Route of chronic kidney patients foreigners in the search for health care in a border area.

OBJECTIVES: to describe the journey of foreigners with chronic kidney diseases searching for treatment in the Brazilian Unified Health System in a border area. METHODS: this is a qualitative research conducted with thirteen foreign participants. Data were collected by interviews and analyzed based on the theoretical-methodological framework of the therapeutic itinerary. RESULTS: empirical evidence showed seven thematic categories, indicating poor illness perception; poor family support throughout treatment; social aspects such as work, income, and housing as sources of distress; search for alternative treatments; interrupted search for healthcare abroad due to financial problems; journey to healthcare-seeking in Brazil eased by family members and social networks. FINAL CONSIDERATIONS: the asymmetries within the Paraguayan and Brazilian health systems spur the search for cross-border integration actions. Identifying another country's assistance aspects may help in planning more welcoming policies in border regions.

Route of chronic kidney patients foreigners in the search for health care in a border area / Trayectoria de extranjeros con enfermedad renal crónica en busca de asistencia sanitaria en la zona fronteriza / Percurso de estrangeiros doentes renais crônicos na busca por assistência à saúde em área fronteiriça

ABSTRACT Objectives: to describe the journey of foreigners with chronic kidney diseases searching for treatment in the Brazilian Unified Health System in a border area. Methods: this is a qualitative research conducted with thirteen foreign participants. Data were collected by interviews and analyzed based on the theoretical-methodological framework of the therapeutic itinerary. Results: empirical evidence showed seven thematic categories, indicating poor illness perception; poor family support throughout treatment; social aspects such as work, income, and housing as sources of distress; search for alternative treatments; interrupted search for healthcare abroad due to financial problems; journey to healthcare-seeking in Brazil eased by family members and social networks. Final considerations: the asymmetries within the Paraguayan and Brazilian health systems spur the search for cross-border integration actions. Identifying another country's assistance aspects may help in planning more welcoming policies in border regions.

RESUMEN Objetivo: describir la trayectoria de los extranjeros con enfermedad renal crónica que buscan tratamiento en el Sistema Único de Salud en un municipio fronterizo. Métodos: investigación cualitativa que realizó entrevistas a trece participantes extranjeros y que utilizó el marco teórico-metodológico del itinerario terapéutico en el análisis de datos. Resultados: los datos empíricos resultaron en siete categorías temáticas que indicaron: poca percepción acerca de la enfermedad; apoyo familiar dificultoso durante el tratamiento; aspectos sociales relacionados con el trabajo, los ingresos y la vivienda como fuente de angustia; búsqueda de tratamientos alternativos; búsqueda de asistencia sanitaria en el extranjero interrumpida por problemas financieros; camino recorrido en busca de asistencia sanitaria en Brasil facilitado por familiares y redes sociales. Consideraciones finales: las asimetrías en los sistemas de salud paraguayo y brasileño impulsan la búsqueda de integración de acciones de salud en la frontera. La identificación de aspectos subjetivos de la asistencia en otro país puede favorecer la planificación de políticas más acogedoras en las regiones fronterizas.

RESUMO Objetivo: descrever o percurso de estrangeiros doentes renais crônicos em busca de tratamento no Sistema Único de Saúde em um município fronteiriço. Métodos: pesquisa qualitativa com entrevista a treze participantes estrangeiros e análise de dados pautada no referencial teórico-metodológico do itinerário terapêutico. Resultados: os dados empíricos resultaram em sete categorias temáticas que indicaram: pouca percepção da doença; suporte familiar dificultado ao longo do tratamento; aspectos sociais que envolvem trabalho, renda e moradia como fonte de angústia; procura por tratamentos alternativos; busca por assistência à saúde no exterior interrompida por questões financeiras; caminho percorrido à procura de assistência à saúde no Brasil facilitado por familiares e redes sociais. Considerações finais: assimetrias dos sistemas de saúde paraguaio e brasileiro instigam a busca por integração das ações de saúde na fronteira. Identificar aspectos subjetivos da assistência em outro país pode favorecer o planejamento de políticas mais acolhedoras em regiões de fronteira.

Investigation of chemical modifiers for the direct determination of arsenic in fish oil using high-resolution continuum source graphite furnace atomic absorption spectrometry.

High-resolution continuum source graphite furnace atomic absorption spectrometry (HR-CS GF AAS) has been applied for the development of a method for the determination of total As in fish oil samples using direct analysis. The method does not use any sample pretreatment, besides dilution with 1-propanole, in order to decrease the oil viscosity. The stability and sensitivity of As were evaluated using ruthenium and iridium as permanent chemical modifiers and palladium added in solution over the sample. The best results were obtained with ruthenium as the permanent modifier and palladium in solution added to samples and standard solutions. Under these conditions, aqueous standard solutions could be used for calibration for the fish oil samples diluted with 1-propanole. The pyrolysis and atomization temperatures were 1400 °C and 2300 °C, respectively, and the limit of detection and characteristic mass were 30 pg and 43 pg, respectively. Accuracy and precision of the method have been evaluated using microwave-assisted acid digestion of the samples with subsequent determination by HR-CS GF AAS and ICP-MS; the results were in agreement (95% confidence level) with those of the proposed method.

Determination of sulfur in crude oil using high-resolution continuum source molecular absorption spectrometry of the SnS molecule in a graphite furnace.

An analytical method for the determination of sulfur, as the tin mono-sulfide (SnS) molecule, in crude oil using high-resolution continuum source graphite furnace molecular absorption spectrometry (HR-CS GF MAS) has been developed. The molecular absorbance of the SnS has been measured using the wavelength at 271.624 nm and the crude oil samples were prepared as micro-emulsions due to their high viscosity. Several chemical modifiers (Ir, Pd, Ru, Zr) were tested and palladium was chosen, because it exhibited the best performance. The heating program was optimized by comparing the pyrolysis and vaporization curves obtained for an aqueous sulfur standard and a micro-emulsion of a crude oil certified reference material (CRM). The optimum pyrolysis and vaporization temperatures were found to be 600 and 2000°C, respectively. The limit of detection and the characteristic mass using micro-emulsion analysis of crude oil samples were 5.8 and 13.3 ng S. Accuracy and precision of the method has been evaluated using two crude oil CRM (NIST 2721 and NIST 2722), showing good agreement with the informed or certified values.

Simultaneous determination of bromine and chlorine in coal using electrothermal vaporization inductively coupled plasma mass spectrometry and direct solid sample analysis.

A new method for the direct analysis of coal using electrothermal vaporization inductively coupled plasma mass spectrometry and direct solid sample analysis was developed, aiming at the determination of Br and Cl. The procedure does not require any significant sample pretreatment and allows simultaneous determination of both elements to be carried out, requiring small mass aliquots of sample (about 0.5 mg). All operating parameters, including carrier gas flow-rate and RF power, were optimized for maximum sensitivity. The use of modifiers/aerosol carriers (Pd, Pd+Al and Pd+Ca) was evaluated, and the mixture of Pd and Ca was chosen, allowing pyrolysis and vaporization temperatures of 700°C and 1900°C, respectively. Chlorine was accurately determined using calibration against solid standards, whereas Br could also be determined using calibration against aqueous standard solutions. The limits of quantification were 0.03 µg g(-1) for Br and 7 µg g(-1) for Cl, and no spectral interferences were observed.

Assessment of dispersive liquid-liquid microextraction for the simultaneous extraction, preconcentration, and derivatization of Hg2+ and CH3Hg+ for further determination by GC-MS.

This work reports the development of a dispersive liquid-liquid microextraction method for the simultaneous extraction, preconcentration, and derivatization of Hg(2+) and CH3Hg(+) species from water samples for further determination by GC-MS. Some parameters of the proposed method, such as volume and type of disperser and extraction solvent, and Na[B(C6H5)4] concentration were investigated using response surface methodology. Suitable recoveries were obtained using 80 µL C2 Cl4 (as extraction solvent), 1000 µL ethanol (as disperser solvent), and 300 µL 2.1 mmol/L Na[B(C6H5)4] (as derivatizing agent). Accuracy was evaluated in terms of recovery and ranged from 87 to 99% with RSD values <7%. In addition, a certified reference material of water (NIST 1641d) was analyzed and agreed with the certified value about 107% (for Hg(2+)), with RSD values <8.5%. LODs were 0.3 and 0.2 µg/L, with enrichment factors of 112 and 115 for Hg(2+) and CH3Hg(+), respectively. The optimized method was applied for the determination of Hg(2+) and CH3Hg(+) in tap, well, and lake water samples.

Assessment of modified matrix solid-phase dispersion as sample preparation for the determination of CH3Hg+ and Hg2+ in fish.

This paper reports, for the first time, the development of an analytical method employing modified matrix solid-phase dispersion (MSPD) for the extraction of CH3Hg(+) and Hg(2+) species from fish samples. Separation and determination of mercury species were performed by gas chromatography coupled to mass spectrometry (GC/MS). Important MSPD parameters, such as sample mass, type and mass of solid support, concentration of extraction solution (HCl and NaCl), and stirring time, were investigated by the response surface methodology. The derivatization step and the separation of mercury species were also evaluated for the determination by GC/MS. Quantitative recoveries were obtained with 0.2 g of fish sample, 0.5 g of SiO2 as the solid support, 0.5 mol L(-1) NaCl and 4.2 mol L(-1) HCl as the extraction solution, and 1 min stirring time. The MSPD method showed to be suitable for the extraction and determination of mercury species in certified reference materials of dogfish liver (DOLT-3) and dogfish muscle (DORM-2). It had good agreement (about 99%) with the certified values, and the relative standard deviation was lower than 9.5%. The limits of detection were 0.06 and 0.12 µg g(-1), for CH3Hg(+) and Hg(2+), respectively. A matrix effect was observed, and the quantification was carried out by the matrix-matched calibration. The method was applied to tuna fish ( Thunnus thynnus ), angel shark ( Squatina squatina ), and guitarfish ( Rhinobatos percellens ) samples. The results of the mercury speciation by MPSD and GC/MS were compared to the total mercury concentration determined by flow injection cold vapor generation inductively coupled plasma mass spectrometry, after microwave-assisted digestion. Agreement ranged from 102% to 105%.