Epidemiology of hepatitis B virus infection in people living in poverty in the central-west region of Brazil.

BACKGROUND: People living in poverty (PLP) are highly vulnerable to hepatitis B virus (HBV) infection. This study aimed to investigate the epidemiology of HBV infection in PLP in the metropolitan region of Goiânia, Goiás State, in the Central-West Region of Brazil. METHODS: A cross-sectional study was conducted from August to December 2016 in adults aged ≥12 years living in poverty. The following serological markers for HBV were investigated: hepatitis B surface antigen (HBsAg), antibody to HBV core antigen (total anti-HBc), IgM anti-HBc, and hepatitis B surface antibody (anti-HBs), which were detected by enzyme-linked immunosorbent assay (ELISA). Poisson regression analysis with robust variance was performed to verify the factors associated with HBV exposure. RESULTS: The study included 378 participants. The overall prevalence rate of HBV (any viral marker) was 9.8% (95% confidence interval [CI], 7.2-13.2). The prevalence rate of HBsAg in combination with total anti-HBc was 0.8% (95% CI, 0.3-2.4), total anti-HBc in combination with anti-HBs was 7.7% (95% CI, 5.4-10.9), and total anti-HBc alone was 1.3% (95% CI, 0.5-3.0) in the population. Furthermore, isolated positivity for anti-HBs was identified in only 25.4% (95% CI, 21.3-30.0) of the participants. Multiple regression analysis revealed that age (adjusted prevalence ratio [APR], 1.04; 95% CI, 1.01-1.07), female sex (APR, 2.18; 95% CI, 1.01-4.73), sexual intercourse under the influence of alcohol (APR, 2.49; 95% CI, 1.36-7.06), and exposure to Treponema pallidum (APR, 3.10; 95% CI, 1.36-7.06) were associated with HBV exposure. CONCLUSION: There was a high prevalence of HBV exposure in PLP in the Central-West Region of Brazil, indicating significant viral spread of the infection. Additionally, there was low serological evidence of immunisation against hepatitis B, indicating that a large proportion of the participants in this study are susceptible to the infection. The results support the need for public health policies that facilitate access to the existing healthcare services in hard-to-reach groups with special regard to immunisation programmes against hepatitis B.

NEW BOWEL PREPARATION TECHNIQUE FOR COLONOSCOPY: CLINICAL TRIAL COMPARING AQUANET AND MANNITOL.

BACKGROUND: Fifty-five percent of Americans aged 50-65 are submitted to colonoscopy. For over 65-year, this number increases to 64%. In Brazil, it is forecast that the population submitted to colonoscopy will grow, even though inadequate preparation is still a major problem. AIM: To analyze the quality of a new intestinal preparation technique, Aquanet EC-2000®, compared to oral Mannitol solution. METHODS: This prospective longitudinal study enrolled 200 patients with indication for colonoscopy. The sample was randomly allocated to two groups of 100; one group received Aquanet EC-2000® to prepare for colonoscopy and the other Mannitol solution. The Boston scale was used to analyze the results. RESULTS: As expected both preparations produced similar results with the bowel cleansing of the different regions of the colon being classified as Boston scale 3 (excellent) in most patients (p>0.05). CONCLUSION: The results of bowel preparation using Aquanet EC-2000® were similar to using Mannitol solution.

New bowel preparation technique for colonoscopy: clinical trial comparing aquanet and mannitol / Nova técnica de preparo intestinal para colonoscopia: estudo clínico comparativo entre aquanet e manitol

ABSTRACT Background: Fifty-five percent of Americans aged 50-65 are submitted to colonoscopy. For over 65-year, this number increases to 64%. In Brazil, it is forecast that the population submitted to colonoscopy will grow, even though inadequate preparation is still a major problem. Aim: To analyze the quality of a new intestinal preparation technique, Aquanet EC-2000®, compared to oral Mannitol solution. Methods: This prospective longitudinal study enrolled 200 patients with indication for colonoscopy. The sample was randomly allocated to two groups of 100; one group received Aquanet EC-2000® to prepare for colonoscopy and the other Mannitol solution. The Boston scale was used to analyze the results. Results: As expected both preparations produced similar results with the bowel cleansing of the different regions of the colon being classified as Boston scale 3 (excellent) in most patients (p>0.05). Conclusion: The results of bowel preparation using Aquanet EC-2000® were similar to using Mannitol solution.

RESUMO Racional: Cinquenta e cinco por cento dos norte-americanos entre 50-65 anos fazem colonoscopia. Acima de 65 anos o número foi de 64%. No Brasil, estima-se crescente aumento da população submetida à colonoscopia, apesar da preparação inadequada ainda ser um grande problema. Objetivo: Analisar e comparar a qualidade do novo método de preparo intestinal por meio do Aquanet EC-2000® frente ao uso de solução oral de Manitol. Método: Por randomização 200 pacientes foram divididos em dois grupos de 100. Um recebeu Aquanet EC-2000® e o outro Manitol. O presente estudo seguiu modelo prospectivo longitudinal por meio da seleção de 200 pacientes com indicação à colonoscopia, formando dois grupos de 100. Para analisar os resultados foi utilizada a escala de Boston. Resultados: Ambos os preparos foram estatisticamente significativos com p<0,05. A escala 3 de Boston foi a mais frequente para ambos os métodos.Além disso, na estatística aplicada às diferentes regiões do cólon para ambos os procedimentos as proporções observadas concordaram com o esperado (3-excelente). Conclusão: Os resultados do preparo intestinal utilizando Aquanet EC-2000® foram semelhantes aos do Manitol.

Dental enamel as biomarker for environmental contaminants in relevant industrialized estuary areas in São Paulo, Brazil.

Heavy metal contamination is a long-standing and very well-known public health problem, and its exposure can cause damage to several organs of human body, especially on the central nervous system of young children and teenagers. The aim of this article is to evaluate lead, cadmium, and manganese contamination in 125 children from 6 to 13 years old living in contaminated areas during the period from 2006 to 2009 (São Vicente, Cubatão Downtown, Bertioga and Cubatão Pilões/Água Fria). This estuary area is the most important example of environmental degradation by chemicals from industrial sources. This is a cross-sectional study through clinical examinations and dental enamel tests. All mothers from these children lived in the area since before the pregnancy. Lead, cadmium, and manganese levels (µg/g) were measured on dental enamel samples through graphite furnace atomic absorption spectrometry, searching for the occurrence of heavy metals. The mean lead concentrations were 139.48 µg/g in Cubatão Pilões/Água Fria, 170.45 µg/g in Cubatão Downtown, 213.52 µg/g in São Vicente, and 151.89 µg/g in Bertioga. The mean cadmium concentrations were 10.83 µg/g in Cubatão Pilões/Água Fria, 12.58 µg/g in Cubatão Downtown, 10.92 µg/g in São Vicente, and 14.57 µg/g in Bertioga. The mean manganese concentrations were 23.49 µg/g in Cubatão Pilões/Água Fria, 30.90 µg/g in Cubatão Downtown, 41.46 µg/g in São Vicente, and 42.00 µg/g in Bertioga. Dental surface enamel may be used as an efficient biomarker of past environmental exposure to lead, manganese, and cadmium which are associated to well-known sources of heavy metal contamination. The results suggest that the evaluated children were exposed to sources of lead, cadmium, and manganese since before their conceptions. Although Bertioga initially was chosen as a control area of this study, it was also was verified to have heavy metal contamination on examined children.

Baroreflex sensitivity improvement is associated with decreased oxidative stress in trained spontaneously hypertensive rat.

BACKGROUND: Baroreflex sensitivity (BRS) impairment has been associated with endothelial dysfunction and oxidative stress. METHODS: Because exercise training could improve endothelial function in spontaneously hypertensive rats (SHR), the effect of moderate exercise training on oxidative stress and BRS was investigated. Groups were divided into sedentary and trained Wistar-Kyoto rats (S-WK, n = 7 and T-WK, n = 6) and SHR (S-SHR and T-SHR, n = 9 each). Exercise training was performed on a treadmill (5 days/week, 60 min, 10 weeks), and the lactate threshold (20 m/min) was used to determine moderate intensity. RESULTS: Exercise training reduced mean arterial pressure in WK and SHR (S-WK 127 +/- 4, T-WK 105 +/- 5, S-SHR 169 +/- 4 versus T-SHR 140 +/- 4 mmHg; P < 0.01). Baroreflex bradycardic (S-WK -1.89 +/- 0.15, T-WK -2.11 +/- 0.37, S-SHR -0.80 +/- 0.09 versus T-SHR -1.29 +/- 0.10 bpm/mmHg; P < 0.0001) and tachycardic (S-WK 2.57 +/- 0.19, T-WK 2.73 +/- 0.21, S-SHR 1.18 +/- 0.07 versus T-SHR 2.02 +/- 0.10 bpm/mmHg; P < 0.0001) responses were significantly different between groups. Lipoperoxidation in erythrocytes (S-WK 11 320 +/- 739, T-WK 10 397 +/- 765, S-SHR 20 511 +/- 1627 versus T-SHR 10 211 +/- 589 counts per second (cps)/mg haemoglobin; P < 0.0001) and aortas (S-WK 12 424 +/- 2219, T-WK 7917 +/- 726, S-SHR 26 957 +/- 1772 versus T-SHR 17 777 +/- 1923 cps/mg protein; P < 0.0001) was reduced in T-SHR compared with S-SHR. Inverse correlations were observed between both bradycardic and tachycardic responses and lipoperoxidation in erythrocytes (r = 0.56 and r = -0.77, respectively; P < 0.01) and aortas (r = 0.77 and r = -0.80, respectively; P < 0.0001). CONCLUSION: Our results indicate that exercise training decreases oxidative stress, which is related to an improvement in BRS in SHR.

[Appointment with nurses for transplanted heart clients--impact of educative health actions]. / Consulta de enfermagem ao cliente transplantado cardíaco--impacto das ações educativas em saúde.

The study was aimed at evaluating the impact of educative health actions on nursing appointments with 18 transplanted heart clients, based on Orem's Theory. It was conducted in a Heart Transplant and Insufficiency Unit of a Public Health Institution in Fortaleza-CE. The data were collected by way of nursing appointments. 14 nursing diagnoses were identified in the first appointment and 7 in the last one. It was found out that the clients developed self-care skills with the implementation of educative health actions, tuming them into self-care agents, reaching a good level of health and well-being. On the other hand, it raised nurses' awareness of a systematic and efficacious management of the clinical monitoring of their clientele.