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Author Loza-Correa, M.; Kou, Y.; Taha, M.; Kalab, M.; Ronholm, J.; Schlievert, P.M.; Cahill, M.P.; Skeate, R.; Cserti-Gazdewich, C.; Ramirez-Arcos, S.
Title Septic transfusion case caused by a platelet pool with visible clotting due to contamination with Staphylococcus aureus Type Journal Article
Year 2017 Publication (down) Transfusion Abbreviated Journal Transfusion
Volume 57 Issue 5 Pages 1299-1303
Keywords Aged; Anti-Bacterial Agents/therapeutic use; Central Venous Catheters/microbiology; Erythrocyte Transfusion/adverse effects; Female; Humans; Leukemia, Myeloid, Acute/therapy; Platelet Transfusion/*adverse effects; Sepsis/*etiology; Staphylococcal Infections/*transmission; *Staphylococcus aureus; Transfusion Reaction/*microbiology
Abstract BACKGROUND: Contamination of platelet concentrates (PCs) with Staphylococcus aureus is one of the most significant ongoing transfusion safety risks in developed countries. CASE REPORT: This report describes a transfusion reaction in an elderly patient diagnosed with acute myeloid leukemia, transfused with a 4-day-old buffy coat PC through a central venous catheter. The transfusion was interrupted when a large fibrous clot in the PC obstructed infusion pump flow. Shortly afterward, a red blood cell (RBC) unit transfusion started. After septic symptoms were developed, the RBC transfusion was also interrupted. While the RBC unit tested negative for bacterial contamination, the PC and the patient samples were found to be contaminated with a S. aureus strain that exhibited the same phenotypic and genome sequencing profiles. The isolated S. aureus forms biofilms and produces the superantigen enterotoxin-like U, which was detected in a sample of the transfused PCs. The patient received posttransfusion antibiotic treatment and had her original central line removed and replaced. DISCUSSION: As the implicated PC had been tested for bacterial contamination during routine screening yielding negative results, this is a false-negative transfusion sepsis case. Using a point-of-care test could have prevented the transfusion reaction. This report highlights the increasing incidence of S. aureus as a major PC contaminant with grave clinical implications. Importantly, S. aureus is able to interact with platelet components resulting in visible changes in PCs. CONCLUSION: Visual inspection of blood components before transfusion is an essential safety practice to interdict the transfusion of bacterially contaminated units.
Address Canadian Blood Services
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 0041-1132 ISBN Medium
Area Expedition Conference
Notes PMID:28205241 Approved no
Call Number ref @ user @ Serial 100117
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Author Rocha, G. da S.; Mello Jorge, M.H.P. de; Grembek, O.
Title After-effects and disabilities in traffic crash victims in northern Brazil Type Journal Article
Year 2017 Publication (down) Traffic Injury Prevention Abbreviated Journal Traffic Inj Prev
Volume 18 Issue 4 Pages 412-419
Keywords Accidents, Traffic/*statistics & numerical data; Adolescent; Adult; Aged; Brazil/epidemiology; Child; Cities; Cross-Sectional Studies; *Disabled Persons; Facial Injuries/epidemiology/mortality/pathology; Female; Humans; Injury Severity Score; Logistic Models; Male; Middle Aged; Motorcycles; Odds Ratio; Risk Factors; Wounds and Injuries/*epidemiology/mortality/pathology; Young Adult; Crashes; after-effects; severity of trauma; traffic; victims
Abstract OBJECTIVES: The objective of this study was to identify the characteristics related to crash and victim, as well as the after-effects/disabilities and consequences arising from traffic crashes occurring in the city of Rio Branco-Acre. METHODS: This is an analytical descriptive cross-sectional study conducted in the City of Rio Branco-Acre. The study population consisted of 405 residents of the city who were victims of traffic crashes, of all age groups and genders, who were hospitalized for the first time as a result of the crash in public hospitals and the health system network, as recorded in the Hospital Information System, and who were discharged between January 1 and December 31, 2010. The data sources included hospital record consultations and active searches for the victims. Hierarchical logistic regression was performed to evaluate the factors associated with the after-effects. RESULTS: The majority of the study population was motorcycle victims (68.6%), male, and young (20-39 years). Concerning the after-effects, the following were significantly associated: factors related to the presence of a postcrash activity limitation (odds ratio [OR] = 2.39; 95% confidence interval [CI], 2.39-6.76), length of hospital stay in days (OR = 1 03; 95% CI, 1.01-1.06), and surgical treatment (OR = 1.82; 95% CI, 1.03-3.21). Those who suffered damage to soft tissue and nerves or facial injury showed an odds ratio of 2 to 4 times of having an after-effect/disability, independent of the victim's personal attributes. CONCLUSION: The mechanism, such as the origin of the pattern of injuries, explains the exposure factors shown by each attribute of the victim and their characteristics. Many of the injuries were precursors to after-effects/disabilities, which, due to their nature and extent, result in the modification of the apparently healthy living standards of young victims who are routinely injured in traffic crashes. Therefore, public policies for prevention should be formulated, reformulated, and implemented, taking into account each attribute of the victims and their social conditions, because these are closely related to their habits and customs. This is a starting point for promoting changes to the current reality that traffic crashes present in the morbidity and mortality of the population.
Address c University of California , Berkeley , Safe Transportation Research and Education Center , Berkeley , California
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 1538-9588 ISBN Medium
Area Expedition Conference
Notes PMID:27575383 Approved no
Call Number ref @ user @ Serial 97666
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Author Patino, A.; Alcalde, V.; Gutierrez, C.; Romero, M.G.; Carrillo, A.M.; Vargas, L.E.; Vallejo, C.E.; Zarama, V.; Mora Rodriguez, J.L.; Bustos, Y.; Granada, J.; Aguiar, L.G.; Menendez, S.; Cohen, J.I.; Saavedra, M.A.; Rodriguez, J.M.; Roldan, T.; Arbelaez, C.
Title Characteristics of Emergency Medicine Residency Programs in Colombia Type Journal Article
Year 2017 Publication (down) The Western Journal of Emergency Medicine Abbreviated Journal West J Emerg Med
Volume 18 Issue 6 Pages 1120-1127
Keywords
Abstract INTRODUCTION: Emergency medicine (EM) is in different stages of development around the world. Colombia has made significant strides in EM development in the last two decades and recognized it as a medical specialty in 2005. The country now has seven EM residency programs: three in the capital city of Bogota, two in Medellin, one in Manizales, and one in Cali. The seven residency programs are in different stages of maturity, with the oldest founded 20 years ago and two founded in the last two years. The objective of this study was to characterize these seven residency programs. METHODS: We conducted semi-structured interviews with faculty and residents from all the existing programs in 2013-2016. Topics included program characteristics and curricula. RESULTS: Colombian EM residencies are three-year programs, with the exception of one four-year program. Programs accept 3-10 applicants yearly. Only one program has free tuition and the rest charge tuition. The number of EM faculty ranges from 2-15. EM rotation requirements range from 11-33% of total clinical time. One program does not have a pediatric rotation. The other programs require 1-2 months of pediatrics or pediatric EM. Critical care requirements range from 4-7 months. Other common rotations include anesthesia, general surgery, internal medicine, obstetrics, gynecology, orthopedics, ophthalmology, radiology, toxicology, psychiatry, neurology, cardiology, pulmonology, and trauma. All programs offer 4-6 hours of protected didactic time each week. Some programs require Advanced Cardiac Life Support, Pediatric Advanced Life Support and Advanced Trauma Life Support, with some programs providing these trainings in-house or subsidizing the cost. Most programs require one research project for graduation. Resident evaluations consist of written tests and oral exams several times per year. Point-of-care ultrasound training is provided in four of the seven programs. CONCLUSION: As emergency medicine continues to develop in Colombia, more residency programs are expected to emerge. Faculty development and sustainability of academic pursuits will be critically important. In the long term, the specialty will need to move toward certifying board exams and professional development through a national EM organization to promote standardization across programs.
Address Harvard Affiliated Emergency Medicine Residency, Massachusetts General Hospital / Brigham and Women's Hospital, Boston, Massachusetts
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 1936-900X ISBN Medium
Area Expedition Conference
Notes PMID:29085546 Approved no
Call Number ref @ user @ Serial 97625
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Author Firmansyah, I.; Spiller, M.; de Ruijter, F.J.; Carsjens, G.J.; Zeeman, G.
Title Assessment of nitrogen and phosphorus flows in agricultural and urban systems in a small island under limited data availability Type Journal Article
Year 2017 Publication (down) The Science of the Total Environment Abbreviated Journal Sci Total Environ
Volume 574 Issue Pages 1521-1532
Keywords Nitrogen; Phosphorus; Small island system; Substance Flow Analysis (SFA); Urban metabolism; Urban-agriculture
Abstract Nitrogen (N) and phosphorus (P) are two essential macronutrients required in agricultural production. The major share of this production relies on chemical fertilizer that requires energy and relies on limited resources (P). Since these nutrients are lost to the environment, there is a need to shift from this linear urban metabolism to a circular metabolism in which N and P from domestic waste and wastewater are reused in agriculture. A first step to facilitate a transition to more circular urban N and P management is to understand the flows of these resources in a coupled urban-agricultural system. For the first time this paper presents a Substance Flow Analysis (SFA) approach for the assessment of the coupled agricultural and urban systems under limited data availability in a small island. The developed SFA approach is used to identify intervention points that can provide N and P stocks for agricultural production. The island of St. Eustatius, a small island in the Caribbean, was used as a case study. The model developed in this study consists of eight sub-systems: agricultural and natural lands, urban lands, crop production, animal production, market, household consumption, soakage pit and open-dump landfill. A total of 26 flows were identified and quantified for a period of one year (2013). The results showed that the agricultural system is a significant source for N and P loss because of erosion/run-off and leaching. Moreover, urban sanitation systems contribute to deterioration of the island's ecosystem through N and P losses from domestic waste and wastewater by leaching and atmospheric emission. Proposed interventions are the treatment of blackwater and greywater for the recovery of N and P. In conclusion, this study allows for identification of potential N and P losses and proposes mitigation measures to improve nutrient management in a small island context.
Address Sub-department of Environmental Technology, Wageningen UR, Bornse Weilanden 9, 6708 WG Wageningen, The Netherlands
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 0048-9697 ISBN Medium
Area Expedition Conference
Notes PMID:27613673 Approved no
Call Number ref @ user @ Serial 97161
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Author Castillo, M.E.; Molina, J.R.; Rodriguez Y Silva, F.; Garcia-Chevesich, P.; Garfias, R.
Title A system to evaluate fire impacts from simulated fire behavior in Mediterranean areas of Central Chile Type Journal Article
Year 2017 Publication (down) The Science of the Total Environment Abbreviated Journal Sci Total Environ
Volume 579 Issue Pages 1410-1418
Keywords Wildfire behavior; Wildfire intensity; Wildfire simulation
Abstract Wildfires constitute the greatest economic disruption to Mediterranean ecosystems, from a socio-economic and ecological perspective (Molina et al., 2014). This study proposes to classify fire intensity levels based on potential fire behavior in different types of Mediterranean vegetation types, using two geographical scales. The study considered >4 thousand wildfires over a period of 25years, identifying fire behavior on each event, based on simulations using “KITRAL”, a model developed in Chile in 1993 and currently used in the entire country. Fire intensity values allowed results to be classified into six fire effects categories (levels), each of them with field indicators linking energy values with damage related to burned vegetation and wildland urban interface zone. These indicators also facilitated a preliminary assessment of wildfire impact on different Mediterranean land uses and, are therefore, a useful tool to prioritize future interventions.
Address International Hydrology Research Group, Faculty of Forest Sciences and Nature Conservancy, University of Chile
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 0048-9697 ISBN Medium
Area Expedition Conference
Notes PMID:27923572 Approved no
Call Number ref @ user @ Serial 97511
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