Frequency and pattern of intrauterine hysteroscopic lesions among women coming for IVF in the city of Yaoundé

Background: Hysteroscopy is an essential tool to make intrauterine assessment in infertile patients. Diagnosis and appropriate correction of intrauterine anomalies are considered essential in order to increase chances of conception. Ourobjective was to determine the frequency and pattern of intra uterine anomalies identified among women attending hysteroscopy at the Gynaecological Endoscopic Surgery and Human Reproduction Teaching Hospital Paul et Chantal Biya ­Yaoundé (GESHRTH). Methodsand results.Thiswas a cross sectional retrospective study of 96 women attending diagnostic or operative hysteroscopy at the GESHRTH between January 2020 and December 2021.The mean age was 38.7 ±7.6 years. Fifty-nine (61.5%) of the patients were nulliparous. Primary and secondary infertility were found respectively in fifty-two patients (54.2%) and forty-four patients (45.4%). Eleven patients (11.5%) were post-menopausal. Concerning previous surgery, 29 patients (30.2%) have had a myomectomy, 28 patients (29.1%) curettage,16 patients (16.6%) laparoscopy, eight (8.3%) hysteroscopy and one (1%) caesarean section. In all, 92 patients (95.8%) had abnormal intra uterine findings consisting of endometrial polyps (43.7%), sub-mucosal fibroids (42.7%), uterine cavity adhesions (20.8%), endometrial atrophy (4.1%), foetal bone (2%), uterine septum (1%) and non-absorbable suture thread (1%).Conclusion: Abnormal uterine findings were identified in 95.8% of patients attending hysteroscopy at GESHRTH. Most frequent findings were polypsin 43.7%, sub-mucosal fibroids in 42.7% and synechiae in 20.8%. The overall per operatory complication rate was 6.2%.

Introduction. Le recours à l'hystéroscopie constitue une étape indispensable au bilan cavitaire des patientes infertiles. Le diagnostic et la prise en charge adéquate des lésions intra cavitaires permettent d'améliorer les chances de conception.L'objectif de cette étude était de déterminer la fréquence et les caractéristiques des anomalies intra cavitaires chez les patientes opérées d'une hystéroscopie au Centre Hospitalier de Recherche et d'Application en Chirurgie Endoscopique et Reproduction Humaine Paul et Chantal Biya ­Yaoundé (CHRACERH).Méthodes et résultats. Nous avons mené une étude descriptive transversale de Janvier 2020 à Décembre 2021 et recruté 96 patientes. L'âge moyen était de38,7 ±7,6 ans. Soixante-neuf patientes (61,5%) étaient nullipares. Cinquante-deux (54,2%) et quarante-quatre (45,5%) présentaient une infertilité primaire et secondaire respectivement. Onze patientes (11,5%) étaient ménopausées. Concernant les antécédents chirurgicaux,nous avons identifié une myomectomie chez 29 patientes (30,2%), un curetage utérin chez 28 (29,1%), une cœlioscopie chez 16 (16,6%), une hystéroscopie chez huit (8,3%) et une césarienne chez une (1%). Au total, 92 (95,8%) des patientes avaient des anomalies cavitaires objectivées. Il s'agissait de polypes endométriaux (43,7%), fibromes sous-muqueux (42,7%), synéchies utérines (20,8%), atrophie de l'endomètre (4,1%), métaplasie osseuse (2%), cloison utérine (1%) et corps étranger à type de fil de suture nonrésorbable (1%).Conclusion.Les anomalies intra-cavitaires étaient retrouvées chez 95,8% des patientes réalisant une hystéroscopie au CHRACERH. Les anomalies les plus représentées étaient les polypes endométriaux (43,7%), les fibromes sous-muqueux (42,7%) et les synéchies utérines (20,8%). Le taux global de complications opératoires était de 6,2%.

Formación posgraduada y modos hegemônicos de análisis de políticas públicas

Objetivo Caracterizar los modos de enseñar e investigar políticas públicas a nivel de posgrado en Colombia. Métodos Investigación cualitativa de tipo análisis documental. Inicialmente, se realiza una caracterización general de autores, enfoques teóricos empleados, temáticas de interés, entre otros. En un segundo momento, y a partir del contenido de los programas académicos de los posgrados de donde emergieron las tesis analizadas, se identificaron significantes centrales del discurso curricular. Resultados Se analizaron 313 tesis y 8 programas de posgrado en políticas públicas. Se destaca una marcada preferencia por el empleo de enfoques pospositivistas y estrategias tipo problemsolving; cuestionamientos débiles a determinantes estructurales de opresión, exclusión y explotación, y mantenimiento de relaciones de dominación en la toma de decisiones entre investigadores de ciencias políticas/administrativas y sujetos con otros saberes. Conclusiones Los hallazgos del estudio problematizan el campo del Análisis de Políticas Públicas, sus posturas epistemológicas y métodos predominantes, así como el papel que asume el analista, invitando al lector a reflexionar sobre la necesidad de incursionar en enfoques críticos alternativos.

Objective To describe the methods used at a postgraduate level to teach and research public policies in Colombia. Methods Documentary analysis as part of a qualitative study. Among other things, a broad characterisation of authors, theoretical techniques employed, and areas of interest was accomplished in a first instance. Then, the main significants of the programmatic discourse were recognized based on the postgraduate curriculum from the universities from which the investigated thesis came. Results 313 theses and 8 postgraduate programs in public policy analysis were studied. There is a clear preference for post-positivist mainstream approaches and problem-solving strategies; weak challenges to structural determinants of oppression, exclusion, and exploitation; and the preservation of dominant relationships in decision-making between political/administrative science researchers and subjects with other knowledge. Conclusions The research's findings challenge the discipline of Public Policy Analysis, its epistemological views, and its dominant study methodologies, as well as the analyst's role, encouraging the reader to consider the need for alternative critical approaches.

Política mundial de yodación de sal: desafíos / Global policy of salt iodization: challenges

RESUMEN Objetivo Identificar los desafíos que conlleva la implementación de la política mundial de yodación de sal para el consumo humano. Métodos Se realizó una revisión de la literatura publicada entre el año 2000 y 2021 en PubMed, con los términos MeSH yodo, política pública, cloruro de sodio y los términos complementarios yodo/deficiencia, exceso. Se obtuvieron 141 artículos y se revisaron 50 aplicando como criterio de inclusión el abordaje de la implementación de la política de yodación. Resultados Se identificaron siete desafíos: sostenibilidad de la política, eliminar la brecha entre la explotación y la comercialización de la sal, prevenir la fortificación indiscriminada de los alimentos, promover la educación sobre la ingesta de sal yodada, controlar la ingesta excesiva de yodo, equilibrar la ingesta óptima de yodo con la reducción del consumo de cloruro de sodio y producir suficiente información oficial sobre la política. Conclusión La yodación universal de la sal es una política que requiere mayor sensibilidad a las situaciones locales de cada país para mitigar efectivamente el problema de salud pública de los desórdenes por deficiencia y exceso en la ingesta de yodo alrededor del mundo.

ABSTRACT Objective To identify the challenges involved in the implementation of the global policy on salt iodization for human consumption. Methods A review of the literature published between 2000 and 2021 in PubMed was carried out with the MeSH terms iodine, public policy, sodium chloride and supplementary terms iodine/deficiency, excess. 141 articles were obtained and 50 were reviewed, applying the iodization policy implementation approach as an inclusion criterion. Results Seven challenges were identified: sustainability of the policy, closing the gap between exploitation and commercialization of salt, preventing indiscriminate fortification of food, promoting education on iodized salt intake, controlling excessive iodine intake, balance optimal iodine intake with reduced sodium chloride intake and produce sufficient official policy information. Conclusion The universal iodization of salt is a policy that requires greater sensitivity to the local situations of each country to effectively mitigate the public health problem of disorders due to deficiency and excess intake of iodine around the world.

Improvement of medical education through the establishment of a medical chief resident position in Rwanda

Background: The Chief Medical Resident (CMR) role is a well established, one-year position that has existed in the United States (US) for many years. Through collaboration between Yale University Primary Care Internal Medicine Residency Program and the University of Rwanda/College of Medicine and Health Sciences, the Internal Medicine Residency Program in Rwanda began a collaborative training program for Rwandan medical chief residents two years ago. Aims:This paper describes the selection and collaborative training process of the new Rwandan CMRs in teaching hospitals in Rwanda. We also report on evaluation of the role, its impact, and evolving challenges from the perspectives of the current residents through a quantitative survey. Methodology: A survey was directed to residents of the Internal Medicine residency training program. The survey was conducted at the two tertiary teaching sites in Rwanda: Butare University Teaching Hospital (CHUB) and Kigali University Teaching Hospital (CHUK) where chief residents are assigned. On a Likert scale, a group of continuing residents were asked to grade items assessing a change in several educational aspects. The second group of residents, which consisted of first-year residents, was mainly asked questions directed at describing their perception on the chief resident role. Results: In total, 38 residents out of the 40 at the two tertiary hospitals took the survey. Of the 38 residents who took the survey,74% of respondents agreed or strongly agreed on the statement about improvement in educational conferences. 69.6 % of residents noted an improvement in medical education due to having a chief resident in the program. An overall improvement of the residency training program was observed by 78.3% of our study participants. In general (73.7%), residents perceive chief residents as their role model, with first-year residents (100%) being the most enthusiastic about this statement. Conclusion: The chief resident role establishment has made a positive impact in medical education in Internal Medicine/ University of Rwanda. Chief residents play a big role in medical education and are regarded as role models by their fellow residents

Oxidative stress parameters in juvenile brazilian flounder Paralichthys orbignyanus (Valenciennes, 1839) (Pleuronectiformes: Paralichthyidae) exposed to cold and heat shocks

The aim of this study was to determine oxidative stress parameters in the liver and gill of Brazilian flounder juveniles (307.0 ± 16.0 g and 30.0 ± 4.0 cm) submitted to different water temperature (17.1, 23.0 and 28.8ºC) for 72 h and maintained at salinity 25‰. After the acclimation of 7 days, in 23ºC, fish were transferred to 200 L tanks containing seawater (salinity 25‰) at 28.8ºC (heat shock), 17.1ºC (cold shock) or 23.0ºC (control), five replicates (five fish tank-1). The sampled collection occurred in 0 (pre-challenge), 3, 24, 48 and 72 h after temperature shock. Flounder exposed to 17.1ºC and 28.8ºC showed significantly higher TBARS levels and GST activity in the liver post-exposition (PE) in relation to the control (23ºC). CAT activity in liver present a significantly increase at 17.1ºC, in first 48 h, and subsequently decrease in 72 h PE in relation to 28.8ºC. The gills of flounder showed significantly higher TBARS levels, GST and CAT activity when submitted at 17.1 and 28.8ºC in relation to 23.0ºC. There were observed changes in lipid peroxidation levels (LPO), CAT and GST activities in the liver and gill of Brazilian flounder in response to reactive oxygen species (ROS) produced by thermal shocks.

O objetivo deste estudo foi determinar os parâmetros de estresse oxidativo no fígado e brânquias de juvenis de linguado (307,0 ± 16,0 g e 30,0 ± 4,0 cm) submetidos a diferentes temperaturas da água (17,1, 23,0 e 28,8ºC) por 72 h e mantidos na salinidade de 25‰. Após uma aclimatação de sete dias, em 23ºC, os peixes foram transferidos para tanques de 200 L contendo água do mar (salinidade 25‰) em 28,8ºC (choque quente), 17,1ºC (choque frio) ou 23,0ºC (controle), cinco repetições (cinco peixes/tanque). A coleta de amostras ocorreu em 0 (pré-exposição), 3, 24, 48 e 72 h após o choque térmico. O linguado exposto a 17,1ºC e 28,8ºC apresentaram um significante aumento dos níveis de TBARS e atividade da GST no fígado pós-exposição (PE) em relação ao controle (23ºC). A atividade da CAT no fígado apresentou um aumento significativo em 17,1ºC, nas primeiras 48 h, e subsequente diminuição em 72 h PE em relação a 28,8ºC. As brânquias do linguado apresentaram significante aumento dos níveis de TBARS e atividade da GST e CAT quando submetidos a 17,1ºC e 28,8ºC em relação a 23,0ºC. Foram observadas alterações nos níveis de peroxidação lipídica (LPO) e atividade de GST e CAT no fígado e brânquias de linguado em resposta as espécies reativas de oxigênio (ROS) produzidas pelo choque térmico.

Lactated Ringer's solution or 0.9 por cento sodium chloride as fluid therapy in pigeons (Columba livia) submitted to humerus osteosynthesis / Fluidoterapia com Ringer lactato ou cloreto de sódio 0.9 percent em pombos (Columbia livia) submetidos à osteossíntese de úmero

The study aimed to compare the effects of intraosseous infusion of lactated Ringer's and 0.9% sodium chloride solutions on the electrolytes and acid-base balance in pigeons submitted to humerus osteosynthesis. Eighteen pigeons were undergoing to isoflurane anesthesia by an avalvular circuit system. They were randomly assigned into two groups (n=9) receiving lactated Ringer's solution (LR) or 0.9% sodium chloride (SC), in a continuous infusion rate of 20mL/kg/h, by using an intraosseous catheter into the tibiotarsus during 60-minute anesthetic procedure. Heart rate (HR), and respiratory rate (RR) were measured every 10 min. Venous blood samples were collected at 0, 30 and 60 minutes to analyze blood pH, PvCO2, HCO3 -, Na+ and K+. Blood gases and electrolytes showed respiratory acidosis in both groups during induction, under physical restraint. This acidosis was evidenced by a decrease of pH since 0 min, associated with a compensatory response, observed by increasing of HCO3 - concentration, at 30 and 60 min. It was not observed any changes on Na+ and K+ serum concentrations. According to the results, there is no reason for choosing one of the two solutions, and it could be concluded that both fluid therapy solutions do not promote any impact on acid-base balance and electrolyte concentrations in pigeons submitted to humerus osteosynthesis...

O presente estudo avaliou os efeitos da infusão das soluções de Ringer lactato ou cloreto de sódio 0,9%, no equilíbrio ácido-base e hidroeletrolítico de pombos submetidos à osteossíntese de úmero. Foram utilizados 18 animais, os quais foram submetidos à anestesia por isofluorano, e mantidos em circuito avalvular durante o período anestésico (60 min). Os animais foram distribuídos aleatoriamente em dois grupos (n=9) recebendo Ringer lactato (LR) ou cloreto de sódio 0,9% (SC), administradas na taxa de 20mL/kg/h pela via intraóssea (tibiotarso). Foram monitoradas as frequências cardíaca e respiratória a cada 10 minutos e colhidas amostras sanguíneas venosas aos 0, 30 e 60 min de anestesia, obtendo-se a partir destas, valores de pH sanguíneo, bicarbonato (HCO3), pressão venosa de CO2 (PvCO2), sódio (Na+) e potássio (K+). Os valores referentes ao equilíbrio ácido-base indicam que houve acidose respiratória em ambos os grupos, a qual foi decorrente do processo de indução sob contenção física, caracterizada por diminuição no pH desde o 0 min, associado ao aumento compensatório nos valores de HCO3 -, nos momentos 30 e 60 min. No entanto, no que se refere aos valores obtidos de Na+ e K+ séricos, durante a infusão de ambos os fluidos, não foram observadas alterações que justifiquem a predileção por alguma destas soluções. Diante destes resultados conclui-se que a escolha entre uma das soluções avaliadas não promoveu impacto sob o equilíbrio ácido-base e hidroeletrolítico de pombos submetidos a osteossíntese de úmero...

Pediatric lung transplantation: 10 years of experience

Lung transplantation is a well-established treatment for advanced lung diseases. In children, the diseases that most commonly lead to the need for a transplantation are cystic fibrosis, pulmonary hypertension, and bronchiolitis. However, the number of pediatric lung transplantations being performed is low compared with the number of transplants performed in the adult age group. The objective of this study was to demonstrate our experience with pediatric lung transplants over a 10-year period in a program initially designed for adults.

Preliminary evaluation of children treated with metronomic chemotherapy and valproic acid in a low-income country: Metro-Mali-02.

BACKGROUND: Metronomics is defined by the combination of metronomic chemotherapy and drug repositioning. Since off‑patent chemotherapeutic drugs can be used and given the low toxicity profile of this approach, metronomics appears to be an invaluable alternative to bring affordable targeted therapies in low‑income countries. OBJECTIVE: The aim of this study was to report on the preliminary efficacy and safety of a metronomic vincristine/cyclophosphamide/methotrexate/ valproic acid regimen given to children with refractory cancer of various tumor types or with a very advanced disease. MATERIALS AND METHODS: This prospective, single‑center study evaluated the use of a metronomics protocol, consisting of a first cycle of weekly vincristine 1.5 mg/m2 (days: 1, 8, 15 and 22), daily cyclophosphamide 25 mg/m2 (days: 1‑21), twice weekly methotrexate 15 mg/m² (days: 21‑42) and daily valproic acid (30 mg/kg/d) followed by a 1‑week break. For the following cycles, vincristine was administrated only at week 1 and 5 of the cycle. This treatment was proposed to children with refractory disease and patients who were not eligible for the protocols available in the hospital. Adverse events were determined through laboratory analyses and investigator observations. RESULTS: From January 2010 to January 2011, 7 children (mean age: 5.4 ± 3 years old) were treated. Most frequent diagnosis was retinoblastoma. Two partial responses were observed in patients with neuroblastoma and retinoblastoma. These two patients are alive with stable disease at last follow‑up (6 and 26 months, respectively) after stopping treatment. CONCLUSION: Metronomics allows treating patients with advanced or refractory or relapsing disease and the introduction of targeted treatments in low‑income countries. The potential of metronomics in children and young adults living in middle‑ and low‑income countries warrants further larger studies.

Rectoría y gobernanza en salud pública en el contexto del sistema de salud colombiano, 2012-2013 / Public health stewardship and governance regarding the Colombian healthcare system, 2012-2013

Objetivo Analizar el proceso de toma de decisión en asuntos de salud pública en el contexto del Sistema General de Seguridad Social en Salud Colombiano, el cual está fundamentado en el enfoque de economía de mercado. Metodología Se utilizó la Teoría Fundamentada como método de investigación cualitativa. El estudio se realizó en seis ciudades colombianas (Bogotá, Barranquilla, Bucaramanga, Leticia, Medellín y Pasto) en el 2012 y 2013. Se entrevistaron 120 profesionales de la salud involucrados en procesos de toma de decisiones de nivel directivo y operativo, de vigilancia y control en salud pública, de instituciones públicas y privadas. También se realizaron 14 grupos focales con líderes comunitarios. Resultados Los hallazgos sugieren que hay una débil capacidad de rectoría y una inefectiva gobernanza por parte de las autoridades de salud nacional y municipal en los asuntos de salud pública, lo cual se relaciona con la falta de personal idóneo en este campo. Esto a su vez se articula con la interferencia de los partidos políticos y los intereses particulares de aseguradoras privadas, la fragmentación estructural de las funciones y actores en el sistema de salud, lo que limita la gestión y el desarrollo de la salud pública. Conclusiones Para lograr una cooperación entre los actores del SGSSS, es decir una gobernanza efectiva, se requiere de una nueva axiología que supere los asuntos de competencia y ánimo de lucro que predominan en el sistema.

Objective Analysing decision-making concerning public health issues regarding the Colombian healthcare system from a market economy-based approach. Methods This study involved applying Glaser and Strauss's grounded theory in six Colombian cities during 2012: Bogotá, Barranquilla, Bucaramanga, Leticia, Medellin and Pasto. 120 individual interviews were conducted with professionals involved in decision-making, running public healthcare programmes and making policy within public and private institutions. Fourteen focus groups were held with community organisation leaders. Results The findings suggested national and municipal health authorities' weak stewardship and ineffective governance regarding public healthcare policy and programmes, related to a lack of staff trained in public health management issues. In turn, this was related to political parties' interference and private insurers' particular interests and the structural fragmentation of functions and actors within the health system, thereby limiting public health development. Conclusions A new axiology is necessary for achieving effective governance (I.e. cooperation between Colombian Healthcare Social Security System actors) to overcome current incompetence and financial self-interest predominating within the Colombian healthcare system.

Doenças intersticiais pulmonares associadas às doenças do tecido conjuntivo / Interstitial lung diseases associated with connective tissue diseases

As doenças do tecido conjuntivo representam um grupo heterogêneo de doenças inflamatórias imunomediadas que afetam diversos órgãos, com o sistema respiratório podendo ser envolvido em qualquer um de seus componentes. As manifestações pulmonares podem ser frequentes e precederem, acompanharem ou sucederem os sintomas sistêmicos; quando presentes, são um fator de gravidade e de aumento da mortalidade. Nas doenças do tecido conjuntivo, o envolvimento pulmonar pode ser secundário à doença de base, às infecções secundárias ou à reação às drogas utilizadas no tratamento; por outro lado, é importante o conhecimento de que até 20% dos pacientes com doença pulmonar intersticial são portadores de algum tipo de Doença do Tecido Conjuntivo oculta. Nesta revisão, abordamos as Doenças do Tecido Conjuntivo que mais frequentemente acometem o sistema respiratório: dermatomiosite/polimiosite, doença reumatoide, esclerose sistêmica, doença mista do tecido conectivo, lúpus eritematoso sistêmico e síndrome de Sjõgren.

Pneumonite de hipersensibilidade crônica / Chronic hypersensitivity pneumonitis

A pneumonite de hipersensibilidade é uma síndrome com apresentação clínica variável, cuja inflamação no parênquima pulmonar é causada pela inalação de antígenos específicos em indivíduos previamente sensibilizados. A forma crônica da doença cursa com dispneia e fibrose progressivas, padrão restritivo em testes funcionais pulmonares e pior prognóstico, representando um desafio diagnóstico no diferencial com outras pneumopatias intersticiais idiopáticas. Recentes estudos permitiram um maior entendimento sobre a fisiopatogênese, especificamente no estudo da suscetibilidade genética e na modulação da resposta imune frente a determinados antígenos. A TCAR tem permitido correlações cada vez mais fidedignas com os achados histológicos, podendo muitas vezes evitar a biópsia cirúrgica. Pelo aspecto tomográfico, muitas vezes indistinguível entre aquele de pneumonia intersticial não específica e o de pneumonia intersticial usual, um inquérito sobre exposições sempre deve ser ativamente buscado na investigação clínica dos pacientes com doenças intersticiais fibrosantes. Recentemente, formas de exacerbação aguda semelhantes à fibrose pulmonar idiopática também foram descritas e se associam a um pior prognóstico. O diagnóstico precoce permite o tratamento com o afastamento da exposição e eventual uso de medicação anti-inflamatória. Ainda faltam estudos sobre o real papel da utilização de imunossupressores e corticosteroides no tratamento dessa doença

Registration of work-related diseases, injuries, and complaints in Aruba, Bonaire, and Curaçao / Registro de enfermedades, lesiones y síntomas relacionados con el trabajo en Aruba, Bonaire y Curazao

OBJECTIVE: To estimate the incidence of work-related diseases, injuries, and complaints in Aruba, Bonaire, and Curaçao and to identify some next steps in the prevention process. METHODS: All of the three countries' 18 occupational health specialists were asked to participate; 100 percent agreed to report all work-related diseases, injuries, and complaints in 2004-2008. A standard online notification form was used to register cases in a database maintained by the Netherlands Center for Occupational Diseases (NCOD). The public health service of Curaçao analyzed the data and presented the results to the participating physicians during educational and feedback meetings. RESULTS: During the study period, 1 519 cases were reported: 720 (47.0 percent) work-related diseases; 515 (34.0 percent) injuries; and 284 (19.0 percent) complaints. The mean patient age was 42.4 years (range 16-70 years); 924 (60.8 percent) were males and 571 (37.6 percent), females. Most frequently reported were musculoskeletal diseases, injuries, and complaints; mental health disorders; and skin injuries. Analysis showed incidence rates of work-related diseases, injuries, and complaints in Aruba to be 157 new cases per 100 000 employee years; in Bonaire, 53/100 000; and in Curaçao, 437/100 000. CONCLUSIONS: These results suggest that labor protection laws need improvement and that preventive action should be fostered. Further study is needed on working conditions, preventive policy, and the quality of occupational health and safety practices in Aruba, Bonaire, and Curaçao. Funding is imperative for collecting and publishing accurate data, which will keep this problem on the social-political agenda.

OBJETIVO: Calcular la incidencia de enfermedades, lesiones y síntomas relacionados con el trabajo en Aruba, Bonaire y Curazao e identificar los pasos siguientes en el proceso de prevención. MÉTODOS: Se invitó a participar a los 18 especialistas en salud ocupacional de los tres países; todos aceptaron notificar todas las enfermedades, lesiones y síntomas relacionados con el trabajo entre el 2004 y el 2008. Se usó un formulario estándar de notificación en línea para registrar los casos en una base de datos mantenida por el Centro para las Enfermedades Ocupacionales de los Países Bajos. El servicio de salud pública de Curazao analizó los datos y presentó los resultados a los médicos participantes durante las reuniones educativas y de retroalimentación. RESULTADOS: Durante el período del estudio se notificaron 1 519 casos relacionados con el trabajo: 720 (47,0 por ciento) enfermedades, 515 (34,0 por ciento) lesiones y 284 (19,0 por ciento) síntomas. La edad promedio de los pacientes fue 42,4 años (recorrido, 16-70 años); 924 (60,8 por ciento) eran varones y 571 (37,6 por ciento), mujeres. Se notificaron con mayor frecuencia las enfermedades, lesiones y síntomas musculoesqueléticos; los trastornos mentales; y las lesiones cutáneas. El análisis mostró tasas de incidencia de enfermedades, lesiones y síntomas relacionados con el trabajo de 157 nuevos casos por 100 000 empleados por año en Aruba, 53/100 000 en Bonaire y 437/100 000 en Curazao. CONCLUSIONES: Estos resultados indican que las leyes de protección laboral deben mejorarse y que deben promoverse las medidas preventivas. Es necesario llevar a cabo otros estudios sobre las condiciones de trabajo, los planes de prevención y la calidad de la salud ocupacional y las prácticas de seguridad en Aruba, Bonaire y Curazao. Se requiere financiamiento para recopilar y publicar datos exactos, a fin de mantener este problema en la agenda política y social.