Sistema de prevención de riesgos laborales para el control de radiaciones ionizantes en la planta de producción de radioisótopos del Instituto Peruano de Energía Nuclear, propuesta actual

La tesis denominada: “Sistema de Gestión de Prevención de Riesgos Laborales (SGPRL) para el control de radiaciones ionizantes dentro de la Planta de Producción de Radioisótopos (PPR) del Instituto Peruano de Energía Nuclear, propuesta actual”; cuyo problema se ha identificado en la falta de un adecuado Sistema de Gestión de prevención de Riesgos Laborales acordes con la ley N°29783 “Ley de Seguridad y Salud en el Trabajo”, promulgada el 20 de agosto del 2011 y en concordancia con las Normas de Seguridad Protección Radiológica ocupacional del Organismo Internacional de Energía Atómica (OIEA). Esta problemática se expresa en la siguiente pregunta: ¿De qué manera el sistema de prevención de riesgos laborales podrá facilitar el control de radiaciones ionizantes en la Planta de producción de radioisótopos del Instituto Peruano de Energía Nuclear? Ante la problemática se propone la solución a través de la formulación de la hipótesis: El sistema de prevención de riesgos laborales facilita el control de radiaciones ionizantes en la Planta de producción de radioisótopos del Instituto Peruano de Energía Nuclear (IPEN) Este trabajo se ha orientado al siguiente objetivo: Determinar la manera como el sistema de prevención de riesgos laborales podrá facilitar el control de radiaciones ionizantes en la Planta de producción de radioisótopos del Instituto Peruano de Energía Nuclear, alineando este SGPRL con la política de Seguridad y Salud en el Trabajo del IPEN con el planteamiento de estrategias y procedimiento que facilitan el control de dosis de radiaciones ionizantes incorporadas por los Trabajadores Ocupacionalmente Expuestos (TOE) y la prevención de enfermedades ocupacionales a cauda de esta actividad laboral. La investigación es de tipo descriptiva; del nivel descriptivo-explicativo-correlacional; se utilizó los métodos descriptivo, explicativo e inductivo. El diseño es el no experimental. La población y muestra estuvo compuesta por los TOE de la PPRR. El tipo de muestreo aplicado es el muestreo probabilístico. Las técnicas utilizadas para la recopilación de datos fueron a través de las mediciones realizadas por el Laboratorio de Contaminación Interna de la división de Protección Radiológica Ocupacional y Ambiental (PROA). El instrumento utilizado fue la medición in vivo de los TOE. Se aplicaron las siguientes técnicas de análisis de información: análisis documental, indagación, conciliación de datos, tabulación, comprensión de gráficos. Se aplicó las siguientes técnicas de procesamiento de datos: ordenamiento y clasificación, registro manual, proceso computarizado con Excel, Adquisición de datos, Análisis y cálculo de la espectrometría Gama a través del Software GENIE 2000.Tesi

A systematic review of treatment of Painful Diabetic Neuropathy by Pain Phenotype versus treatment Based on Medical comorbidities

Background: Painful diabetic neuropathy (PDN) is a serious, polymorphic, and prevalent complication of diabetes mellitus. Most PDN treatment guidelines recommend a selection of drugs based on patient comorbidities. Despite the large numbers of medications available, most randomized clinical trials (RCTs) conducted so far have yielded unsatisfactory outcomes. Therefore, treatment may require a personalized approach based on pain phenotype or comorbidities. Methods: To evaluate whether or not a patient's pain phenotype or comorbidities can influence the response to a specific PDN treatment, we conducted a systematic review using two different approaches: pain phenotype and associated comorbidities-based treatment. Results: Out of 45 identified papers, 7 were thoroughly reviewed. We found four RCTs stratified according to pain phenotype with three main results: (1) paroxysmal pain had a better response to pregabalin(2) the preservation of thermal sensation or nociception anticipated a positive response to the topical treatment of painand, (3) after a failure to duloxetine (60 mg/day), the patients with evoked pain or severe deep pain had a better response to association of duloxetine/pregabalin while those with paresthesia/dysesthesia benefited from duloxetine monotherapy (120 mg/day). By contrast, the other three papers provided weak and even contradictory evidence about PDN treatment based on comorbidities. Conclusion: Although more studies are needed to provide an adequate recommendation for clinical practice, our systematic review has provided some evidence that PDN phenotyping may optimize clinical outcomes and could, in the future, lead to both less empirical medicine and more personalized pain therapeutics.Univ Fed Sao Paulo UNIFESP, Diabet Ctr, Endocrinol Div, Escola Paulista Med, Sao Paulo, BrazilUniv Fed Sao Paulo UNIFESP, Brazilian Cochrane Ctr, Escola Paulista Med, Sao Paulo, BrazilUniv Fed Sao Paulo UNIFESP, Diabet Ctr, Endocrinol Div, Escola Paulista Med, Sao Paulo, BrazilUniv Fed Sao Paulo UNIFESP, Brazilian Cochrane Ctr, Escola Paulista Med, Sao Paulo, BrazilWeb of Scienc

Spatial exploration of Streptococcus pneumoniae clonal clustering in São Paulo, Brazil

OBJECTIVES: To examine the spatial distribution of Streptococcus pneumoniae and its clonal patterns collected between 2002 and 2006 in São Paulo, Brazil. METHODS: As part of an observational study in São Paulo city, Brazil, S. pneumoniae isolates routinely cultured from blood, respiratory specimens, or cerebrospinal and other profound fluids were selected. Additionally, only isolates with either penicillin (PEN) intermediate (I) or resistant (R) status on routine antibiogram were included, in order to obtain a higher probability of clonal isolates. A single I/R S. pneumoniae isolate per patient was included and submitted to genotypic determination by pulsed field gel electrophoresis (PFGE). Minimum inhibitory concentrations (MICs) were determined for the isolates by Etest® to PEN and other antimicrobials. Each isolate was geocoded in a digital map. The Kernel function and ratio methods between total isolates vs. clones were used in order to explore possible cluster formations. RESULTS: Seventy-eight (78) S. pneumoniae community isolates from two major outpatient centers in São Paulo, Brazil, were selected from the databank according to their penicillin susceptibility profile, i.e. R or I to penicillin assessed by oxacillin disc diffusion. Of these, 69 were submitted to PFGE, 65 to MIC determination, and 48 to spatial analytical procedures. Preliminary spatial analysis method showed two possible cluster formation located in southwest and southeast regions of the city. CONCLUSION: Further analyses are required for precisely determining the existence of S. pneumoniae clusters and their related risk factors. Apparently there is a specific transmission pattern of S. pneumoniae clones within certain regions and populations. GIS and spatial methods can be applied to better understand epidemiological patterns and to identify target areas for public health interventions.Universidade Federal de São Paulo (UNIFESP) Special Laboratory of Clinical MicrobiologyHospital Israelita Albert EinsteinGC-2 Gestão do Conhecimento Científico LtdInstituto Nacional de Pesquisas Espaciais Department of Image ProcessingUNIFESP, Special Laboratory of Clinical MicrobiologySciEL

Relationship between the rs333 Polymorphism in the CC Chemokine Receptor Type Five (CCR5) Gene and Immunological Disorders: Data from a Meta-Analysis

Introduction: Inflammatory Bowel Disease (IBD), periodontitis and Systemic Lupus Erythematous (SLE) are multifactorial diseases, one of the factors in the course of these diseases is the rs333 polymorphism in the CC chemokine receptor type five (CCR5) gene. However, the results remain contradictory. Therefore, we aimed to perform a meta-analysis evaluating the relation between this polymorphism and the aforementioned conditions. Material and Methods: A search in the literature was performed in diverse scientific and medical databases for studies published before June 22, 2020. The data were extracted from the studies and the statistical evaluation was performed by the calculations of statistical heterogeneity (I²), Odds Ratio (OR) with 95% of Confidence Intervals (CI) and publication bias. The values of P<0.05 were considered as significant for all calculations. Results: 19 articles with 21 case/control studies in 4,304 case patients and 3,492 controls were included. The meta-analysis showed a non-significant association among the rs333 polymorphism and IBD (OR = 1.05, 95% CI: 0.91-1.20, P = 0.51), periodontitis (OR = 0.86, 95% CI: 0.64-1.17, P = 0.34) or SLE (OR = 1.00, 95% CI: 0.56-1.80, P = 1.00) under the allelic model or for any other performed calculation. There were no obvious publication bias in the analyses. Conclusion: In conclusion, this current meta-analysis evidenced the non-significant relation among the rs333 polymorphism and the risk of IBD, periodontitis or SLE. Further studies are required to validate our data

Metrics Based on Information Entropy to Evaluate Landscape Complexities

Information entropy concept is the base for many measures used to evaluate the complexity of complex environmental systems. Its application has great potential to evaluate landscape organization and dynamics, especially if we consider that there is a direct relation between their patterns and processes: the spatial arrangement (structure) of units within a mosaic reflects on system functions. Consequently, changes on structure reflects on functions and vice versa. Here, we exemplify how three measures based on information entropy – LMC and SDL complexity measures and He/Hmax variability measure – could be applied to evaluating the degree of complexity of a landscape and its components by associating their heterogeneity with the diversity of information acquired from the remote sensors’ images. For this, we developed two scripts for a Geographical Information System (QGIS): (1) CompPlex HeROI, that compares the complexity of a landscape patch with others and also with their transition areas; and (2) CompPlex Janus, which analyzes how complexity varies in the landscape over space and time, generating landscape complexity maps. We also use LMC and SDL complexity measures and He/Hmax variability measure to evaluate complexity time series of environmental variables, as rain and temperature, which allow to evaluate how their variations along time and space affects landscape dynamics. Therefore, application of such metrics in multi-temporal studies of landscape dynamics provides indicators of landscape resilience and the degree of conservation or degradation of its different fragments due to anthropic impacts related to land uses

Full-length human placental sFlt-1-e15a isoform induces distinct maternal phenotypes of preeclampsia in mice

<div><p>Objective</p><p>Most anti-angiogenic preeclampsia models in rodents utilized the overexpression of a truncated soluble fms-like tyrosine kinase-1 (sFlt-1) not expressed in any species. Other limitations of mouse preeclampsia models included stressful blood pressure measurements and the lack of postpartum monitoring. We aimed to 1) develop a mouse model of preeclampsia by administering the most abundant human placental sFlt-1 isoform (hsFlt-1-e15a) in preeclampsia; 2) determine blood pressures in non-stressed conditions; and 3) develop a survival surgery that enables the collection of fetuses and placentas and postpartum (PP) monitoring.</p><p>Methods</p><p>Pregnancy status of CD-1 mice was evaluated with high-frequency ultrasound on gestational days (GD) 6 and 7. Telemetry catheters were implanted in the carotid artery on GD7, and their positions were verified by ultrasound on GD13. Mice were injected through tail-vein with adenoviruses expressing hsFlt-1-e15a (n = 11) or green fluorescent protein (GFP; n = 9) on GD8/GD11. Placentas and pups were delivered by cesarean section on GD18 allowing PP monitoring. Urine samples were collected with cystocentesis on GD6/GD7, GD13, GD18, and PPD8, and albumin/creatinine ratios were determined. GFP and hsFlt-1-e15a expression profiles were determined by qRT-PCR. Aortic ring assays were performed to assess the effect of hsFlt-1-e15a on endothelia.</p><p>Results</p><p>Ultrasound predicted pregnancy on GD7 in 97% of cases. Cesarean section survival rate was 100%. Mean arterial blood pressure was higher in hsFlt-1-e15a-treated than in GFP-treated mice (∆MAP = 13.2 mmHg, p = 0.00107; GD18). Focal glomerular changes were found in hsFlt-1-e15a -treated mice, which had higher urine albumin/creatinine ratios than controls (109.3±51.7μg/mg vs. 19.3±5.6μg/mg, p = 4.4x10^-2; GD18). Aortic ring assays showed a 46% lesser microvessel outgrowth in hsFlt-1-e15a-treated than in GFP-treated mice (p = 1.2x10^-2). Placental and fetal weights did not differ between the groups. One mouse with liver disease developed early-onset preeclampsia-like symptoms with intrauterine growth restriction (IUGR).</p><p>Conclusions</p><p>A mouse model of late-onset preeclampsia was developed with the overexpression of hsFlt-1-e15a, verifying the <i>in vivo</i> pathologic effects of this primate-specific, predominant placental sFlt-1 isoform. HsFlt-1-e15a induced early-onset preeclampsia-like symptoms associated with IUGR in a mouse with a liver disease. Our findings support that hsFlt-1-e15a is central to the terminal pathway of preeclampsia, and it can induce the full spectrum of symptoms in this obstetrical syndrome.</p></div

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure &lt; 100 mmHg (n = 1127), estimated glomerular filtration rate &lt; 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation