Records |
Author |
Gredilla, A.; Fdez-Ortiz de Vallejuelo, S.; Gomez-Nubla, L.; Carrero, J.A.; de Leao, F.B.; Madariaga, J.M.; Silva, L.F.O. |
Title |
Are children playgrounds safe play areas? Inorganic analysis and lead isotope ratios for contamination assessment in recreational (Brazilian) parks |
Type |
Journal Article |
Year |
2017 |
Publication |
Environmental Science and Pollution Research International |
Abbreviated Journal |
Environ Sci Pollut Res Int |
Volume |
24 |
Issue |
31 |
Pages |
24333-24345 |
Keywords |
Chemometric analysis; Human health; Icp-Ms; Lead isotopic ratio; Metals; Normalized-and-Weighted Average Concentration; Playgrounds |
Abstract |
In city playgrounds, there is a potential risk of harming children's health by contamination coming from anthropogenic activities. With the aim to determinate the sources and the risk of hazardous elements, soil samples were collected in 19 selected playgrounds of different urban and rural areas from the Rio Grande do Sul state (Brazil). The concentration of 23 metals and metalloids and lead isotopic ratios were determined by ICP-MS. The methodology proposed here, firstly, classified the parks according to the average metal content by means of the NWACs (Normalized-and-Weighted Average Concentrations) and assess the contamination risk determining the Contamination Factors (CFs). Finally, statistical tools (correlation analysis and principal component analysis) were used to identify the most important contamination sources. The statistical tools used, together with lead isotopic composition analysis of the samples, revealed that coal combustion is the main source of contamination in the area. Vegetation was identified as a barrier for the contamination coming from the city. Nonetheless, some of the soils present a possible toxicological risk for humans. In fact, Cr, Sb, and Pb concentrations were higher than the Residential Intervention Values (VIRs) defined by the Environmental Protection Agency of the State of Sao Paulo, also in Brazil. |
Address |
Research Group in Environmental Management and Sustainability, Faculty of Environmental Sciences, Universidad De la Costa, Calle 58, No. 55-56, 080002, Barranquilla, Atlantico, Colombia |
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English |
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ISSN |
0944-1344 |
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Notes  |
PMID:28889400 |
Approved |
no |
Call Number |
ref @ user @ |
Serial |
97629 |
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Author |
Mello, A. de C.; Carvalho, M.S.; Alves, L.C.; Gomes, V.P.; Engstrom, E.M. |
Title |
[Food consumption and anthropometry related to the frailty syndrome in low-income community-living elderly in a large city] |
Type |
Journal Article |
Year |
2017 |
Publication |
Cadernos de Saude Publica |
Abbreviated Journal |
Cad Saude Publica |
Volume |
33 |
Issue |
8 |
Pages |
e00188815 |
Keywords |
Aged; Aged, 80 and over; *Anthropometry; Brazil; Cross-Sectional Studies; Female; *Food; Frail Elderly/*statistics & numerical data; Geriatric Assessment; Humans; Male; Middle Aged; Nutrition Assessment; Nutrition Surveys; Socioeconomic Factors |
Abstract |
The aim of this study was to describe anthropometric and food intake data related to the frailty syndrome in the elderly. This was a cross-sectional study in individuals >/= 60 years of age in a household survey in the Manguinhos neighborhood of Rio de Janeiro, Brazil (n = 137). Frailty syndrome was diagnosed according to Fried et al., anthropometric measures were taken, and a food frequency questionnaire was applied and the results compared to Brazilian Ministry of Health guidelines. In the pre-frail and frail groups, body mass index and measures of central adiposity showed higher levels, while lean muscle parameters showed lower values, proportional to the syndrome's gradation. Frail elderly consumed higher amounts of grains and lower amounts of beans and fruit; pre-frail elderly consumed more vegetables, dairy products, and high-sugar and high-fat foods; the two groups consumed similar amounts of meat. Thus, diagnosis of the syndrome, anthropometric evaluation, and dietary assessment should be included in health policies for the elderly, since they assist in early identification of risk and favor interventions for disease prevention and health and nutritional promotion. |
Address |
Escola Nacional de Saude Publica Sergio Arouca, Fundacao Oswaldo Cruz, Rio de Janeiro, Brasil |
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Portuguese |
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Original Title |
Consumo alimentar e antropometria relacionados a sindrome de fragilidade em idosos residentes em comunidade de baixa renda de um grande centro urbano |
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ISSN |
0102-311X |
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PMID:28832786 |
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no |
Call Number |
ref @ user @ |
Serial |
98007 |
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Author |
Girardi, S.N.; Carvalho, C.L.; Maas, L.W.D.; Araujo, J.F.; Massote, A.W.; Stralen, A.C. de S. van; Souza, O.A. de |
Title |
[Preferences for work in primary care among medical students in Minas Gerais State, Brazil: evidence from a discrete choice experiment] |
Type |
Journal Article |
Year |
2017 |
Publication |
Cadernos de Saude Publica |
Abbreviated Journal |
Cad Saude Publica |
Volume |
33 |
Issue |
8 |
Pages |
e00075316 |
Keywords |
Brazil; *Career Choice; Choice Behavior; Female; Humans; Income; Male; *Primary Health Care; *Professional Practice Location; Sex Factors; *Students, Medical; Surveys and Questionnaires |
Abstract |
This article presents the results of a discrete choice experiment (DCE) conducted in 2012 with 277 final-year medical students from Minas Gerais State, Brazil. The experiment tested students' preferences concerning future work as physicians in primary health care, based on hypothetical job scenarios aimed at measuring the likelihood of placement in areas with a shortage of doctors. Application of DCE involved (i) a qualitative stage to define the attributes and their respective levels to comprise the job scenarios, (ii) construction and application of the instrument, and (iii) analysis with application of multinomial logit with conditional probability to estimate the weight of attributes and to construct scenarios for choice probability. The results indicate that the job attribute that most impacted students' choice was location, followed by job conditions, pay, access to medical residency, type of employment relationship, and workload. Students from private medical schools, with higher family income, and females were generally more likely to resist job assignments in unsafe urban areas and remote areas of the countryside. The job scenarios that proved most plausible in terms of public intervention were those that combined middle-level wages, good working conditions, and 10 to 20 bonus points on medical residency exams. |
Address |
Departamento de Matematica, Universidade Estadual do Centro-Oeste, Guarapuava, Brasil |
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Portuguese |
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Original Title |
Preferencias para o trabalho na atencao primaria por estudantes de medicina em Minas Gerais, Brasil: evidencias de um experimento de preferencia declarada |
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0102-311X |
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Notes  |
PMID:28832780 |
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no |
Call Number |
ref @ user @ |
Serial |
97630 |
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Author |
Saunders, M.J.; Wingfield, T.; Tovar, M.A.; Baldwin, M.R.; Datta, S.; Zevallos, K.; Montoya, R.; Valencia, T.R.; Friedland, J.S.; Moulton, L.H.; Gilman, R.H.; Evans, C.A. |
Title |
A score to predict and stratify risk of tuberculosis in adult contacts of tuberculosis index cases: a prospective derivation and external validation cohort study |
Type |
Journal Article |
Year |
2017 |
Publication |
The Lancet. Infectious Diseases |
Abbreviated Journal |
Lancet Infect Dis |
Volume |
17 |
Issue |
11 |
Pages |
1190-1199 |
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Abstract |
BACKGROUND: Contacts of tuberculosis index cases are at increased risk of developing tuberculosis. Screening, preventive therapy, and surveillance for tuberculosis are underused interventions in contacts, particularly adults. We developed a score to predict risk of tuberculosis in adult contacts of tuberculosis index cases. METHODS: In 2002-06, we recruited contacts aged 15 years or older of index cases with pulmonary tuberculosis who lived in desert shanty towns in Ventanilla, Peru. We followed up contacts for tuberculosis until February, 2016. We used a Cox proportional hazards model to identify index case, contact, and household risk factors for tuberculosis from which to derive a score and classify contacts as low, medium, or high risk. We validated the score in an urban community recruited in Callao, Peru, in 2014-15. FINDINGS: In the derivation cohort, we identified 2017 contacts of 715 index cases, and median follow-up was 10.7 years (IQR 9.5-11.8). 178 (9%) of 2017 contacts developed tuberculosis during 19 147 person-years of follow-up (incidence 0.93 per 100 person-years, 95% CI 0.80-1.08). Risk factors for tuberculosis were body-mass index, previous tuberculosis, age, sustained exposure to the index case, the index case being in a male patient, lower community household socioeconomic position, indoor air pollution, previous tuberculosis among household members, and living in a household with a low number of windows per room. The 10-year risks of tuberculosis in the low-risk, medium-risk, and high-risk groups were, respectively, 2.8% (95% CI 1.7-4.4), 6.2% (4.8-8.1), and 20.6% (17.3-24.4). The 535 (27%) contacts classified as high risk accounted for 60% of the tuberculosis identified during follow-up. The score predicted tuberculosis independently of tuberculin skin test and index-case drug sensitivity results. In the external validation cohort, 65 (3%) of 1910 contacts developed tuberculosis during 3771 person-years of follow-up (incidence 1.7 per 100 person-years, 95% CI 1.4-2.2). The 2.5-year risks of tuberculosis in the low-risk, medium-risk, and high-risk groups were, respectively, 1.4% (95% CI 0.7-2.8), 3.9% (2.5-5.9), and 8.6%. (5.9-12.6). INTERPRETATION: Our externally validated risk score could predict and stratify 10-year risk of developing tuberculosis in adult contacts, and could be used to prioritise tuberculosis control interventions for people most likely to benefit. FUNDING: Wellcome Trust, Department for International Development Civil Society Challenge Fund, Joint Global Health Trials consortium, Bill & Melinda Gates Foundation, Imperial College National Institutes of Health Research Biomedical Research Centre, Foundation for Innovative New Diagnostics, Sir Halley Stewart Trust, WHO, TB REACH, and Innovation for Health and Development. |
Address |
Section of Infectious Diseases and Immunity, Imperial College London, London, UK; Wellcome Trust Imperial College Centre for Global Health Research, London, UK; Innovation for Health and Development (IFHAD), Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Peru; Innovacion Por la Salud Y Desarrollo (IPSYD), Asociacion Benefica PRISMA, Lima, Peru |
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English |
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ISSN |
1473-3099 |
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Notes  |
PMID:28827142 |
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no |
Call Number |
ref @ user @ |
Serial |
97505 |
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Author |
Saleh, H.M.; Tawfik, M.M.; Abouellail, H. |
Title |
Prospective, randomized study of long-term hemodialysis catheter removal versus guidewire exchange to treat catheter-related bloodstream infection |
Type |
Randomized Controlled Trial |
Year |
2017 |
Publication |
Journal of Vascular Surgery |
Abbreviated Journal |
J Vasc Surg |
Volume |
66 |
Issue |
5 |
Pages |
1427-1431.e1 |
Keywords |
Aged; Anti-Bacterial Agents/therapeutic use; Catheter-Related Infections/blood/diagnosis/microbiology/*therapy; Catheterization, Central Venous/*adverse effects/*instrumentation; Catheters, Indwelling/*adverse effects; Central Venous Catheters/*adverse effects; *Device Removal/adverse effects; Disease-Free Survival; Egypt; Equipment Design; Female; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Prospective Studies; Renal Dialysis; Risk Factors; Time Factors; Treatment Outcome |
Abstract |
BACKGROUND: Long-term (tunneled cuffed) hemodialysis catheters are frequently used vascular access in renal failure patients. Catheter-related bloodstream infection (CRBSI) is a common complication of long-term hemodialysis catheters, with severe morbidities and high risk of mortality. Management of CRBSI by systemic antibiotics while keeping the catheter in place is not effective. Among the different modalities of CRBSI management are catheter removal (CR) and guidewire exchange (GE) of the catheter. The aim of this study was to compare the clinical outcome of CRBSI treated with two different strategies: GE vs CR with new catheter insertion 3 to 7 days later. METHODS: This prospective randomized study analyzed the outcomes of all cases of long-term hemodialysis CRBSI during a 5-year period. The catheter infection-free survival time was analyzed in the two groups of patients (GE group, 339 patients; CR group, 339 patients). Three weeks of systemic antibiotic therapy was used according to culture in both groups. The catheter infection-free survival was analyzed using Kaplan-Meier analysis. RESULTS: No statistically significant difference was found in catheter infection-free survival time for GE and CR groups (P = .69), which is not affected by age, sex, presence of diabetes mellitus, or type of causative organism. CONCLUSIONS: Our study did not demonstrate a difference in the clinical outcome of CRBSI treated with GE or CR with new catheter insertion 3 to 7 days later. However, guidewire catheter exchange saves veins for future access, reduces the cost and number of procedures, and avoids complications of new venipuncture. |
Address |
Department of Nephrology, Ain Shams University, El Demerdash Hospital, Cairo, Egypt |
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0741-5214 |
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PMID:28822660 |
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Call Number |
ref @ user @ |
Serial |
99317 |
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