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1.
Health Phys ; 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36066559

RESUMO

ABSTRACT: The onset of the COVID pandemic impacted various regulatory agencies' ability to safely fulfill their regulatory compliance inspection mandates via on-site inspections. Some agencies shifted to a remote or hybrid inspection process, which necessitates the electronic transmittal of a variety of records that may or may not have been transmitted in this fashion in the past, raising concerns about the records being sent and received securely. Considering this new environment, some basic cyber security diagnostic considerations are described for radiation source permit holders to consider prior to responding to an apparent legitimate regulatory inspection request, both in the current COVID cyber risk environment and the environment likely to exist into the future.

2.
Health Phys ; 123(5): 396-401, 2022 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-35951351

RESUMO

ABSTRACT: The Health Physics Society's stated mission is "excellence in the science and practice of radiation safety." Why, then, should we discuss disease outbreaks, epidemics, and pandemics with radiation safety professionals? The answer is simple: all workers are impacted by infectious diseases-and, as safety professionals, we will inevitably be called upon to prepare for and respond to these events. The COVID-19 pandemic has disrupted every facet of life, including home, school, work, and leisure. Moreover, virtually all radiation safety professionals have been impacted by the pandemic either personally, academically, or professionally. Even if radiation safety professionals were not involved directly with COVID-19 response, they were impacted by school closures, remote schooling and work, testing regimes, temperature screenings, vaccination programs, and so forth. However, many radiation safety professionals have been intimately involved in COVID-19 response through activities such as the deployment of personal protective equipment, directional airflow verification for isolation areas, disinfection and decontamination efforts, the design and layout of testing and vaccine centers, and in many other ways. Yet, it is likely that many radiation safety professionals have not received formal training in epidemiology, disease control, or other related topics, and thus may not be attuned to the key aspects to consider when the next pandemic emerges-and it will.


Assuntos
COVID-19 , Pandemias , COVID-19/epidemiologia , COVID-19/prevenção & controle , Física Médica , Humanos , Pandemias/prevenção & controle , Equipamento de Proteção Individual
3.
Neurocirugía (Soc. Luso-Esp. Neurocir.) ; 33(2): 61-70, mar. - abr. 2022. ilus
Artigo em Espanhol | IBECS | ID: ibc-204435

RESUMO

Objetivos: Un buen conocimiento anatómico del cerebelo es fundamental para llevar a cabo abordajes al IV ventrículo (frecuentes en la neurocirugía pediátrica) de forma segura, evitando secuelas como el mutismo cerebeloso. El propósito del presente trabajo es realizar una disección didáctica del cerebelo humano centrándonos especialmente en los pedúnculos cerebelosos y en los núcleos dentados (DN); estructuras en riesgo durante estos procedimientos. Material y métodos :Se disecó el órgano, siguiendo el método de Klingler para fibras blancas, usando material de microcirugía estándar y específico, bajo un microscopio D. F. Vasconcellos M900 con aumento x6-x40. Se utilizó una cámara Canon EOS T7 con un objetivo de 18-55 mm y se editaron las imágenes con Adobe Lightroom Classic CC y Keynote. Se emplearon métodos especiales como la iluminación endoscópica con luz LED para la obtención de algunas fotografías. Resultados: Se logró disecar con éxito los DN del cerebelo y describir su relación con los pedúnculos cerebelosos, vermis inferior y velos medulares. Mediante esta guía de tres pasos (1. cara tentorial; 2. cara suboccipital; 3. estructuras del IV ventrículo) se consiguió mostrar los elementos más importantes para el estudio del órgano y caracterizar sus implicaciones en los distintos abordajes al IV ventrículo. Conclusiones: La mejor forma de completar el estudio de neuroanatomía es la disección de especímenes, ya que aporta una visión 3 D. La transiluminación con luz LED se reveló como una herramienta útil para el registro fotográfico de estructuras del IV ventrículo, lo que mejora la visión espacial. Su principal aplicación la encontramos en los velos medulares y forámenes de la fosa romboide, ya que son permeables a la luz. La guía de disección en tres fases propuesta en este trabajo puede ayudar a los neurocirujanos, en cualquier etapa de su formación, a comprender mejor el cerebelo (AU)


Objectives: A thorough understanding of cerebellum anatomy is essential in 4th ventricle approaches (more frequent in pediatric neurosurgery), avoiding relevant complications such as cerebellar mutism. The aim of the present work is to show the feasibility of a didactic dissection of human cerebellum focusing on cerebellar peduncles and dentate nucleus (DN), which are structures at high risk during these surgical procedures. Material and methods: The cerebellum was dissected according to the Klingler method for white matter, using standard and specific microsurgery tools. Surgical microscope magnification (x6-x40) provided by a D.F. Vasconcellos M900 was required. A Canon EOS T7 18-55 mm digital camera was used and Adobe Lightroom Classic CC and Keynote were selected as photo enhancing software. Special methods such as LED light endoscopic transillumination were used for photographical reasons. Results: DN dissection was successfully achieved and the relations between these nucleus and the cerebellar peduncles, inferior vermis and medullary velums were described. Through this three steps dissection guide (1. tentorial surface; 2. suboccipital surface; 3. 4th ventricle structures), the most relevant anatomical structures were shown and its implications in different 4th ventricle approaches were characterised. Conclusion: 3 D perspective provided by real specimen anatomical dissection is critical for learning neuroanatomy. ED transillumination was shown as a useful technique for the 4th ventricle structures photographic documentation which improves spatial recognition. This benefit can be applied for the study of the relations between the medullary velums and the rhomboid fossa foramina, which are permeable to light. The proposed three-steps dissection guide helps to a better understanding of human cerebellum and to gain self-confidence, allowing safer practice for neurosurgeons in all stages of their career (AU)


Assuntos
Humanos , Microcirurgia/educação , Neuroanatomia/educação , Cerebelo/anatomia & histologia , Cerebelo/cirurgia , Dissecação/educação , Quarto Ventrículo/cirurgia , Substância Branca/cirurgia , Substância Branca/anatomia & histologia
4.
Rev. osteoporos. metab. miner. (Internet) ; 14(1): 55-63, marzo 2022. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-210539

RESUMO

Introducción: La osteonecrosis de los maxilares es una reacción adversa severa poco frecuente, asociado a la administración de medicamentos utilizados para el tratamiento de la osteoporosis y cáncer, como los bisfosfonatos y el denosumab. Sin embargo, muchos profesionales suspenden estos medicamentos, o difieren los procedimientos hasta tener aval del médico tratante. El presente estudio evalúa los conocimientos y actitudes de un grupo de odontólogos colombianos, con respecto al riesgo de desarrollar osteonecrosis de maxilar con el uso de bisfosfonatos y denosumab.Métodos: Se diseñó una encuesta a partir de un grupo focal que fue avalada por expertos. Se obtuvo una herramienta de 30 preguntas, la cual fue enviada a un grupo de odontólogos, cirujanos maxilofaciales, periodoncistas y rehabilitadores orales afiliados a las sociedades odontológicas a través del software Survey Monkey.Resultados: Se analizaron las respuestas de 187 odontólogos (42,6% con estudios de posgrado). El 50,3% de los odontólogos consideraron equivocadamente, que el uso de bisfosfonatos es una contraindicación absoluta para procedimientos odontológicos mayores, y el 51,3% lo consideraron para el uso de denosumab. El 74,6% de los profesionales solicitarían innecesariamente aval del médico tratante para programar procedimientos en pacientes que reciben bisfosfonatos, y el 43,8% para pacientes con denosumab. Los hallazgos fueron similares independientemente de los años de experiencia o el nivel de educativo.Conclusión: Los resultados de nuestro estudio sugieren que hay bajo conocimiento, en relación al riesgo de desarrollar osteonecrosis de maxilar con el uso de medicamentos para el manejo de la osteoporosis. (AU)


Assuntos
Humanos , Osteonecrose , Difosfonatos , Denosumab , Osteoporose , Odontólogos , Preparações Farmacêuticas , Colômbia
5.
Health Phys ; 122(2): 352-359, 2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-34995227

RESUMO

ABSTRACT: In 1992, the University of Texas Health Science Center at Houston (UTHealth) Radiation Safety Program began assembling data on a monthly basis that described various program drivers and associated activities. A summary of the data was assembled on an annual basis and shared with the professional health physics community at the 10-y and 20-y intervals. With the inclusion of 1991 data points, three decades (1991 to 2020) of data have now been collected and summarized into an updated program prospectus. The prospectus models a commercial enterprise prospectus provided to potential investors and displays various program indicator parameters. The consistent formatting of the data affords an easily digestible and succinct snapshot of program activities and trends. Various program stakeholder's feedback regarding this data continues to be well received. Additionally, UTHealth provides increasing support for UT Physicians clinics throughout the greater Houston, Texas area. The prospectus allows succinct description of the drivers of the program, revealed interesting trends, and has identified training needs for both existing personnel and academic programs that support the radiation protection sciences.


Assuntos
Proteção Radiológica , Física Médica , Texas
7.
Science ; 371(6527): 386-390, 2021 01 22.
Artigo em Inglês | MEDLINE | ID: mdl-33479150

RESUMO

Convergent evolution provides insights into the selective drivers underlying evolutionary change. Snake venoms, with a direct genetic basis and clearly defined functional phenotype, provide a model system for exploring the repeated evolution of adaptations. While snakes use venom primarily for predation, and venom composition often reflects diet specificity, three lineages of cobras have independently evolved the ability to spit venom at adversaries. Using gene, protein, and functional analyses, we show that the three spitting lineages possess venoms characterized by an up-regulation of phospholipase A2 (PLA2) toxins, which potentiate the action of preexisting venom cytotoxins to activate mammalian sensory neurons and cause enhanced pain. These repeated independent changes provide a fascinating example of convergent evolution across multiple phenotypic levels driven by selection for defense.


Assuntos
Venenos Elapídicos/enzimologia , Elapidae/classificação , Elapidae/genética , Evolução Molecular , Fosfolipases A2 do Grupo IV/genética , Dor , Células Receptoras Sensoriais/fisiologia , Adaptação Biológica/genética , Animais , Venenos Elapídicos/genética , Filogenia , Células Receptoras Sensoriais/metabolismo
8.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32345506

RESUMO

INTRODUCTION AND AIM: Hepatocellular carcinoma (HCC) is the most frequent primary tumor of the liver. HCC in the noncirrhotic liver accounts for 15-20% of all HCC. Noncirrhotic HCC is a clinically different entity because of the non-neoplastic liver parenchyma involved. Our aim was to describe the presentation, treatment, and predictive survival results of noncirrhotic HCC in Veracruz. MATERIAL AND METHOD: A retrospective study, spanning 13 years, was conducted on patients with noncirrhotic HCC. It analyzed their clinical characteristics, fibrosis/cirrhosis biologic index (NAFLD, MELD, ALBI, APRI, CDS, FIB-4, GUCI, Lok) results, disease treatment, and survival. RESULTS: From a total of 168 cases of HCC, 33 (19.6%) noncirrhotic patients were included in the study. Of those patients, the mean patient age was 67.3 years (51.5% men), 9.1% had hepatitis C virus infection, and 27.3% were alcoholics. Less than 20% of the patients had biologic indexes suggestive of fibrosis/cirrhosis. Mean tumor size was 7.7cm and 42.4% of the patients had alpha-fetoprotein levels>15ng/ml. A total of 52.5% of the tumors were classified as Okuda II and 30.3% of the patients had advanced disease (the Milan criteria). Liver resection was performed on 51.5% of the patients, radiofrequency ablation on 18.2%, and transarterial chemoembolization on 9.1%. The overall 5-year survival rate was 55.4%. Liver resection resulted in the best 5-year survival rate (72.7%). Age>67 years and elevated alpha-fetoprotein levels were associated with poorer survival (P<.05, log-rank). CONCLUSIONS: The characteristics and survival rate of HCC in the noncirrhotic liver were similar to those reported in other studies. Liver resection provided the highest survival rates. The liver fibrosis biologic indexes were not risk factors for survival.

9.
RSC Adv ; 11(47): 29453-29465, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-35479527

RESUMO

NiWO4 with a volumetric storage density (VSD) of 496 g L-1 was studied to evaluate its H2 storage potential as an oxygen carrier under a chemical looping (CL) process scheme. The material was synthesized by precipitation and calcined at 950 °C for 5 hours in air. Characterization consisted in XRD, BET surface area, SEM and EDS analysis. NiWO4 hydrogen storage reduction-oxidation evaluation was performed by TGA using 5% v H2/Ar and 2.2% v H2O/Ar at 800 °C. Global kinetics for the reduction step was studied from 730 to 870 °C using 2 to 5% v of H2/Ar. While oxidation kinetics was examined from 730 to 870 °C using 0.8 to 2.2% v H2O/Ar. A hydrogen storage multicycle stability test was performed by exposing NiWO4 to 17 consecutive redox cycles. XRD results of the synthesized material indicate NiWO4 as the only crystalline phase. Fully reduced material found only W and Ni species, while reoxidation led back to NiWO4. BET surface area of synthesized material was 4.25 m2 g-1. SEM results showed fresh NiWO4 composed of non-porous large particles (1-5 µm). After reduction, the material shown a porous coral-like morphology with particles between 50 to 100 nm. EDS analysis results confirmed the compositions of the reduced (Ni + W) and fully oxidized NiWO4 species, respectively. Oxygen carrier reaction conversions for both reduction and regeneration steps were 100%. Global kinetic studies indicate a first order reaction for the two reduction steps and during oxidation, with activation energies of 22.1, 48.4 and 53.4 kJ mol-1 for the two reduction and oxidation steps, respectively. NiWO4 multicycle stability test shown no loss of VSD and fast reduction and oxidation kinetics under the studied conditions after seventeen consecutive redox cycles, which confirms the potential of this material with respect to current oxygen carriers reported in the literature for hydrogen storage applications.

11.
Rev. argent. reumatolg. (En línea) ; 31(3): 24-30, set. 2020. graf, tab
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1149672

RESUMO

Introducción: Una de las premisas del Treat to Target (T2T) es la decisión conjunta del tratamiento entre el reumatólogo y el paciente. Por esta razón las preferencias del paciente juegan un rol fundamental en el éxito del tratamiento a corto y largo plazo. El objetivo de este estudio fue evaluar las preferencias de tratamiento de los pacientes con Espondiloartritis axial (EsPax) e identificar factores asociados a su elección. Material y métodos: Estudio de corte transversal de la cohorte ESPAXIA de pacientes ≥18 años de edad con EsPax (según criterios ASAS 2009). Se consignaron datos sociodemográficos, comorbilidades, características de la enfermedad, y tratamientos recibidos. Se administró un cuestionario especialmente diseñado, en modalidad de elección múltiple y/o respuesta categorizada según orden de importancia de los enunciados. Análisis estadístico: Estadística descriptiva. Test T de Student, test de Chi2 y análisis de regresión logística múltiple. Se consideró significativo un valor de p<0,05. Resultados: Se incluyeron 70 pacientes con una edad mediana (m) de 46,5 años (RIC: 38-57) y un tiempo m de evolución de 13,5 años (RIC: 7,75-23,25). Los aspectos más importantes en la elección del tratamiento fueron: la capacidad de mejoría en la calidad de vida, seguido por mejoría en la inflamación articular, el dolor y la función física. Las vías de administración elegidas en orden decreciente de frecuencia fueron: vía oral (VO) 51,4%, subcutánea (SC) 41,4%, intramuscular (IM) 4,3% y endovenosa (EV) 2,9%. El intervalo entre dosis más votado en la VO fue 1 comprimido semanal (61,1%), y en la SC, 1 aplicación mensual (34,5%). La elección de la VO, se asoció con: preferencia por la autoaplicación, preferencia de aplicación en el hogar y mayor nivel de escolaridad. La elección de la vía SC, fue más frecuente en los pacientes con EA. Los pacientes que recibían tratamiento biológico por vía SC, así como aquellos que tenían la actividad de su enfermedad más controlada, tuvieron mayor conformidad con el tratamiento. Conclusión: La vía de administración de la medicación preferida en nuestra cohorte de pacientes con EsPax fue la oral. Los pacientes con mayor conformidad de tratamiento fueron aquellos que recibían el tratamiento biológico por vía SC y los que tenían menor actividad de la enfermedad.


Background: One of the premises of the Treat to Target (T2T) is the shared treatment decision between the rheumatologist and the patient. For this reason, patient preferences play a fundamental role in the success of treatment in the short and long term. The aims of this study were to evaluate the treatment preferences of patients with Axial Spondyloarthritis (axSpA) and to identify the factors associated with their choice. Material and methods: Cross sectional study. Patients ≥18 years old that fulfilled the ASAS 2009 criteria for axSpA were included. Sociodemographic data, comorbidities, disease characteristics, and treatments received were recorded. A specially designed questionnaire in both, multiple choice modality and response mode listed in order of priority of the statements was administered. Statistical analysis: Descriptive statistics. Student's T-test, Chi2 test and multiple logistic regression analysis. A value of p <0.05 was considered significant. Results: Seventy patients were included with a median age (m) of 46.5 years (IQR: 38-57), 55 males (78.6%) and a median disease duration of 13.5 years (IQR: 7.75-23.25). The relevant aspects for choosing a treatment were: the ability to improve the quality of life (32.9%), followed by improvement in joint inflammation (22.9%), pain (21.4%) and physical function (14.3%). The chosen administration routes in decreasing order of frequency were: oral (51.4%), subcutaneous (SC) (41.4%), intramuscular (IM) 4.3% and intravenous (IV) 2.9%. The preferred frequency of oral administration was one tablet per week (61.1%) and SC administration, once a month (34.5%). The choice of oral route was associated with: preference for self-administration, preference for receiving the medication at home and higher level of education. The choice of the SC route was independently associated with the type of axSpA (AS) and a lower educational level. The patients under biological SC treatment and with lower disease activity, showed higher level of treatment satisfaction. Conclusion: The most preferred way of administration by patients with axSpA was the oral route. Lower disease activity and SC biological treatment were associated with treatment greater compliance.


Assuntos
Humanos , Espondilartrite , Qualidade de Vida , Terapêutica , Administração Oral
12.
Rehabilitacion (Madr) ; 54(4): 244-248, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32473892

RESUMO

INTRODUCTION: Fibromyalgia is a chronic disease characterised by the presence of musculoskeletal pain, usually associated with other symptoms, including depression, fatigue, and sleep disorders. There is no objective information on the beliefs and perceptions of the diagnosis and treatment of fibromyalgia among rehabilitation and physical medicine specialists. The aim of this study was to describe these beliefs and perceptions among a group of physical medicine and rehabilitation specialists in Colombia. METHODS: We performed a cross-sectional study. A focus group was held with the participation of 2 rheumatologists, one physical medicine and rehabilitation specialist and an expert in qualitative research. The group designed a survey to assess the beliefs and perceptions of physical medicine and rehabilitation specialists of the diagnosis and treatment of fibromyalgia. The self-administered, anonymous questionnaire was completed during meetings of the Colombian Association of Physical Medicine and Rehabilitation. RESULTS: The questionnaire was completed by 99 physical medicine and rehabilitation specialists. Of these, 17.1% (n=17) believed there was insufficient evidence to consider fibromyalgia a disease, 86.8% (n=86) used the ACR 1990 criteria to diagnose patients with fibromyalgia, and 33.3% (n=33) used the criteria of the 2010 classification. The most commonly used drugs for the management of fibromyalgia were antidepressants, prescribed by 84.8% of the surveyed physicians, followed by analgesics (75.7%) and anticonvulsants (66.6%). Concerning multidisciplinary management, 50.6% referred these patients to a rheumatologist and 40.7% to a psychiatrist. In all, 77.2% of rehabilitation specialists believed that patients with fibromyalgia should be managed by their specialty. CONCLUSION: This study provides information on perceptions of the diagnosis and treatment of fibromyalgia among a group of Colombian rehabilitation specialists and found frequent use of the ACR 1990 classification. Among these physicians, the use of drugs, especially antidepressants and analgesics, was high. Most believed that patients with fibromyalgia should be treated by rehabilitation specialists.


Assuntos
Atitude do Pessoal de Saúde , Fibromialgia , Fisiatras/psicologia , Reumatologistas/psicologia , Analgésicos/uso terapêutico , Anticonvulsivantes/uso terapêutico , Antidepressivos/uso terapêutico , Colômbia , Estudos Transversais , Cultura , Fibromialgia/diagnóstico , Fibromialgia/tratamento farmacológico , Fibromialgia/psicologia , Grupos Focais , Humanos , Padrões de Prática Médica , Pesquisa Qualitativa , Pesquisadores/psicologia
13.
Biomed Res Int ; 2019: 2519020, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31886186

RESUMO

Today, the economic and social importance of occupational accidents is undeniable worldwide. Hence, research aimed at reducing this type of accident is considered a discipline of great interest for society in general. In this environment, working conditions play a fundamental role in the occurrence of accidents, and from their study, results can be obtained that provide information for decision-making that guarantee optimum conditions for the development of the employees' tasks. Organizing the conditions of work execution is also a task that constitutes an essential aspect for a firm's productivity, therefore, affecting their viability and results. In this work, a model is proposed for the study of different groups of working conditions and their influence on the probability of occupational accidents, in accordance with the data provided by the 7th National Survey of Working Conditions (VII NSWC). The survey sampled 8892 workers active in all sectors of national production and is the last nation-wide survey administered in Spain. Bayesian networks (BNs) are used to generate a network that analyzes working conditions in all areas (27 variables have been included in addition to those corresponding to the sector and accident), and then, more specifically, the relationship that is established between ergonomic factors in the workplace, psychosocial factors of the worker, and the probability of an accident. The results are achieved through the network obtained by highlighting some of the proposed variables. The dependencies generated by the chosen variables are analyzed, and subsequently, the probability of accident for each of the productive sectors is determined. It is concluded that the ergonomic risks associated with physical strains in the workplace, together with the lack of job satisfaction on the employer's behalf, both pose a very significant increase in the probability of being involved in an occupational accident, above the other variables of study.


Assuntos
Acidentes de Trabalho/estatística & dados numéricos , Ergonomia , Local de Trabalho/estatística & dados numéricos , Acidentes de Trabalho/psicologia , Adulto , Idoso , Feminino , Humanos , Satisfação no Emprego , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Espanha/epidemiologia , Inquéritos e Questionários/estatística & dados numéricos , Local de Trabalho/psicologia
14.
Rev. argent. reumatol ; 30(2): 13-17, jun. 2019. graf, tab
Artigo em Espanhol | LILACS | ID: biblio-1041881

RESUMO

Introducción: Metotrexato (MTX) es la medicación más utilizada en pacientes con Artritis Reumatoidea (AR). Sin embargo, varios autores han cuestionado su éxito debido a la frecuente presencia de eventos adversos y la consiguiente falta de adherencia al tratamiento. Objetivos: Determinar la sobrevida al tratamiento con MTX, eventos adversos y causas de discontinuación en pacientes con AR. Material y métodos: Se incluyeron pacientes ≥18 años de edad con diagnóstico de AR (criterios ACR/EULAR 2010), en forma consecutiva, que hubiesen iniciado en algún momento tratamiento con MTX. Se consignaron datos sociodemográficos, clínicos y terapéuticos. Se determinó fecha de inicio y suspensión de MTX, forma de administración, tratamientos concomitantes, consumo de café y tabaco, como también presencia de eventos adversos (EA). La adherencia se evaluó utilizando el cuestionario Compliance Questionnaire Rheumatology de 5 ítems (CQR5). Análisis estadístico: Estadística descriptiva. Test Chi² o test exacto de Fisher. Sobrevida del tratamiento por Kaplan-Meier y log Rank. Regresión logística múltiple. Una p <0,05 se consideró significativa. Resultados: Se incluyeron 118 pacientes, 101 mujeres (85,6%), con una edad mediana (m) de 56 años (RIC 49-64) y tiempo m de evolución de 10 años (RIC 6-18). Ochenta y cinco pacientes (72%) recibieron MTX por vía oral. 43,2% presentaron EA asociados al MTX, donde solo 20 pacientes (16,9%) tuvieron que discontinuar. La intolerancia digestiva fue el EA más frecuente (27,1%), seguida por alteraciones del laboratorio (12,7%). 86,6% de los pacientes presentaron una adherencia ≥80%. La supervivencia mediana acumulada del tratamiento con MTX fue de 348 meses (IC 95%: 235-460,9). En los análisis uni y multivariados no se encontró asociación de la sobreviva del MTX con variables sociodemográficas, características de la enfermedad, tratamiento concomitante, vía de administración, consumo de café y nivel de adherencia. Conclusión: En nuestra cohorte, la adherencia y sobrevida del tratamiento con MTX fueron buenas. La sobrevida acumulada fue de casi 30 años. La presencia de EA no determinó la suspensión del tratamiento en la mayoría de los casos.


Background: Methotrexate (MTX) is the most frequently used medication in patients with Rheumatoid Arthritis (RA). However, several authors have questioned its success due to the presence of adverse events and the lack of adherence. Objectives: To determine cumulative survival of MTX, frequency and type of adverse events and causes of discontinuation in patients with RA. Methods: Consecutive patients 18 years and older with a diagnosis of RA (ACR/EULAR 2010 criteria), who had begun treatment with MTX during their disease were included. Sociodemographic, clinical and therapeutic data were collected. Date of initiation and suspension of MTX, route of administration, concomitant treatments, consumption of coffee and tobacco, presence of adverse events (AE) were all consigned. Adherence was evaluated using the Compliance Questionnaire Rheumatology questionnaire 5-item summary version (CQR5). Statistical analysis: Descriptive statistics. Chi² test or Fisher's exact test; Survival of treatment by Kaplan-Meier and log Rank. Multiple logistic regression. A p value <0.05 was considered significant. Results: We included 118 patients, 101 were women (85.6%), with a median age (m) of 56 years (IQR 49-64) and disease duration m 10 years (IQR 6-18). Thirty-five patients (29.7%) were smokers and 56 patients (47.5%) consumed coffee. Eighty-five patients (72%) received MTX orally. 43.2% presented AE associated with MTX, but only 20 patients (16.9%) had to discontinue MTX. Gastrointestinal intolerance was the most frequent AE (27.1%), followed by laboratory test abnormalities (12.7%). 86.6% of the patients presented an adherence ≥80%. The median cumulative survival of MTX treatment was 348 months (95% CI: 235-460.9). In the univariate and multivariate analysis, there was no association of survival of MTX with sociodemographic variables, disease characteristics, concomitant treatment, route of administration, coffee consumption nor level of adherence. Conclusions: In our cohort, adherence and survival of MTX treatment were good. The cumulative survival was almost 30 years. The presence of AE did not determine the suspension of treatment in most cases.


Assuntos
Artrite Reumatoide , Terapêutica , Metotrexato
15.
J Environ Radioact ; 196: 15-21, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30368197

RESUMO

Cosmogenic radionuclides in the one-million-year half-life range, like 10Be, find application fields in several Sciences. They are powerful tools in Geology and Geochronology, as they are very important tracers on the Earth, being utilized as chronometer. Meteoric 10Be (T1/2 = 1.39 × 106 y) associated to aerosols can be used as a tracer of atmospheric processes and specifically as indicators of the cosmogenic interactions in lower Stratosphere, upper Troposphere, the air exchange between both and deposition processes on the Earth surface. The applications of 10Be are even more relevant when combined with other radionuclides such as 26Al. In order to provide new data about concentration 10Be in this type of samples, the first atmospheric air filters in Spain have been analysed. Values around 104 at/m3 (atoms per cubic meter of air) for 10Be have been obtained. Due to the location and the features of the sampling site (urban area, at sea level and mid latitude), a new radiochemical procedure was designed and developed in our laboratory for the Accelerator Mass Spectrometry (AMS) measurement of 10Be in this kind of samples. The samples were measured in SARA, the 1 MV AMS system at Centro Nacional de Aceleradores (CNA).


Assuntos
Poluentes Radioativos do Ar/análise , Berílio/análise , Monitoramento de Radiação , Radioisótopos/análise , Aerossóis/análise , Atmosfera/química , Cidades , Espanha
17.
Data Brief ; 20: 1004-1017, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30225315

RESUMO

Obtaining reliable and objective data on certain working conditions is necessary to analyse the causes and variables that can influence the development of hearing loss amongst the working population. Objective occupational data have been collected from a heterogeneous sample of 1418 workers in Spain, see "How activity type, time on the job and noise level on the job affect the hearing of the working population. Using Bayesian networks to predict the development of hipoacusia" (Barrero et al., 2018) [1]. Among the main factors analysed are the noise levels to which these workers are exposed, measured at their respective workstations, and the assessment of their hearing status, evaluated by audiometric medical tests. These factors provide information to predict the development of hypoacusia.

18.
J Environ Radioact ; 189: 227-235, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29705526

RESUMO

The concentration of meteoric 10Be in estuarine sediment samples has been measured by Spanish Accelerator for Radionuclides Analysis (SARA) at CNA and subsequently used to assess the denudation rate in Guadiana river basin together with the sediment budget method, on both sides of the frontier between Spain and Portugal. The two methods yielded coincident results. The estimation by the 10Be method gave the denudation rate of (0.76 ±â€¯0.10) × 10-2 cm/y. After correcting for an approximate 80% attenuation of the sediment discharge into the ocean, caused by the river dams, the sediment budget method yielded the rate of (0.77 ±â€¯0.17) × 10-2 cm/y.


Assuntos
Berílio/análise , Monitoramento de Radiação , Radioisótopos/análise , Rios/química , Poluentes Radioativos da Água/análise , Sedimentos Geológicos/química , Espanha
19.
J Environ Radioact ; 186: 152-160, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29061309

RESUMO

There are very few data available of 236U in marine sediment cores. In this study we present the results from the first oceanic depth profile of 236U in a sediment core sampled in the North Atlantic Ocean, at the PAP site (4500 m depth, Porcupine Abyssal Plain (PAP) site, 49°0' N, 16°30' W). Additionally, the sediment core was radiologically characterized through the measurement of anthropogenic 137Cs, 239Pu, 240Pu, 129I and 14C and natural 210Pb, 40K and 226Ra. The measured 236U concentrations decrease from about 90·106 at g-1 at the seafloor down to 0.5·106 at g-1 at 6 cm depth. They are several orders of magnitude lower than the reported values for soils from the Northern Hemisphere solely influenced by global fallout (i.e. from 2700·106 to 7500·106 at g-1). 236U/238U atom ratios measured are at least three orders of magnitude above the estimated level for the naturally occurring dissolved uranium. The obtained inventories are 1·1012 at m-2 for 236U, 80 Bq m-2 for 137Cs, 45 Bq m-2 for 239+240Pu and 2.6·1012 at m-2 for 129I. Atomic ratios for 236U/239Pu, 137Cs/236U and 129I/236U, obtained from the inventories are 0.036, 0.11 and 2.5 respectively. Concentration profiles show mobilization probably due to bioturbation from the abundant detritivore holothurian species living at the PAP site sea-floor. The range of 236U, 137Cs, 239+240Pu and 129I values, inventories and ratios of these anthropogenic radionuclides are more similar to the values due to fall-out than values from a contribution from the Nuclear Fuel Reprocessing Plants dispersed to the south-west of the North Atlantic Ocean. However, signs of an additional source are detected and might be associated to the nuclear wastes dumped on the Eastern North Atlantic Ocean.


Assuntos
Sedimentos Geológicos/química , Cinza Radioativa/análise , Urânio/análise , Poluentes Radioativos da Água/análise , Oceano Atlântico , Monitoramento de Radiação
20.
Braz. j. biol ; 77(3): 622-631, July-Sept. 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-888791

RESUMO

Abstract The large estuaries can present long narrow branches called subestuaries or tidal creeks. These types of subsystems are distributed along the Uruguayan coast of the Río de la Plata estuary and are very important as nursery and refuge areas for fish. For the first time, the seasonal composition and abundance of the fish community of the Solís Chico subestuary was studied by using beach and gill nets. Fourteen species, mainly euryhaline (86%) presented a significant representation of juvenile stages. The fish community was dominated by Odontesthes argentinensis, Platanichthys platana, Mugil liza, Brevoortia aurea, Micropogonias furnieri and Paralichthys orbignyanus, similar to adjacent subestuaries. While Micropogonias furnieri and B. aurea were the most abundant species, some other species were rarely caught. A seasonal variation of the fish assemblage abundance was detected, with higher values in autumn showing a positive correlation with temperature. Species that complete their life cycle in the Río de la Plata estuary, some of which are relevant to fisheries (64% of the analyzed species) were captured in the Solís Chico subestuary. The importance of this environment as a transitional system for some estuarine fish species is advised.


Resumo Os grandes estuários podem apresentar longos ramos estreitos chamados subestuários e riachos de maré. Estes subsistemas estão distribuídos ao longo da costa uruguaia no estuário do Río de la Plata e são muito importantes como áreas de reprodução e refúgio para os peixes. Pela primeira vez, a composição sazonal e abundância da comunidade de peixes do subestuário Solís Chico foi estudada usando redes de arrasto de praia e rede de emalhar. Quatorze espécies com predominância das eurialinas foram capturadas, havendo uma representação significativa das fases juvenis e espécies alvo para a pesca. A comunidade de peixes foi dominada por Odontesthes argentinensis, Platanichthys platana, Mugil liza, Brevoortia aurea, Micropogonias furnieri e Paralichthys orbignyanus, semelhante aos subestuários adjacentes. Enquanto, M. furnieri e B. aurea foram as espécies com maior número de individuos. Solís Chico apresentou espécies exclusivas com baixa abundância e ocorrência. Foi verificada uma variação sazonal da abundância de peixes, com valores maiores no outono, mostrando uma correlação positiva com a temperatura. Algumas espécies relevantes para a pesca que completam seu ciclo de vida no estuário do Río de la Plata foram capturadas (64% das espécies estudadas) no subestuário Solís Chico, indicando a importância deste ambiente como um sistema transitório para algumas espécies estuarinas de peixes.


Assuntos
Animais , Biomassa , Biodiversidade , Peixes/fisiologia , Estações do Ano , Uruguai , Densidade Demográfica , Estuários , Pesqueiros
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