Intoxicaciones agudas por drogas en los servicios de urgencias del hospital Joaquín Albarrán, 2010 / Acute drug poisoning in hospital emergency departments Joaquin Albarran, 2010

Las intoxicaciones agudas por sustancias adictivas son causas de demanda asistencial en los Servicios de Urgencias en la actualidad en nuestro país, cuyo impacto ha sido poco analizado hasta el momento, por lo cual se realiza un estudio descriptivo, de corte transversal, de 56 pacientes atendidos en los Servicios de Urgencias del Hospital Clínico Quirúrgico Docente Joaquín Albarrán con el diagnóstico de Intoxicación Aguda por Drogas, con los objetivos de analizar el comportamiento de estos casos en dichos servicios y caracterizarlos según edad y sexo, frecuencia, droga implicada, características clínicas y evolución, confeccionando un modelo de recogida de datos para la realización del estudio. Se encontró un predominio del sexo masculino con una relación de 1,2:1, siendo frecuentes las edades entre 18 y 27 años; la droga más implicada fue el alcohol en el 80, 4 por ciento. Más del 50 por ciento de los pacientes sufrieron intoxicación por abuso de fármacos, en su mayoría por las benzodiacepinas (31,2 por ciento). Las intoxicaciones por drogas ilícitas no fueron frecuentes (8,9 por ciento) y sólo el 26, 8 por ciento de los pacientes presentaron intoxicaciones severas. La evolución fue satisfactoria en el 67,8 por ciento de los casos. Las especialidades interconsultantes fueron Psiquiatría, Toxicología, Medicina Intensiva y Nefrología. Se concluye planteando que las intoxicaciones agudas por drogas fueron motivo de atención frecuente en nuestros Servicios de Urgencias y con la necesidad de darle un carácter multidisciplinario a la atención de los pacientes drogodependientes(AU)

Acute poisoning addictive substances are causes of health care demand in the Emergency Services at present in our country, whose impact has been little used so far, so a descriptive, cross-sectional, 56 were performed patients seen in the Emergency Services Teaching Surgical Hospital Joaquin Albarran diagnosed with Acute drug Intoxication with the objectives of analyzing the behavior of these cases and characterize such services by age and sex, frequency, drug involved, clinical characteristics and evolution, preparing a model of collecting data for the study. Male predominance with a ratio of 1.2 was found: 1, with frequent between 18 and 27 years; the drug was alcohol involved in the 80, 4 percent. Over 50 percent of patients suffered poisoning from drug abuse, mostly by benzodiazepines (31.2 percent). Illicit drug poisoning were rare (8.9 percent) and only 26, 8 percent of patients had severe poisoning. The outcome was satisfactory in 67.8 percent of cases. The specialties were interconsultantes Psychiatry, Toxicology, Critical Care Medicine and Nephrology. We conclude by stating that acute drug poisonings were the subject of frequent attention in our emergency services and the need to provide multi-disciplinary care for drug dependent patients(AU)

Ingreso en unidad de cuidados intensivos por complicaciones asociadas al consumo de drogas. Hospital Joaquín Albarrán 2009 2010 / Admission to intensive care unit for complications associated with drug use. Joaquin Albarran Hospital 2009-2010

La drogodependencia constituye un fenómeno en la sociedad actual, lo que genera un número considerable de complicaciones que requieren atención especializada por constituir un peligro para la vida. Es por ello que se realiza un estudio descriptivo, de corte transversal, de 82 pacientes que ingresaron en las Unidades de Atención al Paciente Grave del Hospital Clínico Quirúrgico Docente Joaquín Albarrán por complicaciones asociadas al abuso de sustancias adictivas durante los años 2009 y 2010, con el objetivo de diagnosticar si son frecuentes los ingresos en las Unidades de Atención al Paciente Grave por dichas complicaciones, así como caracterizar el comportamiento de las mismas, habilitando para ello un modelo de recogida de datos. Se obtuvo un predominio del sexo masculino con una relación de 1,4:1, siendo las edades medias de la vida las más frecuentes y el alcohol la droga más implicada (91,4 por ciento), generando las complicaciones más significativas (64,6 por ciento) que se produjeron mayoritariamente con un consumo de más de 10 años, ocasionando la muerte en el 34,1 por ciento de los casos. El 45, 4 por ciento de los pacientes que consumieron alcohol y medicamentos presentaron convulsiones graves y los medicamentos más implicados fueron las benzodiacepinas (51,7 por ciento). Se concluye que las complicaciones por abuso de drogas son causas frecuentes de ingreso en UCI(AU)

The drug dependence constitutes a phenomenon in the current society, generates a considerable number of complications that require a specialized attention because constitute a danger for life. Because of that a descriptive study, of sectional cut was carried out, of 82 patients that were admitted in the Units of Attention of the Serious Patient at the Educational Surgical Clinical Hospital Joaquin Albarrán with complications associated to the abuse of addictive substances during the years 2009 and 2010, with the objective to know if the admission are frequent in the Serious Patient Attendance Units for these complications, as well as to characterize the behaviour of the same ones, enabling for it a model of collection of data. A prevalence of the male sex was obtained with a relationship of 1,4:1, being the middle ages of the life the more frequent and the alcohol the most implied drug (91,4 percent), generating the most significant complications (64,6 percent) that took place for the most part with a consumption of more than 10 years, causing the death in 34,1 percent of the cases. It was concluded that the complications for drug abuse are frequent cause of admission at UIC(AU)

Simultaneous immobilization of metals and arsenic in acidic polluted soils near a copper smelter in central Chile.

INTRODUCTION: Acidic and metal(oid)-rich topsoils resulted after 34 years of continuous operations of a copper smelter in the Puchuncaví valley, central Chile. Currently, large-scale remediation actions for simultaneous in situ immobilization of metals and As are needed to reduce environmental risks of polluted soils. Aided phytostabilization is a cost-effective alternative, but adequate local available soil amendments have to be identified and management options have to be defined. MATERIALS AND METHODS: Efficacy of seashell grit (SG), biosolids (B), natural zeolite (Z), and iron-activated zeolite (AZ), either alone or in mixtures, was evaluated for reducing metal (Cu and Zn) and As solubilization in polluted soils under laboratory conditions. Perennial ryegrass was used to test phytotoxicity of experimental substrates. RESULTS: Soil neutralization to a pH of 6.5 with SG, with or without incorporation of AZ, significantly reduces metal (Cu and Zn) solubilization without affecting As solubilization in soil pore water; furthermore, it eliminates phytotoxicity and excessive metal(oid) accumulation in aerial plant tissues. Addition of B or Z to SG-amended soil does not further reduce metal solubilization into soil pore water, but increase As solubilization due to excessive soil neutralization (pH > 6.5); however, no significant As increase occurs in aerial plant tissues. CONCLUSION: Simultaneous in situ immobilization of metal(oid) in acidic topsoils is possible through aided phytostabilization.

Efficacy of lime, biosolids, and mycorrhiza for the phytostabilization of sulfidic copper tailings in Chile: a greenhouse experiment.

Inadequate abandonment of copper mine tailings under semiarid Mediterranean climate type conditions has posed important environmental risks in Chile due to wind and rain erosion. There are cost-effective technologies for tailings stabilization such as phytostabilization. However, this technology has not been used in Chile yet. This study evaluated in a greenhouse assay the efficacy of biosolids, lime, and a commercial mycorrhiza to improve adverse conditions of oxidized Cu mine tailings for adequate establishment and grow of Lolium perenne L. var nui. Chemical characterization of experimental substrates and pore water samples were performed; plant density, biomass production, chlorophyll content, and metal content in shoots was evaluated in rye grass plants after an eight-week growth period. Results showed that neutralization of tailings and superficial application of biosolids increased both aerial biomass production and chlorophyll content of rye grass. Increased Cu solubilization and translocation to shoots occurred after biosolids application (mixed), particularly on unlimed tailings, due to formation of soluble organometallic complexes with dissolved organic carbon (DOC) which can be readily absorbed by plant roots. Positive effects of mycorrhizal inoculation on rye grass growth were restricted to treatments with superficial application of biosolids, probably due to Cu toxicity effects on commercial mycorrhiza used (Glomulus intraradices).

Soil acidification as a confounding factor on metal phytotoxicity in soils spiked with copper-rich mine wastes.

Pollution of soil with mine wastes results in both Cu enrichment and soil acidification. This confounding effect may be very important in terms of phytotoxicity, because pH is a key parameter influencing Cu solubility in soil solution. Laboratory toxicity tests were used to assess the effect of acidification by acidic mine wastes on Cu solubility and on root elongation of barley (Hordeum vulgare L.). Three contrasting substrates (two soils and a commercial sand) and two acidic, Cu-rich mine wastes (oxidized tailings [OxT] and smelter dust [SmD]) were selected as experimental materials. Substrates were spiked with a fixed amount of either SmD or OxT, and the pH of experimental mixtures was then modified in the range of 4.0 to 6.0 and 7.0 using PIPES (piperazine-1,4-bis(2-ethanesulfonic acid)), MES (2-(N-morpholino)ethanesulfonic acid), and MOPS (3-(N-Morpholino)-propanesulfonic acid) buffers. Chemical (pore-water Cu and pH) and toxicological (root length of barley plants) parameters were determined for experimental mixtures. Addition of SmD and OxT to substrates resulted in acidification (0.11-1.16 pH units) and high levels of soluble Cu and Zn. Neutralization of experimental mixtures with MES (pH 6.0) and MOPS (pH 7.0) buffers resulted in a marked decrease in soluble Cu and Zn, but the intensity of the effect was substrate-dependent. Adjustment of soil pH above the range normally considered to be toxic to plants (pH in water extract, > 5.5) significantly reduced metal toxicity in barley, but phytotoxicity was not completely eliminated. The present results stress the importance of considering confounding effects on derivation of toxicity thresholds to plants when using laboratory phytotoxicity tests.

Agricultural soils spiked with copper mine wastes and copper concentrate: implications for copper bioavailability and bioaccumulation.

A better understanding of exposure to and effects of copper-rich pollutants in soils is required for accurate environmental risk assessment of copper. A greenhouse experiment was conducted to study copper bioavailability and bioaccumulation in agricultural soils spiked with different types of copper-rich mine solid wastes (copper ore, tailing sand, smelter dust, and smelter slag) and copper concentrate. A copper salt (copper sulfate, CuSO4) that frequently is used to assess soil copper bioavailability and phytotoxicity also was included for comparison. Results showed that smelter dust, tailing sand, and CuSO4 are more likely to be bioavailable and, thus, toxic to plants compared with smelter slag, concentrate, and ore at equivalent total copper concentrations. Differences may be explained by intrinsic differences in copper solubilization from the source materials, but also by their capability to decrease soil pH (confounding effect). The copper toxicity and bioaccumulation in plants also varied according to soil physicochemical characteristics (e.g., pH and total organic carbon) and the available levels of plant nutrients, such as nitrogen, phosphorus, and potassium. Chemistry/mineralogy of mine materials, soil/pore-water chemistry, and plant physiological status thus should be integrated for building adequate models to predict phytotoxicity and environmental risk of copper.

Micro-spatial variation of soil metal pollution and plant recruitment near a copper smelter in Central Chile.

Soil chemical changes produced by metal smelters have mainly been studied on a large scale. In terms of plant survival, determination of small scale variability may be more important because less toxic microhabitats may represent safe sites for successful recruitment and thus for plant survival. Three dominant microhabitats (open spaces and areas below the canopy of Sphaeralcea obtusiloba and Baccharis linearis shrubs) were defined in a heavily polluted area near a copper smelter and characterised in terms of microclimate, general soil chemistry, total and extractable metal concentrations in the soil profile (A0 horizon, 0-5 and 15-20 cm depth), and seedling densities. Results indicated a strong variability in microclimate and soil chemistry not only in the soil profile but also among microhabitats. Air/soil temperatures, radiation and wind speed were much lower under the canopy of shrubs, particularly during the plant growth season. Soil acidification was detected on top layers (0-5 cm depth) of all microhabitats while higher concentrations of N, Cu and Cd were detected on litter and top soil layers below shrubs when compared to open spaces; however, high organic matter content below shrubs decreased bioavailability of metals. Plant recruitment was concentrated under shrub canopies; this may be explained as a result of the nursery effect exerted by shrubs in terms of providing a more favourable microclimate, along with better soil conditions in terms of macronutrients and metal bioavailability.