Delgado J.M.,Instituto Madrileno Of Oncologia |
Morales J.,Instituto Nacional Of Oncologia Y Radiobiologia |
McDonnell J.D.,National University of Rosario |
Ortiz Lopez P.,International Atomic Energy Agency |
And 12 more authors.
Health Physics | Year: 2013
Knowledge and lessons from past accidental exposures in radiotherapy are very helpful in finding safety provisions to prevent recurrence. Disseminating lessons is necessary but not sufficient. There may be additional latent risks for other accidental exposures, which have not been reported or have not occurred, but are possible and may occur in the future if not identified, analyzed, and prevented by safety provisions. Proactive methods are available for anticipating and quantifying risk from potential event sequences. In this work, proactive methods, successfully used in industry, have been adapted and used in radiotherapy. Risk matrix is a tool that can be used in individual hospitals to classify event sequences in levels of risk. As with any anticipative method, the risk matrix involves a systematic search for potential risks; that is, any situation that can cause an accidental exposure. The method contributes new insights: The application of the risk matrix approach has identified that another group of less catastrophic but still severe single-patient events may have a higher probability, resulting in higher risk. The use of the risk matrix approach for safety assessment in individual hospitals would provide an opportunity for self-evaluation and managing the safety measures that are most suitable to the hospital's own conditions. Copyright © 2013 Health Physics Society.
Vargens D.D.,Instituto Nacional Of Cgncer |
Neves R.R.S.,Instituto Estadual Of Diabetes E Endocrinologia Luiz Capriglione |
Bulzico D.A.,Instituto Nacional Of Cgncer |
Ojopi E.B.,University of Sao Paulo |
And 6 more authors.
Pharmacogenetics and Genomics | Year: 2011
There is a considerable interindividual variation in L-thyroxine [3,5,3',5'-tetraiodo-l-thyronine (T 4)] dose required for thyrotropin (thyroid-stimulating hormone) suppression in patients with differentiated thyroid cancer. To investigate whether uridine diphosphate-glucuronosyl transferase 1A1 (UGT1A1)-mediated T 4 glucuronidation in liver affects T 4 dose, we genotyped 101 patients for the common UGT1A1-53(TA)n polymorphism and compared T 4 doses among patients having zero (5/6 and 6/6 genotypes), one (6/7 genotype), or two (7/7 and 7/8 genotypes) copies of the low-expression (TA) 7 and (TA)8 alleles. A significant trend for decreasing T 4 dose with increasing number of copies of (TA) 7 and (TA)8 (P=0.037) and significant difference in T 4 dose across the UGT1A1-53(TA)n genotypes (P=0.048) were observed, despite considerable overlap of T 4 doses among different genotypes. These results are consistent with reduced T 4 glucuronidation in patients with low-expression (TA)7 and (TA)8 alleles and provide the first evidence for association between UGT1A1-53(TA)n and T 4-dose requirement for thyroid-stimulating hormone suppression in a natural clinical setting. © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.
De Oliveira R.C.,Instituto Oswaldo Cruz |
Padula P.J.,INEI ANLIS Dr C.G. Malbran |
Gomes R.,Instituto Oswaldo Cruz |
Martinez V.P.,INEI ANLIS Dr C.G. Malbran |
And 8 more authors.
Vector-Borne and Zoonotic Diseases | Year: 2011
An ecological assessment of reservoir species was conducted in a rural area (Jaborá) in the mid-west of the state of Santa Catarina in southern Brazil, where hantavirus pulmonary syndrome is endemic, to evaluate the prevalence of hantavirus infection in wild rodents. Blood and tissue samples were collected from 507 rodents during seven field trips from March 2004 to April 2006. Some of the animals were karyotyped to confirm morphological identification. Phylogenetic reconstructions of rodent specimens, based on the mitochondrial DNA cytochrome b gene sequences, were also obtained. Hantavirus antibody was found in 22 (4.3%) of the 507 rodents: 5 Akodon montensis, 2 Akodon paranaensis, 14 Oligoryzomys nigripes, and 1 Sooretamys angouya. Viral RNAs detected in O. nigripes and A. montensis were amplified and sequenced. O. nigripes virus genome was 97.5% (nt) and 98.4% (nt) identical to sequences published for Araucaria (Juquitiba-like) virus based on N and G2 fragment sequences. Viral sequences from A. montensis strain showed 89% and 88% nucleotide identities in a 905-nt fragment of the nucleocapsid (N) protein-coding region of the S segment when it was compared with two other Akodontine rodent-associated viruses from Paraguay, A. montensis and Akodon cursor, respectively. Phylogenetic analysis showed the cocirculation of two genetic hantavirus lineages in the state of Santa Catarina, one from O. nigripes and the other from A. montensis, previously characterized in Brazil and Paraguay, respectively. The hantavirus associated with A. montensis, designed Jaborá virus, represents a distinct phylogenetic lineage among the Brazilian hantaviruses. © Copyright 2011, Mary Ann Liebert, Inc. 2011.
MacCariello E.,NepHro Consultoria em Doencas Renais |
MacCariello E.,Federal University of Fluminense |
Valente C.,NepHro Consultoria em Doencas Renais |
Nogueira L.,NepHro Consultoria em Doencas Renais |
And 9 more authors.
Nephrology Dialysis Transplantation | Year: 2011
Background. Studies on cancer patients with acute kidney injury (AKI) are restricted to specialized intensive care units (ICUs). The aim of this study was to compare the characteristics and outcomes of cancer and non-cancer patients requiring renal replacement therapy (RRT) for AKI in general ICUs.Methods. A prospective cohort study was conducted in 14 ICUs from three tertiary care hospitals. A total of 773 (non-cancer 85%; cancer 15%) consecutive patients were included over a 44-month period. Logistic regression was used to identify factors associated with hospital mortality.Results. Continuous RRT was used in 79% patients. The main contributing factors for AKI were sepsis (72%) and ischaemia/shock (66%); AKI was multifactorial in 87% of cancer and in 71% non-cancer patients. Hospital mortality rates were higher in cancer (78%) than in non-cancer patients (68%) (P = 0.042). However, in multivariate analyses, older age, medical admission, poor chronic health status, comorbidities, ICU days until the RRT start and number of associated organ dysfunctions were associated with hospital mortality. The diagnosis of cancer was not independently associated with mortality [odds ratio = 1.54 (95% confidence interval, 0.88-2.62), P = 0.115]. Mortality in cancer patients was mostly dependent on the number of associated organ dysfunctions. Of note, 85% cancer patients recovered renal function at hospital discharge.Conclusions. In general ICUs, one in six patients requiring RRT has cancer. Despite a relatively higher mortality, the presence of cancer was not independently associated with mortality in the present cohort. © The Author 2010. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.