ABSTRACT INTRODUCTION Mortality is associated with daily temperatures and extreme cold events. This study aimed to analyze the effects of low temperatures on mortality in the main urban areas of Argentina during 2005-2015. METHODS A time-series study with generalized additive models was conducted, modeling the relationship between low temperatures and mortality for 21 cities in Argentina between 2005 and 2015. Total mortality was analyzed as well as mortality by sex, age and cause of death, considering cold days, cold spells and delays of 7 and 14 days after those events. RESULTS Within a 7-day lag, the risk of death increases for a cold day in half of the cities analyzed between 1.04 [CI95%: 1.00-1.08] and 1.14 [CI95%: 1.06-1.23]. The most vulnerable group was people aged 65 or more years, with increases of up to 1.20 [CI95%: 1.05-1.39]. Cold spells are associated with an increased risk within the subsequent 7 days in 8 cities (1.05 [CI95%: 1.03-1.08] to 1.30 [CI95%: 1.03-1.65]), which increases to 10 cities for the 14-day lag, with slightly lower values. CONCLUSIONS With differences in magnitude and statistical robustness by cities, the population of most urban areas presents an increased risk of death within 7 and 14 days after an event of extreme cold.

RESUMEN INTRODUCCIÓN La mortalidad guarda relación con las temperaturas diarias y los eventos extremos. Este estudio buscó analizar los efectos de las bajas temperaturas sobre la mortalidad en las principales ciudades de Argentina en el período 2005-2015. MÉTODOS Se realizó un estudio de series temporales con modelos aditivos generalizados, modelando la relación entre bajas temperaturas y mortalidad para 21 ciudades de Argentina entre 2005 y 2015. Se analizó la mortalidad general y por grupos de sexo, edad y causa de muerte, en días fríos y días de olas de frío, así como los rezagos de 7 y 14 días posteriores a dichos eventos. RESULTADOS En los 7 días posteriores a un día frío, el riesgo de muerte aumenta en la mitad de las ciudades entre un 1,04 [IC95%: 1,00-1,08] y un 1,14 [IC95%: 1,06-1,23] según la ciudad. El grupo de 65 años y más es el que muestra mayor impacto, con un incremento de hasta el 1,20 [I C95%: 1,05-1,39]. Las olas de frío se asocian con un aumento más pronunciado en el riesgo de morir en los siguientes 7 días en 8 ciudades (1,05 [IC95%: 1,03-1,08] a 1,30 [IC95%: 1,03-1,65]), y en 10 ciudades en los siguientes 14 días, aunque con valores algo más bajos. CONCLUSIONES Con diferencias en magnitud y robustez estadística según las ciudades, la población de las áreas urbanas presenta un riesgo aumentado de muerte durante los 7 y 14 días posteriores a un evento de frío extremo.

INTRODUCTION: Climate change is a matter of public health. The carbon footprint is relevant to the ecological footprint of an entity which measures the biological surface needed to produce goods and services consumed by the same, as well as the ability to assimilate the waste it generates, so its estimation is a good indicator of the environmental impact generated by the activities of the establishment. OBJECTIVES: Estimate the carbon footprint of the Hospital General of Acutes Enrique Tornu of the city of Buenos Aires during 2015. METHODS: The design was based on a descriptive qualitative-quantitative study of transverse type, which included the sources of greenhouse gases to calculate emissions from the activities of the hospital with a perspective of an organization. RESULTS: The carbon footprint obtained was 1526.47 tons of equivalent CO2 - 43% was generated by direct emissions, 29% by indirect emissions due to energy consumption and the remaining 28% by indirect emission. Indicator I2015 = 9.09 tCO2e/bed. CONCLUSIONS: The results show the environmental impact of the hospital functioning and its contribution to global warming. The contribution of each activity allows identifying the most significant emission sources and opportunity areas for the implementation of reduction and/or mitigation strategies. The performance indicator will serve to measure progress in terms of scheduled emission reduction.

INTRODUCCIÓN: El cambio climático es una cuestión de salud pública. La huella de carbono constituye parte esencial de la huella ecológica de una entidad, que mide la superficie biológica necesaria para producir los bienes y servicios consumidos por la misma, así como la capacidad para asimilar los residuos que genera, por lo que es importante su estimación como indicadora del impacto ambiental que generan las actividades del establecimiento. OBJETIVOS: Estimar la huella de carbono del Hospital General de Agudos Enrique Tornú de la Ciudad Autónoma de Buenos Aires en 2015. MÉTODOS: estudio cuali-cuantitativo descriptivo, de tipo transversal, que incluyó las fuentes emisoras de gases con efecto invernadero para calcular las emisiones de las actividades del hospital desde la perspectiva de una organización. RESULTADOS: La huella de carbono obtenida en toneladas de dióxido de carbono equivalente fue 1526,47 El 43% fueron generadas por emisiones directas, 29% por emisiones indirectas por consumo de energía y el 28% restante por otras emisiones indirectas. Indicador obtenido: I2015 = 9,09 tCO2e/cama. CONCLUSIONES: Los resultados muestran el impacto ambiental generado por el funcionamiento del hospital y su contribución al calentamiento global. Los aportes de cada actividad permiten identificar las fuentes de emisión de mayor peso como áreas de oportunidad para la implementación de estrategias de reducción y/o mitigación. El indicador de desempeño permitirá medir avances en términos de reducción programada de emisiones.

Scorpion stings and their associated mortality increased in the last years in Argentina, with a cumulative record of 73,617 cases and 30 deaths during the period 2001-2012, occurring almost all the deaths in pediatric patients. However, deaths due to severe envenoming by scorpion stings have not been recorded in Buenos Aires city and suburban regions, although the presence of scorpions in this city has been increasingly reported. We studied the temporal and geographical distribution of Tityus trivittatus findings in Buenos Aires city from the database of the Research and Development Area from the National Institute for Production of Biologics of the National Ministry of Health during the period 10/01/2001 to 31/12/2012 in order to correlate these findings with the distribution of health centers in the city. In this period 385 consults with identification of scorpions were recorded. Annual records showed a growing trend. Geo-referenced data showed that findings appeared to increase in the surroundings of metro and train stations, mainly at the east of the city with expansion to the west. Although Toxicology services are geographically related to the zones with higher density of finding of scorpions, the accessibility to the centers with antivenom may hinder its application in the recommended time; some measures to avoid possible delays in the application of the treatment are suggested.

En Argentina, las picaduras de alacrán (escorpión) y la mortalidad asociada aumentaron en los últimos años. Durante el período 20012012, se registraron 73 617 accidentes y 30 óbitos, casi todos en pacientes pediátricos. A diferencia de otras latitudes del país, en la Ciudad de Buenos Aires y su Conurbano, no se registraron envenenamientos graves o muertes por estos arácnidos. El objetivo fue describir la distribución temporal y geográfica de los hallazgos de Tityus trivittatus en la Ciudad de Buenos Aires desde el 10/1/2001 al 31/12/2012 y su relación con la distribución de los centros asistenciales. Hubo 385 consultas con identificación de escorpiones. Los registros anuales mostraron una tendencia creciente. El georreferenciamiento mostró áreas con mayor frecuencia de hallazgos y densidad en proximidades de ciertas estaciones de ferrocarril y subterráneos, principalmente al este de la ciudad con expansión hacia el oeste. Si bien los centros con servicios de Toxicología coinciden geográficamente con estas zonas, la accesibilidad a centros que disponen del antiveneno puede dificultar su aplicación en el tiempo recomendado. Se sugieren medidas para prevenir demoras en los tratamientos.

O envenenamento por corais (Micrurus sp.) é um dos mais perigosos na América e considerado uma emergência médica grave ainda que acidentes por estas serpentes pareçam raros. Analisamos dados epidemiológicos e clínicos e o uso de soro antiofídico, durante o período de 1979-2003. As comunicações indicam 46 acidentes por Micrurus, aproximadamente dois casos anuais, sem registro. A maioria dos casos ocorreu em homens de idade entre 31 e 40 anos, principalmente no período de primavera e verão e provenientes do noroeste e nordeste do país. Os acidentes na sua maioria ocorreram em mãos e pés, durante atividades agrícolas envolvendo trabalhadores rurais. Apenas quatro acidentes foram relacionados a manejo dos animais. Em todos os casos analisados houve descrição de dor local e em 41% dos pacientes houve edema. Por paciente foram administradas, em média, duas ampolas. O tempo médio de aplicação do soro foi de 60 minutos. Em todos os casos a recuperação foi favorável sem presença de sequelas. Neste estudo foi possível observar uma baixa incidência de acidentes e baixa severidade nos envenenamentos. Apesar de que não aconteceram mortes nos últimos 30 anos, dado a toxicidade do veneno das cobras corais, o risco de envenenamento severo deveria ser considerado.

Envenomation by coral snakes (Micrurus sp.) is one of the most dangerous injuries in America and it is considered as a serious medical emergency, however bites by these snakes appear to be rare. We analyzed epidemiological data, clinical signs and antivenom use in Argentina during the period between 1979-2003. During this period of study 46 non-fatal Micrurus bites were reported. The majority of cases were men from 31 to 40 years old. Bites occurred primarily in spring and summer. Most cases were reported from the northeast and northwest provinces of the country. The bites were mostly located on hands or feet and occurred mostly during agricultural activities and so mainly involved farmers. Only four cases occurred as a result of handling snakes. The median time it took for antivenom to be administrated was 60 minutes after the bite, and the median number of vials applied was 2. Local pain was mentioned and edema was reported in 41% of patients. All patients recovered without sequelae. This study showed a low incidence of Micrurus bites and low severity of envenomation. However, although no deaths have been reported during the last 30 years, given the toxicity of the venom of Micrurus snakes, the risk of severe envenomation should be considered.