Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Actividad antimicobacteriana de algunas plantas de la flora colombiana.

The current incidence of tuberculosis worldwide and the presence of Mycobacterium tuberculosis multi-resistant strains to chemotherapy agents make it necessary the search for new compounds that can be used for the control of the illness. Myristicaceae, Magnoliaceae, Lauraceae and Piperaceae families present lignans, compounds that can be potential antimycobacterial agents. In this investigation extracts and fractions from Virola calophylla, V. flexuosa, Piper sp., P. hispidum and Dugandiodendron sp., present an in vitro antibacterial good activity against M. tuberculosis H37Rv. The isolation of lignans and one flavonoid is also reported.La incidencia actual de la tuberculosis a nivel mundial y la aparición de cepas de Mycobacterium tuberculosis multirresistentes a los agentes quimioterapeuticos hace necesaria la búsqueda de nuevas sustancias que puedan ser usadas para el control de la enfermedad. Las familias Myristicaceae, Magnoliaceae, Lauraceae y Piperaceae presentan lignanos, compuestos que pueden ser potenciales agentes antimicobacterianos. En esta investigación extractos y fracciones de Virola calophylla, V. flexuosa, Piper sp., P. hispidum, y Dugandiodendron sp. presentan un buena actividad antibacterial in vitro frente a M. tuberculosis H37Rv. También se reporta el aislamiento de compuestos del tipo lignano y de un flavonoide

Guía para el Diagnóstico, Manejo y Tratamiento de Enfermedad de Chagas en fase Aguda a nivel de los Establecimientos de Salud

xvi, 538 hal. : il. ; 21 cm

Memorias IX Congreso Geológico Venezolano (3)

Memorias IX Congreso Geológico Venezolano (3