Environmental and human-health risks of As in soils with abnormal arsenic levels located in irrigated agricultural areas of Paracatu (MG), Brazil.

The municipality of Paracatu (Brazil) is notorious for its large irrigated agricultural area and by abnormal arsenic (As) levels in selected soils of the region. Concerns regarding As exposure via ingestion of water and food are frequent, yet little is known about the behavior of arsenic in irrigated agricultural soils, as well as on As bioaccessibility/bioavailability in agroecosystems of this region. This work evaluated total and available As in agricultural soils cultivated under irrigation and in soils under native vegetation in Paracatu. We also assessed reactive arsenic fractions and As bioaccessibility in the soil, as well as arsenic levels in plant shoots to estimate As risks in these agroecosystems. Soil (different depths) and plant tissue samples were collected in 6 irrigated agricultural areas (CA1 to CA6) and 4 reference areas (RA1 to RA4). Total soil-As did not differ between soil depths, reinforcing that the source of As in agricultural soils is natural. This was evident when counterpointing arsenic and phosphorus contents at different soil depths, as both accumulate on the surface of oxidic soils when added to agroecosystems by anthropogenic routes (e.g., phosphate fertilization for P and irrigation for As). Available As levels in soils and plants were very small (below detection limit). Furthermore, all soils presented very low oral As bioaccessibility. Our findings revealed that the irrigated soils are not As polluted due to the low enrichment and accumulation of arsenic, as well as the prevalence of low ecological risks. There is no non-carcinogenic risk for the local population, except for children in RA2. The estimated carcinogenic risk for children followed the order RA2 > CA3 > CA4 > RA3 > CA2, and for adults, RA2 > CA3. Ultimately, the strategy of comparing the behavior of P and As in the soils of this study proved to be efficient in showing that there are no major risks to humans and the environment in the investigated area. However, periodic monitoring of As bioavailability in these areas is recommended.

Study of the formulation optimization and reusability of a MAGAT gel dosimeter.

PURPOSE: This study aims to optimize the formulation of a methacrylic acid gelatine and tetrakis (hydroxymethyl) phosphonium chloride (MAGAT) gel dosimeter to achieve acceptable dosimetric characteristics and the lowest final costs. This study also evaluates the reusability of the dosimeter. METHODS: The MAGAT gel dosimeter formulation was optimized. Tetrakis (hydroxymethyl) phosphonium chloride (THPC) concentrations (2, 5, 8, 10, 20, and 65 mM), methacrylic acid (MA) concentrations (2.0, 2.5, 3.0, 3.5, and 4.0% w/w) and gelatin concentrations (4.36, 6.45, 8.36, and 10.45% w/w) were evaluated to provide an adequate dosimetric response. The final dosimeter formulation linearity and dose rate dependence were evaluated. The reutilization methodology of the optimized gel formulation, but containing 2 mM of THPC, which was previously irradiated with a dose of 2 Gy, is also presented. RESULTS: The optimized mass concentration of the dosimeter consists of 88.60% deionized water, 8.36% gelatin, 3.00% of MA and 0.04% THPC (5 mM). It presents a linear response for doses up to 10 Gy with a 1.16 Gy-1 s-1 sensitivity. A maximum sensitivity variation of less than 4.0% was found when varying the dose rate of the radiation beams from 300 to 500 cGy/min. It was possible to reuse the dosimeter, however the sensitivity decreased by 15% from the first to the second irradiation. CONCLUSIONS: A low-cost MAGAT gel dosimeter with optimized formulation that responds to radiation in a dose range of 0 to 10 Gy with small dose-rate dependence is presented. The MAGAT gel can be reused after a 2 Gy irradiation.

Developmental dysplasia of the hip: do the responsible for screening know what to do?

ABSTRACT Objective: To evaluate the knowledge on developmental dysplasia of the hip (DDH) by professionals involved in its diagnosis. Methods: This is a cross-sectional study using questionnaires to assess the knowledge about DDH. Orthopedic surgeons and pediatricians, residents and medical students from a tertiary teaching hospital were included in the study. Results: We evaluated 142 medical students, eight orthopedic residents, ten pediatric residents, seven pediatricians, and nine orthopedic surgeons; 50% declared not having examined any DDH case in the last year and only three had diagnosed more than 10 cases during their career. Regarding self-assessed knowledge (0-10), the average score was 4.25 [n=186; SD=2.43]. Nineteen percent of the participants ignored semiological tests and 26.1% of pediatricians (specialists and residents), were unaware of how to perform them. The most acknowledged and neglected risk factor was pelvic presentation (68%) and CMT (9.3%), respectively. None of the participants were able to identify all the risk factors. The average number of risk factors identified was two (n=186; SD=1.58). Forty seven point three percent of the participants failed to recognize the time of birth as the ideal moment for diagnosis; 17% reported it was after the first month. Regarding neglected severe DDH, 45.3% failed to recognize its natural history. Conclusion: Knowledge on DDH among health professionals who are involved in screening is flawed. Level of Evidence IV, Developing a Decision Model.

Brucella abortus RB51 in milk of vaccinated adult cattle.

The aim of this study was to evaluate the shedding of Brucella abortus in the milk of cows vaccinated with a full dose of RB51 during lactation. Eighteen cows, nine previously vaccinated with S19 as calves and nine non-vaccinated, were immunized subcutaneously with 1.3×10(10)CFU of B. abortus RB51, 30-60days after parturition. Milk samples from all animals were collected daily until day 7, and at weekly interval for the next 9 weeks after vaccination. To evaluate the shedding of B. abortus, milk samples were submitted for culture and PCR. No B. abortus was isolated from any sample tested. Only one sample, collected on first day after vaccination from a cow previously vaccinated, was faintly positive in the PCR. In conclusion, the public health hazard associated with milk consumption from cows vaccinated with RB51 in post-partum is very low, despite vaccination with the full dose and regardless of previous S19 vaccination.

DEVELOPMENTAL DYSPLASIA OF THE HIP: DO THE RESPONSIBLE FOR SCREENING KNOW WHAT TO DO?

OBJECTIVE: To evaluate the knowledge on developmental dysplasia of the hip (DDH) by professionals involved in its diagnosis. METHODS: This is a cross-sectional study using questionnaires to assess the knowledge about DDH. Orthopedic surgeons and pediatricians, residents and medical students from a tertiary teaching hospital were included in the study. RESULTS: We evaluated 142 medical students, eight orthopedic residents, ten pediatric residents, seven pediatricians, and nine orthopedic surgeons; 50% declared not having examined any DDH case in the last year and only three had diagnosed more than 10 cases during their career. Regarding self-assessed knowledge (0-10), the average score was 4.25 [n=186; SD=2.43]. Nineteen percent of the participants ignored semiological tests and 26.1% of pediatricians (specialists and residents), were unaware of how to perform them. The most acknowledged and neglected risk factor was pelvic presentation (68%) and CMT (9.3%), respectively. None of the participants were able to identify all the risk factors. The average number of risk factors identified was two (n=186; SD=1.58). Forty seven point three percent of the participants failed to recognize the time of birth as the ideal moment for diagnosis; 17% reported it was after the first month. Regarding neglected severe DDH, 45.3% failed to recognize its natural history. CONCLUSION: Knowledge on DDH among health professionals who are involved in screening is flawed. Level of Evidence IV, Developing a Decision Model.

A dissincronia mecânica é semelhante em diferentes padrões do bloqueio de ramo esquerdo / Mechanical dyssynchrony is similar in different patterns of left bundle-branch block

FUNDAMENTOS: O bloqueio do ramo esquerdo (BRE) e a presença de disfunção sistólica são as principais indicações de terapia de ressincronização cardíaca (TRC). A dissincronia ventricular mecânica pela ecocardiografia pode ajudar a identificar pacientes responsivos à TRC. O BRE pode mostrar diferentes padrões em sua morfologia. OBJETIVO: Comparar a prevalência de dissincronia mecânica em diferentes padrões de BRE em pacientes com disfunção sistólica esquerda. MÉTODOS: Analisaram-se 48 pacientes com fração de ejeção (FE) < 40% e BRE referidos consecutivamente para análise de dissincronia. Foram realizados ecocardiograma convencional e análise da dissincronia mecânica, interventricular e intraventricular, por 10 conhecidos métodos, usando modo M, Doppler e Doppler tecidual, sozinhos ou combinados. A morfologia do BRE foi categorizada pelo desvio esquerdo do eixo no plano frontal e duração de QRS > 150 ms. RESULTADOS: Eram 24 homens, com idade 60 ± 11 anos e FEVE de 29 ± 7%. Trinta e dois apresentavam QRS > 150 ms, e 22, ECG eixo entre -30º e +90º. A dissincronia interventricular foi identificada em 73% dos pacientes e a intraventricular em valores entre 37-98%. Portadores de QRS > 150 ms apresentaram maiores dimensões do átrio e ventrículo esquerdos, e menor FE (p < 0,05), e o desvio esquerdo do eixo associou-se a pior função diastólica e maior diâmetro atrial. A presença de dissincronia mecânica interventricular e intraventricular (10 métodos) foi semelhante entre os diferentes padrões de BRE (p = ns). CONCLUSÃO: Nos dois diferentes padrões eletrocardiográficos de BRE analisados, não foram observadas diferenças em relação à presença de dissincronia mecânica.

BACKGROUND: Left bundle-branch block (LBBB) and the presence of systolic dysfunction are the major indications for cardiac resynchronization therapy (CRT). Mechanical ventricular dyssynchrony on echocardiography can help identify patients responsive to CRT. Left bundle-branch block can have different morphologic patterns. OBJECTIVE: To compare the prevalence of mechanical dyssynchrony in different patterns of LBBB in patients with left systolic dysfunction. METHODS: This study assessed 48 patients with ejection fraction (EF) < 40% and LBBB consecutively referred for dyssynchrony analysis. Conventional echocardiography and mechanical dyssynchrony analysis were performed, interventricular and intraventricular, with ten known methods, using M mode, Doppler and tissue Doppler imaging, isolated or combined. The LBBB morphology was categorized according to left electrical axis deviation in the frontal plane and QRS duration > 150 ms. RESULTS: The patients' mean age was 60 ± 11 years, 24 were males, and mean EF was 29% ± 7%. Thirty-two had QRS > 150 ms, and22, an electrical axis between -30º and +90º. Interventricular dyssynchrony was identified in 73% of the patients, while intraventricular dyssynchrony, in 37%-98%. Patients with QRS > 150 ms had larger left atrium and ventricle, and lower EF (p < 0.05). Left electrical axis deviation associated with worse diastolic function and greater atrial diameter. Interventricular and intraventricular mechanical dyssynchrony (ten methods) was similar in the different LBBB patterns (p = ns). CONCLUSION: In the two different electrocardiographic patterns of LBBB analyzed, no difference regarding the presence of mechanical dyssynchrony was observed.

Mechanical dyssynchrony is similar in different patterns of left bundle-branch block.

BACKGROUND: Left bundle-branch block (LBBB) and the presence of systolic dysfunction are the major indications for cardiac resynchronization therapy (CRT). Mechanical ventricular dyssynchrony on echocardiography can help identify patients responsive to CRT. Left bundle-branch block can have different morphologic patterns. OBJECTIVE: To compare the prevalence of mechanical dyssynchrony in different patterns of LBBB in patients with left systolic dysfunction. METHODS: This study assessed 48 patients with ejection fraction (EF) < 40% and LBBB consecutively referred for dyssynchrony analysis. Conventional echocardiography and mechanical dyssynchrony analysis were performed, interventricular and intraventricular, with ten known methods, using M mode, Doppler and tissue Doppler imaging, isolated or combined. The LBBB morphology was categorized according to left electrical axis deviation in the frontal plane and QRS duration > 150 ms. RESULTS: The patients' mean age was 60 ± 11 years, 24 were males, and mean EF was 29% ± 7%. Thirty-two had QRS > 150 ms, and22, an electrical axis between -30º and +90º. Interventricular dyssynchrony was identified in 73% of the patients, while intraventricular dyssynchrony, in 37%-98%. Patients with QRS > 150 ms had larger left atrium and ventricle, and lower EF (p < 0.05). Left electrical axis deviation associated with worse diastolic function and greater atrial diameter. Interventricular and intraventricular mechanical dyssynchrony (ten methods) was similar in the different LBBB patterns (p = ns). CONCLUSION: In the two different electrocardiographic patterns of LBBB analyzed, no difference regarding the presence of mechanical dyssynchrony was observed.

Síndrome coronariana aguda sem supradesnivelamento do segmento ST: estratificação de risco / Acute coronary syndrome without ST-segment elevation: risk stratification

O tema deste estudo foi estratificação de risco da síndrome coronariana aguda (SCA) sem supradesnivelamento do segmento ST (SST)...