Percepção de profissionais sobre resíduos sólidos em saúde no contexto hospitalar / Professionals' perception of solid health-care waste in the hospital context / Percepción de profesionales sobre residuos sólidos en salud en el contexto hospitalario

Objetivo: Compreender a percepção, atitudes e práticas de trabalhadores de um hospital universitário frente a resíduos sólidos de saúde (RSS). Métodos: Realizou-se, por meio de metodologia descritiva e qualitativa, entrevista com profissionais de saúde em 2019 em um hospital universitário do município de Bagé, situado na Região da Campanha do Estado do Rio Grande do Sul, Brasil. Desenvolveram-se um total de quatro questões norteadoras: (1) conhecimento sobre resíduos sólidos hospitalares; (2) identificação de resíduos sólidos hospitalares; (3) rotina no serviço de saúde ao manusear resíduos sólidos hospitalares; e (4) entendimento sobre danos provocados por resíduos sólidos hospitalares, sendo as falas dos depoentes (n=18) gravadas, com posterior degravação para análise de conteúdo. Emergiram as categorias: Entendimento sobre Resíduos Sólidos Hospitalares; Etapas do Gerenciamento de RSS; Dificuldades e Limitações; e Risco do Descarte Inapropriado. Resultados: Os dados revelaram fragilidades sobre a temática quanto conceito, gestão e riscos; não havendo clareza sobre a logística dada aos RSS; há falta de conhecimento sobre a categorização dos distintos tipos e o gerenciamento de RSS, evidenciando o não entendimento do correto descarte dos RSS gerados no contexto hospitalar, sinalizando para a necessidade de treinamento sobre o tema. Conclusão:Compreenderam-se as dificuldades sobre o conhecimento e entendimento dos entrevistados do presente estudo acerca da temática, impactando em suas atitudes e em suas práticas.

Objective: To understand university hospital workers' perception, attitudes and practices in relation to solid health-care waste (SHW). Methods: An interview with health professionals was carried out using a descriptive and qualitative methodology in 2019 at a university hospital in the city of Bagé, located in the Campanha Region of the State of Rio Grande do Sul, Brazil. A total of four guiding questions were formulated: (1) knowledge about solid hospital waste; (2) identification of solid hospital waste; (3) routine in the health service when handling solid hospital waste; and (4) understanding of damage caused by solid hospital waste, with the interviewees' reports (n=18) being recorded and transcribed verbatim for content analysis. The following categories emerged: Understanding Solid Hospital Waste; SHW Management Steps; Difficulties and Limitations; and Risk of Inappropriate Disposal. Results: The data revealed weaknesses on the subject in terms of concept, management and risks; there is no clarity about the logistics involving SHW; there is a lack of knowledge about the categorization of the different types and the management of SHW, highlighting the lack of understanding of the correct disposal of the SHW generated in the hospital context and signaling the need for training on the subject. Conclusion: The difficulties related to the interviewees' knowledge and understanding of the subject were understood and impact their attitudes and practices.

Objetivo: Comprender la percepción, actitudes y prácticas de trabajadores de un hospital universitario frente a residuos sólidos de salud (RSS). Métodos: Fue realizado, por medio de metodología descriptiva y cualitativa, encuesta con profesionales de salud en 2019 en un hospital universitario del municipio de Bagé, ubicado en la Región de la Campaña del Estado del Rio Grande del Sur, Brasil. Fueron desarrolladas un total de cuatro cuestiones norteadoras: (1) conocimiento sobre residuos sólidos hospitalarios; (2) identificación de residuos sólidos hospitalarios; (3) rutina en el servicio de salud al manejar residuos sólido hospitalarios; y (4) entendimiento sobre daños provocados por residuos hospitalarios, siendo las hablas de los deponentes (n=18) grabadas, con posterior transcripción literal para análisis de contenido. Surgieron las categorías: Entendimiento sobre Residuos Sólidos Hospitalarios; Etapas de Gestión de RSS; Dificultades y Limitaciones; y Riesgo de Eliminación Inapropiado. Resultados: Los datos mostraron debilidad sobre la temática cuanto al concepto, gestión y riesgos; no habiendo claridad sobre la logística dada a los RSS; hay falta de conocimiento sobre la categorización de los distintos tipos y la gestión de RSS, evidenciando el no entendimiento de la correcta eliminación de los RSS generados en el contexto hospitalario, señalando para la necesidad de entrenamiento sobre el tema. Conclusión: Se comprendieron las dificultades sobre el conocimiento y entendimiento de los encuestados del presente estudio acerca de la temática, impactando en sus actitudes y en sus prácticas.

Biotoxicological Analyses of Trimeroside from Baccharis trimera Using a Battery of In Vitro Test Systems.

The use in folk medicine of Baccharis trimera and recent studies on DNA damage by oxidative stress mechanisms have motivated this study. We investigated the biotoxicological effects of trimeroside from this plant. Aqueous extract from aerial parts of B. trimera was fractioned by flash chromatography for further isolation by thin-layer chromatography. The novel nor-monoterpene glycoside, trimeroside, and three flavonoids, cirsimaritin, luteolin and quercetin, were isolated. The genotoxic and mutagenic potential of trimeroside was determined by Salmonella/microsome (TA98 and TA100), comet assay, and cytokinesis-block micronucleus cytome assay (CBMN-cyt) in HepG2 cells. We also screened trimeroside into different human tumoral cell lines by sulforhodamine B (SRB) assay. Mutagenicity was detected in TA100 strain with metabolic activation. Genotoxic effects were not observed in HepG2 by comet assay. However, a decrease in the nuclear index division in the 2.0 mg·mL-1 concentration and an increase of nucleoplasmic bridges in the 1.5 mg·mL-1 concentration were detected by CBMN-cyt assay indicating cytotoxic and mutagenic effects. In SRB assay, trimeroside showed weak antiproliferative activity against the cell lines.

Genetic and oxidative damage of peripheral blood lymphocytes in workers with occupational exposure to coal.

Coal is an important fossil fuel used to generate energy. Coal dust is constituted primarily of hydrocarbons and metals. During coal extraction, large quantities of coal dust particles are emitted, contributing to environmental pollution. Coal miners are constantly exposed to coal dust and its derivatives. The goal of this study was to evaluate the potential genotoxic effects of coal and oxidative stress in individuals from Candiota who were exposed to coal as part of their occupation. The comet assay and micronucleus (MN) test were used to assess these effects. This study involved 128 male participants of whom 71 reported work that included exposure to coal (exposed group) and 57 reported working at different jobs (unexposed group). The exposed group had a significantly increased damage index and damage frequency, as assessed using the comet assay, and increased MN and nucleoplasmic bridge frequencies, as assessed using the MN assay, compared with unexposed individuals. Significant and positive correlations between MN frequencies in the lymphocytes and buccal cells of control and exposed individuals were observed. The exposed individuals presented lower average levels of thiobarbituric acid reactive substances (TBARS) and catalase activity (CAT), while the mean superoxide dismutase activity (SOD) levels were higher in this group. The exposed group also had higher hematocrit levels. No correlation between DNA damage and inorganic elements, as identified using PIXE, was found; however, there was a correlation between the damage index and zinc. The evidence that exposure to coal and its derivatives presents a genetic hazard demonstrates the need for protective measures and educational programs for coal miners.

Baccharis trimera (Less.) DC as genotoxicity indicator of exposure to coal and emissions from a thermal power plant.

During coal combustion, hazardous elements are discharged that impair environmental quality. Plant cover is the first available surface for the atmospheric pollutants in terrestrial ecosystems. The aim of this study was to evaluate genotoxicity in the aqueous extract of the native plant, Baccharis trimera, exposed to coal and emissions from a thermal power plant (coal-fired power plant in Candiota, Brazil), correlating seasonality, wind tunnel predominance, and presence of inorganic elements. The presence of inorganic elements in the aerial parts of B. trimera was analyzed by particle-induced X-ray emission (PIXE) spectrometry, and genotoxicity was evaluated by ex vivo comet assay. The genotoxic effects of aqueous extracts of B. trimera from four sites located in the area around power plant were analyzed by comet assay in peripheral human lymphocytes. Winter samples showed greater levels of metals than summer samples. Genotoxicity was detected in B. trimera extracts collected from the region exposed to extraction and burning coal. Extracts from the site impacted by the dominant wind induced more damage to DNA than those from other sites. Based on our data, we can suggest that in winter the inorganic elements from extraction and burning of coal and carried through the wind tunnel were responsible for the genotoxicity observed in aqueous extract of B. trimera.

Compreensão das prescrições pediátricas de antimicrobianos em Unidades de Saúde em um município do sul do Brasil / Understanding of pediatric antimicrobial prescriptions at health units in a Southern Brazil city

O objetivo do estudo foi avaliar a compreensão da prescrição de antimicrobianos por acompanhantes de crianças após consulta pediátrica, descrevendo seu perfil de prescrição em Unidades de Saúde, em um município do sul do Brasil. Trata-se de um delineamento transversal, no qual a população-alvo foram acompanhantes das crianças que tiveram prescrição de antimicrobianos (n = 209) entre maio e julho de 2007. Foi gerado um escore de compreensão (4-12 pontos) embasado em afirmativas corretas, incorretas ou ignoradas, relativas às informações da prescrição. A compreensão foi considerada adequada quando o valor do escore foi menor do que 6,5 pontos. Verificou-se que a escolaridade (p = 0,05), renda (p = 0,03), cor da pele (p = 0,007) do acompanhante e o tempo de consulta (p = 0,05) estiveram diretamente associados com a melhor compreensão da prescrição. A compreensão adequada representou 58,9 por cento das prescrições. Os antimicrobianos mais prescritos foram a amoxicilina e a associação de sulfametoxazol/trimetoprima. Os resultados do estudo apontam a necessidade da padronização da informação escrita por prescritores e implantação de medidas educativas aos acompanhantes das crianças, tais como o fornecimento de orientações verbais e escritas quanto ao correto uso dos antimicrobianos. Assim, assegura-se uma melhor compreensão da prescrição, o que favorece o sucesso do tratamento, evitando também o fenômeno de resistência microbiana.