Risk factors for Helicobacter pylori infection in children: is education a main determinant?

To investigate potential risk factors associated with Helicobacter pylori (Hp) infection, we performed a case-control study in 167 consecutively selected hospitalized children in Salvador, Brazil. Hp infection was identified by the presence of IgG against Hp in serum samples. Data were gathered using a structured questionnaire, 38.3% children were found to be seropositive and classified as cases, and 61.7% were seronegative controls. After multivariate analysis, independent variables associated with Hp infection included: the educational attainment of the child's provider > or = 11 years (OR 0.1, 95% CI 0.01-0.9), poor garbage disposal service (OR 2.2, 95% CI 1.0-4.9), thumb sucking (OR 4.6, 95% CI 1.1-19.8), brushing teeth more than once a day (OR 5.6, 95% CI 1.8-17.7), having a pet dog (OR 2.5, 95% CI 1.0-6.1), and a history of chronic urticaria (OR 4.0, 95% CI 1.5-10.8). The risk factors identified are consistent with some, but not all, previous studies supporting either oral-oral or faecal-oral transmission of Hp. Our data suggested that a higher educational attainment might play an important role in preventing Hp infection.

Aplicação da zeólita natural escolecita na remoção de metais pesados de efluentes industriais: competição entre os cátions e processo de dessorção

Efluentes aquosos industriais são a principal causa de contaminação das águas com metais pesados. Diante de uma legislação cada vez mais rígida para o descarte desses metais, o desenvolvimento de procedimentos eficientes e de baixo custo para o tratamento de efluentes contendo metais pesados torna-se de grande interesse. Um estudo sobre a capacidade de retenção de metais pesados pela zeólita natural escolecita foi realizado, de modo a se avaliar a viabilidade desta aplicação. Os cátions utilizados foram Mn(II), Cd(II), Ni(II) e Cr(III). Nesta etapa do trabalho, foi avaliado o comportamento da zeólita na adsorção seletiva de cátions presentes nos pares Cd/Mn, Cr/Ni, Cr/Cd e Ni/Mn, bem como a possibilidade de dessorção dos cátions metálicos adsorvidos em sua estrutura. A escolecita apresentou uma seletividade que pode ser relacionada, na maioria dos casos, à valência e ao raio iônico das espécies hidratadas. Os cátions Cr(III) e Ni(II) foram fortemente adsorvidos, não podendo ser substancialmente removidos por troca com cátions sódio ou cálcio. Dos cátions testados, apenas o Cd(II) apresentou comportamento de adsorção e de dessorção atípicos, demonstrando uma elevada labilidade no processo de troca iônica.

Are International Asthma Guidelines effective for low-income Brazilian children with asthma?

The present study was designed to evaluate the effectiveness of International Asthma Guidelines in low-income asthmatic children in the city of São Paulo, Brazil. Fifty children with moderate or severe asthma were evaluated. Patients were evaluated before and after a 1 yr follow-up period using a pre- and post-education design with patients acting as their own controls. Parents were interviewed before and 1 yr after the programme. Most of the children were receiving inadequate medical care from their primary physicians, based mainly on bronchodilators. After the educational programme combined with a medical treatment based mainly on inhaled steroids, there was a decrease in emergency room visits and no need for hospital admissions. There was also a significant decrease in asthma severity and impairment scores (p<.0001). The combination of good medical care and an educational programme can reduce the symptoms of asthma and significantly increase the quality of life, as well as decreasing the costs of asthma treatment. We conclude that by applying the International Asthma Guidelines substantial success was achieved, resulting in moving the patients from crises-orientated management into a chronic care and preventive management mode.

[Risk factors related with occupational and environmental exposure to organochlorine insecticides in the state of Bahia, Brazil, 1985]

In the cacao-growing region in the southern part of the state of Bahia, the organochlorine insecticides, mainly gamma-benzene hexachloride (BHC) and dichlorodiphenyltrichloroethane (DDT), have been used for about 40 years on cacao crops and in public health programs for control of the insect vectors of different diseases, especially malaria. This paper presents the results of tests performed on 127 persons, all males, between the ages of 15 and 52 years, divided into eight groups as follows: three groups consisted of persons occupationally exposed to 1.5% BHC, that is, technical hexachlorocyclohexane (HCH); two groups consisted of individuals who had had occasional contact with the products or worked in areas near those in which they were used; two groups were appliers of DDT, and the last group--the control group--consisted of 50 individuals who had had no history of occupational exposure to insecticides. All the participants underwent testing to determine the parameters of biochemistry, hematology, and organochlorine insecticide residues in the blood. It was found that improper handling of the products and failure to use individual protective equipment, together with longer time of exposure, significantly increased the rates of GOT and GPT in the appliers of DDT and technical HCH, and in the latter the rates of alkaline phosphatase, albumin, and cholesterol were also found to be higher. In view of the high morbidity among pesticide appliers in agriculture and public health campaigns, it is important to institute programs to teach these workers to avoid contamination of their persons and of the environment by developing good hygiene habits, using individual protective equipment, and correctly handling the products. Rural workers and public health authorities must become aware of the importance of protective equipment, periodic health examinations, and reduced environmental pollution in order to lessen occupational risks of field workers and promote improved conditions of life for the rural population at large.

[Acute poisoning by aldrin: relationship between serum levels and toxic effects in humans]

In the attempt to correlate clinical findings with serum levels of aldrin, sixteen patients were followed-up after acute intoxication by this agent. Eight of them, males and females, aged from 1 to 37 years, presented no or light symptoms (some discomfort and nausea). The serum of one of these patients was found to contain 16.6 ppb of aldrin and that of another, 1.41 ppb of dieldrin. A group of five patients, aged from two to 30 years, showed symptoms of moderate severity, reporting nausea, vomiting, drowsiness, dyspnea, sweating, mild jerking, rise in blood pressure and convulsions. Of these cases, two were accidental and three were attempted suicides, the majority achieving complete recovery within 24 hours. Serum levels of aldrin were between 6.98 ppb and 26.3 ppb and of dieldrin between 82.00 and 314.18 ppb. We found three severe cases, aged from 21 to 35 years, two attempted suicides and one occupational case. Two of these patients died and one of them presented hypothermia, coma, absence of reflexes and generalized convulsions, and another presented abdominal pain, paleness, sweating, cold extremities, dyspnea, hyperthermia and generalized convulsions. In the first one that died the serum levels were: of aldrin 30.00 ppb and of dieldrin 720 ppb. In the other levels of 747.3 ppb of aldrin and 1,314.00 ppb of dieldrin were found. The third had less serious symptoms and presented serum levels of aldrin of 31.05 ppb and of dieldrin 147.11 ppb.(ABSTRACT TRUNCATED AT 250 WORDS)