RESUMEN
The aim of this paper is to investigate the use of different self-reported measures for assessing the human response to environmental vibration from the construction of an urban LRT (Light Rapid Transit) system. The human response to environmental stressors such as vibration and noise is often expressed in terms of exposure-response relationships that describe annoyance as a function of the magnitude of the vibration. These relationships are often the basis of noise and vibration policy and the setting of limit values. This paper examines measures other than annoyance by expressing exposure-response relationships for vibration in terms of self-reported concern about property damage and acceptability. The exposure-response relationships for concern about property damage and for acceptability are then compared with those for annoyance. It is shown that concern about property damage occurs at vibration levels well below those where there is any risk of damage. Earlier research indicated that concern for damage is an important moderator of the annoyance induced. Acceptability, on the other hand, might be influenced by both annoyance and concern, as well as by other considerations. It is concluded that exposure-response relationships expressing acceptability as a function of vibration exposure could usefully complement existing relationships for annoyance in future policy decisions regarding environmental vibration. The results presented in this paper are derived from data collected through a socio-vibration survey (N=321) conducted for the construction of an urban LRT in the United Kingdom.
Asunto(s)
Exposición a Riesgos Ambientales , Genio Irritable , Vibración/efectos adversos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Industria de la Construcción , Monitoreo del Ambiente , Femenino , Humanos , Masculino , Persona de Mediana Edad , Vías Férreas , Autoinforme , Adulto JovenRESUMEN
Objetivos: analizar la morbilidad y alteración del funcionalismo rectal a largo plazo de la radioterapia postoperatoria tras resección con anastomosis en el cáncer de recto. Material y métodos: se incluyen 37 pacientes intervenidos con intención curativa y con una evolución mínima de 3 años. Se dividen en dos grupos: 14 tratados con quimio-radioterapia postoperatoria, 5-fluoracilo más ác. folínico y 45 Gy más "boost" de 5 Gy y 23 no tratados utilizados como grupo control. Se realizó una encuesta sobre su funcionalismo rectal y se analizó la morbilidad detectada en el seguimiento. Resultados: el grupo tratado con quimio-radioterapia postoperatoria presentaba mayor frecuencia defecatoria diaria (p=0,03) y nocturna (p=0,04); incontinencia en el 69,2 por ciento frente al 17,4 por ciento del grupo control (p=0,002) y mayor irritación perianal (p=0,04). Aunque sin diferencias significativas, el grupo tratado precisó usar más frecuentemente compresas, tenía más urgencia defecatoria, diferenciaba peor gases y heces y precisó más medidas antidiarreicas. El 28,6 por ciento del grupo tratado presentaron complicaciones mayores: 3 resecciones intestinales por estenosis actínicas quedando uno con una fístula estercorácea residual; otro tuvo varias crisis suboclusivas resueltas con tratamiento conservador. Conclusiones: la quimio-radioterapia postoperatoria tiene una alta tasa de morbilidad, que condiciona una alteración importante de la calidad de vida por lo que es necesario sopesar bien la indicación y tener presente las posibilidades que se abren con la quimio-radioterapia preoperatoria y la excisión mesorrectal total (AU)
Asunto(s)
Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Complicaciones Posoperatorias , Estudios Retrospectivos , Radioterapia Adyuvante , Traumatismos por Radiación , Encuestas y Cuestionarios , Calidad de Vida , Quimioterapia Adyuvante , Morbilidad , Neoplasias del Recto , Estadificación de NeoplasiasRESUMEN
The aim of this study was to compare the rate of recovery of mycobacteria and the time to detection in 5208 samples using the MB/BacT culture system (Organon Teknika, USA) and Löwenstein-Jensen medium. Mycobacteria were recovered from 301 (5.7%) samples. Two hundred fifty-seven (85.3%) isolates from 114 patients were Mycobacterium tuberculosis [135 (52.5%) smear-positive, 122 (47.4%) smear-negative], and 44 (14.6%) were potentially pathogenic environmental mycobacteria. The yield with the MB/BacT was higher than that with Löwenstein-Jensen [287 (95.3%) vs. 200 (66.4%), P<0.001] for both Mycobacterium tuberculosis [247 (96.1%) vs. 187 (72.7%), P<0.001] and potentially pathogenic environmental mycobacteria [40 (90.9%) vs. 13 (29.5%), P<0.001], mainly at the expense of the smear-negative samples. Moreover, 70 (27.2%) samples were positive only in the MB/BacT, whereas ten (3.8%) samples were positive only in Löwenstein-Jensen. The number of patients with tuberculosis detected by the MB/BacT was higher than that detected by Löwenstein-Jensen medium [111 (97.3%) vs. 89 (78%), P<0.001]. In 25 (21.9%) patients the diagnosis was established solely by means of the MB/BacT. In smear-positive and smear-negative samples, the mean times to detection of Mycobacterium tuberculosis were 16.7 and 26.3 days, respectively, with Löwenstein-Jensen and 11.5 and 19.3 days, respectively, with the MB/BacT. These results indicate that the MB/BacT is more efficient and faster than Löwenstein-Jensen for the recovery of mycobacteria.