Rev Invest Clin
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Comparative Study
An assessment of immediate DNA damage to occupationally exposed workers to low dose ionizing radiation by using the comet assay.
Several cytogenetic studies have shown an increased frequency of chromosomal aberrations for workers exposed to low dose ionizing radiation, however the dose, type of radiation and management vary among the areas of work; it is possible that this variation may generate different quantity of DNA damage, detectable within the first hours after exposure of the personnel. In this study we assessed early DNA lesions caused by exposure to low doses of ionizing radiation in 41 workers from the departments of Radiology, Nuclear Medicine and Radiotherapy and a group of 20 healthy unexposed individuals, all from the same Institution. ⋯ All the workers occupationally exposed showed an increase in DNA fragmentation after the workday. The amount of radiation in all three services is different, in Nuclear Medicine and Radiotherapy the workers showed a greater monthly dose of exposure and greater DNA damage than the Radiology workers. The longer tails were observed in Nuclear Medicine where radionuclides are used; these radioactive substances are handled and administered to patients orally or intravenously by the workers, which implies a different type of exposure and radiation, this may explain the differences found in this study. Most of the DNA damage detected by the comet assay is repaired, however a part of it may result in stable chromosomal rearrangements that may represent a long-term health risk. It is important to sensitize exposed workers on their responsibility of working with radiation and the improvement of the hospital safety practices.
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Case Reports
Bicuspid aortic valve: a synergistic factor for aortic dilation and dissection in Marfan syndrome?
Patients with either Marfan syndrome or bicuspid aortic valve are at increased risk for aortic dilation and dissection, but occurrence of both conditions has barely been reported. Whether bicuspid aortic valve adversely impacts the cardiovascular outcome in Marfan syndrome patients is unknown. The objective was to investigate the prevalence of bicuspid aortic valve and to define whether its combined presence would adversely impact cardiovascular outcome in patients with Marfan syndrome. ⋯ Presence of bicuspid aortic valve shows trends for association with aortic dilation (Odds ratio [OR] 4.2; 95% Confidence interval [95% CI] 0.2-81), and aortic dissection (OR 5.5; 95% CI 0.7-42), while negative association with the Walker-Murdoch sign (OR 0.07; 95% CI 0.006-0.73) was found. Prevalence of bicuspid aortic valve in patients with Marfan syndrome patients is 4.5%. While it is intriguing and even intuitive that the concurrence of both conditions would lead to more aggressive aortic disease, a true synergistic role for aortic wall weakening cannot be supported.
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In invasive monitoring, subclavian-vein puncture is a routine procedure indicated for central vein cathe-terization. It is indicated in patients according to hospital stay, including the administration of drugs and the treatment of chronic and cardiac disease. The techniques described to date include infraclavicular percutaneous puncture; others place catheters using angiographic methods, and the use of magnetic resonance imaging and ultrasound has also been reported. Studies have been done in cadavers to get a better understanding of the procedure since the relationship between vascular elements and surrounding tissues are obtained. The usual technique is with the patient in Trendelenburg position, with the arm in adduction, the placement of an interscapular roll, and the head turned away from the puncture site. ⋯ Greater efficacy with the technique modified by the authors was confirmed. Anatomical cadaver dissections showed a greater space between the right subclavian vein and the clavicle.
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Multicenter Study
[Endemic intravenous fluid contamination in pediatric wards].
To determine the rate of contamination of intravenous solutions and injection ports in pediatric patients. ⋯ Contamination of parenteral solutions is not a rare phenomenon and it could be related to inappropriate practices in the preparation of intravenous solutions and medications as well as the contamination of injection ports. In hospitals working with standards similar to those reported here, the monitoring of sterility of intravenous solutions could contribute to reduce the rate of nosocomial bacteremia.