RESUMO
The bioburden in a Hospital building originates not only from patients, visitors and staff, but is also disseminated by several indoor hospital characteristics and outdoor environmental sources. This study intends to assess the exposure to bioburden in one central Hospital with a multi-approach protocol using active and passive sampling methods. The microbial contamination was also characterized through molecular tools for toxigenic species, antifungal resistance and mycotoxins and endotoxins profile. Two cytotoxicity assays (MTT and resazurin) were conducted with two cell lines (Calu-3 and THP-1), and in vitro pro-inflammatory potential was assessed in THP-1 cell line. Out of the 15 sampling locations 33.3% did not comply with Portuguese legislation regarding bacterial contamination, whereas concerning fungal contamination 60% presented I/O > 1. Toxigenic fungal species were observed in 27% of the sampled rooms (4 out of 15) and qPCR analysis successfully amplified DNA from the Aspergillus sections Flavi and Fumigati, although mycotoxins were not detected. Growth of distinct fungal species was observed on Sabouraud dextrose agar with triazole drugs, such as Aspergillus section Versicolores on 1 mg/L VORI. The highest concentrations of endotoxins were found in settled dust samples and ranged from 5.72 to 23.0 EU.mg-1. While a considerable cytotoxic effect (cell viability < 30%) was observed in one HVAC filter sample with Calu-3 cell line, it was not observed with THP-1 cell line. In air samples a medium cytotoxic effect (61-68% cell viability) was observed in 3 out of 15 samples. The cytokine responses produced a more potent average cell response (46.8 ± 12.3 ρg/mL IL-1ß; 90.8 ± 58.5 ρg/mL TNF-α) on passive samples than air samples (25.5 ± 5.2 ρg/mL IL-1ß and of 19.4 ± 5.2 ρg/mL TNF-α). A multi-approach regarding parameters to assess, sampling and analysis methods should be followed to characterize the biorburden in the Hospital indoor environment. This study supports the importance of considering exposure to complex mixtures in indoor environments.
Assuntos
Microbiologia do Ar , Poluição do Ar em Ambientes Fechados , Exposição Ambiental/estatística & dados numéricos , Micotoxinas , Poeira , Monitoramento Ambiental , Fungos , HumanosRESUMO
Accurate assessment of particulate matter (PM) dose and respiratory deposition is essential to better understand the risks of exposure to PM and, consequently, to develop the respective risk-control strategies. In homes, this is especially relevant in regards to ultrafine particles (UFP; <0.1 µm) which origin in these environments is mostly due to indoor sources. Thus, this study aimed to estimate inhalation doses for different PM mass/number size fractions (i.e., PM10, PM2.5 and UFP) in indoor air of residential homes and to quantify the deposition (total, regional and lobar) in human respiratory tract for both newborn children and mothers. Indoor real-time measurements of PM10, PM2.5 and UFP were conducted in 65 residential homes situated in Oporto metropolitan area (Portugal). Inhalation doses were estimated based on the physical characteristics of individual subjects and their activity patterns. The multi-path particle dosimetry model was used to quantify age-specific depositions in human respiratory tract. The results showed that 3-month old infants exhibited 4-fold higher inhalation doses than their mothers. PM10 were primarily deposited in the head region (87%), while PM2.5 and UFP depositions mainly occurred in the pulmonary area (39% and 43%, respectively). Subject age affected the pulmonary region and the total lung deposition; higher deposition being observed among the newborns. Similarly, lower lobes (left lobe: 37% and right lobe: 30%) received higher PM deposition than upper and middle lobes; right lobes lung are prone to be more susceptible to respiratory problems, since asymmetric deposition was observed. Considering that PM-related diseases occur at specific sites of respiratory system, quantification of site-specific particle deposition should be predicted in order to better evidence the respective health outcomes resulting from inhaled PM.
Assuntos
Poluição do Ar em Ambientes Fechados , Poluentes Atmosféricos , Monitoramento Ambiental , Feminino , Humanos , Recém-Nascido , Exposição por Inalação , Mães , Tamanho da Partícula , Material Particulado , PortugalRESUMO
Frailty is an age-related syndrome expected to increase over the next decades. This syndrome has been identified to be the most common condition leading to disability, institutionalisation and death in the elderly. The aim of this pilot study is to investigate a possible link between frailty status, biomarkers and environmental exposures. A group of 71 older adults (≥65 years old) was engaged in this study. The study population was classified as 45.1% robust, 45.1% pre-frail and 9.8% frail. A significant higher prevalence of second-hand smokers was found in the pre-frail group when compared to robust. Furthermore, a higher prevalence of robust individuals was found among those consuming home-produced vegetables and water from well/springs. Significant differences were found between data collected in a lifetime exposure questionnaire (LTEQ) and the levels of genotoxicity endpoints and the mercury levels analysed regarding some exposure-related parameters, namely, smoking habits, intake of home-produced vegetables and the use of pesticides in agriculture. Understanding if the way we live(d) or worked can impact the way we age are important questions to be explored. Data obtained in this pilot study encourage further studies on this matter, exploring the role of exposures history and its impact on health.
RESUMO
Background: By observing the high prevalence of failures in the surgical treatment of myocardial revascularization (MR), with the use of the Left Internal Thoracic Artery (LITA) as a graft, evidenced by the international literature, it was sought to demonstrate the prevalence of lesions that would not allow the use of LITA as a graft in myocardial revascularization surgery, with possible alteration in the surgical management performed by the cardiac surgeon, and reduction of the morbimortality of these patients. Objectives: To evaluate the prevalence of atherosclerotic lesions of the LITA, through selective preoperative angiography, in patients submitted to coronary angiography and indicated for myocardial revascularization. We also analyzed other lesions that made the use of LITA unfeasible as a main graft in cases of myocardial revascularization surgery (MRS). Methods: This was a cross-sectional, prevalence study that evaluated, through selective angiography, the LITA of 39 patients with a median age of 63 years, submitted to coronary angiography, with indication of Coronary Artery Bypass Graft (CABG). Categorical variables were compared by chi-square test and Fisher's exact test. The single continuous variable, age, was tested for normality by the Kolmogorov-Smirnov test, described in median (P25; P75) and the groups compared with the Mann-Whitney test. The level of statistical significance adopted was p < 0.05. The analyzes were performed in SPSS ® software version 20. Results: It was identified the presence of 7.7% of disorders in the LITA that made it unfeasible to be used. In all of the patients there was no specific symptomatology evidencing the lesion. No variable was shown as a predictor for the occurrence of the outcomes. Conclusion: The prevalence of the lesions found in the study was significant, indicating that a preoperative evaluation of LITA could bring future benefits to the patients submitted to CABG
Fundamento: Pela observação da alta prevalência de falhas no tratamento cirúrgico da revascularização do miocárdio (RM), com o uso da Artéria Torácica Interna Esquerda (ATIE) como enxerto, evidenciadas pela literatura internacional, buscou-se demonstrar a prevalência de lesões que inviabilizem o uso da ATIE como enxerto na cirurgia de revascularização do miocárdio, com possível alteração na conduta cirúrgica tomada pelo cirurgião cardíaco, e redução da morbimortalidade destes pacientes. Objetivos: Avaliar a prevalência de lesões ateroscleróticas da ATIE, por meio da angiografia seletiva, pré - operatória, em pacientes submetidos à cinecoronariografia e com indicação de revascularização cirúrgica do miocárdio. Também foram analisadas outras lesões que inviabilizam o uso da ATIE como enxerto principal em casos de necessidade da cirurgia de revascularização do miocárdio (CRM). Métodos: Estudo analítico, transversal, de prevalência, que avaliou por meio da angiografia seletiva, a ATIE de 39 pacientes com mediana de idade de 63 anos, submetidos ao exame de cinecoronariografia, com indicação de CRM. As variáveis categóricas foram comparadas pelo teste do qui-quadrado e exato de Fisher. A única variável contínua, a idade, foi testada para normalidade pelo teste de Kolmogorov-Smirnov, descrita em mediana (P25; P75) e os grupos comparados com teste de Mann-Whitney. O nível de significância estatística adotado foi p < 0,05. As análises foram realizadas no software SPSS ® versão 20. Resultados: Foi identificada a presença de 7,7% de alterações na ATIE que inviabilizam sua utilização. Em todos os pacientes inexistiu a presença de qualquer sintomatologia especifica que evidencia a lesão. Nenhuma variável se mostrou como fator preditor para ocorrência dos desfechos. Conclusão: A prevalência das lesões encontradas no estudo mostrou-se significativa, indicando que uma avaliação pré-operatória de ATIE possa trazer benefícios futuros aos pacientes submetido à CRM
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Aterosclerose/complicações , Angiografia Coronária/métodos , Artéria Torácica Interna , Prevalência , Doença da Artéria Coronariana/complicações , Diabetes Mellitus/diagnóstico , Diagnóstico por Imagem/métodos , Revascularização Miocárdica/métodos , Fatores de Risco , Comportamento Sedentário , Interpretação Estatística de Dados , Tabagismo/complicaçõesRESUMO
A amelogênese imperfeita (AI) é uma condição de origem genômica que causa um defeito na estrutura dentária, se apresentando exclusivamente no esmalte e, altera tanto sua formação quanto seu conteúdo. Ela se manifesta na dentição decídua e permanente e é hereditária, podendo se apresentar de quatro formas que foram classificadas como: Hipoplásica (tipo I), Hipomaturada (tipo II), Hipocalcificada (tipo III) e Hipomaturada-Hipoplásica com Taurodontismo (tipo IV). Elas apresentam alteração na tonalidade e podem envolver cores que variam do branco opaco, branco- amareladas, amarelo ao marrom-amarelado e ou marrom. O presente estudo, tem como objetivo apresentar um relato de caso de reabilitação oral, funcional e estética em paciente portador de amelogenese imperfeita do tipo hipomaturada. Foi apresentado um plano de tratamento para este tipo de paciente, com uma técnica para alteração de dimensão vertical de oclusão (DVO). Modelos superior e inferior foram obtidos com o objetivo de realizar uma montagem em articulador semi-ajustável para enceramento diagnóstico e planejamento do caso. Foi proposto uma alteração de DVO para mais com a confecção de restaurações provisórias resina acrílica auto polimerizável pela técnica da pré moldagem a partir do enceramento e também na técnica da faceta com dente de estoque nos dentes anteriores. Desta forma, a terapia proposta poderemos restabelecer a função mastigatória e a estética ao paciente, contribuindo assim, para elevação de sua autoestima e melhoria na qualidade de vida.
Amelogenesis imperfecta (AI) is a condition of genomic origin that causes a defect in the tooth structure, presenting exclusively in the enamel and altering both its formation and its content. It manifests itself in the deciduous and permanent dentition and is hereditary, and can present in four ways that have been classified as: Hypoplastic (type I), Hypomaturated (type II), Hypocalcified (type III) and Hypomature-Hypoplastic with Taurodontism (type IV). They present a change in tonality and may involve colors ranging from opaque white, yellowish white, yellow to yellowish-brown and/or brown. The present study aims to present a case report of oral, functional and aesthetic rehabilitation in a patient with hypomature amelogenesis imperfecta. A treatment for this type of patient was presented, with a technique for altering the vertical dimension of occlusion (DVO). Assembly was carried out in a semi-adjustable articulator, diagnostic wax-up for case planning, alteration of DVO to more, provisional making from wax-up with pre-molding and from the veneer technique with stock tooth. In this way, the proposed therapy reestablished masticatory function and restored aesthetics to the patient, thus contributing to raising their self-esteem and improving their quality of life.