Factores de riesgo de contagio de la Covid-19 en personal sanitario / Risk Factors for COVID-19 transmission among healthcare workers

Objetivos: El personal sanitario se sitúa en la primera barrera en la lucha contra la Covid-19, constituyendo un colectivo con una alto riesgo de infección. El objetivo del presente estudio es describir los factores de riesgo asociados en una población de profesionales que trabajan en un consorcio sanitario que incluye diferentes centros relacionados con la atención a la salud. Métodos: Estudio observacional analítico retrospectivo; población 2.620 trabajadores sanitarios; desde el inicio del Estado de Alarma en España (15/03/20) hasta 21/06/2020. Se calcula la asociación entre las variables independientes sexo, edad, años de antigüedad, categoría profesional y lugar de trabajo con la presencia de Covid-19 mediante la prueba Chi-Cuadrado y el cálculo de la Odds Ratio (OR) e intervalo de confianza al 95% (IC95%) simple y ajustado mediante Regresión Logística Múltiple. Límite de significación aceptado ≤0,05. Resultados: El personal sanitario, en todas las categorías, presenta siempre más riesgo respecto al no sanitario. Enfermería mostró los riesgos más altos -OR:14,03 (3,19-61,66)-. En el lugar de trabajo, Hospitalización-Médico-Quirúrgica -OR:13,43 (1,7-106,12)- y Sociosanitario -OR:17,77 (2,19-144,04)- presentaron más riesgo respecto a los que no tienen contacto con pacientes. Conclusión: El riesgo más elevado de contagio se presentó entre los profesionales que tienen mayor contacto con pacientes y en los lugares en los que se detectaron por PCR positivos para Covid-19 entre los pacientes ingresados por otras patologías, teniendo un riesgo mayor los profesionales que atienden estos pacientes que aquellos que atienden zonas destinadas a Covid-19 (AU)

Objective: Frontline healthcare workers are the first line of defense against Covid-19, resulting in a higher risk of infection. The objective of this study was to describe the impact of the SARS-CoV-2 infection and its associated risk factors among professionals working in a healthcare consortium that includes different centers. Methods: This was a retrospective analytical observational study of 2620 healthcare workers; the project period began with the declaration of the state of alarm in Spain (March 15, 2020) and ended on June 21, 2020. We estimated associations between the independent variables sex, age, seniority, professional category and work location and confirmed COVID-19 as the outcome variable. Bivariate study analysis was based on chi-square test and simple logistic regression with calculation of the odds ratio (OR) and 95% confidence interval (95%CI). Multivariate analysis was performed using multiple logistic regression. Statistical significance was set at p ≤0.05. Results: All frontline healthcare worker categories were at higher risk than non-patient-facing personnel. Nurses had the highest risk [OR, 14.03 (3.19-61.66)]. With respect to work location, and as compared to non-patient-facing personnel, working in the surgical-medical-hospitalization-clinic [OR 13.43 (1.7-106.12)] and socio-health center [OR 17.77 (2.19-144.04) posed the greatest risks. Conclusions: The greatest risk of acquiring COVID-19 was among patient-facing healthcare professionals working in areas where COVID-19 was detected among patients admitted for other pathologies. This risk was higher than in those areas designated for the care of COVID-19 patients, possibly due to differences in the use of personal protective equipment (AU)

Utilidad del antígeno para el diagnóstico de infección por SARS-CoV-2 en pacientes con y sin síntomas / Usefulness of the antigen for diagnosing SARS-CoV-2 infection in patients with and without symptoms

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Estudi de la relació entre el nivell d'activitat física i el control de la diabetis mellitus tipus 1 determinat pels valors d'hemoglobina glicosilada / Relación entre nivel de actividad física y control de la Diabetes Mellitus tipo 1 / Evaluation of the association of physical activity with metabolic control of type 1 Diabetes Mellitus

Fonament: els principals beneficis que l'activitat física aporta a la salut dels pacients diabètics tipus 1 s'han estudiat en diverses publicacions prèvies. Tot i això, l'evidència que l'exercici físic millora els controls metabòlics dels pacients no ha estat totalment demostrada i hi ha resultats controvertits. Objectiu: l'objectiu del treball és conèixer la relació entre el nivell d'activitat física dels pacients amb diabetis mellitus tipus 1 (DM1) i el control metabòlic de la malaltia, definit pels valors de l'hemoglobina glicosilada (HbA1c). Mètode: en l'estudi s'han inclòs 44 pacients diagnosticats de DM1 nascuts entre els anys 1998 i 2009, i que, per tant, tenen una edat compresa entre 7 i 18 anys. Les dades dels pacients s'han extret de la revisió de les històries clíniques. Tots els pacients de l'estudi han omplert els qüestionaris PAQ-C o PAQ-A (Physical Activity Questionnaire) per tal de registrar l'activitat física setmanal. Resultats: tant en l'anàlisi univariable com en l'anàlisi multivariable ajustada per factors de confusió, s'ha obtingut una relació estadísticament significativa entre el nivell d'activitat física i els valors d'HbA1c (Beta -0,510, p<0,01). Conclusió: l'activitat física millora el control glicèmic dels pacients diabètics tipus 1

Fundamento. Los principales beneficios que la actividad física aporta a la salud de los pacientes con diabetes tipo 1 se han estudiado previamente. Aún así, la evidencia de que el ejercicio físico mejora los controles metabólicos no se ha demostrado totalmente y existen resultados controvertidos. Objetivo. El objetivo de este trabajo es conocer la relación entre el nivel de actividad física de los pacientes con diabetes mellitus tipo 1 y el control metabólico de la enfermedad, definido por los valores de HbA1c. Método. En el estudio se han incluido 44 pacientes diagnosticados de diabetes mellitus tipo1 nacidos entre los años 1998 i 2009. Los datos se han obtenido de la revisión de las historias clínicas. Todos los pacientes del estudio han rellenado el cuestionario PAQ-C o PAQ-A para registrar la actividad física semanal. Resultados. El análisis univariable y el multivariable ajustado por factores de confusión muestran de manera estadísticamente significativa el efecto beneficioso del nivel de actividad física sobre los valores de HbA1c (Beta -0,510, p>0,01). Conclusión. La actividad física mejora el control metabólico de los pacientes diabéticos tipo 1 (AU)

Background. The benefits of physical activity in patients with type 1 diabetes mellitus have been previously reported. However, the association between physical activity and HbA1c levels is controversial, and studies have not shown consistent results. Objective. The aim of this study was to evaluate the association between the level of physical activity and the metabolic control of the disease, as defined by HbA1c levels. Method. Forty-four patients with type 1 diabetes mellitus and born between 1998 and 2009 were included in the study. Patient data were extracted from clinical records, and all patients completed the PAQ-C or PAQ-A questionnaire to document the weekly physical activity. Results. The analysis adjusted for possible confounding factors (Beta -0.510, p<0.01) showed that physical activity had a significant effect on the metabolic control of the HbA1c levels. Conclusion. Physical activity improves metabolic control of type 1 diabetes mellitus (AU)

Retracted: Impact on quality of life of using an onlay mesh to prevent incisional hernia in midline laparotomy: a randomized clinical trial.

BACKGROUND: Recent studies have demonstrated the effectiveness of using prophylactic meshes to achieve abdominal wall closure, decreasing the risk of incisional hernia. However, the effect of prophylactic mesh placement on a patient's quality of life has not yet been evaluated. STUDY DESIGN: A controlled, prospective, randomized, and blind study was carried out. The patients in group A (mesh) were fitted with a polypropylene mesh to reinforce the standard abdominal wall closure. The patients in group B (nonmesh) were given a standard abdominal wall closure and were not fitted with the mesh. All patients were administered the 36-Item Short-Form generic health questionnaire during their preoperation visit and during their 1-month, 6-month, and 1-year follow-up appointments. The scores of the questionnaires have been compared with those recorded when the questionnaire was administered before surgery. RESULTS: The Kaplan-Meier survival curves show that the likelihood of incisional hernia at 12 months is 1.5% in mesh group compared with 35.9% in nonmesh group (p > 0.0001), which means that the differences are statistically significant. Patients with mesh placement had greater improvement in general health and bodily pain than patients in nonmesh group at 1-month and 6-month post operation. One year after operation, patients in the mesh group had statistically significant better quality of life than patients in the nonmesh group in the physical functioning, general health perceptions, vitality, social role functioning, mental health, physical component summary and mental component summary dimensions. CONCLUSIONS: Fitting a prophylactic supra-aponeurotic mesh prevents incisional hernia.

[The night shift: a risk factor for health and quality of life in nursing staff]. / Turno nocturno: un factor de riesgo en la salud y calidad de vida del personal de enfermería.

OBJECTIVES: To study shift-related differences (day shift vs. night shift) in health and quality of life in nursing staff in hospitals in the Catalan public health system. METHOD: We performed a cross-sectional multicenter study in a sample of 476 nursing staff in the wards and special services of five Catalan public hospitals working for at least 6 consecutive months on the day shift or night shift. The nurses completed a validated, self-administered questionnaire on quality of life (M. Ruiz and E. Baca) and another questionnaire on health-related aspects such as sleep, working conditions, and demographic variables. RESULTS: Nurses working on the night shift showed a higher prevalence of appetite disturbance (45.2% vs 34.4%; p=0.01) and varicose veins (46.6% vs 36.4%; p=0.008). Sleeping disorders were also more frequent on the night shift, including insomnia and sleep fragmentation, with no differences in those who slept during the day (22.3%vs 33.7% ) or night (17.6% vs 30%) with respect to the day shift (12.2% vs 22.6%). Multivariate analysis of the results of the quality of life questionnaire revealed the night shift to be associated with the dimensions of social support (OR: 1.17; 95% CI, 1.01-3.01), physical/psychological well-being (OR: 1.04; 95% CI, 1.004-1.07) and leisure time (OR: 1.07; 95% CI, 1.003-1.1), although the overall score was similar. CONCLUSIONS: The night shift is associated a higher incidence of varicose veins, appetite disturbance and sleep disorders, as well as alterations related to social support, leisure time, and physical and physiological well-being.

Turno nocturno: un factor de riesgo en la salud y calidad de vida del personal de enfermería / The night shift: a risk factor for health and quality of life in nursing staff

Objetivos: estudiar las diferencias en los aspectos de salud y calidad de vida del personal de enfermería de los hospitales de la sanidad pública catalana con relación al turno de trabajo (diurno/nocturno). Métodoestudio transversal multicéntrico sobre una muestra de 476 profesionales de enfermería de 5 hospitales públicos catalanes, que desarrollaban su actividad en plantas de hospitalización y servicios especiales, con una permanencia continua, mínima de 6 meses, en un turno diurno (TD) o nocturno (TN). Respondieron un cuestionario autoadministrado, validado, de calidad de vida de M. Ruiz y E. Baca, y otro acerca de aspectos relacionados con la salud, el sueño, las condiciones laborales y las variables demográficas. Resultadoscon relación a los trastornos de la salud, en el TN, se observa una prevalencia superior de trastornos del apetito (el 45,2 frente al 34,4%; p=0,01) y varices (el 46,6 frente al 36,4%; p=0,008). También fueron significativamente superiores en el TN la proporción de problemas de insomnio e interrupciones del sueño, tanto si dormían de día (el 22,3 frente al 33,7%) como de noche (el 17,6 frente al 30%) respecto al TD (el 12,2 frente al 22,6%). Tras efectuar el análisis multivariable sobre el cuestionario de calidad de vida, se encontró asociación significativa entre el trabajo nocturno y la dimensión de apoyo social (odds ratio [OR]: 1,17; intervalo de confianza [IC] del 95%, 1,01¿3,1), bienestar físico/psicológico (OR: 1,04; IC del 95%, 1,004¿1,07) y ocio (OR: 1,07; IC del 95%, 1,003¿1,1), aunque la puntuación global fue similar. Conclusionesel trabajo en TN se asocia a una mayor incidencia de varices, trastornos del apetito, insomnio e interrupciones del sueño, así como alteraciones relacionadas con el apoyo social, ocio y bienestar físico/psicológico(AU)

Objectives. To study shift-related differences (day shift vs. night shift) in health and quality of life in nursing staff in hospitals in the Catalan public health system. MethodWe performed a cross-sectional multicenter study in a sample of 476 nursing staff in the wards and special services of five Catalan public hospitals working for at least 6 consecutive months on the day shift or night shift. The nurses completed a validated, self-administered questionnaire on quality of life (M. Ruiz and E. Baca) and another questionnaire on health-related aspects such as sleep, working conditions, and demographic variables. ResultsNurses working on the night shift showed a higher prevalence of appetite disturbance (45.2% vs 34.4%; p=0.01) and varicose veins (46.6% vs 36.4%; p=0.008). Sleeping disorders were also more frequent on the night shift, including insomnia and sleep fragmentation, with no differences in those who slept during the day (22.3%vs 33.7% ) or night (17.6% vs 30%) with respect to the day shift (12.2% vs 22.6%). Multivariate analysis of the results of the quality of life questionnaire revealed the night shift to be associated with the dimensions of social support (OR: 1.17; 95% CI, 1.01¿3.01), physical/psychological well-being (OR: 1.04; 95% CI, 1.004¿1.07) and leisure time (OR: 1.07; 95% CI, 1.003¿1.1), although the overall score was similar. ConclusionsThe night shift is associated a higher incidence of varicose veins, appetite disturbance and sleep disorders, as well as alterations related to social support, leisure time, and physical and physiological well-being(AU)