Módulo VI: Enfermagem na atenção à saúde materno-fetal: pré-natal

Ministério da Saúd

Caracterização molecular de Cryptosporidium spp. de pacientes de área urbana do Brasil infectados por HIV

Cryptosporidium spp. são importantes causas de doenças entéricas em humanos, mas podem também ser encontrados em animais. O presente estudo descreve a frequência relativa de diversas espécies de Cryptosporidium em amostras de humanos da cidade de São Paulo, Brasil, obtidas de janeiro a julho de 2007. Análises de sequências de produtos de nested PCR direcionadas ao genes codificadores da menor unidade ribosomal e da proteina de parede de oocistos revelaram 17 (63,0%) isolados de C. hominis, quatro (14,8%) C. parvum, cinco (18,5%) C. felis, e um (3,7%) C. canis. Estes resultados sugerem que, em ambientes urbanos no Brasil, o genótipo adaptado ao gato pode desempenhar potencial papel na transmissão zoonótica de criptosporidiose, enquanto a transmissão antroponótica da criptosporidiose causada pelo C. hominis parece predominar.Cryptosporidium spp. are important cause of enteric disease in humans, but may also infect animals. This study describes the relative frequency of several Cryptosporidium species found in human specimens from HIV infected patients in the São Paulo municipality obtained from January to July 2007. Sequence analysis of the products of nested-PCR based on small subunit rRNA and Cryptosporidium oocyst wall protein coding genes revealed 17 (63.0%) isolates of C. hominis, four (14.8%) C. parvum, five (18.5%) C. felis and one (3.7%) C. canis. These findings suggest that, in urban environments of Brazil, the cat adapted C. felis may play a potential role in the zoonotic transmission of cryptosporidiosis whereas the anthroponotic transmission of cryptosporidiosis caused by C. hominis seems to predominate

Determination of Nicotine in Cigarette Tobacco Smuggled to Brazil by Modified QuEChERS Methodology

The study of cigarette authenticity in Brazil is important due to increasing consumption of contraband cigarettes. Nicotine concentration is an important parameter reflecting the quality of tobacco used in the production of these cigarettes. Simple methods for this determination, which produce reduced waste, are environmentally and industrially important. The nicotine concentration of smuggled cigarette tobacco was determined by the QuEChERS method, requiring some modifications, such as decreasing the volume of the extractor solvent, changes in pH, and removal of the sample hydration step. Quantification was performed by gas chromatography using a flame ionization detector. The Doehlert matrix design was used to optimize the method. The extraction recoveries ranged from 97.5% to 99.6%, with relative standard deviation (RSD) ≤ 2.5% and limits of detection and quantification of 0.6 mg L-1 and 2.5 mg L-1, respectively. The method was sensitive and accurate for the detection and quantification of nicotine. The nicotine concentration in contraband cigarettes was found to be lower than that observed in legal cigarettes. The method was successfully applied to real samples of smuggled and legal cigarettes, providing a robust method for routine analysis and proving the need for more studies on quality control of smuggled cigarettes in Brazil

Contribution for the phytochemical studies of Ageratum fastigiatum

Organic extracts from leaves plus branches plus inflorescences of Ageratum fastigiatum (Gardner) R. M. King & H. Rob., Asteraceae, were fractionated through classic chromatography. The steroids stigmasterol, chondrillasterol and campesterol were isolated from hexane extract. The triterpenes lupeol, taraxasterol, α-amyrin, β-amyrin, pseudotaraxasterol, lupeol acetate and α-amyrin acetate were isolated from ethyl acetate extract. Steroids and triterpenes were identified by GC-MS. The coumarin ayapin was isolated from ethanol extract and identified by NMR. Essential oils of the fresh leaves and fresh inflorescences were obtained by hydrodistillation and analyzed for GC-MS. The main components in both essential oils were α-pinene, limonene and germacrene D.FAPEMI

Epidemiology and Clinical Forms of Primary Hyperparathyroidism: A Review

Primary hyperparathyroidism (PHPT) is a disease caused by overactive parathyroid glands with consequent hypercalcemia. However, its presentation is variable, with patients demonstrating a range from normocalcemia to severe hypercalcemic PHPT. The present study aims to perform a literature review on the epidemiology and the clinical forms of PHPT using information published in the PubMed and Cochrane databases. It describes data about prevalence, etiology, diagnosis, classic and non-classic manifestations, providing updated information on classical hypercalcemic hyperthyroidism, in addition to its normocalcemic variant

Distinctive features of composts of different origin: a thorough examination of the characterization results

The potential of composts produced from different origin residues to be used in environmentally friendly agriculture is addressed in this work. Seven composts obtained from different raw materials and composting methodologies are compared using elemental, thermal and spectroscopic characterization data. Despite the stabilization of the organic matter in all composts being adequate for agricultural applications, they display distinct elemental and structural compositions. Likewise, the fertilisers have very different effects on lettuce growth. Despite the observed differences, some common features were found, namely a mass loss (TGA) of 25.2 g per mol C, association between groups of elements (Fe, Al, Ni, Co, Cr, Cu and S; Mg, Na, K and P, C, Coxi, N and Pb) and correlations between the amount of carbon nanostructures and the characteristic aromaticity parameters. These results suggest that the tuning of the compost features for specific cultures may be possible for sustainable food production.This work was financially supported by the Interreg VA Spain-Portugal Programme (EU) through the project Res2ValHum (0366_RES2VALHUM_1_P). A.C. Silva acknowledges receipt of a PhD grant (UMINHO/BD/40/2016) financed by the Operational Programme Norte 2020 (through the Project “NORTE-08-5369-FSE-000033”). A. Teixeira acknowledges the grant (Res2ValHum 01/2018) to develop experimental work for 11 months on the project. J. Antelo and S. Fiol are also grateful for the financial support provided by Xunta de Galicia—Consellería de Educación e Ordenación Universitaria de Galicia (Consolidation of Competitive Groups of Investigation; GI-1245, ED431C 2018/12 and CRETUS AGRUP2015/02, ref. 2018-PG10)

Tinnitus emerging in the context of a COVID-19 infection seems not to differ in its characteristics from tinnitus unrelated to COVID-19

Background and aim: COVID-19 is a respiratory disease caused by the new coronavirus SARS-CoV-2, for which the first cases were reported in China, by December 2019. The spectrum of clinical presentations is wide, ranging from asymptomatic cases to a severe acute respiratory syndrome, sometimes with multiple systems involvement. Viral infections, including those related to respiratory virus, may cause hearing loss and, by extent, considering its pathophysiology, tinnitus. A systematic review on inner ear related symptoms in patients with COVID-19 reported 4.5% occurrence rate of tinnitus, with high variance of prevalence between the studies. Our aim is to further explore the relationship between COVID-19 and tinnitus. For this purpose we analyzed a sample of people who had suffered from a COVID-19 infection in the city of Volta Redonda, Brazil. In detail, we compared those with new onset tinnitus during or after the COVID-19 infection with those without tinnitus and those with tinnitus onset before the COVID-19 infection. Methods: Fifty-seven patients over 18 years old and previously diagnosed with COVID-19 confirmed by a RT-PCR test were included. Patients were subdivided in three groups: no tinnitus (NT), tinnitus that already existed before COVID-19 (chronic tinnitus, CT) and tinnitus that arose during or after COVID-19 (post-COVID-19 tinnitus, PCT). Data concerning COVID-19 symptoms, drugs prescribed for COVID-19, tinnitus characteristics, comorbidities and other otological symptoms were collected. For all the patients, tonal audiometry and otoacoustic emissions were performed. Tinnitus patients fulfilled the Tinnitus Handicap Inventory (THI) and visual-analog scales (VAS) for loudness and distress. Patients with CT answered a simple question about the worsening of their tinnitus after COVID-19. Results: PCT was reported by 19.3% of the patients, while 22.8% reported CT. No statistical difference was found between CT and PCT concerning hearing function, tinnitus characteristics and tinnitus distress. There was also no statistically significant difference between PCT and NT with respect to COVID-19 symptoms and pharmacological COVID-19 treatment. Patients with CT reported worsening of their tinnitus after COVID-19. Conclusion: As with other viral infections, inner ear symptoms may be associated with COVID-19. In our sample patients with tinnitus onset before COVID-19 and those with tinnitus onset during or after COVID-19 did not differ significantly in their clinical characteristics and their hearing function, suggesting that tinnitus occurring in the context of a COVID-19 infection is not related to a unique pathophysiological mechanism. The comparison of COVID-19 patients, who developed tinnitus with those who did not develop tinnitus did not reveal any differences in COVID-19 symptoms or COVID-19 treatment. Thus, there was no hint, that a specific expression of COVID-19 is closely related to post COVID-19 tinnitus onset. Although some drugs used to treat tinnitus are known to damage the inner ear cells (especially hydroxychloroquine), we did not see any relationship between the intake of these drugs and tinnitus onset, eventually due to the short prescription time and low doses. Among those patients who had tinnitus before COVID-19 30,8% reported worsening after COVID-19. Overall, tinnitus emerging in the context of a COVID-19 infection seems not to differ from tinnitus unrelated to COVID-19. For further exploring the relationship of tinnitus and COVID-19, large population based studies are warranted