Contaminação ambiental por ovos de Toxocara sp. no município de Ribeirão Preto, Estado de São Paulo, Brasil

Toxocariasis is a zoonosis mainly caused by Toxocara canis, an intestinal nematode of dogs. Man acquires the infection through accidental ingestion of viable eggs, and the toxocariasis clinical manifestations may vary from an asymptomatic infection up to the Visceral Larva Migrans syndrome. Seventy eight public squares of Ribeirão Preto, São Paulo, Brazil, including Bonfim Paulista district were visited aiming to evaluate the soil contamination by Toxocara eggs. The squares were divided in five different areas corresponding to the Sanitary Districts of the city. From May to December 2003, soil samples weighting about 250 g each were collected from five distinct sites of each public square. The laboratorial analysis was done by centrifugal-flotation techniques in magnesium sulphate solutions with 5% of potassium iodide (d = 1.33) and zinc sulphate (d = 1.20), and by the sedimentation- flotation in conic chalices with zinc sulphate (d = 1.20). Toxocara sp. eggs were found on 16 (20.5%) squares, with the lowest prevalence (12%) at the central area. From these results, it is expected that the legal authority will adopt protection measures for the city public areas, reducing thus the contamination risk by Toxocara sp. eggs.A toxocaríase é uma zoonose causada principalmente pelo Toxocara canis, nematóide intestinal de cães. O homem adquire a infecção através da ingestão acidental de ovos viáveis, sendo que as manifestações clínicas da toxocaríase podem variar desde uma infecção assintomática à síndrome da Larva Migrans Visceral. Com o objetivo de avaliar a contaminação do solo por ovos de Toxocara sp, foram visitadas 78 praças públicas de Ribeirão Preto, incluindo o distrito de Bonfim Paulista. As praças foram distribuídas em cinco áreas diferentes correspondentes as mesmas dos Distritos Sanitários do município. Entre maio a dezembro de 2003 foram coletadas de cinco pontos de cada praça amostras de solo de aproximadamente 250 gramas. A análise laboratorial foi realizada pelas técnicas da centrífugo-flutuação em soluções de sulfato de magnésio com 5% de iodeto de potássio (d = 1.33) e de sulfato de zinco (d = 1.20) e da flotação-sedimentação em cálice cônico com sulfato de zinco (d = 1.20). Foram encontrados ovos de Toxocara sp. em 16 (20,5%) praças, sendo que a região central apresentou a mais baixa prevalência (12,0%). Espera-se que a partir destes resultados as autoridades competentes adotem medidas de proteção das áreas públicas do município, reduzindo o risco da contaminação por ovos de Toxocara sp

Uma alimentação saudável para crianças na educação infantil

Orientadora: Profª Andréia AssmannMonografia (Especialização) - Universidade Aberta do Brasil Universidade Federal do Paraná. Coordenação de Integração de Politica de Educação a Distancia.Setor de Ciências da Saúde.Departamento de Enfermagem. Curso de Especialização em Saúde para Professores do Ensino Fundamental e Médi

Enteroparasitosis in food handlers in the city of Ribeirão Preto - SP, Brazil, 2000

INTRODUÇÃO: A segurança alimentar vêm adquirindo mundialmente uma importância crescente. As doenças transmitidas por alimentos (DTAS) têm impactos na saúde pública e socioeconômicos, acarretando custos hospitalares em tratamentos e internações. As pessoas envolvidas na produção de alimentos podem ser portadoras de enteroparasitos e vir a contaminar os alimentos, provocando surtos de origem alimentar. OBJETIVOS: Investigar a presença de enteroparasitoses em manipuladores de alimentos do município de Ribeirão Preto, SP, propondo medidas que assegurem a qualidade sanitária dos alimentos. MÉTODOS: Entre julho a dezembro de 2000, 429 manipuladores de alimentos (248 mulheres e 181 homens), com idades entre 16 e 77 anos, foram submetidos ao exame coproparasitológico por ocasião da obtenção ou renovação da carteira de saúde. As amostras de fezes foram examinadas pelos métodos de Kato e da sedimentação espontânea. A pesquisa de oocistos de Cryptosporidium spp foi realizada em 7,0% das amostras de fezes diarréicas através da técnica de concentração pelo formol-éter. RESULTADOS: Foram encontradas enteroparasitoses em 33,1% dos manipuladores, incluindo 20,0% de casos de poliparasitismo. Prevalências mais altas de infecções ocorreram entre os indivíduos envolvidos com atividades de manipulação direta dos alimentos (68%). CONCLUSÕES: Considerando os resultados obtidos, são necessários a educação sanitária e o treinamento dos manipuladores bem como a implementação da metodologia da Análise dos Perigos e Pontos Críticos de Controle (APPCC) em todas as etapas da cadeia de produção dos alimentos, para garantir produtos alimentícios seguros aos consumidores.INTRODUCTION: Food safety has become increasingly importance worldwide. Food borne diseases have impacts on public health and socioeconomic factors, accounting for hospital costs in treatments and hospitalizations. People involved in food production can be carriers of enteroparasites and contaminate food, causing food borne diseases OBJECTIVE: The aim of this study was to investigate the presence of enteroparasites in food handlers in Ribeirão Preto, SP, proposing measures to ensure the sanitary quality of food. METHODS: From July to December 2000, 429 food handlers (248 women and 181 men), aged between 16 and 77 years, underwent coproparasitological analysis as a mandatory professional requirement. Fecal samples were analyzed by the Kato's and spontaneous sedimentation methods. Cryptosporidium spp oocysts were investigated in 7.0% of diarrheic fecal samples using the formalin-ether concentration technique. RESULTS: The results showed enteroparasitosis in 33.1% of food handlers, including 20.0% cases of multiple parasitic infections. A higher prevalence of infections (68.0%) was detected among the individuals involved in direct food handling activities. CONCLUSIONS: Considering these results, it is necessary to provide sanitary education and training to food handlers, and to implement the method of Hazard Analysis and Critical Control Points (HACCP) in all stages of the food chain so as to ensure food safety for consumers

Principais enteropatógenos causadores de diarréia em crianças, na região de Ribeirão Preto-SP, Brasil

Com o objetivo de caracterizar os principais enteropatógenos causadores de diarréia na região de Ribeirão Preto, quanto aos sorogrupos e sorotipos, por um período de 4 anos foram estudadas fezes de 1836 crianças, menores de 10 anos de idade, de ambos os sexos, portadoras de gastrenterite aguda no IAL de Ribeirão Preto, SP. Foram pesquisados os seguintes enteropatógenos: Escherichia coli, Salmonella sp., Shigella sp., Campylobacter sp., Yersinia sp., e Cryptosporidium sp., identificados através de metodologia tradicional. Foram positivas 419 (22,8%) amostras, com 1,7% de associação entre enteropatógenos. Houve predomínio na faixa etária de 0 a 11 meses. Destacou-se a E.coli enteropatogênica (EPEC) (8,7%), sendo mais frequente o sorogrupo O119 (40,2%), seguida do gênero Shigella (6,2%), dos quais 63,2% corresponderam à S. sonnei.To study the main enteropathogens causing diarrhea in the region of Ribeirão Preto regarding serogroups and serotypes, the feces of 1836 children under 10 years old, from both sexes, attack of acute gastroenteritis, were analysed during a period of 4 years in Adolfo Lutz Institute - Ribeirão Preto, SP. The pathogens identified by standard methods were the following: Escherichia coli, Salmonella spp., Shigella spp., Campylobacter spp., Yersinia spp., and Cryptosporidium spp. Positive samples were 22.8% (419) with 1.7% association of pathogens. Larger isolates were mainly from children 0 to 11 months old. Enteropathogenic E. coli (EPEC) was most frequent (8.7%) with predominance of serogroup O119 (40.2%), followed by Shigella (6.2%), 63.6% of which S. sonnei

Weekly continuous monitoring of glucose levels in chronic hemodialysis diabetic patients: comparative study of two dialysis solutions

Diabetes mellitus (DM) is the first cause of End-Stage Kidney Disease (ESKD). DM regulation has many peculiarities and difficulties in patients with ESKD. Especially in HD diabetes patients there are many factors, but mainly there is the glucose elimination from the dialysis filter, they make the DM management even more difficult. These patients have a higher risk of developing day-to-day glucose variability, hypoglycemic episodes and even not diagnosed asymptomatic hypoglycemic episodes, which associated with increased mortality. The use of glucose-free dialysis solution contributes to increased glucose loss, especially in patients with unregulated DM, and increases the incidence of hypoglycemia during dialysis. Glycated hemoglobin (HbA1c), which has been established as the ideal glycemic index worldwide, presents several limitations in its use for patients with DM and ESKD. In addition, HbA1c does not take into account changes in glucose during the day. In recent years we have latest technologies of continuous glucose monitoring (CGM) systems, which they are devices that measure glucose by continuous measurements in the subcutaneous tissue. Also, newer glycemic indexes, such as glycated albumin (GA) and serum glycated protein (SGP) are now being evaluated for the assessment of DM regulation. The purpose of the present comparative study between two different dialysis solutions (glucose free vs 100mg/dl glucose) is to evaluate and better regulate patients with type 2 DM undergoing HD, utilizing the latest technology of Medronic's iPro CGM. Also, the study evaluate the latest glycemic indexes GA and SGP as alternative markers for HbA1c to determine the glycemic status of diabetic patients on HD.. The final study population consisted of 36 patients, who were fitted with a 7-day CGM. Phase A of the study corresponds to 3 consecutive weekly dialysis sessions with glucose free solution and phase B with 100mg/dl glucose solution respectively. Comparison of the two phases A and B showed that the addition of glucose solution to the 4 hour HD period helps to avoid blood glucose lowering (p <0.001), and avoid the risk of hypoglycaemia during the HD session (p <0.001). However, does not appear to be involved in modifying the overall mean glucose, but it seems to reduce the variability of glucose in long term time periods. Finally, the present study showed that GA has higher sensitivity and specificity (r: 0.884, p <0.001) and was more strongly correlated with mean glucose compared to SGP and HbA1c (r: 0.672, p <0.001 and r: 0.694, p <0.001).According to the above results of the present study it is found that CGM system is the only method that accurately records the significant fluctuations in blood sugar levels of hemodialysis patients. Although it is the largest comparative study with a CGM system until today, larger documented research studies are needed with the use of CGM in HD diabetes patients to expand our knowledge in the control of diabetes and the high risk of its complications.Ο σακχαρώδης διαβήτης είναι η πρώτη αιτία Χρόνιας Νεφρικής Νόσου Τελικού Σταδίου (ΧΝΝΤΣ). Η ρύθμιση του ΣΔ παρουσιάζει ιδιαιτερότητες και δυσκολίες στους ασθενείς με ΧΝΝΤΣ. Ειδικά για τους ασθενείς με ΣΔ υπό αιμοκάθαρση, η διαχείριση του ΣΔ είναι ακόμη δυσκολότερη, διότι η δίοδος της γλυκόζης από το φίλτρο αιμοκάθαρσης φαίνεται να παίζει σημαντικό ρόλο μεταξύ άλλων στην συχνότερη εμφάνιση μεγάλων διακυμάνσεων της γλυκόζης, περισσότερων υπογλυκαιμικών επεισοδίων και κυρίως ασυμπτωματικών υπογλυκαιμικών επεισοδίων, γεγονότα που σχετίζονται με αυξημένη θνησιμότητα. Η χρήση διαλύματος αιμοκάθαρσης χωρίς γλυκόζη, ειδικά σε ασθενείς με αρρύθμιστο ΣΔ φαίνεται να αυξάνει τη συχνότητα υπογλυκαιμίας κατά τη διάρκεια της αιμοκάθαρσης.Η γλυκοζυλιωμένη αιμοσφαιρίνη (HbA1c), η οποία έχει καθιερωθεί παγκοσμίως ως ο ιδανικός δείκτης γλυκαιμικής ρύθμισης, παρουσιάζει αρκετούς περιορισμούς σε ασθενείς με ΣΔ και ΧΝΝΤΣ. Επιπλέον, η HbA1c δεν λαμβάνει υπόψη τις αλλαγές στα επίπεδα της γλυκόζης κατά τη διάρκεια της ημέρας. Τα τελευταία χρόνια έχουμε τελευταίας τεχνολογίας συστήματα συνεχούς καταγραφής γλυκόζης (CGM), τα οποία είναι συσκευές που πραγματοποιούν συνεχείς μετρήσεις γλυκόζης στον υποδόριο ιστό. Επίσης, νεότεροι γλυκαιμικοί δείκτες, όπως η γλυκοζυλιωμένη αλβουμίνη (GA) και η γλυκοζυλιωμένη πρωτεΐνη (GSP) αξιολογούνται στις μέρες μας ως εναλλακτικοί δείκτες γλυκαιμικής ρύθμισης. Ο σκοπός της παρούσας συγκριτικής μελέτης μεταξύ δύο διαφορετικών διαλυμάτων αιμοκάθαρσης (διάλυμα χωρίς γλυκόζη έναντι διαλύματος με περιεκτικότητα 100mg/dl γλυκόζης) είναι η αξιολόγηση των ασθενών με ΣΔ τύπου 2 που υποβάλλονται σε αιμοκάθαρση, χρησιμοποιώντας την συσκευή CGM iPro της Medronic 7ημερης καταγραφής . Επίσης, η μελέτη αξιολογεί τους δείκτες GA και το GSP ως εναλλακτικούς δείκτες έναντι της HbA1c για τον προσδιορισμό της γλυκαιμικής ρύθμισης στους αιμοακαθαιρόμενους διαβητικούς ασθενείς.Ο τελικός πληθυσμός μελέτης αποτελείται από 36 ασθενείς, στους οποίους τοποθετήθηκε η συσκευή CGM 7 ημερών. Η φάση Α της μελέτης αντιστοιχεί σε 3 διαδοχικές συνεδρίες αιμοκάθαρσης με διάλυμα χωρίς γλυκόζη και φάση Β με διάλυμα γλυκόζης 100 mg/dl αντίστοιχα. Η σύγκριση των δύο φάσεων Α και Β έδειξε ότι η χρήση διαλύματος γλυκόζης συμβάλλει στην αποφυγή μείωσης της γλυκόζης (p <0.001) και μειώνει τα επεισόδια υπογλυκαιμίας κατά τη διάρκεια της 4ωρης συνεδρίας αιμοκάθαρσης (p <0.001). Ωστόσο, δεν φαίνεται να επηρεάζει την μέση γλυκόζης, αλλά φαίνεται ότι μειώνει τη μεταβλητότητα της γλυκόζης σε μακροπρόθεσμες χρονικές περιόδους. Τέλος, η παρούσα μελέτη έδειξε ότι η GA έχει υψηλότερη ευαισθησία και ειδικότητα (r:0.884, p<0.001) και συσχετίζεται περισσότερο με τη μέση γλυκόζης της 7ημερης καταγραφής σε σύγκριση με την GSP και την HbA1c (r: 0.672, p <0.001 και r: 0.694, 0,001).Σύμφωνα με τα παραπάνω αποτελέσματα της παρούσας μελέτης διαπιστώθηκε ότι το σύστημα CGM είναι η μοναδική μέθοδος που καταγράφει με ακρίβεια τις σημαντικές διακυμάνσεις στα επίπεδα σακχάρου των διαβητικών ασθενών που υποβάλλονται σε αιμοκάθαρση. Αν και είναι η μεγαλύτερη συγκριτική μελέτη με σύστημα CGM μέχρι σήμερα, απαιτούνται μεγαλύτερες τεκμηριωμένες ερευνητικές μελέτες με τη χρήση CGM σε ασθενείς με ΣΔ υπό αιμοκάθαρση για την επέκταση των γνώσεων μας στον έλεγχο του διαβήτη και την αποφυγή των υψηλού κινδύνου των επιπλοκών του

Uma alimentação saudável para crianças na educação infantil

Orientadora: Profª Andréia AssmannMonografia (Especialização) - Universidade Aberta do Brasil Universidade Federal do Paraná. Coordenação de Integração de Politica de Educação a Distancia.Setor de Ciências da Saúde.Departamento de Enfermagem. Curso de Especialização em Saúde para Professores do Ensino Fundamental e Médi

Ocorrência de parasitas com potencial zoonótico em fezes de cães coletadas em áreas públicas do município de Ribeirão Preto, SP, Brasil

OBJETIVO: Avaliar a ocorrência de parasitos zoonóticos em fezes de cães colhidas em áreas públicas do município de Ribeirão Preto, enfatizando o risco da ocorrência de infecção humana. MÉTODOS: Entre os meses de maio a dezembro de 2003 foram visitadas 78 praças, localizadas em cinco diferentes áreas do município: sudoeste, noroeste, norte, central e sudeste. Foram recolhidos 331 "pools" de material fecal canino, os quais foram processados pela técnica de sedimentação espontânea. RESULTADOS: Em 56,8% "pools" foram observados os parasitos zoonóticos: Ancylostoma spp. (41,7%), Toxocara canis (24,2%), Trichuris vulpis (15,7%), Giardia spp. (10,2%) e Isospora spp. (3,3%). A prevalência de parasitos foi maior nas praças localizadas na área norte do município (70%). CONCLUSÕES: É necessária a adoção de programas de preservação sanitária destes locais, no sentido de prevenir a contaminação ambiental por parasitos potencialmente patogênicos para o homem

Relato de nematóides da família Anisakidae em bacalhau comercializado em Ribeirão Preto, SP Report of nematodes of the Anisakidae family in codfish commercialized in Ribeirão Preto, SP

A anisaquíase é uma parasitose gastrointestinal dos seres humanos, resultante da ingestão acidental de larvas infectantes de nematóides da família Anisakidae. Foram analisadas 11 amostras de bacalhau sendo que 64% estavam em desacordo com a legislação em vigor por conter nematóides da família Anisakidae e, portanto, impróprias para o consumo.<br>Anisakiasis is a human gastrointestinal parasitosis that results from accidental ingestion of infective larvae belonging to the Anisakidae family. Eleven codfish samples were analyzed and 64% did not conform to the present legislation, because they contained nematode larvae from the Anisakidae family and were therefore unfit for consumption