Main Safeguard Research Articles

Neonatal and infantile appendicitis still confuses minds: report of two cases

BackgroundAcute appendicitis is extremely rare in the neonatal and infantile periods. The number of cases published in the last century is just over 100. Mortality and morbidity are still high due to diagnostic problems because there are no specific clinical features and reliable investigation for the diagnosis. Herein, we present two patients to remind physicians that the diagnosis of neonatal and infantile appendicitis should always be kept in mind.Case presentationsA 30 3/7-week-old 740-g newborn girl was delivered by cesarean section because of preeclampsia. The newborn was followed in the neonatal intensive care unit and fed with an orogastric catheter. An abdominal distention developed on the 18th day of her life. While following up with a preliminary diagnosis of necrotizing enterocolitis, she was operated on the 4th day due to abdominal free air seen on X-ray. A perforated appendicitis was detected in the abdominal exploration and formal appendectomy was performed. Histology demonstrated marked transmural inflammation and necrosis at the perforated site and there was no evidence of Hirchsprung’s disease. The patient was started on breast milk on the third postoperative day and discharged home on day 98.A 3.5-month-old boy was admitted to our clinic because of abdominal distention, discomfort, and constipation which had been ongoing for 4 days. He was followed up as an outpatient basis for 4 days in another center with the diagnosis of infantile colic. An increase in echogenicity due to intense inflammation was observed in mesenteric plans using USG in the right lower quadrant of the abdomen. Following preoperative preparations, the patient underwent abdominal exploration and appendectomy. He had an uneventful recovery and pathologic examination demonstrated a necrotizing appendicitis with perforation. He was discharged on the fourth postoperative day without any problems.ConclusionIt is a fact that acute appendicitis in neonates and infants may not be diagnosed easily and quickly as in older children because there are no specific clinical features and reliable investigation for the diagnosis. Delay in diagnosis and treatment often results in appendicular perforation and peritonitis. The main safeguard against mortality and morbidity remains a high index of suspicion.

El rol del abogado ante la ética y el ejercicio profesional

La intencion principal de este trabajo, es acercarnos a la idea de la existencia de una relacion inequivoca entre la etica-moral con la deontologia, con respecto a las profesiones juridicas en general y en particular, con la profesion de la abogacia.En este sentido, adquiere una especial atencion el analisis sobre la naturaleza de las normas deontologicas y los instrumentos que posibilitan la eficacia de estos codigos. Por lo tanto, aunque las normas deontologicas pudieran realmente encontrarse en ese estadio intermedio entre el Derecho y la moral, una vez normativizadas en un codigo, establecen un marco de principios y deberes profesionales de obligado cumplimiento. La deontologia legitima asi, un ambito de actuacion profesional que afecta a materias sensibles y valoradas de la sociedad. Con ello, se aplica un espiritu etico minimo en un marco de cotidianidad profesional que capacita sobremanera en su actuacion al operador juridico, garantizando a la sociedad en la que ejerce, un quantum de garantias legales y morales como salvaguarda principal de su actuacion.

Quantitative Risk Evaluation of Obstacle Limitation Surfaces for Final Approaches at Airports

Obstacle limitation surfaces (OLS) are the main safeguard against objects that can pose a hazard to aircraft operations at and around airports. The standard dimensions of the most of those surfaces were estimated using the pilot’s experience at the time when they were included in the standard documents. As a result, some of these standards may have been overestimated, while others may not provide an adequate level of safety. With airports moving to the Safety Management System (SMS) approach to design and operations safety, proper evaluation of the level of safety provided by OLS at specific sites becomes important to airport operators. Therefore, this study attempts to collect actual flight path data using information provided by air traffic control radars and to construct a methodology to assess the probability of aircraft deviating from their approach path. This will be helpful to estimate safe and efficient standard dimensions of the OLS and assess the risk level of objects to the aircraft operations around airports. The methodology is presented using the aircraft trajectories of approaches at Ottawa International Airport (CYOW). Estimated dimensions of Code 3 approach surfaces also are presented.

Towards a safety index for assessing head injury potential in service robotics

There are many standards worldwide dealing with safety issues in robots and adequate protections for their industrial use. Two main safeguard actions are considered to avoid mechanical risks, namely physical or non-physical protections and design guidelines for robots and their components. Nevertheless, there is a lack of specific standards for service robots. Safety in these robots needs a new point of view. It requires a strategy to be changed from pre-contact to post-contact safety, since it is not possible to avoid human–robot interaction. On the other hand, in automotive industry crash test results are used for assessing car safety by means of safety indices. In this paper, quantitative head injury indices for automobiles are analysed and a new safety index for robots NIR is derived. The similitude between NIR and indices used in automotive industry lets the new index to take advantage of previous results and knowledge available in automotive field. Results with NIR are compared with those given by experimental tests with robots. The effects of main parameters on the new index are analysed and results are compared with other safety criteria in order to clarify differences and benefits.

Counterfeit botulinum toxins—A serious risk to patient safety

With the increasing use of botulinum toxin for a range of clinical and aesthetic conditions, particular attention has to be paid to the quality of products used for patient treatment. At all times, patients must be treated with products of the highest quality to avoid any issues about adverse reactions and safety-related, unwanted outcomes. In turn, increased botulinum toxin use has led to a similar increase in the number of counterfeit products arriving on the market. These counterfeits may become the subject of police and regulatory actions. We report studies on several counterfeit toxins that have appeared in Brazil, Italy, Iran and Russia and which claim to be Dysport® or Dysport®-like. In the majority of cases, the labelled potency of the counterfeit (as determined by an ELISA, endopeptidase assay or a mouse potency assay) was incorrect. For other counterfeits, only physical appearance has been examined due to the poor quality of the sample obtained. Although some counterfeits can look very similar to the licensed product in appearance, the contents of the vials, both active toxin and excipients, are highly questionable. The use of licensed toxin products from known suppliers is the main safeguard to ensure that patient safety is not jeopardised.

Fracture strength of relatively brittle structures and materials

In the case of relatively brittle structural materials, linear fracture mechanics provides an analysis basis for testing and control of fracture strength. Standardized methods of crack toughness testing are available only for metals which can be pre-cracked by fatigue. Hence, further work on this topic is needed for glassy and polymeric solids. Proper use of surface residual compressive stress is a primary method of fracture control for such materials, and environment-assisted stable crack extension is often a significant factor. In the case of layered or parallel-fiber stiffened composites, the single crack fracture mechanics viewpoint usually applies to individual separations, but the aggregate effect of the expected distribution of cracks must be taken into account. Often the proof test is the main safeguard against strength-type failures in service, and the efficiency with which proof testing is employed is important.

動力炉の安全性

Safety review is made on the recent power reactor in this paper outlining about recent views of the USA and U.K. government and main safeguard devices provided for reactors in practice, together with picking up important points to be consid ered for safety.