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1.
Referência ; serVI(2): e22082, dez. 2023. tab, graf
Article in Portuguese | LILACS-Express | BDENF - Nursing | ID: biblio-1521456

ABSTRACT

Resumo Enquadramento: Os médicos residentes das salas operatórias apresentam sinais e sintomas relacionados à exposição ao fumo cirúrgico. Objetivo: Determinar a incidência e o risco relativo do desenvolvimento de sinais e sintomas relacionados com a exposição ao fumo cirúrgico em médicos residentes. Metodologia: Estudo de coorte, realizado com médicos residentes expostos e não expostos ao fumo cirúrgico. A colheita de dados foi realizada em dois momentos, durante quatro meses, com um formulário contendo as características sociodemográficas, de trabalho, sinais e sintomas e medidas preventivas. Resultados: Os sinais e sintomas mais incidentes nos expostos quando comparados com os não expostos ao fumo cirúrgico foram sensação de corpo estranho na garganta, ardência de faringe, irritação de outras mucosas e lesões nasofaríngeas. A utilização dos óculos de proteção foi um fator de proteção para os expostos (p = 0,01). Conclusão: Houve maior incidência de sinais e sintomas relacionados com o fumo cirúrgico nos expostos quando comparados aos não expostos. O risco relativo de desenvolvimento de sinais e sintomas é sempre maior para os expostos.


Abstract Background: Medical residents in operating rooms present signs and symptoms associated with occupational exposure to surgical smoke. Objective: To determine the incidence and relative risk of developing signs and symptoms associated with surgical smoke exposure in medical residents. Methodology: A cohort study was conducted with medical residents exposed and unexposed to surgical smoke. Data collection was conducted in two moments, over four months, using a questionnaire containing items on sociodemographic and occupational characteristics and surgical smoke-related signs and symptoms and protective measures. Results: The most frequent signs and symptoms in those exposed compared to those unexposed to surgical smoke were foreign body sensation in the throat, burning sensation in the pharynx, irritation of other mucous membranes, and nasopharyngeal lesions. The use of protective eyewear was a protective factor for those exposed (p = 0.01). Conclusion: Surgical smoke-related signs and symptoms are higher in medical residents exposed than in those unexposed. The relative risk of developing signs and symptoms is always higher for those exposed.


Resumen Marco contextual: Los médicos residentes de los quirófanos presentan signos y síntomas relacionados con la exposición al humo quirúrgico. Objetivo: Determinar la incidencia y el riesgo relativo de desarrollar signos y síntomas relacionados con la exposición al humo quirúrgico en médicos residentes. Metodología: Estudio de cohorte, realizado con médicos residentes expuestos y no expuestos al humo quirúrgico. La recogida de datos se realizó en dos momentos, durante cuatro meses, con un formulario que contenía las características sociodemográficas y laborales, los signos y los síntomas, y las medidas preventivas. Resultados: Los signos y síntomas más incidentes en aquellos expuestos en comparación con los no expuestos al humo quirúrgico fueron sensación de cuerpo extraño en la garganta, ardor faríngeo, irritación de otras mucosas y lesiones nasofaríngeas. El uso de gafas protectoras fue un factor de protección para los expuestos (p = 0,01). Conclusión: Hubo una mayor incidencia de signos y síntomas relacionados con el humo quirúrgico en aquellos expuestos en comparación con los no expuestos. El riesgo relativo de desarrollar signos y síntomas es siempre mayor para los expuestos.

2.
Rev. Arbitr. Interdiscip. Cienc. Salud ; 7(13): 28-39, jun. 2023. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1535066

ABSTRACT

RESUMEN Objetivo: Analizar la contaminación microbiana durante la atención odontológica por la producción de aerosoles y salpicaduras. Metodología: De tipo documental, bibliográfica. La búsqueda se realizó a través de las bases de datos PubMed y Scopus. Considerando los lineamientos de la declaración PRISMA obteniendo un total de 221 artículos. Posteriormente se aplicaron los criterios de exclusión como de inclusión, obteniendo un total de 25 artículos. Resultados: La carga microbiana presente en el ambiente odontológico ha sido analizada de manera cuantitativa a través de las Unidades Formadoras de Colonias (UFC) en diferentes espacios y superficies de las clínicas dentales. En conclusión: La contaminación microbiológica asociada con la generación de aerosoles es una problemática que se experimenta en la consulta diaria, relacionándose principalmente con procedimientos asociados con equipos como las piezas de mano de alta velocidad, el equipo ultrasónico y la jeringa triple.


ABSTRACT Objective: To analyze microbial contamination during dental care due to the production of aerosols and splashes. Methodology: Documentary, bibliographic type. The search was carried out through the Pubmed and SCOPUS databases. Considering the guidelines of the PRISMA declaration, a total of 221 articles were obtained. Subsequently, the exclusion and inclusion criteria were applied, obtaining a total of 25 articles. Results: The microbial load present in the dental environment has been analyzed quantitatively through Colony Forming Units (CFU) in different spaces and surfaces of dental clinics. In conclusion: Microbiological contamination associated with the generation of aerosols is a problem that is experienced in the daily dental practice, mainly related to procedures associated with equipment such as high-speed handpieces, ultrasonic equipment and triple syringe.

3.
Med. clín (Ed. impr.) ; 160(12): 519-524, jun. 2023. tab, ilus
Article in English | IBECS | ID: ibc-221815

ABSTRACT

Introduction and aims Environmental pollution are one of the most relevant risk factors to atherosclerosis. To know awareness about the importance of urban air pollution as a trigger for hospital admission due to acute coronary syndrome (ACS), this study analyzed levels of different gaseous air pollutants in the air and its correlation with number of ACS. Methods Epidemiological data of patients admitted for ACS in five towns during the years 2006–2008 were recovered. Clinical data regarding admissions for ACS were obtained from the hospital admission services. Measures of seven air contaminants were recovered from the environmental stations. Mixed model including sex, age, location, and the average levels of air pollutants contaminants as fixed effects and its interaction were performed. Results The incidence rate of ACS is higher in man than woman, and higher in older people than young. The maximum ACS were in the last trimester of the year, was the most elevated levels of gaseous pollutants have been found. Levels of NO2, NO, and CO are positively correlated between them, and negatively correlated with O3 levels. All air pollutants analyzed increase the number of ACS hospital admission in the five locations evaluated. Conclusions Levels of gaseous pollutants are related between them, being the levels of NO2, NO, and CO, positively correlated, and negatively correlated with levels of O3. Number of ACS hospital admission increases with levels of five air gaseous pollutants studied (AU)


Introducción y objetivos La contaminación ambiental es uno de los factores de riesgo más relevantes para la aterosclerosis. Para conocer la importancia de la contaminación del aire urbano como desencadenante del ingreso hospitalario por síndrome coronario agudo (SCA), este estudio analizó los niveles de diferentes contaminantes atmosféricos gaseosos en el aire y su correlación con el número de SCA. Métodos Se recuperaron datos epidemiológicos de pacientes ingresados por SCA en 5 municipios durante los años 2006 a 2008. Los datos clínicos relativos a los ingresos por SCA se obtuvieron de los servicios de ingreso hospitalario. Se recuperaron medidas de 7 contaminantes del aire de las estaciones ambientales. Se realizó un modelo mixto que incluye sexo, edad, ubicación y los niveles promedio de contaminantes atmosféricos como efectos fijos y su interacción. Resultados La tasa de incidencia de SCA es mayor en hombres que en mujeres, y mayor en personas mayores que en jóvenes. La mayoría de los SCA se dieron en el último trimestre del año, cuando se encontraron niveles más elevados de gases contaminantes. Los niveles de NO2, NO y CO se correlacionan positivamente entre ellos y negativamente con los niveles de O3. Todos los contaminantes atmosféricos analizados aumentan el número de ingresos hospitalarios por SCA en las 5 localidades evaluadas. Conclusiones Los niveles de contaminantes gaseosos se relacionan entre sí, estando los niveles de NO2, NO y CO correlacionados positivamente entre sí y negativamente con los niveles de O3. El número de ingresos hospitalarios por SCA aumenta con los niveles de 5 contaminantes gaseosos del aire estudiados (AU)


Subject(s)
Humans , Male , Female , Aged , Acute Coronary Syndrome/epidemiology , Acute Coronary Syndrome/etiology , Air Pollution/adverse effects , Nitrogen Dioxide/adverse effects , Particulate Matter/adverse effects , Air Pollution/analysis , Nitrogen Dioxide/analysis , Particulate Matter/analysis , Longitudinal Studies , Risk Factors , Spain/epidemiology
4.
Med Clin (Barc) ; 160(12): 519-524, 2023 06 23.
Article in English, Spanish | MEDLINE | ID: mdl-37088610

ABSTRACT

INTRODUCTION AND AIMS: Environmental pollution are one of the most relevant risk factors to atherosclerosis. To know awareness about the importance of urban air pollution as a trigger for hospital admission due to acute coronary syndrome (ACS), this study analyzed levels of different gaseous air pollutants in the air and its correlation with number of ACS. METHODS: Epidemiological data of patients admitted for ACS in five towns during the years 2006-2008 were recovered. Clinical data regarding admissions for ACS were obtained from the hospital admission services. Measures of seven air contaminants were recovered from the environmental stations. Mixed model including sex, age, location, and the average levels of air pollutants contaminants as fixed effects and its interaction were performed. RESULTS: The incidence rate of ACS is higher in man than woman, and higher in older people than young. The maximum ACS were in the last trimester of the year, was the most elevated levels of gaseous pollutants have been found. Levels of NO2, NO, and CO are positively correlated between them, and negatively correlated with O3 levels. All air pollutants analyzed increase the number of ACS hospital admission in the five locations evaluated. CONCLUSIONS: Levels of gaseous pollutants are related between them, being the levels of NO2, NO, and CO, positively correlated, and negatively correlated with levels of O3. Number of ACS hospital admission increases with levels of five air gaseous pollutants studied.


Subject(s)
Acute Coronary Syndrome , Air Pollutants , Air Pollution , Environmental Pollutants , Female , Humans , Aged , Gases , Nitrogen Dioxide/adverse effects , Nitrogen Dioxide/analysis , Acute Coronary Syndrome/etiology , Acute Coronary Syndrome/chemically induced , Spain/epidemiology , Air Pollutants/adverse effects , Air Pollutants/analysis , Air Pollution/adverse effects , Air Pollution/analysis , Particulate Matter/analysis
5.
Rev. esp. salud pública ; 97: e202304033, Abr. 2023. ilus, tab
Article in Spanish | IBECS | ID: ibc-219802

ABSTRACT

Fundamentos: El conjunto de exposiciones a sustancias químicas y su papel como causa de enfermedad da lugar al conceptode exposoma, conformado parcialmente por contaminantes químicos a los que un individuo se ve expuesto. Por ello, a diferenciadel genoma, es un factora priori modificable, siendo su estudio crucial en materia de Salud Pública. La población del archipiélagocanario ha sido estudiada en cuanto a sus niveles de contaminación química, con numerosos estudios de biomonitorización, lo quehace necesario caracterizar el exposoma de ésta y sus consecuencias en términos de enfermedad, para poder implementar medidascorrectoras específicas que minimicen el impacto en su salud.Métodos: Se realizó una revisión de la literatura científica (MEDLINE yScopus) de acuerdo con los criterios PRISMA y siguiendo lametodología PICO, para incluir estudios de biomonitorización de contaminantes, o que evaluaran el efecto de éstos en enfermedadesprevalentes en el archipiélago.Resultados: Se seleccionaron veinticinco estudios, tanto de base poblacional como de base hospitalaria. Los resultados de-muestran que el exposoma lo conforman, como mínimo, 110 compuestos o elementos, 99 de los cuales parecen estar presentes desdela etapa intrauterina. Destaca la presencia de contaminantes clorados y metales, lo que parece relacionarse con la alta incidencia deenfermedades metabólicas (diabetes), cardiovasculares (hipertensión) y ciertos tipos de neoplasias (cáncer de mama). Aunque talesconsecuencias vienen condicionadas por el genoma de la población expuesta, reforzando la enorme importancia de las interaccionesgenoma-exposoma en el desarrollo de patologías.Concluiones: Nuestros resultados indican que es necesario establecer medidas correctoras sobre las fuentes de contamina-ción que modifiquen el exposoma de esta población.(AU)


Background: The set of exposures to chemical substances and their role as a cause of disease gives rise to the concept of theexposome, partially made up of chemical pollutants to which an individual is exposed, which is why, unlike the genome, it is an a priorimodifiable factor, its study being crucial in terms of Public Health. The population of the Canary Islands has been studied in terms ofits levels of chemical contamination, with numerous biomonitoring studies, which makes it necessary to characterise its exposomeand its consequences in terms of disease, in order to implement specific corrective measures to minimize the impact on its health.Methods: A review of scientific literature (MEDLINE and Scopus) was made, according to PRISMA criteria and PICO methodology, toinclude studies on biomonitoring of pollutants, or evaluating the effect of pollutants on diseases prevalent in the archipelago.Results: Twenty-five studies, both population-based and hospital-based, were selected. The results show that the exposome is madeup of at least 110 compounds or elements, 99 of which appear to be present from the intrauterine stage. The presence of chlorinated po-llutants and metals stands out, which seems to be related to the high incidence of metabolic diseases (diabetes), cardiovascular diseases(hypertension) and certain types of neoplasms (breast cancer). In short, the consequences are conditioned by the genome of the exposedpopulation, reinforcing the enormous importance of genome-exposome interactions in the development of pathologies.Conclusions: Our results indicate that it is necessary to establish corrective measures on the sources of pollution that modifythe exposome of this population.(AU)


Subject(s)
Humans , Chemical Contamination , Neoplasms , Cardiovascular Diseases , Metabolic Diseases , Public Health , Chemical Pollutants
6.
Rev. argent. microbiol ; 55(1): 11-20, mar. 2023. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1441181

ABSTRACT

Resumen La actividad cervecera en la Patagonia andina argentina tiene un rol muy importante en la economía de la región; una de las problemáticas que enfrenta, en términos de calidad, son las contaminaciones microbianas. La presencia de bacterias y levaduras contaminantes en la cerveza produce cambios microbiológicos, físicos y químicos, que impactan en sus atributos sensoriales. No obstante, pocas cervecerías establecen criterios y políticas que garanticen la calidad microbiológica de sus productos. El propósito de este trabajo fue estudiar por primera vez la incidencia de contaminantes microbianos en cervezas artesanales embotelladas producidas en la Patagonia andina argentina, además de identificar los principales microorganismos involucrados y determinar posibles relaciones entre los eventos de contaminación y variables fisicoquímicas de la cerveza. Para ello se analizaron 75 cervezas provenientes de 37 cervecerías de 12 localidades andinas. El 69,3% de las muestras analizadas evidenció crecimiento de microorganismos en los medios de cultivo empleados para la detección de contaminantes cerveceros. La bacteria Levilactobacillus brevis y levaduras del género Saccharomyces fueron los principales contaminantes identificados. Se comprobó que las contaminaciones microbianas impactaron sobre el perfil sensorial de la cerveza y que el cambio de pH fue un indicador de contaminación por bacterias lácticas. De cada 10 fábricas estudiadas, 8 presentaron problemas de contaminación, lo que pone en evidencia la necesidad de diseñar estrategias de prevención y control de contaminaciones en microcervecerías.


Abstract The brewing activity in Andean Patagonia plays a very important role in the region's economy, being microbial contamination one of the main problems in terms of quality. The presence of contaminant bacteria and wild yeasts in beer generate microbiological, physical and chemical changes that impact on its sensory attributes. However, few breweries establish criteria and policies to guarantee the quality of their products in a microbiological sense. The purpose of this work was to study for the first time the incidence of microbial contaminants in bottled craft beers from Andean Patagonia, identify the main microorganisms involved and establish relationships between contamination and the physicochemical variables of beer. We analyzed 75 beers from 37 breweries from 12 different Patagonian cities. Our results showed that 69.3% of the analyzed beer exhibited contaminant microorganism growth. Bacteria Levilactobacillus brevis and wild yeasts of Saccharomyces were the main microorganisms responsible for these contaminations. In addition, we found that microbial contamination had an impact on beer sensory profile and also that pH was correlated with the presence of lactic acid bacteria in beer, being an indicator of contamination for these bacteria. In conclusion, we observed that 8 out of 10 breweries studied showed contamination problems, highlighting the need to design prevention and control strategies in microbreweries.

7.
Rev Argent Microbiol ; 55(2): 120-128, 2023.
Article in English | MEDLINE | ID: mdl-36682905

ABSTRACT

The high load of agrochemicals and antibiotics present in agricultural aquatic environments represents a risk for wildlife. Since enteric bacteria, which play a key role in the physiological functioning of their hosts, are sensitive to a wide variety of pollutants, their study allows to evaluate the health of organisms. This study aimed to evaluate the effects of commercial formulations of a glyphosate-based herbicide (GBH) and the antibiotic ciprofloxacin (CIP), individually and in mixture, on the bacterial diversity of the intestinal content of common toad (Rhinella arenarum) tadpoles. The diversity of cultivable fast-growing bacteria with low nutritional requirements was evaluated using classic microbiological tests and matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry identification. Bacterial diversity varied among treatments. Taxa diversity increased in the GBH-treated group but decreased in the CIP-treated group. Remarkably, Yersinia spp. and Proteus spp. were only found in the GBH-treated group. The prevalence of Klebsiella spp. and Pseudomonas spp. decreased in the intestinal microbiota of the GBH-CIP-treated group. To our knowledge, this is the first report on the alteration of cultivable enteric bacteria of autochthonous tadpoles due to two pollutants of emerging concern. Our results demonstrate that R. arenarum tadpoles can be used as non-conventional model organisms for environmental pollution monitoring. Our preliminary findings would contribute to understanding how the presence of GBH and CIP in freshwaters may represent a threat to wildlife and human health by causing enteric dysbiosis of part of the bacterial community.


Subject(s)
Gastrointestinal Microbiome , Herbicides , Animals , Humans , Larva , Ciprofloxacin/adverse effects , Herbicides/pharmacology , Enterobacteriaceae , Anti-Bacterial Agents/adverse effects , Glyphosate
8.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1428988

ABSTRACT

Analizar la contaminación microbiana durante la atención odontológica por la producción de aerosoles y salpicaduras. Metodología: De tipo documental, bibliográfica. La búsqueda se realizó a través de la en las bases de datos Pubmed y SCOPUS. Considerando los lineamientos de la declaración PRISMA obteniendo un total de 221 artículos. Posteriormente se aplicó los criterios de exclusión como de inclusión, obteniendo un total de 25 artículos. Resultados: La carga microbiana presente en el ambiente odontológico ha sido analizada de manera cuantifica a través de Unidades Formadoras de Colonias (UFC) en diferentes espacios y superficies de las clínicas dentales. En conclusión: La contaminación microbiológica asociada con la generación de aerosoles es una problemática que se experimenta en la consulta diaria, relacionándose principalmente con procedimientos asociados con equipos como las piezas de mano de alta velocidad, el equipo ultrasónico y la jeringa triple.


To analyze microbial contamination during dental care due to the production of aerosols and splashes. Methodology: Documentary, bibliographic type. The search was carried out through the Pubmed and SCOPUS databases. Considering the guidelines of the PRISMA declaration, a total of 221 articles were obtained. Subsequently, the exclusion and inclusion criteria were applied, obtaining a total of 25 articles. Results: The microbial load present in the dental environment has been analyzed quantitatively through Colony Forming Units (CFU) in different spaces and surfaces of dental clinics. In conclusion: Microbiological contamination associated with the generation of aerosols is a problem that is experienced in the daily dental practice, mainly related to procedures associated with equipment such as high-speed handpieces, ultrasonic equipment and triple syringe.

9.
Rev Argent Microbiol ; 55(1): 88-99, 2023.
Article in Spanish | MEDLINE | ID: mdl-35738976

ABSTRACT

The brewing activity in Andean Patagonia plays a very important role in the region's economy, being microbial contamination one of the main problems in terms of quality. The presence of contaminant bacteria and wild yeasts in beer generate microbiological, physical and chemical changes that impact on its sensory attributes. However, few breweries establish criteria and policies to guarantee the quality of their products in a microbiological sense. The purpose of this work was to study for the first time the incidence of microbial contaminants in bottled craft beers from Andean Patagonia, identify the main microorganisms involved and establish relationships between contamination and the physicochemical variables of beer. We analyzed 75 beers from 37 breweries from 12 different Patagonian cities. Our results showed that 69.3% of the analyzed beer exhibited contaminant microorganism growth. Bacteria Levilactobacillus brevis and wild yeasts of Saccharomyces were the main microorganisms responsible for these contaminations. In addition, we found that microbial contamination had an impact on beer sensory profile and also that pH was correlated with the presence of lactic acid bacteria in beer, being an indicator of contamination for these bacteria. In conclusion, we observed that 8 out of 10 breweries studied showed contamination problems, highlighting the need to design prevention and control strategies in microbreweries.


Subject(s)
Beer , Yeasts , Beer/analysis , Argentina , Bacteria , Fermentation
10.
Gac Sanit ; 37: 102282, 2023.
Article in Spanish | MEDLINE | ID: mdl-36577266

ABSTRACT

The Canary Islands Health Service is aware of the health risks arising from climate change. So health systems must be, with their action, part of the solution, not part of the problem. Currently, 4.4% of global carbon dioxide emissions come from activities related to the health field. To respond to this situation, the Canary Islands Health Service has launched the "Carbon Net Zer0 2030" strategy intending to achieve neutrality in net carbon emissions in the year 2030, applying measures direct and indirect, especially on the supply chain of the public health system. This is a ground-breaking project in Spain and is under continuous review, adding new specific actions to the strategy as the carbon footprint of the different procedures involved in the provision of health services is quantified.


Subject(s)
Air Pollutants , Humans , Spain , Health Services , Climate Change
11.
Cad. Saúde Pública (Online) ; 39(10): e00238422, 2023. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1520541

ABSTRACT

Resumo: Este estudo buscou analisar a relação entre as hospitalizações por agravos respiratórios e a queima regular da cana-de-açúcar em Pernambuco, Brasil. Trata-se de um estudo ecológico de série temporal correspondente ao período de 2008 a 2018. Foram comparadas as taxas de hospitalizações por agravos respiratórios em crianças menores de 5 anos e em idosos maiores de 60 anos em municípios produtores e não produtores de cana-de-açúcar, por meio da análise estatística não paramétrica de Mann-Whitney. Conjuntamente, foi observada a distribuição mensal das ocorrências de focos de calor nos municípios casos e controles e aplicada a correlação de Pearson para analisar a associação entre ambas as variáveis. Foi verificado que, para ambos os grupos etários, as taxas de hospitalizações são maiores nos municípios produtores de cana-de-açúcar, com diferença estatística significativa p < 0,005. A taxa de internação hospitalar em idosos é 28% mais elevada nos municípios casos, sendo ainda maior em crianças menores de 5 anos, cuja razão das medianas é 40%. No entanto, foi identificado que o comportamento sazonal das hospitalizações por agravos respiratórios diverge do observado na distribuição mensal dos focos de calor, não havendo correlação estatística significativa. Esses achados sugerem possível associação com a exposição crônica aos particulados emitidos pela queima de biomassa, comprometendo a saúde de grupos vulneráveis, e endossam a necessidade de substituição das queimadas no monocultivo da cana-de-açúcar, bem como a estruturação de políticas públicas de proteção à saúde humana e ambiental.


Abstract: This study aimed to analyze the relationship between hospitalizations for respiratory problems and the regular burning of sugarcane in Pernambuco State, Brazil. This is an ecological time series study corresponding to the period from 2008 to 2018. The rates of hospitalizations for respiratory diseases in children aged under 5 years and in adults older than 60 years in sugarcane-producing and non-producing municipalities were compared using nonparametric Mann-Whitney statistical analysis. Together, we observed the monthly distribution of the hot spots occurrences in the case and control municipalities and applied Pearson's correlation to analyze the association between both variables. For both age groups, hospitalization rates are higher in sugarcane-producing municipalities, with a statistically significant difference p < 0.005. The rate of hospitalization in older adults is 28% higher in the case municipalities, and is even higher in children aged under 5 years whose ratio of the medians is 40%. However, the seasonal behavior of hospitalizations for respiratory diseases differs from that observed in the monthly distribution of hot spots, without statistically significant correlation. These findings suggest a possible association with chronic exposure to particulates emitted by biomass burning, compromising the health of vulnerable groups, and endorse the need to replace fires in the monoculture of sugarcane and to structure public policies to protect human and environmental health.


Resumen: Este estudio buscó analizar la relación entre las hospitalizaciones por enfermedades respiratorias y la quema regular de caña de azúcar en Pernambuco, Brasil. Se trata de un estudio ecológico de serie temporal correspondiente al período entre 2008 y 2018. Las tasas de hospitalizaciones por enfermedades respiratorias en niños menores de 5 años y en ancianos mayores de 60 años en municipios productores de caña de azúcar y en los municipios no productores de azúcar se compararon mediante el análisis estadístico no paramétrico de Mann-Whitney. Se observó en conjunto la distribución mensual de las ocurrencias de puntos calientes en los casos y controles de los municipios, y se aplicó la correlación de Pearson para analizar la asociación entre ambas variables. Se encontró que, para ambos grupos de edad, las tasas de hospitalización fueron más altas en los municipios productores de caña de azúcar, con una diferencia estadísticamente significativa p < 0,005. La tasa de hospitalización de los ancianos fue un 28% mayor en los municipios casos, y aún mayor que la de los niños menores de 5 años cuya relación de las medianas fue del 40%. Sin embargo, se identificó que el comportamiento estacional de las hospitalizaciones por enfermedades respiratorias difiere de lo observado en la distribución mensual de puntos calientes, sin correlación estadística significativa. Estos hallazgos evidencian una posible asociación con la exposición crónica a partículas emitidas por la quema de biomasa, lo que afecta la salud de los grupos vulnerables, además apuntan a la necesidad de implementar medidas contra los incendios en el monocultivo de la caña de azúcar y políticas públicas para proteger la salud humana y el medioambiente.

12.
Rev. bras. enferm ; 76(supl.4): e20220647, 2023. tab, graf
Article in English | LILACS-Express | LILACS, BDENF - Nursing | ID: biblio-1521727

ABSTRACT

ABSTRACT Objectives: to describe a technological innovation in the development of an individual, ergonomic, sustainable and effective occupational respiratory protection mask for workers exposed to surgical smoke. Methods: applied, exploratory, quantitative research, using design methods and tools: Sense Intent, Know Context, Know People, Frame Insights, Explore Concepts, Frame Solutions, Realize Offerings, in addition to the Product Development Process tools. It was developed from March 2019 to December 2021. Results: from the prototyping mold, it became possible to represent the abstract to the physical, where all the concepts created in the methodological steps were implemented and the necessary adjustments were made to create the model as a technological innovation, which will have the concept for product commercialization. Conclusions: a mask for protection against surgical smoke (HeLP) was developed, from the design step to the prototype development, being a technological innovation.


RESUMEN Objetivos: describir una innovación tecnológica en el desarrollo de una máscara de protección respiratoria ocupacional individual, ergonómica, sostenible y eficaz para trabajadores expuestos al humo quirúrgico. Métodos: investigación exploratoria aplicada con un enfoque cuantitativo, utilizando métodos y herramientas de diseño: Sense Intent, Know Context, Know People, Frame Insights, Explore Concepts, Frame Solutions, Realize Offers, además de las herramientas del Proceso de Desarrollo de Producto. Fue desarrollado de marzo de 2019 a diciembre de 2021. Resultados: a partir del molde de prototipado, se logró representar lo abstracto a lo físico donde implementó los conceptos creados en las etapas metodológicas y realizó los ajustes necesarios para la creación del modelo como innovación tecnológica en el cual tendrá el concepto para la comercialización del producto. Conclusiones: se desarrolló una máscara de protección contra el humo quirúrgico (HeLP), desde la etapa de diseño hasta el desarrollo del prototipo, configurando una innovación tecnológica.


RESUMO Objetivos: descrever uma inovação tecnológica do desenvolvimento de máscara de proteção ocupacional respiratória individual, ergonômica, sustentável e eficaz para trabalhadores expostos à fumaça cirúrgica. Métodos: pesquisa aplicada, exploratória com abordagem quantitativa, empregando métodos e ferramentas em design: Sense Intent, Know Context, Know People, Frame Insights, Explore Concepts, Frame Solutions, Realize Offerings, além das ferramentas do Processo de Desenvolvimento de Produtos. Foi desenvolvida no período de março de 2019 a dezembro de 2021. Resultados: a partir do molde da prototipagem, tornou-se possível a representação do abstrato para o físico, onde implementou os conceitos criados nas etapas metodológicas e realizou os ajustes necessários para a criação do modelo como uma inovação tecnológica em que terá o conceito para a comercialização do produto. Conclusões: foi desenvolvida uma máscara de proteção contra a fumaça cirúrgica (HeLP), desde a etapa de projeto até o desenvolvimento do protótipo, configurando-se uma inovação tecnológica.

13.
Gac. sanit. (Barc., Ed. impr.) ; 37: 102282, 2023. tab
Article in Spanish | IBECS | ID: ibc-217788

ABSTRACT

El Servicio Canario de la Salud es consciente de los riesgos para la salud derivados del cambio climático y de que los sistemas de salud deben ser, con su acción, parte de la solución y no parte del problema. Actualmente, el 4,4% de las emisiones mundiales de dióxido de carbono provienen de actividades relacionadas con el ámbito sanitario. Para dar respuesta a esta situación, el Servicio Canario de la Salud ha puesto en marcha la estrategia «Salud Zer0 Emisiones Netas 2030», con la que se pretende alcanzar la neutralidad en emisiones netas de carbono en el año 2030 aplicando medidas tanto directas como indirectas, en especial sobre la cadena de suministro del sistema público de salud de Canarias. Este proyecto es pionero en España y está sujeto a revisión continua, sumándose nuevas acciones concretas a la estrategia conforme se vaya cuantificando la huella de carbono de los diferentes procedimientos implicados en la prestación de servicios sanitarios. (AU)


The Canary Islands Health Service is aware of the health risks arising from climate change. So health systems must be, with their action, part of the solution, not part of the problem. Currently, 4.4% of global carbon dioxide emissions come from activities related to the health field. To respond to this situation, the Canary Islands Health Service has launched the “Carbon Net Zer0 2030” strategy intending to achieve neutrality in net carbon emissions in the year 2030, applying measures direct and indirect, especially on the supply chain of the public health system. This is a ground-breaking project in Spain and is under continuous review, adding new specific actions to the strategy as the carbon footprint of the different procedures involved in the provision of health services is quantified. (AU)


Subject(s)
Humans , Air Pollutants , Environmental Pollution , Spain , Climate Change , Global Warming , Zoonoses , Health Services
14.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1537065

ABSTRACT

El herbicida ácido 2,4 - diclorofenoxiacético (2,4-D) es un ácido selectivo y sistémico que, desde 1940, es ampliamente utilizado en suelo agrícolas, de todo el mundo. Su uso radica a su selectividad entre la vegetación de hoja ancha y cultivos de gramíneas y como regulador del crecimiento vegetal; sin embargo, este herbicida se puede acumular en el ambiente y, adicionalmente, puede ser transportado por lixiviación, a través del suelo, llegando a contaminar aguas subterráneas, lo que genera un alto riesgo para el ambiente y la salud del ser humano. El estudio de la movilidad del 2,4-D en suelos con alto contenido de materia orgánica permitió conocer, que no solo la materia orgánica se correlaciona indirectamente con la movilidad de este compuesto, sino que, también, influye la humedad, al reducir la lixiviación y el potencial de contaminación del recurso hídrico subterráneo, mientras que la conductividad hidráulica se relaciona, de manera directa, con la lixiviación de este herbicida.


The herbicide 2,4-dichlorophenoxyacetic acid (2,4-D) is a selective and systemic acid that has been widely used in agricultural soils since 1940. Its use lies in its selectivity between broadleaf vegetation and grass crops, and as a regulator of plant growth. However, this herbicide can accumulate in the environment, and additionally, it can be transported by leaching through the soil, contaminating groundwater, which generates a high risk for the environment and human health. In this study, the mobility of 2,4-D in organic-matter-rich soils was assessed. The results revealed that not only the organic material is indirectly correlated with the mobility of this compound but also influences humidity and reduces leaching and potential pollution of groundwater resources, whereas hydraulic conductivity is directly related to herbicide leaching.

15.
Rev. colomb. neumol ; 34(2): 47-58, July-Dec. 2022.
Article in Spanish | LILACS, COLNAL | ID: biblio-1412777

ABSTRACT

Mediante la disminución de los niveles de contaminación del aire los países pueden reducir la carga en morbilidad derivada de accidentes cerebrovasculares, cáncer de pulmón y neumopatías crónicas y agudas. Por lo tanto, el objetivo de esta investigación fue determinar los efectos a corto y largo plazo que tiene la contaminación ambiental sobre la salud de la población por medio de una revisión narrativa de tipo cualitativo y descriptivo. El método de búsqueda e identificación de los estudios se realizó por medio de las siguientes bases de datos electrónicas: Medline, Pubmed, Science Direct, entre otras; con un estado del arte de máximo 5 años posteriores a su fecha de publicación. De acuerdo con la búsqueda realizada en las bases de datos, se seleccionaron un total de 10 artículos en los cuales se encontraron diferentes efectos de la contaminación ambiental en la salud humana a nivel respiratorio, cardiovascular, hepático, neurológico, gestacional, inmunológico, entre otros sistemas a causa del material particulado encontrado en el ambiente como los son del PM 2.5, PM10 Y otros gases relacionados con la contaminación y los efectos sobre la salud. Los resultados de esta revisión narrativa confirman los efectos asociados a la contaminación ambiental a corto plazo y largo plazo del aumento de las concentraciones de las partículas contaminantes encontradas en el ambiente. Palabras claves: contaminación ambiental, partículas contaminantes, efectos corto plazo, efectos largo plazo, material particulado.


By lowering air pollution levels, countries can reduce the burden of disease from strokes, lung cancer, and chronic and acute lung diseases. Therefore, the objective of this research was to determine the short and long-term effects of environmental pollution on the health of the population through a qualitative and descriptive narrative review. The search and identification method of the studies was carried out through the following electronic databases: Medline, Pubmed, Science Direct, among others; with a state of the art of a maximum of 5 years after its publication date. According to the search carried out in the databases, a total of 10 were selected in which different effects of environmental pollution on human health were found at the respiratory, cardiovascular, liver, neurological, gestational, and immune levels, among other systems. due to particulate matter found in the environment such as PM 2.5, PM10 and other gases related to pollution and health effects. The results of this narrative review confirm the short-term and long-term effects associated with environmental pollution of increased concentrations of polluting particles found in the environment.


Subject(s)
Humans , Environmental Pollutants , Environmental Pollution , Particulate Matter , Lung Diseases , Morbidity , Stroke , Lung Neoplasms
16.
Rev. esp. nutr. comunitaria ; 28(4): 1-9, Octubre - diciembre, 2022. tab, ilus, graf
Article in Spanish | IBECS | ID: ibc-214961

ABSTRACT

Fundamentos: La Organización de las Naciones Unidas para la Alimentación y la Agricultura, ha propuesto laentomofagia como alternativa para abordar la inseguridad alimentaria. Esto se basa en el gran aporte proteicode los insectos, además de que su ciclo de vida y consumo ayudan a mantener la integridad del medio ambiente.El objetivo de este estudio fue evaluar la inocuidad alimentaria (agentes biológicos y físicos) de los chapulines(saltamontes) ofertados para consumo humano en la ciudad de Miahuatlán de Porfirio Díaz, Oaxaca, México.Métodos: Estudio transversal, descriptivo-exploratorio. Se utilizaron dos agares: métodos estándar paradetectar E. coli, Staphylococcus aureus y L. monocytogenes y Mac Conkey para bacterias Salmonella spp yColiformes.Resultados: Se halló la presencia de diferentes contaminantes físicos: hojas en 90,9% (n=10), palos en 81,8%(n=9), otros insectos en 54,5% (n=6), cabello en 36,3% (n=4) y piedras en 18,1% (n=2). No se hallaron restos depapel, tierra, plástico, huesos, metal ni cristal. Las Unidades Formadoras de Colonias halladas se encuentran enun rango de valores aceptables según normativas vigentes.Conclusiones: El consumo de insectos orthópteros representa, además de su aporte proteico, un consumoinocuo en esta población. Este estudio sienta las bases para realizar investigaciones con las diferentes especiescomestibles y en las distintas comunidades donde son consumidas en México. (AU)


Background: The FAO has proposed entomophagy as an alternative to address food insecurity. This is basedon the great protein contribution of insects, in addition to the fact that their life cycle and consumption helpmaintain the integrity of the environment. The objective of this study was to evaluate the Food Safety(biological and physical agents) of chapulines (grasshoppers) offered for human consumption in the city ofMiahuatlán de Porfirio Díaz, Oaxaca, MexicoMethods: Cross-sectional, descriptive-exploratory study. 11 samples was used. Two agars: standard methodsto detect E. coli, Staphylococcus aureus and L. monocytogenes and MacConkey for Salmonella spp and Coliformbacteria.Results: The presence of different physical contaminants was found: leaves in 90.9% (n=10), sticks in 81.8%(n=9), other insects in 54.5% (n=6), hair in 36.3% (n=4) and stones in 18.1% (n=2). No remains of paper, soil,plastic, bones, metal or glass were found. The CFUs found are within a range of acceptable values accordingto regulations.Conclusions: The consumption of orthopteran insects represents, in addition to its protein content, aninnocuous consumption in this population. This study lays the foundations for conducting research with thedifferent edible species at the communities in Mexico. (AU)


Subject(s)
Animals , 52503 , Orthoptera , Food Safety , Biological Pollutants , Mexico , Cross-Sectional Studies , Epidemiology, Descriptive
17.
Salud UNINORTE ; 38(2)mayo-ago. 2022.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1536805

ABSTRACT

Introducción: A nivel laboral se presentan muchas afecciones en la salud de los trabajadores debido a riesgos químicos a los que están expuestos diariamente; a esto se suma la falta de compromiso de los empleadores con la salud de sus subordinados, ya que estos manejan diariamente sustancias químicas nocivas sin la debida protección personal. Objetivo: Identificar los efectos nocivos para la salud respiratoria de los trabajadores expuestos en su área laboral a sustancias químicas. Metodología: Se realizó una revisión sistemática de la literatura, se consideraron artículos de investigación realizados a partir de 2014 hasta 2020. Las palabras claves fueron "trabajadores" OR "laboral" AND "contaminantes" OR "agentes" AND "enfermedad reconocida", y se revisaron artículos de bases de datos como Google académico, SciELO (Scientific Electronic Library Online), ProQuest, Redalyc y Biblioteca Digital Universidad Cooperativa de Colombia. Conclusión: La salud de los trabajadores, sin importar en qué área laboral se desempeñen, se ve afectada en varios aspectos, los cuales pueden variar; entre ellos se encuentran los sistemas respiratorios, el sistema reproductor, el sistema nervioso, el sistema tegumentario y el sistema gastrointestinal de forma crónica o aguda. Entre los agentes más comunes causantes de las enfermedades respiratorias se reportan los pesticidas, el plomo y solventes.


Introduction: At work, there are many health conditions for workers due to chemical risks to which they are daily exposed, in addition to the lack of commitment of employers to the health of their subordinates, since they handle harmful chemical substances on a daily basis without proper personal protection. Objective: to identify the harmful effects for the respiratory health of workers exposed in their workplace to chemical substances. Methodology: A systematic review of the literature was carried out, research articles from 2014 to 2020 were considered. The keywords were "Workers" OR "Labor" AND "Contaminants" OR "Agents" AND "Recognized disease", and articles from databases such as Google Academic, SciELO (Scientific Electronic Library Online), ProQuest, Redalyc, and the Cooperative University of Colombia Digital Library were reviewed. Conclusion: The health of workers, regardless of their work area, is affected in several aspects which may vary. Among them, the respiratory systems, the reproductive system, the nervous system, the integumentary system, and the gastrointestinal system, in a chronic or acute manner. Among the most common causative agents of respiratory diseases are pesticides, lead, and solvents.

18.
Medicina (B.Aires) ; 82(3): 428-438, ago. 2022. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1394460

ABSTRACT

Resumen Se denominan disruptores endocrinos (DEs) a aquellas sustancias químicas capaces de interferir con la homeostasis hormonal, alterando la síntesis, función, almacenamiento y/o metabolismo de las hormonas. Estas sustancias se encuentran en el ambiente y en una amplia variedad de productos de uso diario, por lo que la exposición humana es permanente. Experimentos con animales han confirmado la capacidad de los DEs para inducir desórdenes reproductivos, por lo que se ha sugerido que podrían ser un factor importante como causa de subfertilidad humana. El bisfenol A, los ftalatos y los compuestos orgánicos persistentes son tres tipos de DEs presentes en el medio ambiente y asociados con alteraciones reproductivas. Consultando las bases de datos MEDLINE y PubMed, en la presente revisión, se reúne bibliografía de los últimos 20 años donde se evalúan los efectos provocados por la exposición a los DEs mencionados en mujeres durante la vida adulta. Se resumen los efectos sobre marcadores de reserva ovárica y los resultados de tratamientos de fertilización in vitro. Por otro lado, se evalúa la evidencia a nivel molecular de los efectos provocados por los DEs sobre la fisiología reproductiva en estudios in vitro e in vivo.


Abstract Endocrine disruptors (EDs) are those chemical substances capable of interfering with hormonal homeostasis, altering the synthesis, function, storage and / or metabolism of hormones. These substances are found in the environment and in a wide variety of products for daily use, so human exposure is permanent. Animal experiments have confirmed the capacity of EDs to induce reproductive disorders, which is why it has been suggested that they could be an important factor in causing human subfertility. Bisphenol A, phthalates and persistent organic compounds are three types of EDs present in the environment and associated with reproductive disorders. Consulting the MEDLINE and PubMed databases, in this review, a bibliography of the last 20 years is gathered where the effects caused by exposure to the mentioned EDs in women during adult life are evaluated. The effects on ovarian reserve markers and the results of in vitro fertilization treatments are summarized. On the other hand, the evidence at the molecular level of the effects caused by EDs on reproductive physiology is evaluated in in vitro and in vivo studies.

19.
Pediatr. (Asunción) ; 49(2)ago. 2022.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1386700

ABSTRACT

RESUMEN Introducción: En la Leucemia linfoblástica aguda se han estudiado el rol de factores de riesgo ambientales y genéticos. Menos frecuentemente otros como los perinatales y parentales El objetivo del estudio fue analizar los factores de riesgo ambientales, parentales y perinatales de los niños con Leucemia linfoblástica aguda (LLA) en tratamiento en el servicio de oncología de un hospital pediátrico. Materiales y Métodos: estudio de caso-control, realizado en el departamento de oncohematología de un hospital pediátrico. Los casos fueron niños con diagnóstico de leucemia linfoblástica aguda y los controles niños con patología quirúrgica, previamente sanos pareados por edad. Se estudiaron variables ambientales, perinatales y parentales. Los análisis uni y multivariado fueron realizados en SPSS y los resultados se expresaron en OR con IC 95%. El protocolo fue aprobado por el comité de ética institucional. Resultados: se incluyó 66 casos y 132 controles. El 33,3 (22/66) vs el 8,3% (11/132) OR 5,5 (IC 95% 2,4 - 12,5 p=0,0001 de los casos y controles respectivamente, eran residentes desde el nacimiento de los departamentos con mayor área de cultivos. En el análisis multivariado el riesgo de proceder de departamentos con extensas áreas de cultivo fue 3,6 veces mayor, OR 3,6 (IC 95% 1,4 -9) p=0,008 ajustado por la edad materna, antecedente de hospitalización neonatal, ocupación paterna y exposición a rayos X. Conclusiones: La residencia en zonas con gran extensión de cultivos fue el factor de riesgo ambiental en los niños con LLA de una población hospitalaria.


ABSTRACT Introduction: The role of environmental and genetic risk factors has been studied in acute lymphoblastic leukemia, but other factors, such as perinatal and parental factors, less so. The objective of the study was to analyze the environmental, parental and perinatal risk factors of children with acute lymphoblastic leukemia (ALL) being treated in the oncology department of a pediatric hospital. Materials and methods: This was a case-control study, carried out in the oncohematology department of a pediatric hospital. The cases were children diagnosed with acute lymphoblastic leukemia and the controls were previously healthy children diagnosed with a surgical pathology, matched by age. Environmental, perinatal and parental variables were studied. Univariate and multivariate analysis were performed in SPSS and the results were expressed as OR with 95% CI. The protocol was approved by the institutional ethics committee. Results: We included 66 cases and 132 controls. 33.3% (22/66) vs. 8.3% (11/132) OR 5.5 (95% CI 2.4 - 12.5 p=0.0001) of the cases and controls, respectively, had been residents since birth of the departments with larger farmland crop areas. In the multivariate analysis, the risk of being from departments with extensive crop areas was 3.6 times higher, OR 3.6 (95% CI 1.4 -9, p=0.008) adjusted for maternal age, history of neonatal hospitalizations, paternal occupation, and exposure to X-rays. Conclusions: Residence in areas with a large area of crops was the environmental risk factor in children with ALL in a hospital population.

20.
J. Health NPEPS ; 7(1): 1-18, Jan-Jun, 2022.
Article in English | LILACS, BDENF - Nursing, Coleciona SUS | ID: biblio-1380082

ABSTRACT

Obcjetive: to investigate short-term effects of air pollution, climate variability on respiratory morbidity and mortality from 2005 to 2020. Method: the study was carried out in the city of Campo Grande, Mato Grosso do Sul, Brazil. Daily counts of hospital admissions from 2005 to 2020 were analyzed in relation to daily variations in atmospheric pollutants (NO2, O3) from the Aurea satellite column, OMI sensor. Poisson regression in generalized additive models was used for analysis. The models were adjusted for the effects of temporal trend, seasonality, meteorological factorsand autocorrelation. Results: there was, in the period, an increasing trend in mortality rates and hospital admissions, with an increase in the proportion of deaths from respiratory diseases in relation to other causes. Conclusion: respiratory diseases are worrying causes of hospitalization and death in the population. The results found are consistent with studies that point to an association between short-term variations in air pollutants and the increase in morbidity and mortality in large urban centers.


Objetivo:investigar los efectos a corto plazo de lacontaminación del aire, la variabilidad climática en la morbilidad y mortalidad respiratoria de 2005 a 2020. Método:el estudio se llevó a cabo en la ciudad de Campo Grande, Mato Grosso do Sul, Brasil. Se analizaron los conteos diarios de ingresos hospitalarios de 2005 a 2020 en relación con las variaciones diarias de contaminantes atmosféricos (NO2, O3) de la columna del satélite Aurea, sensor OMI. Para el análisis se utilizó la regresión de Poisson en modelos aditivos generalizados. Los modelos fueron ajustados por los efectos de tendencia temporal, estacionalidad, factores meteorológicos y autocorrelación. Resultados:hubo, en el período, una tendencia creciente en las tasas de mortalidad e ingresos hospitalarios, con aumento en la proporción de muertes por enfermedades respiratorias en relación a otras causas. Conclusión:las enfermedades respiratorias son causas preocupantesde hospitalización y muerte en la población. Las acciones de prevención y atención de estas causas, así como la profundización de la investigación etiológica, deben ser priorizadas en el actual contexto epidemiológico de salud en Brasil. Los resultados encontrados son consistentes con estudios que apuntan a una asociación entre las variaciones a corto plazo de los contaminantes atmosféricos y el aumento de la morbilidad y mortalidad en los grandes centros urbanos.


Objetivo:investigar os efeitos a curto prazo da poluição do ar, variabilidade climática na morbimortalidade respiratória entre os anos de 2005 a 2020. Método: o estudo foi realizado na cidade de Campo Grande, Mato Grosso do Sul, Brasil. As contagens diárias de internações hospitalares entre os anos de 2005 a 2020 foram analisadas em relação às variações diárias de poluentes atmosféricos (NO2, O3) da coluna satélite Aurea, sensor OMI. A regressão de Poisson em modelos aditivos generalizados foi utilizada para análise. Os modelos foram ajustados pelos efeitos de tendência temporal, sazonalidade, fatores meteorológicos e autocorrelação. Resultados: houve, no período, tendência crescente nas taxas de mortalidade e internações hospitalares, com aumento da proporção de óbitos por doenças respiratórias em relação a outras causas. Conclusão: as doenças respiratórias são causas preocupantes de hospitalização e morte na população. Ações de prevenção e atenção a essas causas, bem como a investigação etiológica , devem ser priorizadas no atual contexto epidemiológico da saúde no Brasil. Os resultados encontrados são consistentes com estudos que apontam para uma associação entre as variações de curto prazo dos poluentesatmosféricos e o aumento da morbimortalidade nos grandes centros urbanos.


Subject(s)
Respiratory Tract Diseases , Air Pollutants , Hospitalization
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