Manganese and lead levels in settled dust in elementary schools are correlated with biomarkers of exposure in school-aged children.

Previously, we showed that manganese (Mn) levels in settled dust in elementary schools increased at a rate of 34.1% per km closer to a ferro-manganese alloy plant in the rainy season. In this study, we investigated how this environmental pollution indicator varied in the dry season and if there was an association with Mn biomarker levels in school-aged children. Dust samples were collected with passive samplers (disposable Petri dishes) placed in interior and exterior environments of 14 elementary schools. Occipital hair, toenails and blood samples were collected from 173 students aged 7-12 years from three of these schools, with varying distance from the industrial plant. Mn and lead (Pb) levels were measured by graphite furnace atomic absorption spectrometry. Mn concentration geometric means (GM) in dust fall accumulation in interior environments of schools located at 2, 4, 6 and > 6 km-radii from the plant were 2212, 584, 625 and 224 µg Mn/m2/30 days, respectively. The modelled rate of change of dust Mn levels decreases by 59.8% for each km further from the plant. Pb levels in settled dust varied between 18 and 81 µg/m2/30 days with no association with distance from the plant. Blood lead levels median (range) were 1.2 µg/dL (0.2-15.6), of which 97.8% were <5 µg/dL. Mn in hair and toenails were 0.66 µg/g (0.16-8.79) and 0.86 µg/g (0.15-13.30), respectively. Mn loading rates were positively associated with log MnH (ß = 1.42 × 10-5, p < 0.001) after adjusting for children's age; and also with log MnTn (ß = 2.31 × 10-5, p < 0.001) independent of age. Mn loading rates explained 18.5% and 28.5% of the variance in MnH and MnTn levels, respectively. School-aged children exposure to Mn, independently of age, increases significantly with school proximity to the ferro-manganese alloy plant.

Lead and cadmium in mangrove root crab (Goniopsis cruentata), in natura and at food processing stages.

Lead (Pb) and cadmium (Cd) were determined in mangrove root crab (Goniopsis cruentata) tissues (in natura) and in two culinary preparations by graphite furnace atomic absorption spectrometry. Mangrove root crab samples from three sampling sites along the Jaguaripe River, Bahia, Brazil, where lead-glazed ceramics are produced, and from two commercial preparations were collected or purchased in March and April 2016. Cd levels in raw and processed samples were below the methods' limits of detection (0.016 mg kg-1), while Pb levels in the raw tissues were determined only in the gills (0.67 mg kg-1) and in the hepatopancreas (0.14 mg kg-1). However, Pb levels increased from 0.05 to 2.84 mg kg-1 in boiled/sorted muscle and in the traditional stew (with a 57-fold increase), respectively. Pb levels augmented significantly in the processed food due to migration of Pb used in the glazing of cooking ceramic utensils, surpassing the Brazilian and international safety limits.

Manganese and lead in dust fall accumulation in elementary schools near a ferromanganese alloy plant.

Previous studies have shown elevated airborne manganese (Mn) in villages adjacent to a Mn alloy production plant in Brazil and negative associations between biomarkers of Mn and children's cognition and behavior. Since small Mn particles may be carried for long distances, we measured manganese (Mn) and lead (Pb) dust fall accumulation in 15 elementary schools, located between 1.25 and 6.48km from the plant in the municipality of Simões Filho, Bahia, Brazil. Passive samplers (polyethylene Petri dishes) were set in interior and exterior environments. After 30 days, the samplers' content was solubilized with diluted nitric acid and Mn and Pb levels were analyzed by electrothermal absorption spectrometry. The overall geometric mean and range of Mn and Pb accumulation in dust fall (loading rates) were 1582µg Mn/m(2)/30 days (37-37,967) and 43.2µg Pb/m(2)/30 days (2.9-210.4). A logarithmic decrease in interior and exterior Mn loading rates was observed with distance from the ferro-manganese alloy plant. Multiple regression analyses of log-transformed Mn loading rate within the schools showed a positive association with Mn levels in outdoor dust, a negative association with distance from the plant; as well, wind direction (downwind>upwind) and school location (urban>rural) entered significantly into the model. For the interior school environments, located within a 2-km radius from the plant, loading rate was, on average, 190 times higher than the Mn levels reported by Gulson et al., (2014) in daycare centers in Sydney, Australia, using a similar method. Pb loading rates were not associated with distance from the plant and were lower than the rates observed in the same daycare centers in Sydney. Our findings suggest that a significant portion of the children in this town in Brazil may be exposed to airborne Mn at concentrations that may affect their neurodevelopment.

Relationship between DNA damage in liver, heart, spleen and total blood cells and disease pathogenesis of infected rats by Trypanosoma evansi.

Trypanosoma evansi is an important pathogen that causes changes in nitric oxide (NO) levels and antioxidant enzymes, as well as oxidative stress. The present study evaluated the in vivo effect of T. evansi infection on frequency and index of DNA damage in liver, heart, spleen and total blood of rats. Twenty rats were assigned into two groups with ten rats each, being subdivided into four subgroups (A1 and A2, 5 animals/group; and B1 and B2, 5 animals/group). Rats in the subgroups A1 and A2 were used as control (uninfected) and animals in the subgroups B1 and B2 were inoculated with T. evansi (infected). NO in serum and the comet assay were used to measure DNA damage index (DI) and damage frequency (DF) in liver, heart, spleen and total blood of infected rats. Increased NO levels on days 3 and 9 post-infection (PI) was observed (P < 0.001). Also, it was verified an increase on DI and DF in the evaluated organs on days 3 and 9 PI (P < 0.001). Our data show that T. evansi infection causes genotoxicity due to the production of NO, causing not only the death of the protozoan, but also inducing DNA damage in the host.

Actual preoperative fasting time in Brazilian hospitals: the BIGFAST multicenter study.

BACKGROUND: Prolonged fasting increases organic response to trauma. This multicenter study investigated the gap between the prescribed and the actual preoperative fasting times in Brazilian hospitals and factors associated with this gap. METHODS: Patients (18-90-years-old) who underwent elective operations between August 2011 and September 2012 were included in the study. The actual and prescribed times for fasting were collected and correlated with sex, age, surgical disease (malignancies or benign disease), operation type, American Society of Anesthesiologists score, type of hospital (public or private), and nutritional status. RESULTS: A total of 3,715 patients (58.1% females) with a median age of 49 (18-94) years from 16 Brazilian hospitals entered the study. The median (range) preoperative fasting time was 12 (2-216) hours, and fasting time was longer (P<0.001) in hospitals using a traditional fasting protocol (13 [6-216] hours) than in others that had adopted new guidelines (8 [2-48] hours). Almost 80% (n=2,962) of the patients were operated on after 8 or more hours of fasting and 46.2% (n=1,718) after more than 12 hours. Prolonged fasting was not associated with physical score, age, sex, type of surgery, or type of hospital. Patients operated on due to a benign disease had an extended duration of preoperative fasting. CONCLUSION: Actual preoperative fasting time is significantly longer than prescribed fasting time in Brazilian hospitals. Most of these hospitals still adopt traditional rather than modern fasting guidelines. All patients are at risk of long periods of fasting, especially those in hospitals that follow traditional practices.

The combination of haloperidol, dexamethasone, and ondansetron for prevention of postoperative nausea and vomiting in laparoscopic sleeve gastrectomy: a randomized double-blind trial.

BACKGROUND: Many patients may experience postoperative nausea and vomiting (PONV) following laparoscopic sleeve gastrectomy (LSG). We evaluated the efficacy of the combination of haloperidol, dexamethasone, and ondansetron for prevention of PONV after LSG. METHODS: Ninety patients were included in this prospective, randomized, double-blinded, three-arm study (group O: ondansetron 8 mg; group DO: dexamethasone 8 mg and ondansetron 8 mg; group HDO: haloperidol 2 mg, dexamethasone 8 mg, and ondansetron). Nausea, vomiting, rescue antiemetic use, morphine consumption, adverse events, and volume of intravenous fluids infused were recorded at regular intervals for 36 h postoperatively. RESULTS: The incidence of nausea was lower 0-2 h postoperatively in group HDO compared to group O (23.7 versus 56.7 %, p = 0.016) and at 12-24 h postoperatively was lower in group HDO (23.3 %) and group DO (26.7 %) compared to group O (60 %) (p = 0.008 and p = 0.009, respectively). At 0-36 h postoperatively, nausea was lower in group HDO compared to group O (53.3 versus 86.7 %, p = 0.013). Vomiting at 0-36 h postoperatively was lower in group HDO compared to group O (20 versus 53.3 %, p = 0.015). Rescue antiemetic drug and morphine consumption were less used in group HDO compared to group O (p <0.01). The volume of fluids infused in group O was approximately 1 l greater than in group HDO (p = 0.026). CONCLUSION: The combination of haloperidol, dexamethasone, and ondansetron reduced PONV and the necessity of rescue antiemetics and also reduced morphine consumption and the volume of fluids infused postoperatively.

Changes in body composition, hematologic parameters, and serum biochemistry after rapid intravenous infusion or oral intake of 2 liters of 0.9% saline solution in young healthy volunteers: randomized crossover study.

BACKGROUND: The perioperative infusion of 2 L of saline is associated with weight gain and decreased serum albumin and hematocrit. We hypothesized that these parameters would respond differently to oral administration and intravenous infusion of saline solution. METHODS: This was a crossover study that included 10 healthy young men (ages 18-26 years). At two times, 8 weeks apart, the participants were randomized to receive 2 L of 0.9% saline over 1 h by intravenous (IV) administration to a forearm vein or by oral intake. The participants were weighed and body masses were calculated. Bioelectrical impedance analysis was performed with a single-frequency device using tetrapolar distal limb electrodes. Blood samples were collected 1 h after the administration period for laboratory assays: hematocrit, hemoglobin, blood glucose, serum electrolytes, albumin, creatinine, osmolality. RESULTS: There was an increase in body weight (p<0.01), total body water (p<0.01), and lean body mass (p<0.01) after the experiment in both groups, with no difference between them. The volume of urine output was similar in the two experiments. The hemoglobin (oral group from 14.4±0.8 g/dl to 13.8±0.8 g/dl; IV group from 14.4±0.6 g/dl to 12.6±0.6 g/dl) and hematocrit (oral group from 43.2±1.8% to 43.2±2.8%; IV group from 43.6±2.2% to 40.0±2.6%) significantly decreased (p<0.01) with IV saline. Serum albumin remained stable after oral intake but significantly decreased (p=0.04) after IV infusion. CONCLUSIONS: Oral intake of 2 L of 0.9% saline results in minimal variations in serum albumin, hemoglobin, and hematocrit when compared to IV infusion of the same volume.