EVALUATION OF WATER QUALITY FOR CONSUMPTION AND PREVALENCE OF ANTIBIOTIC-RESISTANT BACTERIA:

Resumo: O consumo inadequado de água representa um risco para a saúde, porque leva a um aumento na incidência de doenças infecciosas propagadas pela água. Amostras de água coletadas em torneiras foram avaliadas quanto à presença de coliformes e outras bactérias, testes fenotípicos foram realizados para identificá-los e definir seus padrões de susceptibilidade antimicrobiana. Também foram analisadas a presença de metais potencialmente tóxicos e os padrões físico-químicos estabelecidos para a água consumida pelo homem. Por meio da avaliação microbiológica foi possível observar que a quantidade de coliformes na maioria das amostras é superior à recomendada pelos órgãos que regulam os padrões de potabilidade da água. Além disso, através da análise microbiológica foi possível identificar a presença de bactérias relacionadas a doenças comuns em humanos, das quais muitas apresentavam resistência a múltiplos antibacterianos. Os resultados das análises físico-químicas e dos metais potencialmente tóxicos demonstraram que esses parâmetros estão de acordo com os padrões estabelecidos para água potável pelas instituições normativas. Assim, o presente trabalho alerta para o problema da contaminação bacteriana em água para consumo de regiões quilombolas e também para o crescente problema da transmissão de genes de resistência antimicrobiana em água. Palavras chave: Coliformes. Água subterrânea. Multidroga-resistente. Físico-químico. Metais tóxicos.   Abstract: Inappropriate water consumption represents a health risk because it leads to an increase in the incidence of infectious diseases propagated by water. Samples of water collected in taps were evaluated for the presence of coliforms and other bacteria, phenotypic tests were performed to identify them and define their patterns of antimicrobial susceptibility. Were also analyzed for the presence of potentially toxic metals and for the physico-chemical standards established for human consumed water. By means of the microbiological evaluation it was possible to observe that the quantity of coliforms in the majority of the samples is superior to that recommended by the organs that regulate the water potability standards. In addition, through the microbiological analysis it was possible to identify the presence of bacteria related to common diseases in humans, of which many presented resistance to multiple antibacterial. Physico-chemical analyzes and potentially toxic metals were performed, the results demonstrated that these parameters are in agreement with the standards established for potable water by the normative institutions. Thus, the present work alerts to the problem of bacterial contamination in water for consumption of quilombola regions and also to the growing problem of the transmission of antimicrobial resistance genes in water. Keywords: Coliform. Groundwater. Multidug-resistance. Physico-chemical. Toxic metals. &nbsp

Cisplatin and Etoposide in Childhood Germ Cell Tumor: Brazilian Pediatric Oncology Society Protocol GCT-91

Purpose In 1988, we formed a consortium of Brazilian institutions to develop uniform standards for the diagnostic assessment and multidisciplinary treatment of children and adolescents with germ cell tumors. We also implemented the first childhood Brazilian germ cell tumor protocol, GCT-91, evaluating two-agent chemotherapy with cisplatin and etoposide (PE). We now report on the clinical characteristics and survival of children and adolescents with germ cell tumors treated on this protocol. Patients and Methods From May 1991 to April 2000, 115 patients (106 assessable patients) were enrolled onto the Brazilian protocol with a diagnosis of germ cell tumor. Results Patients were treated with surgery only (n = 35) and chemotherapy (n = 71). Important prognostic factors included stage (P = .025), surgical procedure at diagnosis according to resectability (P = .032), and abnormal lactate dehydrogenase value at diagnosis (P = .001). Conclusion The improvement in survival by the introduction of a standard protocol is an important achievement. This is of particular importance for smaller institutions with previous limited experience in the treatment of childhood germ cell tumors. In addition, the results of a two-agent regimen with PE were favorable (5-year overall survival rate is 83.3% for patients in the high-risk group [n = 36] who received PE v 58.8% for patients in the high-risk patients group who received PE plus ifosfamide, vinblastine, and bleomycin [n = 17; P = .017]). Thus for selected patients, complex three-agent regimens may not be necessary to achieve long-term survival, even for some patients with advanced disease