Omission of breakfast and risk of gastric cancer in Mexico

AIM: To investigate factors associated with gastric cancer (GC) in the Mexican population using a validated questionnaire. METHODS: We designed and validated in Spanish a Questionnaire to Find Factors Associated with Diseases of the Digestive Tract using GC as a model. A crosssectional study using 49 subjects, with confirmed histopathological GC diagnosis, and 162 individuals without GC participated. Odds ratio and 95% CIs were estimated in univariate and multivariate analysis adjusted for possible confounding factors. In order to match agegroups, a multivariate sub-analysis was performed in subjects ≥ 39 years of age and in females and males separately. RESULTS: In the univariate analysis, we found an association between GC and education to primary level or below, low socioeconomic status, the use of dental prostheses, omission of breakfast, consumption of very hot food and drink, addition of salt to prepared foods, consumption of salt-preserved foods and the pattern of alcohol consumption. We found protection against GC associated with the use of mouthwash, food refrigeration and regular consumption of fruit and vegetables. In the multivariate sub-analysis with subjects of ≥ 39 years, the omission of breakfast was identified as a risk factor for GC. CONCLUSION: Our study suggests an association between the omission of breakfast and the failure to refrigerate food with GC in the Mexican population.     

Outcome of three cases of untreated maternal glutaric aciduria type I

We report, for the first time, the outcome of three children born to two women with untreated glutaric aciduria type I (GA I). Isolated hypocarnitinemia in neonatal screening in one baby allowed the identification of the disease in his mother, who was undiagnosed so far and had had a previous daughter. The other baby was born to an already diagnosed mother who was not treated; newborn screening in the child reflected the metabolic state of the mother. Biochemical abnormalities returned to normal within one week. At the age of 4 months, neuroimaging showed Sylvian enlargement in both infants and bilateral temporal arachnoid cysts in one. Physical and neurological developments were normal for the three patients at ages 2 and 5 years. We conclude that long-term follow up will determine the true impact of GA I in such children. Paula Garcia and Esmeralda Martins contributed equally to this work.     

Impact of hospitalization on breastfeeding practices in a pediatric hospital in Salvador, Bahia State, Brazil

This cross-sectional study enrolled 97 inpatients at a teaching hospital in Salvador, Bahia, Brazil, to determine breastfeeding prevalence in infants less than 4 months of age hospitalized due to respiratory infection, and to evaluate the impact of hospitalization on breastfeeding. Patients' mothers were interviewed, and a standardized questionnaire was completed. After hospital discharge, medical records were reviewed and information on the infant's feeding practices during hospitalization was recorded. Exclusive breastfeeding was observed in 57.1% of patients, but it was interrupted in 35.4%, with the introduction of infant formula during hospitalization. Mean duration was not associated with the introduction of complementary feeding in the hospital. In the bivariate analysis, early interruption of exclusive breastfeeding was associated with higher maternal schooling and lower family income. Prevalence of exclusive breastfeeding was low. Hospitalization contributed to early interruption of exclusive breastfeeding in 35.4% of infants, possibly due to inadequate hospital infrastructure and insufficient support from health professionals to maintain exclusive breastfeeding.     

Occupational health legislation and practices related to seafarers on passenger ships focused on communicable diseases: results from a European cross-sectional study (EU SHIPSAN PROJECT)

Background  

Seafarers play an important role in the transmission of communicable diseases. The aim of the present study is to draw information and identify possible gaps on occupational health practices related to seafarers sailing on ships within the European Union Member States (EU MS) with focus on communicable diseases.     

Raising the bar of care for older people in Ontario emergency departments

flynn d.s., jennings j., moghabghab r., nancekivell t., tsang c., cleland m. & shipman-vokner k. (2010) Raising the bar of care for older people in Ontario emergency departments. International Journal of Older People Nursing 5 , 219–226
doi: 10.1111/j.1748-3743.2010.00209.x Aim. To describe the role of geriatric emergency management nurses as a catalyst for culture change in emergency department processes with the goal to improve care and outcomes of older people. Background. The changing context and literature has called for a culture change within emergency department care to integrate principles of older people care into care delivery. There is a paucity of reports describing how geriatric emergency care models bring about a broader change in culture within the entire emergency department. Methods. The Ontario Ministry of Health and Long-term Care in Canada established a programme to place geriatric emergency management nurses into emergency departments with the goal to improve delivery of care through development of unique, site-appropriate solutions. Results. Geriatric emergency management nurses incorporate capacity building into their role to develop and strengthen the skills, instincts, abilities, process and resources of the emergency department. Care processes focus on areas of staffing, mobilization, comfort, medication, hygiene, nutrition/hydration, cognition, environment, equipment and stimulation. Multi-modal educational strategies and advocacy promote appropriate person-centred care. Improved communication among care providers at key patient transition points remains a priority system-level improvement. Conclusion. Geriatric emergency management nurses work collaboratively with the emergency department team to facilitate change in the way that emergency department care is provided to the older person experiencing health emergencies. Implications for practice. Known strategies that have been effective in improving outcomes for older people within the hospital and residential care setting can be generalized into emergency department care. Further research into the effectiveness of these strategies in this environment is recommended.     

Disseminated sporotrichosis as a manifestation of immune reconstitution inflammatory syndrome

We describe two cases of disseminated sporotrichosis as a manifestation of immune reconstitution inflammatory syndrome. After the initiation of highly active anti-retroviral therapy, one patient presented disseminated lesions, whereas the other patient's preexisting lesions worsened and became more extensive. Simultaneously, their CD4 T cell counts increased and HIV viral loads decreased.