Procedimientos endoscópicos y pandemia COVID-19: consideraciones básicas / Basic considerations regarding endoscopic procedures during the COVID-19 pandemic

El SARS-Cov-2 es un coronavirus productor de la enfermedad COVID-19. Esta inició en Wuhan, capital de la provincia Hubei, China. En menos de cuatro meses la enfermedad se dispersó por el mundo, lo que dio origen a miles de muertes. La Organización Mundial de la Salud (OMS) la ha declarado pandemia. La humanidad está consternada, múltiples gobiernos han obligado al aislamiento total, con éxito variable debido a la negligencia de parte de la comunidad. En muchas ciudades las instituciones y el personal sanitario no son suficientes para atender la catástrofe. El aislamiento es la única estrategia eficaz para detener el crecimiento logarítmico de COVID-19. El motivo científico del aislamiento es que más del 60 % de los contagios surgen de personas asintomáticas. La enfermedad no solo produce síntomas respiratorios. El SARS-Cov-2, además, puede producir náuseas, dolor abdominal, vómito, diarrea, anosmia y ageusia. El 50% de los infectados pueden tener síntomas digestivos, que incluso preceden a los respiratorios. La ruta fecal-oral trasmite el virus, aún sin diarrea. En las unidades de endoscopia están todas las formas de contagio: aerosoles (vómitos, arcadas, eructos, flatos), materia fecal, contacto estrecho, contaminación del ambiente. Se deben suspender todas las endoscopias programadas para diagnóstico. Solo deben realizarse las urgentes y terapéuticas. Todo el personal de endoscopia debe tener medidas de protección estrictas. El paciente debe saber que en la sala de endoscopia puede contagiarse, con constancia en el consentimiento informado. Debe contactarse al paciente posendoscopia vía telefónica a los días 7 y 14 para indagar sobre todos los síntomas mencionados.(AU)

SARS-CoV-2 is the coronavirus which produces the dreaded COVID-19. Starting in Wuhan, the capital of China's Hubei province, it has spread it spread throughout the world in less than four months and has caused thousands of deaths. The WHO has declared it to be a pandemic. Humanity is shocked, and many governments have imposed total isolation. It has had varying success due to community negligence. In many cities, institutions and health personnel have not successfully managed this catastrophe. Isolation is the only effective strategy to stop the logarithmic growth of COVID 19. The scientific reason for isolation is that more than 60 % of infections arise from asymptomatic people. SARS-CoV-2 not only produces respiratory symptoms but can also cause nausea, abdominal pain, vomiting, diarrhea, anosmia and ageusia. Fifty percent of those infected may have digestive symptoms which may even precede respiratory symptoms. The fecal-oral route can transmit the virus even when there is no diarrhea. All forms of contagion are found in endoscopy units: aerosols from vomiting, retching, bel-ching, and flatus; fecal matter, close contact, and contamination of the environment. All diagnostic endoscopies should be discontinued. Only urgent and therapeutic endoscopy should be performed. All endoscopy personnel must have strict protection measures. Each patient should be informed, and sign an informed consent form, that the virus can be spread within the endoscopy room. After performance of endoscopy, the patient should be contacted by phone on days 7 and 14 to inquire about all symptoms mentioned.(AU)

Qualidade higiênico-sanitária e prevalência de sorovares de Salmonella em linguiças frescais produzidas artesanalmente e inspecionadas, comercializadas no oeste do Paraná, Brasil / Sanitary quality and prevalence of serovars of Salmonella in handmade and inspected fresh pork sausages sold in western Paraná, Brazil

A fabricação de linguiça do tipo frescal requer uma série de etapas de manipulação, o que eleva as possibilidades de contaminação por diversas espécies de micro-organismos patogênicos ou deterioradores. Isso pode comprometer a qualidade microbiológica do produto final e veicular enfermidades a partir de seu consumo. No período de abril a setembro de 2009, foi avaliada a qualidade microbiológica de 40 amostras de linguiça tipo frescal produzidas artesanalmente e inspecionadas pelo Serviço de Inspeção Estadual e Federal nos municípios de Cascavel e Toledo (PR), através da quantificação de coliformes termotolerantes, contagem de Staphylococcus spp., bactérias mesófilas aeróbias estritas e facultativas viáveis, pesquisa de Salmonella spp., Campylobacter spp., Bacillus cereus, Clostridium sulfito-redutores e bolores e leveduras. Os resultados revelaram que 55% das amostras analisadas de linguiça tipo frescal inspecionadas e artesanais apresentaram-se fora dos parâmetros estabelecidos pela Resolução RDC nº 12, de 2 de janeiro de 2001, da Agência Nacional de Vigilância Sanitária (Anvisa), em pelo menos um dos grupos de micro-organismos estudados. Portanto, pode-se dizer que a linguiça tipo frescal comercializada no oeste do Paraná pode oferecer riscos à saúde da população.(AU)

The manufacture of fresh pork sausage requires a series of manipulation steps, which increases the chances of contamination by several species of micro-organisms, be them pathogenic or deteriorating. This may compromise the microbiological quality of the final product and transmit diseases with consumption. In the period from April to September 2009, the microbiological quality of 40 samples of fresh handmade sausage inspected by the Inspection State and Federal Service in the cities of Cascavel and Toledo (PR) was assessed, through the quantification of thermotolerant coliforms, Staphylococcus spp., viable facultative and strict mesophilic aerobic bacteria, Salmonella spp., Campylobacterspp., Bacillus cereus, Clostridium sulfite reducers, molds and yeasts. The results revealed that 55% of the analyzed samples of fresh handmade and inspected sausages were not in accordance with the parameters established by Resolution RDC Nº 12, of January 2nd, 2001, from ANVISA, in at least one of the studied groups of micro-organisms. Therefore, we can say the sausages sold in western regions, may present a risk to public health.(AU)

Fecal indicators and bacterial pathogens in bottled water from Dhaka, Bangladesh

Forty-six bottled water samples representing 16 brands from Dhaka, Bangladesh were tested for the numbers of total coliforms, fecal indicator bacteria (i.e., thermotolerant Escherichia coli and Enterococcus spp.) and potential bacterial pathogens (i.e., Aeromonas hydrophil, Pseudomonas aeruginos, Salmonella spp., and Shigella spp.). Among the 16 brands tested, 14 (86%), ten (63%) and seven (44%) were positive for total coliforms, E. coil and Enterococcus spp., respectively. Additionally, a further nine (56%), eight (50%), six (37%), and four (25%) brands were PCR positive for A. hydrophila lip, P. aeruginosa ETA, Salmonella spp. invA, and Shigella spp. ipaH genes, respectively. The numbers of bacterial pathogens in bottled water samples ranged from 28 ± 12 to 600 ± 45 (A. hydrophila lip gene), 180 ± 40 to 900 ± 200 (Salmonella spp. invA gene), 180 ± 40 to 1,300 ± 400 (P. aeruginosa ETA gene) genomic units per L of water. Shigella spp. ipaH gene was not quantifiable. Discrepancies were observed in terms of the occurrence of fecal indicators and bacterial pathogens. No correlations were observed between fecal indicators numbers and presence/absence of A. hydrophila lip (p = 0.245), Salmonella spp. invA (p = 0.433), Shigella spp. ipaH gene (p = 0.078), and P. aeruginosa ETA (p = 0.059) genes. Our results suggest that microbiological quality of bottled waters sold in Dhaka, Bangladesh is highly variable. To protect public health, stringent quality control is recommended for the bottled water industry in Bangladesh.

Avaliação qualitativa da contaminação microbiológica das águas de poços no município de Carlinda – MT / Qualitative evaluation of microbiological contamination of the wells water in the Carlinda – MT

O presente trabalho foi desenvolvido visando a avaliar qualitativamente a água de poços rústicos utilizados pelos moradores do bairro Bom Jesus, na cidade de Carlinda-MT. Realizaram-se 24 amostragens na época de chuvas e 24 amostragens na época de seca, sendo também aplicados questionários para levantamento de dados sobre os cuidados que os poços recebem, bem como a proximidade de fossas sépticas. O objetivo do trabalho foi centrado na determinação de coliformes totais, Escherichia coli e bactérias mesófilas, nas duas estações pluviométricas do ano. Os resultados nos revelam um alto grau de contaminação desses poços nas duas estações pluviométricas, uma vez que o índice de contaminação por coliformes totais foi de 100% em todas as coletas. No que se refere a Escherichia coli, foi observado um maior índice de contaminação no período chuvoso (91%), em relação ao período da seca (79%), entretanto não há diferença significativa entre os períodos pluviométricos observados. A contagem total de bactérias mesófilas seguiu o mesmo padrão observado para Escherichia coli, do qual a maior concentração foi encontrada no período chuvoso (10.430 UFC/100 mL) estatisticamente diferente em relação ao período de estiagem (6.390 UFC/100mL). De acordo com os questionários aplicados, 70% dos moradores utilizam a água para consumo humano e, destes, 20% dos moradores fervem e/ou filtram a água. Os poços localizam-se a uma distância média de 8m das fossas sépticas.

This work was developed in order to evaluate qualitatively the water from wells used by people who live in the neighborhood of Bom Jesus, in the city of Carlinda, State of Mato Grosso (MT). Two water collections were carried out in the rainfall season and two in the drought season. In each of them, twelve wells were used as samples. Questionnaires were applied for the data gathering on the care concerning wells as well as the proximity of septic tanks. The purpose of this work was to determine total coliform, Escherichia coli and mesophile bacteria, in the two rainfall seasons of the year. Results show a high level of contamination of these wells in the rainfall seasons, once the level of contamination by total coliform was of 100% in all water collections. Concerning Escherichia coli, it was observed a higher level of contamination in the rainfall period (91%) in relation to the drought period (79%), with no significant difference between the observed rainfall periods. The total counting of mesophile bacteria followed the same pattern observed for Escherichia coli, where the higher concentration was found in the rainfall period (10.430 UFC/100mL) statistically different in relation to the drought period (6.390 UFC/100mL). According to the applied questionnaires, 70% of the people use the water for human consumption, and out of these, 20% boil and/or filter the water. The wells are located at an average 8m-distance from the septic tanks.

Technical and economic feasibility of gradual concentric chambers reactor for sewage treatment in developing countries

A major challenge in developing countries concerning domestic wastewaters is to decrease their treatment costs. In the present study, a new cost-effective reactor called gradual concentric chambers (GCC) was designed and evaluated at lab-scale. The effluent quality of the GCC reactor was compared with that of an upflow anaerobic sludge bed (UASB) reactor. Both reactors showed organic matter removal efficiencies of 90 percent; however, the elimination of nitrogen was higher in the GCC reactor. The amount of biogas recovered in the GCC and the UASB systems was 50 percent and 75 percent of the theoretical amount expected, respectively, and both reactors showed a slightly higher methane production when the feed was supplemented with an additive based on vitamins and minerals. Overall, the economical analysis, the simplicity of design and the performance results revealed that the GCC technology can be of particular interest for sewage treatment in developing countries.

Eficiência de diferentes sanitizantes sobre a microbiota da alface orgânica (Lactuca sativa L. ) / Efficiency of different sanitizers on microbial organic lettuce (Lactuca sativa L. )

A busca por alimentos saudáveis e de alta qualidade vem aumentando diariamente e um aspecto de importância na qualidade de hortaliças é o tratamento adequado com sanitizantes que assegure a redução de microrganismos aos níveis considerados seguros. Visando diminuir a carga microbiana inicial e seu desenvolvimento em alface orgânica, este estudo teve por objetivo verificar a eficiência de soluções de dicloroisocianurato de sódio (NaDCC), hipoclorito de sódio (NaOCI), ambos na concentração de 100 ppm, e ozônio (O3) 6,4 ppm sobre a população de coliformes fecais, coliformes totais, bactérias aeróbias mesófilas e Salmonella sp. A avaliação da microbiota inicial revelou que 100 por cento das amostras apresentavam níveis altos para coliformes totais e bactérias aeróbias mesófilas e 30 por cento das amostras apresentavam coliformes fecais. Não foi detectada Salmonella sp. Os tratamentos com NaDCC e NaOCI foram mais efetivos na redução de coliformes totais, seguidos da água ozonizada. Na redução de coliformes fecais todos os sanitizantes testados foram eficientes. Menores contagens de bactérias aeróbias mesófilas foram encontrados após tratamento com NaDCC, seguidos da água ozonizada e NaOCI.

Calidad bacteriológica del agua utilizada en clínicas odontológicas / Bacteriological quality of the water used in dental clinics

Se evaluó la calidad bacteriológica del agua de 8 clínicas odontológicas de la FESI UNAM, determinándose Coliformes fecales y Coliformes totales, por medio de la técnica de filtro de membrana. Realizándose de 2 a 4 muestreos semanales, en cada clínica se tomaron muestras de la jeringa triple y el llena vasos de 10 unidades dentales, además del suministro de entrada. Se tomaron 188 muestras, a cada una se le efectuaron 2 determinaciones (Coliformes totales y Coliformes fecales), haciendo un total de 376 análisis. De las muestras analizadas únicamente 8 presentaron contaminación bacteriana; 7 correspondieron al primer muestreo realizado en la Clínica de Acatlán después de un periodo vacacional; la contaminación fue consecuencia del prolongado estancamiento del agua debido a la inactividad clínica, lo cual contribuyó a la presencia de Coliformes fecales y Coliformes totales. Posteriormente a ese periodo vacacional los siguientes muestreos salieron negativos. En la clínica Ecatepec una muestra proveniente de una unidad dental que contaba con el sistema Flush, también resultó positiva para Coliformes totales. En las clínicas odontológicas se atiende anualmente más de 30,000 pacientes de diversas edades y estados de salud, a quienes se efectúan diversos tratamientos odontológicos que van desde extracciones hasta cirugías maxilofaciales.

The bacteriological quality of the water of 8 dental clinics of FESI UNAM, was evaluated determining total and fecal coliforms, by means of the technique of membrane filter. They were made 2 to 4 weekly samplings, and in each clinic, were taken samples of the triple syringe and the flood glasses of 10 dental units, in addition water tap. 188 samples were taken and both determinations of coliforms were made to each sample, making a total of 376 analyses. From all the analyzed samples only 8 presented bacterial pollution; 7 of them, corresponded to the first sampling made in Acatlán clinic after a vacational period; the pollution was consequence of the prolonged water stagnation due to the clinical inactivity, which contributed to the presence of fecal and total coliforms. After vacations the following samplings were negatives. In Ecatepec clinic one sample which came from a dental unit that with a Flush system, also was positive for total coliforms. The dental clinics, annually give service of more than 30.000 patients of diverse ages and states of health, offering diverse types of dental treatments since extractions to some maxilofacial surgeries. It was conclude that in general, the bacteriological quality of the water used in the dental clinics is good, which is very important, because water makes directly contact with the mucous membrane of oral cavity, dental structures, blood and saliva of the patient, avoiding infectious processes that could put in risk their integral health.

Coliformes totais e Escherichia coli em coxas de frango comercializados no Rio de Janeiro / Total coliforms and Escherichia coli chicken thigh commercialized in Rio de Janeiro

Os objetivos deste trabalho foram enumerar coliformes totais e Escherichia coli, que é um indicador de contaminação fecal,comparando os resultados obtidos frente aos padrões de identidade e qualidade nacionais vigentes, além de realizar asorologia das cepas de E. coli isoladas em coxas de frango, obtidas em estabelecimentos com e sem inspeção sanitária,comercializadas no município do Rio de Janeiro. Para enumeração dos microrganismos foi utilizada metodologia miniaturizadacom meios de cultura de rápida detecção, contendo indicadores fluorogênicos e cromogênicos. Das 30 amostras analisadas,12 apresentaram número mais provável (NMP) de E. coli variando de <3 a 2,9x107/g, sendo seis (20 por cento) consideradas imprópriaspara o consumo de acordo com a legislação vigente. Das 150 colônias suspeitas e confirmadas em testes bioquímicos 18(12 por cento) foram positivas para os sorogrupos E. coli enteropatogênica (EPEC) e E. coli enteroinvasiva (EIEC), provenientes de 15amostras diferentes. Das 17 colônias suspeitas para E. coli enterohemorrágica (EHEC), nenhuma cepa pertencia a estegrupo. Os resultados indicam que a existência de um serviço de inspeção eficiente, em todas as fases do processo tecnológicodo frango, é muito importante para obtenção de um produto de qualidade e seguro, sem riscos para a saúde do consumidor.

The objectives of this work were to enumerate total coliforms and Escherichia coli, that is indicators of fecal contamination,comparing the achieved results with the current standards of national identity and quality, and also to perform the serologicalconfirmation of isolated strains E. coli in chicken thigh, obtained in establishments with and without sanitary inspection,commercialized in the city of Rio de Janeiro. In the enumeration of the microorganisms, the miniaturized methodology wasperformed with culture media for rapid detection, based in fluorogenic and chromogenic substrates in their composition. Twelveof the 30 analyzed samples presented most probable number (MPN) of E. coli varying from <3 to 2.9x107/g, with six (20 percent)considered improper for human consumption in accordance with the current legislation. From the 150 colonies suspected andconfirmed with biochemical tests, 18 (12 percent) were tested positive for enteropathogenic E. coli (EPEC) and enteroinvasive E. coli(EIEC), taken from 15 different samples. From 17 colonies suspected for enterohaemorrhagic E. coli (EHEC), no strain belongedto this group. The results indicate that the existence of a service of efficient inspection, in all the stages of the technologicalprocess of the poultry, is very important to supply a product with quality and safety, without risking the health of the consumer.