Rosany Bochner

Epidemiologia dos acidentes ofídicos nos últimos 100 anos no Brasil: uma revisäo

We review 30 studies on snake bites in Brazil, published from 1901 to 2000, and conclude that epidemiological analyses conducted in the last 100 years are based on the same variables already identified by Vital Brazil in his pioneering report, i.e., characteristics of the individuals prone to snake bites, the bites themselves, and treatment. The original epidemiological profile was also maintained over the years and indicates that such accidents are more frequent among male farm workers in the 15-49-year age bracket, affecting mainly the lower limbs, and caused by snakes from genus Bothrops.

Acidentes por animais peçonhentos e sistemas nacionais de informação

Neste trabalho foram analisados, sob a otica da vigilância epidemiologica dos acidentes por animais peconhentos, quatro sistemas nacionais de informacao, o SINAN (Sistema de Informacoes de Agravos de Notificacao), o SINITOX (Sistema Nacional de Informacoes Toxico-Farmacologicas), o SIH-SUS (Sistema de Informacoes Hospitalares do Sistema Unico de Saude) e o SIM (Sistema de Informacoes sobre Mortalidade). Concluiu-se que esses sistemas possuem caracteristicas proprias, foram criados para atender demandas diferentes e apesar de produzirem um grande volume de dados, nao conseguem, ainda que analisados em conjunto, dar conta da dimensao real desses acidentes.

Impacto dos medicamentos nas intoxicações humanas no Brasil

This article analyzes the role of pharmaceuticals in human poisoning in Brazil from 1993 to 1996, based on data from the National Network of Poison Control Centers. Results are presented according to cause, age group, sex, and evolution. The paper discusses measures aimed at preventing this serious public health problem, which primarily impacts children under five years of age in accidents caused by inappropriate use of medicines. The authors also analyze the association between female gender and deaths caused by intentional intake of drugs.

Sistema Nacional de Informações Tóxico-Farmacológicas SINITOX e as intoxicações humanas por agrotóxicos no Brasil

This study analyzes the profiles of pesticide intoxication, here distinguished by agricultural pesticides, household pesticides, veterinary products, and rodenticides, according to data obtained from the National Poisoning Information System (SINITOX) database, from 1999 to 2003. The findings indicate different profiles for poisonings caused by these four products. While poisoning by agricultural pesticides and veterinary products is more frequent among adults and males, poisoning by household pesticides and rodenticides is more frequent among children and females. The lethality for each kind also varies greatly, from 0.44% for household pesticides to 2.80% for agricultural pesticides. The integrated analyses of poisonings by pesticides, without distinguishing the type of pesticide may be an error, distorting the findings, even hiding risk factors. It is therefore necessary to disseminate information on each kind of poisoning.

Perfil das intoxicações em adolescentes no Brasil no período de 1999 a 2001

This paper analyzes the profile of poisonings among adolescents as reported by the Brazilian National Poisoning Information System (SINITOX) database. This database covers cases and deaths secondary to human poisoning recorded by Poison Control Centers (1999-2001). With relation to cases, venomous animals (33.7%) and medicines (25.7%) are the main toxic agents in pre-adolescents (10-14 years). For adolescents (15-19 years), medicines ranked first (33.0%), followed by bites/stings from venomous animals (21.4%). There were 35 deaths among pre-adolescents, 54.3% resulting from accidental poisoning, 54.3% in males, and 31.4% caused by venomous animals. Ninety-eight deaths were reported among adolescents, 72.4% of which were suicides, 54.1% in females, and 38.8% resulting from pesticide poisoning.

Aspectos ambientais e sócio-econômicos relacionados à incidência de acidentes ofídicos no Estado do Rio de Janeiro de 1990 a 1996: uma análise exploratória

This article reports on an exploratory analysis of potential associations between snakebite incidence and environmental and socioeconomic variables in Rio de Janeiro from 1990 to 1996. Specific geographic locations in the State of Rio de Janeiro, the percentage of working children aged 10 to 14 years, illiteracy, low income, the proportion of households in agricultural areas, the proportion of crops such as beans, coffee, banana, and sugar cane, the proportion of the population working in farming activities, fallow arable land areas, natural and secondary forests, and total swine population appeared as risk factors for snakebites.

The international view of envenoming in Brazil: myths and realities

Being distant from Brazil’s great natural diversity, from its long tradition in the study of snakebites and from the fact that it is one of the few countries which has a national information system for monitoring incidents involving venomous animals, non-Brazilian researchers face risks when estimating the incidence of these accidents in the country. The present work offers a critical review of the main estimates undertaken since 1954. It is interesting to note contradictions between textual and graphic information within the same article, variations over time in the work of a same researcher and differences among distinct authors, and that all these issues remain unmentioned or undiscussed. Comparison among such estimates and the data available at the Brazilian Information System on Diseases of Compulsory Declaration (Sistema de Informação de Agravos de Notificação – SINAN) creates an opportunity to identify the degree of imprecision present in those articles, and draws attention to the need for the production of studies at both the regional and national levels, based on concrete data collected at national, state and municipal levels, which has been available on the internet since 2001.

Subnotificação de acidentes por animais peçonhentos registrados pelo SINAN no Estado do Rio de Janeiro no período de 2001 a 2005

Com o objetivo de verificar se o Sistema de Informacao de Agravos de Notificacao (SINAN) ja permite prescindir de sistemas de informacao paralelos voltados ao controle da distribuicao do soro, essencial ao atendimento das vitimas de acidentes por animais peconhentos, foram comparados os dados dos acidentes causados por serpentes, aranhas e escorpioes, disponibilizados pelo SINAN para o Estado do Rio de Janeiro, com os registrados pela Secretaria de Estado de Saude do Rio de Janeiro (SES-RJ), de 2001 a 2005. Constatou-se o aumento da capacidade do SINAN para registrar os acidentes e a existencia de discrepâncias de dados em municipios e regioes do Estado. Foi especialmente alta a subnotificacao de acidentes ofidicos pelo SINAN. Discute-se as implicacoes desse resultado para estudos e pesquisas, bem como para o planejamento e a gestao dos servicos e distribuicao dos soros, e conclui-se que ainda nao e possivel prescindir dos dados da SES-RJ.

Análise das internações hospitalares de crianças menores de um ano relacionadas a intoxicações e efeitos adversos de medicamentos no Brasil

Abstract The widespread use of drugs without medi-cal prescription, nearly always ignoring the adverse effects they can cause, is the main cause for human intoxications registered in Brazil. Children are the greatest victims of the practice of self-medication due to the lack of appropriate studies on safe use of medicines in this age group, errors linked to the inappropriate delivery of medicines, besides the fact that the natural curiosity due to their age leads to accidental inges-tion. The purpose of this study is to identify the main therapeutic classes responsible for drug intoxications or adverse events related to the hospitalization of children under one year old, registered by the Hospital Information System of the Unified Health System in the years 2003-2005. A total of 1.063 hospitalizations were analyzed, 151 of them involving children aged less than one month and 912 children aged 1-11 months. Sedative-hypnotics were responsible for 15.2% of hospitalizations related to drug intoxication and adverse effects in children under one month of age and for 21.2% of such events in children aged 1-11 months. Antibiotics responded for 12.6% and 18.9% of hospitalizations for the same age groups, respectively. Analgesics/antipyretics had a smaller participation, with 7.3% of hos-pitalizations in the group under 1 month and 6.7% in the group aged 1- 11 months. A great number of cases has been observed on zero day old children, leading us to consider possible intoxications through placenta or nursing. Therefore the study shows the im-portance of a good pre-natal care, as well as the extra attention required when drugs are prescribed to both mother and child.

Problemas associados ao uso de plantas medicinais comercializadas no Mercadão de Madureira, município do Rio de Janeiro, Brasil

The use of medicinal plants by the Brazilian population is a traditional practice and is often the main resource used in primary healthcare. The therapeutic use of these plants involves several steps in the supply chain: origin, harvest, drying, storage, form of preparation by the user and use. The aim of this documental study of exploratory nature was to survey the scientific literature about the problems associated with each of those steps and discuss the issues related to the lack of studies to prove the pharmacological efficacy and the absence of toxicological risks, as well as the autodiagnosis practice. The 20 plants most commercialized in a large market of Rio de Janeiro City in August 2007 were the basis for the documental survey of the present study. Of these, six had proven toxic properties depending on their preparation and use: arnica ( Solidago chilensis Meyen), aroeira ( Shinus terebinthifolius Raddi.), rue ( Ruta graveolens L.), “babosa” ( Aloe vera L.), comfrey ( Symphytum officinale L.) and pennyroyal ( Mentha pulegium Lam. & DC.). The National Agency