Bibliometric Study of Technology and Occupational Health in Healthcare Sector: A Worldwide Trend to the Future

Since the eighties, technological tools have modified how people interact in their environment. At the same time, occupational safety and health measures have been widely applied. The European Agency for Safety and Health at Work considers that information and communication technologies are the main methods to achieve the goals proposed to improve working life and the dissemination of good practices. The principal objective was to determine the trends of publications focused on these technologies and occupational safety in the healthcare sector during the last 30 years. A bibliometric study was carried out. The 1021 documents showed an increased trend per country, especially for the United States (p < 0.001) and year (p < 0.001). The citations per year showed significant differences between citations of articles published before 2007 (p < 0.001). The year was also linked to the increase or decrease of articles (72.2%) and reviews (14.9%) (p < 0.001). The analysis of journal co-citations also showed that the main journals (such as Infection Control and Hospital Epidemiology) were linked to other important journals and had a major part in the clusters formed. All these findings were discussed in the manuscript and conclusions were drawn

Tuberculosis and Other Airborne Microbes in Occupational Health and Safety

Airborne pathogens and non-malignant infectious diseases such as tuberculosis are highly contagious and can have severe effects on healthcare workers. The symptoms of these diseases take time to manifest, which can prevent workers from noticing that they have been exposed until symptoms appear. The current paper sought to assess the occupational safety and preventative measures taken in laboratories in Spain, and to compare these measures with those reported by other studies worldwide. A cross-sectional study of workers (35–50 years old) was conducted using a web survey (N = 30), and a bibliometric analysis was carried out in the Scopus database (92 documents were selected). The occupational safety and health measures were inadequate, according to the opinions of the workers. The training (p < 0.01), the amount of work (p < 0.05), and how the workers followed their protocols (p < 0.001) were linked to incidents and exposure to airborne pathogens. The most significant previous publication was a report (848 citations) stating that the previous variables linked to exposure are vital for prevention. Most works focused on countries like the U.S.A. (p = 0.009) were reviews, with a limited number of studies focused on occupational safety

Occupational Safety and Health Training for Undergraduates Nursing Students: A Spanish Pilot

Most of blood borne and airborne pathogens are highly contagious, harmful and have prevalence among healthcare workers. In this group, healthcare students, especially nursing undergraduates, have even higher risk to be exposed and suffered a contagious accident. One of the main pillars to prevent exposure to such pathogens and decrease accidents seems to be through education. A prospective observational educational research focused on quantifying the students’ knowledge, and prevention culture was carried out. The educational approach based on the development of a technological tool, its integration in the students’ education, and posterior assessment. The Chi-square, ANOVA, Kruskal–Wallis, Man–Whitney U, and Spearman correlations were used to determine the effect of such educational methodology. The results, previous to the integration of the educational approach, showed differences between the elementary and proficient knowledge and correct procedure in each academic year (p < 0.05), being the best year the third academic year. The mean of elementary knowledge among second year students after the inclusion of the educational methodology improved for 2017/2018 with a mean of 7.5 (1.11) and in 2018/2019 with 7.87 (1.34). This study argued that the educational approach proposed could improve the prevention culture and knowledge among students and future healthcare professionals

Valorization of discarded red beetroot through the recovery of bioactive compounds and the production of pectin by surfactant-assisted microwave extraction

Producción CientíficaDiscarded red beetroot (DRB) is an organic waste generated in the food industry. This study is focused on the valorization of DRB through the recovery of bioactive compounds. The characterization of the DRB juice confirmed a higher content of antioxidants (DPPH 504 ± 24 μmol TE/L, FRAP 10920 ± 440 μmol TE/L, ABTS 22012 ± 592 μmol TE/L), phenolic compounds (1789 ± 56 mg GAE/L), flavonoids (471 ± 17 mg CE/L) and betalains (1426 ± 24 mg/L) than commercial juices. DRB pomace contains pectin that was recovered by microwave extraction aided by a surfactant (polyethylene glycol, PEG4000). Conditions (temperature, time and surfactant concentration) for the extraction of galacturonic acid (GalA) or pectooligosaccharides (POS) were optimized by a central composite experimental design. POS were extracted at high temperatures (160 °C, 5.3 min, 8.4 g PEG4000/L, yield of 271.2 g POS/kg dry pomace). In comparison, galacturonic acid extraction was favored at moderate conditions (137 °C, 5 min, 2.5 g PEG4000/L, yield of 120.1 g GalA/kg dry pomace). The characterization of the freeze-dried hydrolysates revealed that the solid obtained under moderate temperature conditions (137 °C) showed a higher GalA content (49.5%) and lower neutral sugars (11.4%), as GalA degrades at lower temperatures than pentoses. The recovered pectin can be considered high-methoxyl pectin, as the degree of esterification was higher than 50%. FTIR spectra of the freeze-dried hydrolysates showed functional groups consistent with pectin. MALDI-TOF-MS analysis revealed the presence of oligosaccharides of hexoses and pentoses with different structures and degrees of polymerization. Thus, DRB, a low-value vegetable waste, can be converted into high-value-added bioproducts in a biorefinery framework.Ministerio de Ciencia e Innovación (proyect PID2020-115110RB-I00/AEI/10.13039/501100011033)Junta de Castilla y León (UIC 320, VAG028G19, CLU-2017-09) and grant (REF EDU/875/2021

Enhancement of industrial pectin production from sugar beet pulp by the integration of surfactants in ultrasound-assisted extraction followed by diafiltration/ultrafiltration

Producción CientíficaTo recover industrial pectin from sugar beet pulp (SBP), a combined surfactant and ultrasound-assisted extrac- tion, followed by a concentration with ultrafiltration/diafiltration membranes is proposed. First, the operation conditions of the extraction were optimized for synthetic (Tween80, PEG4000) and natural (Saponin) surfac- tants. Tween 80 and Saponin provided maximum galacturonic acid (GalA) concentrations (5.5 and 5.8 g/L, respectively) under the best extraction conditions (4 gsurfactant/L, pH = 1, amplitude = 90%, and time = 90 min). The extracted liquid was purified and concentrated through membranes. The final retentate maintained 73% of the initial GalA and eliminated a high percentage of oligosaccharides. Finally, the pectin was precipitated with ethanol, and the precipitate solid contained 57 g GalA/100 g GalA of SBP with a high degree of esterification (DE = 81%) and MW (930 kDa). The pectin yield for the global process was 24.6%. The ultrasound-assisted extraction with surfactants followed by diafiltration/ultrafiltration could become a promising process for the chemical industry, able to provide pectin-enriched products of commercial interest from sugar beet pulp.Ministerio de Ciencia e Innovación (Proyecto PID2020–115110RB-I00/ AEI/10.13039/501100011033)Junta de Castilla y León (UIC 320, VAG028G19, CLU-2017–09, CL-EI-2021–07)Junta de Castilla y Leon (postdoctoral grant E-47–2019-0114592

Spanish adaptation and validation of the ALS Depression Inventory-12 (ADI-12) in patients with Amyotrophic Lateral Sclerosis

Background. Patients with Amyotrophic Lateral Sclerosis (ALS) have a higher prevalence of mood disorders, including depression, than the general population. Non-specific measurement instruments have been used to evaluate depression in these patients, which complicates accurate diagnosis. The ALS Depression Inventory (ADI-12) exclusively assesses depressive symptoms in patients with ALS. Aim. To adapt and validate the ADI-12 in a Spanish sample. Methods. A selective design was used with 74 patients with ALS, using the ADI-12 questionnaire. The original instrument was translated and back-translated into Spanish. The internal structure, temporal stability, convergent, and discriminant validity of the instrument were analyzed. Results. Two confirmatory models showed internal validity (p = 0.502 for the one-factor model, p = 0.507 for the two-factor model). The Cronbach's alpha (0.900 in the first measurement and 0.889 in the second one) indicated a high internal consistency of the test. The Pearson correlation (0.90) indicated high temporal stability. In terms of convergent validity, the ADI-12 showed moderate correlations with the Beck Anxiety Inventory (BAI) (0.51-0.58), and low correlations with time since ALS diagnosis (-0.26 to-0.27). Limitations. The main limitation of the present study was the small sample size. Conclusions. The ADI-12 is fitted to a single general factor of depression, and the scale shows high internal consistency and high temporal stability, therefore, its use is recommended for the diagnosis of depression in patients with ALS.This study was funded by the Catholic University of Va- lencia San Vicente Mártir (grant 2021-203-003 ).Medicin

Frequency of hereditary transthyretin amyloidosis among elderly patients with transthyretin cardiomyopathy

Transthyretin amyloid cardiomyopathy (ATTR-CM) is increasingly recognized as a cause of heart failure in the elderly. Although wild-type transthyretin amyloidosis is the most frequent form of ATTR-CM found in the elderly, hereditary transthyretin amyloidosis (ATTRv) can also occur. We sought to determine the prevalence of ATTRv among elderly ATTR-CM patients, identify predictors of ATTRv and evaluate the clinical consequences of positive genetic testing in this population. Prevalence of ATTRv in elderly ATTR-CM patients (≥70 years) was assessed in a cohort of 300 consecutive ATTR-CM patients (median age 78 years at diagnosis, 82% ≥70 years, 16% female, 99% Caucasian). ATTRv was diagnosed in 35 (12%; 95% confidence interval [CI] 3.1–8.8) and 13 (5.3%; 95% CI 5.6–26.7) patients in the overall cohort and in those ≥70 years, respectively. Prevalence of ATTRv among elderly female patients with ATTR-CM was 13% (95% CI 2.1–23.5). Univariate analysis identified female sex (odds ratio [OR] 3.66; 95% CI 1.13–11.85; p = 0.03), black ancestry (OR 46.31; 95% CI 3.52–Inf; p = 0.005), eye symptoms (OR 6.64; 95% CI 1.20–36.73; p = 0.03) and polyneuropathy (OR 10.05; 95% CI 3.09–32.64; p<0.001) as the only factors associated with ATTRv in this population. Diagnosis of ATTRv in elderly ATTR-CM patients allowed initiation of transthyretin-specific drug treatment in 5 individuals, genetic screening in 33 relatives from 13 families, and identification of 9 ATTRv asymptomatic carriers. Hereditary transthyretin amyloidosis is present in a substantial number of ATTR-CM patients aged ≥70 years. Identification of ATTRv in elderly patients with ATTR-CM has clinical meaningful therapeutic and diagnostic implications. These results support routine genetic testing in patients with ATTR-CM regardless of ageThis study has been funded by Instituto de Salud Carlos III (ISCIII) through the projects ‘PI18/0765 & PI20/01379’ (co-funded by European Regional Development Fund/European Social Fund ‘A way to make Europe’/‘Investing in your future’). AMB receives grant support by ISCIII (CM20/002209). The CNIC is supported by the ISCIII, MCIN, the Pro-CNIC Foundation, and the Severo Ochoa grant (CEX2020-001041-S

Influence of renal dysfunction on the differential behaviour of procalcitonin for the diagnosis of postoperative infection in cardiac surgery

Producción CientíficaBackground: procalcitonin is a valuable marker in the diagnosis of bacterial infections; however, the impairment of renal function can influence its diagnostic precision. The objective of this study is to evaluate the differential behaviour of procalcitonin, as well as its usefulness in the diagnosis of postoperative pulmonary infection after cardiac surgery, depending on the presence or absence of impaired renal function. Materials and methods: A total of 805 adult patients undergoing cardiac surgery with extracorporeal circulation (CBP) were prospectively recruited, comparing the behaviour of biomarkers between the groups with and without postoperative pneumonia and according to the presence or absence of renal dysfunction. Results: Pulmonary infection was diagnosed in 42 patients (5.21%). In total, 228 patients (28.32%) presented postoperative renal dysfunction. Procalcitonin was significantly higher in infected patients, even in the presence of renal dysfunction. The optimal procalcitonin threshold differed markedly in patients with renal dysfunction compared to patients without renal dysfunction (1 vs. 0.78 ng/mL p < 0.05). The diagnostic accuracy of procalcitonin increased significantly when the procalcitonin threshold was adapted to renal function. Conclusions: Procalcitonin is an accurate marker of postoperative infection in cardiac surgery, even in the presence of renal dysfunction. Renal function is an important determinant of procalcitonin levels and, therefore, its diagnostic thresholds must be adapted in the presence of renal dysfunction.Instituto de Salud Carlos III - (grant COV20/00491, PI18/01238, CIBERINFEC CB21/13/00051)Junta de Castilla y León - (grant VA321P18, GRS 1922/A/19, GRS 2057/A/19)Junta de Castilla y León, Consejería de Educación - (grant VA256P20)Fundación Ramón Areces - (grant CIVP19A5953)Instituto de Salud Carlos III y Fondo Europeo de Desarrollo Regional (FEDER)/Fondo Social Europeo - (grant CM20/00138

A 3’-UTR polymorphism in soluble epoxide hydrolase gene Is associated with acute rejection in renal transplant recipients

Antecedentes y finalidad: Los ácidos epoxyeicosatrienoic (EETs) son metabolitos del ácido araquidónico que desempeñan una función protectora contra procesos perjudiciales que pueden ocurrir después de re-oxigenación del injerto. Decidimos investigar si la presencia de polimorfismos funcionales en el gen que codifica el epóxido hidrolasa soluble (EPHX2), que metaboliza EETs a menos compuestos activos, pueden jugar un papel importante en el resultado del trasplante renal. Métodos En un grupo de 259 receptores caucásicos de trasplante renal y 183 donantes fallecidos, se determinó la presencia de tres EPHX2 común, a saber, los SNPs rs41507953 (K55R), rs751141 (R287Q) y rs1042032 A/G. Las asociaciones con los parámetros de la función del injerto y la incidencia de rechazo agudo fueron investigados retrospectivamente durante el primer año después del injerto mediante regresión logística, ajustándose a las variables clínicas y demográficas. Resultados Los portadores del genotipo rs1042032 GG muestran significativamente menor tasa de filtración glomerular estimada (eGFR) (38.15 ± 15.57 vs. 45.99 ± 16.05; p = 0,04) y mayores valores de creatinina sérica (1,57 ± 0,58 vs. 1,30 ± 0,47 g/dL; p=0.02) un año después del injerto, en comparación con los pacientes portadores del alelo A wildtype. El mismo genotipo GG también se asoció a un mayor riesgo de rechazo agudo. Curiosamente, esta asociación fue observada por el genotipo de ambos destinatarios [o =6.34 (1.35-29.90); p = 0,015] y donantes [OR = 5.53 (1.10 - 27.80); p=0,042]. Un modelo estadístico incluyendo ambos genotipos junto con otras variables demográficas y clínicas significativas se tradujo en un aumento de la importancia de la asociación con los receptores del genotipo [OR=8,28 (1.21-74.27); p=0,031]. Conclusiones Nuestros resultados indican que la variabilidad genética en el gen metabolizante de EETs, EPHX2, pueden tener un impacto significativo en los resultados del trasplante renal de donante fallecido.Background and Purpose: Epoxyeicosatrienoic acids (EETs) are arachidonic acid metabolites that play a protective role against damaging processes that may occur after re-oxygenation of the graft. We aimed to investigate whether the presence of functional polymorphisms in the gene encoding soluble epoxy hydrolase (EPHX2), which metabolizes EETs to less active compounds, may play a role in the outcome of renal transplantation. Methods In a group of 259 Caucasian renal transplant recipients and 183 deceased donors, we determined the presence of three common EPHX2 SNPs, namely rs41507953 (K55R), rs751141 (R287Q) and rs1042032 A/G. Associations with parameters of graft function and the incidence of acute rejection were retrospectively investigated throughout the first year after grafting by logistic regression adjusting for clinical and demographic variables. Results Carriers of the rs1042032 GG genotype displayed significantly lower estimated glomerular filtration rate (eGFR) (38.15 ± 15.57 vs. 45.99 ± 16.05; p = 0.04) and higher serum creatinine values (1.57 ± 0.58 vs. 1.30 ± 0.47 g/dL; p=0.02) one year after grafting, compared to patients carrying the wildtype A-allele. The same GG genotype was also associated to increased risk of acute rejection. Interestingly, this association was observed for the genotype of both recipients [OR =6.34 (1.35-29.90); p = 0.015] and donors [OR = 5.53 (1.10- 27.80); p=0.042]. A statistical model including both genotypes along with other meaningful demographic and clinical variables resulted in an increased significance for the association with the recipients’ genotype [OR=8.28 (1.21-74.27); p=0.031]. Conclusions Our results suggest that genetic variability in the EETs-metabolizing gene, EPHX2, may have a significant impact on the outcome of deceased-donor renal transplantation.• Asociación para el Estudio y la Prevención de las Enfermedades Renales (ASEPER), Badajoz • Junta de Extremadura, Consejería de Economía, Comercio e Innovación: Proyecto GR10022 • Red de Investigación Renal - REDINREN (Instituto de Salud Carlos III – Fondo Europeo de Desarrollo Regional – FEDER) : Ayudas a Eliecer Coto García, Carmen Díaz Corte y Carlos López LarreapeerReviewe

El estudio PROPRESE: resultados de un nuevo modelo organizativo en atención primaria para pacientes con cardiopatía isquémica crónica basado en una intervención multifactorial

ResumenObjetivoComparando los resultados obtenidos en los estudios EUROASPIRE I y EUROASPIRE III en pacientes con cardiopatía isquémica se muestra que el grado de control de los factores de riesgo mayores es mejorable. El objetivo de este estudio es evaluar la eficacia de una intervención multifactorial orientada a la mejora del grado de control en estos pacientes en el ámbito de la atención primaria.MétodosEn este estudio de intervención aleatorizado, con 1 año de seguimiento, se reclutó a pacientes con diagnóstico de cardiopatía isquémica (145 en el grupo de intervención y 1.461 en el grupo control). Se aplicó una intervención organizativa mixta basada en la mejora de la relación profesional sanitario-paciente (de acuerdo a los modelos del Chronic Care, el Stanford Expert Patient Programme y el Kaiser Permanente) y en la formación profesional continuada. Los principales resultados fueron el efecto sobre el tabaquismo, el colesterol unido a lipoproteínas de baja densidad (cLDL), la presión arterial sistólica (PAS) y la presión arterial diastólica (PAD) a través de un análisis multivariable.ResultadosLas características de los pacientes fueron: edad (68,4±11,8 años), varones (71,6%), diabetes mellitus (51,3%), dislipemia (68,5%), hipertensión arterial (76,7%), no fumadores (76,1%); cLDL < 100mg/dl (46,9%); PAS < 140mmHg (64,5%); PAD < 90 (91,2%). El análisis multivariable mostró que el riesgo para el buen control en el grupo de intervención fue tabaquismo, riesgo relativo ajustado (RRa): 15,7 (intervalo de confianza del 95% [IC95%], 4,2–58,7); p < 0,001; cLDL, RRa: 2,98 (IC95%, 1,48–6,02); p < 0,002; PAS, RRa: 1.97 (IC95%, 1,21–3,23); p < 0,007, y PAD; RRa: 1,51 (IC95%, 0,65–3,50); p < 0,342.ConclusionesUna intervención multifactorial basada en el modelo de paciente crónico centrada en atención primaria y que facilite la toma de decisiones compartidas con los pacientes y la formación de los profesionales mejora el grado de control de los factores de riesgo cardiovascular (tabaquismo, cLDL y PAS). Las estrategias de mejora en la atención de la cronicidad pueden ser una herramienta eficaz para conseguir mejores resultados.AbstractObjectiveComparison of the results from the EUROASPIRE I to the EUROASPIRE III, in patients with coronary heart disease, shows that the prevalence of uncontrolled risk factors remains high. The aim of the study was to evaluate the effectiveness of a new multifactorial intervention in order to improve health care for chronic coronary heart disease patients in primary care.MethodsIn this randomized clinical trial with a 1-year follow-up period, we recruited patients with a diagnosis of coronary heart disease (145 for the intervention group and 1461 for the control group). An organizational intervention on the patient-professional relationship (centered on the Chronic Care Model, the Stanford Expert Patient Programme and the Kaiser Permanente model) and formative strategy for professionals were carried out. The main outcomes were smoking control, low-density lipoprotein cholesterol (LDL-C), systolic blood pressure (SBP) and diastolic blood pressure (DBP). A multivariate analysis was performed.ResultsThe characteristics of patients were: age (68.4±11.8 years), male (71.6%), having diabetes mellitus (51.3%), dyslipidemia (68.5%), arterial hypertension (76.7%), non-smokers (76.1%); LDL-C < 100mg/dL (46.9%); SBP < 140mmHg (64.5%); DBP < 90 (91.2%). The multivariable analysis showed the risk of good control for intervention group to be: smoking, adjusted relative risk (aRR): 15.70 (95% confidence interval [95%CI], 4.2–58.7); P < .001; LDL-C, aRR: 2.98 (95%CI, 1.48–6.02); P < .002; SPB, aRR: 1.97 (95%CI, 1.21–3.23); P < .007, and DBP: aRR: 1.51 (95%CI, 0.65–3.50); P < .342.ConclusionsAn intervention based on models for chronic patients focused in primary care and involving patients in medical decision making improves cardiovascular risk factors control (smoking, LDL-C and SBP). Chronic care strategies may be an efficacy tool to help clinicians to involve the patients with a diagnosis of CHD to reach better outcomes