Sample records for GESTION DE MATERIALES NUCLEARES (nuclear materials management)
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1

Programa de Protección Ambiental y Bioseguridad en el Instituto Nacional de Psiquiatría Ramón de la Fuente/ Environmental protection and biosecurity program at the National Institute of Psichiatry Ramón de la Fuente

Nieto, Itzchel; Murillo, Susana; Rojo, Maricela; Asai, Miguel
2008-04-01

Resumen en español A partir de 1998, en el Instituto Nacional de Psiquiatría Ramón de la Fuente (INPRF) se iniciaron las actividades del Programa de Protección Ambiental y Civil (PPAyC). Sus objetivos son dar cumplimiento a los requisitos legales, prevenir riesgos, generar estrategias de atención a emergencias, capacitar a la población interna y mejorar el uso y aprovechamiento de los recursos institucionales. El propósito del presente trabajo es presentar los resultados obtenidos des (mas) pués de nueve años de trabajo del PPAyC en las áreas de manejo de residuos biológico-infecciosos, ahorro de energía eléctrica, uso y optimización de agua potable, control de emisiones a la atmósfera de los equipos fijos de combustión, seguridad radiológica y simulacros de emergencia. Residuos peligrosos biológico-infecciosos (RPBI). Con el objeto de reducir riesgos y prevenir accidentes, en el INPRF se implementó un procedimiento operativo para el manejo de los residuos peligrosos biológico-infecciosos en todas las áreas generadoras. Los resultados de las estrategias aplicadas muestran que la cantidad de los residuos y sus costos de manejo han disminuido gradualmente y se han observado mejores prácticas de manejo de residuos por parte de los trabajadores involucrados, con la consecuente reducción de riesgos. Ahorro de energía. Ante la necesidad de optimizar el uso de la energía, disminuir costos y crear conciencia entre la población, se implementó en todo el país el programa de ahorro de energía. Los resultados obtenidos muestran que, a partir de la implementación de las estrategias de ahorro en el INPRF, se obtuvo una reducción en el consumo de energía de 9.6% anual acumulado entre 2004 y 2005. Uso y aprovechamiento de agua potable. A partir de 2003, en el INPRF se implementaron medidas destinadas a disminuir el consumo per capita de agua potable que se recibe por la red municipal y optimizar su uso en las instalaciones. Como resultado se observó una disminución gradual en el uso de agua potable, de tal manera que, de los 170 litros/persona que se utilizaban en 2003, en 2006 únicamente se utilizaron 98 litros/persona. Seguridad radiológica. El programa de seguridad radiológica en el INPRF se inició con el objeto de minimizar los riesgos y efectos adversos que pudieran generar los materiales radiactivos en la salud del personal expuesto ocupacionalmente (POE), prevenir accidentes y cumplir con la normatividad. Como resultado de estas acciones, ningún POE ha excedido el máximo valor de dosis total acumulada (DTA) de radiaciones ionizantes permitido por la Comisión Nacional de Seguridad Nuclear y Salvaguardas (CNSNS) para cuerpo total. Por otro lado, a la fecha no se han registrado accidentes o contaminación con materiales o residuos radiactivos. Simulacros. En el INPRF se implementó un programa de protección civil, cuya labor principal fue la de capacitar periódicamente a los trabajadores para responder ante situaciones de emergencia. Como resultado de los simulacros de sismo que se han realizado (40 parciales y siete generales), se han reducido gradualmente los tiempos de desalojo de los inmuebles y la detección oportuna y sistemática de elementos de seguridad que requieren ser reparados o instalados. Emisiones a la atmósfera. En cumplimiento con la normatividad vigente en la Ciudad de México, en el INPRF se elaboró el programa de mantenimiento anual preventivo y correctivo de las dos calderas que dotan de agua caliente a la institución. Como resultado, se detectó la necesidad de sustituir los equipos por otros que utilizaran tecnología más limpia. Esto favoreció el cumplimiento de los límites máximos permitidos para emisiones gaseosas contaminantes y los costos de mantenimiento se redujeron. Discusión La implementación de diversas estrategias en materia de protección ambiental y civil y la capacitación reducen los riesgos del personal y protegen los bienes inmuebles y el entorno de la ciudad que habitamos. Resumen en inglés Since the beginning, mankind has been subjected to various natural disasters such as floods, hurricanes, earthquakes, droughts and wildfires. Therefore, societies have to organize themselves in order to cope with nature, provide support to each other and to protect the most vulnerable individuals and their properties. Depending on their social organization, some countries have developed their response strategies in the field of civil protection faster than others. After S (mas) eptember 19th, 1985, when an earthquake of Richter magnitude of 8.1 affected Mexico City, the Mexican government decided to establish the guidelines of the National Civil Protection System (SINAPROC). After a few years, the Environmental Protection and Ecological Equilibrium Law was published. This environmental protection regulation is specific and is directed to minimize the negative impact over the environment that could be generated through industrial activities, as well as from research centers, hospitals, and others institutions. To ensure full compliance with the Mexican regulations, in 1998 the Instituto Nacional de Psiquiatría Ramón de la Fuente (INPRF) initiated the Environmental and Civil Protection Program (ECPP). The aim of this program is to meet the legal and operational requirements applicable to an institution which has biomedical research, administration and hospitalization areas. In addition, the ECPP is in charge of giving workers training and generating specific strategies for environmental management in all activities that take place at the Institute. By establishing compliance guidelines to meet the government regulations on environmental and civil protection, the INPRF would develop strategies for minimizing risks, as well as staff training to enhance the use of institutional resources and reduce the response time to deal with emergencies. Objective Since its foundation, the environmental and civil protection program at the INPRF has had two basic objectives: 1. to attend the legal and operative requirements in a third level institution conformed by hospitalization, teaching, research and administrative areas, and 2. to offer continuous training to the internal population of a hospital in order to minimize work risks, to make an optimum use of the institutional resources and to reduce the response time of the workers in emergency situations. To develop and implement such an environmental and civil protection program, the following areas have been considered: Biohazardous wastes, saving electricity, use and optimization of drinking water, control of air emissions from stationary combustion equipment, radiation safety and emergency response procedures. The purpose of this work is to show the results achieved by ECPP after nine years since its inception. Results Biohazardous wastes (BW), by definition, are those materials generated during medical care which contain biological agents that may cause adverse effects to human health and the environment. BW are generated frequently in biomedical research areas, clinical laboratories and hospitals. In order to minimize risks and prevent accidents, INPRF implemented since 1997 an operating procedure for handling biohazardous wastes in all generating areas. Some of those strategies are directed to training medical personnel (physicians, nurses and clinical laboratory technicians) about the identification and classification of biohazardous wastes. Moreover, we have designed and distributed different kinds of written ads in order to help people to recognize and separate wastes correctly. Besides the latter actions, the INPRF hired a registered and certificated company which provides the proper recollection, treatment and final disposal of biological wastes, according to current legal ordinances. As a result of those strategies in the handling of biohazardous wastes in the Institution, the amount of wastes and their disposal costs have gradually decreased. Through staff training, personnel have learned to do a proper segregation of wastes, reducing the quantities of BW and therefore reducing risks. Energy saving. As a way to optimize the institutional resources, as well as reducing costs and creating awareness among the people, the INPRF's Energy Saving program was implemented in 2003. Since 2003, when ECPP began implementing the saving strategies, accumulated energy consumption per year had a 9.6% reduction between 2004 and 2005. Use of potable water. In the search for strategies to optimize the use of potable water that is received through the municipal network, in 2003 the INPRF-ECPP implemented measures aimed not only at reducing the per capita consumption of potable water but also to give it a proper use on the institution areas. As a result of these saving measures, there was a gradual decrease in the use of drinking water. So, from the 170 liters/person-day used in 2003, during 2006 only 98 liters/person-day were used. Radiological safety. Due to the adverse effects to human health that could result from exposure to radioactive materials, an institution that uses this kind of material in its basic biomedical research area must implement the necessary actions to minimize the risk of contamination for users and work areas. For that reason, the INPRF began the Radiological Safety Program, which had as its main objectives to minimize the risks and to prevent accidents involving radioactive materials based on regulation compliance. As a result of these strategies, the maximum value of the total dose accumulated per year of ionizing radiation received by personnel exposed who has carried out research in this institution in recent years has been of 3.14 mSv. Therefore, it had not exceeded the annual limit dose of ionizing radiation allowed for the total body by the Comisión Nacional de Seguridad Nuclear y Salvaguardas (CNSNS) of 50 mSv = 5rem. To date, there has been no accidents or contamination with radioactive materials or wastes in the INPRF. Emergency simulations. Considering the need of being prepared for emergencies and to comply with the regulation that establishes the compulsory conducting simulations in INPRF, the Internal Committee for Civil Protection (ICPC) conducts periodic training of employees on risk prevention, through courses and simulations of situations of earthquake, attempt of fire, handling of hazardous substances spills and first aid. As a result of the earthquake simulations that have been carried out at the INPRF, the time of evacuation of workers, hospitalized patients and floating population from buildings has gradually reduced. An additional advantage of conducting emergency simulations has been the early detection of systematic security features that need to be repaired or installed. Emissions to air. In recent years, increasingly strict regulation and monitoring of gaseous emissions generated by stationary and mobile sources in Mexico City has been established. In order to comply with the current regulations, it became necessary to develop a program of annual preventive and corrective maintenance of combustion equipment that is used to provide hot water, and to make periodic analysis of gaseous emissions. Among the parameters that have to be reported are: temperature of combustion gases, monoxide and dioxide carbon content, sulfur dioxide, nitrogen dioxide percentages and generated soot.

Scientific Electronic Library Online (Spanish)

2

Divertículos uretrales: Revisión de nuestra casuística y de la literatura/ Urethral diverticulum: Our casuistic and the literature review

Ramírez Backhaus, M.; Trassierra Villa, M.; Broseta Rico, E.; Gimeno Argente, V.; Arlandis Guzmán, S.; Alonso Gorrea, M.; Jiménez Cruz, J.F.
2007-09-01

Resumen en español Objetivo: Se valoran los posibles factores etiopatogénicos y se describen la clínica, métodos diagnósticos, abordaje quirúrgico, resultados y complicaciones del manejo de los divertículos uretrales. Material y métodos: Se realizó una revisión retrospectiva de las historias clínicas con diagnóstico de divertículo uretral en el periodo 1986-2006. Resultados: Durante estos 20 años se han tratado un total de 19 pacientes con esta patología: 15 mujeres y 4 hombre (mas) s. Cinco de las mujeres debutaron clínicamente con sensación de masa vaginal; el resto fueron diagnosticadas en el contexto de un síndrome miccional, incontinencia urinaria o infección urinaria. En el caso de los varones, 3 de ellos presentaron una tumoración palpable en el pene. La prueba diagnóstica más utilizada fue la uretrocistografía miccional seriada; la uretrografía con sonda de doble balón se utilizó en 5 ocasiones y la uretroscopia en 4 pacientes. En los casos más complejos se utilizaron otras técnicas de diagnóstico por la imagen, como la resonancia magnética nuclear. El tratamiento fue la extirpación del divertículo en todos los pacientes, excepto en una mujer que rechazó la intervención. La evolución de las pacientes ha sido satisfactoria realizándose controles periódicos hasta dos años después de la intervención. Dos de los casos, en varones, tuvieron recidivas complejas. Conclusiones: Los divertículos uretrales son una entidad nosológica de difícil diagnóstico dada su baja prevalencia y su clínica inespecífica lo que motiva que, en algunas ocasiones, el diagnóstico sea incidental. La etiopatogenia es adquirida en la mayoría de los casos y su tratamiento quirúrgico, con peores resultados en los hombres debido, probablemente, a que los divertículos se producen en uretras con antecedentes de cirugías previas, manipulación endourológica o lesiones asociadas. Resumen en inglés Purpose: The possible etiopathogenic factors, symptoms, diagnostic methods, surgical management and complications of the urethral diverticula are reviewed. Materials and methods: A retrospective study of the clinical charts with urethral diverticula diagnosis during the period 1986-2006 was carried out. Results: In the last 20 years a total of 19 patients have been treated for this pathology: 15 females and 4 males. Five of the females started with a sensation of vaginal (mas) mass; the rest were diagnosed of micturitional (irritative) syndrome, urinary incontinence or urinary infection. In the case of males, 3 of them had a palpable tumour in the penis. The most used diagnostic method was retrograde and voiding cystourethrography; urethrography with double-occlusion balloon catheter was used in 5 cases and urethroscopy in 4 patients; other techniques of image diagnosis like magnetic resonance imaging were necessary for the most complex cases. The treatment was the excision of the diverticulum, except for one of the females who rejected the treatment. The evolution in all treated women was successful, according to follow up 2 years after the treatment. In males, two of them had complex recurrent diverticula. Conclusions: Urethral diverticula are nosologic entities of difficult diagnosis, due to their low prevalence and their unspecific clinic, therefore diagnosis is sometimes incidental. The etiopathogenity is acquired in most cases and its surgical treatment is more challenging in males than in females probably linked to the fact that diverticula appear in urethras with previous surgery, endourologic manipulation or associated injuries.

Scientific Electronic Library Online (Spanish)