Diagnostic performance of high sensitive troponin in non-ST elevation acute coronary syndrome. / Rendimiento diagnóstico de la troponina de alta sensibilidad en el síndrome coronario agudo sin elevación del segmento ST.

OBJECTIVE: To assess the diagnostic performance of high-sensitivity troponin T (hs-TnT) in patients with suspected non-ST elevation acute coronary syndrome (NSTE-ACS); confirm whether it shortens the time to diagnosis; and analyze the clinical consequences derived from its use. METHOD: A prospective, longitudinal observational study was carried out in 5 emergency care departments. Patients seen for chest pain with suspected of NSTE-ACS were consecutively included. Patient care followed the internal protocols of the center, based on the consensus guidelines of the European Society of Cardiology. Serial conventional cardiac troponin (cTn) and hs-TnT determinations were made. RESULTS: A total of 351 patients were included in the study. A final diagnosis of acute myocardial infarction (AMI) was established in 77 patients, with unstable angina in 102, and no acute coronary syndrome in 172 patients. The hs-TnT values were above percentile 99% in a large number of patients without AMI. In the initial determination, the diagnostic sensitivity of the hs-TnT was significantly greater than that of cTn (87.0% vs. 42.9%), which led to a negative predictive value of 95.1%. CONCLUSIONS: High-sensitivity troponin T improves diagnostic performance compared with conventional troponin assay, shortens the time to diagnosis, and identifies a larger number of patients with smaller myocardial infarctions.

Calibration of a portable HPGe detector using MCNP code for the determination of 137Cs in soils.

In situ gamma spectrometry provides a fast method to determine (137)Cs inventories in soils. To improve the accuracy of the estimates, one can use not only the information on the photopeak count rates but also on the peak to forward-scatter ratios. Before applying this procedure to field measurements, a calibration including several experimental simulations must be carried out in the laboratory. In this paper it is shown that Monte Carlo methods are a valuable tool to minimize the number of experimental measurements needed for the calibration.

Low level radioactivity measurements with phoswich detectors using coincident techniques and digital pulse processing analysis.

A new system has been developed for the detection of low radioactivity levels of fission products and actinides using coincidence techniques. The device combines a phoswich detector for alpha/beta/gamma-ray recognition with a fast digital card for electronic pulse analysis. The phoswich can be used in a coincident mode by identifying the composed signal produced by the simultaneous detection of alpha/beta particles and X-rays/gamma particles. The technique of coincidences with phoswich detectors was proposed recently to verify the Nuclear Test Ban Treaty (NTBT) which established the necessity of monitoring low levels of gaseous fission products produced by underground nuclear explosions. With the device proposed here it is possible to identify the coincidence events and determine the energy and type of coincident particles. The sensitivity of the system has been improved by employing liquid scintillators and a high resolution low energy germanium detector. In this case it is possible to identify simultaneously by alpha/gamma coincidence transuranic nuclides present in environmental samples without necessity of performing radiochemical separation. The minimum detectable activity was estimated to be 0.01 Bq kg(-1) for 0.1 kg of soil and 1000 min counting.

Radon measurements with a PIN photodiode.

Silicon photodiodes are well suited to detect alphas coming from different sources as neutron reactions or radon daughters. In this work a radon in air detecting device, using an 18x18 mm silicon PIN photodiode is studied. The ionized airborne decay products formed during radon diffusion were focused by an accelerating high voltage to the PIN surface. Several conducting rings were disposed inside a cylindrical PVC vessel in such a way that they reproduced the electric field created by a punctual charge located behind PIN position. Alpha spectra coming from the neutral and ionized species deposited on the PIN surface, dominated by 218Po and 214Po progeny peaks, were recorded for varying conditions. Those include radon concentration from a Pylon source, high voltage (thousands of volts) and PIN inverse bias voltage. Different parameters such as temperature and humidity were also registered during data acquisition. The increase in the particle collection efficiency with respect to zero electric field was compared with the corresponding to a parallel plates configuration. A discussion is made in terms of the most appropriate voltages for different radon concentrations.

Resistances to turnip mosaic potyvirus in Arabidopsis thaliana.

The responses of a collection of Arabidopsis thaliana ecotypes to mechanical inoculation with turnip mosaic potyvirus were assessed. The virus induced characteristic severe symptoms of infection in systemically infected plants. Resistance was found in four ecotypes: Bay-0, Di-0, Er-0, and Or-0. Enzyme-linked immunosorbent assay results of the resistant ecotypes suggested that ecotypes Di-0, Er-0, and Or-0 actually consist of mixed genotypes with resistances acting at different levels in the virus life cycle. Another form of resistance was found in ecotype Bay-0, for which several lines of evidence indicated an interference with viral cell-to-cell movement in the inoculated leaves.

[Determination of endotoxemia by means of the Limulus test in patients with septicemia (author's transl)]. / Determinación de endotoxemia por el test del Limulus en enfermos septicémicos.

The Limulus test was applied to determine bacterial endotoxemia in 42 patients suspected of having septicemia. Hemocultures were practiced simultaneously. A comparative study is made of the two presently most commonly recommended tests for neutralizing the factors inhibiting the endotoxin-amebocyte reaction. According to our results the dilution of plasma in isotonic saline solution is preferable; we obtained a sensitivity of determination of 0.0001 micrograms of E. coli endotoxin per ml of plasm. Seventeen cases of bacteriemia were diagnosed, only one of which with sepsis due to Serratia marcescens responded positively to the limulus test. The test was positive in three of the remaining 25 patients. Two of them had liver failure. The basic role that liver failure plays in the high level of endotoxin in the blood is discussed. The prognostic value of this test and the low correlation between bacteremia and endotoxemia are also commented on

[Assessing an automated dispensation system in the emergency department of a level III-hospital]. / Evaluación de un sistema automático de dispensación en el Servicio de Urgencias de un hospital de tercer nivel.

OBJECTIVE: The objective of this work was to describe and to assess an automated drug dispensing system in the emergency department of a level-III hospital. MATERIALS AND METHODS: Sequential implementation of PyxisA(R) commenced in July 2001 in a number of Emergency areas. The addition of a Medanalistâ system speeds up the evaluation of generated information. Analysed variables were classified as: a) logistic: workload distribution; b) financial: cost per emergency patient attended; c) number of pharmaceutical procedures. Statistical descriptors were analysed using the SPSS 10.0 software. RESULTS: 1. Logistic: increased workload in PD and decreased Emergency staff calls. 2. Financial: Consumption in the emergency department was reduced by 12% in 2001. In addition, the number of applications for drugs not included within the hospital formulary decreased. CONCLUSION: The main benefit of this system is the information it provides on drug use. However, the fact that this projectâs implementation increased workload in our department, and that a definitive set-up would require a pharmacy assistant staff member should be considered. Regarding this memberâs work, at least a half-day commitment during implementation stages would be needed to direct this change in mentality. Once the system is set up, time is needed to review and monitor previous day activities, and to analyse generated information monthly.

[Retrospective comparative study between sevoflurane and propofol in maintaining anaesthesia during liver transplant: Effects on kidney and liver function]. / Estudio retrospectivo comparativo entre sevoflurano y propofol en el mantenimiento de la anestesia durante el trasplante hepático. Efectos sobre la función renal y hepática.

OBJECTIVE: To compare the post-operative effects of sevoflurane versus propofol on liver and kidney function while maintaining anaesthesia in the orthotopic liver transplant (OLT), as well as to analyse the short-term survival as regards these functions. PATIENTS AND METHODS: A retrospective analysis was conducted on patients subjected to an OLT between January 2002 and December 2009. Patients on pre-transplant haemodialysis, re-transplants, and hepatorenal transplants were excluded. The incidence of acute renal failure, initial dysfunction of the graft, reperfusion syndrome, rejection, and the transaminase peak depending value depending on the hypnotic used, were recorded. RESULTS: About one-third (31.2%) of the patients developed acute renal failure and 11.9% an initial dysfunction, with no differences between the groups. There was a tendency for a lower incidence of initial dysfunction of the graft in the sevoflurane group (8.6% compared to 12.8%), a lower transaminase peak (greater than 2000 U/L, 12.1% versus 15.9%), and a lower incidence of reperfusion syndrome (10.3% compared to 21.6%). CONCLUSIONS: Despite the fact that the renal metabolism sevoflurane is elevated, we did not find any higher incidence of acute renal failure. Sevoflurane in the liver transplant anaesthesia is as least equally as safe propofol as regards renal function and liver function. New prospective studies are needed to clarify the possible effects of the hypnotic in liver transplant.

Evaluation of CdZnTe as neutron detector around medical accelerators.

The operation of electron linear accelerators (LINACs) and cyclotrons can produce a mixed gamma-neutron field composed of energetic neutrons coming directly from the source and scattered lower energy neutrons. The thermal neutron detection properties of a non-moderated coplanar-grid CdZnTe (CZT) gamma-ray detector close to an 18 MV electron LINAC and an 18 MeV proton cyclotron producing the radioisotope (18)F for positron emission tomography are investigated. The two accelerators are operated at conditions producing similar thermal neutron fluence rates of the order of 10(4) cm(-2) s(-1) at the measurement locations. The counting efficiency of the CZT detector using the prompt 558 keV photopeak following (113)Cd thermal neutron capture is evaluated and a good neutron detection performance is found at the two installations.

Nucleotide sequence of Chinese rape mosaic virus (oilseed rape mosaic virus), a crucifer tobamovirus infectious on Arabidopsis thaliana.

The complete nucleotide sequence of Chinese rape mosaic virus has been determined. The virus is a member of the tobamovirus genus of plant virus and is able to infect Arabidopsis thaliana (L.) Heynh systemically. The analysis of the sequence shows a gene array that seems to be characteristic of crucifer tobamoviruses and which is slightly different from the one most frequently found in tobamoviruses. Based on gene organization and on comparisons of sequence homologies between members of the tobamoviruses, a clustering of crucifer tobamoviruses is proposed that groups the presently known crucifer tobamovirus into two viruses with two strains each. A name change of Chinese rape mosaic virus to oilseed rape mosaic virus is proposed.

[Identification of quality problems in the clinical information to hospital emergency department patients]. / Identificación de problemas de calidad en la información clínica a usuarios de un servicio de Urgencias hospitalario.

OBJECTIVES: To evaluate the comprehension level of the information provided to patients and relatives attending an emergency department and to know their satisfaction degree. METHODS: A cross-sectional descriptive study was designed. The selection of study patients was made by means of a simple randomized sampling and the total of patients was 213. At discharge, these patients and their relatives answered a written, anonymous questionnaire. To evaluate the comprehension of the information provided, the questionnaire responses were checked against the clinical records. RESULTS: The self-identification of the health care providers, information on the estimated length of stay at the ED, the explanation of complementary tests and their results significantly determined the satisfaction score on the provided information, which for the patients was 6.3 on a 10-point scale. The percentages of patients who were knowledgeable of the performed tests, diagnosis, and administered treatment were 61.5%, 50.7%, and 35.2%, respectively. Understanding the diagnosis and the administered treatment differed according to age (p < 0.001) and the assimilation of the information on recommendations at patients's discharge differed according to the education level (p < 0.05). CONCLUSIONS: The self-identification of health care personnel would allow for a better bi-directional information flow. Given the socio-cultural characteristics of our population, the information provided should be clear and concise. The transmission of information to most emergency department users would be best achieved with previous information of the workflow at the emergency department in the form of booklets at the entrance, and also establishing protocols for the informed consent on different diagnostic and treatment techniques inherent to emergency care.

Neutron KERMA factors of human tissues

A program to calculate the neutron KERMA in human tissues has been developed. The program was developed in Mathcad and contains the neutron kerma factors of those elements that are present in different human tissues. Having the elemental composition of any human tissue the neutron kerma can be easily calculated. The program was tested using the elemental composition of tumor tissues such as sarcoma, melanoma, carcinoma and adenoid cystic. Neutron kerma for adipose and muscle tissue for normal adult was calculated. The results are in agreement with those published in literature. The neutron kerma for water was also calculated because in some dosimetric calculations water is used to describe normal and tumor tissues. From this comparison was found that at larger energies kerma factors are approximately the same, but energies less than 100 eV the differences are large.