Gravimetric composition of the rejects coming from the segregation process of the municipal recyclable wastes.

Rejects from selective collection are municipal solid waste (MSW) not used for recycling and are, therefore, destined for the landfill in Brazil. Knowledge of the composition and generation of this waste is important for strategically planning public policies that minimize its generation and its negative environmental impacts. However, this portion of MSW is not very well known. Therefore, the aim of this study was to analyze the rejects from the sorting process of the selective waste collection in the municipality of Blumenau, in the State of Santa Catarina, southern Brazil. The studied rejects came from the largest cooperative in the city, and its composition was sorted into 17 categories of 101 samples over the course of one year, with a total of 3893 kg of analyzed rejects. The waste collected by the selective collection of the municipality was evaluated monthly to determine which part of this quantity became rejects and to determine the composition and seasonality of these rejects. The study found that 30.5% of the waste sorted by the cooperative was rejected. Among these rejects, the presence of materials that could be marketed by the cooperative was verified. Hazardous and/or legally prohibited waste were also identified, as were organics, construction and demolition waste, health care waste, electronics, textiles, footwear, batteries, and bulbs. Seasonal analysis indicated a concerning constant generation of health care waste. Aside from that, there was an increase in the generation of waste from electrical and electronic equipment (EEE) during the Christmas period, when a large part of the population discards their EEE. This information is important for the enforcement of the MSW management structure as well as for educational campaigns aimed at the correct separation of waste that should be sent for selective collection.

Clinical characteristics of acute myocardial infarction in patients with Chagas' disease.

From 1981 to 1988, 404 patients at our institution were found to have acute myocardial infarction. Of them, 18 (4%) had a positive fixation test for Chagas' disease. Patient age ranged from 41 to 80 years (median = 59). Eleven patients were males. Eighteen nonchagasic patients were matched by 2 year age intervals and sex with each chagasic patient. Before acute myocardial infarction, there were no differences between chagasic and nonchagasic patients with regard to the proportion of stable angina, unstable angina and coronary risk factors. Atypical chest pain occurred in 8 of 15 (53%) chagasic patients for whom this information was found in the medical records and in 1 of 18 (5%) nonchagasic patients (p = 0.003); dyspnea and palpitations occurred in 6 of 15 (40%) chagasic and 1 of 17 (5%) nonchagasic patients (p = 0.025). There were no differences between chagasic and nonchagasic patients with respect to both clinical characteristics and cardiac complications of acute myocardial infarction. Nonetheless, 4 of 11 (36%) chagasic patients for whom this information was listed in the medical records but none of 16 nonchagasic patients had normal coronary arteries (p = 0.019). Thus, chagasic patients who develop acute myocardial infarction have some peculiarities both in the clinical profile before the acute event and in the anatomy of the coronary arteries.

Clinical profile of patients with Chagas' disease before and during sustained ventricular tachycardia.

Sustained ventricular tachycardia was diagnosed in 15 patients undergoing ordinary activity with Chagas' disease seen at our Institute from 1978 to 1989. Palpitations were observed in 11 (66%) of the patients, dyspnea in 7 (46%), atypical chest pain in 5 (33%) and syncope in 2 (13%). Cardiac arrhythmia was detected in 4 (26%) on physical examination. The resting electrocardiogram showed premature ventricular contractions in 13 (86%) patients, ST-T changes in 12 (80%), left axis deviation in 9 (60%) and right bundle branch block in 4 (26%). Chest X-rays showed mild cardiomegaly in 8 (53%) and moderate cardiomegaly in 3 (20%) patients. Mild left ventricular dysfunction was detected echocardiographically in 1 (10%), moderate in 3 (30%) and severe in 1 (10%) of the 10 patients studied. During sustained ventricular tachycardia, dyspnea was found in 7 of 15 (46%) patients, palpitations in 6 (40%), atypical chest pain in 6 (40%), syncope in 1 (6%), systemic arterial hypotension in 3 (20%) and cardiogenic shock in 2 (13%). The electrocardiographic findings were as follows: mean heart rate was 201 bpm; mean QRS lengthening was 0.16 sec; right bundle branch block plus right axis deviation was seen in 5 of 15 (33%) patients; right bundle branch block plus left axis deviation in 4 (26%); and a positive concordance of all precordial leads in 5 (33%) patients. Based on these findings, we conclude that the majority of patients with Chagas' disease who develop sustained ventricular tachycardia do not have severe myocardial disease, show an uncommon electrocardiographic pattern of this arrhythmia, and most importantly, have a benign clinical course.