Factors influencing sick leave episodes in Mexican workers with rheumatoid arthritis and its impact on working days lost.

To evaluate impact of working days lost and factors for developing sick leave episodes in Mexicans workers with rheumatoid arthritis (RA). A prospective cohort of 123 patients with RA was followed for 1 year. Factors evaluated for sick leave episodes included: demographics, job characteristics, comorbidity, depressive symptoms, and clinical/therapeutic variables. Rates of sick leave episodes, working days lost, and permanent work disability (PWD) were identified. Statistical analysis included Cox regression models estimating hazard risks (HR) and their 95 % confidence intervals (95% CI). Cumulative time of follow-up for the cohort was 43,380 days, 24 % of workers had at least one episode of sick leave, with a mean of working days lost per patient-year of 18.36; 4.1 % developed PWD. Development of sick leave in the Kaplan-Meier analysis was associated with: age ≥40 years (p = 0.04), having a couple (p = 0.04), performing manual work (p = 0.03), suffering depressive symptoms (p = 0.04), limitations in functioning (p = 0.01), and poor global functional status ≥ III (p = 0.01). Cox regression models identified HAQ-Di ≥ 0.6 as the stronger predictor for sick leave (HR = 4.04, 95 % CI 1.41-11.58, p = 0.009) followed by age (HR = 1.05, 95 % CI 1.01-1.11, p = 0.04), ≥4 risk factors had a HR to 9.4 (95 % CI: 2.1-42.7) for sick leave. In this prospective cohort of Mexican workers with RA, we identified several factors associated with sick leave episodes and working days lost that should be potentially addressed by a multidisciplinary approach, being required to revaluate these strategies with the aim of increasing the work permanence of these patients.

[Motives of requirement for health care consultations and factors associated to mortality due to poisoning]. / Motivos que generan demanda de atención y factores asociados a mortalidad en un centro especializado en toxicología.

BACKGROUND: The poisoning is a public health problem. This problem requires continuous evaluation to decrease it. Our objective was to identify causes of requirement for health care consults and factors associated to mortality due to poisoning. METHODS: We assessed the requirements for health care consults during one year and the outcomes of these consultations in a center of toxicology. Odds ratios (OR) were used as risk estimator. RESULTS: There were 3116 consultations due to poisons. From these 79% required hospitalization. The identified causes were: be bite and wound inflected by poisonous animals in 57 % (44 % of these were due to scorpions); medications in 15 %; agrochemicals in 5 % and in 4 % prohibit substances (marihuana or cocaine). A poisoning caused by suicidal attempt was observed in 28 %. Mortality rate was 3/1000, and the mortality rate for suicidal attempt was 0.7 % meaning an OR = 6 (95 % CI = 1.3 to 31) compared with the overall mortality rate. The most frequent cause of mortality was organophosphorates poisoning (OR = 30, 95 % CI = 2.86-759). CONCLUSIONS: The poisoning secondary to animals represented the most frequent cause for consultation. The suicidal attempt and organophosphorates intoxication were associated with higher mortality.