Epidemiologia ambiental e exposição a substâncias tóxicas

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Environmental Epidemiology and Toxic Chemical Exposure

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SISTEMAS OPERACIONAIS PARA SOFTWARE EMBARCADO: UM MAPEAMENTO SISTEMÁTICO DA LITERATURA

Embedded systems are constantly increasing today, becomingubiquitous in people's lives. Today there are a widerange of devices, so every day we have new technologies,optimizations, and techniques being applied to embeddedsystems as they need a high degree of reliability, and security,pose new challenges to development. This systematicmapping of the literature (MSL) aims to search for signsthat show the real impact of using a real-time operatingsystem (RTOS) in embedded software. We carry out anMSL using the ACM Digital Library, IEEE Digital Library,ISI Web of Science, Science @ Direct, Springer Link, andScopus databases, looking for articles that relate RTOS andEmbedded Systems to be reviewed. 245 articles were foundon the topic. We excluded articles that were out of contextmaintaining 21 articles on performance, RTOS, embeddedsystem, embedded software development, advantages anddisadvantages regarding the use of RTOS. We conductedan MSL with the purpose of identifying the main methods,diculties, and solutions in the embedded system development.After the research we realized there are no articlesthat lead to a reasonable conclusion because none of the articlesanalyzed clearly show the relationship between the useof an RTOS in embedded systems and the real impact, pros,cons, and obstacles for adopting it.DOI: 10.36558/rsc.v11i2.726

Pandemia pela Covid-19 e multilateralismo: reflexões a meio do caminho

RESUMO O presente artigo analisa, de forma preliminar, as principais posições e respostas de instituições-chave do sistema multilateral das Nações Unidas, como a Assembleia Geral (AGNU) e a Secretaria Geral, e sua agência especializada em saúde, a Organização Mundial da Saúde (OMS), quanto à pandemia pela Covid-19, no período compreendido entre janeiro e maio de 2020. Usando como metodologia a análise de conteúdo dos principais documentos produzidos no âmbito do referido sistema multilateral, identifica a amplitude dessa abordagem, mas também seus limites, assim como os conflitos inerentes a um mundo dividido, que traduzem as disputas de atores políticos relevantes da cena mundial, transferidas também para o campo da saúde global. Ao final, aponta questões fundamentais a serem resolvidas no âmbito de um multilateralismo fraturado e enfraquecido

Saúde ambiental na América Latina e no Caribe: numa encruzilhada

There has been undeniable progress in addressing health, environment and sustainable development in recent decades. Yet, global gains have not been distributed equally, leaving major populations groups excluded, with negative consequences to health. We are also beginning to recognize emerging global problems with significant local impacts, mostly in impoverished populations, both in rural and urban settings. Environmental health is at the crossroads, where new models and partnerships are required. This paper explores these issues with specific reference to the Latin American and Caribbean countries.É inegável que a discussão sobre saúde, meio ambiente e desenvolvimento sustentável tem progredido muito em décadas recentes. Contudo, ganhos globais não têm sido distribuídos de maneira uniforme, deixando grandes grupos populacionais excluídos, com conseqüências negativas à saúde. Também estamos começando a reconhecer problemas globais emergentes que causam impactos locais significativos, principalmente em populações pobres, tanto em áreas rurais como urbanas. A saúde ambiental está numa encruzilhada, em que novos modelos e parcerias são necessários. Este artigo explora essas questões especificamente em relação aos países latino-americanos e caribenhos

Imunoterapia específica com venenos de Hymenoptera: revisão sistemática

CONTEXT AND OBJECTIVE: The only effective treatment for patients who have severe reactions after Hymenoptera stings is venom immunotherapy. The aim of this study was to review the literature to assess the effects of venom immunotherapy among patients presenting severe reactions after Hymenoptera stings. DESIGN AND SETTING: Randomized controlled trials in the worldwide literature were reviewed. The manuscript was produced in the Discipline of Allergy and Clinical Immunology, Universidade de São Paulo (USP). METHODS: Randomized controlled trials involving venom immunotherapy versus placebo or only patient follow-up were evaluated. The risk of systemic reactions after specific immunotherapy was evaluated by calculating odds ratios (OR) and their 95% confidence intervals. RESULTS: 2,273 abstracts were identified by the keywords search. Only four studies were included in this review. The chi-square test for heterogeneity showed that two studies were homogeneous and could be included in a meta-analysis. By combining the two studies, the odds ratio became significant: 0.29 (0.10-0.87). However, analysis on the severity of the reactions after immunotherapy showed that the benefits may not be so significant because the reactions were mostly similar to or milder than the original reaction. CONCLUSIONS: Specific immunotherapy should be recommended for adults and children with moderate to severe reactions, but there is no need to prescribe it for children with skin reactions alone, especially if the exposure is very sporadic. On the other hand, the risk-benefit relation should always be assessed in each case.CONTEXTO E OBJETIVO: O único tratamento eficaz para pacientes que têm reações graves após ferroada de Hymenoptera é a imunoterapia com veneno. O objetivo deste estudo foi rever a literatura para avaliar os efeitos da imunoterapia com veneno em pacientes com reações graves após ferroada de Hymenoptera. TIPO DE ESTUDO E LOCAL: Foram revisados na literatura mundial ensaios clínicos controlados e aleatórios. O manuscrito foi realizado na Disciplina de Alergia e Imunologia Clínica, Universidade de São Paulo (USP). MÉTODOS: Ensaios clínicos controlados e aleatórios envolvendo imunoterapia com veneno de Hymenoptera versus placebo ou apenas acompanhamento dos pacientes foram avaliados. Realizada imunoterapia específica, o risco de reações sistêmicas foi avaliado através de cálculo do "odds ratio" e intervalo de confiança de 95%. RESULTADOS: 2.273 resumos foram identificados na busca pelas palavras chave. Apenas quatro estudos foram incluídos nesta revisão. O teste qui-quadrado de heterogeneidade mostrou que dois estudos foram homogêneos e puderam ser incluídos na metanálise. Ao combinar os dois estudos, o "odds ratio" passou a ser significativo: 0.29 (0.10-0.87). Entretanto, ao analisar a gravidade das reações ocorridas após a imunoterapia, observou-se que os benefícios podem não ser tão relevantes, pois as reações foram, na grande maioria, ou mais leves ou semelhantes à reação original. CONCLUSÕES: A imunoterapia específica deve ser recomendada para adultos e crianças com reações moderadas a graves, porém não há necessidade de prescrevê-la para as crianças apenas com reações cutâneas, especialmente se a exposição é muito esporádica. No outro lado, a relação risco-benefício deve ser sempre avaliada em cada caso

Avaliação da eficiência de produtos alternativos para o controle do míldio e da antracnose em videira, cultivar Niágara Branca

The aim of this study was to evaluate the efficiency of alternative products to control downy mildewand anthracnose in grapevine. An experiment was carried out at Epagri/Urussanga Experiment Station, in Santa Catarina State, Brazil, from September 2004 to February 2005. The following treatments were tested: FitophosK®, Phosphorus K®, Ecolife-40®, Bordeaux mixture, extract of the alga Ulva fasciata and control. All treatments reduced leaf downy mildew severity compared to non-treated plants (24,7%). However, the highest diseasereduction was reached by spraying Ulva-extract, which did not differ significantly from both Bordeaux mixture and Ecolife-40® treatments. Plants treated with alga extract had lower anthracnose incidence in grape bunches(15%) than the control (42,5%), but did not differ from those treated with Phosphorus K®, Bordeaux mixture and Fitophos K®.Com o objetivo de avaliar a eficiência de produtos alternativos para o controle das principais doenças fúngicas da videira, foi conduzido um experimento na Epagri/Estação Experimental de Urussanga – EEUR – noperíodo de setembro de 2004 a fevereiro de 2005. Em 24 parcelas, foram testados os seguintes tratamentos: Fitophos K®, Phosphorus K®, Ecolife-40®, calda bordalesa, extrato da alga Ulva fasciata e testemunha. Todos os tratamentos reduziram significativamente a severidade do míldio em relação à testemunha (24,7%), destacandose o extrato de U. fasciata, calda bordalesa e Ecolife-40®. As plantas tratadas com o extrato da alga exibiram menor incidência de frutos com antracnose (15%), comparadas às testemunhas (42,5%), mas não diferiram daquelas tratadas com Phosphorus K®, calda bordalesa e Fitophos K®

La investigación como instrumento innovador de la sanidad ambiental

Research increasingly demonstrates that the environment is a contributing factor to the emergence of a number of diseases. Environmental risk factors are inherent in the processes of production and arise in different stages including in the extraction of raw materials, in the production of materials, in consumption and as well as in the environmental waste generated in production. All these factors have a serious impact on public health. This article is three-fold, thus, addressing research in the field of environmental health emphasizing prevention and mitigation of exposure to current risk situations in the environment, highlighting the methodological challenges that researchers face in the sphere of environmental health due to an increasing number of variables related to exposure and risk. Finally, the need for an interdisciplinary team utilizing an inter-sectoral approach and the participation of professionals in charge of action research are explored in this article. The contributions of research on Epidemiology, Toxicology, and Risk Assessment are also assessed and discussed.La difusión de resultados de investigaciones muestran que el medio ambiente es un factor que contribuye a la aparición de enfermedades de diversos orígenes y que las situaciones de riesgo son inherentes a los procesos de producción y surgen en distintas etapas: extracción de las materias primas, la producción de los productos, el consumo y los residuos ambientales generados en todo el proceso y causando efectos graves a la salud. En este documento se discuten cuestiones sobre las investigaciones en el campo de la salud ambiental, enfatizando las dificultades metodológicas que encuentran los investigadores en el ámbito de la salud ambiental y la necesidad de un equipo interdisciplinario con un enfoque intersectorial y la participación de los sujetos de la pesquisa. Finalmente, se presentan las contribuciones de las investigaciones en epidemiología, toxicología y evaluación de riesgos

Emergency removal of transplanted graft due to the failure of clinical treatment of serious acute rejection in case of small bowel transplantation: case report

Introduction: Intestinal transplantation is a complex procedure that has become more common in recent years. It can be performed isolated or with other organs of the digestive tract, which characterizes a multivisceral transplantation. Its indication mainly involves patients with irreversible intestinal failure, submitted or not to an enterectomy, and who have complications from parenteral nutrition. Among the main difficulties after transplantation is the immunosuppressive therapy, since the small intestine is an extremely immunogenic organ. Insufficient immunosuppression may cause graft rejection, but excessive immunosuppression may lead to Graft vs. Host Disease, where the intestine’s own immune cells attack Host organs. In Brazil, however, the practical experience with this type of surgery and with the management of immunosuppressive therapy is restricted because of the reduced number of small bowel transplants performed. Objective: To report a case of small bowel transplantation with graft rejection and necessity of surgical removal of the graft. Case Report: A male patient, 21 years old, presented a complicated acute appendicitis in July 2015, being submitted to appendectomy and right colectomy. After the operation, he developed thrombosis and intestinal infarction. This complication affected more than 90% of the patient’s small bowel, requiring extensive enterectomy. The patient developed short bowel syndrome and relied on parenteral nutrition. After 7 months in the home parenteral nutrition regimen, the patient underwent small bowel transplantation due to complications of parenteral nutrition. Immunosuppressive therapy was based on the use of tacrolimus. The patient presented no intercurrences until the 6th postoperative month, when he developed systemic histoplasmosis, staying 33 days in the intensive care unit. He presented resolution of the condition with itraconazole. At the 18th postoperative month, he was admitted with fever and intense diarrhea. The ileoscopy examination showed intestinal ulcers and loss of villi. Graft biopsies were consistent with severe acute T cell mediated rejection. The patient was transferred to our institution to treat the rejection. The combined use of increased tacrolimus, pulse therapy with methylprednisolone, use of thymoglobulin and use of monoclonal antibody against tumor necrosis factor alpha were not effective. The patient`s general condition deteriorated and he had to be submitted to urgent removal of the transplanted graft. The patient returned to the parenteral nutrition regimen and underwent reconstruction of the digestive tract with anastomosis between jejunum and transverse colon 5 months after grafting. Currently, he is in outpatient follow-up using home parenteral nutrition