Dermatological diseases in seamen's lower extremity: a prevalence study.

BACKGROUND: Little is known about the impact of occupational seafaring on lower limb conditions. The aim of the study was to estimate the prevalence of dermatological diseases affecting the feet and lower extremities of seafarers, as well as the possible impact of working conditions on the development of the pathologies analysed. MATERIALS AND METHODS: A prevalence study was performed through self-completed questionnaires at the "Instituto Social de la Marina" (ISM) centres at A Coruña, Ribeira, Noya and Cádiz (Spain). Sociodemographic, anthropometric and podiatric variables, as well as the type of maritime sector, duty on board and, working footwear, were studied (n = 137). The study has been approved by the Ethics Committee of the University of A Coruña (CE 13/2016). RESULTS: The average age of the study subjects was 45.71 ± 9.90 years and the number of years sailed was 20.31 ± 11.64 years. The most prevalent pathologies were mycosis (21.9%), helomas and tylomas (29.9%) and hyperhidrosis (17.5%). A statistically significant relationship was obtained between pruritus and scabies (p ≤ 0.000), xerosis (p ≤ 0.005), eczema (p ≤ 0.000), obesity (p ≤ 0.018) and psoriasis (p ≤ 0.005). A significant relationship was also found between onychocryptosis, and psoriasis (p ≤ 0.000). Frequency with which the study participants have visited the podiatrist was significantly related to the presence of helomas and tylomas (p ≤ 0.013) and hyperhidrosis (p ≤ 0.025). CONCLUSIONS: A high prevalence of diverse dermatological diseases has been found, revealing the importance of podiatric assessment in sea workers prior to boarding.

Asistencia médica a bordo de los buques en altamar basada en la telemedicina / Medical assistance via telemedicine on ships at sea

Introduction: Statistical study about the health care provided to seafarers on board their ships by the Spanish Radio Medical Center of the Marine Social Institute (Ministry of Employment and Social Security). Material and results: In 2015, 1658 calls were received requesting medical assistance and 1014 patients were attended (average: 1.64 calls / case). The use of satellite communication was the most common means of communication used (92.2%). The mean age of the patients was 44.51 (standard deviation = 9.892). The average age of Spanish and European Union crew members is higher than those of other origin (p < 0.01). Trawlers account for the 76.4% of the calls asking for medical assistance, merchant ships the 13.2%, travelling ships 1%, yachts 0.5% and others 8.8%. No significant differences were found between the pathology seen and the type of vessel (p> 0.1). 25% of medical consultations were due to trauma conditions and 75% to other diseases. In trauma patients, the affected body regions were: the upper limbs (40.2%), the head (10.8%), the lower limbs (16.7%) and the trunk (12.7%). Isolated eye traumas represented the 11.2% of cases. 81.6% of all the cases were treated on board until port destination. In the 18.4% of the cases, rescue was required (3.2% per helicopter). In the trauma cases, only 61.26% were able to remain on board. Rescue was more frequent in the event of trauma (p < 0.01). Conclusions: Assistances due to diseases are more frequent than those due to trauma. Most patients could be assisted on board. It was observed that seafarer population is becoming older.

Introducción: Estudio estadístico de la atención sanitaria prestada por el Centro Radio Médico Español del Instituto Social de la Marina a los marinos a bordo de sus buques. Material y resultados: Durante un año, se asistieron 1014 pacientes y se recibieron 1658 llamadas demandando consulta médica (media: 1.64 llamadas/caso). El satélite es el medio de comunicación más empleado para la consulta (92.2%). La media de edad de los pacientes fue de 44.51 (desviación estándar = 9.892). La media de edad de los tripulantes españoles y de la Unión Europea es mayor que el resto (p = 0,00). Los pesqueros representan un 76.4% de las asistencias; los mercantes, 13.2%; pasaje, 1%; buques de recreo, 0.5%, y otros, 8.8%. No se han encontrado diferencias significativas entre la afección consultada y el tipo de buque (p > 0.1). El 25% de las atenciones se debieron a accidentes y el 75% a enfermedades. En los accidentes, las regiones corporales afectadas fuern: miembros superiores (10%), cabeza (5.5%), miembros inferiores (4.1%) y tronco (3.2%). Los ojos representan el 2.8% de los casos. El 81.6% de todos los casos fue atendido a bordo hasta la siguiente llegada a puerto. En el 18.4% fue necesaria la evacuación (3.2% por helicóptero). En el caso de los accidentados, sólo el 6.26% pudo permanecer a bordo. La evacuación es más frecuente en caso de accidente (p = 0.00). Conclusiones: Son más frecuentes las asistencias por enfermedad que por accidente. La mayoría de los pacientes pueden permanecer a bordo. Se observa un envejecimiento de la población embarcada.

Correlacionan las urgencias marítimas con los antecedentes clínicos de los tripulantes / Correlation between maritime emergencies and medical histories of crew members

El trabajo relaciona la asistencia médica a bordo y los reconocimientos laborales. Para mejorar la asistencia a los marinos se precisa mayor conexión entre los centros de reconocimiento médico y las clínicas que los asisten.

Effect of therapeutic horseback riding on balance and gait of people with multiple sclerosis.

BACKGROUND: Exercise therapy is an important part of symptomatic and supportive treatment in patients with multiple sclerosis (PwMS). According to the literature, equine-assisted therapies--such as therapeutic horseback riding (THR) and hippotherapy (HT)--are exercise therapies that can have positive physical effects on coordination, muscle tone, postural alignment, stiffness/flexibility, endurance and strength, correcting abnormal movement patterns and improving gait and balance. While HT is known to have a positive effect on balance in PwMS, data about THR are limited. OBJECTIVE: The aim of the present work was to determine the effect of THR on the balance and gait of ambulatory PwMS. METHODS: Twenty-seven PwMS were included in the study. Patients were divided into two groups: 12 underwent THR and 15 traditional physiotherapy (for both groups, two series of 10 weekly sessions were performed). Before and after the study period, the following outcome measures were applied: Extended Disability Status Scale (EDSS), Barthel Index, Tinetti Performance-Oriented Mobility Assessment (POMA). In addition, patients of the THR group underwent a gait analysis to assess spatiotemporal gait parameters and ground reaction forces. RESULTS: The THR group showed a significant improvement in POMA scores (p<0.005) and two gait parameters: stride time (p<0.04) and ground reaction forces (p<0.01). No statistically significant change was found in the control group. CONCLUSION: The results of the study show that THR can improve balance and gait of ambulatory PwMS. Findings are preliminary, but promising and in line with the recent literature.