Cyanobacterial dynamics and toxins concentrations in Lake Alto Flumendosa, Sardinia, Italy

Seasonal blooms of cyanobacteria (CB) are a typical feature of Lake Alto Flumendosa (Sardinia, Italy). The waters of this lake are used for drinking water supply, for agricultural and industrial uses, and fish farming activities. Since cyanotoxins are not monitored in edible organisms, diet could be a relevant route of human exposure. CB also represent a threat for the health of wild and domestic animals that use lake water for beverage. Therefore, to characterize the CB community and assess the risk for human and animal population, CB dynamic, mcyB+ fraction, and microcystins (MCs) concentration have been followed monthly for 18 months, in three stations. Results confirmed the presence of several toxigenic species. Planktothrix rubescens dominated between August 2011 and April 2012 (3.5×106 cells L-1), alternating with Woronichinia naegeliana (8×106 cells L-1) and Microcystis botrys (9×105 cells L-1). Dolichospermum planctonicum was always present at low densities (104 cells L-1). MCs were detected, at values well below the 1 µg L-1 threshold of WHO for drinking water. The molecular analysis of mcyB gene for P. rubescens indicated the presence of a persistent toxic population (average 0.45 mcyB/16S rDNA). Highly significant linear regressions were found between P. rubescens and the sum of the demethylated MC variants, and between M. botrys and the sum of MC-LR and MC-LA, also when co-occurring, suggesting that these two species were responsible for different MC patterns production. The regression lines indicated a quite stable MC cell quota. However, in some spotted samples very different values were obtained for both MC concentrations and cell quota (from 10-fold lower to 30-40-fold higher than the 'average') showing an unexpected significant variability in the rate of toxin production. The relatively low cell densities during the monitoring period is consistent with the low-to absent MC contamination level found in trout muscle; however, the analytical method was affected by low recovery, probably due to MC-protein binding. Our results show that, during the study period, no risk of exposure for the human and animal population occurred. However, the persistence of a complex CB community characterised by a significant toxic fraction suggests the need for periodic monitoring activity. Particularly, the hidden deep summer P. rubescens blooms, located where water is taken for drinking water supply, and M. botrys, able to produce the most toxic MC variants with high cell quota, should be kept under control. The documentation and interpretation of sudden changes in toxins concentrations deserve special attention. This is particularly relevant in proximity of fish farming plants and water catchment sites

emerging health issues of cyanobacterial blooms

This paper describes emerging issue related to cyanobacterial dynamics and toxicity and human health risks. Data show an increasing cyanobacteria expansion and dominance in many environments. However there are still few information on the toxic species fitness, or on the effects of specific drivers on toxin production. Open research fields are related to new exposure scenario (cyanotoxins in water used for haemodialysis and in food supplements); to new patterns of co-exposure between cyanotoxins and algal toxins and/or anthropogenic chemicals; to dynamics affecting toxicity and production of different cyanotoxin variants under environmental stress; to the accumulation of cyanotoxins in the food web. In addition, many data gaps exist in the characterization of the toxicological profiles, especially about long term effects

A comunicação da suspensão de cirurgias pediátricas: sentimentos dos familiares envolvidos no processo

A hospitalização é uma experiência complexa, sendo agravada no caso de necessidade de intervenção cirúrgica, principalmente quando o paciente é criança. Quando a cirurgia é suspensa, paciente e seus familiares podem apresentar sentimentos de insegurança, angústia e ansiedade. Este estudo teve como objetivo identificar e descrever a percepção de quinze mães e/ou responsáveis por crianças de 0 a 18 anos, internadas em um hospital, após receberem a notícia de que a cirurgia de seu filho foi suspensa. É um estudo descritivo, qualitativo, que utilizou o referencial teórico da Comunicação Interpessoal e o metodológico da Análise de Conteúdo. Os resultados evidenciaram que as suspensões de cirurgias pediátricas são fatos presentes na instituição, que trazem repercussões ao paciente e familiares, e à organização institucional; que a comunicação entre profissionais da saúde, pacientes e familiares é inadequada; que a atuação do enfermeiro na notícia da suspensão da cirurgia precisa ser efetiva.La hospitalización es una experiencia compleja, agravada en el caso de ser necesaria una intervención quirúrgica, en particular cuando el enfermo es un niño. Cuando la cirugía es suspendida, el enfermo y sus familiares pueden manifestar sentimientos de inseguridad, angustia y ansiedad. Este estudio tuve como objetivo identificar e describir la percepción de quince madres y/o responsables por niños con edades entre 0 y 18 años internados en un hospital después de recibir la noticia de que la cirugía de su hijo fue suspendida. Se trata de un estudio descriptivo cualitativo que utilizó el referencial teórico de la Comunicación Interpersonal y la metodología del Análisis de Contenido. Los resultados evidenciaron que las suspensiones de cirugías pediátricas son hechos presentes en la institución, que traen repercusiones al enfermo y familiares y en la propia organización institucional, que la comunicación entre profesionales de la salud, enfermos y familiares es inadecuada y que la actuación del enfermero en la noticia de la suspensión de la cirugía debe ser necesariamente efectiva.Hospitalization is a complex experience; this can be made worse if surgical intervention is required, especially when the patient is a child. When surgery is suspended, patient and family can experience feelings of insecurity, distress, and anxiety. The objective of this study was to identify and describe the perceptions of fifteen mothers or guardians of children between 0 and 18 years old admitted in a teaching hospital, after receiving news that surgery for their child was suspended. This was a descriptive qualitative study which used Interpersonal Communication as theoretical reference and Analysis of Content as the methodology. Results showed that suspension of pediatric surgery in our institution causes repercussions to patients, their families, and institution organisation; that communication between health team professionals, patients and families is inadequate; and that the nurses' participation in informing surgery suspension must be effective

A importância da comunicação durante o período de recuperação pós-operatória

Este estudo teve como objetivo conhecer a importância da comunicação durante as orientações pós-operatórias fornecidas pela equipe de enfermagem a pacientes e/ou familiares de uma instituição privada e apreender a percepção destes indivíduos acerca das orientações recebidas. Foi um estudo transversal, descritivo, com abordagem qualitativa, que utilizou o referencial teórico da Comunicação Interpessoal e o referencial metodológico da Análise de Conteúdo. Participaram do estudo 16 pacientes entrevistados no período pós-operatório mediato. Os resultados evidenciaram que a equipe de enfermagem focaliza as orientações nas técnicas instrumentais da profissão, não abordando o indivíduo de forma holística. Também foi possível perceber que, quando o profissional enfermeiro permanece afastado do paciente e/ou não presta informações adequadas gera sentimentos de ansiedade, medo, insegurança e sensação de falta de cuidado. Por outro lado, quando a equipe de enfermagem se fez presente com cuidado e informações coerentes, os clientes relataram um alto nível de satisfação e a sensação de ser bem cuidado

REFLEXÕES SOBRE MÉTODOS QUALITATIVOS DE PESQUISA EM ENFERMAGEM

Este ensaio traz considerações sobre métodos quantitativos e qualitativos de pesquisa em Enfermagem Aborda suas especificidades, faz uma distinção entre método e técnica, e dá ênfase aos pressupostos epistemológicos que embasam o método

Cyanobacterial dynamics and toxins concentrations in Lake Alto Flumendosa, Sardinia, Italy

Seasonal blooms of cyanobacteria (CB) are a typical feature of Lake Alto Flumendosa (Sardinia, Italy). The waters of this lake are used for drinking water supply, for agricultural and industrial uses, and fish farming activities. Since cyanotoxins are not monitored in edible organisms, diet could be a relevant route of human exposure. CB also represent a threat for the health of wild and domestic animals that use lake water for beverage. Therefore, to characterize the CB community and assess the risk for human and animal population, CB dynamic, mcyB+ fraction, and microcystins (MCs) concentration have been followed monthly for 18 months, in three stations. Results confirmed the presence of several toxigenic species. Planktothrix rubescens dominated between August 2011 and April 2012 (3.5×106 cells L-1), alternating with Woronichinia naegeliana (8×106 cells L-1) and Microcystis botrys (9×105 cells L-1). Dolichospermum planctonicum was always present at low densities (104 cells L-1). MCs were detected, at values well below the 1 µg L-1 threshold of WHO for drinking water. The molecular analysis of mcyB gene for P. rubescens indicated the presence of a persistent toxic population (average 0.45 mcyB/16S rDNA). Highly significant linear regressions were found between P. rubescens and the sum of the demethylated MC variants, and between M. botrys and the sum of MC-LR and MC-LA, also when co-occurring, suggesting that these two species were responsible for different MC patterns production. The regression lines indicated a quite stable MC cell quota. However, in some spotted samples very different values were obtained for both MC concentrations and cell quota (from 10-fold lower to 30-40-fold higher than the ‘average’) showing an unexpected significant variability in the rate of toxin production. The relatively low cell densities during the monitoring period is consistent with the low-to absent MC contamination level found in trout muscle; however, the analytical method was affected by low recovery, probably due to MC-protein binding. Our results show that, during the study period, no risk of exposure for the human and animal population occurred. However, the persistence of a complex CB community characterised by a significant toxic fraction suggests the need for periodic monitoring activity. Particularly, the hidden deep summer P. rubescens blooms, located where water is taken for drinking water supply, and M. botrys, able to produce the most toxic MC variants with high cell quota, should be kept under control. The documentation and interpretation of sudden changes in toxins concentrations deserve special attention. This is particularly relevant in proximity of fish farming plants and water catchment sites

Emerging health issues of cyanobacterial blooms

This paper describes emerging issue related to cyanobacterial dynamics and toxicity and human health risks. Data show an increasing cyanobacteria expansion and dominance in many environments. However there are still few information on the toxic species fitness, or on the effects of specific drivers on toxin production. Open research fields are related to new exposure scenario (cyanotoxins in water used for haemodialysis and in food supplements); to new patterns of co-exposure between cyanotoxins and algal toxins and/or anthropogenic chemicals; to dynamics affecting toxicity and production of different cyanotoxin variants under environmental stress; to the accumulation of cyanotoxins in the food web. In addition, many data gaps exist in the characterization of the toxicological profiles, especially about long term effects