Absenteeism-disease in university employees: a cross-sectional study of the reasons for leave from 2013 to 2018

The Server's Integrated Health Subsystem is used to register health treatment licenses in the Federal Public Service, enabling knowledge about absenteeism-illness. To subsidize health promotion actions, it is intended to know its motivating causes in a Federal Education Institution in Minas Gerais. A cross-sectional study on leave between 2013 and 2018 was carried out. The variables were: position, sex, number of days off and the motivating code of the leave. Descriptive and inferential analyzes were performed using Poisson Regression. The main motivations found were: musculoskeletal disorders, followed by mental health in the group of professors and respiratory disorders in the group of administrative technicians, among whom, technicians up to 50 years old are associated with sick leave due to respiratory tract disorders and civil servants over 50 years old for musculoskeletal reasons. There was no difference in age with regard to mental disorder in this group. The static ergonomic risk associated with respiratory and psychic outcomes, and the risk due to dynamic activities in the absence of musculoskeletal disorders. Based on the data presented, it is possible to propose measures for Health Policy, aimed at improving the environment and work process, minimizing its risks and protecting the health of the employee

Workers absenteeism: sickness in a federal educational institution in the state of Minas Gerais

Introdução: Absenteísmo-doença é a ausência ao trabalho ocorrida por motivo de saúde e pode ter relação com fator ambiental. O registro das licenças para tratamento da saúde (LTS) do servidor público federal é realizado no Subsistema Integrado da Saúde do Servidor (SIASS), o que possibilita conhecer o perfil de adoecimento na instituição, para fins de subsidiar ações de promoção da saúde e prevenção de acidentes. Desta forma, pretende-se conhecer sobre o absenteísmo-doença de uma Instituição de Ensino Federal de Minas Gerais, registrados no SIASS entre 2013 e 2018. Métodos: Realizou-se estudo observacional transversal e em série temporal das LTS registradas no SIASS de uma instituição no período de 2013 a 2018. As variáveis estudas foram cargo, sexo, número de dias de afastamento e o código (CID) motivador da licença. Foram calculados os índices de frequências (IF) e gravidade (IG), além de análises descritiva e estatística inferencial com a regressão linear e a regressão de Poisson. Resultados: Não houve variação nos IF e IG do absenteísmo-doença ao longo dos anos e o grupo de docentes apresentam menores índices do que o grupo de técnico-administrativos (TA). As LTS foram principalmente motivadas por transtorno osteomuscular, seguido pela saúde mental no grupo de docentes e por afecções respiratórias no grupo dos TA. Os servidores TA com até 50 anos de idade estão associados aos afastamentos por afecção da via respiratória e acima de 50 anos para motivos osteomusculares. No desfecho por transtorno psíquico não houve diferença na idade para nenhum grupo de servidor. O risco ergonômico classificado como estático foi associado aos desfechos respiratórios e psíquicos, e o risco ergonômico dinâmico associado com transtornos osteomusculares. Conclusões: O estudo do absenteísmo-doença registrado no SIASS permitiu conhecer sobre o perfil de adoecimento dos servidores da instituição. Os técnico-administrativos apresentaram maior frequência e gravidade. A doenças osteomusculares são a grande causa de afastamentos nos dois grupos. Os transtornos mentais e as doenças respiratórias são causas importantes de adoecimento. A partir dos dados apresentados é possível propor medidas em forma de Política de Saúde, que visem melhorias no ambiente e processo de trabalho, minimizando seus riscos e protegendo a saúde do servidor. Palavras-chave: Absenteísmo. Perfil de saúde. Saúde do trabalhador.Introduction: Absenteeism-sickness is the absence from work due to health issues and may be related to environmental factor. The federal public servant registration of licenses for health treatment (LTS) is performed in the Integrated Server Health Subsystem (SIASS), which allows to know the disease profile in the institution, for the purpose of subsidizing health promotion actions. Thus, it is intended to know the absenteeism-sickness in a Federal Education Institution of Minas Gerais registered in SIASS between 2013 and 2018. Methods: A cross-sectional and time series observational study of the LTS registered at SIASS in an institution from 2013 to 2018 was performed. The variables studied were position, gender, number of days off and the motivator license code (ICD). Frequency indices (IF) and severity (IG) were calculated, as well as descriptive and inferential statistical analyzes with linear regression and Poisson regression. Results: There were no variations in the IF and GI of absenteeism-sickness over the years and the group of teachers presented lower rates than the group of technical-administrative (TA). TA servers up to 50 years old were more prevalent for respiratory tract leave, while those over 50 years old for musculoskeletal reasons. The outcome for psychic disorder showed no difference in age for any server group. Ergonomic risk classified as static was associated with respiratory and psychic outcomes, and dynamic ergonomic risk was associated with musculoskeletal disorders. Conclusions: The study of absenteeism-sickness registered in SIASS allowed to know about the disease profile of the institution's employees. The administrative technicians had higher frequency and severity. Musculoskeletal diseases are the major cause of sick leave in both groups. Mental disorders and respiratory problems are important causes of illness. From the data presented, it is possible to propose measures in the form of Health Policy aimed at improvements in the environment and work process, minimizing their risks and protecting the health of the server. Keyword: Absenteeism. Health profile. Occupational health

Utilização de endopróteses auto-expansíveis em tumores concomitantes de esôfago e região pré-pilórica

Self-expanding endoprostheses are well established and minimally invasive devices used to re-establish patency of the gastrointestinal tract. Before their development, patency could only be re-established through palliative surgery, a procedure that though still the gold standard, caries significant risk and increases morbidity and mortality rates. Management of localized tumors with multiple prostheses is still rarely reported in the literature. We report a 92-year-old women with anemia of unknown origin and progressive dysphagia. Endoscopy revealed an infiltrative lesion of the esophagus along with ulcerated vegetative lesions of gastric body and antrum. Gastric hemorrhage was endoscopically controlled. The family initially agreed with the introduction of a self-expanding prosthesis in the esophagus alone. On re-evaluation one month later the possibility of gastric obstruction was discussed and the introduction of a pre-pyloric endoprosthesis was agreed upon. Significant improvement in life quality was observed in the last nine months of survival following introduction of the second prosthesis.Endopróteses auto-expansíveis são dispositivos utilizados com objetivo de restituir a patência da luz do Trato Gastrointestinal, sendo consideradas ferramentas bem estabelecidas e minimamente invasivas. Antes de seu desenvolvimento, o único meio para a restituição da continuidade do trânsito era através de cirurgia paliativa, que, embora ainda considerada padrão-ouro, não é isenta de riscos, podendo acarretar aumento nas taxas de morbidade e mortalidade. A utilização de múltiplas próteses na abordagem de tumores localizados em pontos distintos é rara, sendo poucos os casos relatados na literatura. Relatamos o caso de uma paciente de 92 anos com quadro de anemia de etiologia desconhecida e disfagia progressiva. Ao exame endoscópico, observou-se lesão infiltrante de esôfago e lesões vegetantes ulceradas em corpo e antro. Procedeu-se ao controle endoscópico da hemorragia gástrica. A família autorizou a introdução de endoprótese auto-expansível somente no esôfago inicialmente. Contudo, após nova reavaliação e explicação da possibilidade de obstrução gástrica, procedeu-se, um mês após, à colocação de endoprótese também na região pré-pilórica. Durante os últimos nove meses de sobrevida depois da introdução da segunda prótese, observou-se melhora importante da qualidade de vida da paciente

Colelitíase assintomática: quando operar?

The cholelithiasis can present itself in three ways: asymptomatic, symptomatic and complicated. The conduct in asymptomatic patients is often controversial. With the aim of identifying the conduct of gastroenterologists and surgeons facing the diagnosis of asymptomatic cholelithiasis and establish a consensus, sent a questionnaire with 21 questions to 23 gastroenterologists, 108 surgeons and 101 surgeons general of the digestive tract. Participants in the study agreed on the indication of cholecystectomy in the following questions: diagnostic ultrasound of cholelithiasis; gallstones below 0.5 cm, and above 2cm; gallbladder in porcelain; patients below 20 years; carriers of sickle cell anemia and diabetes and the concomitant laparotomy because no biliary, using the same incision. Only surgeons general and the digestive tract indicate cholecystectomy: in asymptomatic patients over 60 years, in morbidly obese, in the presence of two or more risk factors for cholelithiasis; abdominal surgery with the need to enlarge the incision; in patients with dyspeptics symptoms and normal endoscopy, refractory to clinical treatment or with atypical symptoms, in women with prospect of future pregnancies and as the wish of the patient. In asymptomatic patients over 70 years, only the surgeons of the digestive tract indicate cholecystectomy. Professionals agree to the non-cholecystectomy indication of the candidates for liver transplantation. We note, therefore, that there is agreement on the conduct of the 21 questions in 11 surveyed (52.3%), with divergence in the remaining items (47.7%). Thus, in agreement with the literature, it is not yet possible to establish a consensus for treatment of cholelithiasis asymptomatic.A colelitíase pode apresentar-se de três formas: assintomática, sintomática e complicada. A conduta nos pacientes assintomáticos é frequentemente controversa. Com o objetivo identificar as condutas de gastroenterologistas e cirurgiões frente ao diagnóstico de colelitíase assintomática e estabelecer um consenso, foi enviado um questionário com 21 quesitos a 23 gastroenterologistas, 108 cirurgiões gerais e 101 cirurgiões do aparelho digestivo. Os participantes do estudo concordaram quanto à indicação de colecistectomia nos seguintes quesitos: diagnóstico ultra-sonográfico de colelitíase; cálculos abaixo de 0,5cm, assim como acima de 2cm; vesícula em porcelana; pacientes abaixo de 20 anos; portadores de anemia falciforme e diabetes e concomitante à laparotomia por causa não biliar, utilizando a mesma incisão. Apenas cirurgiões gerais e do aparelho digestivo indicam colecistectomia: nos pacientes assintomáticos acima de 60 anos; na presença de obesidade mórbida, de dois ou mais fatores de risco para calculose; na cirurgia abdominal com necessidade de ampliar a incisão; nos pacientes com sintomas dispépticos e endoscopia normal, refratários ao tratamento clínico ou com sintomas atípicos; na mulher com perspectiva de futura gravidez e conforme o desejo do paciente. Em pacientes assintomáticos acima de 70 anos, apenas os cirurgiões do aparelho digestivo indicam colecistectomia. Os profissionais concordam com a não-indicação de colecistectomia nos candidatos a transplante hepático. Verificamos, portanto, que há concordância na conduta em 11 dos 21 quesitos pesquisados (52,3%), havendo divergência nos itens restantes (47,7%). Deste modo, em concordância com a literatura, ainda não ser possível estabelecer um protocolo de condutas frente à colelitíase assintomática que satisfaça a clínicos e cirurgiões

Inequalities in esophageal cancer mortality in Brazil: Temporal trends and projections

<div><p>The main objective of the study was to analyze the effect of age, period and birth cohort on esophageal cancer mortality in Brazil and its geographic regions, per sex. An ecological study is presented herein, which evaluated the deaths by esophageal cancer and the distribution, per geographic region. Poisson Regression was utilized to calculate the effects of age, period and birth cohort, and projections were made with the statistical software R, using the age-period-cohort model. Projection of data covered the period 2015–2029. Regarding the geographic regions of Brazil, a decrease was verified, throughout time, for the mortality rates of the South and Southeast regions, for men and women. For the North, Northeast and Midwest regions, an increase was evidenced in mortality rates, mainly for men, after the 2000's. Regarding the projections, a progressive increase of mortality rates was verified for the Northeast and North regions. Divergences evidenced for observed and projected esophageal cancer mortality rates revealed inequalities among the geographic regions of Brazil.</p></div

Mortality rates for esophageal cancer in males, according to age, death period, and geographical region in Brazil.

<p>Mortality rates for esophageal cancer in males, according to age, death period, and geographical region in Brazil.</p

Observed and predicted number of deaths in males by age and world age-standardized rates (ASW) in Brazil.

<p>Observed and predicted number of deaths in males by age and world age-standardized rates (ASW) in Brazil.</p

Observed and predicted number of deaths in females by age and world age-standardized rates (ASW) in Brazil.

<p>Observed and predicted number of deaths in females by age and world age-standardized rates (ASW) in Brazil.</p

Estimated annual percentage variation (EAPC) of esophageal cancer mortality rates, in Brazil.

<p>1980–2014.</p

Deviance changes in the sequential construction of APC models.

<p>Deviance changes in the sequential construction of APC models.</p