Occupational accidents involving exposure to biological material reported at a worker's health sentinel unit: 11,645 cases.

Introduction: Health professionals are exposed to various occupational biological, chemical, physical, and ergonomic risks, in addition to the risk of accidents. Understanding occupational accidents involving biological material in a specific area could be an initial step towards prioritizing correct working conditions. Objectives: To determine the profile of occupational accidents involving exposure to biological material based on data from a sentinel unit in Curitiba, Brazil. Methods: This observational, retrospective, descriptive study with quantitative methods collected disease notification system data from 2008-2018. Results: During the study period, 11,645 cases of occupational accidents involving biological material were reported. Most victims were women (80.4%) and nursing technicians (30.9%). The highest number of accidents involved material found on the floor (11.1%). Regarding personal protective equipment, 69% of the victims used procedure gloves. The years with the most reported accidents were 2016 and 2018. Treatment abandonment was high (56%). Conclusions: The number of accidents involving biological material was high, as was that of victims who abandoned serological follow-up. Prevention and awareness strategies are necessary to change this scenario.

Introdução: Na área da saúde, os profissionais estão expostos a variados riscos ocupacionais: biológico, químico, físico, ergonômico e de acidentes. O conhecimento acerca dos acidentes de trabalho com material biológico de determinado setor pode ser o passo inicial para a priorização de medidas de correção das condições de trabalho. Objetivos: Traçar um perfil dos acidentes de trabalho com exposição a material biológico, com base em dados de uma unidade sentinela de Curitiba, Paraná. Métodos: Estudo observacional, retrospectivo e descritivo com abordagem quantitativa, realizado através de levantamento de dados do Sistema de Informação de Agravos de Notificação, entre 2008 e 2018. Resultados: Durante o período, foram notificados 11.645 casos de acidentes de trabalho com exposição a material biológico. A maioria ocorreu em pessoas do sexo feminino (80,4%), e a ocupação mais envolvida foi técnico de enfermagem (30,9%). O maior número de acidentes ocorreu com materiais encontrados no chão (11,1%). Quanto ao uso de equipamentos proteção individual, 69% utilizavam luvas de procedimento. Os anos com maior número de notificações foram 2016 e 2018. Na evolução, houve alta taxa de abandono de tratamento (56%). Conclusões: O número de acidentes com material biológico é alto, assim como de profissionais que abandonam seguimento sorológico. Estratégias de prevenção e conscientização são necessárias para mudança desse cenário.

Spinal cannabinoid CB1 or CB2 receptors activation attenuates mechanical allodynia in streptozotocin-induced diabetic rats.

Diabetes is a chronic disease associated with a high number of complications such as peripheral neuropathy, which causes sensorial disturbances and may lead to the development of diabetic neuropathic pain (DNP). The current treatment for DNP is just palliative and the drugs may cause severe adverse effects, leading to discontinuation of treatment. Thus, new therapeutic targets need to be urgently investigated. Studies have shown that cannabinoids have promising effects in the treatment of several pathological conditions, including chronic pain. Thus, we aimed to investigate the acute effect of the intrathecal injection of CB1 or CB2 cannabinoid receptor agonists N-(2-chloroethyl)-5Z, 8Z, 11Z, 14Z-eicosatetraenamide (ACEA) or JWH 133, respectively (10, 30 or 100 µg/rat) on the mechanical allodynia associated with experimental diabetes induced by streptozotocin (60 mg/kg; intraperitoneal) in rats. Cannabinoid receptor antagonists CB1 AM251 or CB2 AM630 (1 mg/kg) were given before treatment with respective agonists to confirm the involvement of cannabinoid CB1 or CB2 receptors. Rats with diabetes exhibited a significant reduction on the paw mechanical threshold 2 weeks after diabetes induction, having the maximum effect observed 4 weeks after the streptozotocin injection. This mechanical allodynia was significantly improved by intrathecal treatment with ACEA or JWH 133 (only at the higher dose of 100 µg). Pre-treatment with AM251 or AM630 significantly reverted the anti-allodynic effect of the ACEA or JWH 133, respectively. Considering the clinical challenge that the treatment of DPN represents, this study showed for the first time, that the intrathecal cannabinoid receptors agonists may represent an alternative for the treatment of DNP.

Severe occupational accidents reported at a sentinel unit from 2008 to 2018.

Introduction: Occupational accidents are a major public health problem. In addition to damages to workers' health, they are also associated with economic and social losses. Since 2004, this type of accident has become of mandatory reporting through the Notifiable Diseases Information System. However, underreporting still reaches high levels. Objectives: To identify and describe data on severe occupational accidents reported at an Occupational Health Unit. Methods: This is a retrospective observational study based on data from the Notifiable Diseases Information System. Occupational accidents that occurred from 2008 to 2018 in the state of Paraná, Brazil, and reported by the Occupational Health Unit, located in Hospital do Trabalhador in Curitiba. Results: Overall, 7,396 occupational accidents were reported, and most workers evolved with temporary disability (86%). The most frequently affected occupations were related to the area of construction industry (3.4%); however, it is worth highlighting the significant absence of this information in the reports (16.4%). Upper limbs were the most affected body region (42.5%). Conclusions: The report of occupational accidents has significantly improved in the last years, but underreporting remains a significant issue and there is a gap in data about the accident circumstances. Therefore, this study aimed to generate data to assist in the development of policies for the promotion and care of workers' health, in addition to being used for comparison in future statistics.

Perfil epidemiológico dos portadores de sífilis entre 2010 e 2018 no Estado do Paraná, Brasil / Epidemiological profile of syphilis patients between 2010 and 2018 in Paraná State, Brazil

O objetivo desse trabalho foi analisar os casos de sífilis no Estado do Paraná, e descrever o perfil epidemiológico dos infectados, entre os anos de 2010 e 2018. O presente estudo é quantitativo, descritivo e observacional, foi desenvolvido com dados secundários do Sistema Nacional de Agravos de Notificação (SINAN), com a análise das taxas de detecção da sífilis adquirida. Entre 2010 e 2018 o Paraná registrou 39.900 casos de sífilis adquirida, sendo que 58,5% ocorreram em homens e 41,5% em mulheres. A faixa etária de maior incidência foi entre 20-29 anos (26,9%), seguida por 30-39 anos (21,4%). Quanto a escolaridade, a maioria dos infectados possuía ensino fundamental (18,5%) e médio (19%). A macrorregião leste do Estado apresentou a maior incidência de casos (59,28% dos casos em 2016). Devido ao aumento dos casos de sífilis adquirida no Paraná entre os anos de 2010 a 2018, conclui-se a necessidade do direcionamento de ações de prevenção e rastreio. (AU)

The study aimed to analyze the syphilis cases in Paraná State, and to describe the epidemiological profile of infected individuals, between 2010 and 2018. The present study is quantitative, descriptive and observational; it was developed with secondary data from the National System of Disorders notification, evaluating the detection rate of syphilis acquired. Between 2010 and 2018 Paraná registered 39,900 cases of Acquired Syphilis, being 58.5% in males and 41.5% in females. The age group with the highest incidence was between 20-29 years (26.9%), followed by 30-39 years (21.4%). As for schooling, most of the individuals in the identified cases had elementary (18.5%) and high school education (19%). The eastern macro- region of the state had the highest cases incidence (59.28% of cases in 2016). Due to the increase in syphilis cases acquired in Paraná between 2010 and 2018, it concludes the need to target prevention and screening actions. (AU)

Profile of gestational syphilis in the state of Paraná between 2010 and 2018 / Perfil da sífilis gestacional no estado do Paraná entre 2010 e 2018

Introduction: Gestational syphilis is responsible for increased fetal morbidity and mortality. It is related to intrauterine and neonatal complications, with vertical transmission being the most severe outcome. Screening and treatments are part of the prenatal routine. Objective: To describe the profile of gestational syphilis by state, regional incidence, time of diagnosis and treatment. Methods: Quantitative, descriptive, and observational study developed with secondary data from the National System of Notification of Disorders (Sistema de Informação de Agravos de Notificação ­ SINAN), to evaluate the variables: region, trimester of diagnosis and treatment of gestational syphilis. Results: Between 2010­2018, Paraná recorded 12,011 cases of gestational syphilis, corresponding to 8.5 per 1,000 live births. There was an increase in the number of cases across the state. Among infected pregnant women, most were between 20­29 years old (50.6%). Of the diagnoses, 43.6% were performed in the first trimester of pregnancy and 26.6% in the second. The most widely used treatment regimen was benzathine penicillin G 7,200,000 IU (63.7%). Conclusion: There was an increase in gestational syphilis in Paraná, however, there was greater effectiveness in diagnosis and treatment, with greater detection in the first trimester of pregnancy and prevalence of use of benzathine penicillin G. The study highlights the importance of correct clinical management and early detection, measures that prevent vertical transmission.

Introdução: A sífilis gestacional é responsável pelo aumento da morbimortalidade fetal. Está relacionada a complicações intrauterinas e neonatais, sendo a transmissão vertical o desfecho mais grave. Sua triagem e seu tratamento fazem parte da rotina do pré-natal. Objetivo: Descrever o perfil da sífilis gestacional no estado, a incidência em regionais, a época do diagnóstico e o tratamento. Métodos: Estudo quantitativo, descritivo e observacional desenvolvido com dados secundários do Sistema de Informação de Agravos de Notificação (SINAN), para avaliar as variáveis: região, trimestre do diagnóstico e tratamento da sífilis gestacional. Resultados: O Paraná registrou, entre 2010­2018, 12.011 casos de sífilis gestacional, o que corresponde a 8,5 a cada 1.000 nascidos vivos. Houve aumento no número de casos em todo o estado. Entre as gestantes infectadas, a maioria tinha entre 20­29 anos (50,6%). Dos diagnósticos, 43,6% foram realizados no primeiro trimestre de gestação e 26,6%, no segundo trimestre. O esquema terapêutico mais utilizado foi o de penicilina G benzatina 7.200.000 UI (63,7%). Conclusão: Houve aumento da sífilis gestacional no Paraná, porém, observou-se maior efetividade no diagnóstico e tratamento, com maior detecção no primeiro trimestre da gestação e prevalência do uso da penicilina G benzatina 7.200.000 UI. O estudo ressalta a importância do correto manejo clínico e da detecção precoce, medidas que evitam a transmissão vertical.