Eduardo De Capitani

• Associate Professor
• Researcher at State University of Campinas (UNICAMP)

Phoneutrism (bites by wandering spiders of the genus Phoneutria) frequently results in local pain. We describe a retrospective cohort study of a case series of phoneutrism admitted to our Emergency Department (ED), in which we used the Numeric Pain Rating Scale (NPRS 0-10) to assess the intensity of local pain upon admission, and recorded the analg...

Unlabelled: The lack of safe levels of asbestos exposure and the long latency of asbestos-related disease (ARD) makes workers' health surveillance challenging, especially in lower-income countries. This paper aims to present the recently developed Brazilian system for monitoring workers and general population exposed to asbestos (Datamianto), and...

Background: Although loxoscelism (bites by brown spiders of the genus Loxosceles) frequently results in dermonecrosis, no previous clinical reports have provided detailed temporal photodocumentation of the evolution of dermonecrotic lesions in a case series. Methods: This was a retrospective cohort study involving a case series of loxoscelism. O...

Objective: To describe a case series of severe acute toxic exposures (SATE) in individuals <20 years old followed-up by a regional Poison Control Center (PCC). Methods: Descriptive cross-sectional study. All patients who were <20yo and classified as score 3 (severe) and 4 (fatal) following Poisoning Severity Score were included for analysis. Acc...

Objective: To report a near-fatal poisoning after intentional injection of ricin from a castor bean (Ricinus communis) extract. Case report: A 21 year-old man self-injected ∼3 mL of a castor bean extract intramuscularly and subcutaneously in the left antecubital fossa. Upon admission to our ED (1 h post-exposure; day 1, D1) he was awake and alert,...

RESUMO Apresentamos um estudo interdisciplinar onde condições ambientais, sociais e de saúde são integradas para avaliar o risco de exposição ao arsênio na população de Paracatu, devido à exploração da maior mina de ouro a céu aberto do Brasil. O estudo possui três fases: avaliação da contaminação ambiental;

Apresentamos um estudo interdisciplinar onde condições ambientais, sociais e de saúde são integradas para avaliar o risco de exposição ao arsênio na população de Paracatu, devido à exploração da maior mina de ouro a céu aberto do Brasil. O estudo possui três fases: avaliação da contaminação ambiental; estudo epidemiológico de exposição ambiental hu...

Objective: To report two patients who developed systemic neurotoxicity after consecutive bites by the same coral snake. Case report: Two previously healthy men (32-year-old and 34-year-old) found a coral snake in a woodpile while collecting wood for a barbecue. During the barbecue, both men became drunk and “played” with the snake, believing that t...

Objective To evaluate the frequency and severity of pleuropulmonary alterations in anthophyllite‐exposed former workers in Itapira, São Paulo, Brazil. The amphibole anthophyllite, a magnesium‐iron silicate, had its mining, marketing, and use forbidden in Brazil in 1995. Methods Former workers were followed from 1999 to 2011. All completed chest X‐...

Estudo realizado na Disciplina de Pneumologia e Laboratório de Microbiologia do HC Unicamp. Foram analisados todos os casos de micobacterioses não-tuberculosas detectados durante os anos de 2012 a 2017, identificados por meio dos resultados de cultura positivos e de revisão de prontuário destes pacientes.

Purpose: The abuse of cocaine and its derivatives presents a likely risk factor for injury. Trauma incurred by cocaine and derivative abusers may be more severe than that incurred by non-users. Objectives: To ascertain the presence of cocaine and its derivatives in trauma patients and to correlate RTS (Revised Trauma Score) and ISS (Injury Sever...

Context: Erucism, envenomation caused by dermal contact with larval forms of moths, may result in intense local pain, mainly after contact with puss caterpillars (family Megalopygidae). Objective: To evaluate the response to different treatments for controlling severe pain in a case series of erucism in Campinas, southeastern Brazil. Patients and m...

Context: Thrombotic microangiopathy (TMA) is an uncommon and severe complication of snakebites, and is similar, in general, to hemolytic-uremic syndrome (HUS). We describe a case of TMA following envenomation by Bothrops jararaca. Case details: A 56-y-old-woman with controlled hypertension was transferred from a primary hospital to our ER ∼7 h a...

Context: Acetonitrile (ACN) is a solvent rapidly absorbed through lungs and intestinal tract, and is slowly metabolized to cyanide (CN) by enzymatic processes mediated by CYP2E1. Objective: To describe the clinical and laboratory evolution, ACN elimination half-life, and its presence in breast milk in a nursing mother who attempted suicide. Cas...

Context and objective:: The lack of availability of antidotes in emergency services is a worldwide concern. The aim of the present study was to evaluate the availability of antidotes used for treating poisoning in Campinas (SP). Design and setting:: This was a cross-sectional study of emergency services in Campinas, conducted in 2010-2012. Meth...

Objectives: To analyze and to compare clinical repercussions of accidents involving legally and illegally commercialized household sanitizers in children under 7 years of age. Methods: A descriptive cross-sectional design was used to collect data from electronic database of a regional Poison Control Center during one year. Data were analyzed by me...

Background: Computed tomography (CT) allows phenotyping of COPD patients, but its relationship with functional features are unclear. Volumetric capnography (VC) uses the principle of gas washout and analyzes the pattern of CO2 elimination as a function of expired volume. Aim: Discover if VC allows the identification of subsets of patients with dist...

Context: Stroke following scorpion stings is rare. We report a fatal envenomation involving multiple, extensive brain infarcts in a patient with a previous diagnosis of essential thrombocythemia (ET) who was stung by Tityus serrulatus (T. serrulatus). Case details: A 44-year-old woman with a diagnosis of low-risk ET (platelets <1,000,000/mm(3),...

Background Computed tomography (CT) phenotypic characterization helps in understanding the clinical diversity of chronic obstructive pulmonary disease (COPD) patients, but its clinical relevance and its relationship with functional features are not clarified. Volumetric capnography (VC) uses the principle of gas washout and analyzes the pattern of...

Context: In the Americas, the main representatives of the family Elapidae are coral snakes of the genus Micrurus, of which 33 species are in Brazil. They are the smallest cause of venomous snakebite in Brazil. We analyzed literature reports of coral snake bites in Brazil from 1867 to 2014, and provide a brief review of case series and reports of c...

Background Obstructive lung diseases of different etiologies present with progressive peripheral airway involvement. The peripheral airways, known as the silent lung zone, are not adequately evaluated with conventional function tests. The principle of gas washout has been used to detect pulmonary ventilation inhomogeneity and to estimate the locati...

Unexpected deaths of three patients happened at a magnetic resonance imaging (MRI) clinic during cranial examinations with gadolinium-based contrast media. A toxicological screening using liquid chromatography-tandem mass spectrometry (LC-MS-MS) and gas chromatography-mass spectrometry (GC-MS) for blood and urine samples collected during autopsy of...

Context: In order to report the outcome of a patient who developed compartment syndrome after South American rattlesnake (Crotalus durissus terrificus) envenomation, confirmed by subfascial pressure measurement and magnetic resonance imaging (MRI). Case details: A 63-year-old male was admitted 1 h after being bitten on the right elbow by a "larg...

Objective: Severe hepatotoxicity caused by paracetamol is rare in neonates. We report a case of paracetamol-induced acute liver failure in a term neonate. Case description: A 26-day-old boy was admitted with intestinal bleeding, shock signs, slight liver enlargement, coagulopathy, metabolic acidosis (pH=7.21; bicarbonate: 7.1 mEq/L), hypoglycemi...

Antidotes and certain other drugs are essential for treating some types of poisoning. Failures in their supply can jeopardize the population's health and safety. The current study aimed to assess the availability of antidotes and other drugs used in the treatment of poisonings in Brazil. International guidelines were used as the basis for selecting...

Context: Rattlesnake bites in Brazil are generally caused by adult individuals, with most of the envenomed patients showing systemic manifestations that include varying degrees of neurotoxicity (acute myasthenia), rhabdomyolysis and coagulopathy, with only mild or no local manifestations. We report a case of envenoming by a juvenile South American...

Background: This study was designed to assess the effect of asbestos exposure on longitudinal lung function decline. Methods: A group of 502 former asbestos-cement workers with at least two spirometry tests 4 years apart. Repeated evaluations included respiratory symptoms questionnaire, spirometry and chest imaging. Asbestos exposure was ascerta...

Blister formation and eccrine sweat gland necrosis is a cutaneous manifestation associated with states of impaired consciousness, most frequently reported after overdoses of central nervous system depressants, particularly phenobarbital. The case of a 45-year-old woman who developed "coma blisters" at six distinct anatomic sites after confirmed (la...

Interstitial lung diseases (ILDs) are heterogeneous disorders, involving a large number of conditions, the approach to which continues to pose an enormous challenge for pulmonologists. The 2012 Brazilian Thoracic Association ILD Guidelines were established in order to provide Brazilian pulmonologists with an instrument that can facilitate the manag...

To describe a prospective case series of poisonings caused by ingestion of illegal rodenticides containing acetylcholinesterase inhibitors, mainly "chumbinho," followed-up by the Campinas PCC for a period of 1 year. Seventy-six cases were included, of which 53.9% were males. Age ranged from 2 to 74 years (median = 36 years). The main circumstances...

The most important millipede species causing accidents in Brazil is Rhinocricus padbergi (order Spirobolida, family Rhinocricidae), a vegetarian scavenger distributed from Central to South America. Eleven clinical cases of dermal and oral accidental exposures to secretions from Rhinocricus spp. milipedes are described. Eleven cases of skin and oral...

Lung cancer is a multifactorial disease. Hereditary, genetic, and environmental factors interact in its genesis. The principal risk factor for lung cancer is smoking. However, the workplace provides an environment in which there is a risk of exposure to carcinogens. The International Agency for Research on Cancer currently lists 19 substances/work...

A previously healthy 35-year-old female was bitten on the anterior right thigh by a brown spider while dressing her trousers; the spider was stored and later identified as an adult female Loxosceles anomala. Clinical evolution involved a relatively painless bite with mild itching, followed by local, indurated swelling and a transient, generalized e...

“Earth and Health” or medical geology has been promoted worldwide as one of the fundamental themes of the International Year of Planet Earth (2007–2009). This was in response to relevant achievements noted in this new field of applied science from the time of the IGCP 454 project which led to foundation of the International Medical Geology Associat...

Environmental contamination by arsenic compounds in the Ribeira River Valley, São Paulo, Brazil has already been observed. Lead mining and refining activities had been carried on since late colonial times and finished recently, at the end of 1995. The source of As in the region is known to be mainly from arsenopirite geological presence in the lead...

To report the outcome of a patient who developed compartment syndrome after Bothrops jararaca snakebite. A 39-year-old male was admitted 5 h after being bitten on the lower right leg. Physical examination revealed tense swelling, ecchymosis, hypoesthesia, and intense local pain that worsened after passive stretching, limited right foot dorsiflexion...

Hydrofluoric acid (HF) is widely used in industry and at home. Severe lesions can occur after contact with highly concentrated solutions, leading to tissue necrosis and bone destruction. Specific treatment is based on neutralization of fluoride ions with calcium or magnesium solutions. A 41-year-old male was seen at the emergency department 35 minu...

Objective: To study racial incidence in chronic adult lung paracoccidioidomycosis (PCM). Methods: 54 patients with PCM were classified according to the colour of the skin as white or non-white, and percentages were compared with information from the official census of 2000 (São Paulo), and with data from our hospital out-patients average racial dis...

Como resultado do crescimento da contaminacao ambiental, houve um aumento do interesse relacionado ao acumulo de metais pesados no corpo humano e seus efeitos danosos. Alguns desses metais, tal como o como chumbo, sao elementos nao essenciais e exercem efeitos toxicos no sistema biologico. Apesar das medidas de controle estabelecidas por lei, intox...

O diagnostico clinico da intoxicacao por chumbo deve levar em conta os orgaos-alvo que determinam os sinais e sintomas mais caracteristicos da intoxicacao: cerebro, sistema hematopoietico, rins, e sistema nervoso periferico. O orgao alvo critico e o cerebro, promovendo sinais e sintomas de encefalopatia mais ou menos acentuada, tais como, cefaleia,...

Apesar de rara, a pneumoconiose reumatoide, também chamada de síndrome de Caplan, pode ser diagnosticada entre trabalhadores expostos à sílica e entre pacientes com silicose, pneumoconiose dos mineiros de carvão e asbestose. A maior prevalência ocorre entre os silicóticos, apesar de ter sido descrita inicialmente em mineiros de carvão com pneumocon...

Although rare, rheumatoid pneumoconiosis, also known as Caplan's syndrome, can occur in workers exposed to silica, as well as in patients with silicosis, coal workers' pneumoconiosis or asbestosis. Prevalence is higher among patients with silicosis, despite the fact that it was originally described in coal workers with pneumoconiosis. The classical...

To report a case of serotonin syndrome (SS) after sibutramine overdose in a child. A 4-year-old girl was admitted 25 h after accidentally ingesting approximately 27 pills of sibutramine (15 mg, approximately 23 mg/kg). The child developed clinical features suggestive of SS, including diaphoresis, tachycardia, hypertension, agitation, insomnia, inco...

To estimate and compare the frequency of CYP1A1*2A gene polymorphisms in a Brazilian population and determine the possible contribution of these genetic variations to lung cancer risk. The study population included 200 patients with lung cancer, and the control group consisted of 264 blood donors. Genomic DNA was obtained from peripheral blood samp...

Lead does not participate in any metabolic process in humans. Nevertheless, it is the most important non ferrous metal in industry since ancient times. This fact promoted a huge and extensive environmental contamination, allowing for an excessive input of lead by humans through ingestion and inhalation. In this review it is discussed aspects of kin...

Diagnosis of lead intoxication must be based basically on signs and symptoms produced by the main affected target organs: brain, hemopoietic system, kidneys, and periphery nervous system. The critical organ is the brain, promoting signs and symptoms of encephalopathy more or less pronounced according to the dose and duration of exposure. Such a sym...

As result of increased environmental contamination, the interest on the accumulation of heavy metals in the human body and its harmful effects has increased. Some metals, such as lead, are non-essential elements and exert toxic effects on biological system. Despite the control measures established by law, acute and chronic intoxication by lead stil...

Most patients with methanol poisoning typically show up one to several days after ingestion, presenting severe acidosis, visual disorders, or both. Reports of hospitalization less than 6 h after exposure are unusual. We describe a case of attempted suicide using methanol admitted 3 h after ingestion. A 52-year-old male was hospitalized 3 h after in...

Apresenta-se caso clínico de dermatite de contato e reação a distância por contato com mercúrio elementar.Paciente apresentou eritema, edema e vesículas após contato dérmico com mercúrio. Lesões evoluíram para placas eritematosas com pequenas áreas enegrecidas sugerindo necrose e vesículas secas. Ocorreram lesões eritematosas a distância no tórax,...

A clinical case of contact dermatitis following direct skin contact with elemental mercury is presented. Patient had metal mercury in contact with extensive part of his leg and foot skin resulting in erythematous, edematous, and vesicular dermatitis. Lesions evolved to erythematous plaques with small scattered areas of necrosis and drying vesicle l...

Context: Lead poisoning due to retained gunshot bullets is a well-known clinical problem that is fairly frequently described in the literature. The risk factors for this occurrence relate mainly to whether the lead bullet is in contact with the joint fluid or cerebrospinal fluid (CSF). The treatment for these cases entails chelation therapy while...

As result of increased environmental contamination, the interest on the accumulation of heavy metals in the human body and its harmful effects has increased. Some metals, such as lead, are non-essential elements and exert toxic effects on biological system. Despite the control measures established by law, acute and chronic intoxication by lead stil...

Mycobacteriosis is frequently diagnosed among HIV-infected patients. In Mozambique, where few patients are under antiretroviral therapy and the prevalence of tuberculosis is high, there is need for better characterization of mycobacteria at the species level, as well as for the identification of patterns of resistance to antituberculous drugs. We s...

To assess possible alterations in the tidal volume and peak inspiratory pressure delivered by seven models of manually operated self-inflating resuscitation bags as a function of the oxygen supply rate used. The resuscitation bags tested were the following: Oxigel, models A and B; CE Reanimadores; ProtecSolutions; Missouri; Axmed; and Narcosul. For...

OBJECTIVE: To assess possible alterations in the tidal volume and peak inspiratory pressure delivered by seven models of manually operated self-inflating resuscitation bags as a function of the oxygen supply rate used. METHODS: The resuscitation bags tested were the following: Oxigel, models A and B; CE Reanimadores; ProtecSolutions; Missouri; Axme...

OBJETIVO: O objetivo deste trabalho foi investigar a alteração da pressão intra-cuff (Pcuff) do tubo endotraqueal em pacientes sob ventilação mecânica, após alteração de sua posição corporal. MÉTODOS: Todos os pacientes selecionados eram inicialmente colocados em posição de semi-Fowler (35º), Pcuff em 20 mmHg, e divididos aleatoriamente em dois gru...

The purpose of this study was to investigate endotracheal tube cuff pressure (Pcuff) alteration in patients under mechanical ventilation after changes in position. All selected patients were initially placed in the 35 degrees semi-Fowler position, with Pcuff adjusted to 20 mmHg, and randomly divided into two groups. Group A, in which patients were...

Glutathione S-transferases (GST) modulates the effects of various cytotoxic and genotoxic agents, particularly those derived from benzo[a]pyrene, which is one of the main tobacco carcinogens. Both the mu 1 (GSTM1) and theta 1 (GSTT1) genes have a null variant allele in which the entire gene is absent. The GSTP1*B allele has an A to G transition at...

To evaluate the frequency of the real association between paracoccidioidomycosis (PCM) and tuberculosis (TB) as well as the rate of previous TB misdiagnosis in individuals with PCM among the patients treated in the Pulmonology Division of the State University of Campinas Hospital das Clínicas, Campinas, Brazil. A retrospective study of 227 adult pa...

OBJETIVO: Avaliar a freqüência da real associação entre paracoccidioidomicose (PCM) e tuberculose (TB) e a freqüência do diagnóstico errôneo prévio de TB em doentes com PCM entre os pacientes atendidos na Disciplina de Pneumologia do Hospital das Clínicas da Universidade Estadual de Campinas, Campinas (SP). MÉTODOS: Estudo retrospectivo de 227 paci...

A battery recycling plant located in an urbanized area contaminated the environment with lead oxides. The Secretary of Environment of the State of São Paulo demanded an evaluation of lead exposure among the population in the vicinity of the plant. To assess the lead exposure of children, to propose control measures and evaluate the impact of these...

Background Data on prevalence of lung diseases due to inhalation of carbonaceous materials other than mineral coal is very limited.Methods We present three cases of wood charcoal pneumoconiosis, two due to activated carbon, and one from wood charcoal artisan handling. To our knowledge, no clinical cases of wood charcoal pneumoconiosis, from artisan...