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3.
Iatreia ; 13(4): 206-214, dic. 2000. tab, graf
Artigo em Espanhol | LILACS | ID: lil-422911

RESUMO

Objetivo: conocer el enfoque inicial de los pacientes con diagnóstico de síndrome de respuesta inflamatoria sistémica de origen infeccioso (SRIS) en unidades de urgencias.Diseño: estudio observacional analítico en una cohorte concurrente.Lugar de estudio: servicios de urgencias del Hospital Universitario San Vicente de Paúl y el Hospital General de Medellín Luz Castro de Gutiérrez.Pacientes: admitidos por urgencias con SRIS de etiología no traumática entre agosto de 1998 y marzo de 1999, de edad igual o superior a 14 años, y con sospecha de Infección como uno de los principales diagnósticos de admisión.Mediciones: descripción de la frecuencia de enfermedades asociadas, factores de riesgo y exploración física básica, determinación y utilidad de ayudas diagnósticas más usadas; y asociación entre foco infeccioso, microbiología, uso previo de antibióticos y antibioterapia empírica inicial en la admisión. Se utilizaron Chi cuadrado o prueba exacta de Fisher para la comparación de proporciones.Resultados: fueron admitidos 502 pacientes. Los principales antecedentes fueron EPOC (21.5 por ciento) y trauma o cirugía previa (18.7 por ciento). La toma de signos vitales se determinó de la siguiente forma: frecuencia cardíaca en 100 por ciento, frecuencia respiratoria en 94.8 por ciento, presión arterial en 99.2 por ciento, temperatura en 80.3 por ciento y escala de Glasgow en 75.7 por ciento de los pacientes. Las solicitudes de laboratorio fueron: recuento de leucocitos en 98.4 por ciento, radiografía de tórax en 71.1 por ciento, recuento de plaquetas en 94.4 por ciento y creatinina en 89 por ciento de pacientes. En 26.5por ciento de los pacientes no se solicitó ningún tipo de cultivo; en los restantes los más solicitados fueron los hemocultivos en 48.8 por ciento del total de la cohorte, de los cuales hubo crecimiento en 19.2por ciento de las muestras. Conclusiones: no todos los signos definitorios de SRIS se determinan en los pacientes con sospecha de infección. El estado neurológico, determinado por la escala de Glasgow, y la toma de temperatura, a pesar de ser parámetros obligatorios de urgencias, se omiten en una cuarta parte de los pacientes. La solicitud de exámenes de laboratorio y los estudios microbiológicos no concuerdan en todos los casos con el diagnóstico de ingreso y la antibioterapia empírica.


Assuntos
Antibacterianos , Sepse , Síndrome de Resposta Inflamatória Sistêmica , Linhas Vitais
4.
In. U.S. Central United States Earthquake Consortium (CUSEC). Monograph 5 : Socioeconomic impacts. Memphis, Tennesse, U.S. Central United States Earthquake Consortium (CUSEC), May 1993. p.69-106, ilus, tab.
Monografia em En | Desastres | ID: des-225

RESUMO

The failure of lifeline system in natural disasters canbe devastating, hampering both response and recovery. Recent events, such as the 1989 Loma Prieta earthquake, heve demonstrated that indirect impacts associated with the failure of lifeline systems may outweigh the direct costs associated with system repair. As a result, the problem of quantifying possible indirect losses is currently receiving increased attention. This chapter addresses previous, current and future efforts in the field of indirect loss assessment. Direct loss is defined as those costs associated with the repair of a damaged lifeline system. Indirect or secondary losses include a variety of post-earthquake costs such as business interruption losses, environmental damage, and collateral damage, e.g., fire following. To describe the basic elements needed to perform an indirect loss assessment, a general methodology is presented. In addition, a review of previous loss assessment studies as well as summaries of several state-of-the-art studies currently underway are presented. Some recent studies focusing on earthquake impacts in the Central and Eastern United States are highlighted. Finally, a discussion is provided on future directions, with respect to models and methodologies, with particular emphasis on the Central and Eastern United States.(AU)


Assuntos
32465 , Avaliação de Danos , Emergências em Desastres , Estados Unidos , Avaliação de Desastres , Linhas Vitais
5.
New York; U. S. National Center for Earthquake Engineering Research (NCEER); Mar. 1989. 80 p. ilus, mapas, tab.(Technical Report, NCEER-89-0009).
Monografia em En | Desastres | ID: des-14570

RESUMO

In this report the effects of the 1985 Michoacan Earthquake on water systems in Mexico are investigated. Because the damage from the 1985 event was most severe in Mexico city, the report concentrates on the Metropolitan Mexico City Area. A historical perspective is provided by information about seismic damage to Mexican water systems due to past earthquakes. This historical perspective highlights the seismic vulnerability of these types of systems. The effects of the earthquake on water supply as well as some aspects of the emergency response are discussed. Soil conditions in Mexico City and the characteristics of the earthquake are investigated and correlated with the observed damage. Damage statistics are presented for the buried segmented pipelines in the water system. Other sections are devoted to damage to a continuous (welded steel) pipeline and to seismic effects on the sewer and underground Metro lifelines. Seismic damage to lifelines in the epicentral region was relatively light. A comparison of ground motion characteristics recorded in Mexico City and in the epicentral region is used to explain these differences. Finally , a general summary and recommendations to reduce the seismic vulnerability of the Mexico City water system as well as other water systems are given.(AU)


Assuntos
Linhas Vitais , Abastecimento de Água , Tubulações , Prevenção e Mitigação de Desastres , Análise de Vulnerabilidade , Avaliação de Danos em Infraestrutura , México
7.
Quito; U.S. Agencia para el Desarrollo Internacional (USAID);Ecuador. Escuela Politécnica Nacional;U.S. National Research Council; s.f. 144 p. ilus, tab.(Estudios de Geografía, 9).
Monografia em Es | Desastres | ID: des-15079
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