La violencia ocupa un lugar en el trabajo

Silenciosa y progresivamente la violencia sicológica puede ocupar su puesto de trabajo sin que siquiera la haya notado. Estudios recientes muestran que, como resultado de las transformaciones globales del mundo del trabajo en términos de productividad, se están incrementando ese tipo de fenómenos. Juan Alberto Castillo Martínez, PhD e investigador del Grupo de Investigación Salud, Cognición y Trabajo de la Facultad de Rehabilitación y Desarrollo Humano de la Universidad del Rosario, explicó que esos estudios evidencian que la línea que define la noción de “violencia en el trabajo” es bastante difusa y depende de un sinnúmero de factores, tales como la cultura local, la organizacional y la apreciación colectiva de ciertos comportamientos. ¿Qué significa, entonces, un acto violento de trabajo en el marco de los sistemas de producción colombiano? Pensar el significado del acto violento en una cultura marcada por varias generaciones de trabajadores expuestos a violencias de diverso orden (social, cultural, familiar, política) hace difícil identificar, controlar y manejar el fenómeno. En el estudio desarrollado por el Grupo de Investigación GiSCYT sobre ”Los Riesgos Sicológicos y Sociales en el Trabajo”, 2006-2007, los investigadores advierten también a cerca de la necesidad de reflexionar sobre la tolerancia a la violencia, y tener en cuenta que la definición de violencia varía ampliamente en función de la época y el momento histórico en que los actos violentos se producen. En el ámbito familiar, por ejemplo, se consideraba en el pasado que ejercer la autoridad de los padres o de los maestros pasaba por la agresión física directa a los niños. Hoy en día, la sociedad considera ésto como una expresión de brutalidad. En el campo del trabajo, las formas diversas de violencia han sido objeto de controversia legal, política y de expertos en ciencias de la salud, a tal punto que hoy el reconocimiento e identificación de dichos actos en el mundo laboral es difícil y, a veces, imposible. Recientemente en Colombia y en diversos países del mundo, se han desarrollado normas que tratan de limitar la producción de fenómenos que involucran el ejercicio del poder sobre otros (estrés, acoso, presión). Sin embargo, hacer evidente la génesis y el desarrollo de estos fenómenos tiene un alto costo social y organizacional

Branched Chain Amino Acids Are Associated with Physical Performance in Patients with End-Stage Liver Disease

Decreased circulating branched chain amino acids (BCAA) represent a prominent change in amino acid profiles in patients with end-stage liver disease (ESLD). These alterations are considered to contribute to sarcopenia and hepatic encephalopathy and may relate to poor prognosis. Here, we cross-sectionally analyzed the association between plasma BCAA levels and the severity of ESLD and muscle function in participants of the liver transplant subgroup of TransplantLines, enrolled between January 2017 and January 2020. Plasma BCAA levels were measured by nuclear magnetic resonance spectroscopy. Physical performance was analyzed with a hand grip strength test, 4 m walking test, sit-to-stand test, timed up and go test, standing balance test and clinical frailty scale. We included 92 patients (65% men). The Child Pugh Turcotte classification was significantly higher in the lowest sex-stratified BCAA tertile compared to the highest tertile (p = 0.015). The times for the sit-to-stand (r = −0.352, p &lt; 0.05) and timed up and go tests (r = −0.472, p &lt; 0.01) were inversely correlated with total BCAA levels. In conclusion, lower circulating BCAA are associated with the severity of liver disease and impaired muscle function. This suggests that BCAA may represent a useful prognostic marker in the staging of liver disease severity.</p

Claves para prevenir lesiones osteomusculares en el trabajo

La creciente presencia de lesiones osteomusculares que afectan, alteran o transforman los patrones de movimiento de los trabajadores que realizan actividades industriales, plantean serios interrogantes para las disciplinas científicas que tratan de estudiar la naturaleza del movimiento humano. Conocedor de esta problemática, el Grupo de Investigación Salud, Cognición y Trabajo (GiSCYT) de la Facultad de Rehabilitación y Desarrollo Humano de la Universidad del Rosario, ha venido desarrollando herramientas para el estudio del movimiento en el trabajo, con el fin de identificar estrategias para la prevención de lesiones a través del análisis del gesto precursor de las mismas y poder así replantearlo en términos de funcionalidad y eficiencia. Las necesidades de coordinación, velocidad y fuerza requeridas en el desarrollo de las actividades productivas están relacionadas con los patrones de movimiento de los trabajadores; por lo tanto, cualquier alteración en dichos patrones puede traer consecuencias para el sistema de producción y para la salud. Para poder enfrentar estos problemas, los investigadores del GiSCYT, Juan Castillo y Alejandro Orozco, han logrado identificar las formas mediante las cuales los trabajadores logran la integración y desarrollo de habilidades para ejecutar movimientos bien orientados, con alto grado de precisión; movimientos que son de uso común en el mundo del trabajo y cuya importancia es frecuentemente subestimada. Cuando ocurren lesiones o daños en el aparato locomotor se presentan alteraciones en los patrones de movimiento humano, ésto trae como consecuencia problemas asociados a la autonomía y el control para desplazarse o ejercer fuerza y realizar movimientos. En algunas ocasiones incluso llega a limitar la capacidad individual para ejecutar las tareas domésticas y cotidianas más simples. Es así como se evidencia un vínculo entre estudio del movimiento y lesiones osteomusculares al tratar de comprender los mecanismos que operan en el control del movimiento y de la postura. A la par, también se hace evidente la importancia de las estrategias de control y de anticipación desarrolladas por los individuos, y que en muchos casos hacen la diferencia frente al riesgo de lesión o trauma

How I treat splenomegaly in myelofibrosis

Symptomatic splenomegaly, a frequent manifestation of myelofibrosis (MF), represents a therapeutic challenge. It is frequently accompanied by constitutional symptoms and by anemia or other cytopenias, which make treatment difficult, as the latter are often worsened by most current therapies. Cytoreductive treatment, usually hydroxyurea, is the first-line therapy, being effective in around 40% of the patients, although the effect is often short lived. The immunomodulatory drugs, such as thalidomide or lenalidomide, rarely show a substantial activity in reducing the splenomegaly. Splenectomy can be considered in patients refractory to drug treatment, but the procedure involves substantial morbidity as well as a certain mortality risk and, therefore, patient selection is important. For patients not eligible for splenectomy, transient relief of the symptoms can be obtained with local radiotherapy that, in turn, can induce severe and long-lasting cytopenias. Allogeneic hemopoietic stem cell transplantation is the only treatment with the potential for curing MF but, due to its associated morbidity and mortality, is usually restricted to a minority of patients with poor risk features. A new class of drugs, the JAK2 inhibitors, although also palliative, are promising in the splenomegaly of MF and will probably change the therapeutic algorithm of this disease

The SIN-DME questionnaire (symptoms of INcomfort associated with muscle skeletal disorders)

This research was carried out between 2010 and 2017; the objective was to develop the Intervention Protocol for the Prevention of Musculoskeletal Disorders, the research followed three phases as follows: the first one dealt with the design of the protocol and the analysis tools, the second one focused on the adjustment of the intervention and modeling processes of the tools and the third one on the validation of the protocol and its operation in the companies. In total, the applications of the tools and the validation of the development were carried out with the results obtained from 97 companies from 11 economic sectors that participated; from this universe of companies a sample of 2648 workers was constituted. This is a self-assessment questionnaire of WMSD’s-related symptoms, designed in the category of questionnaires that focus on identification through the perception of health by individuals. In this regard, it should be noted that previous studies carried out by the scientific team of the ergonomics laboratory of the University of Rosario, started from the hypothesis that groups of workers with some pathology associated with WMSD’s would present a low perception of health, however, it was found that most of the workers perceived their own state of health as excellent. This is explained because when the symptomatology of the pathology presented by the worker does not prevent or condition the activities of daily life, people will perceive that they have an adequate state of health [1]. The questionnaire uses validated information, scales and the development of visual identification items to bring the representations of individuals closer to the estimates made. The conceptual objective for the development of the questionnaire is to record and measure the prevalence of symptoms in workers who may be associated with a musculoskeletal disorder, with the purpose of verifying the presence of symptoms later through a more exhaustive evaluation of health conditions. © Springer Nature Switzerland AG 2019

Improved classification of leukemic B-cell lymphoproliferative disorders using a transcriptional and genetic classifier.

B-cell chronic lymphoproliferative disorders (B-CLPD) encompass a group of hematologic tumors that often present with leukemic involvement.1 Their heterogeneity and the lack of relatively specific diagnostic markers for most of these diseases make their diagnosis challenging, especially in cases that only have blood involvement or when histology is not available. With the currently used immunophenotypic and molecular markers, around 10% of B-CLPD cases remain unclassifiable and are categorized as B-CLPD, not otherwise specified (B-CLPD, NOS). Few recurrent gene mutations and chromosomal abnormalities have been documented in some entities: BRAF and MYD88 mutations in hairy cell leukemia (HCL) and lymphoplasmacytic lymphoma (LPL), respectively,2,3 in addition to the recurrent 7q31–q32 deletion in splenic marginal zone lymphoma (SMZL).1 However, none of them are diagnostic hallmarks of any particular entity. Gene expression profiling studies have recognized specific signatures that identify most common hematological neoplasms.4,5 Based on these results we postulated that the analysis of the gene expression profiling (GEP) of a large series of leukemic B-CLPD could identify specific signatures for each leukemic disease entity. These signatures could be useful for the classification of cases with undetermined diagnosis (B-CLPD, NOS). In this study, we have investigated the GEP of a large series of leukemic lymphoid neoplasms and identified specific gene signatures for most entities that were validated in an independent cohort. We have also derived and validated a simplified quantitative polymerase chain reaction (qPCR)-based 8-gene assay that reliably recognized these entities and could assist in the diagnosis in routine practice, particularly in atypical cases and B-CLPD, NOS