Organización y actividades preventivas en el sector del transporte de mercancías por carretera

[ES] Objetivos: Identificar los recursos y actividades preventivas más prevalentes en el sector del transporte de mercancías por carretera y los hechos diferenciales con el resto de la población trabajadora española. Metodología: Estudio descriptivo de los datos de la Encuesta de Salud y Condiciones de Trabajo del sector del transporte y estudio comparativo con el resto de la población trabajadora a través de la V-Encuesta Nacional de Condiciones de Trabajo. Para el análisis estadístico se ha aplicado el ji cuadrado y la t-student. Resultados: El 77% de las empresas de este sector tienen menos de 50 trabajadores. El 41% de los conductores señala que en su empresa no existe Delegado de Prevención y un 25% no dispone de ningún Recurso Preventivo. Destaca el alto desconocimiento existente entre los conductores de los recursos preventivos en su empresa (34,3%). La modalidad preventiva más frecuentemente instaurada en el sector es la asunción de la prevención por parte del empresario (13,6%) a diferencia del resto de sectores donde predomina el SP. Ajeno (43%). Conclusiones: Predominio de la pequeña empresa en el Sector del transporte asociado a un escaso desarrollo del tejido prevenGoals: To identify the most prevalent resources and preventive activities in professional long-haul drivers and their peculiarities related to the other Spanish production branches. Methodology: We develop a descriptive analysis of data from the Survey of Health and Working Conditions in professional truck drivers and we compare these results with the other Spanish production branches through the VNational Survey on Working Conditions. The statistical analysis applied T-Student test and the Ji square. Results: In this branch 77% of companies have less than 50 employees. 41% of drivers referred that it does not exist the «Delegado de Prevención» (workers representative) in their companies and 25% that there is not any Preventive Action. It is specially relevant the unknowledge among drivers about preventive resources in their companies (34.3%). The most frequently introduced preventive modality in the sector is the employer taking prevention by himself (13.6%) whilst other sectors are mainly covered by External Preventive Services (43%). Conclusions: If Transport branch is compared with the general - reference population it shows an image in which undersized companies linked to a weak development of preventive network could be determinant to their lowest preventive activities. Also we find a better self perceived health related to a better access to preventive activities.tivo en comparación con la población de referencia. Ambas características pueden ser determinantes de la menor actividad preventiva, más baja que la observada en la población de referencia. El acceso a actividades preventivas entre los conductores se relaciona con una mejor salud percibida. Goals: To identify the most prevalent resources and preventive activities in professional long-haul drivers and their peculiarities related to the other Spanish production branches. Methodology: We develop a descriptive analysis of data from the Survey of Health and Working Conditions in professional truck drivers and we compare these results with the other Spanish production branches through the VNational Survey on Working Conditions. The statistical analysis applied T-Student test and the Ji square. Results: In this branch 77% of companies have less than 50 employees. 41% of drivers referred that it does not exist the «Delegado de Prevención» (workers representative) in their companies and 25% that there is not any Preventive Action. It is specially relevant the unknowledge among drivers about preventive resources in their companies (34.3%). The most frequently introduced preventive modality in the sector is the employer taking prevention by himself (13.6%) whilst other sectors are mainly covered by External Preventive Services (43%). Conclusions: If Transport branch is compared with the general - reference population it shows an image in which undersized companies linked to a weak development of preventive network could be determinant to their lowest preventive activities. Also we find a better self perceived health related to a better access to preventive activities.[EN] Goals: To identify the most prevalent resources and preventive activities in professional long-haul drivers andtheir peculiarities related to the other Spanish production branches.Methodology: We develop a descriptive analysis ofdata from the Survey of Health and Working Conditions inprofessional truck drivers and we compare these resultswith the other Spanish production branches through the VNational Survey on Working Conditions. The statistical analysis applied T-Student test and the Ji square. Results: In this branch 77% of companies have less than 50 employees. 41% of drivers referred that it does not exist the "Delegado de Prevención" (workers representative) in their companies and 25% that there is not any Preventive Action. It is specially relevant the unknowledge among drivers about preventive resources in their companies (34.3%). The most frequently introduced preventivemodality in the sector is the employer taking prevention by himself (13.6%) whilst other sectors are mainly covered by External Preventive Services (43%). Conclusions: If Transport branch is compared with the general - reference population it shows an image in which undersized companies linked to a weak development of preventive network could be determinant to their lowest preventive activities. Also we find a better self perceived health related to a better access to preventive activitiesS

Enhancing physicians’ radiology diagnostics of COVID-19’s effects on lung health by leveraging artificial intelligence

Introduction: This study aimed to develop an individualized artificial intelligence model to help radiologists assess the severity of COVID-19’s effects on patients’ lung health.Methods: Data was collected from medical records of 1103 patients diagnosed with COVID-19 using RT- qPCR between March and June 2020, in Hospital Madrid-Group (HM-Group, Spain). By using Convolutional Neural Networks, we determine the effects of COVID-19 in terms of lung area, opacities, and pulmonary air density. We then combine these variables with age and sex in a regression model to assess the severity of these conditions with respect to fatality risk (death or ICU).Results: Our model can predict high effect with an AUC of 0.736. Finally, we compare the performance of the model with respect to six physicians’ diagnosis, and test for improvements on physicians’ performance when using the prediction algorithm.Discussion: We find that the algorithm outperforms physicians (39.5% less error), and thus, physicians can significantly benefit from the information provided by the algorithm by reducing error by almost 30%

A Predictive Model and Risk Factors for Case Fatality of COVID-19

This study aimed to create an individualized analysis model of the risk of intensive care unit (ICU) admission or death for coronavirus disease 2019 (COVID-19) patients as a tool for the rapid clinical management of hospitalized patients in order to achieve a resilience of medical resources. This is an observational, analytical, retrospective cohort study with longitudinal follow-up. Data were collected from the medical records of 3489 patients diagnosed with COVID-19 using RT-qPCR in the period of highest community transmission recorded in Europe to date: February-June 2020. The study was carried out in in two health areas of hospital care in the Madrid region: the central area of the Madrid capital (Hospitales de Madrid del Grupo HM Hospitales (CH-HM), n = 1931) and the metropolitan area of Madrid (Hospital Universitario Príncipe de Asturias (MH-HUPA) n = 1558). By using a regression model, we observed how the different patient variables had unequal importance. Among all the analyzed variables, basal oxygen saturation was found to have the highest relative importance with a value of 20.3%, followed by age (17.7%), lymphocyte/leukocyte ratio (14.4%), CRP value (12.5%), comorbidities (12.5%), and leukocyte count (8.9%). Three levels of risk of ICU/death were established: low-risk level (20%). At the high-risk level, 13% needed ICU admission, 29% died, and 37% had an ICU-death outcome. This predictive model allowed us to individualize the risk for worse outcome for hospitalized patients affected by COVID-19

Enhancing physicians’ radiology diagnostics of COVID-19’s effects on lung health by leveraging artificial intelligence

Introduction: This study aimed to develop an individualized artificial intelligence model to help radiologists assess the severity of COVID-19's effects on patients' lung health.Methods: Data was collected from medical records of 1103 patients diagnosed with COVID-19 using RT- qPCR between March and June 2020, in Hospital Madrid-Group (HM-Group, Spain). By using Convolutional Neural Networks, we determine the effects of COVID-19 in terms of lung area, opacities, and pulmonary air density. We then combine these variables with age and sex in a regression model to assess the severity of these conditions with respect to fatality risk (death or ICU).Results: Our model can predict high effect with an AUC of 0.736. Finally, we compare the performance of the model with respect to six physicians' diagnosis, and test for improvements on physicians' performance when using the prediction algorithm.Discussion: We find that the algorithm outperforms physicians (39.5% less error), and thus, physicians can significantly benefit from the information provided by the algorithm by reducing error by almost 30%

An Updated Review of SARS-CoV-2 Vaccines and the Importance of Effective Vaccination Programs in Pandemic Times

first_pagesettingsOrder Article Reprints Open AccessReview An Updated Review of SARS-CoV-2 Vaccines and the Importance of Effective Vaccination Programs in Pandemic Times by Cielo García-Montero 1ORCID,Oscar Fraile-Martínez 1,Coral Bravo 2,3,4,Diego Torres-Carranza 5,Lara Sanchez-Trujillo 1,6ORCID,Ana M. Gómez-Lahoz 1,Luis G. Guijarro 7,Natalio García-Honduvilla 1,8,Angel Asúnsolo 8,9ORCID,Julia Bujan 1,8ORCID,Jorge Monserrat 1,8ORCID,Encarnación Serrano 10,Melchor Álvarez-Mon 1,8,11,Juan A De León-Luis 3,4,5,*ORCID,Miguel A. Álvarez-Mon 1,8,12ORCID andMiguel A. Ortega 1,8,13ORCID 1 Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain 2 Department of Public and Maternal and Child Health, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain 3 Department of Obstetrics and Gynecology, University Hospital Gregorio Marañón, 28009 Madrid, Spain 4 Health Research Institute Gregorio Marañón, 28009 Madrid, Spain 5 First of May Health Centre, Health Area I, Rivas Vaciamadrid, 28521 Madrid, Spain 6 Service of Pediatric, Hospital Universitario Principe de Asturias, 28801 Alcalá de Henares, Spain 7 Unit of Biochemistry and Molecular Biology (CIBEREHD), Department of System Biology, University of Alcalá, 28801 Alcalá de Henares, Spain 8 Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain 9 Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain 10 Los fresnos of Health Centre, Health Area III, Torrejon de Ardoz, 28850 Madrid, Spain add Show full affiliation list * Author to whom correspondence should be addressed. Vaccines 2021, 9(5), 433; https://doi.org/10.3390/vaccines9050433 Received: 9 April 2021 / Revised: 21 April 2021 / Accepted: 22 April 2021 / Published: 27 April 2021 (This article belongs to the Special Issue Unraveling SARS-CoV-2 Pathogenesis: Development of Vaccines and Therapeutics for COVID-19) Download Browse Figures Versions Notes Abstract Since the worldwide COVID-19 pandemic was declared a year ago, the search for vaccines has become the top priority in order to restore normalcy after 2.5 million deaths worldwide, overloaded sanitary systems, and a huge economic burden. Vaccine development has represented a step towards the desired herd immunity in a short period of time, owing to a high level of investment, the focus of researchers, and the urge for the authorization of the faster administration of vaccines. Nevertheless, this objective may only be achieved by pursuing effective strategies and policies in various countries worldwide. In the present review, some aspects involved in accomplishing a successful vaccination program are addressed, in addition to the importance of vaccination in a pandemic in the face of unwillingness, conspiracy theories, or a lack of information among the public. Moreover, we provide some updated points related to the landscape of the clinical development of vaccine candidates, specifically, the top five vaccines that are already being assessed in Phase IV clinical trials (BNT162b2, mRNA-1273, AZD1222, Ad26.COV2.S, and CoronaVac)

Chronic Venous Disease in Pregnant Women Causes an Increase in ILK in the Placental Villi Associated with a Decrease in E-Cadherin

Chronic venous disease (CVD) is a multifactorial vascular disorder frequently manifested in lower limbs in the form of varicose veins (VVs). Women are a vulnerable population for suffering from CVD, especially during pregnancy, when a plethora of changes occur in their cardiovascular system. Previous studies have indicated a worrisome association between CVD in pregnancy with the placental structure and function. Findings include an altered cellular behavior and extracellular matrix (ECM) composition. Integrin-linked kinase (ILK) is a critical molecule involved in multiple physiological and pathological conditions, and together with cadherins, is essential to mediate cell to ECM and cell to cell interplay, respectively. Thus, the aim of this study was to evaluate the implication of ILK and a set of cadherins (e-cadherin, cadherin-6 and cadherin-17) in placentas of women with CVD in order to unravel the possible pathophysiological role of these components. Gene expression (RT-qPCR) and protein expression (immunohistochemistry) studies were performed. Our results show a significant increase in the gene and protein expression of ILK, cadherin-6 and cadherin-17 and a decrease of e-cadherin in the placenta of women with CVD. Overall, this work shows that an abnormal expression of ILK, e-cadherin, cadherin-6 and cadherin-17 may be implicated in the pathological changes occurring in the placental tissue. Further studies should be conducted to determine the possible associations of these changes with maternal and fetal well-being

EDUCORE project: a clinical trial, randomised by clusters, to assess the effect of a visual learning method on blood pressure control in the primary healthcare setting

<p>Abstract</p> <p>Background</p> <p>High blood pressure (HBP) is a major risk factor for cardiovascular disease (CVD). European hypertension and cardiology societies as well as expert committees on CVD prevention recommend stratifying cardiovascular risk using the SCORE method, the modification of lifestyles to prevent CVD, and achieving good control over risk factors. The EDUCORE (Education and Coronary Risk Evaluation) project aims to determine whether the use of a cardiovascular risk visual learning method - the EDUCORE method - is more effective than normal clinical practice in improving the control of blood pressure within one year in patients with poorly controlled hypertension but no background of CVD;</p> <p>Methods/Design</p> <p>This work describes a protocol for a clinical trial, randomised by clusters and involving 22 primary healthcare clinics, to test the effectiveness of the EDUCORE method. The number of patients required was 736, all between 40 and 65 years of age (n = 368 in the EDUCORE and control groups), all of whom had been diagnosed with HBP at least one year ago, and all of whom had poorly controlled hypertension (systolic blood pressure ≥ 140 mmHg and/or diastolic ≥ 90 mmHg). All personnel taking part were explained the trial and trained in its methodology. The EDUCORE method contemplates the visualisation of low risk SCORE scores using images embodying different stages of a high risk action, plus the receipt of a pamphlet explaining how to better maintain cardiac health. The main outcome variable was the control of blood pressure; secondary outcome variables included the SCORE score, therapeutic compliance, quality of life, and total cholesterol level. All outcome variables were measured at the beginning of the experimental period and again at 6 and 12 months. Information on sex, age, educational level, physical activity, body mass index, consumption of medications, change of treatment and blood analysis results was also recorded;</p> <p>Discussion</p> <p>The EDUCORE method could provide a simple, inexpensive means of improving blood pressure control, and perhaps other health problems, in the primary healthcare setting;</p> <p>Trial registration</p> <p>The trial was registered with ClinicalTrials.gov, number NCT01155973 [<url>http://ClinicalTrials.gov</url>].</p

Semicircular lipoatrophy: a sistematic review of the literature

Artículos originales[ES ]Introducción: La lipoatrofia semicircular (LS) es un trastorno benigno del tejido subcutáneo, de causa desconocida. Se caracteriza por depresiones semicirculares en la cara anterolateral de los muslos, unilaterales o bilaterales. Se relaciona con condiciones ambientales laborales, microtraumas repetidos y factores personales. Se plateó esta revisión sistemática de la literatura científica para caracterizar el conocimiento existente. Métodos: Revisión sistemática. Bases de datos: IBECS, IBSST, LILACS, IME, OSH-UPDATE, ISI-WOK, PubMed, CIS-DOC y Cochrane. Se incluyeron los artículos sobre lipoatrofia semicircular relacionada con condiciones de trabajo y medioambientales. Se utilizaron los niveles de evidencia científica del Scottish Intercollegiate Guidelines Network. Resultados: Se recuperaron 66 artículos. Solo 22 cumplieron los criterios de inclusión: Quince con nivel de evidencia 3 y 7 con nivel 4. Siete estudios de series de casos y ocho de casos únicos, sumaron 838 casos, informados entre 1982-2010. Los principales factores de riesgo para LS son: Microtraumas repetidos, humedad relativa baja y electricidad en los edificios modernos de oficinas. Las depresiones semicirculares ocurren en la cara anterolateral de muslos, sin alteración de la piel, en mujeres (85%), sin signos inflamatorios con histopatología inespecífica. La resonancia magnética, radiología y los anticuerpos antinucleares son negativos. El diagnóstico es clínico, apoyado con ecografía. El tratamiento psicológico y fisioterapia pueden ser útiles. Las medidas preventivas de mayor impacto son controlar los factores mencionados. Conclusiones: Existe insuficiente evidencia científica sobre las causas de LS. Es un trastorno prevalente, que genera alarma, relacionado con las condiciones de trabajo. Es necesario continuar la investigación sobre agentes causales. [EN] Introduction: The semicircular lipoatrophy (LS) is a benign disorder of the subcutaneous tissue with unkvown cause. It is characterized by unilateral o bilateral semicircular depressions in the anterolateral side of the thighs. It is related to environmental labor conditions, repeated microtraumas and personal factors. We conducted this systematic review of the scientific literature to characterize the existing knowledge. Methods: Systematic Review. Databases: IBECS, IBSST, LILACS, IME, OSH-UPDATE, ISI-WOK, PubMed, CIS-DOC and Cochrane. We included articles about semicircular lipoatrophy related to working and environmental conditions. We used the levels of scientific evidence of the Scottish Intercollegiate Guidelines Network. Results: 66 articles were recovered. Only 22 fulfilled the inclusion criteria: Fifteen with evidence level 3 and 7 with evidence level 4. Seven studies were series of cases and 8 were unique case reports. All of them added 838 cases, informed between 1982-2010. The principal risk factors for LS are repetitive microtrauma, low relative humidity and electricity in modern office buildings. The semicircular depressions occur in the anterolateral side of thighs, without alteration of the skin and muscles, mostly in women (85%), without inflammatory signs and with unspecific histopathology. The magnetic resonance, x rays and the antinuclear antibodies are negative. The diagnosis is clinical, supported by ultrasonography. Psychological treatment and physical therapy can be useful. The preventive measures of greater impact are controlling risk factors. Conclusions: Insufficient scientific evidence exists about the causes of LS. It is a prevalent disorder that generates alarm, related to workplace conditions. It is necessary to continue investigating about causative agents.N

SYSTEMATIC REVIEW AND META-ANALYSIS OF INCIDENCE AND PREVALENCE OF ENDOMETRIOSIS

There is still much controversy regarding the epidemiology of endometriosis. The objective of this work is to conduct a systematic review, and if possible, proceed with a meta-analysis of studies that have analyzed the incidence and prevalence of this condition among women in the general population. The inclusion criteria were papers published after 1997 that had reported data of the incidence or prevalence of endometriosis. The PubMed search engine was used to identify papers meeting the inclusion criteria from 1997 to 2019, with an additional manual search for the identification of potentially eligible studies. The search was limited to papers published in English. The risk of bias was assessed according to the Joanna Briggs Institute Critical Appraisal Checklist...

Systematic Review and Meta-Analysis of Incidence and Prevalence of Endometriosis

There is still much controversy regarding the epidemiology of endometriosis. The objective of this work is to conduct a systematic review, and if possible, proceed with a meta-analysis of studies that have analyzed the incidence and prevalence of this condition among women in the general population. The inclusion criteria were papers published after 1997 that had reported data of the incidence or prevalence of endometriosis. The PubMed search engine was used to identify papers meeting the inclusion criteria from 1997 to 2019, with an additional manual search for the identification of potentially eligible studies. The search was limited to papers published in English. The risk of bias was assessed according to the Joanna Briggs Institute Critical Appraisal Checklist. As a result, 27 papers, which included a total of 28,660,652 women, were classified according to the type of design and sources of information in five subgroups. Pooled estimates of prevalence for studies with self-reported data were 0.05 (95% CI: 0.03; 0.06), 0.01 for population-based integrated information systems (95% CI: 0.01; 0.02), and 0.04 (95% CI 0.04; 0.05) in studies using other designs. The pooled incidence rate of endometriosis was: 1.36 per 1000 person-years (PY) (95% CI: 1.09; 1.63) for studies based on hospital discharges, 3.53 per 1000 PY (95% CI: 2.06; 4.99) for cohort studies, and 1.89 per 1000 PY (95% CI: 1.42; 2.37) for population-based integrated information systems. Meta-analysis indicated high heterogeneity based on I-squared statistics. This significant variability may not only be due to methodological issues and the specific limitations of the different designs and data analyzed, including case definitions and subject selection strategies, but also to the inherent heterogeneity of endometriosis. Epidemiological studies with appropriate study designs remain necessary to provide a valid estimation of the population burden of endometriosis