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.

[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.

[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.

[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).

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.

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.