An Exploratory Study of the Metabolite Profiling from Pesticides Exposed Workers.

Pesticides constitute a category of chemical products intended specifically for the control and mitigation of pests. With their constant increase in use, the risk to human health and the environment has increased proportionally due to occupational and environmental exposure to these compounds. The use of these chemicals is associated with several toxic effects related to acute and chronic toxicity, such as infertility, hormonal disorders and cancer. The present work aimed to study the metabolic profile of individuals occupationally exposed to pesticides, using a metabolomics tool to identify potential new biomarkers. Metabolomics analysis was carried out on plasma and urine samples from individuals exposed and non-exposed occupationally, using liquid chromatography coupled with mass spectrometry (UPLC-MS). Non-targeted metabolomics analysis, using principal component analysis (PCA), partial least squares discriminant analysis (PLS-DA) or partial least squares discriminant orthogonal analysis (OPLS-DA), demonstrated good separation of the samples and identified 21 discriminating metabolites in plasma and 17 in urine. The analysis of the ROC curve indicated the compounds with the greatest potential for biomarkers. Comprehensive analysis of the metabolic pathways influenced by exposure to pesticides revealed alterations, mainly in lipid and amino acid metabolism. This study indicates that the use of metabolomics provides important information about complex biological responses.

Survival in cases of intestinal tumors

Objective: To assess the survival rate of patients with colorectal cancer at Hospital Universitário Alzira Vellano, in the municipality of Alfenas, state of Minas Gerais (MG), Brazil, from 2007 to 2016. Methodology: A search was conducted in the laboratory files and medical records of patients diagnosed with colorectal cancer and cared for during the aforementioned period. Results: In total, 128 cases were found: 52.3% were men, and 47.7% were women, with ages ranging from 25 to 91 years. The most common types of cancer in both genders were of the colon, rectum and sigmoid. The most common stages were T3N1Mx, followed by T3N0Mx and T3N2Mx. Patients with T1 or T2 cancers had a 100% survival rate, whereas the rate for those with grade 4 (T4) was of 0%. An association (p<0.05) of the location of the tumor with the survival rate was confirmed. Conclusion: There was a high mortality rate among patients diagnosed with colorectal cancer at Hospital Universitário Alzira Vellano from 2007 to 2016. (AU)

Assessment of Primary Health Care for rural workers exposed to pesticides.

OBJECTIVE: To evaluate the attributes of Primary Health Care (PHC) for rural workers; to analyze sociodemographic conditions, history of poisoning and hospitalizations for pesticides and use of personal protective equipment; and to verify exposure to pesticides by determining bioindicators. METHODS: Cross-sectional, descriptive-analytical study with a sample of 1,027 rural workers living in municipalities belonging to a regional health department in Southern Minas Gerais, whose PHC is governed by the Family Health Strategy model. We used the adult version of the Primary Care Assessment Tool (PCATool Brazil) and a structured questionnaire to collect socioeconomic data, history of poisoning and hospitalization for pesticides and use of personal protective equipment. Blood samples were collected to measure biomarkers of pesticide exposure and signs of renal and hepatic sequelae. RESULTS: Low education was prevalent, as well as the intense contact of workers with pesticides. Frequent use of personal protective equipment was higher among men, as was the history of poisoning and hospitalizations for pesticides. Rates of 20% poisoning, 15% liver disease and 2% nephropathy were detected. Signs of hepatotoxicity were more frequent in men. Gender differences were all statistically significant. Regarding PHC, only the attribute "degree of affiliation" had a high score. None of the poisoning cases detected in the study were previously diagnosed. CONCLUSIONS: Despite the high coverage of the Family Health Strategy, occupational risk and its consequences have not been detected by health services, which do not seem oriented to primary care, even lacking their essential attributes. There is a need for immediate and effective adaptation of public policies regarding the health of rural workers, with adequate training of teams and review of the portfolio of PHC services offered.

Assessment of Primary Health Care for rural workers exposed to pesticides / Avaliação da atenção primária à saúde de trabalhadores rurais expostos a praguicidas

ABSTRACT OBJECTIVE To evaluate the attributes of Primary Health Care (PHC) for rural workers; to analyze sociodemographic conditions, history of poisoning and hospitalizations for pesticides and use of personal protective equipment; and to verify exposure to pesticides by determining bioindicators. METHODS Cross-sectional, descriptive-analytical study with a sample of 1,027 rural workers living in municipalities belonging to a regional health department in Southern Minas Gerais, whose PHC is governed by the Family Health Strategy model. We used the adult version of the Primary Care Assessment Tool (PCATool Brazil) and a structured questionnaire to collect socioeconomic data, history of poisoning and hospitalization for pesticides and use of personal protective equipment. Blood samples were collected to measure biomarkers of pesticide exposure and signs of renal and hepatic sequelae. RESULTS Low education was prevalent, as well as the intense contact of workers with pesticides. Frequent use of personal protective equipment was higher among men, as was the history of poisoning and hospitalizations for pesticides. Rates of 20% poisoning, 15% liver disease and 2% nephropathy were detected. Signs of hepatotoxicity were more frequent in men. Gender differences were all statistically significant. Regarding PHC, only the attribute "degree of affiliation" had a high score. None of the poisoning cases detected in the study were previously diagnosed. CONCLUSIONS Despite the high coverage of the Family Health Strategy, occupational risk and its consequences have not been detected by health services, which do not seem oriented to primary care, even lacking their essential attributes. There is a need for immediate and effective adaptation of public policies regarding the health of rural workers, with adequate training of teams and review of the portfolio of PHC services offered.

ABSTRACT OBJETIVO Avaliar os atributos da atenção primária à saúde (APS) na assistência à saúde de trabalhadores rurais; analisar condições sociodemográficas, histórico de intoxicação e internações por agrotóxicos e uso de equipamentos de proteção individual; e verificar a exposição aos praguicidas pela determinação de bioindicadores. MÉTODOS Estudo transversal, descritivo-analítico, com amostra de 1.027 trabalhadores rurais residentes em municípios pertencentes a uma superintendência regional de saúde do sul de Minas Gerais, cuja APS é regida pelo modelo da Estratégia Saúde da Família. Utilizou-se o Instrumento de Avaliação da Atenção Primária (PCATool Brasil) versão adulto e um questionário estruturado para coleta de dados socioeconômicos, histórico de intoxicação e internação por agrotóxicos e uso de equipamentos de proteção individual. Foram coletadas amostras sanguíneas para dosagem de biomarcadores de exposição a praguicidas e de sinais de sequelas renais e hepáticas. RESULTADOS A baixa escolaridade foi prevalente, bem como o contato intenso dos trabalhadores com praguicidas. O uso frequente de equipamentos de proteção individual foi maior entre os homens, assim como o histórico de intoxicação e de internações por agrotóxicos. Detectaram-se índices de 20% de intoxicação, 15% de hepatopatia e 2% de nefropatia. Os sinais de hepatotoxicidade foram mais frequentes em homens. As diferenças entre sexos foram todas estatisticamente significantes. Com relação à APS, apenas o atributo "grau de afiliação" apresentou escore elevado. Nenhum dos casos de intoxicação detectados no estudo tinha diagnóstico prévio. CONCLUSÕES A despeito de uma alta cobertura da Estratégia Saúde da Família, o risco ocupacional e suas consequências não têm sido detectados pelos serviços de saúde, que se apresentam como não orientados à atenção primária, carecendo mesmo de seus atributos essenciais. Percebe-se a necessidade de adequação imediata e efetiva das políticas públicas no que concerne à saúde do trabalhador rural, com adequada capacitação das equipes e revisão da carteira de serviços da APS ofertados.

Assessment of exposure to pesticides in rural workers in southern of Minas Gerais, Brazil.

The aim of the study was to assess of occupational exposure to pesticides in rural workers using genotoxicity test, bioindicators and clinical evaluation. Blood, urine and buccal samples from persons, rural workers exposed to a complex mixture of pesticides with organophosphates (n=94) and without organophosphates (n=94) were collected to compare the activities of cholinesterases, the levels of urinary dialkyl phosphates, genotoxicity data, from a cytome assay. Biomarkers were analysed by traditional/published methods Control group consisted of 50 other persons, non- occupationally exposed to pesticides from the city of Alfenas, Minas Gerais, Brazil. All subjects underwent a clinical evaluation. In the group exposed to organophosphates, the activity of acetylcholinesterase, butyrylcholinesterase and total cholinesterase was lower by 63.8%, 12.8%, and 14.8%, respectively, and 92.6% of the group had dialkyl phosphates present in their urine. The cytome assay was used to measure biomarkers of DNA damage (micronuclei and/or elimination of nuclear material by budding), cytokinetic defects (binucleated cells), and proliferative potential (basal cell) and/or cell death (condensed chromatin, karyorrhectic, pyknotic, and karyolytic cells). The group exposed to organophosphates showed significant changes in all these parameters compared to the control group and showed significant changes in budding, condensed chromatin and karyolytic cells compared with the group non-exposed to organophosphates. Data from the clinical evaluation showed significant changes in the central nervous, respiratory and auditory systems. The studied biomarkers are able to distinguish occupational and environmental exposure to pesticides and the data showed hazardous exposure to organophosphates and afforded valuable data to estimate the risk to cancer development.

Effectiveness of exclusive self-monitoring of fasting capillary blood glucose in the treatment of diabetes / Análise da eficácia do automonitoramento exclusivo de glicemia capilar de jejum no tratamento da diabetes

The study aims to analyze the efficacy of the exclusive self -monitoring of the fasting capillary blood glucose in the control and treatment of diabetic patients. This is a quasi-experimental study, for which five individuals with diabetes were selected, who perform only the fasting capillary blood glucose monitoring, being added about seven other measurements, a variable number according to the individual availability of the volunteer, at different times throughout the day. It was verified that four individuals presented blood glucose values by the use of the fasting capillary blood glucose monitoring, within the parameters of normality for diabetics, between 70-130 mg dL-1 of blood (ADA, 2014b), although in the other measurements, they presented values far from the ideal goal, in a significant part of the time. The study outlines a trend that shows that the glycemic monitoring values based solely on the fasting capillary blood glucose is ineffective, since they can erroneously indicate satisfactory control of the blood glucose levels. Based on the results obtained, to a more effective monitoring and which denotes levels of reliability, it is required at least three measurements of capillary blood glucose throughout the day, and also, the importance of long laboratory tests for glycemic monitoring, such as glycated hemoglobin.

O objetivo deste estudo é analisar a eficácia do automonitoramento exclusivo da glicemia capilar de jejum no controle e no tratamento de pacientes diabéticos. Trata-se de um estudo quase experimental, para o qual foram selecionados cinco indivíduos portadores de diabetes que realizam apenas o monitoramento da glicemia capilar de jejum e acrescentaram cerca de outras sete medições, número variável de acordo com a disponibilidade individual do voluntário, em diferentes horários ao longo do dia. Verificou- se que quatro indivíduos apresentaram os valores glicêmicos pelo monitoramento da glicemia capilar de jejum dentro dos parâmetros de normalidade para os diabéticos, entre 70 ­ 130 mg dL-1 de sangue (ADA, 2014b), apesar de nas outras medições apresentarem, em parte significativa das vezes, valores fora da meta ideal. Logo, o estudo traça uma tendência que mostra que o acompanhamento glicêmico baseado exclusivamente nos valores de glicemia capilar de jejum é ineficaz, uma vez que pode erroneamente indicar controle satisfatório dos níveis glicêmicos. Mediante os resultados obtidos, para um monitoramento mais efetivo e que denote níveis de confiabilidade é necessário de pelo menos três medições de glicemia capilar ao longo do dia e, também, a importância de exames laboratoriais de acompanhamento glicêmico longo, como a hemoglobina glicada.

Dialkyl phosphates determination by gas chromatography: Evaluation of a microwave-assisted derivatization†.

Dialkyl phosphates are organophosphate insecticide metabolites and their urinary analysis is useful for assessing human exposure to these compounds. This study presents a sample preparation method with microwave-assisted derivatization for two dialkyl phosphates to make the process faster before gas chromatographic analysis. The optimized conditions for derivatization procedure were: 250 µL of 2,3,4,5,6-pentafluorobenzyl bromide 3% in acetonitrile for derivative; microwave for 5 min with intensity of 160 W. The electron ionization mass spectrometric analysis was performed using a gas chromatography with mass spectrometry QP-2010 from the Shimadzu(®) equipped with RTx(®) -5MS capillary column. Ions were monitored at selected-ion monitoring mode at m/z 350 for diethyl thiophosphate and m/z 366 for diethyl dithiophosphate. The developed method was linear for both metabolites. The intra-assay precision was the values ranged between 1.1 and 9.1%, for diethyl thiophosphate, and between 4.06 and 6.9%, for diethyl dithiophosphate. The interassay precision showed relative standard deviation between 10.3 and 15.1%, for diethyl thiophosphate and between 4.9 and 11.9%, for diethyl dithiophosphate. The results obtained suggests that derivatization assisted by microwave, before gas chromatography with mass spectrometry analysis, can be applied to monitoring of exposure to organophosphates once is fast, sensible, and precise method to determinate dialkyl phosphates.

Análise micológica e toxicológica em amendoim e derivados / Mycological and toxicological analysis of peanuts and derivatives

The filamentous fungi Aspergillus flavus, Aspergillus parasiticus and Aspergillus nomius produce toxins, which are secondary metabolites called aflatoxins. These toxin-producing species grow rapidly on peanuts and cereals in favorable conditions of temperature and humidity. Their toxins can either cause acute effects, and even be lethal or accumulate in the organism, resulting in liver cancer in the long term. Based on the health risks of aflatoxins in food, a research was conducted on peanuts and derivatives sold in Alfenas, MG, Brazil, to evaluate the presence of Aspergillus sp. and aflatoxins. The samples were randomly collected at ?popular stores?, from November 2008 to May 2009, to assess the occurrence of aflatoxins B1, B2, G1 and G2 by thin layer chromatography (TLC). The mycological analysis revealed the presence of fungi in 50% of the samples: Penicillium sp. (53.85%), A. flavus (19.23%), A. niger (15.38%) and A. fumigatus (11.54%), and 63.64% of these showed the presence of aflatoxins : B1 (43.14%), B2 (25.49%), G1 (23.53%) and G2 (7.84%). It is concluded that the results reported here are a cause for concern, given the harmfulness of these cumulative and carcinogenic toxins.

As espécies Aspergillus flavus, Aspergillus parasiticus e Aspergillus nomius produzem micotoxinas, que são metabólitos secundários denominados de aflatoxinas. Desenvolvem-se rapidamente em amendoins e cereais produzindo esta toxina, quando em condições favoráveis de temperatura e umidade. Essas toxinas podem produzir efeitos agudos, letais ou não, ou efeito cumulativo no organismo, que a longo prazo, podem causar, principalmente, lesões carcinogênicas hepáticas. Sabendo-se dos riscos à saúde, devido à presença de aflatoxinas nos alimentos, foi realizada uma pesquisa em amendoins e derivados comercializados na cidade de Alfenas ? MG, Brasil, para avaliar a presença de aflatoxinas e de fungos do gênero Aspergillus sp. Amostras foram coletadas aleatoriamente em lojas populares no período de novembro de 2008 a maio de 2009 e avaliada a ocorrência de aflatoxinas B1, B2, G1 e G2, utilizando-se a técnica de Cromatografia de Camada Delgada (CCD). Na análise micológica foi constatada a presença de fungos em 50% das amostras, das espécies: Penicillium sp. (53,85%), A. flavus (19,23%), A. niger (15,38%), A. fumigatus (11,54%). Obteve-se como resultado para a presença de aflatoxinas 63,64 %, sendo: B1 (43,14%), B2 (25,49%), G1 (23,53%), G2 (7,84%). Concluiu-se que os números encontrados são preocupantes, tendo em vista a periculosidade desta substância