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Objectives: The spread of extended-spectrum cephalosporin-resistant Enterobacterales (ESCrE) and carbapenem-resistant Enterobacterales (CRE) has resulted in increased morbidity, mortality, and health care costs worldwide. To identify the factors associated with ESCrE and CRE colonization within hospitals, we enrolled hospitalized patients at a regional hospital located in Guatemala. Methods: Stool samples were collected from randomly selected patients using a cross-sectional study design (March-September, 2021), and samples were tested for the presence of ESCrE and CRE. Hospital-based and household variables were examined for associations with ESCrE and CRE colonization using lasso regression models, clustered by ward (n = 21). Results: A total of 641 patients were enrolled, of whom complete data sets were available for 593. Colonization with ESCrE (72.3%, n = 429/593) was negatively associated with carbapenem administration (odds ratio [OR] 0.21, 95% confidence interval [CI] 0.11-0.42) and positively associated with ceftriaxone administration (OR 1.61, 95% CI 1.02-2.53), as was reported hospital admission within 30 days of the current hospitalization (OR 2.84, 95% CI 1.19-6.80). Colonization with CRE (34.6%, n = 205 of 593) was associated with carbapenem administration (OR 2.62, 95% CI 1.39-4.97), reported previous hospital admission within 30 days of current hospitalization (OR 2.58, 95% CI 1.17-5.72), hospitalization in wards with more patients (OR 1.05, 95% CI 1.02-1.08), hospitalization for ≥4 days (OR 3.07, 95% CI 1.72-5.46), and intubation (OR 2.51, 95% CI 1.13-5.59). No household-based variables were associated with ESCrE or CRE colonization in hospitalized patients. Conclusion: The hospital-based risk factors identified in this study are similar to what has been reported for risk of health care-associated infections, consistent with colonization being driven by hospital settings rather than community factors. This also suggests that colonization with ESCrE and CRE could be a useful metric to evaluate the efficacy of infection and prevention control programs in clinics and hospitals.
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The construction industry is one of the riskiest sectors worldwide, with crane operations being one of the most dangerous activities. The aim of this study was to gain insight into the key factors involved in crane-related occupational accidents in the construction industry in Spain. To this end, 1314 accidents involving cranes were analyzed from a total of 241,937 accidents that occurred in the construction of buildings. The data were collected from the Spanish government's occupational accident statistics corresponding to the years 2012-2021. The results evidenced a statistically significant relationship between cranes as the material agent and the size of the company, with 95% of cases corresponding to small- or medium-sized companies (less than 250 employees). Additionally, it shows how the crane operator is identified as a material contributor to crane accidents in the construction industry, and may be considered a key component to these accidents. In conclusion, improving the knowledge gained about the key factors in crane-related accidents at work in the construction industry provides essential information that helps to design and implement appropriate preventive measures to avoid the recurrence of unwanted events with these machines.
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Indústria da Construção , Saúde Ocupacional , Humanos , Acidentes de Trabalho , Espanha/epidemiologia , Comportamento PerigosoRESUMO
Brain metastases are tumors that arise from a tumor cell originated in another organ reaching the brain through the blood. In the brain this tumor cell is capable of growing and invading neighboring tissues, such as the meninges and bone. In most patients a known tumor is present when the brain lesion is diagnosed, although it is possible that the first diagnose is the brain tumor before there is evidence of cancer elsewhere in the body. For this reason, the neurosurgeon must know the management that has shown the greatest benefit for brain metastasis patients, so treatments can be streamlined and optimized. Specifically, in this document, the following topics will be developed: selection of the cancer patient candidate for surgical resection and the role of the neurosurgeon in the multidisciplinary team, the importance of immunohistological and molecular diagnosis, surgical techniques, radiotherapy techniques, treatment updates of chemotherapy and immunotherapy and management algorithms in brain metastases. With this consensus manuscript, the tumor group of the Spanish Society of Neurosurgery (GT-SENEC) exposes the most relevant neurosurgical issues and the fundamental aspects to harmonize multidisciplinary treatment, especially with the medical specialties that are treating or will treat these patients.
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Neoplasias Encefálicas , Neurocirurgia , Humanos , Consenso , Neoplasias Encefálicas/cirurgia , Neoplasias Encefálicas/diagnóstico , Procedimentos NeurocirúrgicosRESUMO
BACKGROUND: We estimated the prevalence of colonization with extended-spectrum cephalosporin-resistant Enterobacterales (ESCrE) and carbapenem-resistant Enterobacterales (CRE) from a hospital and associated communities in western Guatemala. METHODS: Randomly selected infants, children, and adults (<1, 1-17, and ≥18 years, respectively) were enrolled from the hospital (n = 641) during the coronavirus disease 2019 (COVID-19) pandemic, March to September 2021. Community participants were enrolled using a 3-stage cluster design between November 2019 and March 2020 (phase 1, n = 381) and between July 2020 and May 2021 (phase 2, with COVID-19 pandemic restrictions, n = 538). Stool samples were streaked onto selective chromogenic agar, and a Vitek 2 instrument was used to verify ESCrE or CRE classification. Prevalence estimates were weighted to account for sampling design. RESULTS: The prevalence of colonization with ESCrE and CRE was higher among hospital patients compared to community participants (ESCrE: 67% vs 46%, P < .01; CRE: 37% vs 1%, P < .01). Hospital ESCrE colonization was higher for adults (72%) compared with children (65%) and infants (60%) (P < .05). Colonization was higher for adults (50%) than children (40%) in the community (P < .05). There was no difference in ESCrE colonization between phase 1 and 2 (45% and 47%, respectively, P > .05), although reported use of antibiotics among households declined (23% and 7%, respectively, P < .001). CONCLUSIONS: While hospitals remain foci for ESCrE and CRE colonization, consistent with the need for infection control programs, community prevalence of ESCrE in this study was high, potentially adding to colonization pressure and transmission in healthcare settings. Better understanding of transmission dynamics and age-related factors is needed.
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Antibacterianos , COVID-19 , Adulto , Criança , Humanos , Lactente , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Bactérias , Carbapenêmicos , Resistência Microbiana a Medicamentos , Guatemala/epidemiologia , Hospitais , Pandemias , Pré-Escolar , AdolescenteRESUMO
Torsion tests are performed for cylindrical type of a novel exo-endoprosthesis internal part. It is verified that it has values greater than those obtained for elliptical type. The best bonding method between PEEK and threaded rod is the resin adhesive, matching the obtained results for elliptical implant. Results of cylindrical type are discussed versus elliptical type.
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Adesivos , Próteses e Implantes , AnimaisRESUMO
Adult low-grade gliomas (Low Grade Gliomas, LGG) are tumors that originate from the glial cells of the brain and whose management involves great controversy, starting from the diagnosis, to the treatment and subsequent follow-up. For this reason, the Tumor Group of the Spanish Society of Neurosurgery (GT-SENEC) has held a consensus meeting, in which the most relevant neurosurgical issues have been discussed, reaching recommendations based on the best scientific evidence. In order to obtain the maximum benefit from these treatments, an individualised assessment of each patient should be made by a multidisciplinary team. Experts in each LGG treatment field have briefly described it based in their experience and the reviewed of the literature. Each area has been summarized and focused on the best published evidence. LGG have been surrounded by treatment controversy, although during the last years more accurate data has been published in order to reach treatment consensus. Neurosurgeons must know treatment options, indications and risks to participate actively in the decision making and to offer the best surgical treatment in every case.
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Neoplasias Encefálicas , Glioma , Neurocirurgia , Adulto , Humanos , Neoplasias Encefálicas/patologia , Glioma/patologia , Encéfalo , Procedimentos NeurocirúrgicosRESUMO
Objectives. Improving knowledge about the mechanism of accident occurrence in the construction industry provides important information to help design and implement appropriate barriers to stop the spread of unexpected events. This study characterizes the sequence of accidents in the construction industry by linking the most commonly identified circumstances, the barriers and barrier functions infringed and the specific way in which each of these functioned. Methods. In order to achieve the proposed objective, an analysis was made of 241 investigations of work accidents that occurred in the construction sector in Spain between 2009 and 2014. The statistical difference between the groups of variables was determined using contingency tables in which the value of the χ2 statistic was calculated. Results. The results obtained show that behavioural factors are fundamentally identified, such as the worker's non-observance of ensuring their own safety or the deficient interpretation of rules. Conclusions. This study illustrates that to understand the performance of barrier systems and functions, efforts must be focused not only on the things that go wrong, i.e., accidents, but also on the things that go right within the variability of daily performance in systems as complex as the construction industry.
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Indústria da Construção , Humanos , Acidentes de Trabalho/prevenção & controle , Espanha/epidemiologiaRESUMO
Exo-endoprosthesis is a limb salvage procedure poorly described for animals, as only expensive metal devices have been used so far. Currently, additive manufacturing (AM) can make this type of implant affordable by exploring a wide new range of materials. However, safety factors should be considered and could be related to kinetic and kinematic studies of canine natural gaits. The suitability of a novel inner part of an exo-endoprosthesis manufactured by fuse deposition modeling (FDM) was assessed for long canine bones with an elliptical medullary canal. Polyether ether ketone (PEEK) was the material used as an alternative to metal for veterinary traumatology. Poisson's ratio of 3D-printed PEEK material and ex vivo mechanical tests of the customized endoprosthesis were performed for the evaluation. The customized endoprostheses had promising outcomes for the radii of 20 kg dogs. Quasistatic mechanical tests of bone-inserted endoprostheses-pure compression tests-reached a maximum force of 1045.0 ± 78.0 N. In fatigue tests, the samples reached 500,000 cycles without failure or detriment to their quasistatic results. These outcomes surpass the natural weight-bearing of dogs, even during a galloping pace. Furthermore, torque tests with different adhesives were performed to obtain reference data for future assessments comparing with natural dog movements.
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Exo-endoprosthesis is a limb salvage procedure for animals, although only expensive metal devices have been described. Now-a-days, new materials for this type of implant could be considered due to novel and affordable manufacturing techniques. However, a factor of safety (FoS) should be considered. There are kinetic and kinematic studies of canine natural gaits, which can be used to establish an FoS for mechanical tests for new non-metallic devices. Polyetheretherketone (PEEK) is used in different specialties in human medicine. Its mechanical properties (and its close mechanical stiffness to that of bone) make this polymer an alternative to metals in veterinary traumatology. PEEK could also be used in 3D printing. The suitability of a novel inner part of an exo-endoprosthesis manufactured by fuse deposition modeling (FDM) was presented in this study for long canine bones. Mechanical characterization of 3D-printed PEEK material and ex vivo mechanical tests of a customized endoprosthesis were performed to address it. Young's modulus of 3D-printed PEEK suffered a reduction of 30% in relation to bulk PEEK. Customized 3D-printed PEEK endoprostheses had promising outcomes for the tibiae of 20 kg dogs. Pure compression tests of the non-inserted endoprostheses showed a maximum force of 936 ± 199 N. In the bending tests of non-inserted endoprostheses, the PEEK part remained intact. Quasistatic mechanical tests of bone-inserted endoprostheses (compression-bending and pure compression tests) reached a maximum force of 785 ± 101 N and 1,642 ± 447 N, respectively. In fatigue tests, the samples reached 500,000 cycles without failure or detriment to their quasistatic results. These outcomes surpass the natural weight-bearing of dogs, even during a galloping pace. In conclusion, the 3D-printed PEEK part of the endoprosthesis for an exo-endoprosthesis can withstand loading, even during a galloping pace.
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This study explores the biotechnological potential of lignocellulolytic fungi collected in an oak forest. Fungal collections were obtained from natural reserves located in Boyacá-Colombia, ranging from 2700 to 3000 m.a.s.l. Twenty-three strains were isolated on malt agar, molecular characterization was performed, and ligninolytic and cellulolytic enzymatic activities were screened. Several white-rot fungi of biotechnological importance were identified as follows: Trametes sp., Trametes versicolor, Trametes villosa, Pycnoporus sanguineus, Bjerkandera adjusta, Lentinula boryana, Panus conchatus, Antrodia neotropica, Brunneoporus malicola, Laetiporus gilbertsonii, Stereum sp., Ganoderma sp., and Dichomitus sp. The strains T. versicolor 0554 and 0583, T. villosa 0562, and B. adusta 0556 showed the highest response in the qualitative enzymatic assays. These strains were used to determine their ability to decolorate the dyes aniline blue and Congo red, and it was found that T. villosa 0562 reached a level of decolorization close to 90% after 48 h of submerged culture. The fungal strains obtained here could offer alternatives to develop a process to accomplish sustainable development objectives.
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Trametes , Madeira , Colômbia , Corantes , Florestas , Madeira/microbiologiaRESUMO
Abstract In the context of the border dispute presented by Peru against Chile in the The Hague Court, this study analyzes the influences of two ideological motivational dimensions: Right-Wing Authoritarianism (RWA) and Social Dominance Orientation (SDO) on a set of intergroup attitudes that involve both nations. To this end, a survey study of 196 Chileans and 223 Peruvians participants was conducted. The instruments used to measure ideology and political attitudes are the following ones: RWA Scale; SDO Scale; Scale of Intergroup attitudes between Chile-Peru and specific questions on interest in the Hague litigation and willingness to fight for one's country. The results show that in the Peruvian case attitudes of belligerence and alert and a greater willingness to fight for the country are better explained by the RWA, while in the Chilean case these same attitudes are explained both by the RWA as well as the SDO. On the other hand, pacificist attitudes are explained inversely by SDO in both countries. These findings support the hypothesis that intergroup dynamics between both countries have been marked by expressed actions of a Chilean expansionism versus a Peruvian vengefulness and suggest that equalitarianism will promote attitudes toward respect and cooperation between both groups, changing the frames of expansionism and vengefulness for one of a culture of peace.
Resumo Este estudo analisa as influências de duas dimensões motivacionais ideológicas: o Autoritarismo de Direita (RWA) e a Orientação à Dominação Social (SDO) em um conjunto de atitudes intergrupais que envolvem Perú e Chile, no contexto da disputa fronteiriça apresentada pelo primeiro contra o segundo na Corte de Haia. Para isso, foi desenvolvido um estudo com 196 participantes do Chile e 223 do Peru. Os instrumentos utilizados para medir a ideologia e as atitudes políticas são os seguintes: Questionário de RWA; questionário de SDO; questionário de atitudes intergrupos entre Chile é Peru e itens de interesse na disputa ante A Haia e a vontade de lutar pelo próprio país. Os resultados mostram que, no caso peruano, as atitudes de beligerância e alerta, e uma maior disposição de lutar pelo país são explicadas pelo RWA, enquanto no caso chileno, essas mesmas atitudes são explicadas tanto pelo RWA quanto pela SDO. Por outro lado, as atitudes pacifistas são diminuidas pela SDO nos dois países. Estos resultados corroboram á hipótese da dinâmica intergrupal entre os dois países, marcada por ações explícitas do expansionismo chileno versus revanchismo peruano; os resultados também sugerem que as ideologias igualitarias poderão promover atitudes de respeito e cooperação entre os dois grupos, alterando os esquemas expansionista e revanchista para uma cultura de paz.
Resumen En el contexto de la disputa fronteriza presentada por Perú contra Chile ante la Corte de la Haya, este estudio analiza las influencias dos dimensiones motivacionales ideológicas: el Autoritarismo de Derecha (RWA) y la Orientación a la Dominancia Social (SDO) en un conjunto de actitudes intergrupales que involucran a ambas naciones. Con esta finalidad, fue desarrollado un estudio por encuestas con 196 participantes de Chile y 223 de Perú. Los instrumentos utilizados para medir la ideología y las actitudes políticas son los siguientes: Escala de RWA; Escala de SDO; Escala de actitudes intergrupales entre Chile-Perú y preguntas específicas sobre el interés en el litigio de La Haya y la disposición de luchar por el propio país. Los resultados muestran que en el caso peruano las actitudes de beligerancia y alerta, y una mayor disposición a luchar por el país son explicadas por el RWA, mientras en el caso chileno, estas mismas actitudes son explicadas tanto por el RWA como por la SDO. Por otra parte, las actitudes pacifistas son explicadas inversamente por la SDO en ambos países. Estos hallazgos corroboran la hipótesis sobre las dinámicas intergrupales entre ambos países, las cuales han estado marcadas por acciones explicitas de expansionismo chileno versus revanchismo peruano; asimismo, los resultados sugieren que el igualitarismo promovería actitudes hacia el respeto y cooperación entre ambos grupos, cambiando los esquemas expansionista y revanchista por uno de cultura de paz.
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BACKGROUND: The scientific literature contextualizes health and safety (H&S) in two major models, the first is based on a holistic perspective with H&S processes in all company departments, and the second approaches health and safety management from a more operational perspective. In this study, we examine the issue of health and safety in wineries. In 2017, a census showed that wineries account for 14% of the food and beverage industry in Spain. They provide direct employment for 24,051 people and involve complex winemaking processes that can cause accidents or occupational diseases. Wineries are part of the industrial sector, which, with 5,264 lost-time accidents per 100,000 workers in 2017, ranks second in the number of occupational accidents in Spain. This shows the need to determine the changes needed to improve health and safety in wineries. METHODS: In this study, we identify H&S determinants in wineries using Delphi methodology with a panel of 11 experts. CONCLUSION: The experts gave high scores to the "activities" dimension, and others such as "control of personal and collective protective equipment" and "training", together with "accident investigation", "coordinated health and safety measures" and "signage" are associated with operational health and safety determinants, namely, capitalizing on knowledge gained in situ and promoting organizational learning.
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Saúde Ocupacional , Acidentes de Trabalho/prevenção & controle , Humanos , Indústrias , Gestão da Segurança , EspanhaRESUMO
Worker safety awareness on construction sites is a major concern due to the hazardous work conditions. Additionally, globalization is increasing the cultural diversity of the workforce and this influences workers' attitudes, beliefs and behaviour. The growing number of migrant workers in this sector has become a distinctive feature of the industry's labour market. The objective of this article is to analyse occupational accidents that occurred on Spanish construction sites while taking into consideration the nationality of the workers. Due to the large number of accidents and attributes associated with them, the use of association rules is proposed. Overall, results evince similar behaviour, although interesting differences can be observed regarding the occupation of workers. In addition, the results are in accordance with previous studies carried out in other countries. The analysis of these accidents will serve to establish initiatives that provide safer work environments.
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Indústria da Construção , Saúde Ocupacional , Acidentes de Trabalho , Humanos , Espanha/epidemiologia , Local de TrabalhoRESUMO
La hidatidosis humana es una enfermedad endémica en nuestro país. Es una zoonosis causada por el céstode Equinococus granulosus, cuyos huevos al ser ingeridos en el agua o alimentos, accidentalmente por los humanos, provoca que se rompan en el intestino migrando a través de la circulación a distintos órganos donde provocan quistes que paulatinamente van aumentando de tamaño y haciéndose sintomáticos. El presente caso clínico informa del diagnóstico y tratamiento por cirugía mínimamente invasiva de un quiste hidatídico gigante de hígado con buena evolución hasta el año de seguimiento. El objetivo del presente artículo fue revisar y describir la técnica quirúrgica del tratamiento conservador y presentarla como método de tratamiento seguro y efectivo en casos seleccionados, constituyéndose en una alternativa útil para este tipo de pacientes.
The human hydatidosis is a endemic disease in our country. Is a zoonosis caused by the Echinococcus granulosus tapeworm, whose eggs when ingested in the water or food, accidentally by the humans, causes them to break in the small intestine migrating through circulation at various organs producing cysts that increase in size generating symptomatology. This case reports the diagnosis and treatment for minimally invasive surgery of a liver hidatidic cyst giant with good evolution until a year of follow-up. The objective of this work is describing the surgical technique of benign treatment and offer it as a treatment safe and effective in sectioned cases, becoming a useful alternative for this kind of patients.
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Cistos , Tratamento ConservadorRESUMO
Resumen El objetivo de la presente investigación es analizar las propiedades psicométricas de la Escala Orientación hacia la Dominancia Social (SDO), en una muestra no universitaria de la ciudad de Arica, Chile, implementando técnicas psicométricas de acuerdo con el estado del arte disciplinar. El muestreo fue no probabilístico, por conveniencia y disponibilidad de 812 participantes, entre edades de 18 a 89 años. Se realizaron estimaciones de fiabilidad, análisis factoriales confirmatorios y modelos de ecuaciones estructurales exploratorios, contrastando diferentes modelos. Los resultados proporcionaron evidencia de validez basada en la estructura interna de la prueba, presentando buen ajuste de la estructura de la SDO (RMSEA=.076; CFI=.963; TLI=.956), y adecuados niveles estimados de fiabilidad (Oposición a la Igualdad: α=.85, ω=.84; Dominancia Grupal: α =.67, ω =.66). Finalmente, se concluye que las puntuaciones de la escala SDO poseen evidencia suficiente para sustentar su uso e interpretación, en población no universitaria equivalente a la del presente estudio.
Abstract The objective of this research is to analyze the psychometric properties of the Social Dominance Orientation (SDO) Scale in a non-university sample of the city of Arica, Chile, implementing psychometric techniques according to the state of disciplinary art. The sampling was non-probabilistic due to the convenience and availability of 812 participants in a range of ages from 18 to 89 years. To contrast different models were performed reliability estimates, confirmatory factorial analyses, and exploratory structural equation models. The results provided evidence of validity based on the internal structure of the test, presenting good adjustment of the SDO structure (RMSEA=.076; CFI=.963; TLI=.956), and estimated adequate levels of reliability (Opposition to the Equality: α=.85, ω=.84, Group dominance: α =.67, ω =.66). Finally, the research concluded that the scores of the SDO scale have sufficient evidence to support its use and interpretation, in a non-university population equivalent to that of the present study.
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Existen varios trastornos mentales que se relacionan con el consumo del alcohol y otras drogas, cierto número de personas desarrollan un patrón evolutivo al abuso, sea este persistente o esporádico, produce perturbaciones o limitaciones clínicamente significativas con variadas manifestaciones en el hogar, la escuela y el trabajo. Se determinó la frecuencia y asociación entre trastornos psiquiátricos, patrones de consumo de sustancias y variables sociodemográficas en estudiantes de medicina de la Universidad Nacional de Asunción. El diseño de estudio fue observacional, analítico, corte transversal, La población estuvo constituida por 626 estudiantes de la carrera de medicina del primero al quinto curso, que fueron seleccionados por un muestreo no probabilístico por conveniencia. Se aplicaron 3 cuestionarios que abarcaban tres aspectos: datos sociodemográficos, abuso de drogas y diagnóstico psiquiátrico. Los datos fueron analizados mediante GNU Perfect Statistics Professionally Presented y Epi Info. Se concluyó que el trastorno más frecuente fue el Trastorno por Abuso de drogas, seguido del Trastorno Obsesivo-Compulsivo y el Trastorno Depresivo Mayor. La sustancia más consumida fue el alcohol, seguido del tabaco y la marihuana. Esta última fue la única que se asoció con todas las sustancias. El consumo de alcohol presentó asociación con TOC, Fobia Social y Ansiedad; los consumidores de benzodiacepinas presentaron mayor riesgo de Trastorno Depresivo, Trastorno por Estrés Postraumático, Bulimia, Pánico, Agorafobia, Ansiedad y Trastorno de Somatización. Se recomienda la implementación de políticas de educación preventiva, así como estudios prospectivos para evaluar relaciones de causalidad en las asociaciones encontradas.
There are several mental disorders that are related to the consumption of alcohol and other drugs, a number of people develop an evolutionary pattern of abuse, whether it is persistent or sporadic, it produces clinically significant disturbances or limitations with various manifestations at home, school and the job. The frequency and association between psychiatric disorders, patterns of substance use and socio-demographic variables in medical students of the National University of Asunción was determined. The study design was observational, analytical, cross-sectional. The population consisted of 626 medical students from the first to the fifth year, who were selected by a non-probabilistic convenience sampling. 3 questionnaires were applied that covered three aspects: sociodemographic data, drug abuse and psychiatric diagnosis. The data was analyzed using GNU Perfect Statistics Professionally Presented and Epi Info. It was concluded that the most frequent disorder was Drug Abuse Disorder, followed by Obsessive-Compulsive Disorder and Major Depressive Disorder. The most used substance was alcohol, followed by tobacco and marijuana. The latter was the only one that was associated with all substances. Alcohol consumption was associated with OCD, Social Phobia and Anxiety; Benzodiazepine users had a higher risk of Depressive Disorder, Post-Traumatic Stress Disorder, Bulimia, Panic, Agoraphobia, Anxiety and Somatization Disorder. The implementation of preventive education policies is recommended, as well as prospective studies to evaluate causal relationships in the associations found.
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Ansiedade , Transtornos de Estresse Pós-Traumáticos , Cannabis , Transtorno Depressivo Maior , Etanol , Transtornos Mentais , Transtorno Obsessivo-Compulsivo , Estudantes , Causalidade , Estudos Prospectivos , Inquéritos e Questionários , Estudos de AmostragemRESUMO
BACKGROUND: Human papillomavirus infection is an important factor associated with cervical cancer (CC) development. The prevalence and genotype distribution vary greatly worldwide. Examining local epidemiological data constitutes an important step towards the development of vaccines to prevent CC. In this work, we studied the prevalence of HPV genotypes in women from Western Mexico with the COBAS 4800 and/or Linear Array Genotyping Test (LA). METHODS: The samples analysed in this study represent a population from Western Mexico, which includes six different states. Our approach was first to test for HPV in cervical samples from women who attended their health clinic for routine gynaecological studies (open-population, n = 3000) by utilizing COBAS 4800. Afterwards, 300 of the HPV-positive samples were randomly selected to be genotyped with LA; finally, we genotyped samples from women with cervical intraepithelial neoplasia grade 1 (CIN 1, n = 71) and CC (n = 96) with LA. Sociodemographic data of the diverse groups were also compared. RESULTS: The overall HPV prevalence among the open-population of women as determined by COBAS 4800 was 12.1% (n = 364/3000). Among the HPV-positive samples, single infections (SI) with HPV16 were detected in 12.4% (n = 45/364), SI with HPV18 were detected in 1.4%, and infection with at least one of the genotypes included in the high-risk HPV pool was detected in 74.5% of the cases. LA analysis of the samples showed that in addition to HPV genotypes 16 and 18, there was a high prevalence of HPV genotypes 59, 66, 52, 51, 39 and 56 in women from Western Mexico. With respect to the sociodemographic data, we found statistically significant differences in the number of pregnancies, the use of hormonal contraceptives and tobacco intake. CONCLUSIONS: Our data indicate that there is a high prevalence of HPV genotypes which are not covered by the vaccines currently available in Mexico; therefore, it is necessary to include HPVs 59, 66, 51, 39 and 56 in the design of future vaccines to reduce the risk of CC development. It is also essential to emphasize that the use of hormonal contraceptives and tobacco smoking are risk factors for CC development in addition to the presence of HPV.
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Genótipo , Papillomavirus Humano 16/genética , Papillomavirus Humano 18/genética , Infecções por Papillomavirus/epidemiologia , Displasia do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Feminino , Humanos , Incidência , México/epidemiologia , Pessoa de Meia-Idade , Infecções por Papillomavirus/virologia , Prevalência , Fatores de Risco , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias do Colo do Útero/virologia , Adulto Jovem , Displasia do Colo do Útero/prevenção & controle , Displasia do Colo do Útero/virologiaRESUMO
Sales of electric and hybrid electric vehicles are increasing steadily worldwide, and consequently their presence increases in city areas. At low speeds, the low levels of noise produced by these vehicles could become a new risk factor for road users. However, the magnitude of the risk has not been accurately determined. In addition, its inclusion in the work environment could pose a new risk that should be managed. Thus, in relation to low noise levels of electric and hybrid vehicles, this study aimed to characterise the risk situations and determine the risk perception of workers as pedestrians and internal combustion engine vehicle drivers coming into contact with these vehicles. The data were extracted from 417 questionnaires filled out by the employees of public service companies who come into contact with electric and hybrid vehicles during their working day in the city of Málaga, in the region of Andalusia, Spain. According to the experiences reported, it seems that the risk due to the low noise levels of electric vehicles is moderate and does not reach alarming levels. These risk situations usually occurred in low speed urban areas, particularly when crossing the road, or in semi-pedestrian areas. Almost half the respondents considered that the electric vehicle poses a risk to other road users because it is more difficult to hear, and they believe it likely that other road users could be injured. Despite that risk, pedestrians did not change their way of walking or moving around the parking areas and other areas of the company. Electric and hybrid electric cars are now required to produce sound when travelling at low speeds. Nevertheless, the effectiveness of this measure should be assessed once implemented and future research should explore alternative non-acoustic measures.
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Acidentes de Trânsito , Percepção Auditiva , Veículos Automotores , Ruído , Pedestres , Adulto , Idoso , Cidades , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Risco , Segurança , Espanha , Adulto JovemRESUMO
(1) Objective: The objective of this study was to evaluate the effect of enforcement capabilities on the efficacy of two public interventions to improve occupational safety in olive mills. (2) Method: The difference in efficacy was evaluated by comparing the risks detected in two groups in an initial assessment (with visits in the 2006-2008 period) to the risks detected in a later assessment, either after an intervention by Authorized Technicians with enforcement capabilities or after an intervention by Technical Advisors without enforcement capabilities (2011-2013). The assessments identified risks in the companies, according to a specific risk map for olive oil mill enterprises. (3) Results: Statistically significant differences were observed in the comparison of the risk reductions of the two groups, with regard to the initial assessment. The greatest reductions in risk were found in the companies that received interventions by Authorized Technicians with enforcement capabilities, in the sections of individual protection equipment and the storage of dangerous products. (4) Conclusion: Interventions by Authorized Technicians with enforcement capabilities are more effective than interventions by Technical Advisors without enforcement capabilities.
Assuntos
Saúde Ocupacional , Humanos , Aplicação da Lei , Instalações Industriais e de ManufaturaRESUMO
INTRODUCTION: Glioblastoma (GBM) treatment starts in most patients with surgery, either resection surgery or biopsy, to reach a histology diagnose. Multidisciplinar team, including specialists in brain tumors diagnose and treatment, must make an individualize assessment to get the maximum benefit of the available treatments. MATERIAL AND METHODS: Experts in each GBM treatment field have briefly described it based in their experience and the reviewed of the literature. RESULTS: Each area has been summarized and the consensus of the brain tumor group has been included at the end. CONCLUSIONS: GBM are aggressive tumors with a dismal prognosis, however accurate treatments can improve overall survival and quality of life. Neurosurgeons must know treatment options, indications and risks to participate actively in the decision making and to offer the best surgical treatment in every case.