Until the 1990's the 1,1,1-trichloro-bis-2,2′-(4chlorophenyl) ethane (DDT) was sprayed in the walls of the house in the along the Madeira River basin, Brazilian Amazon, a region well known by its large number of malaria cases. In the 1910, the relate of Oswaldo Cruz about health conditions in Madeira River region describes the presence of malaria in rates ranging until 100% of infected people in some localities. Data available in the literature points to the DDT contamination in fishes captured in Madeira River region. Fish is the major source of dietary protein to this people. DDT tends to accumulate in lipid rich tissues being eliminated by different events, including lactation. Considering the importance of the breast milk to the children feeding, the associated risks of DDT exposure via breast milk intake to children must be assessed. This is the main objective of this work: to analyse the presence of the p,p′-DDT and its metabolites p,p′-DDE and p,p′-DDD in 69 human milk samples and to estimate the intake of DDT and its metabolite in terms of total DDT (total DDT = p,p′-DDE + p,p′-DDD+ p,p′-DDT). All sample showed contamination with DDT and its metabolites ranging from 25.4 to 9361.9 ng of total DDT / g of lipid (median=369.6 ng of total DDT / g of lipid) and 8.7 % of the Estimated Daily Intake (EDI), in terms of total DDT, was higher than the Acceptable Daily Intake proposed by the WHO.
In the Amazon Basin, naturally occurring methylmercury bioaccumulates in fish, which is a key source of protein consumed by riverine populations. The hydroelectric power-plant project at Santo Antônio Falls allows us to compare the Hg exposure of riverine populations sparsely distributed on both sides of the Madeira river before the area is to be flooded. From 2009 to 2011, we concluded a population survey of the area (N = 2,008; representing circa 80% of community residents) that estimated fish consumption and mercury exposure of riverine populations with different degrees of lifestyle related to fish consumption. Fish samples from the Madeira river (N = 1,615) and 110 species were analyzed for Hg. Hair-Hg was significantly lower (p < 0.001) in less isolated communities near to the capital of Porto Velho (median 2.32 ppm) than in subsistence communities in the Cuniã Lake, 180 km from Porto Velho city (median 6.3 ppm). Fish Hg concentrations ranged from 0.01 to 6.06 µg/g, depending on fish size and feeding behavior. Currently available fish in the Madeira river show a wide variability in Hg concentrations. Despite cultural similarities, riparians showed hair-Hg distribution patterns that reflect changes in fish-eating habits driven by subsistence characteristics.
Over the last 20 years several projects carried on the Madeira River basin in the Amazon produced a great amount data on total Hg concentration in different fish species. In this paper we discuss temporal trends in Hg contamination and its relation to body weight in some of those fishes, showing that even within similar groups, such as carnivorous and non-migratory fish, the interspecies variability in Hg accumulation is considerable.
ObjectiveTo assess the correlation between different pain symptoms and different domains of women's health-related quality of life (HRQoL).MethodsSeventy-seven women with deep infiltrating endometriosis were successively enrolled between June 2011 and August 2013 while being prepared to undergo laparoscopy due to pain and/or infertility. We quantified the intensities of dysmenorrhea, deep dyspareunia, chronic pelvic pain, and dyschezia (menstrual and non-menstrual) using a 11-point visual analog scale (VAS: 0–10) and the validated full versions of the Short Form 36 (SF36) and Endometriosis Health Profile (EHP30) questionnaires to assess HRQoL. The pain symptoms were considered simultaneously in a hierarchical agglomerative clustering method (exploratory multivariate approach) and the associations among scores were tested by bivariate correlation.ResultsDysmenorrhea showed the lowest similarity on to the multivariate cluster analysis and no statistically significant correlation with the other pain symptoms: deep dyspareunia (P=0.244), chronic pelvic pain (P=0.108), menstrual dyschezia (P=0.238), and non-menstrual dyschezia (P=0.380). Dysmenorrhea and chronic pelvic pain were the main symptoms correlated with all domains of the SF36 and the EHP30 (core instrument) questionnaires (P<0.05).ConclusionDysmenorrhea and chronic pelvic pain were independent factors associated with HRQoL.
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