Covid-19 control measures and its impact on seafarers’ mental health

The appearance of COVID-19 in maritime transport has been an exceptional challenge for all stakeholders in this sector, mainly for seafarers who have been caught between the need to keep supply chains operational and the limitations imposed by administrations to prevent the spread of the virus. With these objectives in mind, international institutions and organizations have developed a long series of regulations that have emerged in parallel with the measures established to control the pandemic. This article compiles the recommendations and regulations on health management established for this sector, as well as the implications of this entire process on fatigue and stress in seafarers.  Issues such as difficulties experienced in crew changes and repatriation, extended working hours, social isolation caused by mobility limitations in ports, limited medical equipment and services available, health care restrictions in some ports, the need to quarantine, and the possibility of being infected have been reported, among others, as causes of increased fatigue and stress among seafarers, as well as an upturn in anxiety, depression and other psychiatric disorders in this group. Thus, despite the efforts of the international maritime community to regulate the problematic areas related to the outbreak of the pandemic with the aim of keeping seafarers free of coronavirus and facilitating the continuity of maritime transport, its levels of fatigue and stress have increased notably, demonstrating that these efforts have neither been sufficient nor effective regulations have been developed that specifically take into account how COVID-19 and actions aimed at the continuity of maritime transport have affected and may continue to affect seafarers’ mental health.Peer Reviewe

The impact of foot arch height on quality of life in 6-12 year olds

[Abstract] Objective To determine whether arch height has an effect on the health-related quality of life of schoolchildren. Methods One hundred and thirteen schoolchildren attended an out-patient centre where self-reported data were recorded, their feet were classified into one of three groups according to their arch index (high, normal or low) and the scores obtained from the Foot Health Status Questionnaire (FHSQ - Spanish version) were compared. Results The groups with high, low and normal arch recorded lower scores in Section One for the general foot health and footwear domains and higher scores in foot pain and foot function. In Section Two they obtained lower scores in general health and higher scores in physical activity, social capacity and vigour. Conclusions Comparison of the scores obtained reveals that arch height has a negative impact on quality of life. Given the limited extent of available evidence in respect of the aetiology and treatment of foot diseases and deformities, these findings reveal the need to implement programmes to promote foot health and carry out further research into this commonly occurring disabling condition.[Resumen] Objetivo: conocer si la altura del arco del pie tiene impacto en la calidad de vida relacionada con la salud en la etapa escolar. Métodos: ciento trece escolares acudieron a un centro ambulatorio donde se registraron datos autoinformados, se clasificaron los pies en función de los valores del índice del arco en tres grupos (aumentado, disminuido y normal) y se compararon las puntuaciones obtenidas según el Foot Health Status Questionnaire (FHSQ) versión española. Resultados: Los grupos con arco del pie aumentado, disminuido y normal muestran puntuaciones más bajas en la primera sección en las dimensiones salud del pie y calzado y puntuaciones altas en dolor y función del pie. En la segunda sección obtuvieron menos puntuación en la dimensión salud general y puntuaciones altas en función física, función social y vitalidad. Conclusiones: La comparación de las puntuaciones obtenidas muestra que la altura del arco tiene un impacto negativo en la calidad de vida. Dado que la evidencia actual sobre la etiología y el tratamiento de las enfermedades y deformidades es limitada, estos resultados ponen de manifiesto la necesidad de implementar programas para promover la salud de los pies y seguir investigando en esta condición común e incapacitante

Impacto de la altura del arco del pie en la calidad de vida, de escolares de entre 6 a 12 años

Objective: to determine whether arch height has an effect on the health-related quality of life of schoolchildren. Methods: One hundred and thirteen schoolchildren attended an out-patient centre where self-reported data were recorded, their feet were classified into one of three groups according to their arch index (high, normal or low) and the scores obtained from the Foot Health Status Questionnaire (FHSQ – Spanish version) were compared. Results: The groups with high, low and normal arch recorded lower scores in Section One for the general foot health and footwear domains and higher scores in foot pain and foot function. In Section Two they obtained lower scores in general health and higher scores in physical activity, social capacity and vigor. Conclusions: Comparison of the scores obtained reveals that arch height has a negative impact on quality of life. Given the limited extent of available evidence in respect of the aetiology and treatment of foot diseases and deformities, these findings reveal the need to implement programmes to promote foot health and carry out further research into this commonly occurring disabling condition.Objetivo: conocer si la altura del arco del pie tiene impacto en la calidad de vida relacionada con la salud en la etapa escolar. Métodos: ciento trece escolares acudieron a un centro ambulatorio donde se registraron datos autoinformados, se clasificaron los pies en función de los valores del índice del arco en tres grupos (aumentado, disminuido y normal) y se compararon las puntuaciones obtenidas según el Foot Health Status Questionnaire (FHSQ) versión española. Resultados: Los grupos con arco del pie aumentado, disminuido y normal muestran puntuaciones más bajas en la primera sección en las dimensiones salud del pie y calzado y puntuaciones altas en dolor y función del pie. En la segunda sección obtuvieron menos puntuación en la dimensión salud general y puntuaciones altas en función física, función social y vitalidad. Conclusiones: La comparación de las puntuaciones obtenidas muestra que la altura del arco tiene un impacto negativo en la calidad de vida. Dado que la evidencia actual sobre la etiología y el tratamiento de las enfermedades y deformidades es limitada, estos resultados ponen de manifiesto la necesidad de implementar programas para promover la salud de los pies y seguir investigando en esta condición común e incapacitante.S

Determination of plantar pressure in people who use orthoses of the foot

[Abstract] Objective: to know the transfer of static plantar pressures and body weight distribution through the lower limbs that occur in people with and without the use of orthoses of different densities and influence in other areas of the foot. Material and Methods: 32 people participated through non-probability convenience sampling in a quasi-experimental study in which self-reported data were recorded, the determination of plantar pressure, and body weight distribution. Results: 64 feet were studied, showing no difference between the medium pressure and the forefoot without orthoses of 5 mm and 10 mm. Decrease in average pressure and percentage of body weight, both statistically significant, with hindfoot orthoses 10 mm was observed. Conclusions: Given the current evidence for the prescribing and use of foot orthoses is limited, designed to improve the functionality and prevent the onset of disease and foot deformities, these results highlight the need to prescribe orthotics 10 mm when needed to relieve pressure on the backfoot, not seeing the average pressure increased nor diminished in other areas of the foo

Executive summary: Diagnosis and Treatment of Catheter-Related Bloodstream Infection: Clinical Guidelines of the Spanish Society of Clinical Microbiology and Infectious Diseases (SEIMC) and the Spanish Society of Intensive Care Medicine and Coronary Units (SEMICYUC)

Catheter-related bloodstream infections (CRBSI) constitute an important cause of hospital-acquired infection associated with morbidity, mortality, and cost. The aim of these guidelines is to provide updated recommendations for the diagnosis and management of CRBSI in adults. Prevention of CRBSI is excluded. Experts in the field were designated by the two participating Societies (Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica and the Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias). Short-term peripheral venous catheters, non-tunneled and long-term central venous catheters, tunneled catheters and hemodialysis catheters are covered by these guidelines. The panel identified 39 key topics that were formulated in accordance with the PICO format. The strength of the recommendations and quality of the evidence were graded in accordance with ESCMID guidelines. Recommendations are made for the diagnosis of CRBSI with and without catheter removal and of tunnel infection. The document establishes the clinical situations in which a conservative diagnosis of CRBSI (diagnosis without catheter removal) is feasible. Recommendations are also made regarding empirical therapy, pathogen-specific treatment (coagulase-negative staphylococci, Sthaphylococcus aureus, Enterococcus spp, Gram-negative bacilli, and Candida spp), antibiotic lock therapy, diagnosis and management of suppurative thrombophlebitis and local complications

Prediction of poor outcome in clostridioides difficile infection: A multicentre external validation of the toxin B amplification cycle

Producción CientíficaClassification of patients according to their risk of poor outcomes in Clostridioides difficile infection (CDI) would enable implementation of costly new treatment options in a subset of patients at higher risk of poor outcome. In a previous study, we found that low toxin B amplification cycle thresholds (Ct) were independently associated with poor outcome CDI. Our objective was to perform a multicentre external validation of a PCR-toxin B Ct as a marker of poor outcome CDI. We carried out a multicentre study (14 hospitals) in which the characteristics and outcome of patients with CDI were evaluated. A subanalysis of the results of the amplification curve of real-time PCR gene toxin B (XpertTM C. difficile) was performed. A total of 223 patients were included. The median age was 73.0 years, 50.2% were female, and the median Charlson index was 3.0. The comparison of poor outcome and non–poor outcome CDI episodes revealed, respectively, the following results: median age (years), 77.0 vs 72.0 (p = 0.009); patients from nursing homes, 24.4% vs 10.8% (p = 0.039); median leukocytes (cells/μl), 10,740.0 vs 8795.0 (p = 0.026); and median PCR-toxin B Ct, 23.3 vs 25.4 (p = 0.004). Multivariate analysis showed that a PCR-toxin B Ct cut-off <23.5 was significantly and independently associated with poor outcome CDI (p = 0.002; OR, 3.371; 95%CI, 1.565–7.264). This variable correctly classified 68.5% of patients. The use of this microbiological marker could facilitate early selection of patients who are at higher risk of poor outcome and are more likely to benefit from newer and more costly therapeutic options

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Pasados y presente. Estudios para el profesor Ricardo García Cárcel

Ricardo García Cárcel (Requena, 1948) estudió Historia en Valencia bajo el magisterio de Joan Reglà, con quien formó parte del primer profesorado de historia moderna en la Universidad Autónoma de Barcelona. En esta universidad, desde hace prácticamente cincuenta años, ha desarrollado una extraordinaria labor docente y de investigación marcada por un sagaz instinto histórico, que le ha convertido en pionero de casi todo lo que ha estudiado: las Germanías, la historia de la Cataluña moderna, la Inquisición, las culturas del Siglo de Oro, la Leyenda Negra, Felipe II, Felipe V, Austrias y Borbones, la guerra de la Independencia, la historia cultural, los mitos de la historia de España... Muy pocos tienen su capacidad para reflexionar, ordenar, analizar, conceptualizar y proponer una visión amplia y llena de matices sobre el pasado y las interpretaciones historiográficas. A su laboriosidad inimitable se añade una dedicación sin límites en el asesoramiento de alumnos e investigadores e impulsando revistas, dosieres, seminarios o publicaciones colectivas. Una mínima correspondencia a su generosidad lo constituye este volumen a manera de ineludible agradecimiento

Prevalence of Podiatric Pathologies in See Workers and Ground Workers That Use Labor Footwear

[Resumen] Objetivos: estudiar y comparar la prevalencia de patologías dermatológicas en el pie de una muestra de trabajadores del mar en relación con una muestra de trabajadores de tierra.Material y Métodos: Una muestra de 94 participantes, edad promedio 41,29 ± 10,603 años acudieron a un centro ambulatorio donde se registraron datos autoinformados, se determinaron la actividad laboral.Resultados: El grupo de trabajadores del mar mostró mayor prevalencia de fracturas (p = 0,003), tratamiento farmacológico (p = 0,003) y patologías podológicas (p = 0,013) que los trabajadores de tierra. Conclusiones: Las malas condiciones de humedad unidas al empleo del calzado de laboral genera sobre el miembro inferior un impacto negativo, provocando un aumento de prevalencia de las ciertas patologías podológicas de los trabajadores del mar en comparación con la población que no trabaja en el mar.[Abstract] Objective: the present work is to study and to compare the prevalence of dermatological pathologies in the foot of a workers' sample of the sea in relation with a workers' sample of land.Methods: A sample of 94 participants, average age 41,29 ± 10,603 years came to an ambulatory center where autoinformed information was registered, they determined the labor activity.Results: The group of workers of the sea proved to be a major prevalence of fractures (p= 0,003), pharmacological treatment (p=0,003) and podiatric pathologies (p=0,013) that the workers of landConclusions: The bad conditions of dampness joined the use of the labor footwear generate on the low member a negative impact, provoking an increase of the prevalence of certain podiatric pathologies of the workers of the sea in comparison with the population who is not employed at the sea