Gridless adult cervical spine radiography and its' effect on image quality and radiation dose: A phantom study.

INTRODUCTION: Imaging of the cervical spine in general radiography is most frequently performed using an anti-scatter grid. The purpose of this study was to investigate the effects of a gridless setting on image quality and radiation dose during digital radiography of the anteroposterior (AP) and lateral (LAT) cervical spine. METHODS: A phantom study was performed with a variety of tube voltages (63-75 kV) with and without an anti-scatter grid. The tube current time product (mAs) and dose area product (DAP) were recorded and used to calculate effective dose (ED) and individual organ dose using PCXMC 2.0 software, as well as entrance surface dose (ESD) and objective image quality: signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Subjective visual image quality grading characteristics (VGC) was performed by five qualified radiographers. RESULTS: In a gridless setting, the AP and LAT positions showed significantly lower DAP (1.6 µGym2; 61.3 % and 1.6 µGym2; 51.2%), ESD (27.6 µGy; 57.3% and 77.2 µGy; 47.2%) and ED (4.2 µSv; 61.3% and 2.3 µSv; 48.9%). In a gridless setting in the AP position, there is a slight significant deterioration in image quality. In the lateral projection, on the other hand, the image quality without the use of grid was only significantly reduced in three of six criteria and there was no difference in the objective image quality between the two settings examined. CONCLUSION: The results of this study show that gridless setting significantly decreases radiation dose and image quality, but the quality in the lateral projection is still acceptable for diagnostic purpose. IMPLICATIONS FOR PRACTICE: The protocol without the use of the anti-scatter grid in cervical spine radiography leads to a reduction in the radiation dose in both projections, but the image quality in the AP is significantly reduced for all criteria examined, with a slight deterioration in image quality in the lateral projection.

Molecular characterization of Giardia lamblia and risk factors for giardiasis among immunocompromised patients in southern Brazil.

Acute Giardia infections often cause diarrhea and stomach upset. Chronic infections can lead to malnutrition, micronutrient deficiencies, malabsorption and weight loss. This study assessed the prevalence of G. lambia infection and assessed associated risk factors among immunocompomised patients undergoing chemotherapeutic treatment in southern Brazil. A total of 110 immunocompromised patients in Pelotas, RS, Brazil, consented to participate in this study and were recruited. Socioeconomic and epidemiological profile of patients was collected by questionnaire. The prevalence for Giardia were determined through microscopy by the centrifugation-flotation technique using stool samples of every patient. In addition, the genetic characterization of the parasite was carried out by amplifying and sequencing the glutamate dehydrogenase (gdh) gene. By microscopy, the prevalence of giardiasis was 17.3% (19/110). Furthermore, the DNA sequences revealed that 7 (36.8%) out of 19 isolates belonged to assemblage B, while 6 of them (31.6%) belonged to assemblage C, 5 (26.3%) to assemblage A and 1 (5.3%) to assemblage D. Risk factors (p ≤ 0.05) for giardiasis were schooling level (OR=8.0 (1.02 - 62.91) sharing a house with more than three people (OR=14.1 (3.77 - 52.51), water sources (OR=38.9 (10.4 - 145.7), sewage treatment (OR=14.2 (3.1 - 65.5), waste destination (OR=7.44 (2.0 - 27.3), owning pets (OR=4.6 (1.0 - 21.2) and cultivating a vegetable garden (OR=4.2 (1.3 - 13.6). The prevalence of G. lamblia in immunocompromised patients was considered elevate with the identification of four assemblage of the parasite (A, B, C and D).

Diagnosis and Management of Intravenous Drug Users' Chronic Wounds: A Case Series Collection of a Single Center.

Background: Intravenous drug users (IVDUs) represent a very small group of patients affected by chronic wounds (CWs). Objectives: To assess the risk factors for CWs in IVDUs, to improve their treatment. Methods: A retrospective review of 7 IVDUs with CWs was performed at the Dermatology of the University of Bologna. Results: A history of 10 years of the most frequent injection was heroin in the gaiter area. The most observed comorbidities were HIV, HCV and HBV. They were treated most with an alginate with silver dressing with an average follow-up of 2.8 years. Conclusions: We would like to highlight the importance of clinical history in this type of patients and that in our experience specialized skin wounds risk assessment and management could be useful, aside from traditional compression therapy.

Seroprevalence of Chagas disease in Southern Brazilian cardiac patients and their knowledge about the parasitosis and vectors / Soroprevalência da doença de Chagas em pacientes cardíacos do sul do Brasil e seu conhecimento sobre a parasitose e vetores

Abstract Chagas disease (CD) is considered a typical low-income population sickness of the developing countries in Latin America. Given the historical relevance of CD in individuals in southern Rio Grande do Sul (RS) State, Brazil, the aim of this study was to identify the knowledge of the CD and its vectors by cardiac patients, and the prevalence of anti-T cruzi antibodies in these individuals in Pelotas, city located in Rio Grande do Sul (RS) state, Brazil. The subjects with cardiac disease were submitted to a semi-structured questionnaire as well as two serological tests in order to detect anti-T. cruzi IgG antibodies. Of the individuals that born in municipalities showing the highest triatomine infestation rates in recent decades, 81.8% were able to recognize the vector insect (p = 0.0042; OR = 5.9), and 83.3% reported either themselves or someone in their families to have CD (p = 0.043, OR = 5.2). Of the 54 patients submitted to serological analysis, only 01 patient (1.9%) was positive for anti-T. cruzi antibodies, a 55 year old man from the rural area of Canguçu county. This study provides support for the evaluation to be extended to other cardiology centers, given the importance of Chagas disease in Brazil.

Resumo A doença de Chagas (DC) é considerada uma doença típica da população de baixa renda dos países em desenvolvimento da América Latina. Dada a relevância histórica da DC em indivíduos do sul do Estado do Rio Grande do Sul (RS), o objetivo deste estudo foi identificar o conhecimento da doença de Chagas (DC) e seus vetores em pacientes cardíacos, e a prevalência de anticorpos anti-T cruzi nesses indivíduos, em Pelotas, cidade localizada no Rio Grande do Sul (RS), Brasil. Os pacientes cardiopatas foram submetidos a um questionário semiestruturado, e também a dois testes sorológicos para detecção de anticorpos anti-T. cruzi IgG. Dos indivíduos que nasceram em municípios com as maiores taxas de infestação por triatomíneos nas últimas décadas, 81,8% foram capazes de reconhecer o inseto vetor (p = 0,0042; OR = 5,9), e 83,3% relataram que eles próprios ou alguém em suas famílias tem DC (p = 0,043, OR = 5,2). Dos 54 pacientes submetidos à análise sorológica, apenas 01 paciente (1,9%) foi positivo para anticorpos anti-T.cruzi, um homem de 55 anos da área rural do município de Canguçu. Este estudo fornece subsídios para que a avaliação seja estendida a outros centros de cardiologia, devido à importância da doença de Chagas no Brasil.

Validation of a documentary on Chagas disease by a population living in an endemic area / Validação de um documentário sobre a doença de Chagas por uma população de área endêmica

Abstract Educational interventions may trigger actions that contribute to prevent parasitic diseases, such as Chagas disease (CD). This study aimed at investigating the impact of an instructional video named "Documentary on Chagas Disease" on knowledge about CD and its vectors displayed by a population that lives in an endemic area in Brazil, so as to validate it as an educational tool. The video was shown to 226 subjects, divided into two groups. Group 1 was composed of users of Basic Health Units (BHU) in Pelotas and Pinheiro Machado, cities located in Rio Grande do Sul (RS) state, Brazil, where CD is endemic. Group 2 consisted of students who attend three public schools located in the rural area in Pinheiro Machado, RS. Two questionnaires with questions about their knowledge about triatomines and CD were applied, before and after the documentary was shown. After the video was shown, there was significant increase in individuals' knowledge (in both groups) about "kissing bugs", their notification, the disease and its prevention. Besides, watchers considered that the quality of the material was satisfactory. Since the "Documentary on CD" can be easily accessed on the internet and was effective in teaching the population that lives in endemic areas, its use should be encouraged in places and meetings connected to health that aim at fighting against triatominae and at exposing an updated view of CD.

Resumo Intervenções educacionais podem desencadear ações que contribuam para a prevenção de doenças parasitárias, como a doença de Chagas (DC). Este estudo teve como objetivo investigar o impacto de um vídeo instrucional denominado "Documentário Doença de Chagas" no conhecimento sobre DC e seus vetores exibidos a uma população que vive em área endêmica no Brasil, para validá-lo como uma ferramenta educacional. O vídeo foi exibido para 226 indivíduos, divididos em dois grupos. O grupo 1 foi composto por usuários das Unidades Básicas de Saúde (UBS) de Pelotas e Pinheiro Machado, cidades do estado do Rio Grande do Sul (RS), Brasil, onde a DC é endêmica. O grupo 2 foi formado por estudantes que frequentam três escolas públicas localizadas na zona rural de Pinheiro Machado, RS. Dois questionários com perguntas sobre conhecimentos sobre triatomíneos e DC foram aplicados, antes e depois da exibição do documentário. Após a exibição do vídeo, houve um aumento significativo no conhecimento dos indivíduos (em ambos os grupos) sobre "triatomíneos", sua notificação, a doença e sua prevenção. Além disso, os observadores consideraram que a qualidade do material era satisfatória. Como o "Documentário DC" pode ser facilmente acessado na Internet e ser eficaz no ensino à população que vive em áreas endêmicas, seu uso deve ser incentivado em locais e reuniões relacionadas à saúde, que visam combater os triatomíneos e exibir uma informação atualizada sobre a DC.

Validation of a documentary on Chagas disease by a population living in an endemic area.

Educational interventions may trigger actions that contribute to prevent parasitic diseases, such as Chagas disease (CD). This study aimed at investigating the impact of an instructional video named "Documentary on Chagas Disease" on knowledge about CD and its vectors displayed by a population that lives in an endemic area in Brazil, so as to validate it as an educational tool. The video was shown to 226 subjects, divided into two groups. Group 1 was composed of users of Basic Health Units (BHU) in Pelotas and Pinheiro Machado, cities located in Rio Grande do Sul (RS) state, Brazil, where CD is endemic. Group 2 consisted of students who attend three public schools located in the rural area in Pinheiro Machado, RS. Two questionnaires with questions about their knowledge about triatomines and CD were applied, before and after the documentary was shown. After the video was shown, there was significant increase in individuals' knowledge (in both groups) about "kissing bugs", their notification, the disease and its prevention. Besides, watchers considered that the quality of the material was satisfactory. Since the "Documentary on CD" can be easily accessed on the internet and was effective in teaching the population that lives in endemic areas, its use should be encouraged in places and meetings connected to health that aim at fighting against triatominae and at exposing an updated view of CD.

Seroprevalence of Chagas disease in Southern Brazilian cardiac patients and their knowledge about the parasitosis and vectors.

Chagas disease (CD) is considered a typical low-income population sickness of the developing countries in Latin America. Given the historical relevance of CD in individuals in southern Rio Grande do Sul (RS) State, Brazil, the aim of this study was to identify the knowledge of the CD and its vectors by cardiac patients, and the prevalence of anti-T cruzi antibodies in these individuals in Pelotas, city located in Rio Grande do Sul (RS) state, Brazil. The subjects with cardiac disease were submitted to a semi-structured questionnaire as well as two serological tests in order to detect anti-T. cruzi IgG antibodies. Of the individuals that born in municipalities showing the highest triatomine infestation rates in recent decades, 81.8% were able to recognize the vector insect (p = 0.0042; OR = 5.9), and 83.3% reported either themselves or someone in their families to have CD (p = 0.043, OR = 5.2). Of the 54 patients submitted to serological analysis, only 01 patient (1.9%) was positive for anti-T. cruzi antibodies, a 55 year old man from the rural area of Canguçu county. This study provides support for the evaluation to be extended to other cardiology centers, given the importance of Chagas disease in Brazil.

Neoplastic patients knowledge about intestinal parasitoses in southern Brazil / Conhecimento de pacientes neoplásicos sobre parasitoses intestinais no sul do Brasil

Abstract Since oncologic patients have been considered an important risk group for parasitic infections, it is fundamental to find out what they know about intestinal parasites. This study aimed at evaluating knowledge that the adult oncologic patients undergoing chemotherapy in the main centers of treatment for cancer in the city of Pelotas, Brazil, has about intestinal parasites. A semi-structured questionnaire was used for collecting data from two hundred oncologic patients who were undergoing chemotherapy. Results showed that 69.5% know what intestinal parasites are and cited Ascaris lumbricoides and Taenia sp. as being the most known ones. The statistical comparison between the group that knows intestinal parasites and the one that does not know about them - associated with socioeconomic variables -, showed that factors that significantly influenced their knowledge were their place of residence, schooling and household income (p≤0.05). Only 36% stated that they know when they are infected with parasites and misdescribed some signs and symptoms. Regarding prevention, 52% mentioned that they do not know how to avoid parasitism. The population under study showed that there are some gaps in its knowledge of the theme under investigation. Therefore, it is important to implement socioeducational measures in hospitals and clinics that treat cancer patients.

Resumo Pacientes oncológicos são considerados um importante grupo de risco para infecções parasitárias, logo, é fundamental conhecer o que sabem sobre parasitos intestinais. O objetivo deste estudo foi avaliar os conhecimentos de indivíduos oncológicos adultos submetidos à quimioterapia nos principais centros de tratamento para o câncer no município de Pelotas, RS, sobre as enteroparasitoses. O instrumento utilizado para coleta dos dados foi um questionário semiestruturado. Foram incluídos nesta pesquisa 200 pacientes oncológicos submetidos à quimioterapia. Destes, 69,5% sabem o que são parasitos intestinais, citando Ascaris lumbricoides e Taenia sp. como os mais conhecidos. Quando realizada a comparação estatística do grupo que conhece parasitos intestinais/vermes com o grupo dos que desconhecem o tema, associadas com variáveis socioeconômicas, foi verificado que a zona em que residiam, a escolaridade e a renda familiar são fatores que influenciam no conhecimento dos indivíduos de forma significativa (p≤0,05). Apenas 36% dos indivíduos afirmaram saber quando estão parasitados, relatando alguns sinais e sintomas equivocadamente. Relacionado à prevenção, 52% mencionaram não saber como evitar o parasitismo. A população estudada possui lacunas no conhecimento sobre o tema abordado e, por isso, é importante a realização de ações socioeducativas junto aos hospitais e clínicas de tratamento dos pacientes com câncer.

Neoplastic patients' knowledge about intestinal parasitoses in southern Brazil.

Since oncologic patients have been considered an important risk group for parasitic infections, it is fundamental to find out what they know about intestinal parasites. This study aimed at evaluating knowledge that the adult oncologic patients undergoing chemotherapy in the main centers of treatment for cancer in the city of Pelotas, Brazil, has about intestinal parasites. A semi-structured questionnaire was used for collecting data from two hundred oncologic patients who were undergoing chemotherapy. Results showed that 69.5% know what intestinal parasites are and cited Ascaris lumbricoides and Taenia sp. as being the most known ones. The statistical comparison between the group that knows intestinal parasites and the one that does not know about them - associated with socioeconomic variables -, showed that factors that significantly influenced their knowledge were their place of residence, schooling and household income (p≤0.05). Only 36% stated that they know when they are infected with parasites and misdescribed some signs and symptoms. Regarding prevention, 52% mentioned that they do not know how to avoid parasitism. The population under study showed that there are some gaps in its knowledge of the theme under investigation. Therefore, it is important to implement socioeducational measures in hospitals and clinics that treat cancer patients.

Intestinal parasites in cancer patients in the South of Brazil / Parasitos intestinais em pacientes com câncer do Sul do Brasil

Abstract Intestinal parasitic infections in immunocompromised patients can lead to serious complications when not diagnosed and treated early. This study aimed to investigate the frequency of intestinal parasites in cancer patients undergoing chemotherapy in the South of Brazil. Three fecal samples collected from each patient (73 individuals) were processed by Ritchie and Faust techniques and submitted to specific staining methods for intestinal protozoa. A 61.6% parasite and/or commensal positivity was found. Helminths identified were Ascaris lumbricoides (33.3%), Taenia spp. (6.6%), Strongyloides stercoralis (4.4%) and Trichuris trichiura (2.2%). Among protozoans, Giardia lamblia (26.6%), Cryptosporidium spp. (13.3%) and Cystoisospora belli (4.4%) were identified. The presence of Entamoeba coli, Endolimax nana and Entamoeba hartmanni was also recorded. The results obtained warn of the importance of fecal parasitological diagnosis and the use of specific staining methods for the detection of intestinal parasites in cancer patients. These exams should be regularly requested at the patient's first clinic visit, given the high prevalence found in this study and the possible severity of such conditions for these individuals.

Resumo As parasitoses intestinais em pacientes imunocomprometidos podem levar a graves complicações se não diagnosticadas e tratadas precocemente. Este estudo teve como objetivo investigar a frequência de parasitos intestinais em pacientes oncológicos submetidos ao tratamento quimioterápico. Foram coletadas três amostras de fezes de cada paciente, sendo processadas pelas técnicas de Ritchie e Faust e submetidas à métodos de coloração específicos para protozoários intestinais. Foi encontrada positividade de 61,6% para parasitos e/ou comensais. Os helmintos identificados foram Ascaris lumbricoides (33,3%), Taenia spp. (6,6%), Strongyloides stercoralis (4,4%) e Trichuris trichiura (2,2%). Dentre os protozoários, foram identificados Giardia lamblia (26,6%), Cryptosporidium spp. (13,3%) e Cystoisospora belli (4,4%). Também foi registrada presença de Entamoeba coli, Endolimax nana e Entamoeba hartmanni. Os resultados encontrados alertam para a importância do diagnóstico parasitológico de fezes junto à utilização de colorações específicas para parasitos intestinais em pacientes oncológicos, sendo que os mesmos deveriam ser requeridos como conduta já na primeira consulta clínica destes pacientes, dada à elevada prevalência aqui constatada e a possível severidade que tais moléstias podem acarretar nestes indivíduos.

Correction: Sediment biomarkers elucidate the Holocene ontogeny of a shallow lake.

[This corrects the article DOI: 10.1371/journal.pone.0191073.].

Sediment biomarkers elucidate the Holocene ontogeny of a shallow lake.

We carried out geochemical analyses on a sediment core from Lake Harris, Florida (USA) to identify sources of organic matter to the sediment throughout the Holocene, and relate changes in those sources to shifts in past climate and environmental conditions. We hypothesized that the sources of organic matter changed in response to regional hydrologic shifts following de-glaciation, and to human population expansion in the state during the 20th century. Hydroclimate shifts in Florida were related to: 1) a steady rise in relative sea level and the fresh water table that began in the early Holocene, 2) wetland formation and expansion ca. 5,000 cal yrs BP, and 3) the onset of the modern El Niño (ENSO) cycle ~3,000 cal yrs BP. Stratigraphic changes in sediment variables from Lake Harris reflect each of these hydroclimate periods. Early in the Holocene, Lake Harris was a marsh-like system in a relatively dry, open-prairie environment. Organic sediments deposited at that time were derived largely from terrestrial sources, as inferred from high TOC/TN ratios, a dominance of longer-chain of n-alkanes (n-C29-31), relatively negative organic carbon isotope values (δ13CTOC), and low biogenic silica concentrations. In the middle Holocene, a positive shift in δ13CTOC coincided with the onset of wetter conditions in Florida. Submerged macrophyte biomarkers (n-C21-23) dominated, and during that period bulk organic carbon isotope values were most similar to δ13C values of mid-chain-length n-alkanes. In the late Holocene, δ13CTOC values declined, CaCO3 levels decreased to trace amounts, organic carbon concentrations increased and diatom biogenic silica concentrations increased from 10 to 120 mg g-1. Around 2,900 cal yrs BP, the effects of ENSO intensified and many Florida lakes deepened to their current limnetic state. Concentrations of algal and cyanobacterial biomarkers in the Lake Harris core increased by orders of magnitude after about AD 1940, in response to human-induced eutrophication, an inference supported by values of δ15N that fluctuate around zero.

Intestinal parasites in cancer patients in the South of Brazil.

Intestinal parasitic infections in immunocompromised patients can lead to serious complications when not diagnosed and treated early. This study aimed to investigate the frequency of intestinal parasites in cancer patients undergoing chemotherapy in the South of Brazil. Three fecal samples collected from each patient (73 individuals) were processed by Ritchie and Faust techniques and submitted to specific staining methods for intestinal protozoa. A 61.6% parasite and/or commensal positivity was found. Helminths identified were Ascaris lumbricoides (33.3%), Taenia spp. (6.6%), Strongyloides stercoralis (4.4%) and Trichuris trichiura (2.2%). Among protozoans, Giardia lamblia (26.6%), Cryptosporidium spp. (13.3%) and Cystoisospora belli (4.4%) were identified. The presence of Entamoeba coli, Endolimax nana and Entamoeba hartmanni was also recorded. The results obtained warn of the importance of fecal parasitological diagnosis and the use of specific staining methods for the detection of intestinal parasites in cancer patients. These exams should be regularly requested at the patient's first clinic visit, given the high prevalence found in this study and the possible severity of such conditions for these individuals.

Inconsistencies between 14C and short-lived radionuclides-based sediment accumulation rates: Effects of long-term remineralization.

14C is the most widely utilized geochronometer to investigate geological, geochemical and geophysical problems over the past 5 decades. Establishment of precise sedimentation rates is crucial for the reconstruction of paleo-climate, -ecological and - environmental studies when extrapolation of sedimentation rates is utilized for time scales beyond the dating range. However, agreement between short-term and long-term sedimentation rates in anthropogenically unperturbed sediment cores has not been shown. Here we show that the AMS 14C-based long-term mass accumulation rate (MAR) of an organic-rich (>70%) sediment core from Mud Lake, Florida to be ∼5 times lower than the short-term MAR obtained using 239,240Pu, 137Cs and excess 210Pb (210Pbxs). The measured sediment inventories of 210Pbxs, 137Cs and 239,240Pu are comparable to the atmospheric fallout for the sampling site, indicating very little accelerated sediment erosion over the past several decades. Presence of sharp fallout peaks of 239,240Pu indicates very little sediment mixing. The penetration depths of 137Cs and 239,240Pu were found to be much deeper than expected and this is attributed to their post-depositional mobility. MAR calculated using 14C-ages in successive layers also indicated decreasing MARs with depth, and was reflective of progressive remineralization. Using first-order kinetics, the sediment remineralization rate was found to be 4.4 × 10-4 y-1 and propose that over the long-term, remineralization of organic-rich sediment affected the long-term MAR, but not the ratio of 14C/12C. Thus, the MAR and linear sedimentation rate obtained using 14C (and other isotope-based methods) could be erroneous, although 14C ages may not be affected by such remineralization. Long-term remineralization rates of organic matter has a direct bearing on the biogeochemical cycling of elements in aqueous systems and mass balance of elements needs to be taken into consideration.

Intestinal parasites in cancer patients in the South of Brazil

Abstract Intestinal parasitic infections in immunocompromised patients can lead to serious complications when not diagnosed and treated early. This study aimed to investigate the frequency of intestinal parasites in cancer patients undergoing chemotherapy in the South of Brazil. Three fecal samples collected from each patient (73 individuals) were processed by Ritchie and Faust techniques and submitted to specific staining methods for intestinal protozoa. A 61.6% parasite and/or commensal positivity was found. Helminths identified were Ascaris lumbricoides (33.3%), Taenia spp. (6.6%), Strongyloides stercoralis (4.4%) and Trichuris trichiura (2.2%). Among protozoans, Giardia lamblia (26.6%), Cryptosporidium spp. (13.3%) and Cystoisospora belli (4.4%) were identified. The presence of Entamoeba coli, Endolimax nana and Entamoeba hartmanni was also recorded. The results obtained warn of the importance of fecal parasitological diagnosis and the use of specific staining methods for the detection of intestinal parasites in cancer patients. These exams should be regularly requested at the patients first clinic visit, given the high prevalence found in this study and the possible severity of such conditions for these individuals.

Resumo As parasitoses intestinais em pacientes imunocomprometidos podem levar a graves complicações se não diagnosticadas e tratadas precocemente. Este estudo teve como objetivo investigar a frequência de parasitos intestinais em pacientes oncológicos submetidos ao tratamento quimioterápico. Foram coletadas três amostras de fezes de cada paciente, sendo processadas pelas técnicas de Ritchie e Faust e submetidas à métodos de coloração específicos para protozoários intestinais. Foi encontrada positividade de 61,6% para parasitos e/ou comensais. Os helmintos identificados foram Ascaris lumbricoides (33,3%), Taenia spp. (6,6%), Strongyloides stercoralis (4,4%) e Trichuris trichiura (2,2%). Dentre os protozoários, foram identificados Giardia lamblia (26,6%), Cryptosporidium spp. (13,3%) e Cystoisospora belli (4,4%). Também foi registrada presença de Entamoeba coli, Endolimax nana e Entamoeba hartmanni. Os resultados encontrados alertam para a importância do diagnóstico parasitológico de fezes junto à utilização de colorações específicas para parasitos intestinais em pacientes oncológicos, sendo que os mesmos deveriam ser requeridos como conduta já na primeira consulta clínica destes pacientes, dada à elevada prevalência aqui constatada e a possível severidade que tais moléstias podem acarretar nestes indivíduos.

Neoplastic patients knowledge about intestinal parasitoses in southern Brazil

Abstract Since oncologic patients have been considered an important risk group for parasitic infections, it is fundamental to find out what they know about intestinal parasites. This study aimed at evaluating knowledge that the adult oncologic patients undergoing chemotherapy in the main centers of treatment for cancer in the city of Pelotas, Brazil, has about intestinal parasites. A semi-structured questionnaire was used for collecting data from two hundred oncologic patients who were undergoing chemotherapy. Results showed that 69.5% know what intestinal parasites are and cited Ascaris lumbricoides and Taenia sp. as being the most known ones. The statistical comparison between the group that knows intestinal parasites and the one that does not know about them associated with socioeconomic variables , showed that factors that significantly influenced their knowledge were their place of residence, schooling and household income (p0.05). Only 36% stated that they know when they are infected with parasites and misdescribed some signs and symptoms. Regarding prevention, 52% mentioned that they do not know how to avoid parasitism. The population under study showed that there are some gaps in its knowledge of the theme under investigation. Therefore, it is important to implement socioeducational measures in hospitals and clinics that treat cancer patients.

Resumo Pacientes oncológicos são considerados um importante grupo de risco para infecções parasitárias, logo, é fundamental conhecer o que sabem sobre parasitos intestinais. O objetivo deste estudo foi avaliar os conhecimentos de indivíduos oncológicos adultos submetidos à quimioterapia nos principais centros de tratamento para o câncer no município de Pelotas, RS, sobre as enteroparasitoses. O instrumento utilizado para coleta dos dados foi um questionário semiestruturado. Foram incluídos nesta pesquisa 200 pacientes oncológicos submetidos à quimioterapia. Destes, 69,5% sabem o que são parasitos intestinais, citando Ascaris lumbricoides e Taenia sp. como os mais conhecidos. Quando realizada a comparação estatística do grupo que conhece parasitos intestinais/vermes com o grupo dos que desconhecem o tema, associadas com variáveis socioeconômicas, foi verificado que a zona em que residiam, a escolaridade e a renda familiar são fatores que influenciam no conhecimento dos indivíduos de forma significativa (p0,05). Apenas 36% dos indivíduos afirmaram saber quando estão parasitados, relatando alguns sinais e sintomas equivocadamente. Relacionado à prevenção, 52% mencionaram não saber como evitar o parasitismo. A população estudada possui lacunas no conhecimento sobre o tema abordado e, por isso, é importante a realização de ações socioeducativas junto aos hospitais e clínicas de tratamento dos pacientes com câncer.

Validation of a documentary on Chagas disease by a population living in an endemic area

Abstract Educational interventions may trigger actions that contribute to prevent parasitic diseases, such as Chagas disease (CD). This study aimed at investigating the impact of an instructional video named Documentary on Chagas Disease on knowledge about CD and its vectors displayed by a population that lives in an endemic area in Brazil, so as to validate it as an educational tool. The video was shown to 226 subjects, divided into two groups. Group 1 was composed of users of Basic Health Units (BHU) in Pelotas and Pinheiro Machado, cities located in Rio Grande do Sul (RS) state, Brazil, where CD is endemic. Group 2 consisted of students who attend three public schools located in the rural area in Pinheiro Machado, RS. Two questionnaires with questions about their knowledge about triatomines and CD were applied, before and after the documentary was shown. After the video was shown, there was significant increase in individuals knowledge (in both groups) about kissing bugs, their notification, the disease and its prevention. Besides, watchers considered that the quality of the material was satisfactory. Since the Documentary on CD can be easily accessed on the internet and was effective in teaching the population that lives in endemic areas, its use should be encouraged in places and meetings connected to health that aim at fighting against triatominae and at exposing an updated view of CD.

Resumo Intervenções educacionais podem desencadear ações que contribuam para a prevenção de doenças parasitárias, como a doença de Chagas (DC). Este estudo teve como objetivo investigar o impacto de um vídeo instrucional denominado Documentário Doença de Chagas no conhecimento sobre DC e seus vetores exibidos a uma população que vive em área endêmica no Brasil, para validá-lo como uma ferramenta educacional. O vídeo foi exibido para 226 indivíduos, divididos em dois grupos. O grupo 1 foi composto por usuários das Unidades Básicas de Saúde (UBS) de Pelotas e Pinheiro Machado, cidades do estado do Rio Grande do Sul (RS), Brasil, onde a DC é endêmica. O grupo 2 foi formado por estudantes que frequentam três escolas públicas localizadas na zona rural de Pinheiro Machado, RS. Dois questionários com perguntas sobre conhecimentos sobre triatomíneos e DC foram aplicados, antes e depois da exibição do documentário. Após a exibição do vídeo, houve um aumento significativo no conhecimento dos indivíduos (em ambos os grupos) sobre triatomíneos, sua notificação, a doença e sua prevenção. Além disso, os observadores consideraram que a qualidade do material era satisfatória. Como o Documentário DC pode ser facilmente acessado na Internet e ser eficaz no ensino à população que vive em áreas endêmicas, seu uso deve ser incentivado em locais e reuniões relacionadas à saúde, que visam combater os triatomíneos e exibir uma informação atualizada sobre a DC.

Seroprevalence of Chagas disease in Southern Brazilian cardiac patients and their knowledge about the parasitosis and vectors

Abstract Chagas disease (CD) is considered a typical low-income population sickness of the developing countries in Latin America. Given the historical relevance of CD in individuals in southern Rio Grande do Sul (RS) State, Brazil, the aim of this study was to identify the knowledge of the CD and its vectors by cardiac patients, and the prevalence of anti-T cruzi antibodies in these individuals in Pelotas, city located in Rio Grande do Sul (RS) state, Brazil. The subjects with cardiac disease were submitted to a semi-structured questionnaire as well as two serological tests in order to detect anti-T. cruzi IgG antibodies. Of the individuals that born in municipalities showing the highest triatomine infestation rates in recent decades, 81.8% were able to recognize the vector insect (p = 0.0042; OR = 5.9), and 83.3% reported either themselves or someone in their families to have CD (p = 0.043, OR = 5.2). Of the 54 patients submitted to serological analysis, only 01 patient (1.9%) was positive for anti-T. cruzi antibodies, a 55 year old man from the rural area of Canguçu county. This study provides support for the evaluation to be extended to other cardiology centers, given the importance of Chagas disease in Brazil.

Resumo A doença de Chagas (DC) é considerada uma doença típica da população de baixa renda dos países em desenvolvimento da América Latina. Dada a relevância histórica da DC em indivíduos do sul do Estado do Rio Grande do Sul (RS), o objetivo deste estudo foi identificar o conhecimento da doença de Chagas (DC) e seus vetores em pacientes cardíacos, e a prevalência de anticorpos anti-T cruzi nesses indivíduos, em Pelotas, cidade localizada no Rio Grande do Sul (RS), Brasil. Os pacientes cardiopatas foram submetidos a um questionário semiestruturado, e também a dois testes sorológicos para detecção de anticorpos anti-T. cruzi IgG. Dos indivíduos que nasceram em municípios com as maiores taxas de infestação por triatomíneos nas últimas décadas, 81,8% foram capazes de reconhecer o inseto vetor (p = 0,0042; OR = 5,9), e 83,3% relataram que eles próprios ou alguém em suas famílias tem DC (p = 0,043, OR = 5,2). Dos 54 pacientes submetidos à análise sorológica, apenas 01 paciente (1,9%) foi positivo para anticorpos anti-T.cruzi, um homem de 55 anos da área rural do município de Canguçu. Este estudo fornece subsídios para que a avaliação seja estendida a outros centros de cardiologia, devido à importância da doença de Chagas no Brasil.

Recommendations for the management of biofilm: a consensus document.

The potential impact of biofilm on healing in acute and chronic wounds is one of the most controversial current issues in wound care. A significant amount of laboratory-based research has been carried out on this topic, however, in 2013 the European Wound Management Association (EWMA) pointed out the lack of guidance for managing biofilms in clinical practice and solicited the need for guidelines and further clinical research. In response to this challenge, the Italian Nursing Wound Healing Society (AISLeC) initiated a project which aimed to achieve consensus among a multidisciplinary and multiprofessional international panel of experts to identify what could be considered part of 'good clinical practice' with respect to the recognition and management of biofilms in acute and chronic wounds. The group followed a systematic approach, developed by the GRADE working group, to define relevant questions and clinical recommendations raised in clinical practice. An independent librarian retrieved and screened approximately 2000 pertinent published papers to produce tables of levels of evidence. After a smaller focus group had a multistep structured discussion, and a formal voting process had been completed, ten therapeutic interventions were identified as being strongly recommendable for clinical practice, while another four recommendations were graded as being 'weak'. The panel subsequently formulated a preliminary statement (although with a weak grade of agreement): 'provided that other causes that prevent optimal wound healing have been ruled out, chronic wounds are chronically infected'. All members of the panel agreed that there is a paucity of reliable, well-conducted clinical trials which have produced clear evidence related to the effects of biofilm presence. In the meantime it was agreed that expert-based guidelines were needed to be developed for the recognition and management of biofilms in wounds and for the best design of future clinical trials. This is a fundamental and urgent task for both laboratory-based scientists and clinicians.