Elemental plasma content and urinary excretion in vineyard farmers occupationally exposed to pesticides in southern Brazil.

This is a cross-sectional study with data and biological material collection from vineyard farmers in southern Brazil. An interview was carried out through a questionnaire developed according to the reference guide of the state government. Plasma and urine samples were screened for Aluminum, Chromium, Manganese, Copper, Nickel, Cobalt, Zinc, Arsenic, Selenium, Cadmium, Antimony, Barium, Mercury, Lead and Uranium, with a technique for fast determination of these elemental contents in biological material utilizing dynamic reaction cell inductively coupled mass spectrometry. Principal component analysis was used to identify associations between these elemental contents in biological samples and the information obtained from the interviews. The farmers showed some trace elements in plasma and urine at a higher concentration than unexposed populations from other studies. This study highlights recent findings of trace elements in biological material and their association with characteristics of pesticide use. In addition, it also contributes to the gap in the literature regarding trace elements content in plasma and urine of workers exposed to pesticides.

Avaliação da eficácia e do grau de adesão ao uso prolongado de fibra dietética no tratamento da constipação intestinal funcional / Evaluation of the efficacy and adherence to long-term use of dietary fiber in the treatment of functional intestinal constipation

OBJETIVO: Avaliar o grau de adesão e a eficácia da fibra dietética no tratamento da constipação intestinal funcional. MÉTODOS: Estudo clínico longitudinal, envolvendo 59 indivíduos, 54 mulheres e 5 homens, idade média de 46 anos (variação: 18-74 anos), com diagnóstico de constipação intestinal funcional. Após regularização do hábito intestinal, com a introdução de fibra dietética, era recomendado aos pacientes manter a dieta com fibra e retornar quatro meses depois, a fim de ser verificada a continuidade da eficácia e o grau de adesão ao seu uso. Associação entre adesão e eficácia foi pesquisada pelo teste exato de Fisher. RESULTADOS: Nove pacientes abandonaram o estudo e 50 continuaram. Destes, 32 mantiveram hábito intestinal satisfatório e a constipação recorreu em 18. Naqueles com manutenção do hábito intestinal, dezesseis mantiveram a ingestão de fibra recomendada, quatro aumentaram, nove reduziram e três interromperam. Nos casos com recorrência do sintoma, a quantidade de fibra foi mantida em três, aumentada em um, diminuída em três e suspensa em onze. Foi encontrada associação estatisticamente significante entre adesão e eficácia (p=0,008). CONCLUSÃO: A eficácia da fibra dietética mostrou-se moderada, ocorrendo benefício em 64 por cento dos casos. A perda de adesão foi grande, mais da metade dos indivíduos avaliados (52 por cento). Tais resultados sugerem a necessidade de novas estratégias, visando garantir maior fidelidade à terapêutica com fibra e com isto melhorar seus resultados no tratamento da constipação intestinal.

OBJECTIVE: The objective of this study was to evaluate the adherence to and efficacy of dietary fiber in the treatment of functional constipation. METHODS: This is a longitudinal clinical study involving 59 subjects, 54 women and 5 men, aged 18 to 74 years, mean age of 46 years, with functional constipation. Once the bowel movements became regular with the use of dietary fiber, subjects were instructed to maintain the fiber-rich diet for four months in order to determine if the efficacy continued over time and the degree of adherence to its use. The association between adherence and efficacy was investigated by the Fisher's exact test. RESULTS: Although nine individuals abandoned the study, 50 returned. From these, 32 sustained normal bowel movements and 18 had recurrence of the constipation. In the first group, 16 continued consuming the same amount of fiber, four increased, nine reduced and three stopped taking it. In the group with recurrence, three maintained the same amount of fiber, one increased, three reduced and eleven stopped taking it. There was a significant statistical association between adherence and efficacy (p=0.008). CONCLUSION: The long-term efficacy of dietary fiber for the treatment of constipation was moderate (64 percent) and treatment drop-out rate was high (52 percent). These results suggest the need of new strategies that promote greater fidelity to fiber therapy, thereby improving the efficacy of constipation treatment.