Underreporting of work accidents associated with blood-borne risk factors

Background: Work accidents (WA) due to percutaneous or mucocutaneous injury are frequent among health professionals. Accident notification ensures compliance with legal requirements, enabling health institutions to develop, implement and evaluate prevention strategies. This study aimed to estimate the proportion of underreporting of work accidents caused by percutaneous and mucocutaneous lesions in a hospital setting and its determinants. Methods: A self-administered questionnaire was made available to all hospital employees. The multivariate logistic regression models computed age, gender, professional category, and type of service adjusted odds ratios (OR) and 95% confidence intervals (95% CI). Results: Underreporting of WA associated with biological risk factors was high, particularly in accidents by mucocutaneous injury (80.9%). Physicians were the professional category that least reported this type of work accident (OR=4.64; 95% CI2.20-9.78). The main determinants of underreporting were underestimating the risk of transmission and the excessive bureaucracy. Conclusion: The underreporting of work accidents associated with biological risk factors was considerable, and it contributes to a high degree of uncertainty on accidents'' characterization.     

Eating Patterns and Dietary Interventions in ADHD: A Narrative Review

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders in childhood, affecting ~7% of children and adolescents. Given its adverse health outcomes and high healthcare and societal costs, other treatment options beyond pharmacotherapy have been explored. Case-control studies have shown that dietary patterns may influence the risk of ADHD, and specific dietary interventions have been proposed as coadjuvant treatments in this disorder. These include nutritional supplements, gut microbiome-targeted interventions with biotics, and elimination diets. The purpose of this review is to examine which dietary patterns are most associated with ADHD and to summarize the existing evidence for the clinical use of dietary interventions. The literature showed that non-healthy dietary patterns were positively associated with ADHD, whereas healthy patterns were negatively associated. As for nutritional supplements, only vitamin D and vitamin D + magnesium appeared to improve ADHD symptoms when baseline levels of vitamin D were insufficient/deficient. Regarding biotics, evidence was only found for Lactobacillus rhamnosus GG and for multi-species probiotic supplementation. Elimination diets have scarce evidence and lead to nutritional deficiencies, so caution is advised. Overall, more robust scientific evidence is required for these dietary interventions to be implemented as part of ADHD therapy.     

Intimate partner violence (IPV) and preeclampsia among Peruvian women

OBJECTIVE: Mounting evidence supports the view that intimate partner violence (IPV) is an important cause of maternal mortality. Some, but not all, prior studies suggest that IPV is associated with increased risks of maternal medical conditions such as hypertensive disorders of pregnancy which are leading causes of maternal mortality worldwide. We assessed the relation between IPV and risk of preeclampsia among Peruvian women. STUDY DESIGN: We conducted a case-control study at two large hospitals in Lima, Peru. Preeclampsia cases were 339 women with pregnancy-induced hypertension and proteinuria (i.e., preeclampsia). Controls were 337 normotensive women. Information concerning women's exposure to physical and emotional violence during pregnancy was collected during in-person interviews conducted after delivery and while patients were in hospital. Odds ratios (OR) and 95% confidence intervals (CI) were estimated from logistic regression models. RESULTS: The prevalence of IPV was 43.1% among cases and 24.3% among controls. Compared with those reporting never exposure to IPV during pregnancy, women reporting any exposure had a 2.4-fold increased risk of preeclampsia (OR=2.4; 95% CI: 1.7-3.3). The association was strengthened slightly after adjusting for maternal age, parity and pre-pregnancy adiposity (OR=2.7; 95% CI: 1.9-3.9). Emotional abuse in the absence of physical violence was associated with a 3.2-fold (95% CI: 2.1-4.9) increased risk of preeclampsia. Emotional and physical abuse during pregnancy was associated with a 1.9-fold increased risk of preeclampsia (95% CI: 1.1-3.5). CONCLUSIONS: IPV among pregnant women is common and is associated with an increased risk of preeclampsia. These data support recent calls for coordinated global health efforts to prevent violence against women.     

Cesárea a petición de la embarazada

Objetive

: To know Spanish Obstetrics and Gynaecology Society (SEGO) members about cesarean section on request.

Method

Three questions appeared on SEGO web: 1) If a normal primigravid with a term, cephalic presentation foetus ask you for a caesarean section, would you do it?; 2) If a normal primigravid with a term, breach presentation foetus ask you for a caesarean section, would you do it?; 3) If a woman on her normal third pregnancy with two previous vaginal and with a term, breach presentation foetus ask you for a caesarean section, would you do it? Questions were asked in May 2006 and answers were collected 19^th October 2006. Data analysis was processed with web page statistic method.

Results

Among the 5300 members of SEGO, 1222 contacted the web page (23%). To question n° 1, 57.8% answered no, 24.8% yes and 17.4% had no answer. To question n° 2, 6.1% answered no, 93.8% yes and there were no abstention. To n° 3 question, 16.7% said no, 74.5% said yes and 8.8% has no opinion.Results are commented, advantages and disadvantages of caesarean are discussed as well as sanitary consequences of such an indication.     

Opioid-based micro and nanoparticulate formulations: alternative approach on pain management

Context Opioids have been used as the reference treatment on chronic pain. However, they are related to serious adverse effects which affect the patient compliance to treatment, as well as, his quality of life. Particulate formulations have been investigated as an alternative to improve opioid efficacy and safety. Objective Summarise the available studies concerning micro and nanoencapsulated opioid formulations discussing their biopharmaceutical characteristics, such as composition, size, in vitro release, pharmacokinetic and antinociceptive profile. Methods Papers available in 1995–2015 at Medline, Science Direct and Web of Science databases were collected and assessed. Searches were performed using varied combinations of the keywords of this work. Results Opioid-loaded particles showed prolonged drug release with maintenance of serum therapeutic concentrations and extended analgesia when compared with the free drugs. The side effects incidences were reduced or maintained the same. Conclusion Particulate formulations can significantly increase both potency and safety profiles of opioids.     

Successful incorporation of robotic surgery into gynecologic oncology fellowship training

Background

The increasing role of robotic surgery in gynecologic oncology may impact fellowship training. The purpose of this study was to review the proportion of robotic procedures performed by fellows at the console, and compare operative times and lymph node yields to faculty surgeons.

Methods

A prospective database of women undergoing robotic gynecologic surgery has been maintained since 2008. Intra-operative datasheets completed include surgical times and primary surgeon at the console. Operative times were compared between faculty and fellows for simple hysterectomy (SH), bilateral salpingo-oophorectomy (BSO), pelvic (PLND) and paraaortic lymph node dissection (PALND) and vaginal cuff closure (VCC). Lymph nodes counts were also compared.

Results

Times were recorded for 239 SH, 43 BSOs, 105 right PLNDs, 104 left PLNDs, 34 PALND and 269 VCC. Comparing 2008 to 2011, procedures performed by the fellow significantly increased; SH 16% to 83% (p < 0.001), BSO 7% to 75% (p = 0.005), right PLND 4% to 44% (p < 0.001), left PLND 0% to 56% (p < 0.001), and VCC 59% to 82% (p = 0.024). Console times (min) were similar for SH (60 vs. 63, p = 0.73), BSO (48 vs. 43, p = 0.55), and VCC (20 vs. 22, p = 0.26). Faculty times (min) were shorter for PLND (right 26 vs. 30, p = 0.04, left 23 vs. 27, p = 0.02). Nodal counts were not significantly different (right 7 vs. 8, p = 0.17 or left 7 vs. 7, p = 0.87).

Conclusions

Robotic surgery can be successfully incorporated into gynecologic oncology fellowship training. With increased exposure to robotic surgery, fellows had similar operative times and lymph node yields as faculty surgeons.     

Ternary Blends for Self-Compacting Mortars Production Composed by Electric Arc Furnace Dust and Other Industrial by-Products

This study is framed within the circular economy model through the valorisation of industrial by-products. This research shows the results of producing self-compacting mortars (SCMs) with electric arc furnace dust (EAFD) and other industrial by-products such as fly ash, conforming (FA) or not conforming (NcFA), from coal-fired power plants, or recovery filler (RF) from hot-mix asphalt plants. Three batches of SCMs, each with one industrial-by product (FA, NcFA, or RF), and three levels of EAFD ratio incorporation (0%, 10%, 20%), were tested. An extra batch with a greater amount of FA was manufactured. When the incorporation ratio of EAFD rose, the mechanical strength decreased, due to the presence of a calcium zinc hydroxide dihydrate phase; nevertheless, this decrease diminished over time. All SCM mixes, except the 40C 40FA 20 EAFD mix, were above 20 MPa at 28 days. All mixes named 70C and 40C reached 40 and 30 MPa, respectively, at 90 days. Mixes with EAFD showed less capillarity and no difference in water absorption by immersion with respect to mixes without EAFD after 91 days. The SCMs designed proved to be stable in terms of leaching of the heavy metals contained in EAFD, where all the hardened SCMs were classified as inert.     

No Association between Vitamin D and Weight Gain: A Prospective,Population-Based Study

Background: The association between vitamin D and weight gain remains controversial due to important limitations in the studies. We investigated the relationship between vitamin D levels and 5 and 10 years of weight and waist circumference change in a population-based prospective cohort study. Methods: Prospective study including participants aged between 35 and 75 years living in the city of Lausanne, Switzerland. Weight and waist change at 5- and 10-year follow-up were assessed according to baseline vitamin D status (normal, insufficiency and deficiency). Results: A total of 3638 participants (47.9 % women, mean age 51.6 ± 10.4 years) were included for the 5-year follow-up. No association was found between vitamin D categories and weight change, multivariate-adjusted average ± standard error: 1.6 ± 0.3, 1.5 ± 0.2 and 1.2 ± 0.1 kg for normal, insufficiency and deficiency, respectively, p = 0.159. For waist change, the corresponding values were 3.3 ± 0.4, 3.3 ± 0.2 and 3.4 ± 0.2 cm, p = 0.792. For the 10-year follow-up, data from 2999 participants (45.8% women, mean age 50.8 ± 10.3 years) were used. No association was found for weight 2.3 ± 0.4, 2.3 ± 0.2 and 2.0 ± 0.2 kg, p = 0.588, or for waist 3.7 ± 0.4, 3.6 ± 0.3 and 4.2 ± 0.2 cm for normal, insufficiency and deficiency, respectively, p = 0.259. Conclusion: No association between vitamin D status and weight or waist gain at 5- and 10-year follow-up was found.     

Linfadenitis por micobacterias no tuberculosas: experiencia de 15 años

Objective

To study the epidemiology, clinical features, diagnosis, therapeutic management, and outcome of non-tuberculous mycobacterial lymphadenitis in a paediatric population of Aragón (Spain).