[Abdominal pain in pregnancy--ultrasound as the diagnostic tool of choice for rapid decision making]. / Akutes Abdomen in der Schwangerschaft--Ultraschall als Mittel zur raschen Entscheidungsfindung.

Pregnant women with abdominal pain profit by using ultrasound as a first line diagnostic tool. Together with the clinical evaluation the ultrasound examination in the same room reduces time until a diagnostic decision can be made. By a systematic approach and the classification in pregnancy-related sources of pain and pregnancy-unrelated sources of pain the risks for mother and child can be quickly recognised and the necessary diagnostic and therapeutic steps can be taken. The sonographer must be experienced and a good ultrasound equipment must be available at the site.

Comparative study of human exposure to mercury in riverside communities in the Amazon region

Four populations in the Amazon area were selected for a comparative study of mercury-exposed and non-exposed populations: São Luiz do Tapajós, Barreiras, Panacauera, and Pindobal Grande. The highest mercury levels in human hair samples were found in São Luiz do Tapajós and Barreiras, greatly exceeding the limits established by the World Health Organization. Panacauera showed an intermediate level below 9 µg/g. This was the first comparative and simultaneous evaluation of mercury exposure in the Amazon area. Also, thanks to this type of monitoring, we were able to eliminate the uncertainties about the reference dose. On the basis of these data, we can conclude that the mercury levels detected in exposed populations of the Tapajós River basin may be dangerous not only because they are above the World Health Organization limits, but also because the simultaneous mercury detection in non-exposed populations with similar characteristics provided a valid control and revealed lower mercury levels. Our results support the importance of continuous monitoring in both exposed and non-exposed populations.

Comparative study of human exposure to mercury in riverside communities in the Amazon region.

Four populations in the Amazon area were selected for a comparative study of mercury-exposed and non-exposed populations: São Luiz do Tapajós, Barreiras, Panacauera, and Pindobal Grande. The highest mercury levels in human hair samples were found in São Luiz do Tapajós and Barreiras, greatly exceeding the limits established by the World Health Organization. Panacauera showed an intermediate level below 9 microg/g. This was the first comparative and simultaneous evaluation of mercury exposure in the Amazon area. Also, thanks to this type of monitoring, we were able to eliminate the uncertainties about the reference dose. On the basis of these data, we can conclude that the mercury levels detected in exposed populations of the Tapajós River basin may be dangerous not only because they are above the World Health Organization limits, but also because the simultaneous mercury detection in non-exposed populations with similar characteristics provided a valid control and revealed lower mercury levels. Our results support the importance of continuous monitoring in both exposed and non-exposed populations.

Mercury and selenium concentrations in hair samples of women in fertile age from Amazon riverside communities.

The aim of the present study was to evaluate mercury and selenium concentrations in hair samples of reproductive age women from riverside communities of the Tapajós River basin. We studied 19 pregnant and 21 non-pregnant women, 13 to 45 years old, living in the region for at least 2 years, and having a diet rich in fish. The analysis of Se and total Hg were performed in the Instituto de Pesquisas Energéticas e Nucleares (IPEN, São Paulo, Brazil) by using a Varian AA220-FS atomic absorption spectrometer with a flow injection system. There were no differences between the two groups - pregnant and non-pregnant -- concerning age (23.80 +/- 6.92 and 26.60 +/- 9.60 years old, respectively) and residential time (20.21 +/- 8.30 and 22.20 +/- 10.90 years, respectively). The geometric means and ranges for total Hg concentration were similar (p > 0.05): 8.25 microg/g (1.51-19.43) in pregnant and 9.39 microg/g (5.25-21.00) in non-pregnant women, respectively. Total Hg concentrations were also similar in different gestational stages. However, there was a significant difference between the two groups (p < 0.05, Student t test) in relation to Se concentration: 0.61 microg/g (0.40-2.33) in pregnant and 2.46 microg/g (0.92-5.74) in non-pregnant women, respectively. We concluded that Hg exposure levels in reproductive age women were only slightly higher than a provisional tolerable weekly intake of MeHg would provide, that Hg concentration in maternal hair samples was independent of gestational age, and that low Se concentration in pregnant women indicates high mineral consumption by fetal organism to satisfy their metabolic requirements raised during pregnancy, including as a protective mechanism for Hg cytotoxic effects.

Evaluation of total mercury concentrations in fish consumed in the municipality of Itaituba, Tapajós River Basin, Pará, Brazil.

The environmental exposure to mercury by riverine and Indian communities can occur through the ingestion of fish and products contaminated by mercury compounds. The present study aims to evaluate the total mercury concentration in the different fish species most consumed in the municipality of Itaituba, Tapajós river basin, where there are intense gold-mining activities. These fish samples were analyzed by atomic absorption spectrophotometry by cold vapor technique, Automatic Mercury Analyzer HG-3500. The largest mercury concentrations were found in the carnivorous species ranging from 112.4 to 2250 microg/g, while the detritivorous, herbivorous and omnivorous species presented total mercury levels ranging from 3.2 to 309.8 microg/g, which is below the limit established by the World Health Organization. This paper also reports and identifies which species are more polluted and present a statistical relationship among concentration and weight of the carnivorous species studied in detail, Brachyplatystoma flavicans (dourada) (r2 = 0.691) and Pseudoplatystoma sp. (surubim) (r2 = 0.654).

Determination of total mercury in workers' urine in gold shops of Itaituba, Pará State, Brazil.

Gold extraction and its commercialization in the Amazon region is mainly by rudimentary procedures. Therefore, during the process of extraction and recovery of this precious metal, large amounts of mercury vapors are thrown into the environment. This paper is an attempt to establish a correlation between the concentration of total mercury in the urine of workers at the gold shop in the Municipality of Itaituba, Pará, and the information related to the lifestyles of each individual studied. Through statistical analysis, it was possible to divide the workers into three groups: people with normal mercury concentrations, [Hg] < or = 10 ppb, (29%); with concentrations at the biological limit of tolerance, [Hg] up to 50 ppb, (49%); and contaminated people, [Hg] > or = 50 ppb (22%). It may be concluded that fish consumption, time of alcohol consumption, number of amalgam fillings, as well as working hours, are important variables when evaluating mercurial contamination of people who are occupationally exposed to mercury vapors.

Mercury contamination in fish from Santarém, Pará, brazil.

This paper reports on total mercury concentrations in edible tissue from 11 fish species caught in the Municipality of Santarém, Tapajós River Basin, Pará State, which are most consumed by the local population and investigates the influence of the distance between the goldmining areas and Santarém city on fish contamination by mercury. It was found that the carnivorous species reached an average of 222.1 ng.g(-1) (n=69), higher than the herbivorous species with 31.9 ng.g(-1) (n=30) and the omnivorous species with 68.7 ng.g(-1) (n=10). Significant relationships are found between fish weight and total mercury concentrations by using descriptive statistical and regression analysis for the two species, the carnivorous Pellona sp. (Sarda, r=0.73) and Pseudoplatystoma sp. (Surubim, r=0.63).

[Kinetocardiotocography--KCTG--during pregnancy in an ambulatory care patient sample and in hospitalized patients with special reference to tocolysis]. / Kinetokardiotokografie-KCTG--im Schwangerschaftsverlauf bei einem ambulantbetreuten und einem hospitalisierten Kollektiv unter besonderer Berücksichtigung der Tokolyse.

With kinetocardiotocography (KCTG), fetal movements can be registered parallel to the fetal heart rate. Hewlett Packard equipment of the series 1350 A allows the movements to be registered an quantified on the CTG paper. In this study, hospitalized pregnant women > 26 gestational weeks (GW) on i.v. tocolysis, and out-patients > 34 GW at the out patient department were examined with KCTG and the results compared. A wide distribution of fetal activity was seen in both groups. With advancing pregnancy, the number of fetal movements as well as the duration of activity per time unit decreased, whereas the length of time of individual movements slightly increased, in both groups. No statistically significant difference was seen between different gestational ages nor between the two groups. KCTG is being increasingly used to monitor the fetal condition, especially for risk pregnancies. It can provide additional information in the form of a biophysical variable.

[Popliteal aneurysm]. / Das Poplitealaneurysma.

At our institution operative repair was undertaken for 67 popliteal aneurysms in 45 patients between 1986 and 1991. In 24 cases emergency surgery was necessary: acute critical ischemia due to thrombosis or embolism in 22 cases, and rupture of the aneurysm in 2 cases. Two patients died within the first 30 postoperative days. Four major amputations could not be avoided. On the other hand, elective surgical intervention was possible in 43 cases without operative morbidity and mortality. Given the high incidence of serious complications such as thrombosis or embolism in popliteal aneurysms, and the reduced success rate of surgery in acute critical ischemia, surgical correction upon diagnosis is especially recommended in aneurysms with intraluminal thrombus.