Brazil hospitality

The authors thank L. M. Abreu, M. C. B. Andrade, T. Kopf, A. Matos Neto, M. de Montigny, H. Queiroz, M. Revzen, T. M. Rocha-Filho, E. S. Santos, J. C. da Silva and J. D. M. Vianna, without whom this work would be impossible. AES and JMCM thank the Department of Physics, University of Alberta for the hospitality during their stay where part of this work was realized. FCK and AES are in debt to D. Matrasulov and M. M. Musakhanov for the warm hospitality during the workshop. NATO, CNPq and FAPERJ (from Brazil) and NSERC (from Canada) are acknowledged for financial support. 

One study that has tackled this issue, however, was recently published by de Souza et al. [104], who set up an environmental risk assessment of the 21 intravenous antibiotics most used in an intensive care unit of a hospital in Curitiba (Brazil). They evaluated the RQ, based on PEC, both in the raw effluent and after a dedicated conventional biological treatment. They found that, in the raw effluent from the ward, the environmental risk was high for 15 compounds, medium for 4 and low for 2 similarly, the treated effluent was labelled as high risk in terms of 14 compounds, medium for 5 and low for 2. 

Our group performed the first clinical trial of transendocardial injection of ABMMCs to treat heart failure patients [26]. This study, performed in collaboration with physicians and scientists at the Hospital Pro-Cardiaco in Rio de Janeiro, Brazil, used EMM-guided transendocardial delivery of stem cells. The results of 2- and 4-month noninva-sive and invasive follow-up evaluations [26] and of 6- and 12-month follow-up evaluation [129] have already been published. 

Chronic cocaine use, which is associated with immunosuppression, may be carcinogenic. The possible association between chronic cocaine exposure and pancreatic adenocarcinoma has been investigated (240,241). A study of hospital records in Brazil for the years 1986-1998 showed that of 198 patients with pancreatic adenocarcinoma, 13 (6.5%) were younger than 40 years of these, five had a history of chronic cocaine inhalation and one had abused marijuana. 

Division of Nephrology, Sao Jose do Rio Preto Medical School, Sao Jose do Rio Preto, Sao Paulo, Brazil Northwest Renal Clinic, Transplant Services, Legacy Good Samaritan Hospital, Portland, Oregon, USA... 

Recent experience suggests that the use of a SRD, intentional or unintentional, is a plausible scenario. One potential SRD source is radioactive Cesium ( Cs), which has many industrial and medical uses. Industry uses Cs in highway construction in devices that measure the density of asphalt. In the Southeast United States, several of these devices have been missing or stolen, with their location unknown (1). The 1987 incident in Goiania, Brazil occurred after thieves stole a Cs therapy source, still contained in its shielding, from a hospital, and sold it for scrap metal. Other involved individuals then broke up the source and shared it. None of the people involved was aware that the device was harmful, and authorities did not detect the incident for 15 days. By that time (1) ... 

Division of Cell Biology, TVW Telethon Institute for Child Research, Subiaco, Australia Federal University of Sao Paulo, Brazil Department of Child Health, Southampton General Hospital, University of Southampton, Southampton, UK... 

Varella, I. S., Canti, I. C. T., Santos, B. R., Coppini, A. Z., Argondizzo, L. C., Tonin, C., and Wagner, M. B. (2009). Prevalence of acute toxoplasmosis infection among 41, 112 pregnant women and the mother-to-child transmission rate in a public hospital in South Brazil. Mem. Inst. Oswaldo Cruz 104, 383-388. 

It is not possible to market a product in Brazil with the storage recommendation on the label Store below 25°C with the exception of those products that must be stored under 25°C and which are for exclusive use in hospitals and medical clinics. For these products, stability studies conducted at conditions specified for Climatic Zone II (25°C/60% RH) will be accepted. However, the company must assure the recommended storage conditions during transportation and distribution (Item 2.14 of the resolution). 

This study was approved by the Ethics in Research Committee of the Research and Graduate Studies, Hospital de Qinicas de Porto Alegre, Porto Alegre, Brazil. 

Thyroid Laboratory Hospital das Clinicas 05403 Sao Paulo, Brazil... 

A nuclear accident, second only to Chernobyl, occurred in 1987 in Goiania, Brazil. An abandoned cancer teletherapy (radiation therapy) radiation source containing Gs-137 was stolen and broken open. Many people rubbed the luminous blue powder on their bodies. Extensive contamination and radiation exposure occurred. More than 250 persons were known to have been contaminated and irradiated. More than 60 people required hospitalization, and many died. Much of the city was contaminated, and in the ensuing years a significant increase in leukemia has been documented there. It is estimated that the actual number contaminated was in the tens of thousands and that thousands experienced serious health problems. 

Goiania, Brazil A medical source of 50.9 TBq of Cs was disposed of in September 1987 and was dismantled by a trader of scrap metal. Subsequently, 20 exposed people were hospitalized and 4 people died. For the decontamination, 42 houses were decontaminated and the total volume of 3,500 m waste was produced and the collective effective dose was estimated to be 60 man-Sv. 

The association between Rotarix and intussusception has been studied using case-series and case-control methods in 615 infants with intussusception who were identified through active surveillance at 69 hospitals (16 in Mexico and 53 in Brazil) and in 2050 age-matched infants from the same neighborhood as controls [22 ]. Immunization dates were verified by a review of vaccination cards or clinic records. There was an increased risk of intussusception at 1-7 days after the first dose among infants in Mexico with the use of both the case-series method (incidence ratio =5.3 95% Cl=3.0, 9.3) and the case-control method (OR=5.8 95% CI=2.6, 13). There was no significant risk after the first dose... 

De Castro-Costa CM, Oria RB, Do Vale OC, et al. Motor neuron diseases in the university hospital of Fortaleza (northeastern Brazil). A clinico-demographic analysis of 87 cases. Arq Neuropsiquiatr 2000 58 986-989. 

Mohs Surgeon, Hospital de Clinicas, Curitiba Dermatologist and Dermatological Surgeon, Hospital Nossa Senhora das Gragas, Curitiba, Brazil... 

T. P. Chagas, L. M. Seki, J. C. Cury, J. A. Oliveira, A. M. Davila, D. M. Silva and M. D. Asensi, Multiresistance, beta-lactamase-encoding genes and bacterial diversity in hospital wastewater in Rio de Janeiro, Brazil, J. Appl. Microbiol, 2011, 111, 572-581. 

---