Avaliação do impacto de laboratórios de análises clínicas de hospitais de urgência e emergência do município de Belém-PA na saúde / Health impact assessment of clinical analysis laboratories in Urgency and Emergency hospitals in Belém (PA, Brazil)

Este trabalho teve como objetivo avaliar o impacto de laboratórios de análises clínicas de hospitais de urgência e emergência do município de Belém-PA na saúde. Trata-se de um estudo do tipo descritivo com abordagem quantitativa, no qual os dados foram coletados por meio de entrevistas diretas por meio de um questionário contendo perguntas abertas e fechadas, seguindo uma ordem de questionamentos divididos em diferentes avaliações de impacto na saúde. Os resultados revelaram que os laboratórios de análises clínicas dos hospitais de urgência e emergência apresentam os serviços bem estruturados, com profissionais próprios qualificados e treinados periodicamente. Para a rotina laboratorial há documentos para guiar na operacionalização dos serviços, manuais de qualidade e credenciamento a programas e/ou empresas de certificação ou acreditação de qualidade. Os laboratórios realizam auditorias internas, apresentam dispositivo de medição quanto a ensaios e equipamentos calibrados, com manutenções periódicas e possuem responsáveis técnicos e diretores de laboratório. Quanto à citação do número de exames laboratoriais, o LAC A e o LAC D apresentam todos os exames hematológicos questionados, no entanto, o LAC B e LAC C apresentam 85,71% (n =12) dos exames questionados. Quando questionados em relação às dosagens bioquímicas, o LAC A e LAC D mostraram-se mais abrangentes por realizarem todos os exames bioquímicos propostos. Diante dos resultados obtidos, conclui-se que os laboratórios de urgência e/ou emergência existentes no município de Belém-PA oferecem ampla variedade de serviços, bem como apresentam preocupação com a garantia da qualidade da prestação de seus serviços...

This study is an assessment of the health impact of 4 clinical analysis laboratories (LAC A, B, C and D) in Urgency and Emergency hospitals in Belém (PA). In a descriptive study with a quantitative approach, we collected data through interviews conducted with a questionnaire containing open and closed questions, which were organized into various levels of health impact assessment. The results revealed that the clinical analysis laboratories of urgency and emergency hospitals have well-structured services, with qualified professionals who received periodic in service training. For routine lab work, there are well documented operational guidelines, quality manuals and programs and/or companies offering quality certification and accreditation. The laboratories make internal audits and possess measuring devices for assays and periodically calibrated equipment; they have responsible technicians and laboratory directors. In response to questions on the number of laboratory tests, LAC A and LAC D exhibited all the hematological tests cited, while LAC B and C showed 85.71% (n = 12) of the tests. Regarding the biochemical dosages, LAC A and LAC D proved to be more inclusive, covering all the recommended biochemical tests. On the basis of these results, we conclude that the clinical laboratories in urgency and/or emergency hospitals in Belém offer a wide variety of services, as well as showing concern for quality assurance in the provision of these services...

Vitamin E-analog Trolox prevents endoplasmic reticulum stress in frozen-thawed ovarian tissue of capuchin monkey (Sapajus apella).

Ovarian fragments were exposed to 0.5 M sucrose and 1 M ethylene glycol (freezing solution; FS) with or without selenium or Trolox. Histological and ultrastructural analyses showed that the percentages of normal follicles in control tissue and in tissue after exposure to FS + 50 µM Trolox were similar. Trolox prevented endoplasmic reticulum (ER)-related vacuolization, which is commonly observed in oocytes and stromal tissue after exposure to FS. From the evaluated stress markers, superoxide dismutase 1 (SOD1) was up-regulated in ovarian tissue exposed to FS + 10 ng/ml selenium. Ovarian fragments were subsequently frozen-thawed in the presence of FS with or without 50 µM Trolox, followed by in vitro culture (IVC). Antioxidant capacity in ovarian fragments decreased after freeze-thawing in Trolox-free FS compared with FS + 50 µM Trolox. Although freezing itself minimized the percentage of viable follicles in each solution, Trolox supplementation resulted in higher rates of viable follicles (67 %), even after IVC (61 %). Furthermore, stress markers SOD1 and ERp29 were up-regulated in ovarian tissue frozen-thawed in Trolox-free medium. Relative mRNA expression of growth factors markers was evaluated after freeze-thawing followed by IVC. BMP4, BMP5, CTGF, GDF9 and KL were down-regulated independently of the presence of Trolox in FS but down-regulation was less pronounced in the presence of Trolox. Thus, medium supplementation with 50 µM Trolox prevents ER stress and, consequently, protects ovarian tissue from ER-derived cytoplasmic vacuolization. ERp29 but not ERp60, appears to be a key marker linking stress caused by freezing-thawing and cell vacuolization.

Poisonous mushrooms: a review of the most common intoxications.

Mushrooms have been used as components of human diet and many ancient documents written in oriental countries have already described the medicinal properties of fungal species. Some mushrooms are known because of their nutritional and therapeutical properties and all over the world some species are known because of their toxicity that causes fatal accidents every year mainly due to misidentification. Many different substances belonging to poisonous mushrooms were already identified and are related with different symptoms and signs. Carcinogenicity, alterations in respiratory and cardiac rates, renal failure, rhabidomyolisis and other effects were observed in toxicity studies with various species including edible and therapeutic ones. Proper identification is important to avoid accidents and toxicity studies are necessary to assure the safe use of mushrooms as food and for medicinal purposes.

Poisonous mushrooms; a review of the most common intoxications / Hongos venenosos; una revisión de las intoxicaciones más comunes

Mushrooms have been used as components of human diet and many ancient documents written in oriental countries have already described the medicinal properties of fungal species. Some mushrooms are known because of their nutritional and therapeutical properties and all over the world some species are known because of their toxicity that causes fatal accidents every year mainly due to misidentification. Many different substances belonging to poisonous mushrooms were already identified and are related with different symptoms and signs. Carcinogenicity, alterations in respiratory and cardiac rates, renal failure, rhabidomyolisis and other effects were observed in toxicity studies with various species including edible and therapeutic ones. Proper identification is important to avoid accidents and toxicity studies are necessary to assure the safe use of mushrooms as food and for medicinal purposes (AU)

Las setas se han utilizado como componentes de la dieta humana y muchos documentos antiguos escritos en los países orientales se han descrito ya las propiedades medicinales de las especies de hongos. Algunos hongos son conocidos por sus propiedades nutricionales y terapéuticas y de todo el mundo, algunas especies son conocidas debido a su toxicidad que causa accidentes mortales cada año, principalmente debido a errores de identificación. Muchas sustancias diferentes que pertenecen a las setas venenosas estaban ya clasificadas y están relacionados con diferentes síntomas y signos. Carcinogenicidad, alteraciones de la frecuencia respiratoria y cardiaca, insuficiencia renal, rhabidomyolisis y otros efectos se observaron en estudios de toxicidad con varias especies incluidas las alimenticias y terapéuticas. La correcta identificación es importante para evitar accidentes y los estudios de toxicidad son necesarias para asegurar el uso seguro de las setas como alimento y con fines medicinales (AU)

Lipid peroxidation and antioxidant capacity of G6PD-deficient patients with A-(202G>A) mutation.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an enzymopathy in which reduced NADPH concentrations are not maintained, resulting in oxidative damage. We evaluated G6PD activity, oxidative stress levels and Trolox equivalent antioxidant capacity in individuals with the A-(202G>A) mutation for G6PD deficiency. Five hundred and forty-four peripheral blood samples were screened for G6PD deficiency; we also analyzed lipid peroxidation products measured as thiobarbituric acid reactive species and Trolox equivalent antioxidant capacity. Men with the A-(202G>A) mutation had lower G6PD activity than women with the same mutation. Individuals with the A-(202G>A) mutation also differed in mean Trolox equivalent antioxidant capacity values but not for thiobarbituric acid reactive species values. We concluded that A-(202G>A) mutation is associated with reduced G6PD activity and increased Trolox equivalent antioxidant capacity.

Edible mushroom Agaricus sylvaticus can prevent the onset of atheroma plaques in hipercholesterolemic rabbits.

Since the involvement of free radicals in the pathophysiology of atherosclerosis was proposed, antioxidant supplementation arose as a potential strategy for the management of this disease. Thus, we decided to investigate the potential benefit of a natural antioxidant--rich edible mushroom (Agaricus sylvaticus) on the prevention of atherosclerosis. New Zealand rabbits underwent atherosclerosis induction by feeding a cholesterol--enriched chow (Group A), while Group B simultaneously received edible mushroom A. sylvaticus water solution. Control group received standard rabbit chow only (Group C). At the end of 10 week treatment period serum samples were drawn for lipid profile, uric acid, thiobarbituric acid reactive substances (TBARS), and total antioxidant status (TAS). The area of aorta arteries taken by atheroma plaques was evaluated. Groups A and B presented higher cholesterol levels (p< 0.01) and reduced TAS (p<0.01), when compared to the Group C. However, TBARS and uric acid levels for Group B animals' were reduced, in comparison to Group A (p<0.05), and equals to group C. Moreover, animals from group A developed extensive atherosclerotic areas (47.0+/-14.0%), and that was prevented by the supplementation of A. sylvaticus (6.6+/-2.9%, p<0.01). Data suggested that A. sylvaticus can prevent the development of atherosclerosis in spite of hipercholesterolemia.

Effect of n-acetylcysteine in a random skin flap after administration of nicotine, in the rat

This study analyzed the perfusion of a random skin flap, after nicotine injection and administration of N-acetylcysteine (NAC). A skin flap was elevated after 6 weeks of nicotine administartion and the percentage of necrosis was determined thereafter, as well as malondialdehyde (MDA) in 4 selected skin areas and in serum. Both nicotine and NAC elicited elevation in MDA levels in the skin samples. Nicotine also led to elevation in serum MDA levels and in the percentage of flap necrosis. NAC did not improve the viability of the flap.

Immunohistochemical demonstration of insulin-like growth factor I (IGF-1) in normal and pathological human pituitary glands.

The authors have studied the presence and distribution of Insulin-Like-Growth-Factor-1 (IGF-1) in 5 autopsied normal and 20 surgically removed human pituitary adenomas, employing a peroxidase-anti-peroxidase method. IGF-1 could be demonstrated in all cases, with variation of cells immunostaining from 60% in normal pituitary gland to 100% in corticotroph cell adenoma.