Radiaciones ionizantes y su impacto Primer Simposio Internacional sobre Medioambiente (ISE 2017)

Son ya varias las décadas en las que en América Latina se ha trabajado arduamente sobre las radiaciones ionizantes; tanto en las ionizantes directas, tales como las partículas beta positivas y negativas, las partículas alfa, los protones, los mesones cargados, los muones y los iones pesados, así como también en las ionizantes indirectas (las producidas por partículas sin cargas), como las generadas por fotones con energías superiores a los 10 keV y los neutrones. Por otro lado, las radiaciones no ionizantes también han sido objeto de detallados estudios, y muy especialmente las provenientes del Sol, como el factor natural más influyente sobre la Tierra. En esta obra se presentan algunos de los avances en los que han participado reconocidos científicos latinoamericanos, como el Dr. Héctor Vega Carrillo, Dr. Daniel Palacios, Dra. Patrizia Pereyra, Dra. Sheila Serrano, y el Dr. Manuel Ernesto Delgado, entre otros. Esta obra puede ser de interés para profesionales del área de la protección radiológica, la ingeniería ambiental, física de la atmósfera y áreas afines, así como para estudiantes

Role of age and comorbidities in mortality of patients with infective endocarditis

Purpose: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. Methods: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015. Patients were stratified into three age groups:<65 years, 65 to 80 years, and = 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. Results: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 = 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients =80 years who underwent surgery were significantly lower compared with other age groups (14.3%, 65 years; 20.5%, 65-79 years; 31.3%, =80 years). In-hospital mortality was lower in the <65-year group (20.3%, <65 years;30.1%, 65-79 years;34.7%, =80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%, =80 years; p = 0.003).Independent predictors of mortality were age = 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI = 3 (HR:1.62; 95% CI:1.39–1.88), and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared, the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. Conclusion: There were no differences in the clinical presentation of IE between the groups. Age = 80 years, high comorbidity (measured by CCI), and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Management of multidrug resistant Gram-negative bacilli infections in solid organ transplant recipients: SET/GESITRA-SEIMC/REIPI recommendations

Solid organ transplant (SOT) recipients are especially at risk of developing infections by multidrug resistant (MDR) Gram-negative bacilli (GNB), as they are frequently exposed to antibiotics and the healthcare setting, and are regulary subject to invasive procedures. Nevertheless, no recommendations concerning prevention and treatment are available. A panel of experts revised the available evidence; this document summarizes their recommendations: (1) it is important to characterize the isolate´s phenotypic and genotypic resistance profile; (2) overall, donor colonization should not constitute a contraindication to transplantation, although active infected kidney and lung grafts should be avoided; (3) recipient colonization is associated with an increased risk of infection, but is not a contraindication to transplantation; (4) different surgical prophylaxis regimens are not recommended for patients colonized with carbapenem-resistant GNB; (5) timely detection of carriers, contact isolation precautions, hand hygiene compliance and antibiotic control policies are important preventive measures; (6) there is not sufficient data to recommend intestinal decolonization; (7) colonized lung transplant recipients could benefit from prophylactic inhaled antibiotics, specially for Pseudomonas aeruginosa; (8) colonized SOT recipients should receive an empirical treatment which includes active antibiotics, and directed therapy should be adjusted according to susceptibility study results and the severity of the infection.J.T.S. holds a research contract from the Fundación para la Formación e Investigación de los Profesionales de la Salud de Extremadura (FundeSalud), Instituto de Salud Carlos III. M.F.R. holds a clinical research contract “Juan Rodés” (JR14/00036) from the Spanish Ministry of Economy and Competitiveness, Instituto de Salud Carlos III

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Características dosimétricas de fuentes isotópicas de neutrones

Mediante métodos Monte Carlo se han calculado los espectros de los neutrones producidos por 252Cf, 252Cf/D2O, 241AmBe, 239PuBe, 140LaBe, 239Pu18O2 y 226RaBe. Con la información del espectro se calculó la energía promedio de los neutrones de cada fuente. Mediante los coeficientes de fluencia a dosis se determinaron, para cada una de las fuentes estudiadas, los factores de fluencia a dosis. Las dosis calculadas fueron H, H*(10), Hp;slab(10,0±), EAP y EISO. Para los cálculos, las fuentes se modelaron como puntuales y sus características se determinaron en el vacío. Además, para el caso de las fuentes de 239PuBe y 241AmBe, se realizaron cálculos Monte Carlo modelando las fuentes con sus dimensiones, y las propiedades dosimétricas se determinaron en un espacio lleno de aire. Los resultados de esta última fase de cálculos se compararon con los resultados experimentales obtenidos para ambas fuentes

Niveles de plomo en la población de alto riesgo y su entorno en San Ignacio, Fresnillo, Zacatecas, México

Objetivo. Determinar la concentración de plomo en la sangre de niños y mujeres, en periodo de lactancia o embarazadas, de la comunidad de San Ignacio, Fresnillo, en Zacatecas, asi como en matrices de suelo, plantas, ceniza y barro vidriado, para determinar la exposición que genera una empresa recicladora de metales. Material y metodos. El estudio se realizó de diciembre de 2004 al mes de abril de 2005. El Pb en sangre se midió por voltamperometria de redisolución anódica, mientras que se utilizó energía dispersa de fluorescencia por rayos X para las otras matrices. Resultados. Con base en los criterios de la Norma Oficial Mexicana (NOM) se encontro que 90% de los menores esta en la categoria I, 5% se encuentra en la categoria II y el otro 5% se ubica en la categoria III. El suelo de los terrenos aledalios a la recicladora tiene en promedio 4 940µg/g, en un intervalo de 73 a 84 238 kg/g. Las mayores concentraciones se localizan en los puntos mas cercanos a la empresa. El suelo de San Ignacio tiene en promedio 109 peg. Se encontraron valores altos en el barro vidriado y la concentración del Pb en las plantas es superior a los 300µg. Conclusiones. A pesar de que la nnayoria de los niños analizados presenta niveles de plomo en sangre que la Norma Mexicana señala como aceptables, varios estudios indican que existen efectos nocivos aún a concentraciones bajas. Los terrenos aledaños a la empresa están contaminados, y en esa medida los alimentos que ahi se producen, al ser consumidos, son una fuente de contaminación, que se agudiza con el uso de barro vidriado

Management of multidrug resistant Gram-negative bacilli infections in solid organ transplant recipients: SET/GESITRA-SEIMC/REIPI recommendations

Solid organ transplant (SOT) recipients are especially at risk of developing infections by multidrug resistant (MDR) Gram-negative bacilli (GNB), as they are frequently exposed to antibiotics and the healthcare setting, and are regulary subject to invasive procedures. Nevertheless, no recommendations concerning prevention and treatment are available. A panel of experts revised the available evidence; this document summarizes their recommendations: (1) it is important to characterize the isolate's phenotypic and genotypic resistance profile; (2) overall, donor colonization should not constitute a contraindication to transplantation, although active infected kidney and lung grafts should be avoided; (3) recipient colonization is associated with an increased risk of infection, but is not a contraindication to transplantation; (4) different surgical prophylaxis regimens are not recommended for patients colonized with carbapenem-resistant GNB; (5) timely detection of carriers, contact isolation precautions, hand hygiene compliance and antibiotic control policies are important preventive measures; (6) there is not sufficient data to recommend intestinal decolonization; (7) colonized lung transplant recipients could benefit from prophylactic inhaled antibiotics, specially for Pseudomonas aeruginosa; (8) colonized SOT recipients should receive an empirical treatment which includes active antibiotics, and directed therapy should be adjusted according to susceptibility study results and the severity of the infection