[Medical examinations in the context of workplace health surveillance in Spain: what for?] / Exámenes médicos en el contexto de la vigilancia de la salud en el lugar de trabajo en España: ¿para qué?

En España, según el Ministerio de Sanidad, el término "vigilancia de la salud de los trabajadores" engloba una serie de actividades referidas tanto a individuos como a colectivos, orientadas a la prevención de los riesgos laborales, y cuyos objetivos principales tienen que ver con la identificación de problemas de salud relacionados con el trabajo y con la evaluación de las intervenciones preventivas en el lugar de trabajo….

Salud laboral desde los servicios de la administración sanitaria: las oportunidades de la "perspectiva laboral" para el ejercicio de la salud pública / Occupational health from the health administration services: the "occupational perspective" opportunities for the exercise of Public Health

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Stroke preceding autoimmune encephalitis with neuronal potassium channel antibody.

Autoimmune encephalitis related to voltage-gated potassium channel (VGKC) antibodies can occur as a complication of cancer but, more frequently, as a non-paraneoplastic disorder. The prompt recognition and treatment could mitigate the morbidity associated with this entity, but the broad-spectrum of neurological manifestations often makes the diagnosis a challenge. The authors describe, here, a unique case of autoimmune encephalitis related to VGKC antibodies preceded by an ischaemic stroke. Conditions associated with the stroke (infection, seizures, metabolic disturbances) had delayed the diagnosis. The authors suggest that autoimmune encephalitis needs to be taken into consideration as part of a differential diagnosis in patients with prolonged encephalopathy following an ischaemic stroke. Infection may trigger an inflammatory response. In addition, the rupture of blood brain barrier that occurs in stroke may have a pathogenic role by allowing antibodies to gain access to the central nervous system.

Influencia de la situación laboral materna en recién nacidos pretérmino y/o con bajo peso / Influence of maternal employment on neonatal prematurity and/or low birth weight

Objetivo: Realizar una revisión de los estudiosepidemiológicos sobre la influencia de la situaciónlaboral y el tipo de ocupación materna en elnacimiento de niños con bajo peso y pretérmino.Material y métodos: Se realizó una búsquedabibliográfica en las bases de datos Medline yEMBASE. Los artículos seleccionados se clasificaronsiguiendo un protocolo que recogía lascaracterísticas de los estudios, la situación laboralmaterna, el tipo de ocupación y el resultado delembarazo.Resultados: Se incluyeron 21 artículos en los quemayoritariamente no se observan diferenciassignificativas entre las amas de casa y las empleadasen ninguno de los 2 efectos. En las investigacionesen las que se evalúa el tipo de ocupación, seobserva un mayor riesgo entre las embarazadas quetrabajan en el sector servicios y manual.Conclusiones: Las evidencias encontradas apuntana la necesidad de protección en el embarazo a lastrabajadoras de estos sectores

Objectives: To review epidemiological studies onthe association between maternal employment andtype of occupation and neonatal prematurity andlow birth weight.Material and methods: We performed a literaturesearch in the Medline and EMBASE databases. Thearticles selected were classified according to aprotocol that included the study’s characteristics’,maternal employment, type of occupation, andreproductive outcome.Results: Twenty-one articles were included. Mostof these articles found no differences in neonatalprematurity or low birth weight between workingwomen and housewives. A higher risk ofprematurity and low birth weight was found inwomen working in manual occupations and theservice sector.Conclusions: The evidence found suggests theneed to protect working women during pregnancy,especially those working in the two abovementionedsectors

Socioeconomic factors and the risk of anencephaly in a Mexican population: a case-control study.

OBJECTIVE: The study was designed to evaluate the association between socioeconomic level (as measured by maternal education, maternal occupation, and monthly family income) and anencephaly. METHODS: The authors conducted a case-control study using data from the Epidemiological Surveillance System Register for Neural Tube Defects for three states of the Mexican Republic: Puebla, Guerrero and the State of Mexico. Mothers of 151 cases of infants born with anencephaly and mothers of 151 control infants born during the period March 2000 to February 2001 were interviewed about their socioeconomic characteristics and other factors including reproductive history, use of prenatal care, use of tobacco and alcohol, fever during pregnancy, and folic acid supplementation. RESULTS: After adjustment for potential confounders, a risk gradient was seen with decreasing maternal education. Women with less than a primary school education (adjusted odds ratio [OR]=3.0; 95% confidence interval [CI] 1.2, 7.6) and women who had completed primary school but had not completed junior high school (adjusted OR=2.2; 95% CI 0.9, 5.7) had higher risks of giving birth to an infant with anencephaly, compared to women with a higher educational level. A monthly income < or = 1,000 pesos (approximately dollars 100 U.S.) was also associated with a higher risk of anencephaly (OR=2.5; 95% CI 1.2, 5.1). Women employed in industry or agriculture during the acute risk period (three months prior to conception to one month after conception) had a risk 6.5 times (95% CI 1.4, 29.6) that of professional and business women. CONCLUSIONS: This study helps to identify groups that may be especially vulnerable to this type of congenital malformation so that primary and secondary preventive strategies can be targeted to these groups.