decorrido entre a aplicação e as manifestações clínicas, complicações, tratamento e evolução. Definiu-se como precoce as manifestações ocorridas até 30 dias da injeção e manifestações tardias após este período. RESULTADOS: Foram atendidos 12 pacientes, oito eram do sexo masculino, sendo sete transexuais. O volume injetado variou de 5ml a 2000ml, sendo desconhecido em três casos. Os locais mais frequentemente utilizados para injeção foram a região de coxas e glúteos. Oito casos apresentaram manifestações precoces, com quadros de inflamação e/ou infecção. Foi necessária a realização de desbridamento cirúrgico em cinco casos. Três pacientes com histórico de injeção na região mamária foram submetidas à adenomastectomia. Houve um óbito por quadro de choque séptico refratário. CONCLUSÃO: O uso do silicone líquido industrial deve ser totalmente contraindicado como material de preenchimento e modificação do contorno corporal, podendo apresentar graves complicações e até mesmo óbito.

OBJECTIVE: To analyze a case series of patients who underwent injection of industrial liquid silicone in a clandestine manner and by unauthorized persons. METHODS: We conducted a retrospective analysis of medical records of patients treated between September 2003 and December 2010. Data regarding gender, age, location and volume of silicone injected, time between application and clinical manifestations, complications, treatment and outcome were collected. Early manifestations were defined as occurring within 30 days of injection and late manifestations, the ones arising after this period. RESULTS: We treated 12 patients, eight were male, seven transsexuals. The volume injected ranged from 5ml to 2000ml, being unknown in three cases. The most often used injected sites were the thighs and buttocks. Eight patients had early manifestations, with inflammation and/or infection. Surgical debridement was necessary in five cases. Three patients with a history of injection in the breast region underwent adenomastectomy. There was one death due to refractory septic shock. CONCLUSION: The use of industrial liquid silicone should be completely contraindicated as a filling material and modification of body contouring, and may have serious complications, even death.

Revisão sistemática sobre antissepsia cirúrgica das mãos com preparação alcoólica em comparação aos produtos tradicionais / A systematic review of surgical hand antisepsis utilizing an alcohol preparation compared to traditional products / Revisión sistemática sobre antisepsia quirúrgica de manos con preparación alcohólica comparada a productos tradicionales

A antissepsia cirúrgica das mãos visa à prevenção de infecções do sítio cirúrgico, importante causa de morbimortalidade pós-operatória e aumento dos custos hospitalares. Este estudo teve como objetivo comparar a eficácia de preparações alcoólicas com os produtos tradicionais na antissepsia cirúrgica das mãos por meio de uma revisão sistemática da literatura. Foram considerados estudos primários ou secundários, tendo como desfecho a contagem microbiana das mãos ou taxas de infecções do sítio cirúrgico. A busca foi realizada no Portal BVS, PubMed, Ask e MEDLINE. Foram selecionados 25 estudos (2 revisões sistemáticas, 19 experimentais e 4 de coorte). As preparações alcoólicas tiveram uma redução microbiana igual e/ou maior aos produtos tradicionais em 17 estudos e inferior em 4; as taxas de infecções do sítio cirúrgico foram similares. Portanto, existem evidências científicas que suportam a segurança das preparações alcoólicas para antissepsia cirúrgica das mãos.

Surgical hand antisepsis aims at preventing surgical site infections, an important cause of postoperative morbidity and mortality and escalating hospital costs. The objectives of this study were to compare the efficacy of alcohol preparations with traditional surgical hand antisepsis products by means of a systematic review of the literature. Primary and secondary studies were included, considering the microbial count or surgical site infection rates as outcomes. The search was performed on the BVS Portal, PubMed, Ask and MEDLINE. Twenty-five studies were selected (two systematic reviews, nineteen experimental and four cohort studies). The alcohol preparations promoted a microbial reduction equal to and/or greater than traditional products in 17 studies, and a lesser reduction in four studies; similar surgical site infection rates were identified. Therefore, there is scientific evidence that support the safety of alcohol preparations for surgical hand antisepsis.

La antisepsia quirúrgica de manos apunta a prevenir infecciones en el sitio quirúrgico, causa importante de morbi-mortalidad postoperatoria y aumento de costos hospitalarios. El estudio objetivó comparar la eficacia de preparaciones alcohólicas con los productos tradicionales de la antisepsia quirúrgica de manos, mediante revisión sistemática de la literatura. Fueron considerados estudios primarios o secundarios, teniendo como objetivo el recuento microbiano en manos o tasas de infecciones del sitio quirúrgico. La búsqueda fue realizada en las bases BVS, PubMed, Ask y MEDLINE. Fueron seleccionados 25 estudios (2 revisiones sistemáticas, 19 experimentales y 4 de cohorte). Las preparaciones alcohólicas consiguieron una reducción microbiana igual y/o mayor que los productos tradicionales en 17 estudios, e inferior en 4; las tasas de infección del sitio quirúrgico fueron equivalentes. Por lo tanto, existen evidencias científicas que dan soporte a la seguridad de las preparaciones alcohólicas para la antisepsia quirúrgica de las manos.

[Ground-clearing fires in the amazon and respiratory disease]. / As queimadas na região amazônica e o adoecimento respiratório.

The intentional burning of forest biomass commonly known as "ground-clearing fires" is an age-old and widespread practice in the country and is seen as a major contributor to global emissions of greenhouse gases. However, global awareness of their potential impact is relatively recent. The occurrence of large ground-clearing fires in the Brazilian and international scenarios drew attention to the problem, but the measures taken to prevent and/or control the fires are still insufficient. In the Amazon region, with distinct geographical and environmental features from the rest of the country, with its historic process of land occupation, every year the ground-clearing fires expose larger portions of the population making them vulnerable to its effects. In this context, this non-systematic review presents the papers written over the past five years about the fires in the Brazilian Amazon and respiratory illness. The main objective is to provide information for managers and leaders on environmental issues about the problems related to biomass burning in the Amazon region.

As queimadas na região amazônica e o adoecimento respiratório / Ground-clearing fires in the amazon and respiratory disease

A queima de biomassa florestal popularmente conhecida como "queimada" é uma prática recorrente e antiga no país e se caracteriza como um dos principais contribuintes mundiais para a emissão de gases de efeito estufa. Entretanto, a consciência global sobre seus possíveis impactos é relativamente recente. A ocorrência de grandes queimadas no cenário brasileiro e internacional despertou a atenção para o problema, mas as medidas tomadas para prevenir e/ou controlar os incêndios ainda são insuficientes. Na região amazônica, com circunstâncias geográficas e ambientais distintas do resto do país, aliadas a um processo histórico de ocupação do território, o uso do fogo expõe a cada ano, parcelas maiores da população tornando-as vulneráveis aos seus efeitos. Neste contexto, esta revisão não sistemática apresenta os trabalhos desenvolvidos nos últimos cinco anos sobre as queimadas na Amazônia Brasileira e o adoecimento respiratório. Tem como objetivo principal fornecer elementos para gestores e dirigentes ambientais sobre as questões que norteiam os problemas relacionados à queima de biomassa florestal na região amazônica.

The intentional burning of forest biomass commonly known as "ground-clearing fires" is an age-old and widespread practice in the country and is seen as a major contributor to global emissions of greenhouse gases. However, global awareness of their potential impact is relatively recent. The occurrence of large ground-clearing fires in the Brazilian and international scenarios drew attention to the problem, but the measures taken to prevent and/or control the fires are still insufficient. In the Amazon region, with distinct geographical and environmental features from the rest of the country, with its historic process of land occupation, every year the ground-clearing fires expose larger portions of the population making them vulnerable to its effects. In this context, this non-systematic review presents the papers written over the past five years about the fires in the Brazilian Amazon and respiratory illness. The main objective is to provide information for managers and leaders on environmental issues about the problems related to biomass burning in the Amazon region.

[A systematic review of surgical hand antisepsis utilizing an alcohol preparation compared to traditional products]. / Revisão sistemática sobre antissepsia cirúrgica das mãos com preparação alcoólica em comparação aos produtos tradicionais.

Surgical hand antisepsis aims at preventing surgical site infections, an important cause of postoperative morbidity and mortality and escalating hospital costs. The objectives of this study were to compare the efficacy of alcohol preparations with traditional surgical hand antisepsis products by means of a systematic review of the literature. Primary and secondary studies were included, considering the microbial count or surgical site infection rates as outcomes. The search was performed on the BVS Portal, PubMed, Ask and MEDLINE. Twenty-five studies were selected (two systematic reviews, nineteen experimental and four cohort studies). The alcohol preparations promoted a microbial reduction equal to and/or greater than traditional products in 17 studies, and a lesser reduction in four studies; similar surgical site infection rates were identified. Therefore, there is scientific evidence that support the safety of alcohol preparations for surgical hand antisepsis.

Palm oil hydrolysis catalyzed by lipases under ultrasound irradiation--the use of experimental design as a tool for variables evaluation.

Diacylglycerol oil has been increasingly recognized by its good nutritional properties and therefore, different technologies have been developed for obtaining it. The present work focuses on the diacylglycerol production by hydrolysis reaction of the palm oil using the PS IM and TL IM commercial lipases as biocatalysts under ultrasound irradiation. An experimental design (central composite rotatable design--CCRD) adopting surface response was applied as a tool to evaluate the optimal reaction conditions beyond a restrict number of experiments. Reactions were performed in an ultrasound equipment and different variables were investigated, such as temperature (30-55 °C), enzyme content (1-2 wt.% of oil mass), mechanical stirring (300-700 rpm) and reaction time. Both, PS IM and TL IM enzymes showed the best results after 1h and 30 min of reaction under 30 °C and, applying 300 rpm as stirring. On these conditions, the diacylglycerol yield was around 34% and 39%, respectively; considering that 1% PS IM was applied for the first one and, 2% TL IM for the second one. Therefore, it was obtained good yield of a diacylglycerol-rich oil in shorter reaction times under sonication and soft conditions. The mathematic model proposed suggested a satisfactorily representation of the process and good correlation among the experimental results and the theoretical values predicted by the model equation were achieved.