Viability of elutriation for the extraction of microplastics from environmental soil samples.

In this study, we evaluated the suitability of elutriation, a method successfully employed in the extraction of microplastics from marine sediments, for the extraction of microplastics from freshwater and terrestrial soils. Five soils were sampled throughout Oklahoma, USA in order to capture a range of sand, silt, clay, and organic matter composition. Each soil was subjected to microplastic extraction with and without elutriation, followed by digestion in 7.5% NaOCl, and then flotation in 6 M ZnCl2. The mass of each soil was measured after elutriation to determine sample mass reduction, and multiple methods including fluorescence imaging and automated particle counting through ImageJ, Attenuated Total Reflectence-Fourier Transfor Infrared Spectroscopy (ATR-FTIR), and Pyrolysis-coupled Gas Chromatography/Mass Spectrometry (py-GC/MS) were used to determine microplastic quantity, mass, and characteristics. T-test was used to check for statistically-significant differences between methods in terms of mass or particle quantity. For all tested soils, elutriation resulted in greater sample mass reduction than non-elutriated samples, and was between 59.0-97.3% for the tested soils. Furthermore, no statistically significant (p < 0.05) differences were observed in particle quantification or polymer mass between methods, and no differences were observed for polymer or size distribution. Additionally, 33% more polymers were positively identified (R 2 = 70%) by ATR-FTIR analysis in elutriated samples compared to non-elutriated soils. The mass reduction provided by elutriation allows for the processing of larger sample volumes, leading to greater accuracy and sensitivity in detecting microplastics. As such, we recommend elutriation be performed as a pretreatment step to extract microplastics from soils.

Bioaccumulation of Microplastics in Decedent Human Brains Assessed by Pyrolysis Gas Chromatography-Mass Spectrometry.

Rising global concentrations of environmental micro- and nanoplastics (MNPs) drive concerns for human exposure and health outcomes. Applying pyrolysis gas chromatography-mass spectrometry (Py-GC/MS) methods to isolate and quantify MNPs from human samples, we compared MNP accumulation in kidneys, livers, and brains. Autopsy samples from the Office of the Medical Investigator in Albuquerque, NM, collected in 2016 and in 2024, were digested for Py-GC/MS analysis of 12 polymers. Brains exhibited higher concentrations of MNPs than liver or kidney samples. All organs exhibited significant increases from 2016 to 2024. Polyethylene was the predominant polymer; the relative proportion of polyethylene MNPs was greater in brain samples than in liver or kidney. Transmission electron microscopy verified the nanoscale nature of isolated particles, which largely appeared to be aged, shard-like plastics remnants across a wide range of sizes. Results demonstrate that MNPs are selectively accumulated into the human brain and concentrations are rising over time.

Microplastic presence in dog and human testis and its potential association with sperm count and weights of testis and epididymis.

The ubiquitous existence of microplastics and nanoplastics raises concerns about their potential impact on the human reproductive system. Limited data exists on microplastics within the human reproductive system and their potential consequences on sperm quality. Our objectives were to quantify and characterize the prevalence and composition of microplastics within both canine and human testes and investigate potential associations with the sperm count, and weights of testis and epididymis. Using advanced sensitive Pyrolysis-Gas Chromatography/Mass Spectrometry (Py-GC/MS), we quantified 12 types of microplastics within 47 canine and 23 human testes. Data on reproductive organ weights, and sperm count in dogs were collected. Statistical analyses, including descriptive analysis, correlational analysis, and multivariate linear regression analyses were applied to investigate the association of microplastics with reproductive functions. Our study revealed the presence of microplastics in all canine and human testes, with significant inter-individual variability. Mean total microplastic levels were 122.63 µg/g in dogs and 328.44 µg/g in humans. Both humans and canines exhibit relatively similar proportions of the major polymer types, with PE being dominant. Furthermore, a negative correlation between specific polymers such as PVC and PET and the normalized weight of the testis was observed. These findings highlight the pervasive presence of microplastics in the male reproductive system in both canine and human testes, with potential consequences on male fertility.

In Vivo Tissue Distribution of Polystyrene or Mixed Polymer Microspheres and Metabolomic Analysis after Oral Exposure in Mice.

BACKGROUND: Global plastic use has consistently increased over the past century with several different types of plastics now being produced. Much of these plastics end up in oceans or landfills leading to a substantial accumulation of plastics in the environment. Plastic debris slowly degrades into microplastics (MPs) that can ultimately be inhaled or ingested by both animals and humans. A growing body of evidence indicates that MPs can cross the gut barrier and enter into the lymphatic and systemic circulation leading to accumulation in tissues such as the lungs, liver, kidney, and brain. The impacts of mixed MPs exposure on tissue function through metabolism remains largely unexplored. OBJECTIVES: This study aims to investigate the impacts of polymer microspheres on tissue metabolism in mice by assessing the microspheres ability to translocate across the gut barrier and enter into systemic circulation. Specifically, we wanted to examine microsphere accumulation in different organ systems, identify concentration-dependent metabolic changes, and evaluate the effects of mixed microsphere exposures on health outcomes. METHODS: To investigate the impact of ingested microspheres on target metabolic pathways, mice were exposed to either polystyrene (5µm) microspheres or a mixture of polymer microspheres consisting of polystyrene (5µm), polyethylene (1-4µm), and the biodegradability and biocompatible plastic, poly-(lactic-co-glycolic acid) (5µm). Exposures were performed twice a week for 4 weeks at a concentration of either 0, 2, or 4mg/week via oral gastric gavage. Tissues were collected to examine microsphere ingress and changes in metabolites. RESULTS: In mice that ingested microspheres, we detected polystyrene microspheres in distant tissues including the brain, liver, and kidney. Additionally, we report on the metabolic differences that occurred in the colon, liver, and brain, which showed differential responses that were dependent on concentration and type of microsphere exposure. DISCUSSION: This study uses a mouse model to provide critical insight into the potential health implications of the pervasive issue of plastic pollution. These findings demonstrate that orally consumed polystyrene or mixed polymer microspheres can accumulate in tissues such as the brain, liver, and kidney. Furthermore, this study highlights concentration-dependent and polymer type-specific metabolic changes in the colon, liver, and brain after plastic microsphere exposure. These results underline the mobility within and between biological tissues of MPs after exposure and emphasize the importance of understanding their metabolic impact. https://doi.org/10.1289/EHP13435.

Quantitation and identification of microplastics accumulation in human placental specimens using pyrolysis gas chromatography mass spectrometry.

The exponential increase in global plastic usage has led to the emergence of nano- and microplastic (NMP) pollution as a pressing environmental issue due to its implications for human and other mammalian health. We have developed methodologies to extract solid materials from human tissue samples by saponification and ultracentrifugation, allowing for highly specific and quantitative analysis of plastics by pyrolysis-gas chromatography and mass spectrometry (Py-GC-MS). As a benchmark, placenta tissue samples were analyzed using fluorescence microscopy and automated particle count, which demonstrated the presence of >1-micron particles and fibers, but not nano-sized plastic particles. Analyses of the samples (n = 10) using attenuated total reflectance-Fourier transform infrared spectroscopy indicated presence of rayon, polystyrene, polyethylene, and unclassified plastic particles. By contrast, among 62 placenta samples, Py-GC-MS revealed that microplastics were present in all participants' placentae, with concentrations ranging widely from 6.5 to 685 µg NMPs per gram of placental tissue, averaging 126.8 ± 147.5 µg/g (mean±SD). Polyethylene was the most prevalent polymer, accounting for 54% of total NMPs and consistently found in nearly all samples (mean 68.8 ± 93.2 µg/g placenta). Polyvinyl chloride and nylon each represented approximately 10% of the NMPs by weight, with the remaining 26% of the composition represented by 9 other polymers. Together, these data demonstrate advancements in the unbiased quantitative resolution of Py-GC-MS applied to the identification and quantification of NMP species at the maternal-fetal interface. This method, paired with clinical metadata, will be pivotal to evaluating potential impacts of NMPs on adverse pregnancy outcomes.

In Vitro Leishmanicidal Activity of Copaiba Oil and Kojic Acid Combination on the Protozoan Leishmania (Leishmania) amazonensis and Host Cell.

(1) Background: Leishmaniasis refers to a group of anthropozoonotic diseases caused by Leishmania. The major chemotherapeutic agent used for its treatment is Glucantime®®, but the search continues for new compounds that are economically viable and act on the protozoan without causing damage to the host cell. As an alternative approach, this study used a combination of copaiba oil (CO) and kojic acid (KA) to determine their in vitro action on host cells, on the Leishmania (Leishmania) amazonensis protozoan and its interaction with macrophages. (2) Methods: In vitro culture, analysis of cytokine release and microscopy assays were performed. Statistical analysis was performed with ANOVA (GraphPad Prism). (3) Results: The combination did not induce cytotoxic effects on macrophages after treatment but promoted morphological changes in the protozoan, such as nuclear alterations (apoptotic characteristics), alterations in the cellular body and an increase in the number of electrodense structures and acidocalcisomes, observed mainly at the concentrations of CO20KA50 and CO30KA50 µg/mL. We observed reductions in the intracellular amastigote number and in the production of proinflammatory cytokines, such as IL-6 and TNF-α, after treatment with CO30KA at 50 µg/mL. (4) Conclusions: We report here, for the first time, that the combination of CO and KA may be a promising approach against Leishmania (Leishmania) amazonensis.

NEUROMETABOLOMIC IMPACTS OF MODELED WILDFIRE SMOKE AND PROTECTIVE BENEFITS OF ANTI-AGING THERAPEUTICS IN AGED FEMALE C57BL/6J MICE.

Wildland fires have become progressively more extensive over the past 30 years in the US, and now routinely generate smoke that deteriorates air quality for most of the country. We explored the neurometabolomic impact that smoke derived from biomass has on older (18 months) female C57BL/6J mice, both acutely and after 10 weeks of recovery from exposures. Mice (N=6/group) were exposed to wood smoke (WS) 4 hours/day, every other day, for 2 weeks (7 exposures total) to an average concentration of 0.448mg/m 3 per exposure. One group was euthanized 24 hours after the last exposure. Other groups were then placed on 1 of 4 treatment regimens for 10 weeks after wood smoke exposures: vehicle; resveratrol in chow plus nicotinamide mononucleotide in water (RNMN); senolytics via gavage (dasatanib+quercetin; DQ); or both RNMN with DQ (RNDQ). Among the findings, the aging from 18 months to 21 months was associated with the greatest metabolic shift, including changes in nicotinamide metabolism, with WS exposure effects that were relatively modest. WS caused a reduction in NAD+ within the prefrontal cortex immediately after exposure and a long-term reduction in serotonin that persisted for 10 weeks. The serotonin reductions were corroborated by forced swim tests, which revealed an increased immobility (reduction in motivation) immediately post-exposure and persisted for 10 weeks. RNMN had the most beneficial effects after WS exposure, while RNDQ caused markers of brain aging to be upregulated within WS-exposed mice. Findings highlight the persistent neurometabolomic and behavioral effects of woodsmoke exposure in an aged mouse model. Significance Statement: Neurological impacts of wildfire smoke are largely underexplored but include neuroinflammation and metabolic changes. The present study highlights modulation of major metabolites in the prefrontal cortex and behavioral consequences in aged (18 month) female mice that persists 10 weeks after wood smoke exposure ended. Supplements derived from the anti-aging field were able to mitigate much of the woodsmoke effect, especially a combination of resveratrol and nicotinamide mononucleotide.

Gestational ozone inhalation elicits maternal cardiac dysfunction and transcriptional changes to placental pericytes and endothelial cells.

Ozone (O3) is a criteria air pollutant with the most frequent incidence of exceeding air quality standards. Inhalation of O3 is known to cause lung inflammation and consequent systemic health effects, including endothelial dysfunction. Epidemiologic data have shown that gestational exposure to air pollutants correlates with complications of pregnancy, including low birth weight, intrauterine growth deficiency, preeclampsia, and premature birth. Mechanisms underlying how air pollution may facilitate or exacerbate gestational complications remain poorly defined. The current study sought to uncover how gestational O3 exposure impacted maternal cardiovascular function, as well as the development of the placenta. Pregnant mice were exposed to 1PPM O3 or a sham filtered air (FA) exposure for 4 h on gestational day (GD) 10.5, and evaluated for cardiac function via echocardiography on GD18.5. Echocardiography revealed a significant reduction in maternal stroke volume and ejection fraction in maternally exposed dams. To examine the impact of maternal O3 exposure on the maternal-fetal interface, placentae were analyzed by single-cell RNA sequencing analysis. Mid-gestational O3 exposure led to significant differential expression of 4021 transcripts compared with controls, and pericytes displayed the greatest transcriptional modulation. Pathway analysis identified extracellular matrix organization to be significantly altered after the exposure, with the greatest modifications in trophoblasts, pericytes, and endothelial cells. This study provides insights into potential molecular processes during pregnancy that may be altered due to the inhalation of environmental toxicants.

Biomass smoke inhalation promotes neuroinflammatory and metabolomic temporal changes in the hippocampus of female mice.

Smoke from wildland fires has been shown to produce neuroinflammation in preclinical models, characterized by neural infiltrations of neutrophils and monocytes, as well as altered neurovascular endothelial phenotypes. To address the longevity of such outcomes, the present study examined the temporal dynamics of neuroinflammation and metabolomics after inhalation exposures from biomass-derived smoke. 2-month-old female C57BL/6 J mice were exposed to wood smoke every other day for 2 weeks at an average exposure concentration of 0.5 mg/m3. Subsequent serial euthanasia occurred at 1-, 3-, 7-, 14-, and 28-day post-exposure. Flow cytometry of right hemispheres revealed two endothelial populations of CD31Hi and CD31Med expressors, with wood smoke inhalation causing an increased proportion of CD31Hi. These populations of CD31Hi and CD31Med were associated with an anti-inflammatory and pro-inflammatory response, respectively, and their inflammatory profiles were largely resolved by the 28-day mark. However, activated microglial populations (CD11b+/CD45low) remained higher in wood smoke-exposed mice than controls at day 28. Infiltrating neutrophil populations decreased to levels below controls by day 28. However, the MHC-II expression of the peripheral immune infiltrate remained high, and the population of neutrophils retained an increased expression of CD45, Ly6C, and MHC-II. Utilizing an unbiased approach examining the metabolomic alterations, we observed notable hippocampal perturbations in neurotransmitter and signaling molecules, such as glutamate, quinolinic acid, and 5-α-dihydroprogesterone. Utilizing a targeted panel designed to explore the aging-associated NAD+ metabolic pathway, wood smoke exposure drove fluctuations and compensations across the 28-day time course, ending with decreased hippocampal NAD+ abundance on day 28. Summarily, these results indicate a highly dynamic neuroinflammatory environment, with potential resolution extending past 28 days, the implications of which may include long-term behavioral changes, systemic and neurological sequalae directly associated with wildfire smoke exposure.

In Vivo Tissue Distribution of Microplastics and Systemic Metabolomic Alterations After Gastrointestinal Exposure.

Global plastic use has consistently increased over the past century with several different types of plastics now being produced. Much of these plastics end up in oceans or landfills leading to a substantial accumulation of plastics in the environment. Plastic debris slowly degrades into microplastics (MPs) that can ultimately be inhaled or ingested by both animals and humans. A growing body of evidence indicates that MPs can cross the gut barrier and enter into the lymphatic and systemic circulation leading to accumulation in tissues such as the lungs, liver, kidney, and brain. The impacts of mixed MPs exposure on tissue function through metabolism remains largely unexplored. To investigate the impact of ingested MPs on target metabolomic pathways, mice were subjected to either polystyrene microspheres or a mixed plastics (5 µm) exposure consisting of polystyrene, polyethylene and the biodegradability and biocompatible plastic, poly-(lactic-co-glycolic acid). Exposures were performed twice a week for four weeks at a dose of either 0, 2, or 4 mg/week via oral gastric gavage. Our findings demonstrate that, in mice, ingested MPs can pass through the gut barrier, be translocated through the systemic circulation, and accumulate in distant tissues including the brain, liver, and kidney. Additionally, we report on the metabolomic changes that occur in the colon, liver and brain which show differential responses that are dependent on dose and type of MPs exposure. Lastly, our study provides proof of concept for identifying metabolomic alterations associated with MPs exposure and adds insight into the potential health risks that mixed MPs contamination may pose to humans.

Neuroinflammatory and Metabolomic Temporal Dynamics Following Wood Smoke Inhalation.

Smoke from wildland fires has been shown to produce neuroinflammation in preclinical models, characterized by neural infiltrations of neutrophils and monocytes, as well as altered neurovascular endothelial phenotypes. To address the longevity of such outcomes, the present study examined the neuroinflammatory and metabolomic temporal dynamics after inhalation exposures from biomass-derived smoke. 2-month-old female C57BL/6J mice were exposed to wood smoke every other day for two weeks at an average exposure concentration of 0.5mg/m 3 . Subsequent serial euthanasia occurred at 1-, 3-, 7-, 14-, and 28-days post-exposure. Flow cytometry of right hemispheres revealed two endothelial populations of PECAM (CD31), high and medium expressors, with wood smoke inhalation causing an increased proportion of PECAM Hi . These populations of PECAM Hi and PECAM Med were associated with an anti-inflammatory and pro-inflammatory response, respectively, and their inflammatory profiles were largely resolved by the 28-day mark. However, activated microglial populations (CD11b + /CD45 low ) remained higher in wood smoke-exposed mice than controls at day 28. Infiltrating neutrophil populations decreased to levels below controls by day 28. However, the MHC-II expression of the peripheral immune infiltrate remained high, and the population of neutrophils retained an increased expression of CD45, Ly6C, and MHC-II. Utilizing an unbiased approach examining the metabolomic alterations, we observed notable hippocampal perturbations in neurotransmitter and signaling molecules like glutamate, quinolinic acid, and 5-α-dihydroprogesterone. Utilizing a targeted panel designed to explore the aging-associated NAD + metabolic pathway, wood smoke exposure drove fluctuations and compensations across the 28-day time course, ending with decreased hippocampal NAD + abundance at day 28. Summarily, these results indicate a highly dynamic neuroinflammatory environment, with potential resolution extending past 28 days, the implications of which may include long-term behavioral changes, systemic and neurological sequalae directly associated wtith wildfire smoke exposure.

Photoaging of polystyrene microspheres causes oxidative alterations to surface physicochemistry and enhances airway epithelial toxicity.

Microplastics represent an emerging environmental contaminant, with large gaps in our understanding of human health impacts. Furthermore, environmental factors may modify the plastic chemistry, further altering the toxic potency. Ultraviolet (UV) light is one such unavoidable factor for airborne microplastic particulates and a known modifier of polystyrene surface chemistry. As an experimental model, we aged commercially available polystyrene microspheres for 5 weeks with UV radiation, then compared the cellular responses in A549 lung cells with both pristine and irradiated particulates. Photoaging altered the surface morphology of irradiated microspheres and increased the intensities of polar groups on the near-surface region of the particles as indicated by scanning electron microscopy and by fitting of high-resolution X-ray photoelectron spectroscopy C 1s spectra, respectively. Even at low concentrations (1-30 µg/ml), photoaged microspheres at 1 and 5 µm in diameter exerted more pronounced biological responses in the A549 cells than was caused by pristine microspheres. High-content imaging analysis revealed S and G2 cell cycle accumulation and morphological changes, which were also more pronounced in A549 cells treated with photoaged microspheres, and further influenced by the size, dose, and time of exposures. Polystyrene microspheres reduced monolayer barrier integrity and slowed regrowth in a wound healing assay in a manner dependent on dose, photoaging, and size of the microsphere. UV-photoaging generally enhanced the toxicity of polystyrene microspheres in A549 cells. Understanding the influence of weathering and environmental aging, along with size, shape, and chemistry, on microplastics biocompatibility may be an essential consideration for incorporation of different plastics in products.

Early Gestational Exposure to Inhaled Ozone Impairs Maternal Uterine Artery and Cardiac Function.

Exposure to air pollutants such as ozone (O3) is associated with adverse pregnancy outcomes, including higher incidence of gestational hypertension, preeclampsia, and peripartum cardiomyopathy; however, the underlying mechanisms of this association remain unclear. We hypothesized that O3 exposures during early placental formation would lead to more adverse cardiovascular effects at term for exposed dams, as compared with late-term exposures. Pregnant Sprague Dawley rats were exposed (4 h) to either filtered air (FA) or O3 (0.3 or 1.0 ppm) at either gestational day (GD)10 or GD20, with longitudinal functional assessments and molecular endpoints conducted at term. Exposure at GD10 led to placental transcriptional changes at term that were consistent with markers in human preeclampsia, including reduced mmp10 and increased cd36, fzd1, and col1a1. O3 exposure, at both early and late gestation, induced a significant increase in maternal circulating soluble FMS-like tyrosine kinase-1 (sFlt-1), a known driver of preeclampsia. Otherwise, exposure to 0.3 ppm O3 at GD10 led to several late-stage cardiovascular outcomes in dams that were not evident in GD20-exposed dams, including elevated uterine artery resistance index and reduced cardiac output and stroke volume. GD10 O3 exposure proteomic profile in maternal hearts characterized by a reduction in proteins with essential roles in metabolism and mitochondrial function, whereas phosphoproteomic changes were consistent with pathways involved in cardiomyopathic responses. Thus, the developing placenta is an indirect target of inhaled O3 and systemic maternal cardiovascular abnormalities may be induced by O3 exposure at a specific window of gestation.

O uso de álcool entre idosos atendidos na Atenção Primária à Saúde / Uso de alcohol entre ancianos atendidos en Atención Primaria de Salud / Use of alcohol among elderly people attending Primary Health Care

Resumo Objetivo: Verificar o padrão do uso de álcool entre idosos atendidos em um serviço de Atenção Primária à Saúde e descrever a relação do uso desta substância com as variáveis sociodemográficas. Métodos: Estudo observacional, transversal, quantitativo, com idosos de um serviço de saúde de Atenção Primária de município do interior de São Paulo/Brasil. De um total de 750 idosos, foram incluídos 112; entrevistados 85 e a amostra final foi de 25 que auto relataram uso de álcool. Os dados do estudo foram obtidos através de entrevistas para aplicação de instrumentos: questionário sociodemográfico, Michigan Alcoholism Screenig Test-Geriatric Version (MAST-G); Alcohol Use Disorders Identification Test (AUDIT). Resultados: Predominou o sexo feminino (56%), a condição de aposentados (56%), a idade média foi 69,8 anos (variação entre 60 e 83 anos), níveis de escolaridade, desde curso superior completo até não possuir grau de instrução, média de 7,4 anos estudados. No AUDIT, 15 idosos (60%) pontuaram entre 8 e 14, portanto uso de risco e 10 (40%) tiveram escore 7 incluídos no uso de baixo risco. No MAST-G, os 25 pacientes (100%) sugerem ter problema relacionado ao uso do álcool. Conclusão: O estudo contribui no que diz respeito à situação do uso de álcool por idosos e isto está na constatação de que, na população estudada, existe maior número de mulheres em situação de risco. Estas questões devem ser consideradas na abordagem e investigações pelos profissionais de saúde, na perspectiva de realizarem estratégias para o tratamento global e humanizado do idoso usuário de álcool.

Resumen Objetivo: Verificar el estándar de consumo alcohólico entre ancianos atendidos en servicio de Atención Primaria de Salud y describir la relación de dicho consumo con las variables sociodemográficas. Métodos: Estudio observacional, transversal, cuantitativo, con ancianos de un servicio de Atención Primaria de municipio del interior de São Paulo/Brasil. Sobre un total de 750 ancianos, fueron incluidos 112; entrevistados 85, con muestra final de 25 que refirieron consumo de alcohol. Datos obtenidos mediante entrevistas para aplicación de los instrumentos: cuestionario sociodemográfico, Michigan Alcoholism Screening Test-Geriatric Version (MAST-G); Alcohol Use Disorders Identification Test (AUDIT). Resultados: Predominio del sexo femenino (56%), la condición de jubilados (56%). La media etaria fue de 69,8 años (variando entre 60 y 83 años), niveles de escolarización desde curso superior completo hasta carecer de educación, promedio de 7,4 años de estudios. En el AUDIT, 15 ancianos (60%) obtuvieron puntajes entre 8 y 14, configurando consumo de riesgo, y 10 (40%) obtuvieron 7, correspondiéndoles bajo riesgo. En el MAST-G, los 25 pacientes (100%) sugieren tener problemas relacionados al consumo alcohólico. Conclusión: El estudio contribuye respecto a la situación del consumo alcohólico en ancianos, y esto constata que en la población estudiada existe mayor número de mujeres en situación de riesgo. Estas cuestiones deben ser consideradas por los profesionales de salud en el abordaje y en investigaciones, con el fin de elaborar estrategias para el tratamiento global y humanizado del anciano consumidor de alcohol.

Abstract Objective: To verify the pattern of alcohol use among the elderly attending a primary health care service and to describe the relationship between the use of alcohol and sociodemographic variables. Methods: Observational, cross-sectional, quantitative study with elderly patients from a primary health care service in a city in the interior of São Paulo/Brazil. Of 750 elderly subjects in total, 112 were included, 85 were interviewed, and the final sample was comprised of 25 subjects who self-reported alcohol use. Data of the study were obtained through interviews for application of the following instruments: sociodemographic questionnaire, Michigan Alcoholism Screening Test-Geriatric Version (MAST-G); and Alcohol Use Disorders Identification Test (AUDIT). Results: There was predominance of the female gender (56%), retirees (56%), mean age was 69.8 years (60-83 years range), educational level of 7.4 years of study, on average, ranging from no education to complete higher education. Fifteen elderly (60%) scored between 8 and 14 points in the AUDIT, which is risk use; and 10 (40%) had a score of 7 points, considered low risk use. In MAST-G, the 25 patients (100%) suggest the presence of problems related to alcohol use. Conclusion: The study contributes to the situation of alcohol use by the elderly. This is based on the existence of a greater number of women at risk in the population studied. These issues should be considered in health professionals' approach and investigations with a view to adopting strategies for the global and humanized treatment of elderly alcohol users.

A força e o crime / Power and crime

O pensamento positivista, aplicado à dimensão psicológica do crime e do criminoso, concentrou seu interesse em detectar e estabelecer relações entre as anormalidades morfo-psicológicas e a anormalidade mental dos delinquentes. Quando um crime é cometido por pessoa que sofre de transtornos mentais, a sentença jurídica é a absolvição e o imediato estabelecimento de uma medida de segurança, a ser cumprida de acordo com a periculosidade do doente em regime ambulatorial ou de internação, por tempo indeterminado. Isso acontece porque o ordenamento jurídico e a maioria das concepções psiquiátricas caracterizam a loucura como deficitária e degenerativa, e os loucos como completamente incapazes de responderem por seus atos.Por outro lado, no início do século XX, com o nascimento da Psicanálise, torna-se possível tematizar a dimensão inconsciente dos atos, bem como uma outra concepção de responsabilidade associada a eles. Os atos criminosos cometidos por esses pacientes passam a ser avaliados de um outro ponto de vista, que não diz mais respeito ao défict orgânico.A partir de Lacan, a pesquisa que deu origem a este texto procurou avaliar como a passagem ao ato evidenciada por um crime se imporia, no caso de uma doença mental, porque faltaria ao transgressor a possibilidade de mediar a ação com o recurso simbólico. Essa impossibilidade de mediação simbólica não implicaria a irresponsabilidade do sujeito que pratica o ato infracional. Ao contrário, o próprio crime seria, nesses casos, uma tentativa de o doente se responsabilizar, de se inserir não-simbolicamente no campo da lei, buscando-o através da punição. Nesse sentido, procurou-se investigar até que ponto seria eficaz para o infrator, se pronunciar com relação a sua transgressão, já que a inimputabilidade implicaria, no âmbito da lei, uma anulação de sua dimensão subjetiva.O que ficou evidente no decorrer das investigações é que a decisão judicial, em alguns casos, pode funcionar como um dispositivo clínico-terapêutico(AU)

Adenocarcinoma renal simulando cisto: importância da tomografia computadorizada / Renal adenocarcinoma simulating cyst: importance of computerized tomography

Paciente apresentava massa renal esquerda que revelou-se sólida à ecografia. A tomografia foi interpretada como correspondente a cisto renal. A cirurgia encontrou-se adenocarcinoma renal esquerdo. O paciente estava bem no quinto mês pós-operatório

Megaureter em rim único / Megaureter in a solitary kidney

The AA. report a case of megaureter in a solitary kidney, discovered during a routine urological exploration for cryptorchidism, in a 9 year-old boy