Efectos biológicos y seguimiento médico de los trabajadores expuestos al formaldehído / Biological effects and follow up of employees exposed to formaldehyde

El formaldehído (FA) es un químico industrial ampliamente utilizado cuya exposición se asocia con aparición de efectos biológicos como irritación de la vía aérea, efectos genotóxicos e inmunotóxicos, sensibilización y cáncer. La Agencia Internacional para la Investigación del Cáncer clasificó el FA como carcinógeno humano (grupo 1). El objetivo de este artículo es revisar los efectos biológicos descritos en cualquier tipo de exposición laboral y no laboral al FA, y posteriormente valorar la anamnesis, la exploración clínica y las pruebas complementarias a considerar en los trabajadores expuestos a formaldehido, ya que la historia clínico-laboral es fundamental para su seguimiento. Se concluye finalmente sobre la necesidad de revisar los protocolos específicos oficiales de vigilancia de la salud para trabajadores expuestos a formaldehido

Formaldehyde (FA) is a widely used industrial chemical which exposure is associated with the appearance of biological effects such as airway irritation, genotoxic and immunotoxic effects, sensitization and cancer. The International Agency for Research on Cancer classified FA as a human carcinogen (group 1). The aim of this review is to study the biological effects in any type of occupational and non-occupational exposure to FA, and then to analyze the assessment of the anamnesis, the physical exploration and the complementary tests to be considered in the medical-occupational history of employees exposed to formaldehyde, since it is fundamental for its follow-up. In conclusion, we propose the revision of the specific official protocols of health surveillance

A new era for Nuclear Medicine neuroimaging in Spain: Where do we start from in Spain? / Nuevos tiempos para la neuroimagen de Medicina Nuclear en España: ¿de dónde partimos?

OBJECTIVE: To determine the status of neuroimaging studies of Nuclear Medicine in Spain during 2013 and first quarter of 2014, in order to define the activities of the neuroimaging group of the Spanish Society of Nuclear Medicine and Molecular Imaging (SEMNIM). MATERIAL AND METHODS: A questionnaire of 14 questions was designed, divided into 3 parts: characteristics of the departments (equipment and professionals involved); type of scans and clinical indications; and evaluation methods. The questionnaire was sent to 166 Nuclear Medicine departments. RESULTS: A total of 54 departments distributed among all regions completed the questionnaire. Most departments performed between 300 and 800 neuroimaging examinations per year, representing more than 25 scans per month. The average pieces of equipment were three; half of the departments had a PET/CT scanner and SPECT/CT equipment. Scans performed more frequently were brain SPECT with 123I-FP-CIT, followed by brain perfusion SPECT and PET with 18F-FDG. The most frequent clinical indications were cognitive impairment followed by movement disorders. For evaluation of the images most sites used only visual assessment, and for the quantitative assessment the most used was quantification by region of interest. CONCLUSIONS: These results reflect the clinical activity of 2013 and first quarter of 2014. The main indications of the studies were cognitive impairment and movement disorders. Variability in the evaluation of the studies is among the challenges that will be faced in the coming years.

Estudio sobre el envejecimiento activo saludable y su relación con las condiciones de trabajo en el sector sanitario: Proyecto adapt@geing2.0 / Study on healthy active aging and its relation to working conditions in the health sector: Project adapt@geing2.0

Objetivo: El envejecimiento de la población constituye un reto para la las empresas, que deben adaptarse para mejorar la capacidad funcional de las personas de edad. El sector sanitario donde el 48,2% de los trabajadores tendría una edad ≥45 años no es ajeno a este reto. Las características especiales de las condiciones de trabajo pueden tener un impacto negativo sobre el envejecimiento saludable y sobre la capacidad para trabajar. Metodología: Se realizó un estudio transversal observacional multicéntrico, a una muestra de 632 trabajadores ≥45 años, del sector sanitario (público/privado, hospitalario/extrahospitalario y todas las categorías profesionales), mediante cuestionario (cuestionario adapt@geing2.0), en donde se analizan las condiciones de trabajo, su relación con la capacidad para trabajar y las adaptaciones o medidas preventivas que están adoptando las empresas. Se realizó un análisis de las variables consideradas y la asociación entre ellas mediante crosstabs. Resultados: Los principales problemas de salud provienen de los trastornos musculoesqueléticos y mentales. Uno de cada 4 trabajadores, manifiesta que su puesto no está adaptado para poder desempeñar su trabajo hasta los 65 años. El 64% de estos trabajadores tiene alterado el índice de Capacidad para Trabajar. Los programas de salud en la empresa ayudan a compensar los procesos degenerativos físicos de la edad. En el estudio se identifican 71 recomendaciones de adaptaciones para facilitar el envejecimiento activo saludable. Conclusión: En el ámbito sanitario, el envejecimiento de los trabajadores es un factor que se debería considerar en especial en ciertos puestos de trabajo que presentan mayores demandas físicas y/o ciertas condiciones como la turnicidad/nocturnidad, con el fin de adoptar medidas preventivas y de adaptación de estos trabajadores al final de su vida laboral (AU)

Aim: The aging population is a challenge for companies, which need to improve the functional capacity of the elderly. The health sector where 48.2% of workers would ≥45 years age is no stranger to this challenge. The special features of working conditions can have a negative impact on healthy aging and the ability to work. Material and Methods: A multicenter observational cross-sectional study, a sample of 632 workers ≥45 years, the health sector (public/private, inpatient / outpatient and all occupational categories, using a questionnaire (questionnaire adapt@geing2.0) in where working conditions are analyzed, their relationship with the ability to work and adaptations or preventive measures being taken by the companies. An analysis of the variables considered and the association between them by crosstabs was performed. Results: The main health problems come from musculoskeletal and mental disorders. One of every 4 workers says that his job is not adapted to carry out their work until age 65. 64% of these workers have altered the Work Ability Index. Health programs in the company help offset the physical degenerative processes of aging. 71 recommendations in the study of adaptations are identified to facilitate healthy active aging. Conclusions: in the healthcare sector, aging workers is a factor that should be considered especially in certain jobs that have higher physical demands and/or certain conditions such as night/shift in order to take preventive measures and adaptation of these workers at the end of their working life (AU)

Comunicación cientifica e indexacion: nuestra revista en SciELO / Scientific Communication: Our Journal in SciELO

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Deficiencia de vitamina D y su relación con la fractura de cadera del anciano y la densidad mineral ósea de la mujer posmenopáusica / Vitamin D deficiency and its relationship with hip fracture of the elderly and bone mineral density of the postmenopausal woman

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[Radionuclide cisternography in spontaneous intracranial hypotension syndrome]. / Cisternogammagrafía en el síndrome de hipotensión endocraneal espontánea.

UNLABELLED: Spontaneous intracranial hypotension (SHI) due to cerebrospinal fluid (CSF) leaks is a clinical entity that is being increasingly recognized. Orthostatic headache is the cardinal clinical manifestation of this disorder. PATIENTS AND METHOD: Seven patients were studied retrospectively because of postural headache associated with low CSF pressure. In all patients, radionuclide cisternography as well as CT and/or MRI were performed. Radionuclide cisternography was obtained after intrathecal injection of radioisotope into the lumbar subarachnoide space. Images were obtained at 30 minutes, 2 and 4 hours after the injection. Pledgets were inserted into the nose and were considered positive for the presence of CSF when the count index of the pledgets regarding a blood sample was > or = 2:1. Criteria of spontaneous SHI was the early appearance of bladder activity with decrease in the distribution in the cerebral convexity and/or visualization of activity in the paraspinal areas. RESULTS: In 5 of the 7 patients scintigraphic abnormalities were found. CONCLUSION: Radionuclide cisternography is a reliable diagnostic method to diagnose SHI.

[Helical CT and perfusion scintigraphy: diagnosis of pulmonary embolus in the clinical practice]. / TAC helicoidal y gammagrafía de perfusión pulmonar: diagnóstico de tromboembolismo pulmonar en la práctica clínica.

UNLABELLED: The purpose of this study was to compare helical CT with lung perfusion scintigraphy (LPS) as the initial investigations of patients with suspected pulmonary embolism (PE). PATIENTS AND METHOD: A total of 54 patients with clinically suspected acute PE were studied retrospectively. Each patient was assigned a pretest clinical probability of acute PE (very likely, 90%; possible, 50%; unlikely, 10%). Within 72 hours of presentation, patients underwent LPS and contrast material-enhanced helical CT. Perfusion LS was classified following the PISAPED criteria as normal or near normal; abnormal consistent with PE or abnormal not consistent with PE. Helical CT studies were categorized as positive for PE, negative for PE or non-diagnostic. The standard reference was a consensus based on LS, helical CT and clinical outcome. RESULTS: In 38 of the 54 patients, the results of LS a hCT were concordant, 13 with PE and 25 without. There were 4 indeterminate hCT. In 12 patients LS and hCT were discordant. There were 4 LS false negative; 2 with parenchyma damage and 2 chronic PE. There were 5 LS false negative; 3 extrinsic vascular compressions and one low clinical probability. There was 1 hCT false positive because of breathing artifact and 2 false negatives because of subsegmental emboli. CONCLUSION: Accurate diagnosis of acute PE is possible combining perfusion scanning and clinical probability. Helical CT has added information in patients with discordant clinical probability and perfusion lung scan results. Helical CT demonstrated lesions other than PE considered responsible for the patient's symptoms, but it was insensitive to embolism of subsegmental branches.

Gammagrafía peritoneal en paciente en diálisis / Peritoneal scintigraphy in patients with dialysis

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[Utility of the hepatic grammagraphy with red blood cells marked with 99mTC in the differential diagnosis between cavernous hemangioma and hepatocarcinoma: based on one clinical case]. / Utilidad de la gammagrafía hepática con hematíes marcados con 99mTc en el diagnóstico diferencial entre hepatocarcinoma y hemangioma cavernoso: a propósito de un caso clínico.

The tomographic red blood cell imaging is useful in the investigation the cavernous hemangioma of the liver (specificity: 100%). In all positive studies, with negative cytology for malignancy, and absence of complications (bleeding, growth, etc.) It'll could adopt conservation aptness.

Inhibition of monoamine oxidase from bovine retina by beta-carbolines.

The behaviour of some beta-carboline derivatives as inhibitors of monoamine oxidase has been studied in bovine retina. Inhibition was found not to show any significant time dependence. Di- and tetrahydro-beta-carbolines were shown to behave as reversible and competitive inhibitors. In contrast, the fully unsaturated beta-carbolines harmane, harmine and harmaline, which showed deviation from linearity at high substrate concentrations, behaved as tight-binding inhibitors. In these cases, the concentration of the enzyme and the inhibitor were of the same order. This was confirmed by the Ki values for these compounds in the nanomolar concentration range. Consistent with this was that inhibition was only partly reversed by dialysis for 18 h at 4 degrees C, although complete reversal was observed after dialysis for the same period at 37 degrees C. Structure-activity relationships indicated that substitution of a methoxy group at the C7 position of the aromatic ring is determinant for this tight-binding behaviour; a substitution of this group at the C6 position greatly reduced inhibition. Since beta-carbolines have been reported to be formed endogenously, this suggests that they might have important physiological actions on monoamine oxidase activity in-vivo. In contrast, all the beta-carbolines investigated in this study had low potencies as inhibitors of monoamine oxidase B.

The effect of side chain substitution at positions 2 and 3 of the heterocyclic ring of N-acetylenic analogues of tryptamine as monoamine oxidase inhibitors.

N-Acetylenic analogues of tryptamine in which the side chain is located at position 2 of the indole ring are compared with those in which the side chain is located at position 3, in terms of their actions as inhibitors of monoamine oxidases A and B. IC50 values at 0 and 30 min of pre-incubation were determined. Time-dependence and irreversible inhibition confirmed that all of them behave as mechanism-based inhibitors. The kinetic constants of each inhibition step were determined for both monoamine oxidase forms and compared between them. In all cases the first-order rate constants for the covalent adduct formation were similar to inhibitor selectivity which is derived solely from differences in affinities for non-covalent binding to the A and B enzymes. Those compounds where the acetylenic side chain was substituted at position 2 of the heterocyclic ring and selective inhibitors of monoamine oxidase A were more potent than those with the side chain in position 3.

[Evaluation of microalbuminuria in children]. / Valoración de microalbuminuria en una población pediátrica.

Microalbuminuria has been shown to be important for the diagnosis and prognosis of glomerular nephropathy. A few studies in normal healthy children were performed. The concentration of albumin was determined in 171 samples of the first morning urine by an immunoturbidimetric method. Microalbumin/creatinine ratio values were 4.07 +/- 0.11 mg/mmol, 1.16 +/- 0.10 mg/mmol and 0.88 +/- 0.11 mg/mmol in children of ages 4 days-1 year, 1-7 years and 7-15 years, respectively. We found a negative inverse correlation (r = 0.31; p < 0.05) between age and microalbumin/creatinine ratio.

Investigations of the possible glycosylation of monoamine oxidase B from pig leucocytes.

Monoamine oxidase B (MAO B) from pig liver has been reported to be a sialoglycoprotein. However, when that enzyme from pig lymphocytes and granulocytes was separated by polyacrylamide gel electrophoresis after labelling with the specific irreversible inhibitor [3H]pargyline, staining with 1-ethyl-2-[3-(1-ethyl-naphtho [1,2d] thiazolin-2-ylidene)-2-methylpropenyl] naphtho [1,2d] thiazolium bromide ("Stains-all") failed to detect the presence of sialic acid residues. Treatment of the enzyme in disrupted lymphocytes and granulocytes, or in mitochondrial fractions prepared from them, with neuraminidase resulted in a decrease in MAO activity. However, after the enzyme was rendered soluble by treatment with octylglucoside, treatment with neuraminidase had no effect on the activity. These results indicate that sialic acid residues are not an intrinsic component of MAO B, although associated material containing such groups appears to affect the activity of the membrane-bound enzyme. The activities of membrane-bound preparations of MAO B from pig lymphocytes and granulocytes were unaffected by treatment with trypsin or beta-chymotrypsin. After the preparations had been rendered soluble by treatment with octylglucoside there was a decrease in the activity on treatment with beta-chymotrypsin, but trypsin treatment had no effect. Thus solubilization resulted in residues sensitive to cleavage by the former enzyme becoming accessible to it. Tryptic and chymotryptic peptides separated from the sodium dodecyl sulphate denatured enzymes by polyacrylamide gel electrophoresis revealed no differences between MAO B prepared from lymphocytes and granulocytes.

Characterization of monoamine oxidase activity present in human granulocytes and lymphocytes.

The characterization of monoamine oxidase (MAO) activity in lymphocytes and granulocytes was studied by using cells prepared from human blood. The specific activities of the enzyme towards beta-phenylethylamine (PEA), benzylamine (Bz), tyramine (TYR) and 5-hydroxytryptamine (5-HT) were found to be 5-times higher in lymphocytes than in granulocytes. The absence of the semicarbazide-sensitive amine oxidase (SSAO) was confirmed by the lack of effect of semicarbazide on the benzylamine oxidation. The presence of MAO-B was corroborated by the inhibition of PEA oxidation with nanomolar deprenyl concentrations and by inhibition of TYR oxidation with high clorgyline concentrations, as well as by the simple sigmoid curve obtained in both cases. These results, together with the substrate preferences, suggest that the MAO activity of human granulocytes and lymphocytes is predominantly of the B form. For each fraction the kinetic constants were determined towards PEA, TYR and Bz as substrates. The Km values were similar for both cellular samples, whereas the Vmax values were higher in lymphocytes than in granulocytes. MAO-B was titrated with [3H]pargyline in order to find out the number of active sites. The corresponding molecular concentration, Kcat values and turnover number showed the presence of related enzymes in human granulocytes and lymphocytes.

[A scale for measuring attitudes toward patients with acquired immunodeficiency syndrome (AIDS) among nursing personnel]. / Una escala de medición de actitudes hacia los sujetos con el síndrome de inmunodeficiencia adquirida (SIDA) en profesionales de enfermería.

A Scale for measuring attitudes to AIDS sufferers among nursing staff. A Likert-type scale has been constructed from a representative 324-subject sample to measure attitudes to AIDS sufferers, among a 1.706 member nursing staff population working in Hospitals. Clinics and Casualty Services in the province of La Coruña, Spain. The final 20-items scale has proved to be valid and reliable.