La radiación sale a la comunidad : Prevención de los efectos sobre los seres humanos de la radiación

En gran cantidad de centros de Atención Primaria, consultorios de atención médica y Odontológica y salas sanitarias, se trabaja con equipos radiográficos, que utilizan radiaciones ionizantes. La radioprotección es un tema poco abordado en proyectos de extensión universitaria y salud pública, todos los pacientes conocen lo que es una radiografía pero la mayoría desconoce que se utilizan radiaciones ionizantes las cuales son acumulativas durante toda la vida del ser humano y que las cuales pueden causar posibles efectos perjudiciales sino se utilizan las medidas de radioprotección. La radiación ionizante es un tipo de energía liberada por los átomos en forma de ondas electromagnéticas (rayos X) o partículas. Debido a la desinformación y por demanda de un sector de la comunidad, vimos la importancia de ejecutar desde la FOLP (Facultad de Odontología de La Plata) este proyecto en dos lugares puntuales de Lisandro Olmos y Berisso. Allí se llevarán a cabo actividades de difusión y concientización sobre esta problemática para lo cual se crearán grupos de trabajo multi e interdisciplinarios. Para esto se realizarán charlas informativas, talleres y proyección de material didáctico con la finalidad de generar interés respecto a radioprotección. Por tal motivo, en contexto de pandemia, revisamos nuestro rol de agentes promotores de salud, viendo necesario además de tratar la problemática de radioprotección, se abordarán todas las acciones y medidas preventivas sobre Covid 19. De esta manera, reformulamos, redirigimos y ajustamos nuestro proyecto original a fin de contribuir a las necesidades actuales en relación a la salud integral de la sociedad y la relevancia que conlleva la prevención. Esta temática es de suma importancia en la actualidad, pero no siendo ajenos a la situación sanitaria que atravesamos, traspasamos la barrera de la radioprotección para involucrarnos en lo que nos ocurre como sociedad. Se llevarán a cabo actividades de concientización y difusión sobre radioprotección y Covid 19 para lo cual se crearán grupos de trabajo multi e interdisciplinarios. Y se realizarán reuniones informativas, talleres y proyección de material didáctico por vía virtual.Facultad de Odontologí

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

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

A Cross Sectional Study of the Prevalence of Metabolic Syndrome and Associated Factors in Colombian Collegiate Students: The FUPRECOL-Adults Study.

Metabolic syndrome (MetS) is one of the major public health problems worldwide. The objective of the present study is to investigate the prevalence and the associated variables of MetS in Colombian collegiate students. This cross-sectional study included a total of 890 (52% women) healthy collegiate students (21.3 ± 3.2 years old). The prevalence of MetS was determined by the definition provided by the International Diabetes Federation (IDF). We further examined associations between the prevalence of MetS and related factors, such as age, gender, anthropometric and body composition, weight status, and nutrition profile. The overall prevalence of MetS was 6.0% (95% CI = 4.5% to 7.6%), and it was higher in men than women. The most prevalent components were low high-density lipoprotein cholesterol, high triglyceride levels, waist circumference, and blood pressure levels. The predisposing factors for having a MetS included: being male, over 23 years old, overweight or obese, and having an unhealthy waist-to-height ratio. In conclusion, the occurrence of MetS in young adults is substantial. These findings may be relevant to health promotion efforts for collegiate students in order to develop prospective studies and screening for young adults, which will aid in targeted intervention development to decrease cardiometabolic risk factors

A cross-sectional study of the prevalence of metabolic syndrome and associated factors in colombian collegiate students: The fuprecol-adults study

Metabolic syndrome (MetS) is one of the major public health problems worldwide. The objective of the present study is to investigate the prevalence and the associated variables of MetS in Colombian collegiate students. This cross-sectional study included a total of 890 (52% women) healthy collegiate students (21.3 ± 3.2 years old). The prevalence of MetS was determined by the definition provided by the International Diabetes Federation (IDF). We further examined associations between the prevalence of MetS and related factors, such as age, gender, anthropometric and body composition, weight status, and nutrition profile. The overall prevalence of MetS was 6.0% (95% CI = 4.5% to 7.6%), and it was higher in men than women. The most prevalent components were low high-density lipoprotein cholesterol, high triglyceride levels, waist circumference, and blood pressure levels. The predisposing factors for having a MetS included: being male, over 23 years old, overweight or obese, and having an unhealthy waist-to-height ratio. In conclusion, the occurrence of MetS in young adults is substantial. These findings may be relevant to health promotion efforts for collegiate students in order to develop prospective studies and screening for young adults, which will aid in targeted intervention development to decrease cardiometabolic risk factors. © 2017 by the authors. Licensee MDPI, Basel, Switzerland

Body Adiposity Index Performance in Estimating Body Fat Percentage in Colombian College Students: Findings from the FUPRECOL—Adults Study

Recently, a body adiposity index (BAI = (hip circumference)/((height)(1.5))−18) was developed and validated in adult populations. The aim of this study was to evaluate the performance of BAI in estimating percentage body fat (BF%) in a sample of Colombian collegiate young adults. The participants were comprised of 903 volunteers (52% females, mean age = 21.4 years ± 3.3). We used the Lin’s concordance correlation coefficient, linear regression, Bland–Altman’s agreement analysis, concordance correlation coefficient (ρc) and the coefficient of determination (R2) between BAI, and BF%; by bioelectrical impedance analysis (BIA)). The correlation between the two methods of estimating BF% was R2 = 0.384, p &lt; 0.001. A paired-sample t-test showed a difference between the methods (BIA BF% = 16.2 ± 3.1, BAI BF% = 30.0 ± 5.4%; p &lt; 0.001). For BIA, bias value was 6.0 ± 6.2 BF% (95% confidence interval (CI) = −6.0 to 18.2), indicating that the BAI method overestimated BF% relative to the reference method. Lin’s concordance correlation coefficient was poor (ρc = 0.014, 95% CI = −0.124 to 0.135; p = 0.414). In Colombian college students, there was poor agreement between BAI- and BIA-based estimates of BF%, and so BAI is not accurate in people with low or high body fat percentage levels

Fatness mediates the influence of muscular fitness on metabolic syndrome in Colombian collegiate students

The purpose of this study was two-fold: to analyze the association between muscular fitness (MF) and clustering of metabolic syndrome (MetS) components, and to determine if fatness parameters mediate the association between MF and MetS clustering in Colombian collegiate students. This cross-sectional study included a total of 886 (51.9% women) healthy collegiate students (21.4 ± 3.3 years old). Standing broad jump and isometric handgrip dynamometry were used as indicators of lower and upper body MF, respectively. Also, a MF score was computed by summing the standardized values of both tests, and used to classify adults as fit or unfit. We also assessed fat mass, body mass index, waist-to-height ratio, and abdominal visceral fat, and categorized individuals as low and high fat using international cut-offs. A MetS cluster score was derived by calculating the sum of the sample-specific zscores from the triglycerides, HDL cholesterol, fasting glucose, waist circumference, and arterial blood pressure. Linear regression models were used to examine whether the association between MF and MetS cluster was mediated by the fatness parameters. Data were collected from 2013 to 2016 and the analysis was done in 2016. Findings revealed that the best profiles (fit + low fat) were associated with lower levels of the MetS clustering (p 0.001 in the four fatness parameters), compared with unfit and fat (unfit + high fat) counterparts. Linear regression models indicated a partial mediating effect for fatness parameters in the association of MF with MetS clustering. Our findings indicate that efforts to improve MF in young adults may decrease MetS risk partially through an indirect effect on improvementsto adiposity levels. Thus, weight reduction should be taken into account as a complementary goal to improvements in MF within exercise program

Characteristics of the participants, by sex.

<p>Characteristics of the participants, by sex.</p