Occupational risks in the elderly, recyclable material collectors, in the Federal District, Brazil / Riscos ocupacionais em idosos, catadores de materiais recicláveis, no Distrito Federal, Brasil

This study aimed to analyze the sociodemographic profile, risk factors and health conditions of elderly collectors of recyclable material who worked in an open-air garbage dump, the Structural City Dump in the Federal District, Brazil. The study is cross-sectional and data were collected from a semi-structured instrument, in which sociodemographic, epidemiological and laboratory variables of the research participants were analyzed. The survey demonstrates great vulnerability of this group, highlighting gender differences such as: 64.6% were women, 46.2% were single, 60% reported brown color, 26.2% had more than 4 children, 33.8% had no education level , 52.3 hypertensive and of these 61.9% were women; 83.1% reported exposure to risks with sharp piercing material and 61.5% to contact with decomposing garbage; 56.9% reported accidents with cuts and perforations; 70.8% contact with rodents; 83.1% reported exposure to smoke. This study suggests that the implementation of public and health policies are important to this group, as well as awareness strategies in society, in order to guarantee safe working and living conditions for the health of this population.

Este trabalho objetivou analisar o perfil sociodemográfico, os fatores de risco e as condições de saúde dos idosos catadores de material reciclável que atuavam em um depósito de lixo a céu aberto, o Lixão da cidade Estrutural no Distrito Federal, Brasil. O estudo é transversal e os dados foram coletados a partir de um instrumento semiestruturado, em que foram analisadas variáveis sociodemográficas, epidemiológicas e laboratoriais dos participantes da pesquisa. A pesquisa demonstra grande vulnerabilidade deste grupo, destacando diferenças de gênero como: 64,6% eram mulheres, 46,2% solteiros, 60% referiram cor parda, 26.2 % com mais de 4 filhos, 33,8% sem nenhum grau de escolaridade, 52,3 hipertensos e destes 61,9% são mulheres; 83,1% relataram exposição a riscos com material perfuro cortante e 61,5 % ao contato com lixo em decomposição; 56,9% relataram acidentes com corte e perfuração; 70,8% contato com roedores; 83,1% relataram exposição à fumaça. Este estudo sugere que a implantação de políticas públicas e de saúde são importantes a este grupo, assim como estratégias de sensibilização da sociedade, a fim de garantir condições de trabalho e de vida seguras para a saúde desta população.

Hypertension induced by pregnancy and neonatal outcome: Results from a retrospective cohort study in preterm under 34 weeks.

OBJECTIVE: The present study seeks to assess the impact of gestational hypertensive disorders on premature newborns below 34 weeks and to establish the main morbidities and mortality in the neonatal period and at 18 months. MATERIALS AND METHODS: A retrospective observational study was carried out with 695 premature newborns of gestational age (GA) between 24 and 33 weeks and 6 days, born alive in the Neonatal ICU of Brasília's Mother and Child Hospital (HMIB), in the period from January 1, 2014, to July 31, 2019. In total, 308 infants were born to hypertensive mothers (G1) and 387 to normotensive mothers (G2). Twin pregnancies and diabetic patients with severe malformations were excluded. Outcomes during hospitalization and outcomes of interest were evaluated: respiratory distress syndrome (RDS), brain ultrasonography, diagnosis of bronchopulmonary dysplasia (BPD), diagnosis of necrotizing enterocolitis, retinopathy of prematurity, breastfeeding rate at discharge, survival at discharge and at 18 months of chronological age and relationship between weight and gestational age. RESULTS: Newborns with hypertensive mothers had significantly lower measurements of birth weight and head circumference. The G1 group had a higher risk small for gestational age (OR 2.4; CI 95% 1.6-3.6; p <0.00), as well as a greater risk of being born with a weight less than 850 g (OR 2.4; 95% CI 1.2-3.5; p <0.00). Newborns of mothers with hypertension presented more necrotizing enterocolitis (OR 2.0; CI 95% 1.1-3.7); however, resuscitation in the delivery room and the need to use surfactant did not differ between groups, nor did the length of stay on mechanical ventilation, or dependence on oxygen at 36 weeks of gestational age. Survival was better in newborns of normotensive mothers, and this was a protective factor against death (OR 0.7; 95% CI 0.5-0.9; p <0.01). In the follow-up clinic, survival at 18 months of chronological age was similar between groups, with rates of 95.3% and 92.1% among hypertensive and normotensive mothers, respectively. Exclusive breastfeeding at discharge was 73.4% in the group of hypertensive women and 77.3% in the group of normotensive mothers. There were no significant differences between groups. CONCLUSION: Among the analyzed outcomes, arterial hypertension during pregnancy can increase the risk of low weight, small babies for gestational age (SGA), deaths in the neonatal period and enterocolitis, with no differences in weight and survival at 18 months of chronological age. Arterial hypertension presents a high risk of prematurity in the neonatal period, with no difference at 18 months of age.

Ethnic and demographic incidence of amyotrophic lateral sclerosis (ALS) in Brazil: A population based study.

Our objectives were to examine demographic and ethnic factors associated with amyotrophic lateral sclerosis in Brazil. The method used was a retrospective study of death certificates performed in June 2015, identifying the incidence of amyotrophic lateral sclerosis over 10 years, from January 2004 to December 2013, related to gender, age and race. Results revealed 8942 death certificates with 8152 as the underlying cause and 790 as a secondary cause. The average age was 62.7 ± 13.2 years, with a predominance of males (1·3:1). The adjusted mortality rate over 20 years was 0.61 to 0.89/100,000 person-years, and over 45 years was 1.77 to 2.3/100,000 person-years. There was a predominance of amyotrophic lateral sclerosis in Caucasians compared to the general population above 20 years (2010 Census), with an odds ratio (OR) of 2.92 (95% CI 2.78-3.07). The OR in blacks was 0.04 (95% CI: 0.03-0.04), in mestizos was 0.05 (0.04-0.07), and in Indians was 0.02 (0.01-0.04). The mean age was lower than in European populations (48.5 ± 12.3 years) (p < 0.0001). In conclusion, the incidence of amyotrophic lateral sclerosis in Brazil is close to other Latin American populations, with a lower age at death and clear predominance in Caucasians.

Responsabilidad institucional y social en la investigación científica: institutional and social responsibility / Scientific research

La investigación constituye una prioridad para cualquier sistema de salud pública porque los resultados generados, positivos o no, tienden a optimizar procesos y reducir costes. En situaciones críticas, las evidencias aportadas por los investigadores pueden determinar en la permanencia, modificación o incluso eliminación de ciertos programas o métodos de la práctica cotidiana. Consecuentemente, quienes diseñan y/o conducen investigaciones deben ser responsables y recibir la mayor atención de los decisores en salud y de la sociedad en general. La ciencia, sus avances, sus desafíos y sobre todo sus resultados, no pueden quedar encerrados en los laboratorios o instituciones científicas, por el contrario, deben abrirse a la sociedad para lograr su implementación oportuna.

The scientific process is a priority for any public health system because the results, positives or not, contribute to optimize processes and to reduce costs. In critical situations the evidences provided by investigators can determine the permanency, modification or even elimination of certain programs or methods of the daily practice. Consequently those who design and/or to drive investigations need to be responsible and to receive the major attention from the society and the politicians. Science, its advances, its challenges and mainly its results, cannot be locked in laboratories or scientific institutions; on the contrary, they should open up to the society for their timely implementation.

Responsabilidad institucional y social en la investigación científica / Scientific research: institutional and social responsibility

La investigación constituye una prioridad para cualquier sistema de salud pública porque los resultados generados, positivos o no, tienden a optimizar procesos y reducir costes. En situaciones críticas, las evidencias aportadas por los investigadores pueden determinar en la permanencia, modificación o incluso eliminación de ciertos programas o métodos de la práctica cotidiana. Consecuentemente, quienes diseñan y/o conducen investigaciones deben ser responsables y recibir la mayor atención de los decisores en salud y de la sociedad en general. La ciencia, sus avances, sus desafíos y sobre todo sus resultados, no pueden quedar encerrados en los laboratorios o instituciones científicas, por el contrario, deben abrirse a la sociedad para lograr su implementación oportuna(AU)

The scientific process is a priority for any public health system because the results, positives or not, contribute to optimize processes and to reduce costs. In critical situations the evidences provided by investigators can determine the permanency, modification or even elimination of certain programs or methods of the daily practice. Consequently those who design and/or to drive investigations need to be responsible and to receive the major attention from the society and the politicians. Science, its advances, its challenges and mainly its results, cannot be locked in laboratories or scientific institutions; on the contrary, they should open up to the society for their timely implementation(AU)

[The functional planning of a enteral nutrition unit for home care at a hospital in Brazil]. / Planificación funcional de unidad de nutrición enteral para atención domiciliaria en un hospital de Brasil.

INTRODUCTION: In order to warrant the quality of the products offered to their clients at home, hospitalar units need to adequate their physical structures to develop their specialized activities on enteral nutrition. OBJECTIVE: The present article aims to provide a functional planning and tools for the reorganization of the physical space of an enteral nutrition preparation unit describing its features and function. METHODS: A descriptive, prospective and documental study was undertaken, providing the tools for the functional planning and quality management at a unit of enteral nutrition preparation in a public hospital in the Federal District, Brazil. Data were collected in the period from 2000 to 2010. RESULTS: Through the establishment of a Home Enteral Nutrition Program in the Public Health Department of the Federal District and as determined by the publication of national legislation, a District Plan of High Complexity in Enteral Nutrition was conducted, according to the demographic and epidemiological profile of the population.This plan consisted of the proposal for implementation of the high complexity in nutritional therapy, according to the Health Ministry legislation. The number of patients assisted by this therapeutical modality has increased, which indicates the need to ensure the quality of dispensed formulas through the planning of functional spaces. CONCLUSION: The functional planning of an Enteral Nutrition Laboratory ensures assistance for the needs of the population enrolled at the hospital and at home, allowing the proper training of caregivers aiming at the adequacy of necessary precautions in manipulating enteral formulas.

Introducción: Con el objeto de garantizar la calidad del producto ofrecido a los clientes en sus domicilios, las unidades hospitalarias necesitan adecuar sus áreas físicas para poder desarrollar todas las actividades especializadas que conlleva la nutrición enteral. Objetivo: Proporcionar una planificación funcional y las herramientas para la reorganización del espacio físico de una unidad de nutrición enteral, describiendo el proceso de preparación, la descripción de sus características y funciones laborales. Métodos. Estudio descriptivo, retrospectivo y documental, proporcionando las herramientas para la planificación funcional y de gestión de calidad en una unidad de preparación de la nutrición enteral en un hospital público del Distrito Federal, Brasil. Los datos fueron recolectados en el período comprendido entre los años 2000 y 2010. Resultados. A través de la creación de un programa de nutrición enteral en el Departamento de Salud Pública del Distrito Federal y según lo dispuesto por la legislación nacional, se efectuó un plan de alta complejidad respecto de la nutrición enteral en atención al perfil demográfico y epidemiológico de la población. Este trabajo consiste en una propuesta de implementación de terapia nutricional dentro de un plan de alta complejidad, y de acuerdo a lo prescrito por la legislación del Ministerio de Salud Brasileño. El número de pacientes atendidos por esta modalidad terapéutica se ha ido incrementando, por consiguiente se hace necesario garantizar la calidad del servicio, por medio de la organización de los espacios funcionales. Conclusión. Por medio de la planificación funcional de un Laboratorio de Nutrición Enteral, se puede garantizar la asistencia nutricional especializada y de calidad, a la población hospitalaria o domiciliaria, tomando las precauciones necesarias en la manipulación de las fórmulas enterales.

Efeitos terapêuticos dos fitosteróis e fitostanóis na colesterolemia / Therapeutic effects of phytosterols and phytostanols in cholesterolemia

Os ésteres de esterol e estanóis vegetais sao reconhecidos como componentes "funcionais" dos alimentos por apresentarem propriedades hipocolesterolêmicas. Os fitosteróis sao compostos esteróis osbtidos de óleos vegetais. Neste estudo foi realizado una análise críticarevisao de estudos experimentais e clínicos recentes, publicados em base de datos Medline e Lilacs, abordando a açao farmacológica dos fitoesteróis e fitoestanóis na colesterolemia. Os efeitos hipocolesterolemiantes sao observados pela ingestao de dosesmarciças, em dose única ou múltipla, de até 2,5 g/dia destes compostos. O consumo diário por durante quatro semanas tem evidenciado a reduçao dos níveis sanguíneos de colesterol total (CT) e LDL-colesterol (LDL-c) em cerca de 10 por cento. O mecanismo de açao na disminuçia da colesterolemia se deve, possivelmente, àsua semelhança estrutural com o colesterol, o que favorece uma competiçao na absorçao intestinal, entre ésteres de esterol e/.ou estanol e o colesterol. Efeitos adversos da suplementaçao de fitosteróis e fitostanóis ocasionaram a disminuçao da absorçao de algunas vitaminas e antioxidantes lipossolúveis