Nuevas variables predictoras en la incidencia de Síndrome Metabólico y Diabetes Mellitus tipo 2. Estudio longitudinal en población trabajadora

El Síndrome Metabólico (SMet) se define como un estado pluripatólogico, caracterizado por la presencia conjunta de varios factores de riesgo cardiovascular como son la obesidad abdominal, la hipertensión arterial y el metabolismo alterado de glúcidos y lípidos (bajo colesterol-HDL y elevación de triglicéridos). La principal consecuencia para la salud del SMet es su asociación con la incidencia de enfermedades cardiovasculares (cardiopatía isquémica, accidente cerebrovascular, enfermedad renal, diabetes, etc.). El aumento general de la prevalencia de MetS ha sido debido a la epidemia de obesidad que padece la población mundial. El sobrepeso y la obesidad son factores relacionados con la aparición de diabetes tipo 2, hipertensión arterial, dislipidemia y enfermedad cardiovascular. Más concretamente, la obesidad central, entendida como una acumulación excesiva de grasa abdominal, es un importante predictor de riesgo metabólico y SMet. Objetivos Conocer la validez predictiva de los diferentes indicadores de obesidad abdominal (IMC, ICT, ICC, PG, ABSI, etc.) en la incidencia y prevalencia de SMet y DM tipo 2. Proponer un valor de corte único para el ICT en hombres y mujeres, así como para los diferentes grupos de edad. Proponer y validar un nuevo método de detección precoz de SMet en población sana basado, únicamente, en variables antropométricas

Depression as a Risk Factor for Dementia and Alzheimer’s Disease

Preventing the onset of dementia and Alzheimer’s disease (AD), improving the diagnosis, and slowing the progression of these diseases remain a challenge. The aim of this study was to elucidate the association between depression and dementia/AD and to identify possible relationships between these diseases and different sociodemographic and clinical features. In this regard, a case-control study was conducted in Spain in 2018–2019. The definition of a case was: A person ≥ 65 years old with dementia and/or AD and a score of 5–7 on the Global Deterioration Scale (GDS). The sample consisted of 125 controls; among the cases, 96 had dementia and 74 had AD. The predictor variables were depression, dyslipidemia, type 2 diabetes mellitus, and hypertension. The results showed that depression, diabetes mellitus, and older age were associated with an increased likelihood of developing AD, with an Odds Ratio (OR) of 12.9 (95% confidence interval (CI): 4.3–39.9), 2.8 (95% CI: 1.1–7.1) and 1.15 (95% CI: 1.1–1.2), respectively. Those subjects with treated dyslipidemia were less likely to develop AD (OR 0.47, 95% CI: 0.22–1.1). Therefore, depression and diabetes mellitus increase the risk of dementia, whereas treated dyslipidemia has been shown to reduce this risk

Aprovechamiento del ripio de carbón antracita generado en la calera ítalo, para la fabricación de briquetas, en el departamento de Cajamarca, 2018

RESUMEN El objetivo de esta tesis fue aprovechar el ripio de carbón antracita generado en la calera Ítalo, para la fabricación de briquetas. Mediante los objetivos específicos que son determinar la cantidad de ripio de carbón antracita generado mensualmente, luego realizar el diseño de briquetas usando el ripio de carbón antracita y evaluar la rentabilidad económica de la fabricación de briquetas. La investigación desarrollada fue cuantitativa, en esta tesis el proceso consistió en observar y analizar el ripio de carbón antracita para luego proponer la fabricación de briquetas usándolo como materia prima. En la calera Ítalo, se produce Oxido de Calcio, para este proceso es necesario calcinar las calizas con carbón antracita, la empresa P I huyu Yuraq actualmente abastece a Minera Yanacocha entre 1800 hasta 2200 toneladas mensuales. Se genera en promedio 20 a 29 toneladas mensuales de carbón cisco también llamado ripio de carbón. Se fabricaron varias briquetas, pero la briqueta que se tomó como muestra tiene las siguientes proporciones: 0.6 kilos de arcilla más 4 kilos de carbón de antracita más 0.62 litros de agua. Las briquetas tienen 14.5 cm de altura y 14.5 cm de diámetro. La resistencia a la compresión uniaxial de las briquetas es 3.1 KN y MPa. 0.17, esto quiere decir que se pueden apilar de 20 briquetas. Las briquetas tienen una duración de encendido de 12 horas 40 minutos. La inversión fija es de 9 097.20 soles y los costos anuales de producción son 34 472.00 soles, las ganancias anuales son 63 960 soles. Por lo tanto, el flujo de caja es de 610 150.80 soles en 21 años. El Payback o la recuperación de la inversión utilizada es de 0.68 años. Eso quiere decir que las inversiones si serían recuperadas. Palabras clave: Carbón antracita, calcinación, briqueta, arcilla

The role of occupational health nursing, an open debate

Editorial[ES] En una realidad social y laboral variable, compleja e inestable, la presencia de la enfermería del trabajo en las organizaciones constituye un valor añadido por su trayectoria y atención especializada. El periodo de formación de la especialidad tiene como objetivo formar a profesionales que puedan realizar actividades dirigidas a prevenir, promover, proteger y restaurar la salud de la población trabajadora. El enfoque de su actuación será laboral con perspectiva de salud pública, integral con mirada holística, integrado en el servicio de prevención de riesgos laborales y basado en la mejor evidencia científica disponible. A su vez, el ejercicio de la actividad debe realizarse también de acuerdo con estándares profesionales y ajustada a principios éticos. Por tanto, esta disciplina debe considerar no sólo que su práctica clínica sea efectiva, sino también coste-eficiente. [EN] In a variable, complex and unstable social and labour reality, the presence of occupational health nursing in organisations is an added value due to its specialised care and experience. The training period of the speciality aims to train professionals who can carry out activities aimed at preventing, promoting, protecting and restoring the health of the working population. The focus of their action will be occupational with a public health perspective, comprehensive with a holistic view, integrated in the occupational risk prevention service and based on the best scientific evidence available. At the same time, the exercise of the activity must also be carried out in accordance with professional standards and in line with ethical principles. Therefore, this discipline must consider not only that its clinical practice is effective, but also cost-efficient.N

Insomnia Interventions in the Workplace: A Systematic Review and Meta-Analysis

The aim of this systematic review and meta-analysis was to identify and evaluate the impact of interventions to improve or reduce insomnia in the workforce through randomized clinical trials. Following the recommendations of the PRISMA and MARS statement, a systematic literature search was carried out on the PubMed, Web of Science, CINHAL, and PsycINFO databases, with no restrictions on the language or publication date. For the meta-analysis, a random-effects model and theInsomnia Severity Indexwere used as outcome measures. To assess the risk of bias and the quality of evidence, the Cochrane Collaboration tool and the GRADE method were used, respectively. Twenty-two studies were included in the systematic review and 12 studies in the meta-analysis, making a total of 14 intervention groups with a sample of 827 workers. Cognitive behavioral therapy was the most widely used intervention. According to the estimated difference between the means, a moderate effect for the reduction of insomnia symptoms after the intervention (MD -2.08, CI 95%: [-2.68, -1.47]) and a non-significant degree of heterogeneity were obtained (p= 0.64; I-2= 0%). The quality of the evidence and the risk of bias were moderate. The results suggest that interventions on insomnia in the workplace are effective for improving workers' health, and that improvements in the quality of sleep and a decrease in the symptoms of insomnia are produced, thanks to an increase in weekly sleeping hours and a reduction in latency at sleep onset. As regards work, they also led to improvements in productivity, presenteeism, and job burnout

Nutritional state, immunological and biochemical parameters, and mortality in the ICU: an analytical study

Intensive care unit (ICU) hospitalization involves critically ill patients with multiple diseases and possible complications, including malnutrition, which increases hospital stay and mortality. Therefore, identifying the patient’s prior nutritional state, following up during hospitalization, and implementing early intervention positively affect patient’s vital situations at discharge. The objective of this study is to determine the nutritional state of patients admitted to an ICU in Cali (Colombia) in 2019 and its association with immunological and biochemical parameters and mortality observed during hospitalization. This was an observational, analytical, and retrospective study of patients admitted to an ICU in a clinic in Cali (Colombia) from 1 January to 31 March 2019. The association between their nutritional state and outcome variables such as hospital stay, immunological and biochemical function, and mortality was analyzed. Logistic regression was used to predict patients’ vital status at hospital discharge. In terms of the nutritional level, low weight was observed in 17.5% patients, and overweight/obesity was observed in 53.5% of the population. Nutritional state was associated with leukocytosis. The patients with lymphocytosis had longer hospital stays than those with normal lymphocyte ranges. Age, blood leukocytes, and creatinine and potassium levels increased the risk of mortality. Lymphocyte values have been used as predictors of severity and hospitalization time. The scientific literature has also evidenced a higher leukocyte count in people with obesity, and such leukocytosis is associated with the risk of mortality. The results of blood and laboratory tests determining kidney function and blood electrolytes allow for the prediction of mortality risk in critically ill patients

An Approach to Early Detection of Metabolic Syndrome through Non-Invasive Methods in Obese Children

Background: Metabolic Syndrome (MetS) has a high prevalence in children, and its presence increases in those with a high BMI. This fact confirms the need for early detection to avoid the development of other comorbidities. Non-invasive variables are presented as a cost-effective and easy to apply alternative in any clinical setting. Aim: To propose a non-invasive method for the early diagnosis of MetS in overweight and obese Chilean children. Methods: We conducted a cross-sectional study on 221 children aged 6 to 11 years. We carried out multivariate logistic regressions, receiver operating characteristic curves, and discriminant analysis to determine the predictive capacity of non-invasive variables. The proposed new method for early detection of MetS is based on clinical decision trees. Results: The prevalence of MetS was 26.7%. The area under the curve for the BMI and waist circumference was 0.827 and 0.808, respectively. Two decision trees were calculated: the first included blood pressure (≥104.5/69 mmHg), BMI (≥23.5 Kg/m2) and WHtR (≥0.55); the second used BMI (≥23.5 Kg/m2) and WHtR (≥0.55), with validity index of 74.7% and 80.5%, respectively. Conclusions: Early detection of MetS is possible through non-invasive methods in overweight and obese children. Two models (Clinical decision trees) based on anthropometric (non-invasive) variables with acceptable validity indexes have been presented. Clinical decision trees can be applied in different clinical and non-clinical settings, adapting to the tools available, being an economical and easy to measurement option. These methods reduce the use of blood tests to those patients who require confirmation

New Simplified Diagnostic Decision Trees for the Detention of Metabolic Syndrome in the Elderly

Background: A new simplified method for the detention of metabolic syndrome (MetS) is proposed using two variables (anthropometric and minimally invasive). Methods: A study of MetS prevalence was made on a sample of 361 older people. The anthropometric variables analyzed were: blood pressure, body mass index, waist circumference (WC), waist–height ratio, body fat percentage, and waist–hip ratio. A crude and adjusted binary logistic regression was performed, and receiver operating characteristic curves were obtained for determining the predictive capacity of those variables. For the new detection method, decision trees were employed using automatic detection by interaction through Chi-square. Results: The prevalence of the MetS was of 43.7%. The final decision trees uses WC and basal glucose (BG), whose cutoff values were: for men, WC ≥ 102.5 cm and BG > 98 mg/dL (sensitivity = 67.1%, specificity = 90.3%, positive predictive value = 85%, validity index = 79.9%); and for women, WC ≥ 92.5 cm and BG ≥ 97 mg/dL (sensitivity = 65.9%, specificity = 92.7%, positive predictive value = 87.1%, validity index = 81.3%). In older women the best predictive value of MetS was a WC of 92.5 cm. Conclusions: It is possible to make a simplified diagnosis of MetS in older people using the WC and basal capillary glucose, with a high diagnostic accuracy and whose use could be recommended in the resource-poor health areas. A new cutting point in older women for the WC should be valued

A Sustainable Approach to the Metabolic Syndrome in Children and Its Economic Burden

The prevalence of obesity continues to grow, resulting in metabolic syndrome and increasing economic burden for health systems. The objectives were to measure the ability of the NIM-MetS test, previously used in the adults, for the early and sustainable detection of the Metabolic Syndrome (MetS) in children and adolescents. Moreover, to determine the economic burden of the children with MetS. Furthermore, finally, to use and implement the NIM-MetS test, via a self-created online software, as a new method to determine the risk of MetS in children. The method used was an observational study using different instruments (NIM-MetS test, International Diabetes Federation (IDF), or Cook) and measures (body mass index). Additionally, the economic burden was estimated via a research strategy in different databases, e.g., PubMed, to identify previous papers. The results (N = 265 children, age from 10–12) showed that 23.1% had obesity and 7.2% hypertension. The prevalence of MetS using the NIM-Mets was 5.7, and the cost of these children was approximate 618,253,99 euros. Finally, a model was obtained and later implemented in a web platform via simulation. The NIM-MetS obtained is a non-invasive method for the diagnosis of risk of MetS in children