Potential urban threat after a radiological fire event.

An accident involving both fire and radioactive material might eventually deteriorate into a dual-threat situation. Such scenario connects two important consequences: (a) fire damage and (b) radiation health threat. Computational simulations considering hypothetic fire scenarios in hospitals using radioactive material can provide valuable information about such an event. The initial decision in regards to an emergency response should consider the fire consequences and radiation doses distribution in the environment with consequences appearing at different times. While the fire presents an immediate threat, radiation exposure also creates immediate and future concerns. The purpose of this study is to evaluate leukemia risk from a hypothetical radiological fire event in a hospital operating Cs-137 gamma blood irradiator. The simulation in this study used the Hotspot Health Physics software to generate output data such as total effective dose (TED). The data from HotSpot was then used as an input to the leukemia risk equations from Biological Effects of Ionizing Radiation Committee V and VII (BEIR V and VII) models accordingly. Results suggest that the risks are dependent of wind speed and height of release; however, when age and sex are taken into account different outputs are shown. Also, the risk model can be changed from BEIR VII (low doses) to BEIR V (high doses) as radiation doses rise due to its time-dependent behavior. Such change would bring potential impacts on logistics and risk communication.

Literacia e autocontrolo da pessoa diabética tipo 2 no Hospital de Santa Luzia / Literacy and self-management of type 2 diabetics at Santa Luzia Hospital

A prevalência da diabetes tipo 2 está a aumentar em todo o mundo. A diabetes tipo 2 é uma doença crónica, associada a graves complicações, que origina elevadas taxas de morbilidade e mortalidade. Verifica-se a persistência do controlo metabólico inadequado, podendo ser reflexo tanto do fracasso do autocontrolo pelas pessoas diabéticas, bem como das estratégias de intervenção inadequadas. O conhecimento e o autocontrolo tornam-se cada vez mais importante no tratamento da diabetes tipo 2, promovendo assim a qualidade de vida das pessoas diabéticas e a diminuição dos custos económicos do processo de cuidados. Tomando como referência os dados epidemiológicos da diabetes e a evolução dos índices demográficos, como o índice de envelhecimento, na região do Alto Minho, verificamos um enorme problema de saúde pública com perspetivas muito negativas, por isso torna-se de extrema importância o envolvimento dos cidadãos e principalmente das pessoas diabéticas, promovendo a sua literacia em saúde e empoderamento. Com o objetivo de avaliar a capacidade de autocontrolo, o nível de conhecimento e a qualidade de vida em saúde das pessoas diabéticas tipo 2 seguidas no Hospital Santa Luzia ­ ULSAM, EPE, face à sua patologia, foi realizado um estudo de natureza exploratória, descritivo-correlacional. A recolha de informação decorreu no período de Maio a Agosto de 2014, através de um instrumento de caraterização sociodemográfica e clínica criado para o efeito, do Diabetes Empowerment Scale - Short Form (DES-SF), do Diabetes Knowledge Test (DKT) e do EuroQol-5 Dimensions (EQ-5D). Estes instrumentos foram aplicados numa amostra aleatória sistemática (n=260) de pessoas diabéticas tipo 2, que se deslocaram nesse período à consulta de diabetes do Hospital Santa Luzia - ULSAM, EPE. Definiu-se o nível de significância de 5%. O perfil sociodemográfico dos inquiridos carateriza-se por ser, de forma dominante, constituído por pessoas do sexo feminino (53,5%), possuir o ensino básico (75,9%) como habilitações académicas e uma idade média ± dp de 62,7 ± 12,8 anos. Do ponto de vista clínico, os inquiridos apresentaram valores médios ± dp de duração de diagnóstico, de hemoglobina glicosilada e de índice de massa corporal de 14,65 ± 9,468 anos; 7,9 ± 1,5 % e 30,8 ± 5,73 kg/m2 respetivamente, sendo a hipertensão arterial a patologia associada com maior relevo (52,9%). O índice DES-SF apresentou uma pontuação média ± dp de 3,677 ± 0,69, o DKT apresenta valores de respostas corretas, avaliando o conhecimento global médio ± dp em 65,74 ± 12,42%. O índice do EQ-5D apresentou a média ± dp 0,65 ± 0,27. Detetamos uma associação positiva significativa entre o DES e o DKT (rsp=.17, p<.01) e entre o DES e o EQ-5D (rs p=.30, p<.001). Adicionalmente, apuramos uma correlação positiva entre o DKT e o EQ-5D (rsp=.15, p<.05). Ou seja, maiores valores em um dos fatores estão associados a scores mais elevados nos restantes. Encontramos diferenças estatisticamente significativas no DES, no DKT e no EQ-5D perante a idade (t=2.611, p<.01; t=2.135, p<.05; t=5.193, p<.001, respetivamente) e as habilitações literárias (t=-2.729, p<.01; t=-2.723, p<.01; t=-3.159, p<.01, respetivamente).

The prevalence of Type 2 diabetes is rising all over the world. Type 2 diabetes is a chronic disease causing severe complications associated with high morbidity and mortality. There is persistence of inadequate metabolic control, which may be the reflection of both the failure of self-monitoring by diabetics, as well as inadequate intervention strategies. Self-management education and knowledge becomes increasingly important in the treatment of type 2 diabetes, thus promoting the quality of life of people with diabetes and the reduction of economic costs in the care process. Taking the epidemiological data of diabetes as a reference and the evolution of demographic indices, such as the aging index in the Alto Minho region, we verify a large problem in public health with a very negative outlook, which makes it extremely important to involve citizens and especially the diabetics, in promoting their health literacy and empowerment. Aiming to evaluate the ability of self-monitoring, the level of knowledge and quality of life of type 2 diabetic patients followed at the Hospital Santa Luzia-ULSAM, EPE due to their disease, a study of exploratory descriptive correlational nature was undertaken. Information gathering took place in the period from May to August of 2014, through a sociodemographic and clinical instrument created for this purpose, the Diabetes Empowerment Scale ­ Short Form (DES-SF), the Diabetes Knowledge Test (DKT), and the EuroQol-5 Dimensions (EQ-5D). These instruments were applied in a systematic random sample (n=250) in type 2 diabetic patients who were followed in the diabetes consultations during this period at the Hospital Santa Luzia ­ULSAM, EPE. The significance level of 5% was defined. The socio-demographic profile of the surveyed is characterized in such that it consists, in a dominant form, of females (53.5%), having primary education (75.9%) as academic qualifications and a mean ± dp age of 62.7 +/- 12.8 years. From a clinical point of view, the respondents showed average values ± dp of diagnostic duration, glycosylated hemoglobin and body mass index of 14.65 +/- 9.468 years; 7.9 +/- 1.5% and 30.8 +/ -5.73 kg/m2, respectively, and arterial hypertension is the pathology associated with higher relief (52.9%). The DES-SF score index showed a mean ± dp of 3.677 +/- 0.69, the DKT presents values of correct responses, evaluating the average ± dp global knowledge in 65.74 +/- 12.42%. The EQ-5D index showed a mean ± dp of 0.65+/- 0.27. We detected a significant positive association between the DES and DKT (rsp=.17, p<.01) and between the DES and the Eq-5D (rsp=.30, p<.001). In addition, a positive correlation was found between the DKT and EQ-5D (rsp = .15, p <.05). That is, higher values in one of the factors are associated with higher scores in the other. We found statistically significant differences in DES, the DKT and the EQ-5D before age (t=2.611, p<.01; t=2.135, p<.05; t=5.193, p<.001, respectively) and educational attainment (t=-2.729, p<.01; t=-2.723, p<.01; t=-3.159, p<.01, respectively).

Hospital-associated methicillin-resistant Staphylococcus aureus carrying the PVL gene outbreak in a Public Hospital in Rio de Janeiro, Brazil

Hospital associated methicillin-resist Staphylococcus aureus has long been associated to outbreaks in the hospital environment. In this work, we investigated an outbreak of Hospital associated methicillin-resist Staphylococcus aureus carrying the Panton-Valentine leukocidin gene, which occurred in a large community hospital in Rio de Janeiro, Brazil.

Hospital-associated methicillin-resistant Staphylococcus aureus carrying the PVL gene outbreak in a Public Hospital in Rio de Janeiro, Brazil.

Hospital associated methicillin-resist Staphylococcus aureus has long been associated to outbreaks in the hospital environment. In this work, we investigated an outbreak of Hospital associated methicillin-resist Staphylococcus aureus carrying the Panton-Valentine leukocidin gene, which occurred in a large community hospital in Rio de Janeiro, Brazil.

Detection of new arr-4 and arr-5 gene cassettes in clinical Pseudomonas aeruginosa and Klebsiella pneumoniae strains from Brazil.

New arr alleles emerged in class 1 integrons from a clinical Pseudomonas aeruginosa strain (arr-4) and four Klebsiella pneumoniae strains (arr-5) in Brazil/American continent. arr-4 was preceded by aacA7-catB3, whereas arr-5 was the unique cassette. The putative proteins shared 75% (Arr-5) and 78% (Arr-4) identities with Arr-2.