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Central venous and arterial catheters are commonly used in critically ill patients. Such catheters may entail mechanical and infectious complications. Catheter-related infections result in a high rate of morbidity and mortality and elevated costs. Numerous contributions have been made in the prevention of catheter-related infections, and the present review focuses on which catheter, which access and which insertion technique should be used. Regarding vascular access, some sites have shown higher risk of catheter-related bloodstream infections (CRBSI), such as the internal jugular site with tracheostomy and the femoral access site. With respect to which catheter should be used, there is evidence that catheters impregnated with rifampicin-(minocycline or miconazole) and chlorhexidine-silver sulfadiazine reduce the risk of CRBSI. These impregnated catheters could be considered in the following circumstances: vascular access channelling with increased risk of CRBSI (such as the internal jugular with tracheostomy or femoral access), immunocompromised patients or patients with disorders of skin integrity. Regarding the choice of insertion technique, there is evidence that ultrasound guidance may decrease cannulation failure and complication rates. © SRLF et Springer-Verlag France 2012.

Delgado-Plasencia L.,Hospital Universitario Of Canarias Ofra | Medina-Arana V.,Hospital Universitario Of Canarias Ofra | Bravo-Gutierrez A.,Hospital Universitario Of Canarias Ofra | Perez-Palma J.,Hospital Universitario Of Canarias Ofra | And 4 more authors.
International Journal of Colorectal Disease | Year: 2013

Purposes: Methylenetetrahydrofolate reductase (MTHFR) plays a key role in folate metabolism, and folate is implicated in carcinogenesis by its role in DNA methylation, repair, and synthesis. We analyzed the impact of MTHFR C677T polymorphism in colorectal cancer in a region of the Tenerife Island whose population has a history of genetic isolation and a low genetic variability. This allows analyzing the effects of the polymorphism that are not due to interactions with different genetic variants. Methods: Genomic DNA of 50 Spanish sporadic colorectal cancer (CRC) patients and 103 controls was analyzed by PCR/RFLP and sequencing. Results: The T allele is more frequent in controls than in patients (P < 0.01). The variant (T) carriers displayed significant odds ratio values for the CT heterozygotes (P = 0.026) and even when grouping heterozygote (CT) and homozygotes (TT) (P = 0.015). Patients carriers of the variant T (CT y TT) show a higher survival rate after chemotherapy than the CC homozygotes (log rank; P = 0.001). Conclusions: The MTHRF C677T variant has a protective effect on CRC development in a population with low allelic variability and an optimal intake of folic acid. Moreover, patients carrying the variant (T) show a better prognosis after 5-fluorouracil/folinic acid-based chemotherapy. © 2013 Springer-Verlag Berlin Heidelberg.

De Miguel-Bilbao S.,HealthInstitute Carlos III | Martin M.A.,Hospital Universitario Of Canarias Ofra | Del Pozo A.,HealthInstitute Carlos III | Febles V.,Hospital Universitario Of Canarias Ofra | And 3 more authors.
Health Physics | Year: 2013

Recent advances in wireless technologies have lead to an increase in wireless instrumentation present in healthcare centers. Thispaper presents an analytical method for characterizing electric field (E-field) exposure within these environments. The E-field levels of the different wireless communications systems have been measuredin two floors of the Canary University Hospital Consortium (CUHC). The electromagnetic (EM) conditions detected with the experimental measures have been estimated using the software EFC-400-Telecommunications (Narda Safety Test Solutions, Sandwiesenstrasse 7, 72793 Pfullingen, Germany). The experimental and simulated results are repesented through 2D contour maps, and have been compared with the recommended safety and exposure thresholds. The maximum value obtained is much lower than the 3 V mj1 that is established in the International Electrotechnical Commission Standard of Electromedical Devices. Results show a high correlation in terms of E-field cumulative distribution function (CDF) between the experimental and simulation results. In general, the CDFs of each pair of experimental and simulated samples follow a lognormal distribution with the same mean. Health Phys. 105(Supplement 5):S209-S222; 2013. © Health Physics Society.

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