Gender differences and health inequality: Evolution of cardiovascular risk in workers.

The aim was to find out if there are any such differences due to gender in a cohort of workers followed for ten years, comparing their lifestyles and following the evolution of the main cardiovascular risk factors (CVRF) and their impact on cardiovascular risk. An observational longitudinal study of 698 civil servants workers (186 women and 512 men) of a local government office from Córdoba (Spain), was conducted over the period 2003-2014. We compared the initial and final prevalence of physical activity, smoking, obesity, hypertension, metabolic syndrome and diabetes. Cardiovascular risk was also assessed using the REGICOR (Registre Gironí del Cor) and SCORE (Systematic Coronary Risk Evaluation) equations. There was a greater rise in the prevalence of hypertension and hypercholesterolemia in the cohort in women than in men (94.2% vs. 38% and 92% vs 21.1%), while the reduction in smoking also differed by gender (26.4% vs. 36.5%). It could be that since women present a lower cardiovascular risk profile, they are treated less or less effort is made to keep the risk factors low, resulting in a worse evolution of smoking, hypercholesterolemia and hypertension in women.

Women-centred workplace health promotion interventions: a systematic review.

AIM: To analyse workplace health promotion interventions implemented exclusively for the female population. BACKGROUND: The differences in biological, psychological and social characteristics, as well as the type of work carried out by men and women, make it necessary for workplace health promotion to be specific for each group. This study focussed on working women. INTRODUCTION: Workplace health promotion interventions are centred on increasing the well-being and health of the employees. Occupational health nurses play an essential role in the implementation of these interventions. METHODS: A systematic review was carried out using the MEDLINE and Scopus databases, following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. RESULTS: Twelve articles met the inclusion criteria. Two lines of interventions were found: (1) promotion of breastfeeding (16.6%) and (2) promotion of physical activity and other healthy lifestyles (83.4%). The interventions studied underlined promoting breastfeeding, preventing a sedentary lifestyle, improving body composition, reducing cardiovascular risk, relieving premenstrual symptoms, time of breastfeeding after returning to work, and showing favourable results. DISCUSSION: The lack of studies on the subject and the medium-to-low quality of the articles included in the review have made it difficult to analyse workplace health promotion interventions, making it necessary to continue research in this area. CONCLUSION: There are very few occupational health promotion interventions targeting women (1.9%), and the majority of them focus on promoting physical activity. It is worrying that specific aspects of women's health are poorly addressed. IMPLICATIONS FOR NURSING PRACTICE AND HEALTH POLICY: The work of the occupational nurse essentially is to guarantee the health of women in the workplace, being the key figure in the research and development of gender-related policies in the field of public health.

Riesgo percibido sobre tabaquismo y tendencia de consumo-exposición en madres con recién nacidos de bajo peso / No disponible

Objetivos. Determinar la tendencia del consumo y exposición al tabaco de madres con recién nacidos de bajo peso antes y durante el embarazo, y describir la percepción de riesgo que tienen estas en relación con el tabaquismo. Pacientes y método. Diseño observacional descriptivo en el que se aplicó un cuestionario específico a las madres cuyos recién nacidos (con peso inferior a 2.500 gramos) se encontraban ingresados en la Unidad de Neonatología del Hospital Universitario Reina Sofía de Córdoba. El cuestionario recogía variables sociodemográficas, así como las relacionadas con la exposición al humo ambiental del tabaco durante la gestación y la salud materno-infantil percibida. Resultados. Se incluyeron en el estudio un total de65 mujeres. El 56,9% estaban expuestas al humo del tabaco en el hogar. Abandonaron el tabaquismo en un mes determinado del embarazo el 35,4% de las mujeres. El 92,3% opinaban que era muy/bastante probable que el humo del tabaco afecte a la salud de su hijo/a. Conclusiones. Las madres muestran una elevada percepción de riesgo en relación con el tabaquismo. Sin embargo, se encuentran expuestas al humo ambiental derivado del mismo en sus hogares. Además, la gran mayoría abandona o reduce el consumo de tabaco durante el primer trimestre del embarazo (AU)

Objectives. To determine the trend of consumption and exposure to tobacco in mothers with low birth weight newborns before and during pregnancy and describe the perception of risk that they have in relation to smoking. Patients and methods. The study was observational and descriptive. A specific questionnaire was administered to the mothers whose infants (weighing less than2.500 grams) were admitted to the Neonatal Unit of the Reina Sofia University Hospital in Córdoba. The questionnaire included sociodemographic variables and those related to exposure to environmental tobacco smoke during pregnancy and perceived maternal-child health. Results. 65 mothers were included in the analysis.56.9% of them were exposed to tobacco smoke at home. 35.4% gave up smoking in a given month of pregnancy. 92.3% of women felt it was very/quite likely that tobacco smoke affected the health of theirs on/daughter. Conclusions. The mothers show a high perception of risk in relation to smoking. They are exposed to secondhand smoke in their homes. Most mothers give up or reduce the consumption of tobacco during the first trimester of pregnancy (AU)

La influencia de factores individuales, relacionados con el trabajo, socioeconómicos y de organización del sistema sanitario sobre la duración de la incapacidad temporal / The influence of individual, work-related, socioeconomic, and the health system organization factors on the duration of sick-leave

Objetivo: Estudiar la frecuencia de aparición de Eventos Adversos (EA) atribuibles a la atención sanitaria en el hospital Severo Ochoa de Leganés y analizar el tipo de EA detectado. Material y método: Se realizó un estudio descriptivo de carácter retrospectivo en pacientes dados de alta durante 2004 en dicho hospital, que constó de dos fases. En la primera fase o de screening se identificaron los casos con riesgo de aparición de un EA. En la segunda fase o de confirmación se realizó la revisión de los casos cribados para confirmar o descartar la existencia del EA. Se consideró EA tanto los Efectos Adversos como los incidentes. Los casos confirmados se analizaron tipificando sus consecuencias y valorando si eran prevenibles o no. Resultados: Se seleccionaron 240 historias clínicas, de las cuales 90 (38%) pasaron a la segunda fase de análisis del estudio. De estas 90 historias, en 47 (52%) se había producido al menos un EA. En 34 pacientes se estimó que se había producido al menos un EA y en 13 un incidente. Del total de EA detectados, el 56% se consideraron prevenibles y el 87% se produjeron durante la hospitalización. El 50% de los EA se consideraron moderados, el 36% leves y el 14% graves. La consecuencia más frecuente de los EA detectados fue haber provocado una «lesión sin secuela con prolongación de la estancia». Conclusión: La tasa de pacientes con EA fue de un 14,2%, y la tasa de pacientes con incidentes de un 5,4%. El estudio ha permitido conocer las áreas prioritarias en las cuales centrar esfuerzos para detectar y prevenir los EA (AU)

Objective: To estimate the frequency of occurrence of Adverse Events (AE) that may be attributed to health care iin Hospital Severo Ochoa de Leganés, an investigation was performed by a descriptive, retrospective study using a random sample of patients released during the year 2004. Material and method: This study is carried out by reviewing clinical records. Results: Out of 240 patients included initially in the study, 90 (38%) were taken for the second stage of the study. At least one AE was considered to have occurred in 47 (52%) of them. At least one AE occurred in 34 of them, and in 13 just an incident occurred. From the total of AE detected, 56% were considered that could be prevented, 87% happened while staying in the hospital. The 50% of the AE were considered mediums, the 36% minor and the 14% serious and the most frequent consequence detected was an «injury with no consequence with an extension of the stay in the hospital». Conclusions: The rate of patients with AE was 14,2% and the rate of patients with an incident was 5.4%. Additionally, this study has contributed to identify the main areas where the efforts should be dedicated for the detection and prevention of AE (AU)

Riesgo biológico accidental entre trabajadores de un área sanitaria / Accidental exposure to biological risk among health care workers of a sanitary area

Objetivos: Los accidentes biológicos se han convertido en el más frecuente de los riesgos laborales entre el personal sanitario. Con este trabajo se pretende realizar una revision de la incidencia de accidentes biológicos en nuestro ámbito: así como de la actuación de los profesionales sanitarios. Procedimientos básicos: Hemos realizado un estudio descriptivo, recogiendo los accidentes biológicos en el Área sanitaria de Puertollano (Ciudad Real) desde el 01/01/99 al 31/12/03. Se han incluído todas aquellas personas que tras sufrir un accidente por exposición a material biológico completaron la ficha del sistema de vigilancia EPINet. Se llevó a cabo un seguimiento con controles analíticos en el momento del accidente biológico, a los 3, 6 y 12 meses de la exposición. Hallazgos principales: En este periodo de tiempo se registraron 188 casos. La tasa de exposición accidental por cada 100 trabajadores fue de 5,1 y de 21,8/100 camas/año. El estamento más afectado fue el personal de enfermería; en el área médica se produjeron mayor número de accidentes. La exposición tipo fue aquella producida durante la mañana, al recoger material usado, provocando inoculación accidental con una aguja contaminada con sangre o hemoderivados en las manos. Conclusiones: Es necesario instaurar programas de salud laboral en nuestras áreas de salud para disminuir la exposición ocupacional a agentes biológicos, que incluyan: medidas educativas, medidas administrativas de control (recogida completa de información), uso correcto de equipos de protección y realizar prácticas de trabajo seguras

Background: The biological accidents have become the most frequent in the occupational risks among the health care workers. The objective of the study was to quantity the importance in our environment. Methods: The descriptive study was carried out in the Sanitary Area of Puertollano (Ciudad Real) between January 99 and December 2003. All reported cases of accidental exposure to biological samples completed the record of the surveillance EPINet, and analytic controls with follow-up in the moment of the biological accident, to the 3, 6 and 12 months of the exposure. Results: In this period, 188 cases were registered. The rate of accidental exhibition for each 100 workers was of 5,1 and of 21,8 per 100 beds per year. The affected was the nursing staff; in the medical area they took place bigger number of accidents. The exposuretype was that taken place during the morning, when picking upused material, needlestick injuries to infected with blood or other biological fluids in the hands. Conclusions: It is necessary to establish programs of occupational health in our areas of health to: promotion aimed at trainingand informing workers in order to modify their habits in the work place and therapy lower the risk of exposure to biological hazards; to prevent the harmful effects of exposure to hazards; and Control Programs for the monitoring and surveillance of health care workers after an exposure has occurred

Nuevos enfoques terapéuticos frente a la tuberculosis multirresistente / New therapeutics possibilities against MDRTB

Objetivos: Investigar el fenómeno de la multirresistencia a la tuberculosis, y posibles alternativas terapéuticas. Procedimientos básicos empleados: Se realiza mediante un estudio prospectivo. Toda cepa de M. tuberculosis identificada es estudiada in vitro, en cuanto a la resistencia a drogas esenciales, segunda línea y tercera línea, así como nuevos fármacos. Se lleva acabo un estudio epidemiológico de los factores de riesgo presentes en los pacientes con tuberculosis multirresistente. Hallazgos principales: Los factores relacionados con la MDRTB, en nuestro estudio, han sido: edad, contactos previos con TB, enfermedad tuberculosa anterior, uso de drogas intravenoso y situación laboral/ingresos. Con relación a la resistencia a fármacos de primera línea, un 87,5 por ciento de las cepas han sido sensibles a estos antimicrobianos, y resistentes el 12,5 por ciento restante. El porcentaje de multirresistencia ha sido del 5,8 por ciento. De los fármacos de segunda y tercera línea empleados en tuberculosis han mostrado mayor resistencia la rifabutina, la rifapentina, ciprofloxacina y ofloxacina. Los nuevos fármacos ensayados, moxifloxacina y linezolid, han mostrado excelentes resultados. Las asociaciones con mayor actividad in vitro han sido: isoniacida, rifapentina, ofloxacina e isoniacida, rifapentina, clofacimina (AU)

[Evaluation of the effect of long term valproic acid treatment on plasma levels of carnitine, ammonia and amino acids related to the urea cycle in pediatric epileptic patients]. / Valoración del efecto del tratamiento prolongado con ácido valproico sobre los niveles plasmáticos de carnitina, amonio y aminoácidos relacionados con el ciclo de la urea en pacientes epilépticos pediátricos.

INTRODUCTION: Valproic acid (VPA) is an antiepileptic drug widely used in paediatrics. In spite of being a safe and effective anticonvulsant, VPA has been involved in the onset of changes in the metabolism of ammonia and carnitine, although few prospective studies have been made of this. OBJECTIVES: To evaluate the effect of long-term VPA administration, particularly on the metabolism of carnitine, ammonia and plasma amino-acids and the possible clinical repercussions of this in a group of epileptic patients studied prospectively and retrospectively. MATERIAL AND METHODS: A study was made of 102 epileptic children on long term anticonvulsant treatment mainly with VPA. These patients were divided into two groups: group I (n = 25) were studied prospectively (basal sample, after one, six and twelve months of treatment) and group II (n = 77) or long term treatment group (a single sample extraction). In each epileptic patient and in 56 children from a control group (group III) studies were made of free plasma carnitine, ammonia and amino-acids related to the urea cycle and the plasma levels of each anticonvulsant drug. RESULTS: It was observed that in group I there was a fall in plasma carnitine concentrations with time and a progressive rise which was statistically significant (p = 0.001) in plasma levels, mainly of ammonia, glutamine, glycine and ornithine, from the basal levels to those after a year of treatment in practically 100% of the children studied. In group II children on antiepileptic drugs, mainly VPA, were seen to have lower plasma carnitine levels than those in the control group and higher serum ammonia, glutamine and glycine levels than the healthy population not treated with anticonvulsants. These differences were statistically significant (p = 0.001). No relationship was found between the parameters studied and the plasma levels of the drug, type of epilepsy or presence of side effects. CONCLUSIONS: These changes show the negative effects of VPA on the metabolism of carnitine and ammonia. It would therefore seem advisable to monitor these parameters in epileptic children on long term antiepileptic treatment.

[Evaluation of compliance with antituberculous chemoprophylaxis among recluse population of the Jaen penitentiary center]. / Valoración del cumplimiento de la quimioprofilaxis antituberculosa por la población reclusa del centro penintenciario de Jaén.

BACKGROUND: This study highlights the importance of antitubercular chemoprophylaxis with isoniazid to control and prevent tuberculosis in prisons. The relationship between compliance with the chemoprophylaxis and study factors was evaluated and we examined whether health education given in our prison motivated the prisoners to comply with this treatment. METHODS: Compliance with chemoprophylaxis using isoniazid by 52 inmates of the Jaén Penal Institution was studied for the period February to May 1995. The dose of isoniazid taken was calculated by means of the spectrophotometric determination of isoniazid metabolites in urine using the Eidus Hamilton method. Likewise, the influence of variables such as sex, HIV infection, legal situation and cultural level on compliance was studied. RESULTS: Out of 52 inmates, 23 (44.23%) were taking a daily dose of isoniazid that was considered to be effective and 29 inmates (55.77%) were taking less than the effective isoniazid dose for the chemoprophylaxis. With regard to the variables studied, greater compliance with the chemoprophylaxis was recorded among men (sex variable) and those inmates with a higher educational level (cultural level) although no significant differences were found. CONCLUSIONS: Compliance with the chemoprophylaxis among our inmates is inadequate although it matches similar studies that have been carried out on the prison population. This is not the case for the community population where compliance with chemoprophylaxis is greater. This low compliance forces us to review our current health education programme and to take steps that might increase this degree of compliance such as direct observation of treatment, a system of intermittent treatment, etc.