Physical rehabilitation in the context of a landslide that occurred in Brazil

Backgrounds

The efforts to develop research and training on physical rehabilitation in regards to disasters is considered recent worldwide. In the late evening of the 11th up until the 12th of January of 2011, the most massive natural disaster occurred in Brazil with extremely heavy downpour, abrupt flood, as well as landslides on multiple areas of the Mountain Region of Rio de Janeiro. The objective of this research was to investigate the challenges in terms of physical rehabilitation provided by this event

Methods

The cross-sectional mixed method’s study, which was conducted in the city of Nova Friburgo, used two different data sources: hospital records on traumatic injuries pre and post disaster, and interviews with key informants - victims who suffered injuries related to the disaster, professionals from rehabilitation services in the municipality, and also the city’s health service management. Pearson’s chi-squared test was performed to evaluate statistical significance between the week of a given incident and the type of injury. Interviews were transcribed and analysed through content analysis.

Results

A total of 2326 hospital records and 27 interviews were analysed. The proportion of traumatic injury in the municipal emergency service increased from 16% in the prior week, to 40% in the week post-disaster (p <  0.0001). Different injuries were identified: multiple fractures, crushing, amputation, perforation of soft tissues, inhalation of dust and establishment of chronic conditions through stress. Despite this scenario, out of the 16 health professionals interviewed, twelve did not observe an increase in the demand for outpatient rehabilitation services after the disaster. Interviews with the victims revealed that the pathways for care ran into different barriers. From 11 victims interviewed, only one received complete physiotherapy care through the public health services in the city, while all others hired additional assistance, received volunteer services, had assistance in other cities or remained without rehabilitation.

Conclusions

The needs for rehabilitation increased after the disaster; however, the demand was repressed due to different barriers such as competing needs and possible lack of medical referral. Recommendations were made, including the action of performing a search of victims with rehabilitation needs.

[Work-related accidents on oil drilling platforms in the Campos Basin, Rio de Janeiro, Brazil]

The offshore oil industry is characterized by complex systems in relation to technology and organization of work. Working conditions are hazardous, resulting in accidents and even occasional full-scale catastrophes. This article is the result of a study on work-related accidents in the offshore platforms in the Campos Basin, Rio de Janeiro State. The primary objective was to provide technical back-up for both workers' representative organizations and public authorities. As a methodology, we attempt to go beyond the immediate causes of accidents and emphasize underlying causes related to organizational and managerial aspects. The sources were used in such a way as to permit classification in relation to the type of incident, technological system, operation, and immediate and underlying causes. The results show the aggravation of safety conditions and the immediate need for public authorities and the offshore oil industry in Brazil to change the methods used to investigate accidents in order to identify the main causes in the organizational and managerial structure of companies.

Effects of ammonia and lactate on growth, metabolism, and productivity of BHK cells

The aim of the present work was to study the effect of ammonia and lactate on growth, metabolism, and productivity of BHK cells producing a recombinant fusion protein. Results show that cell growth was reduced with the increase in ammonia or lactate: k(1/2) of 1.1 mM and 3.5 mM for stirred and stationary cultures, respectively, for ammonia and of 28 mM for both stationary and stirred cultures for lactate, were obtained. The cell-specific consumption rates of both glucose (q(Glc)) and glutamine (q(Gln)) increased, whereas that of oxygen (q(O2)) decreased, with the increase in ammonia or lactate concentrations. The cell-specific production rates of lactate (q(Lac)) increased with an increase in ammonia concentration; similarly for the cell-specific production rates of ammonia (q(Amm)), which also increased with an increase in lactate concentration; on the other hand, both q(Lac) and q(Amm) markedly decreased when lactate or ammonia concentrations were increased, respectively; lactate was consumed at lactate concentrations above 30 mM and ammonia was consumed at ammonia concentrations above 5 mM. In vivo (31)P NMR experiments showed that ammonia and lactate affect the intracellular pH, leading to intracellular acidification, and decrease the content in phosphomonoesters, whereas the cell energy state was maintained. The effect of lactate on cell growth and q(Gln) is partially due to osmolarity, on q(Glc) and q(Amm) is entirely due to osmolarity, but on q(Lac) is mainly due to lactate effect per se. An increase in ammonia from 0 to 20 mM induced a 50% reduction in specific productivity, whereas an increase in lactate from 0 to 60 mM induced a 40% decrease.

Metabolic responses to different glucose and glutamine levels in baby hamster kidney cell culture

In this work, a BHK21 clone producing a recombinant antibody/cytokine fusion protein was used to study the dependence of cell metabolism on the glucose and glutamine levels in the culture medium. Results obtained indicate that both glucose and glutamine consumptions show a Michaelis-Menten dependence on glucose and glutamine concentrations respectively. A similar dependence is also observed for lactate and ammonia productions. The estimated value of the Michaelis constant for the dependence of lactate production on glucose (KLacGlc) was 1.4 +/- 0.1 mM and for the dependence of ammonia production on glutamine (KAmmGln) was 0.25 +/- 0.11 mM and 0.10 +/- 0.03 mM, at glucose concentrations of 0.28 mM and 5.6 mM respectively. At very low glucose concentrations, the glucose to lactate yield decreased markedly, showing a metabolic shift towards lower lactate production. This metabolic shift was also confirmed by the significant increase in the specific oxygen consumption rate also observed at low glucose concentrations. Although it was highly dependent on glucose concentration, the oxygen consumption also increased with the increase in glutamine concentration. At very low glutamine concentrations, the glutamine to ammonia yield increased, showing a more efficient glutamine metabolism.