Agrotóxicos comercializados no Brasil com potencial carcinogênico para humanos

Objetivo: Apontar os agrotóxicos ou ingredientes ativos com potencial carcinogênico, legalmente comercializados no Brasil. Métodos: Trata-se de um estudo documental produzido com base na análise do relatório anual de câncer de 2019, emitido pela Environmental Protection Agency (EPA) e nas 128 monografias disponibilizadas pela International Agency for Research on Cancer (IARC) até o final de 2020, bem como na consulta da lista de monografias autorizadas pela Agência Nacional de Vigilância Sanitária (ANVISA). Resultados: Foram identificados 69 ingredientes ativos de agrotóxicos que são comercializados no Brasil. Nenhum deles é classificado como carcinógeno. Entretanto, 42 foram considerados provavelmente cancerígenos, sendo 38 deles segundo a classificação da EPA e quatro de acordo com a IARC. Os outros 27 são classificados como possíveis cancerígenos, sendo 25 classificados pela EPA e dois de acordo com a IARC. Considerações finais: É necessária uma revisão no registro dessas substâncias no Brasil, visando evitar imensuráveis danos à saúde humana

Insecticide resistance in Aedes aegypti populations from Ceará, Brazil

<p>Abstract</p> <p>Background</p> <p>Organophosphates and pyrethroids are used widely in Brazil to control <it>Aedes aegypti</it>, the main vector of dengue viruses, under the auspices of the National Programme for Dengue Control. Resistance to these insecticides is widespread throughout Brazil. In Ceará the vector is present in 98% of districts and resistance to temephos has been reported previously. Here we measure resistance to temephos and the pyrethroid cypermethrin in three populations from Ceará and use biochemical and molecular assays to characterise resistance mechanisms.</p> <p>Results</p> <p>Resistance to temephos varied widely across the three studied populations, with resistance ratios (RR₉₅) of 7.2, 30 and 192.7 in Juazeiro do Norte, Barbalha and Crato respectively. The high levels of resistance detected in Barbalha and Crato (RR₉₅≥ 30) imply a reduction of temephos efficacy, and indeed in simulated field tests reduced effectiveness was observed for the Barbalha population. Two populations (Crato and Barbalha) were also resistant to cypermethrin, whilst Juazeiro do Norte showed only an altered susceptibility. The <it>Ile1011Met kdr </it>mutation was detected in all three populations and <it>Val1016Ile </it>in Crato and Juazeiro do Norte. <it>1011Met </it>was significantly associated with resistance to cypermethrin in the Crato population. Biochemical tests showed that only the activity of esterases and GSTs, among the tested detoxification enzymes, was altered in these populations when compared with the Rockefeller strain.</p> <p>Conclusions</p> <p>Our results demonstrate that two <it>A. aegypti </it>populations from Ceará are under strong selection pressure by temephos, compromising the field effectiveness of this organophosphate. Our results also provide evidence that the process of reducing resistance to this larvicide in the field is difficult and slow and may require more than seven years for reversal. In addition, we show resistance to cypermethrin in two of the three populations studied, and for the first time the presence of the allele <it>1016Ile </it>in mosquito populations from northeastern Brazil. A significant association between <it>1011M</it>et and resistance was observed in one of the populations. Target-site mechanisms seem not to be implicated in temephos resistance, reinforcing the idea that for the studied populations, detoxification enzymes most likely play a major role in the resistance to this insecticide.</p

Chikungunya Neurological Manifestations: A Systematic Literature Review

Although the most common Chikungunya (do not capitalize the disease unless it is named after a proper noun such as Zika, Ebola or Carrion’s Disease) manifestations are osteoarticular, those which bring the most morbidity and mortality are neurological, where thorough mapping through studies with a methodological outline have not yet been well structured. Therefore, the objective was to review the literature to identify neurological manifestations of CHIKV. We used the Virtual Health Library (VHL) and PubMed with the following descriptors: #1 “Chikungunya” [MeSH]; #2 “neurological manifestations” [MeSH] and their equivalents in the Portuguese language, selecting literature published between July 2007 to January 2018. From the 180 studies that were found, 30 were selected. Findings were divided into two subcategories: “Chikungunya: Typical Neurological Manifestations” and “Chikungunya: Severe Neurological Manifestations”. The studies show that headaches were characterized as the most common symptom in adult patients affected by CHIKV, followed by meningeal involvement. Meningeal involvement is also a more serious clinical scenario associated with encephalitis, convulsions, polyneuropathies such as Guillain-Barré syndrome and death. CHIKV is a public health problem for many reasons including its chronic potential complications. Given the neurological symptoms, this disease is concerning in age extremes, for patients with comorbidities and for patients with more than one viral infection by arboviruses, in whom the most severe neurological manifestations are more common

The HLA-DRB1 Alleles Effects on Multiple Sclerosis:a Systematic Review

Background: Multiple sclerosis (MS) is an autoimmune disease of the central nervous system that affects sensitive and motor functions. Many population studies were made with the intent of knowing better the most affected groups and the disease manifestations. These review analyses some of those studies, evaluating risk factors, especially genetic relations of Human Leukocyte Antigen DRB1 (HLADRB1) gens, for developing clinical disease.Method: We have analyzed 57 articles, published between 2009 and 2014, with the key words “multiple sclerosisâ€, “genetic association studies†and “HLA-DRB1 chainsâ€, through the Scopus database. Only 18 articles were eligible for our study; they were read entirely and included in the fial analysis.Results: Most studies imply genetic and environmental factors for the incidence of MS, its age of starting and prognosis. Previous studies have shown that many gens are related in MS pathogenesis and that interactions between them are important in determining clinicalmanifestations.Limitations: Different results were observed when different populations were targeted in the studies.Conclusion: There is an important relation between HLA-DRB1 and MS in diverse population groups. Complementary studies are needed to know better the importance of environmental factors and its interaction with gens in the development of MS

Epidemiologia e estatística: integrando ensino, pesquisa, serviço e comunidade

O novo modelo de saúde brasileiro exige médicos dotados de visão social abrangente e capacitados para prestar à comunidade cuidados permanentes e resolutivos, bem como profissionais críticos diante da tomada de decisões. Este relato descreve uma experiência estratégica de ensino de epidemiologia e bioestatística no curso de Medicina, cuja construção do processo foi centrada no educando, que foi o agente dos conhecimentos adquiridos, por meio da produção de informações e da pesquisa na comunidade ou nos serviços de saúde. Esta estratégia resultou na integração e interdisciplinaridade acadêmica, contribuindo para a compreensão de assuntos clínicos considerando a abordagem epidemiológica e estatística. Os acadêmicos despertaram para a importância da produção científica e da construção do currículo profissional ainda na fase acadêmica, sendo capazes de identificar problemas locais e direcionar as intervenções, e reconhecer que isto representa um dos objetivos mais importantes da pesquisa em saúde. Os resultados indicam que a epidemiologia e a bioestatística podem ser trabalhadas no curso de Medicina com o mesmo sucesso de outras disciplinas da clínica, desde que seja favorecida a aprendizagem significativa dos acadêmicos

Evaluation of the role of ATP-binding cassette transporters as a defence mechanism against temephos in populations of Aedes aegypti

The role of ATP-binding cassette (ABC) transporters in the efflux of the insecticide, temephos, was assessed in the larvae of Aedes aegypti. Bioassays were conducted using mosquito populations that were either susceptible or resistant to temephos by exposure to insecticide alone or in combination with sublethal doses of the ABC transporter inhibitor, verapamil (30, 35 and 40 &#956;M). The best result in the series was obtained with the addition of verapamil (40 &#956;M), which led to a 2x increase in the toxicity of temephos, suggesting that ABC transporters may be partially involved in conferring resistance to the populations evaluated