Satisfaction of patients with mechanical neck disorders attended to by primary care physical therapists

8 p.Objective: To describe the satisfaction and expectations of the patients with neck pain with relation to the physical therapy received and to analyse the relationship between the patient's characteristics and his degree of satisfaction and expectation. Design: This study is performed in the setting of a random clinical trial. Participants: Subjects between 18 and 60 years of age with subacute mechanical neck disorders. Main variables: Patient's expectations and satisfaction with the received treatment (scale similar to Likert's Scale). OTHER VARIABLES: Pain intensity, episodes of previous neck pain, depression and anxiety symptoms (Goldberg Scale), age and gender, physical disability, general state of health, duration of the present episode of neck pain, regular exercise and regular consumption of medicines. Results and conclusions: A total of 90 patients were studied. The mean age was 40.1 years and 88.9% were female. Thirteen per cent of the subjects expected partial relief, 60% expected good recovery and 27% expected complete recovery. Those patients who have not suffered previous episodes of neck pain and those who have a higher score on the Goldberg Scale have a higher expectation of recovering after the treatment. About patients' satisfaction after the intervention, 2% totally unsatisfied, 1% very unsatisfied, 2% somewhat unsatisfied, 2% indifferent, 17% somewhat satisfied, 42% very satisfied and 30% totally satisfied. Those patients who experienced a greater decrease in pain were more satisfied. It would be interesting to study in depth the measurement of patients' satisfaction with the received physical therapy and to extend it to other pathologies.Fondo de Investigación Sanitari

Lipidomic profiling of chorionic villi in the placentas of women with chronic venous disease

Background: Chronic venous disease (CVD) is a prevalent lower limb venous pathology that especially affects women, who also show an increased risk of this disease during pregnancy. Studies have shown significant structural changes in the placentas of women with CVD and several markers of tissue damage have been also described. Patients and Methods: To try to understand the different placental pathologies, research efforts have focused on examining metabolomic profiles as indicators of the repercussions of these vascular disorders. This study examines changes produced in the metabolomic profiles of chorionic villi in the placentas of women with CVD. In a study population of 12 pregnant women, 6 with and 6 without CVD, we compared through mass spectroscopy coupled to ultra-high performance liquid chromatography (UHPLC-MS), 240 metabolites in chorionic villus samples. Results: This study is the first to detect in the placental villi of pregnant women with CVD, modifications in lysophosphatidylcholines and amino acids along with diminished levels of other lipids such as triglycerides, sphingomyelins, and non-esterified omega 9 fatty acids, suggesting a role of these abnormalities in the pathogenesis of CVD. Conclusions: Our findings are a starting point for future studies designed to examine the impacts of CVD on maternal and fetal well-bein

Chronic Venous Disease in Pregnant Women Causes an Increase in ILK in the Placental Villi Associated with a Decrease in E-Cadherin

Chronic venous disease (CVD) is a multifactorial vascular disorder frequently manifested in lower limbs in the form of varicose veins (VVs). Women are a vulnerable population for suffering from CVD, especially during pregnancy, when a plethora of changes occur in their cardiovascular system. Previous studies have indicated a worrisome association between CVD in pregnancy with the placental structure and function. Findings include an altered cellular behavior and extracellular matrix (ECM) composition. Integrin-linked kinase (ILK) is a critical molecule involved in multiple physiological and pathological conditions, and together with cadherins, is essential to mediate cell to ECM and cell to cell interplay, respectively. Thus, the aim of this study was to evaluate the implication of ILK and a set of cadherins (e-cadherin, cadherin-6 and cadherin-17) in placentas of women with CVD in order to unravel the possible pathophysiological role of these components. Gene expression (RT-qPCR) and protein expression (immunohistochemistry) studies were performed. Our results show a significant increase in the gene and protein expression of ILK, cadherin-6 and cadherin-17 and a decrease of e-cadherin in the placenta of women with CVD. Overall, this work shows that an abnormal expression of ILK, e-cadherin, cadherin-6 and cadherin-17 may be implicated in the pathological changes occurring in the placental tissue. Further studies should be conducted to determine the possible associations of these changes with maternal and fetal well-being

Traumatic stress symptoms among Spanish healthcare workers during the COVID-19 pandemic: a prospective study

Abstract Aim To investigate the occurrence of traumatic stress symptoms (TSS) among healthcare workers active during the COVID-19 pandemic and to obtain insight as to which pandemic-related stressful experiences are associated with onset and persistence of traumatic stress. Methods This is a multicenter prospective cohort study. Spanish healthcare workers (N = 4,809) participated at an initial assessment (i.e., just after the first wave of the Spain COVID-19 pandemic) and at a 4-month follow-up assessment using web-based surveys. Logistic regression investigated associations of 19 pandemic-related stressful experiences across four domains (infection-related, work-related, health-related and financial) with TSS prevalence, incidence and persistence, including simulations of population attributable risk proportions (PARP). Results Thirty-day TSS prevalence at T1 was 22.1%. Four-month incidence and persistence were 11.6% and 54.2%, respectively. Auxiliary nurses had highest rates of TSS prevalence (35.1%) and incidence (16.1%). All 19 pandemic-related stressful experiences under study were associated with TSS prevalence or incidence, especially experiences from the domains of health-related (PARP range 88.4–95.6%) and work-related stressful experiences (PARP range 76.8–86.5%). Nine stressful experiences were also associated with TSS persistence, of which having patient(s) in care who died from COVID-19 had the strongest association. This association remained significant after adjusting for co-occurring depression and anxiety. Conclusions TSSs among Spanish healthcare workers active during the COVID-19 pandemic are common and associated with various pandemic-related stressful experiences. Future research should investigate if these stressful experiences represent truly traumatic experiences and carry risk for the development of post-traumatic stress disorder

Aptitude assessment criteria depending on the profession

Artículos originales[ES] La valoración de la aptitud forma parte de la actividad diaria del médico del trabajo. La queja generalizada es que no hay criterios estandarizados para ello. Lo que sí hay son “criterios de exclusión” utilizados en profesiones de gran responsabilidad, en las cuales un error provocaría consecuencias graves para el trabajador o para terceros. Estos criterios son requisitos mínimos exigidos para la incorporación a un puesto de trabajo pero, están pensados desde un punto de vista de selección del personal más que de salud laboral. Objetivos: Conocer la situación actual en cuanto a la valoración de la aptitud para trabajar y comparar criterios de aptitud con criterios de exclusión para puestos de trabajo concretos. Metodología: La búsqueda de las referencias bibliográficas se realizó mediante palabras clave y descriptores DeCS. Se recuperaron 1593 citas. Tras aplicar los criterios de exclusión y realizar un análisis de pertinencia, se pudo conseguir a texto completo23, encontrándose 7 artículos más relacionados con el tema en la búsqueda manual de la bibliografía. Resultados: Sólo dos artículos tratan el tema de la aptitud a fondo. Los cuadros de exclusión médica se ocupan de prácticamente todos los órganos y aparatos y de la aptitud psíquica, mientras que los artículos revisados tratan únicamente de algunos de estos aspectos. [EN] The assessment of aptitude is part of the daily activity of occupational health doctors. The general complaint is that there is no standardized criteria to do so. What there exists is “exclusion criteria” used in professions of great responsibility, in which an error would cause serious consequences for the worker or others. These criteria are minimum requirements to carry out a job, but they are designed to select workers rather than for labor health purposes. Objectives: Determine the current situation regarding the assessment of aptitude for work and compare aptitude criteria with exclusion criteria for determined jobs. Methodology: The search for references was carried out using keywords and MeSH descriptors. 1593 citations were found. After applying the exclusion criteria and an analysis of relevance, we obtained23 full text citations, finding 7 more articles related to the topic in the manual search of the literature. Results: Only two articles deal with the issue of aptitude thoroughly. The tables of medical exclusion deal with every organ or system and with mental aptitude, while the articles reviewed deal with only some of these issues. Conclusions: The tendency of most authors is not to carry out pre-employment medical examinations unless it is mandatory, and maintain regular health examinations. The illnesses most studied so far are hypertension and poor visual acuity. Professionals in which psychophysical capabilities are thoroughly examined are drivers and aircraft pilots.N

Criterios de valoración de la aptitud según profesiones Aptitude assessment criteria depending on the profession

La valoración de la aptitud forma parte de la actividad diaria del médico del trabajo. La queja generalizada es que no hay criterios estandarizados para ello. Lo que sí hay son "criterios de exclusión" utilizados en profesiones de gran responsabilidad, en las cuales un error provocaría consecuencias graves para el trabajador o para terceros. Estos criterios son requisitos mínimos exigidos para la incorporación a un puesto de trabajo pero, están pensados desde un punto de vista de selección del personal más que de salud laboral. Objetivos: Conocer la situación actual en cuanto a la valoración de la aptitud para trabajar y comparar criterios de aptitud con criterios de exclusión para puestos de trabajo concretos. Metodología: La búsqueda de las referencias bibliográficas se realizó mediante palabras clave y descriptores DeCS. Se recuperaron 1593 citas. Tras aplicar los criterios de exclusión y realizar un análisis de pertinencia, se pudo conseguir a texto completo 23, encontrándose 7 artículos más relacionados con el tema en la búsqueda manual de la bibliografía. Resultados: Sólo dos artículos tratan el tema de la aptitud a fondo. Los cuadros de exclusión médica se ocupan de prácticamente todos los órganos y aparatos y de la aptitud psíquica, mientras que los artículos revisados tratan únicamente de algunos de estos aspectos. Conclusiones: La tendencia de la mayoría de los autores es prescindir del examen médico pre-empleo siempre que no sea obligatorio, y mantener los exámenes de salud periódicos. Las patologías hasta ahora más estudiadas son la hipertensión arterial y las deficiencias en la agudeza visual. Los profesionales en los cuales se vigila más las capacidades psicofísicas son los conductores y los pilotos de aviación.<br>The assessment of aptitude is part of the daily activity of occupational health doctors. The general complaint is that there is no standardized criteria to do so. What there exists is "exclusion criteria" used in professions of great responsibility, in which an error would cause serious consequences for the worker or others. These criteria are minimum requirements to carry out a job, but they are designed to select workers rather than for labor health purposes. Objectives: Determine the current situation regarding the assessment of aptitude for work and compare aptitude criteria with exclusion criteria for determined jobs. Methodology: The search for references was carried out using keywords and MeSH descriptors. 1593 citations were found. After applying the exclusion criteria and an analysis of relevance, we obtained 23 full text citations, finding 7 more articles related to the topic in the manual search of the literature. Results: Only two articles deal with the issue of aptitude thoroughly. The tables of medical exclusion deal with every organ or system and with mental aptitude, while the articles reviewed deal with only some of these issues. Conclusions: The tendency of most authors is not to carry out pre-employment medical examinations unless it is mandatory, and maintain regular health examinations. The illnesses most studied so far are hypertension and poor visual acuity. Professionals in which psychophysical capabilities are thoroughly examined are drivers and aircraft pilots

Alcohol abuse at workplace, risk factors and instruments for health surveillance

Original[ES] Introducción: El consumo excesivo de alcohol es un problema de salud pública, según la OMS anualmente mueren 2,5 millones de personas por esta causa, el sector laboral no escapa a esta situación, creando la necesidad detectar precozmente el consumo de alcohol en los trabajadores. Objetivos: Identificar los factores de riesgo para el consumo de alcohol en el medio laboral, y describir instrumentos útiles para el médico del trabajo, en el reconocimiento de trabajadores con problemas de abuso de alcohol. Método: Se consultaron distintas bases de datos PUBMED, CISDOC, SCIELO, LILACS, MEDLINE The cocrhane library. Se evaluaron resúmenes y se recuperaron a texto completo aquellos relacionados con abuso de alcohol en población trabajadora. Resultados: Se encontraron estudios epidemiológicos, de casos y controles, publicaciones de organismos oficiales y revistas de salud laboral. Estos evaluaron factores psicosociales y alcohol, algunos estudios usaron medidas de cribaje como cuestionarios AUDIT, CAGE y MALT para diagnosticar consumo perjudicial de alcohol.[EN] Background: The alcohol abuse (AA) is a public health problem that causes 2.5 million deaths annually (WHO), the labor sector is not immune to this situation, creating the need for early detection of AA on workers. Objective: To identify risk factors and instruments for health surveillance of workers with AA problems. Methods: We reviewed the literature, PUBMED, CIS-DOC, SCIELO, LILACS, MEDLINE and the Cochrane Library. We included studies relating to AA in the working population, risk factors and consequences in the labor sector. They were classified according to level of evidence (Scottish Intercollegiate Guidelines Network, SIGN). Results: There were 75 articles, 31 met the criteria for inclusion: A 2+ evidence study. Fifteen evidence 3 and sixteen with evidence level 4. Alcohol was the most consumed psychoactive substance in the working population prevalence of 77.8% in men and 72.9% in women. It was considered a risk factor for the AA, nonqualified. Two studies with evidence level 4 reported the increased accident rates and absenteeism related to AA. The AA screening methods used were CAGE and AUDIT . Conclusions: The risk factors were identified in the working population, related to work organization, skill levels and individual factors. The use of CAGE and AUDIT for detection of AA was considered the best option for easy application and low cost. Insufficient documentation was found on the effects of AA, suggesting the promotion of study of these issues and assess the use of screening measures to enhance prevention.N

Abuso de alcohol en el medio laboral, factores de riesgo para el consumo, e instrumentos de valoración aplicables en la vigilancia de la salud Alcohol abuse at workplace, risk factors and instruments for health surveillance

Introducción: El consumo excesivo de alcohol es un problema de salud pública, según la OMS anualmente mueren 2,5 millones de personas por esta causa, el sector laboral no escapa a esta situación, creando la necesidad detectar precozmente el consumo de alcohol en los trabajadores. Objetivos: Identificar los factores de riesgo para el consumo de alcohol en el medio laboral, y describir instrumentos útiles para el médico del trabajo, en el reconocimiento de trabajadores con problemas de abuso de alcohol. Método: Se consultaron distintas bases de datos PUBMED, CISDOC, SCIELO, LILACS, MEDLINE The cocrhane library. Se evaluaron resúmenes y se recuperaron a texto completo aquellos relacionados con abuso de alcohol en población trabajadora. Resultados: Se encontraron estudios epidemiológicos, de casos y controles, publicaciones de organismos oficiales y revistas de salud laboral. Estos evaluaron factores psicosociales y alcohol, algunos estudios usaron medidas de cribaje como cuestionarios AUDIT, CAGE y MALT para diagnosticar consumo perjudicial de alcohol. Conclusiones: Se identificaron factores de riesgo en la población trabajadora, relacionados con el ambiente laboral, organización del trabajo, cualificación profesional y factores individuales: edad, sexo, y nivel socio-cultural. El uso de cuestionarios para detectar consumo de alcohol fue considerado la mejor opción, por fácil aplicación y bajo coste. Es necesario promover el uso de herramientas aplicables en el reconocimiento y prevención del abuso de alcohol en la población trabajadora.Background: The alcohol abuse (AA) is a public health problem that causes 2.5 million deaths annually (WHO), the labor sector is not immune to this situation, creating the need for early detection of AA on workers. Objective: To identify risk factors and instruments for health surveillance of workers with AA problems. Methods: We reviewed the literature, PUBMED, CIS-DOC, SCIELO, LILACS, MEDLINE and the Cochrane Library. We included studies relating to AA in the working population, risk factors and consequences in the labor sector. They were classified according to level of evidence (Scottish Intercollegiate Guidelines Network, SIGN). Results: There were 75 articles, 31 met the criteria for inclusion: A 2+ evidence study. Fifteen evidence 3 and sixteen with evidence level 4. Alcohol was the most consumed psychoactive substance in the working population prevalence of 77.8% in men and 72.9% in women. It was considered a risk factor for the AA, non-qualified. Two studies with evidence level 4 reported the increased accident rates and absenteeism related to AA. The AA screening methods used were CAGE and AUDIT . Conclusions: The risk factors were identified in the working population, related to work organization, skill levels and individual factors. The use of CAGE and AUDIT for detection of AA was considered the best option for easy application and low cost. Insufficient documentation was found on the effects of AA, suggesting the promotion of study of these issues and assess the use of screening measures to enhance prevention