Condiciones de trabajo y morbilidad entre mineros del carbón en Guachetá, Cundinamarca: La mirada de los legos

Introduction: Investigations in Colombia about work and health conditions in coal mining are scarce and few have focused on the perception of the exposed population and their behaviors in response to inherent risks. Objective: To determine the association between work conditions and the perception of morbidity among coal miners in Guachetá, Cundinamarca. Materials and methods: A cross-sectional study was performed with 154 workers selected randomly from the total registered with the municipality. Information about social and demographic characteristics and work and health conditions in the mines was gathered. The prevalence was estimated for respiratory, musculoskeletal and auditory disorders. The associations between certain work conditions, and events with a prevalence over 30% were explored using bivariate and multivariate analyses with Poisson regressions with robust variance. Results: Workers were mostly men. Ages ranged from 18 to 77 years. Most frequently reported health problems were: back pain (46.1 %), pain in an upper limb (40.3%), pain in a lower limb (34.4 %), andrespiratory (17.5 %) and auditory problems (13.6 %). Significant differences in perception were found depending on time on the job and underground or ground work conditions. Conclusions: The most recognized risks were those associated with musculoskeletal disorders since they were closer in time to the work performed (time discount). Some actions to identify psychological traits are proposed in order to improve risk perception among coal miners

Além da hipótese de desigualdade de renda e influência na saúde humana: uma exploração global

OBJECTIVE: To analyze whether the relationship between income inequality and human health is mediated through social capital, and whether political regime determines differences in income inequality and social capital among countries. METHODS: Path analysis of cross sectional ecological data from 110 countries. Life expectancy at birth was the outcome variable, and income inequality (measured by the Gini coefficient), social capital (measured by the Corruption Perceptions Index or generalized trust), and political regime (measured by the Index of Freedom) were the predictor variables. Corruption Perceptions Index (an indirect indicator of social capital) was used to include more developing countries in the analysis. The correlation between Gini coefficient and predictor variables was calculated using Spearman's coefficients. The path analysis was designed to assess the effect of income inequality, social capital proxies and political regime on life expectancy. RESULTS: The path coefficients suggest that income inequality has a greater direct effect on life expectancy at birth than through social capital. Political regime acts on life expectancy at birth through income inequality. CONCLUSIONS: Income inequality and social capital have direct effects on life expectancy at birth. The "class/welfare regime model" can be useful for understanding social and health inequalities between countries, whereas the "income inequality hypothesis" which is only a partial approach is especially useful for analyzing differences within countries.OBJETIVO: Analizar si la relación entre la desigualdad la renta y la salud humana está determinada por el capital social, y si el régimen político determina la distribución de desigualdad de renta en los países. MÉTODOS: Estudio ecológico de trayectorias utilizando datos transversales de 110 países. La esperanza de vida al nacer fue la variable resultado, y la desigualdad en la renta (medida con el coeficiente de Gini), el capital social (medido por el Índice de Percepción de Corrupción o la confianza generalizada) y el régimen político (medido por el Indice de Libertad), las variables independientes. El Indice de Percepción de Corrupción (un indicador indirecto del capital social) fue usado para incluir más países en desarrollo en el análisis. Fueron calculados los coeficientes de correlación de Spearman entre el índice de Gini con las demás variables independientes. El análisis de trayectoria fue realizado para evaluar el efecto de la desigualdad de renta, de los proxys de capital social y del régimen político en la esperanza de vida. RESULTADOS: Los coeficientes de trayectoria sugieren que la desigualdad en la renta tiene un mayor impacto directo sobre la esperanza de vida al nacer que a través del capital social. El régimen político actúa sobre la esperanza de vida al nacer a través de la desigualdad en el ingreso. CONCLUSIONES: La desigualdad en la renta y el capital social tienen efectos directos sobre la esperanza de vida al nacer. El modelo de régimen de "clase/bienestar" puede ser útil para entender las desigualdades sociales y de salud entre países, mientras que la "hipótesis de desigualdad en la renta" es solo una aproximación parcial útil para analizar diferencias dentro de cada país.OBJETIVO: Analisar se a relação entre a desigualdade de renda e a saúde humana é mediada pelo capital social, assim como a influência do regime político na distribuição de renda nos países. MÉTODOS: Estudo ecológico de trajetórias utilizando dados transversais de 110 países. A variável de desfecho foi a esperança de vida ao nascer; as variáveis independentes foram: desigualdade de renda (medida pelo índice de Gini), capital social (medido pelo índice de percepção de corrupção ou confiança generalizada) e regime político (medido pelo Índice de Liberdade). O Índice de Percepção de Corrupção (um indicador indireto do capital social) foi usado para incluir mais países em desenvolvimento na análise. Foram calculados os coeficientes de correlação de Spearman entre o índice de Gini com as demais variáveis independentes. A análise de trajetória foi realizada para avaliar o efeito da desigualdade de renda, dos proxys de social capital e do regime político na expectativa de vida. RESULTADOS: Os coeficientes de trajetória sugerem que a desigualdade de renda tem maior impacto direto sobre a esperança de vida ao nascer do que por meio do capital social. O regime político atua sobre a esperança de vida ao nascer por meio da desigualdade de renda. CONCLUSÕES: A desigualdade de renda e o capital social têm efeitos diretos sobre a esperança de vida ao nascer. O modelo de regime de "classe/bem-estar" pode ser útil para entender as desigualdades sociais e de saúde entre países, enquanto a hipótese de desigualdade de renda se limita a uma aproximação parcial útil para analisar diferenças dentro dos países

AICAR attenuates organ injury and inflammatory response after intestinal ischemia and reperfusion

Intestinal ischemia and reperfusion (I/R) is encountered in various clinical conditions and contributes to multiorgan failure and mortality as high as 60% to 80%. Intestinal I/R not only injures the intestine, but affects remote organs such as the lung leading to acute lung injury. The development of novel and effective therapies for intestinal I/R are critical for the improvement of patient outcome. AICAR (5-aminoimidazole-4-carboxyamide ribonucleoside) is a cell-permeable compound that has been shown to possess antiinflammatory effects. The objective is to determine that treatment with AICAR attenuates intestinal I/R injury and subsequent acute lung injury (ALI). Male Sprague Dawley rats (275 to 325 g) underwent intestinal I/R injury with blockage of the superior mesenteric artery for 90 min and subsequent reperfusion. At the initiation of reperfusion, vehicle or AICAR (30 mg/kg BW) was given intravenously (IV) for 30 min. At 4 h after reperfusion, blood and tissues were collected for further analyses. Treatment with AICAR significantly decreased the gut damage score and the water content, indicating improvement in histological integrity. The treatment also attenuated tissue injury and proinflammatory cytokines, and reduced bacterial translocation to the gut. AICAR administration after intestinal I/R maintained lung integrity, attenuated neutrophil chemotaxis and infiltration to the lungs and decreased lung levels of tumor necrosis factor (TNF)-alpha and interleukin (IL)-6. Inflammatory mediators, lung-inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) proteins, were decreased in the lungs and lung apoptosis was significantly reduced after AICAR treatment. These data indicate that AICAR could be developed as an effective and novel therapeutic for intestinal I/R and subsequent ALI

Condiciones de trabajo y morbilidad entre mineros del carbón en Guachetá, Cundinamarca: la mirada de los legos

Introduction: Investigations in Colombia about work and health conditions in coal mining are scarce and few have focused on the perception of the exposed population and their behaviors in response to inherent risks.Objective: To determine the association between work conditions and the perception of morbidity among coal miners in Guachetá, Cundinamarca.Materials and methods: A cross-sectional study was performed with 154 workers selected randomly from the total registered with the municipality. Information about social and demographic characteristics and work and health conditions in the mines was gathered. The prevalence was estimated for respiratory, musculoskeletal and auditory disorders. The associations between certain work conditions, and events with a prevalence over 30% were explored using bivariate and multivariate analyses with Poisson regressions with robust variance.Results: Workers were mostly men. Ages ranged from 18 to 77 years. Most frequently reported health problems were: back pain (46.1 %), pain in an upper limb (40.3%), pain in a lower limb (34.4 %), and respiratory (17.5 %) and auditory problems (13.6 %). Significant differences in perception were found depending on time on the job and underground or ground work conditions.Conclusions: The most recognized risks were those associated with musculoskeletal disorders since they were closer in time to the work performed (time discount). Some actions to identify psychological traits are proposed in order to improve risk perception among coal miners.Introducción. En Colombia, la investigación sobre las condiciones de trabajo y salud en la minería carbonífera es escasa y no toma en consideración la percepción de la población expuesta y sus comportamientos frente a los riesgos inherentes.Objetivo. Determinar la asociación entre las condiciones de trabajo y la morbilidad percibidas por los trabajadores de minas de carbón en Guachetá, Cundinamarca.Materiales y métodos. Se hizo un estudio transversal con 154 trabajadores seleccionados aleatoriamente del total registrado en la alcaldía municipal. Se indagó sobre las características sociodemográficas, y las condiciones de trabajo y de salud en las minas. Se estimaron las prevalencias de los trastornos respiratorios, osteomusculares y auditivos, y se exploraron las asociaciones entre algunas condiciones de trabajo y los eventos adversos con prevalencia superior al 30 % de forma bivariada y múltiple mediante regresiones de Poisson con varianza sólida.Resultados. Los trabajadores eran, en su mayoría, hombres, con edades entre los 18 y los 77 años. Los problemas de salud más frecuentemente reportados fueron: dolor lumbar (46,1 %), dolor miembros superiores (40,3 %), dolor en miembros inferiores (34,4 %), trastornos respiratorios (17,5 %) y problemas auditivos (13,6 %). Se registraron diferencias importantes en la percepción, dependiendo de la antigüedad laboral y las condiciones de trabajo, subterráneo o de superficie.Conclusión. Los riesgos más reconocidos fueron los relacionados con los trastornos osteomusculares, por ser más cercanos en el tiempo con respecto al trabajo realizado (“descuento temporal”). Se proponen acciones basadas en la identificación de rasgos psicológicos, para mejorar la percepción del riesgo entre los mineros del carbón

Comparison of influenza type A and B with COVID-19: A global systematic review and meta-analysis on clinical, laboratory and radiographic findings

We compared clinical symptoms, laboratory findings, radiographic signs and outcomes of COVID-19 and influenza to identify unique features. Depending on the heterogeneity test, we used either random or fixed-effect models to analyse the appropriateness of the pooled results. Overall, 540 articles included in this study; 75,164 cases of COVID-19 (157 studies), 113,818 influenza type A (251 studies) and 9266 influenza type B patients (47 studies) were included. Runny nose, dyspnoea, sore throat and rhinorrhoea were less frequent symptoms in COVID-19 cases (14, 15, 11.5 and 9.5, respectively) in comparison to influenza type A (70, 45.5, 49 and 44.5, respectively) and type B (74, 33, 38 and 49, respectively). Most of the patients with COVID-19 had abnormal chest radiology (84, p < 0.001) in comparison to influenza type A (57, p < 0.001) and B (33, p < 0.001). The incubation period in COVID-19 (6.4 days estimated) was longer than influenza type A (3.4 days). Likewise, the duration of hospitalization in COVID-19 patients (14 days) was longer than influenza type A (6.5 days) and influenza type B (6.7 days). Case fatality rate of hospitalized patients in COVID-19 (6.5, p < 0.001), influenza type A (6, p < 0.001) and influenza type B was 3(p < 0.001). The results showed that COVID-19 and influenza had many differences in clinical manifestations and radiographic findings. Due to the lack of effective medication or vaccine for COVID-19, timely detection of this viral infection and distinguishing from influenza are very important. © 2020 John Wiley & Sons Ltd

Clinical characteristics, laboratory findings, radiographic signs and outcomes of 61,742 patients with confirmed COVID-19 infection: A systematic review and meta-analysis

Introduction: In the current time where we face a COVID-19 pandemic, there is no vaccine or effective treatment at this time. Therefore, the prevention of COVID-19 and the rapid diagnosis of infected patients is crucial. Method: We searched all relevant literature published up to February 28, 2020. We used Random-effect models to analyze the appropriateness of the pooled results. Result: Eighty studies were included in the meta-analysis, including 61,742 patients with confirmed COVID-19 infection. 62.5 (95 CI 54.5�79, p 50 years old was 39.5, and in all range group was 6. Conclusions: Fever and cough are the most common symptoms of COVID-19 infection in the literature published to date. Thombocytosis, lymphopenia, and increased CRP were common lab findings although most patients included in the overall analysis did not have laboratory values reported. Among Chinese patients with COVID-19, rates of hospitalization, critical condition, and hospitalization were high in this study, but these findings may be biased by reporting only confirmed cases. © 202

Comparison of confirmed COVID-19 with SARS and MERS cases - Clinical characteristics, laboratory findings, radiographic signs and outcomes: A systematic review and meta-analysis

Introduction: Within this large-scale study, we compared clinical symptoms, laboratory findings, radiographic signs, and outcomes of COVID-19, SARS, and MERS to find unique features. Method: We searched all relevant literature published up to February 28, 2020. Depending on the heterogeneity test, we used either random or fixed-effect models to analyze the appropriateness of the pooled results. Study has been registered in the PROSPERO database (ID 176106). Result: Overall 114 articles included in this study; 52 251 COVID-19 confirmed patients (20 studies), 10 037 SARS (51 studies), and 8139 MERS patients (43 studies) were included. The most common symptom was fever; COVID-19 (85.6, P <.001), SARS (96, P <.001), and MERS (74, P <.001), respectively. Analysis showed that 84 of Covid-19 patients, 86 of SARS patients, and 74.7 of MERS patients had an abnormal chest X-ray. The mortality rate in COVID-19 (5.6, P <.001) was lower than SARS (13, P <.001) and MERS (35, P <.001) between all confirmed patients. Conclusions: At the time of submission, the mortality rate in COVID-19 confirmed cases is lower than in SARS- and MERS-infected patients. Clinical outcomes and findings would be biased by reporting only confirmed cases, and this should be considered when interpreting the data. © 2020 John Wiley & Sons, Lt

Comparison of the Full Outline of UnResponsiveness and Glasgow Liege Scale/Glasgow Coma Scale in an Intensive Care Unit Population.

peer reviewedBACKGROUND: The Full Outline of UnResponsiveness (FOUR) has been proposed as an alternative for the Glasgow Coma Scale (GCS)/Glasgow Liege Scale (GLS) in the evaluation of consciousness in severely brain-damaged patients. We compared the FOUR and GLS/GCS in intensive care unit patients who were admitted in a comatose state. METHODS: FOUR and GLS evaluations were performed in randomized order in 176 acutely (<1 month) brain-damaged patients. GLS scores were transformed in GCS scores by removing the GLS brainstem component. Inter-rater agreement was assessed in 20% of the studied population (N = 35). A logistic regression analysis adjusted for age, and etiology was performed to assess the link between the studied scores and the outcome 3 months after injury (N = 136). RESULTS: GLS/GCS verbal component was scored 1 in 146 patients, among these 131 were intubated. We found that the inter-rater reliability was good for the FOUR score, the GLS/GCS. FOUR, GLS/GCS total scores predicted functional outcome with and without adjustment for age and etiology. 71 patients were considered as being in a vegetative/unresponsive state based on the GLS/GCS. The FOUR score identified 8 of these 71 patients as being minimally conscious given that these patients showed visual pursuit. CONCLUSIONS: The FOUR score is a valid tool with good inter-rater reliability that is comparable to the GLS/GCS in predicting outcome. It offers the advantage to be performable in intubated patients and to identify non-verbal signs of consciousness by assessing visual pursuit, and hence minimal signs of consciousness (11% in this study), not assessed by GLS/GCS scales