Equipamentos de proteção individual e exposição ocupacional solar diante da saúde do trabalhador da cajucultura / Personal protection equipment and occupational sun exposure before the cajuculture worker's health

Objetivo: Avaliar a utilização de equipamentos de proteção individual e a exposição solar entre trabalhadores que atuam no beneficiamento dacastanha de caju e seus derivados.Método: Trata-se de uma pesquisa transversal, quantitativa, epidemiológica, realizada no município de Barreira ­CE, no período entre dezembro de 2019 e maio de 2020. A coleta de dados deu-sepor meio da anamnese e da aplicação de instrumento semiestruturadoque abordou as condições laborais e aspectos sociodemográficos desses trabalhadores. O processamento estatístico dos dados foi realizado através do programa Epi Infov. 7.2.1.0.Essa pesquisa foi aprovada peloComitê de Ética e Pesquisa com parecer de número 3.466.070.Resultados: Participaram do estudo 100 pessoas, predominando participantes do sexo masculino (66%). Observou-se que a exposição solar acarretou, em 23% dos entrevistados,eritema. Sobre a utilização de equipamentos de proteção individual (EPI) durante a atividade laboral, 63% dos entrevistados utilizavam apenas um EPI, havendo umamaiorprevalência da utilização de camisa de manga comprida em 26% dos participantes.Assim, foi possível observar que a não utilização de EPIse a exposição solar devido à atividade laboral são fatores de risco consideráveis que podem levar asérias consequências à saúde do trabalhador, como por exemplo a ocorrência de câncer de pele.Conclusões:É imprescindível repensar estratégias em prol da saúde desse grupopara que tanto o empregado como o empregador tenham conhecimento das Normas Regulamentadoras que visam amparar a atividade laboral com o caju e seus derivados.

Objective: To evaluate the use of personal protective equipment and sun exposure among workers who work in the processing ofcashew nuts and their derivatives. Method:This is a cross-sectional, quantitative, epidemiological research, carried out in the city of Barreira -CE, between December 2019 and May 2020. Data collection took place through anamnesis and the application ofa semi-structured instrument which addressed the working conditions and sociodemographic aspects of these workers. Statistical data processing was performed using thePPEInfo v. 7.2.1.0. This research was approved by the Ethics and Research Committee under opinion number 3.466.070. Results: One hundred people participated in the study, predominantly male participants (66%). It was observed that exposure to the sun caused by erythema in 23% of respondents. Regarding the use of personal protective equipment(PPE) during labor activity, 63% of respondents used only one PPE, with a higher prevalence of wearing a long-sleeved shirt in 26% of the participants. Thus, it was possible to note that the non-use of PPE and sun exposure due to work activities are considerable risk factors that can lead to serious consequences for workers' health, such as the occurrence of skin cancer. Conclusions:It is essential to rethink strategies in favor of the health of this group so that both the employee and the employer are aware of the Regulatory Norms that aim to support the work activity with cashew and its derivatives.

Antiretroviral drugs saquinavir and ritonavir reduce inhibitory concentration values of itraconazole against Histoplasma capsulatum strains in vitro

Abstract Recent studies have shown that some drugs that are not routinely used to treat fungal infections have antifungal activity, such as protease inhibitor antiretroviral drugs. This study investigated the in vitro susceptibility of Histoplasma capsulatum var. capsulatum to saquinavir and ritonavir, and its combination with the antifungal itraconazole. The susceptibility assay was performed according to Clinical and Laboratory Standards Institute guidelines. All strains were inhibited by the protease inhibitor antiretroviral drugs. Saquinavir showed minimum inhibitory concentrations ranging from 0.125 to 1 μg mL−1 for both phases, and ritonavir presented minimum inhibitory concentrations ranging from 0.0312 to 4 μg mL−1and from 0.0625 to 1 μg mL−1 for filamentous and yeast phase, respectively. Concerning the antifungal itraconazole, the minimum inhibitory concentration values ranged from 0.0019 to 0.125 μg mL−1 and from 0.0039 to 0.0312 μg mL−1 for the filamentous and yeast phase, respectively. The combination of saquinavir or ritonavir with itraconazole was synergistic against H. capsulatum, with a significant reduction in the minimum inhibitory concentrations of both drugs against the strains (p < 0.05). These data show an important in vitro synergy between protease inhibitors and itraconazole against the fungus H. capsulatum.

Antiretroviral drugs saquinavir and ritonavir reduce inhibitory concentration values of itraconazole against Histoplasma capsulatum strains in vitro.

Recent studies have shown that some drugs that are not routinely used to treat fungal infections have antifungal activity, such as protease inhibitor antiretroviral drugs. This study investigated the in vitro susceptibility of Histoplasma capsulatum var. capsulatum to saquinavir and ritonavir, and its combination with the antifungal itraconazole. The susceptibility assay was performed according to Clinical and Laboratory Standards Institute guidelines. All strains were inhibited by the protease inhibitor antiretroviral drugs. Saquinavir showed minimum inhibitory concentrations ranging from 0.125 to 1µgmL(-1) for both phases, and ritonavir presented minimum inhibitory concentrations ranging from 0.0312 to 4µgmL(-1)and from 0.0625 to 1µgmL(-1) for filamentous and yeast phase, respectively. Concerning the antifungal itraconazole, the minimum inhibitory concentration values ranged from 0.0019 to 0.125µgmL(-1) and from 0.0039 to 0.0312µgmL(-1) for the filamentous and yeast phase, respectively. The combination of saquinavir or ritonavir with itraconazole was synergistic against H. capsulatum, with a significant reduction in the minimum inhibitory concentrations of both drugs against the strains (p<0.05). These data show an important in vitro synergy between protease inhibitors and itraconazole against the fungus H. capsulatum.

Antigens of Coccidioides posadasii as an important tool for the immunodiagnosis of coccidioidomycosis.

Serologic diagnosis has been presented as a safe alternative for coccidioidomycosis. However, commercial kits based on coccidioidal antibodies available in the USA are considered too expensive for laboratories outside that country. In this study, we describe the preparation of antigens for detection of human coccidioidal antibodies by the immunodiffusion test (ID) and enzyme immunoassay (EIA). Antigens were tested against serum samples from patients with coccidioidomycosis, histoplasmosis and paracoccidioidomycosis, as well as healthy individuals. The highest reactivity in the ID tests was seen in the F0-90 antigen. In the EIAs, the best results were obtained with the F60-90 antigen. None of the serum samples from healthy individuals were recognized by any of the antigen extracts tested by ID or EIA. In conclusion, the F0-90 and F60-90 antigens have the potential to be commercially employed in presumptive diagnosis of coccidioidomycosis by ID or EIA, respectively. The tests could improve serological diagnosis of coccidioidomycosis in South America.

Coccidioidomycosis in armadillo hunters from the state of Ceará, Brazil.

Coccidioidomycosis is a systemic mycosis with a variable clinical presentation. Misdiagnosis of coccidioidomycosis as bacterial pneumopathy leads to inappropriate prescription of antibiotics and delayed diagnosis. This report describes an outbreak among armadillo hunters in northeastern Brazil in which an initial diagnosis of bacterial pneumonia was later confirmed as coccidioidomycosis caused by Coccidioides posadasii. Thus, this mycosis should be considered as an alternative diagnosis in patients reporting symptoms of pneumonia, even if these symptoms are only presented for a short period, who are from areas considered endemic for this disease.

Coccidioidomycosis in armadillo hunters from the state of Ceará, Brazil

Coccidioidomycosis is a systemic mycosis with a variable clinical presentation. Misdiagnosis of coccidioidomycosis as bacterial pneumopathy leads to inappropriate prescription of antibiotics and delayed diagnosis. This report describes an outbreak among armadillo hunters in northeastern Brazil in which an initial diagnosis of bacterial pneumonia was later confirmed as coccidioidomycosis caused by Coccidioides posadasii. Thus, this mycosis should be considered as an alternative diagnosis in patients reporting symptoms of pneumonia, even if these symptoms are only presented for a short period, who are from areas considered endemic for this disease.

Synergistic effect of antituberculosis drugs and azoles in vitro against Histoplasma capsulatum var. capsulatum.

This study evaluated in vitro interactions of antituberculosis drugs and triazoles against Histoplasma capsulatum. Nine drug combinations, each including an antituberculosis drug (isoniazid, pyrazinamide, or ethambutol) plus a triazole (itraconazole, fluconazole, or voriconazole), were tested against both growth forms of H. capsulatum. Stronger synergistic interactions were seen in isoniazid or pyrazinamide plus triazoles for the mold form and ethambutol plus voriconazole for the yeast-like form. Further studies should evaluate these combinations in vivo.

In vitro effect of sulfamethoxazole-trimethoprim against Histoplasma capsulatum var. capsulatum.

This study evaluated the in vitro effect of sulfamethoxazole-trimethoprim against Histoplasma capsulatum var. capsulatum isolated from HIV-positive patients. The drugs were tested by microdilution testing in accordance with the CLSI guidelines. All of the strains were inhibited by sulfamethoxazole-trimethoprim, with MIC ranges of 0.039 (sulfamethoxazole)/0.0078 (trimethoprim) mg/ml to 0.625/0.125 mg/ml for mycelial forms and 0.0025/0.0005 to 0.02/0.004 mg/ml for yeast-like forms. However, in vivo studies are necessary to evaluate the significance of these results.

Twelve years of coccidioidomycosis in Ceará State, Northeast Brazil: epidemiologic and diagnostic aspects.

Coccidioidomycosis is an endemic infection in the Americas caused by the dimorphic fungi Coccidioides immitis and Coccidioides posadasii. Although the disease occurs in Brazil in sporadic form, little information about these cases is available. In this study, we summarize the most important clinical, epidemiologic, and diagnostic features of coccidioidomycosis in Ceará State (Northeast Brazil) during the past 12 years. In this period, 19 cases of coccidioidomycosis were diagnosed. All the patients were young males and came from semiarid areas of the state. The majority of cases were associated to armadillo hunting, and pulmonary disease was the most common clinical presentation. In our laboratory, coccidioidomycosis was confirmed by culture, serology, and polymerase chain reaction tests, which together were very suitable for the diagnosis of this disease. Based on our local experience, we believe many cases of this disease are misdiagnosed or not diagnosed in our region. Therefore, some strategies for improvement of diagnosis should be encouraged by local authorities.

Serologic detection of coccidioidomycosis antibodies in northeast Brazil.

Coccidioidomycosis is a systemic infection caused by Coccidioides spp. The disease is endemic in Brazil but its incidence is underreported as it is not a notifiable disease. This article presents the results of a serologic survey carried out with 229 volunteers in northeast Brazil by the immunodiffusion (ID) test with commercial Coccidioides spp. antigens. The commercial ID test detected 15 individuals without clinical diagnosis of the disease and two individuals in treatment for coccidioidomycosis. Regarding the epidemiological data, most of the positive individuals were male, between 18 and 65 years of age and were engaged in armadillo hunting. Three women who had never participated in armadillo hunts also displayed positive results for coccidioidal antibodies. Besides armadillo hunts, exposure to environmental dust in endemic areas may account for the serologic response detected in the study. The data from this study suggest the importance of performing epidemiological surveys for coccidioidomycosis in order to understand the prevalence of this disease in Brazil.

In vitro inhibitory effect of antituberculosis drugs on clinical and environmental strains of Coccidioides posadasii.

OBJECTIVES: The aim of the present study was to evaluate the in vitro effect of the first-line antimicrobial drugs for pulmonary tuberculosis against the fungal pathogen Coccidioides posadasii. METHODS: The in vitro activities of rifampicin, isoniazid, pyrazinamide and ethambutol against clinical and environmental strains of C. posadasii were determined in accordance with the CSLI M38-A macrodilution method. The antimicrobials were tested alone or in combinations of two or more drugs. RESULTS: With the exception of pyrazinamide, all of the tested drugs interfered with the in vitro growth of C. posadasii. The 2 day MIC ranges of the tested drugs were as follows: rifampicin 1,060-4,250 mg/L; isoniazid < or =250 mg/L; ethambutol < or =620 mg/L. Pronounced in vitro synergism was demonstrated for combined antituberculosis drugs. The combination of rifampicin plus pyrazinamide was the only one that did not inhibit fungal growth. CONCLUSIONS: The present study showed that the first-line antituberculosis drugs, alone or in combinations, interfered with the vegetative growth of C. posadasii strains in vitro. Further studies in a murine model will need to be conducted in order to evaluate the in vivo effect of antituberculosis drugs on Coccidioides spp.