A review of the injuries caused by occupational footwear.

BACKGROUND: Occupational footwear is intended to provide protection against the risks associated with work activities. The choice of footwear is complex due to the welfare, health and safety conditions of workers. AIMS: To identify the injuries and problems caused by occupational footwear through a systematic review of the existing literature. METHODS: A literature search was carried out in the Cumulative Index to Nursing and Allied Health Literature, Dialnet Plus, Pubmed, Scientific Electronic Library Online, Medline, Scopus and Web of Science databases over the period 2000-23, following the PRISMA Declaration guidelines. RESULTS: A total of 27 studies were included in the review. The results indicated that there is a wide variety of injuries caused by occupational footwear: from dermal injuries (e.g. calluses) and injuries to the nail apparatus to inflammatory pathologies such as plantar fasciitis or bursitis. In addition, inappropriate footwear can cause pain in the ankle and foot, knees, hips and lower back. Other results include the discomfort derived from the footwear itself. CONCLUSIONS: Inappropriate footwear can cause injuries to the foot and other related bone structures. Further studies are needed on the detection of foot injuries caused by occupational footwear and the levels of action at this level to improve the worker's health, the adaptability of the footwear to the wearer, and the worker's comfort and adherence to the footwear.

Safety of regadenoson in patients with severe chronic obstructive pulmonary disease / Seguridad de regadenosón en pacientes con enfermedad pulmonar obstructiva crónica severa

Objective. To assess the safety of regadenoson, a selective agonist of A2A adenosine receptors, combined with low-level exercise in subjects with severe chronic obstructive pulmonary disease (COPD), referred for myocardial perfusion imaging (MPI). Methods. We studied prospectively 12 male patients with severe COPD. Stress was 4min of low-level exercise with bolus injection of regadenoson (0.4mg) at 1.5min, followed by 99mTc-MPI agent injection. Demographics, medical history, lung medications, adverse events, oxygen saturation (SatO2), MPI findings for coronary artery disease (CAD), and changes in systolic blood pressure (SBP), and heart rate (HR) were registered. Results. The observed adverse event profile of regadenoson was similar to that of patients with mild-moderate COPD. There was no clinical exacerbation of COPD. Adverse events were self-limiting: dyspnea (33.3%), fatigue (25.0%), chest pain, headache (16.7%, respectively), and gastrointestinal discomfort, dry mouth, flushing, feeling hot and dizziness (8.3%, respectively). 25.0% of patients did not report any symptoms. We observed significant increases in SBP and HR from baseline (142.6mmHg±22.3 vs 152.5mmHg±18.5, and 80 b.p.m.±18 vs 105 b.p.m.±22, respectively; p<0.05). Conclusions. Regadenoson combined with low-level exercise is safe and well tolerated in stable patients with severe COPD undergoing MPI (AU)

Objetivo. Evaluar la seguridad de regadenosón, un agonista selectivo de los receptores adenosínicos A2A, combinado con ejercicio de baja intensidad, en sujetos con enfermedad pulmonar obstructiva crónica (EPOC) severa, en estudios de perfusión miocárdica. Métodos. Se estudiaron de forma prospectiva 12 pacientes con EPOC severa (todos ellos varones). El estrés consistió en la realización de un ejercicio de baja intensidad durante 4min junto con la administración de un bolo de regadenosón (0,4mg) a los 1,5min, seguido de la inyección del radiofármaco tecneciado de perfusión miocárdica. Se registraron los datos demográficos, el historial médico, la medicación para patología respiratoria, los efectos adversos, la saturación de oxígeno (SatO2), los hallazgos de enfermedad coronaria en el estudio de perfusión miocárdica y los cambios en la presión arterial sistólica (PAS) y la frecuencia cardiaca (FC). Resultados. El perfil de efectos adversos de regadenosón fue similar al de pacientes con EPOC leve-moderada. No se produjeron exacerbaciones clínicas de la EPOC. Los efectos adversos experimentados, todos autolimitados, fueron disnea (33,3%), cansancio (25%), dolor torácico, cefalea (16,7%, respectivamente), molestias gastrointestinales, boca seca, rubefacción, calor y mareos (8,3%, respectivamente). El 25% de los pacientes no informaron síntomas. Se observaron aumentos significativos desde los valores basales de la PAS y la FC (142,6mmHg±22,3 vs 152,5mmHg±18,5 y 80l.p.m.±18 vs 105l.p.m.±22, respectivamente; p<0,05). Conclusiones. Regadenosón combinado con ejercicio de baja intensidad es seguro y bien tolerado en pacientes con EPOC severa estable sometidos a estudios de perfusión miocárdica (AU)

[Development of a PCR for the detection and quantification of parasitism by Demodex folliculorum infestation in biopsies of skin neoplasms periocular area]. / Desarrollo de una PCR para la detección y cuantificación de la parasitación por Demodex folliculorum en biopsias de neoplasias cutáneas del área periocula.

OBJECTIVE: To standardize the relative quantification by mass of tissue parasitism by Demodex folliculorum infestation from neoplastic skin biopsies periocular using molecular amplification to study the possible relationship of the appearance of eyelid basal cell carcinoma with the presence and density of the mite in later works. METHODS: A quantitative PCR was developed real-time probes TaqMan. PCR was tested in a pilot 46 actual biopsy samples nodular basal cell carcinoma series. RESULTS: The sensitivity was placed with a detection limit of between 1 and 10 copies / µl. 50% (23/46) of the biopsies were positive for D. folliculorum. The specificity was 100% confirmed by sequencing. CONCLUSIONS: The technique shows good results for sensitivity and specificity that can make it useful as a tool for studies of cause and effect D. folliculorum and basal cell carcinoma.

Safety of regadenoson in patients with severe chronic obstructive pulmonary disease.

OBJECTIVE: To assess the safety of regadenoson, a selective agonist of A2A adenosine receptors, combined with low-level exercise in subjects with severe chronic obstructive pulmonary disease (COPD), referred for myocardial perfusion imaging (MPI). METHODS: We studied prospectively 12 male patients with severe COPD. Stress was 4min of low-level exercise with bolus injection of regadenoson (0.4mg) at 1.5min, followed by (99m)Tc-MPI agent injection. Demographics, medical history, lung medications, adverse events, oxygen saturation (SatO2), MPI findings for coronary artery disease (CAD), and changes in systolic blood pressure (SBP), and heart rate (HR) were registered. RESULTS: The observed adverse event profile of regadenoson was similar to that of patients with mild-moderate COPD. There was no clinical exacerbation of COPD. Adverse events were self-limiting: dyspnea (33.3%), fatigue (25.0%), chest pain, headache (16.7%, respectively), and gastrointestinal discomfort, dry mouth, flushing, feeling hot and dizziness (8.3%, respectively). 25.0% of patients did not report any symptoms. We observed significant increases in SBP and HR from baseline (142.6mmHg±22.3 vs 152.5mmHg±18.5, and 80 b.p.m.±18 vs 105 b.p.m.±22, respectively; p<0.05). CONCLUSIONS: Regadenoson combined with low-level exercise is safe and well tolerated in stable patients with severe COPD undergoing MPI.

Predictors of hospital admission in exacerbations of chronic obstructive pulmonary disease.

OBJECTIVE: To identify factors predictive of hospital admission among patients attending an emergency department (ED) with exacerbation of chronic obstructive pulmonary disease (COPD) and to determine if these were consistent with Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommendations. DESIGN: In a prospective cohort of 2487 COPD patients with exacerbations conducted in 16 EDs, clinical data were obtained and physical examination and blood gas analyses were performed on arrival at the ED and at decision time about hospitalisation. Multivariate analyses were performed using hospital admission as the dependent measure. RESULTS: In multivariate analysis, factors predictive of hospital admission on ED arrival were previous hospitalisation for COPD exacerbation (OR 2.03, 95%CI 1.32-3.11), resting dyspnoea (OR 3.05, 95%CI 2.39-3.88) and altered blood gas (PaO2 = 45-60 mmHg, OR 2.7, 95%CI 2.12-3.44; PaO2 < 45 mmHg, OR 3.24, 95%CI 2.14-4.92; PaCO2 = 56-65 mmHg, OR 2.35, 95%CI 1.58-3.51; and PaCO2 > 65 mmHg, OR 6.98, 95%CI 4.03-12.09). The predictive capacity of the model using variables available at decision time was better than for those at ED arrival (area under the receiver operating characteristic curve 0.89 and 0.83). These factors are included in the GOLD recommendations. CONCLUSION: Among COPD patients presenting to the ED with exacerbation, factors immediately associated with episode severity were independent predictors of hospitalisation. Our criteria for hospitalisation are in line with GOLD recommendations.

Importancia pronóstica de la hipertensión pulmonar en insuficiencia cardiaca con fracción de eyección preservada / Prognostic importance of pulmonary hypertension in heart failure with preserved ejection fraction

Objetivos. La hipertensión pulmonar (HP) es una complicación frecuente en insuficiencia cardiaca (IC). Sin embargo, su impacto no está bien establecido en insuficiencia cardiaca con fracción de eyección preservada (ICFEP). El objetivo principal del estudio es conocer el valor pronóstico de la HP en pacientes hospitalizados por ICFEP. Pacientes y métodos. Estudio observacional y prospectivo de pacientes hospitalizados por ICFEP (fracción de eyección del ventrículo izquierdo [FEVI] >45%). Se definió HP por una presión arterial sistólica pulmonar (PASP) >35mmHg medido por el gradiente de regurgitación tricuspidea añadido a la presión auricular. La variable resultado fue un evento compuesto de mortalidad total y/o ingreso hospitalario por IC durante un seguimiento de 1 año. Para valorar diferencias en el seguimiento se realizó una curva de Kaplan-Meier y posteriormente se estimó riesgo ajustado mediante una regresión de Cox. Resultados. Un total de 218 pacientes completaron el periodo de seguimiento, de los que 56 (26,7%) tenían una PASP>35mmHg. La incidencia del evento combinado fue en 126 pacientes (57,8%) y la mortalidad en 70 pacientes (32,1%). El estudio de supervivencia mostró diferencias pronósticas en el grupo de HP tanto para la variable resultado combinada (Log Rank <0,001) como para la mortalidad total (log Rank 0,019). El riesgo ajustado para los pacientes con HP fue de 2,03 (IC 95%: 1,39–2,96; p<0,001) para el evento combinado y de 1,84 (IC 95%: 1,11–3,03; p=0,017) para la mortalidad total. Conclusiones. La hipertensión pulmonar (PASP >35mmHg) medida por métodos no invasivos es un marcador robusto e independiente de mal pronóstico en pacientes hospitalizados por IC con fracción eyección preservada o ligeramente deprimida(AU)

Objectives. Pulmonary hypertension (PH) is a frequent complication in heart failure (HF). However, its impact factor in heart failure with preserved ejection fraction (HFPEF) is not well-known. This study has aimed to identify the prognostic value of PH in hospitalized patients with HFPEF. Material and Methods. An observational and prospective trial of patients admitted due to HFPEF (LVEF >45%). Pulmonary hypertension was defined by Pulmonary artery systolic pressure (PASP) >35mm Hg measured by the tricuspid regurgitation velocity plus atrial pressure. The primary endpoint was all-cause mortality and/or readmissions during 1-year follow-up. Kaplan-Meier survival curves and Cox regression were performed to identify adjusted hazard ratios (HR). Results. A total of 218 patients completed the follow-up period, 56 patients (32.2%) had PASP >35mm Hg. Primary endpoint was observed in 126 patients (57.8%) and 70 patients (32.2%) died. Kaplan-Meier survival curves showed increased significantly all-cause mortality and/or readmission in patients with PH (Log Rank <0.001) and mortality (Log Rank 0.019). Patients with PH were an increased adjusted risk for primary endpoint, HR 2.03 (CI 95%: 1.39–2.96; p<0.001) and all-cause mortality, HR 1.84 (CI 95%: 1.11–3.03; p=0.017). Conclusions. Pulmonary hypertension (PASP >35mm Hg) measured by non-invasive methods is a strong and independent predictor of an unfavorable outcome in patients hospitalized due to heart failure and normal or only mildly reduced ejection fraction(AU)

[Prognostic importance of pulmonary hypertension in heart failure with preserved ejection fraction]. / Importancia pronóstica de la hipertensión pulmonar en insuficiencia cardiaca con fracción de eyección preservada.

OBJECTIVES: Pulmonary hypertension (PH) is a frequent complication in heart failure (HF). However, its impact factor in heart failure with preserved ejection fraction (HFPEF) is not well-known. This study has aimed to identify the prognostic value of PH in hospitalized patients with HFPEF. MATERIAL AND METHODS: An observational and prospective trial of patients admitted due to HFPEF (LVEF >45%). Pulmonary hypertension was defined by Pulmonary artery systolic pressure (PASP) >35mm Hg measured by the tricuspid regurgitation velocity plus atrial pressure. The primary endpoint was all-cause mortality and/or readmissions during 1-year follow-up. Kaplan-Meier survival curves and Cox regression were performed to identify adjusted hazard ratios (HR). RESULTS: A total of 218 patients completed the follow-up period, 56 patients (32.2%) had PASP >35mm Hg. Primary endpoint was observed in 126 patients (57.8%) and 70 patients (32.2%) died. Kaplan-Meier survival curves showed increased significantly all-cause mortality and/or readmission in patients with PH (Log Rank <0.001) and mortality (Log Rank 0.019). Patients with PH were an increased adjusted risk for primary endpoint, HR 2.03 (CI 95%: 1.39-2.96; p<0.001) and all-cause mortality, HR 1.84 (CI 95%: 1.11-3.03; p=0.017). CONCLUSIONS: Pulmonary hypertension (PASP >35mm Hg) measured by non-invasive methods is a strong and independent predictor of an unfavorable outcome in patients hospitalized due to heart failure and normal or only mildly reduced ejection fraction.

A qualitative study about immigrant workers' perceptions of their working conditions in Spain.

BACKGROUND: Spain has recently become an inward migration country. Little is known about the occupational health of immigrant workers. This study aimed to explore the perceptions that immigrant workers in Spain had of their working conditions. METHODS: Qualitative, exploratory, descriptive study. Criterion sampling. Data collected between September 2006 and May 2007 through semi-structured focus groups and individual interviews, with a topic guide. One hundred and fifty-eight immigrant workers (90 men/68 women) from Colombia (n = 21), Morocco (n = 39), sub-Saharan Africa (n = 29), Romania (n = 44) and Ecuador (n = 25), who were authorised (documented) or unauthorised (undocumented) residents in five medium to large cities in Spain. RESULTS: Participants described poor working conditions, low pay and health hazards. Perception of hazards appeared to be related to gender and job sector. Informants were highly segregated into jobs by sex, however, so this issue will need further exploration. Undocumented workers described poorer conditions than documented workers, which they attributed to their documentation status. Documented participants also felt vulnerable because of their immigrant status. Informants believed that deficient language skills, non-transferability of their education and training and, most of all, their immigrant status and economic need left them with little choice but to work under poor conditions. CONCLUSIONS: The occupational health needs of immigrant workers must be addressed at the job level, while improving the enforcement of existing health and safety regulations. The roles that documentation status and economic need played in these informants' work experiences should be considered and how these may influence health outcomes.

Factores de riesgo y patología lumbar ocupacional / Risk factors and occupational low back pain

Uno de los más serios y persistentes problemas en salud pública es la lumbalgia de origen ocupacional, que constituye un problema sanitario y socioeconómico de primer orden en los diversos colectivos de la población trabajadora. El estudio tiene como objetivo conocer la prevalencia debida a patalogía lumbar en los trabajadores de una empresa química, además de identificar algunos de los factores de riesgo de índole laboral que con mayor frecuencia se presentan en esta patalogía. Se realizó un estudio transversal, considerándose como población objeto de estudio a los trabajadores presentes en esa empresa de Huelva durante el año 1996. Para la cumplimentación de los datos del estudio se utilizó un cuestionario validado previamente. Las variables del estudio fueron definidas con antelación, una vez establecidos los criterios diagnósticos del problema que se iba a estudiar y fueron posteriormente incluidas en los apartados del cuestionario y determinadas en los registros que se analizaron. Entre los resultados hemos de destacar los siguientes: alta prevalencia de patalogía lumbar (35 por ciento), elevada recurrencia (80 por ciento), necesidad de baja laboral (20 por ciento) y alta frecuencia de antecedentes lumbares (39 por ciento). Se identificaron como factores agravantes de patalogía lumbar con significación estadística: posición de trabajo de rodillas, manejo de cargas pesadas, levantamiento y empuje de cargas y frecuencia de levantamientos (de 26 a 50 vecesldía); asimismo, la antigüedad en la empresa y el lugar de trabajo están correlacionados con el deseo de cambio de puesto. Como factores agravantes pero sin significación estadística se detectaron: posición en cuclillas, inclinado, posturas forzadas, manejo de cargas ligeras, vibraciones y sedentarismo (entendido como la no práctica de actividades extralaborales) (AU)

La formación especializada en prevención de riesgos laborales: ¿dónde está la autoridad educativa? / No disponible

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[Mortality registries as a source for detecting health disorders probably of occupational etiology]. / Los registros de mortalidad como fuente para la detección de alteraciones de salud de probable etiología laboral.

Study aim was to assess Andalucian death certificate records to find potential occupational disease problems. Methodology proposed by Rutstein (1983) has been adapted. We had checked Seville City Council Mortality Registry (1987-89) and Andalucian Mortality Registry (1975-85). In the former 8.1% of diagnoses and in the latter 8.6% of diagnoses have one included in the Sentinel Health Event (occupational) List. Accurate occupation data in the Seville City Council Mortality provides appropRiate information about occupational diseases. Limitations of the occupational data in the Andalucian Mortality Registries make it impossible to find the majority of potential occupational diseases, and occupation data were even worse during the second period of study (1980-85).