Rastreamento da hipersensibilidade metálica pelos profissionais e estudantes de saúde na prática clínico-cirúrgica / Seguimiento de la hipersensibilidad metálica por profesionales y estudiantes de salud en la práctica clínico-quirúrgica / Screening of metallic hypersensitivity by health professionals and students in clinical-surgical practice

Objetivo: investigar o rastreamento da hipersensibilidade metálica realizada pelos profissionais e estudantes de saúde durante a prática clínico-cirúrgico. Método: estudo exploratório-descritivo realizado com 228 profissionais e estudantes da área da saúde, por meio de questionário eletrônico semiestruturado, aplicado durante abril e maio de 2021, analisado por meio da estatística descritiva e da frequência de palavras. Resultados: 11,0% dos participantes realizaram a investigação sobre a hipersensibilidade metálica. 67,1% declararam que muito provavelmente poderiam incluir essa temática durante a triagem em seus atendimentos. Falta de conhecimento sobre alergia a metais e causas multifatoriais durante a prática clínico-cirúrgica foram citadas como barreiras para a implementação do rastreamento da hipersensibilidade metálica. Conclusão: pouco se evidencia o rastreamento da hipersensibilidade metálica em pacientes durante a prática clínico-cirúrgica dos profissionais e estudantes de saúde.

Objetivo: investigar el rastreo de la hipersensibilidad metálica realizada por los profesionales y estudiantes de salud durante la práctica clínico-quirúrgica. Método: estudio exploratorio-descriptivo realizado con 228 profesionales y estudiantes del área de la salud, por medio de cuestionario electrónico semiestructurado, aplicado durante abril y mayo de 2021, analizado por medio de la estadística descriptiva y de la frecuencia de palabras. Resultados: 11,0% de los participantes realizaron la investigación sobre la hipersensibilidad metálica. El 67,1% declaró que muy probablemente podrían incluir esa temática durante la selección en sus atenciones. La falta de conocimientos sobre la alergia a los metales y las causas multifactoriales durante la práctica clínico-quirúrgica se citaron como barreras para la implementación del seguimiento de la hipersensibilidad metálica. Conclusión: poco se evidencia el rastreo de la hipersensibilidad metálica en pacientes durante la práctica clínico-quirúrgica de los profesionales y estudiantes de salud.

Objective to investigate the screening of metallic hypersensitivity performed by health professionals and students during clinical-surgical practice. Method: an exploratory-descriptive study conducted with 228 health professionals and students, through a semi-structured electronic questionnaire, applied during April and May 2021, analyzed through descriptive statistics and the frequency of words. Results: 11.0% of participants conducted research on metallic hypersensitivity. 67.1% stated that they could very likely include this theme during screening in their care. Lack of knowledge about metal allergy and multifactorial causes during clinical-surgical practice were cited as barriers to the implementation of metallic hypersensitivity screening. Conclusion: there is little evidence of metallic hypersensitivity screening in patients during the clinical-surgical practice of health professionals and students.

Reacciones alérgicas por L-asparaginasa en niños con leucemia linfoide aguda / L-asparagibase allergic reactions in children with lymphoblastic acute leukemia

La L-asparaginasa es un medicamento utilizado en distintas fases de todos los protocolos de tratamiento actuales de la leucemia linfoide aguda (LLA). Se describen múltiples manifestaciones secundarias a la L asparaginasa entre las que las reacciones alérgicas son las más frecuente. Se estudiaron 144 niños con diagnóstico de LLA tratados en el Instituto de Hematología e Inmunología, entre 1998 y el 2013. En 30 pacientes (21 por ciento) se presentaron reacciones alérgicas, similar a lo descrito en la literatura. El 76,6 por ciento de ellos habían recibido una dosis acumulativa menor de 80 000 UI (media de 48 757) y el mayor número de las reacciones alérgicas (86,7 por ciento) se reportó entre las dosis 9 y 18 recibidas (media de 11 dosis). Se observó una mayor supervivencia en los enfermos que recibieron más dosis (19 - 26 dosis) (p = 0.003). La sobrevida libre de eventos fue también mayor en este grupo (p= 0.357)(AU)

ABSTRACT L-asparaginase is a medication used in different phases of all current treatment protocols for acute lymphoid leukemia. Multiple secondary manifestations to L- asparaginase are described, and allergic reactions are the most frequent. We studied 144 children with acute lymphoblastic leukemia treated at the Instituto de Hematología e Inmunología between 1998 and 2013. Thirty patients (21 percent) had allergic reactions, similar to what is described in literature; 76.6 percent of them had received a cumulative dose of less than 80 000 IU (average of 48 757); and the highest number of allergic reactions (86.7 percent) was reported between doses 9 and 18 received (mean of 11 doses). A greater global survival was observed in patients who received more doses (19 - 26 doses) (p=0.003). Event free survival was also higher in this group (p= 0.357)(AU)

Efectividad en la suplementación con omega 3 (Pescado) y vitamina D durante el periodo gestacional para la prevención de diversas alergias en el lactante de 0-1 año de edad / Effectiveness in the omega 3 (Fish) and vitamin D supplementation during the gestational period for the prevention of various allergies in the 0-1 year old infant / Eficácia na suplementação de ômega 3 (peixe) e vitamina D durante o período gestacional para a prevenção de várias alergias na criança de 0 a 1 ano

Resumen El objetivo de esta investigación fue describir la efectividad de la suplementación con omega 3 (pescado) y vitamina D durante la etapa gestacional para la prevención de diversas alergias en el lactante de 0 a 1 año. Se presenta los resultados de una compilación y categorización de la mejor evidencia científica disponible. Se aplicó la metodología sugerida para la práctica clínica basada en la evidencia, la cual inició con el establecimiento de una pregunta clínica seguido por la búsqueda de la información en las bases de datos Medline, Science Direct y Cochrane Library, obteniendo 334 artículos de los cuales al aplicar los criterios de selección se conservan 9. Luego se llevó a cabo un análisis crítico utilizando la plataforma FLC 2.0 y clasificando la evidencia por su calidad y grados de recomendación según Canadian TaskForce on Preventive Health Care.Se concluye que a pesar de que los beneficios de la vitamina D y el omega 3 son múltiples, y que el uso en conjunto de ambos en el embarazo, podría significar una mejora no solo sobre la salud materna sino también sobre el feto y lactante; al no contar con estudios con resultados contundentes, no se puede generalizar o recomendar en la práctica clínica.

Abstract The objective of this research was to describe the effectiveness of omega 3 (fish) and vitamin D supplementation during the gestational stage for the prevention of various allergies in infants aged 0 to 1 year. The results of a compilation and categorization of the best available scientific evidence are presented. The methodology suggested for the clinical practice based on the evidence was applied, which began with the establishment of a clinical question followed by the search of the information in the Medline, Science Direct and Cochrane Library databases, obtaining 334 articles of which when the selection criteria are applied, they are kept 9. Then, a critical analysis was carried out using the FLC 2.0 platform and the evidence was classified by its quality and degrees of recommendation according to the Canadian Task Force on Preventive Health Care. It is concluded that although the benefits of vitamin D and omega 3 are multiple, and that the joint use of both in pregnancy, could mean an improvement not only on maternal health but also on the fetus and infant; By not having studies with conclusive results, it can not be generalized or recommended in clinical practice.

Resumo O objetivo desta pesquisa foi descrever a eficácia da suplementação de ômega 3 (peixe) e vitamina D durante o estágio gestacional para a prevenção de várias alergias em lactentes de 0 a 1 ano de idade. Os resultados de uma compilação e categorização das melhores evidências científicas disponíveis são apresentados. Foi aplicada a metodologia sugerida para a prática clínica baseada na evidência, que começou com o estabelecimento de uma questão clínica seguida pela busca da informação nos bancos de dados da Medline, Science Direct e Cochrane Library, obtendo 334 artigos dos quais quando os critérios de seleção são aplicados, eles são mantidos 9. Então, uma análise crítica foi realizada usando a plataforma FLC 2.0 e a evidência foi classificada por sua qualidade e graus de recomendação de acordo com a Canadian Task Force on Preventive Health Care. Conclui-se que, embora os benefícios da vitamina D e omega 3 sejam múltiplos e que o uso conjunto de ambos na gravidez, pode significar uma melhora não só na saúde materna, mas também no feto e no bebê; Ao não ter estudos com resultados conclusivos, não pode ser generalizada ou recomendada na prática clínica.

Preoperative care of Polypoid exposed mucosal template in bladder exstrophy: the role of high-barrier plastic wraps in reducing inflammation and polyp size

ABSTRACT Objective To assess the role of high-barrier plastic wrap in reducing the number and size of polyps, as well as decreasing the inflammation and allergic reactions in exstro- phy cases, and to compare the results with the application of low-barrier wrap. Materials and Methods Eight patients with bladder exstrophy-epispadias complex (BEEC) that had used a low density polyethylene (LDPE) wrap for coverage of the exposed polypoid bladder in preoperative care management were referred. The main complaint of their parents was increase in size and number of polyps. After a period of 2 months using the same wrap and observing the increasing pattern in size of polyps, these patients were recommended to use a high-barrier wrap which is made of polyvinylidene chloride (PVdC), until closure. Patients were monitored for the number and size of polyps before and after the change of barriers. The incidence of para-exstrophy skin infection/inflammation and skin allergy were assessed. Biopsies were taken from the polyps to identify histopathological characteristics of the exposed polyps. Results The high barrier wrap was applied for a mean ± SD duration of 12±2.1 months. Polyps' size and number decreased after 12 months. No allergic reaction was detected in patients after the usage of PVdC; three patients suffered from low-grade skin allergy when LDPE was applied. Also, pre-malignant changes were observed in none of the patients in histopathological examination after the application of PVdC. Conclusion Polyps' size and number and skin allergy may significantly decrease with the use of a high-barrier wrap. Certain PVdC wraps with more integrity and less evaporative permeability may be more "exstrophy-friendly".

MOLECULAR IDENTIFICATION OF Pseudoterranova azarasi LARVAE IN COD (Gadus sp.) SOLD FOR HUMAN CONSUMPTION IN BRAZIL / Identificação molecular de larva de Pseudoterranova azarasi em bacalhau (Gadus sp.) vendido para consumo humano no Brasil

Anisakiasis and Pseudoterranovosis are human diseases caused by the ingestion of live Anisakidae larvae in raw, undercooked or lightly marinated fish. Larvae were collected from one salted cod sold for human consumption in a Sao Paulo market in 2013. One section of one brownish larva was used for molecular analyses. The partial COX2 gene sequence from the larva had a nucleotide identity of 99.8 % with Pseudoterranova azarasi, which belongs to the Pseudoterranova decipiens species complex. The risk of allergy when consuming dead larvae in salted fish is not well known and should be considered.

Os termos Anisakiasis e Pseudoterranovosis são utilizados para doença em humanos causada pela ingestão de larvas vivas de parasitas da Família Anisakidae em peixes crus, mal cozidos ou levemente marinados. As larvas foram coletadas de bacalhau salgado vendido para consumo humano num mercado de São Paulo em 2013. Uma parte da larva de cor castanha foi utilizada em análises moleculares. A sequencia parcial do gene COX2 obtida da larva mostrou 99,8% de identidade de nucleotídeos com Pseudoterranova azarasi, que faz parte do complexo de espécies Pseudoterranova decipiens. O risco de reação alérgica envolvido no consumo de larvas mortas em peixe salgado não é bem conhecido e deve ser considerado.

Pet avoidance in allergy cases: Is it possible to implement it? / Evitación de mascotas en casos de alergia. ¿Es factible lograrla?

Introduction: Among allergic patients, pet avoidance is commonly recommended. It is difficult for patients to accomplish this because of their emotional attachment to the pets, and its effectiveness is controversial. Objective: To explore the applicability and effectiveness of pet avoidance measures among sensitized patients. Materials and methods: We evaluated 288 patients with asthma, rhinitis, conjunctivitis and/or dermatitis using skin prick test to measure their sensitization to cats, dogs and other animals to which they were exposed. Exposure to animals was evaluated in each patient (pets at home, frequent indirect exposure or no exposure). In those patients sensitized to animals some avoidance measures, such as removing pets from home and preventing indirect exposure, were recommended. On the following two appointments, we evaluated patients' fulfillment of these recommendations. Results: Sensitization to cats, dogs and birds was high (9%, 48%, 14%, respectively), as well as direct and indirect exposure (30%, 46%, 24%, respectively). Most patients denied contact with other animals (horses, hamsters, rabbits or cows), and sensitization to them was low. During the follow-up of patients sensitized to their pets at home (n=50), most of them refused to remove them from their house due to emotional attachment, and only two followed this recommendation. Conclusions: High exposure to animals could explain the frequency of sensitization to pets in this population. However, emotional attachment and prevalent indirect exposure to animals among sensitized patients make avoidance recommendations impractical or impossible to achieve.

Introducción. Entre los pacientes alérgicos se recomienda comúnmente la evitación de mascotas; sin embargo, es difícil que los pacientes cumplan con esta recomendación debido al apego emocional y, además, su efecto clínico no es claro. Objetivo. Explorar la aplicabilidad de las medidas de evitación entre pacientes sensibilizados a mascotas . Materiales y métodos. En 284 pacientes con asma, rinitis, conjuntivitis y dermatitis, se evaluó la sensibilización a gatos, perros y otros animales mediante pruebas de punción epidérmica. Se evaluó, igualmente, el nivel de exposición a animales (mascotas en la casa y exposición indirecta frecuente). A aquellos pacientes sensibilizados a los animales, se les recomendaron medidas de evitación como retirar la mascota de la casa y evitar la exposición indirecta. En las dos citas médicas siguientes se evaluó el cumplimiento de estas recomendaciones. Resultados. La sensibilización a gatos, perros y aves fue alta (9, 48, y 14 %, respectivamente), al igual que la exposición directa o indirecta a estos animales (30, 46, 24 %, respectivamente). La mayoría de los pacientes negó el contacto frecuente con otros animales (caballos, hámsteres, conejos, vacas) y la sensibilización a estos fue baja. La mayoría de los pacientes sensibilizados a su propia mascota (n= 50) se rehusó a retirar la mascota de la casa y solo dos de ellos siguieron la recomendación de hacerlo. Conclusiones. La exposición frecuente a los animales podría explicar la gran frecuencia de sensibilización a las mascotas en esta población. Sin embargo, el apego emocional y la exposición indirecta frecuente, hacen que las recomendaciones de evitación sean imprácticas o casi imposibles de lograr.

Contaminantes biológicos del aire interior de la vivienda: factores contribuyentes, afecciones relacionadas y medidas correctivas / Biological indoor air pollutants at home: contributing factors, related diseases and corrective actions

La contaminación biológica del aire interior de las viviendas y locales de uso público constituye una importante causa de morbilidad y malestar frecuente, la que puede interactuar con los efectos de los contaminantes químicos y con los cuales a menudo comparten causas comunes. Los principales contaminantes biológicos incluyen los mohos, el exoesqueleto y heces de ácaros del polvo, cucarachas y otros insectos, la caspa de la piel y el pelo de animales como las mascotas, todos los cuales pueden actuar como alergenos, bacterias como las Legionellas, virus y otros agentes capaces de producir enfermedades infecciosas. Las fuentes y factores contribuyentes incluyen la humedad generada por filtraciones en instalaciones hidráulicas, elevada humedad relativa, ventilación natural e insolación deficientes, inadecuado control técnico de los componentes de sistemas de climatización mecánica, la limpieza deficiente y el hacinamiento. Las medidas de prevención y corrección incluyen la eliminación de las fuentes de humedad y la reducción de la misma, optimización de la ventilación natural y la insolación, correcto mantenimiento de los sistemas de ventilación mecánica, garantizando una adecuada tasa de recambio de aire, limpieza de alfombras con dispositivos de alta eficiencia de remoción de partículas y lavado frecuente del mobiliario y las cortinas (o remoción de éstas si dificultan la ventilación natural)(AU)

Biological indoor air pollution in households and public places is an important cause of morbidity and discomfort. It may interact with chemical pollution, with which it often shares common sources. The main biological pollutants are moulds, exoskeletons and feces of dust acari, cockroaches and other insects, skin flakes, and hair from pets, all of which may act as allergens, bacteria such as Legionella, viruses and other infection disease agents. Contributing sources and factors include the dampness created by leaks in the plumbing, high relative humidity, poor natural ventilation or insolation, inadequate technical control of components of air conditioning equipment, deficient cleaning, and crowding. Prevention and correction measures include the reduction of humidity and elimination of its sources, optimization of natural ventilation and insolation, appropriate maintenance of mechanical ventilation systems ensuring an adequate rate of air renewal, cleaning of carpets with highly efficient particle removal devices, and frequent washing of the furniture and curtains (or removal of the latter if they obstruct natural ventilation)(AU)

O uso de prebióticos e probióticos na prevenção e tratamento de doenças imuno-alérgicas / The use of prebiotics and probiotics in the prevention and treatment of immuno-allergic diseases

Em leitura à excelente coluna "O aumento da produtividade frente às restrições alimentares", de autoria de Sílvia Panetta Nascimento, nesta revista, além de despertar nossa curiosidade científica, também contribuiu para o conhecimento sobre o tema. Pressupondo que as alergias, intolerâncias e doenças também acabam por interferir nas tecnologias de produção usuais e requerem aplicação de técnicas específicas que, muitas vezes, acabam por dificultar a produção maciça de alimentos.

Implicancia de la inmunidad innata del epitelio bronquiolar en la modulación y prevención del asma / Implication of innate immunity in modulating bronchial epithelium and prevention of asthma

El asma alérgica ha incrementado su prevalencia, constituyéndose como un problema mundial de salud. Factores ambientales derivados de la vida moderna han sido vinculados a este fenómeno a través de la hipótesis de la higiene; la cual postula que la vida urbana disminuye la potenciación de la inmunidad innata, lograda a través del reconocimiento de estímulos microbianos por los receptores Toll-like (TLRs), conduciendo a la mayor prevalencia de respuestas alérgicas. Las investigaciones en asma en el último siglo han tenido como objetivo la disminución de la respuesta inmune adaptativa Th2 asociada a las alergias; sin embargo han conseguido escasos avances terapéuticos. Actualmente, es creciente el número de evidencias que implican a los componentes estructurales de la vía aérea en el inicio y progresión del asma; no obstante su rol en la prevención de la inflamación alérgica no ha sido suficientemente evaluado. Por lo tanto, el presente trabajo de Tesis Doctoral tuvo como objetivo general el estudio de la interacción de la inmunidad innata del epitelio bronquiolar y la inflamación alérgica del asma.

ABSTRACT: Recently, asthma rates have increased becoming a global health problem. The role of environmental factors in this increase, due to modern lifestyles, has been suggested by the hygiene hypothesis, which postulated that the urban hygienic conditions skip the early exposure to microbes hence that are clue to promote innate immune activation by signalling through the Toll-like receptors (TLRs) and thus preventing the allergic responses. Even though many investigations on asthma have been focused on the reduction of the allergic Th2-nflammatory response in the last century, the therapeutic advances have been scarce. Nowadays, there is increasing evidence of the involvement of the airway epithelial cells on the origin and progression of asthma. However, the role of these cells in preventing the triggering of allergic inflammation has not been evaluated. Therefore, the main objective of this thesis was to study the interaction of innate immunity of bronchiolar epithelium and allergic inflammation in asthma.

Alimentação no primeiro ano de vida e prevenção de doenças alérgicas: evidências atuais / Feeding in the first year of life and prevention of allergic diseases: current evidence

A prevalência de doenças alérgicas aumentou significantemente nos últimos anos. Devido a este rápido aumento, surgiu o interêsse em se identificar estratégias de prevenção ou redução do risco de se desenvolver alergia. Acredita-se que esta alta prevalência seja consequência de mudanças ambientais modernas, como o desenvolvimento industrial, mudanças climáticas e de hábitos alimentares que poderiam afetar a função imunológica, independente do seu caráter genético. O presente estudo tem como objetivo discutir o papel da alimentação no primeiro ano de vida sobre a prevenção de doenças alérgicas, através de revisão bibliográfica com base em artigos publicados entre 2003 e abril de 2014, disponíveis nos bancos de dados PubMed, SciELOe LILACS. Com relação ao aleitamento materno, existem poucas evidências do seu efeito protetor para o desenvolvimento de alergia. A recomendação de manter o aleitamento materno exclusivo por período de 4 a 6 meses deve-se a outros benefícios associados a esta prática. Há dados suficientes para a indicação da utilização de fórmulas parcialmente ou extensamente hidrolisadas, com alergenicidade reduzida comprovada, para aqueles com alto risco de desenvolvimento de atopia, quando a amamentação exclusiva não for possível. O início da alimentação complementar é recomendado após 4-6 meses, com atenção à variedade dos alimentos. A alimentação no primeiro ano de vida parece ser importante para a modulação do desenvolvimento do sistema imunológico e prevenção de alergias...

The prevalence of allergic diseases has significantly increased in recent years. Such rapid increase has stimulated research into strategies to prevent or reduce the risk of allergy. It is believed that this high prevalence may be due to recent environmental changes, including industrial development, climate change, and dietary habits, all of which may affect imune function, regardless of genetic background. The aim of the present study was to discuss the role played by feeding in the first year of life in the prevention of allergic diseases. In order to do that, the literature was browsed for articles published between 2003 and April 2014 and available in the PubMed, SciELO, and LILACS databases. With regard to breast feeding, there is little evidence of a protective effect of this practice against the development of allergy. The recommendation of maintaining exclusive breast feeding for 4-6 months is based on other associated benefits. Conversely, there is sufficient evidence to recommend the use of partially or extensively hydrolyzed formula, with proven low allergenic activity, in infants at high risk of developing atopy when exclusive breast feeding is not possible. The initiation of complementary feeding is recommended after 4-6 months, and the variety of foods should be selected with care. Feeding in the first year of life appears to be important to modulate the development of the immune system and to prevent allergies...

Custos diretos e indiretos da asma: revisão de literatura / Direct and indirect costs of asthma: a review

Objetivo: Realizar revisão da literatura sobre análises econômicas utilizadas para a asma, os custos diretos e indiretos, tendo em vista a sobrecarga econômica que essa doença acarreta para o sistema de saúde. Fonte de dados: Pesquisa de artigos originais, revisões e consensos, indexados nos bancos de dados Medline, Lilacs, Embase e Pubmed, publicados entre 1996-2012. Síntese dos dados: A asma é uma doença pulmonar inflamatória crônica que acomete pessoas de todas as idades, cujo descontrole leva a hospitalizações frequentes, visitas à emergência e aumento na morbidade, gerando grande impacto na vida social e econômica dos pacientes, com piora da qualidade de vida. A partir dos programas de controle da asma e rinite alérgica e da dispensação de medicamentos de alto custo, houve significativa queda das hospitalizações por asma no período de 2006 a 2010. Em 2012, implementou-se o “Programa Saúde não tem Preço”, ação integrante do “Programa Farmácia Popular” do Ministério da Saúde (MS), com fornecimento gratuito de brometo de ipratrópio, diproprionato de beclometasona e sulfato de salbutamol. Com este programa, houve crescimento significante de 443% no número de asmáticos beneficiados, aumentando de 48.495 para 263.227 pessoas. Os dados do MS apontaram que a asma ainda causa a morte de 2,5 mil pessoas por ano no Brasil. Em 2011 do total de 117,8 mil internações no Sistema Único de Saúde (SUS) em decorrência da asma, 77,1 mil acometeram crianças na faixa etária de 0 a 6 anos. A asma ainda representa um importante problema global de saúde pública com elevados custos diretos e indiretos, que oneram de forma expressiva os pacientes e os sistemas públicos de saúde. Conclusão: Os programas implementados proporcionaram melhora da saúde dos indivíduos, tornando-os mais aptos ao trabalho, aumentando a produtividade e reduzindo significativamente os custos para a sociedade

Objective: To review the literature on economic analyzes used for asthma, the direct and indirect costs and the economic burden that this disease poses to the health system.Source of data: Survey of original articles, reviews and consensus, indexed in Medline, Lilacs, Embase and PubMed, published between 1996-2012. Data Synthesis: Asthma is a chronic inflammatory lung disease that affects people of all ages, whose lack leads to frequent hospitalizations, emergency room visits and increased morbidity, generating great impact on social and economic life of patients with worsening quality of life. After the beginning of asthma and allergic rhinitis control programs with free delivery of expensive drugs expensive, there was a significant drop in hospitalizations for asthma in the period from 2006 to 2010. In 2012, 48,495 people had access to drugs for asthma, from the implementation of the “Health Program”, integral action of “Popular Pharmacy Program” of the Ministry of Health (MH), with free supply of ipratropium bromide, beclomethasone dipropionate and salbutamol sulphate, this number increased signifcantly from 48,495 to 263,227 people, representing growth of 443% adherence to the program. The MH data showed that asthma still kills 2500 people a year in Brazil, in 2011 the total of 117,800 hospitalizations in the Unified Health System (UHS) due to asthma were affected 77.1 thousand children aged 0-6 years. In addition, asthma is an important global public health problem with high direct and indirect costs, which affect expressively patients and public health systems. Conclusion: The programs implemented provided improves the health of individuals, making them more apt to work, increasing productivity and significantly reducing costs to society

Ausência de efeito da memória imunológica e antígenos micobacterianos sobre a produção de IgE e citocinas em resposta a Dermatophagoides pteronyssinus / No effect of mycobacterial antigens and immunological memory on the production of cytokines and IgE in response to Dermatophagoides pteronyssinus

Introdução: As doenças respiratórias alérgicas, tais como rinite e asma, afetam elevada proporção da população brasileira. Estima-se que mais de 58 mil pessoas foram afetadas por alguma destas condições no Brasil em 2002-2003. Estudos realizados em humanos e animais sugerem que a exposição ambiental ao Mycobacterium tuberculosis ou imunização com o M. bovis (vacina BCG), podem estar relacionadas à proteção contra doenças alérgicas. Objetivo: Investigar a influência da resposta Th1 a antígenos micobacterianos sobre a modulação da resposta do tipo Th2 ao ácaro Dermatophagoides pteronyssinus (Derp). Métodos: O estudo compreendeu duas fases. Para avaliar o efeito da resposta à revacinação com o BCG sobre a modulação de uma resposta do tipo Th2 ao Derp, foi realizado um estudo de intervenção randomizado com coorte prospectiva, e os voluntários que participaram compuseram a Amostra 1. Para avaliar o efeito da resposta à infecção latente com M. tuberculosis sobre a modulação de uma resposta do tipo Th2 ao Derp, foi feito um estudo de caso-controle e os voluntários que participaram compuseram a Amostra 2. A população foi composta por adultos jovens com idade entre 19 a 33 anos. Todos responderam ao questionáro ISAAC...

Introduction: Allergic respiratory diseases such as asthma and rhinitis, affecting a high proportion of the Brazilian population. More than 58.000 people have been affected by some of these conditions in Brazil in 2002-2003. Studies in humans and animals suggest that environmental exposure to Mycobacterium tuberculosis or immunization with Mycobacterium bovis (BCG), may be related to protection against allergic diseases. Objective: To investigate the influence of Th1 response to mycobacterial antigens on the modulation of Th2-type response to aeroallergen Dermatophagoides pteronyssinus (Derp). Methods: The study comprised two phases. To evaluate the effect of the response to revaccination with BCG on the modulation of a Th2-type response to Derp, we conducted a randomized intervention study with prospective cohort, and the volunteers composed the Sample 1. To evaluate the effect of latent response to infection with M. tuberculosis on the modulation of a Th2-type response to Derp, a study was made of case-control and the volunteers composed the Sample 2. The population consisted of young adults aged 19 to 33 years. All responded to questionnaire ISAAC...

Evaluación de la flora fungica del ambiente del archivo general del Estado Sucre Venezuela / Evaluation of the fungic flora of the atmosphere of the general archives of the Sucre State Venezuela

Los agentes fúngicos son capaces de descomponer materia orgánica como madera, papel, pintura, suelo, polvo, alimentos. Pueden ocasionar deterioro de material bibliográfico , texto, mobiliario, pinturas, igualmente causan enfermedades de tipo alérgico. El Archivo General del Estado Sucre es un centro de consulta e investigación donde se encuentran documentos y otros textos que se han ido dañando a través del tiempo; las condiciones de almacenamiento de un área con deficiencias estructurales y ambientales, favorecen el desarrollo de hongos, causando el deterioro dl material bibliográfico. Se realizaó una investigación para evaluar la flora fúngica tanto del mobiliario como documentos y textos existentes, que se servirá de base para un futuro plan de conservación y restauración. Utilizando el método de sedimentación en placa conteniendo Agar Sabouraud Dextrosa, se expusieron 60 placas durante 15 minutos en diferentes secciones del área de estudio, incubándose 10 días a temperatura ambiente. Se aislaron 86 colonias que se caracterizaron macro y microcóspicamente. Los géneros aislados fueron: Aspergillus (38,46%), Fusarium (21,70%), Curcularia (16,76%), Cladosporium (12,76%), Penicillium (10,32%), los cuales han sido descritos como contaminantes habituales de libros o textos, mobiliarios, pinturas, además capaces de causar reacciones alérgicas de tipo respiratorios resultando un riesgo para el material bibliográfico, usuarios y personal de la institución.

The fungies agents are able to disturb organics material as wood, paper, paint, ground, drust, foods they can produce deterioration of bibliographycal material, texts, house-hold goods, paintings, and equally they cause disease of alergic type. The general archives of Sucre state is a consulting center and investigation where it is found historic documents and another texts which have been damaging throuth the time, the conditions of storing in an area with estructural deficiencis and environment improve the development of fungies causing the depreciation of bibliographycal material. An investigation was done to evaluate the fingis flora as the house-hold godos, as the existen documents and texts, that it would serve the base to desing the future plan of conservation and restauration. Using the method of sedimentation in plaque containing Agar Sabouraud Dextrosa, 60 plaques were exposed during 15 minutes in different sections of study area, incubating 10 days at atmosphere temperatura. 86 colonies were isolated that were characterized macro and microcospyly. The aislated fungic species were: Aspegillus (35,46%), Fusarium (21,70%), Curvalaria (16,76%), Cladosporium (12,76%), Penicillium (10,32%), which have been described as usual contaminating of book o texts, house-hold godos, paintings, in addiction to this they are able to cuse alergic rections of respiratory type, resulting a risk to the bibliographycal material, usuaries and personal of the institution.

Allergic reactions and nickel-free braces: a systematic review

Nickel-free braces have gained popularity as a viable alternative for patients who are allergic to nickel. The purpose of this systematic review was to determine whether evidence exists to justify the use of nickel-free brackets in orthodontic patients who are allergic to nickel. An electronic search was performed using 7 databases (MEDLINE, BBO, LILACS, Web of Science, EMBASE, BIREME and Cochrane Library), without restriction regarding year or language, with supplemental manual searching of the references of retrieved articles. The search strategy produced 89 papers. The data extraction and quality score of each paper were evaluated independently by two reviewers, once each. After selection based on the eligibility criteria, four papers, including 2 controlled clinical trials and 2 clinical trials, qualified for the final analysis. Quality assessment of the included articles was also performed. Nickel-free braces (Ni content - 2 percent max.) seem to represent a viable alternative for orthodontic patients who are allergic to nickel. However, further in vivo studies, considering the immunology characteristics of patients, are needed to determine the clinical implications of the findings of this study.

Resorte de Coffin: estudio de 2 diferentes tipos de ligas metálicas / Coffin appliance: study of 2 different types of metal alloys

La aparición de los alambres con una baja cantidad de níquel son un gran avance en ortodoncia, supliendo la necesidad de ortodoncia para pacientes que pueden tener hipersensibilidad de este ión, pero no se conoce mucho acerca de las propiedades mecánicas de estos alambres. El objetivo de este estudio fue probar la hipótesis de que no hay diferencia en el desempeño mecánico de los alambres de acero inoxidable y alambres de acero inoxidable con bajo contenido de níquel, evaluando la fuerza, resistencia y módulo de elasticidad producida por el resorte de Coffin hecho con alambre de 0,032 y 0,036 pulgadas. Se construyeron 60 unidades de Coffin, 30 para cada tipo de aleación, siendo 15confeccionadas con alambre de 0,032 pulgadas y 15 con alambre de 0,036 pulgadas. Todos los arcos fueron sometidos a la prueba mecánica de compresión en la máquina EMIC DL-10000, simulando 4, 6, 9 y 12 mm de activación. El análisis de varianza y comparación múltiple (ANOVA) y la prueba de Tukey (p <0,05) fueron utilizados para evaluar la fuerza, resistencia y módulo de elasticidad. Los grupos que utilizaron alambre de 0,036 pulgadas presentaron estadísticamente (p <0,05) mayores niveles de fuerza, resistencia y módulo de elasticidad en comparación con dispositivos con 0,032 pulgadas de alambre para ambas aleaciones. Para el mismo espesor, no hubieron diferencias estadísticamente significativas entre los 2 tipos de aleaciones, con excepción de los dispositivos con activación de 9 mm y espesor de 0,036 pulgadas que mostraron una diferencia estadística (p <0,05). Los resortes de Coffin evaluados para ambas aleaciones metálicas produjeron fuerzas adecuadas para el tratamiento ortodontico, por lo que debe ser correctamente planificada su aplicación clínica.

The emergence of stainless steel wire made of low-nickel content was a major breakthrough in the orthodontic, supplying the need for orthodontics patients who may have hypersensitivity by this ion, but do not know much about the mechanical properties of these wires. The objective of this study is to test the hypothesis that there is no difference between stainless steel wires and low-nickel stainless steel ones regarding their mechanical behaviour. Force, resilience, and elasticity modulus produced by Coffin appliances made of 0.032-inch and 0.036-inch wires were evaluated. Sixty appliances Coffin were made, thirty for each type of alloy being fifteen for each wire thickness. All the arches were submitted to mechanical compression test by using an EMIC DL-10000 machine simulating activations of 4, 6, 9, and 12 mm. Analysis of variance (ANOVA) with multiple comparisons and Tukey’s test were employed (p< 0.05) for assessing force, resilience, and elasticity modulus. The groups using the 0.036 inch presented statistically (p<0.05) higher levels of force, resiliency and elasticity modulus when compared to the arches using the 0.032 inch wire for both alloys. The Coffin appliances for both alloys evaluated can produce adequate forces for orthodontic treatment as long as their clinical application is correctly planned.