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Open access

Iulia-Rahela Marcu, Ion Toma and Adrian Costin Bighea

Abstract

Quality of life studies in patients with knee osteoarthritis (OA) attest to the significant impact of the disease on day-to-day activities and social interactions. The aim of this study was to assess the efficacy of a physical exercise program on functional status and quality of life in patients with work-related knee osteoarthritis. The present study included 144 participants with knee osteoarthritis, 72% women, mean age (SD) 47.2 (11.1) years. The patients were randomly assigned in two lots based on the type of kinetic treatment: lot A-with knee OA and medication (72 patients) and lot B- with knee OA, medication and exercise program (72 patients). They followed for 12 days ambulatory exercise programs based on increasing knee flexion, muscular strength and endurance, improving balance, coordination, and respiratory exercises. The patients in the control group continued their daily living activities. The evaluation was made at the beginning of the study (T0), after 2 weeks (T1) and 8 weeks after the 12 days of exercise program (T2) and was based on the following parameters: knee mobility (knee flexion), muscular strength, pain assessment on a Visual Analogue Scale (VAS), functional status (Western Ontario &McMaster Universities Osteoarthritis Index - WOMAC) and quality of life evaluation using SF-36 Questionnaire (36-Item Short Form Survey). Out of 144 participants who completed the initial evaluation, 138 also completed the 2 weeks and the 8 weeks follow-up assessments: 70 patients from the control lot and 68 patients from the exercise lot. The benefits of the kinetic programs were shown by a significant improvement in knee mobility and muscular strength for knee extensors (quadriceps muscle) and knee flexor muscles. Testing the linear correlations between the SF-36 score and the VAS (r=0.71, p<0.05) and WOMAC (r=0.83, p<0.05) indicators demonstrates a highly positive relationship between the quality of life expression, the pain assessment score and the functional status score in patients with knee OA. The physical exercise program improves both functional status and quality of life in patients with work-related knee osteoarthritis by increasing the range of motion and muscular strength and by reducing pain.

Open access

Complicated Silicosis Associated with Mycobacterium tuberculosis Infection

Case presentation and literature review of the TB diagnosis in silicosis

Patricia Petculescu, Andrei Năstase, Ana-Maria Mănescu and Marina Ruxandra Oțelea

Abstract

Romania is recognized as the European country with the highest tuberculosis rate in Europe. The association of tuberculosis with silicosis determines synergistic immunosuppression of the alveolar macrophages resulting in a higher grade of pulmonary parenchymal destruction and consequently respiratory failure. The case report approaches a patient with third stage of silicosis and associated active secondary pulmonary tuberculosis disease with positive smears. The impact of the Mycobacterium tuberculosis (MTB) infection’s activation is known to be severe, worsening the prognosis of silicosis and reducing the patient’s quality of life. Regarding the high morbidity rate of tuberculosis, an early diagnosis of tuberculosis in patients with silicosis is paramount, and sometimes cannot be achieved by usual bacteriological tests. Therefore, a better strategy is to be considered in silicotuberculosis, namely to prevent the progression of the latent tuberculosis foci by testing the positive predictive value of up-to-date tests such as IFN-γ inducible protein 10 biomarker, which may allow early detection and treatment.

Open access

Marina Ruxandra Oțelea and Lavinia Călugăreanu

Abstract

Context. It has been decades since the circadian variation of the secretion of the thyroid stimulating hormone (TSH) was proven in humans. Even so, there are few studies on human beings that explored the relationship existing between night shift circadian rhythm deregulation and thyroid disorders.

Methods. We have revised the occupational medicine files of all employees in a single speciality hospital to conduct an observational study on the prevalence of thyroid disorders in night shift compared to day shift workers. Age, gender, occupational history, body mass index and specialist diagnosed thyroid disorders were recorded. Numerical variables were compared with ANOVA test, and categorical ones with chi test (StatPlus for Mac version v6).

Results. Obesity was slightly more prevalent in night shift workers, but not statistically significant. Instead, we found a significant increase in the prevalence of thyroid disorders in night shift workers (X= 7.424, p = 0.006). As this is a mere observational study, our results only contribute to the pool of data concerning the relationship between thyroid dysfunction and night shifts.

Conclusions: These results should raise awareness, particularly among occupational physicians and endocrinologists, about the influence of sleep and circadian rhythm deregulation on the raising incidence of thyroid disorders.

Open access

Xenia Elena Bacinschi

Abstract

Ionizing radiation are classified as Class I carcinogens. The exposure to this factor increases the risk of developing cancer, and researchers aim to establish the relationship between the exposure and the risk levels, as well as guidelines which would limit exposure to it. The risks were assessed through studies related to the atomic bomb survivors, to the populations exposed to radiation for the purpose of diagnosis or therapy and to the professionally exposed populations – radiologists, radiotherapists, workers in uranium mines, operatives in the nuclear industry. The population of Japanese survivors of the atomic bombs is the largest population exposed and studied with an extremely wide age range (from the irradiation in utero to old people). This population, made up of 93.000 people, represents a major source of information used to determine the potential risk of low dose radiation exposure. Health professionals working with ionizing radiation have been studied ever since the 1890’s. After the implementation of a radiation protection system, the doses received decreased only to increase again with the technical development and its use in a wide variety of specialties. Two recent studies on large cohorts and during long periods of time brought information about the cancer risk due to occupational exposure to ionizing radiation and shed light on the need to monitor exposed staff and re-evaluate radiological safety standards. This review is focused on recent literature concerning the radiation exposure of medical professionals.

Open access

Are there still other asbestos-related malignancies to be discovered?

Case-report of Mycosis fungoides in a patient with occupational asbestos exposure

Alexandra Maria Rașcu, Maria-Gabriela Neicu, Agripina Rașcu and Marina Ruxandra Oțelea

Abstract

Mycosis fungoides is one of the most common forms of cutaneous T-cell lymphoma. Its diagnosis is sometimes challenging and quite difficult for the physician, because its onset clinical appearance is similar to other skin diseases. Although there are a few hypotheses about mycosis fungoides’ etiology, they aren’t fully understood and still need confirmation. We report the case of a 68 years old patient diagnosed with mycosis fungoides, who has been exposed to asbestos fibers. This case is one of the few reported cases of association between asbestos and mycosis fungoides. There is no data exploring the causal relation between asbestos exposure and mycosis fungoides but common biological mechanisms could represent an argument. If occupational exposure to asbestos will be confirmed in larger studies, a new research-field of asbestos-related diseases needs to be opened.

Open access

Mihaela Stoia and Doina Merlă

Abstract

Objective. This study aimed to provide the true picture of a ten-year absenteeism survey with regard to work-related illnesses and injuries in medical-social workers, and to develop an analytical model for the occupational health practitioner to facilitate record linkage between health outcomes and occupational data.

Methods. Severity indicator and specific weight indicator were calculated on the basis of sick leaves evidence from seven care facilities, as well as the average lost days per year within the period 2008-2017. Four types of work-related illnesses, non-reported accidents and five occupational groups accounted for statistic modeling of data.

Results. According to the specific weight indicator for occupations, nurses ranked the first place for musculoskeletal disorders, respiratory and cardiovascular diseases, and traumatic injuries, followed by medical-social-educational staff. Severity indicator for musculoskeletal disorders was high correlated with the number of employees (r=0.66).

Conclusions: This analytical method is reliable to be applied in risk assessment procedures and occupational health expertise.

Open access

Mojca Dobnik, Matjaž Maletič and Brigita Skela-Savič

Abstract

Background

Surveys conducted among healthcare workers revealed that nursing staff often face various stressors associated with occupational activities, which reduce their work efficiency. The aim of the study was to establish the level of stress in nurses working at hospitals in Slovenia and to identify stress-related factors.

Methods

A cross-sectional epidemiological design and a standardized instrument called the “Nursing stress scale” were used. The sample included 983 nurses from 21 Slovenian hospitals. The research was conducted in 2016.

Results

Prevalence of high level of stress was 56.5% of respondents (M (median)=75). Prevalence of high level of stress and stress factors may be statistically significant attributable to dissatisfaction at work (p<0.001), disturbing factors at work (p<0.001), inability to take time off in lieu after working on weekend (p=0.003), shorter serving (p=0.009), fixed-term work (p=0.007), and an increased number of workdays on Sunday (p=0.030).

Conclusion

The stress rate and stress factors are substantially influenced by variables reflecting work organization, competences and skills of healthcare management to work with people. Results reflect the need for nursing management and policy makers to design strategies to ensure adequate staffing, efficient organization and an encouraging work environment.

Open access

Armin Paravlić, Saša Pišot and Petar Mitić

Abstract

Purpose

The high rate of injury incidence and its severity is estimated to cause approximately 9% of global mortality, while a large proportion of people surviving their injuries experience temporary or permanent disabilities. To reduce the occurrence of disability and improve general health of survivors, a more comprehensive rehabilitation approach is needed. Motor imagery is recognized as the promising cognitive strategy to counteract impaired functional capacity of the neuromuscular system. Thus, we aimed to provide to the Slovenian-speaking community a valid and reliable version of Motor Imagery Questionnaire – 3 [MIQ-3], that consists of kinaesthetic imagery [KI] and visual [i.e., Internal Imagery [IMI] and external imagery [EVI]] items.

Methods

We investigated both absolute and relative test-retest repeatability; construct validity and internal consistency of the KI, IMI and EMI items of the Slovenian version of MIQ-3 in 86 healthy adult subjects.

Results

Results showed high to very high average intra-class correlation coefficient [ICC] for the visual items [ICC=0.89] and KI items [ICC=0.92], whilst the measure of absolute variability presented as coefficient of variation [CV%] ranged from 4.9% [EVI] to 6.7% [KI]. The internal consistency was satisfactory [Cronbach α=0.91 [KI] and 0.89]) for both visual items. Confirmatory analysis confirmed a two-factorial structure of MIQ-3.

Conclusion

Understanding the content of the questionnaire is of utmost importance to ensure its effectiveness in rehabilitation practice. The Slovenian translation of the MIQ-3 is culturally and linguistically equivalent to the original English version.

Open access

Irena Klavs, Tanja Kustec, Mojca Serdt and Jana Kolman

Abstract

Introduction

The objective was to present the results of the Slovenian National surgical site infections (SSIs) surveillance system from 2013 to 2016 and to compare them to the reference data for the European Union (EU) and European Economic Area (EEA) countries.

Methods

Surveillance was conducted according to the Slovenian protocol consistent with the European Centre for Disease Prevention and Control protocol. Descriptive analyses were performed.

Results

Data were collected for 1080 patients of whom 57.4% were patients with cholecystectomy (from three hospitals), 29.0% with caesarean sections (from four hospitals) and 4.7%, 4.5% and 4.4% patients with hip prosthesis, knee prosthesis and colon surgery (each surgical category from one hospital). The pooled in-hospital SSI incidence density for caesarean section was 3.7 (95% CI: 1.4-8.1; inter-hospital range: 0.0–11.5) and for cholecystectomy 6.8 (95% CI: 3.5-11.9; inter-hospital range: 4.1–11.9) per 1000 post-operative patient-days. The in-hospital SSI incidence density for colon surgery was 24.8 (95% CI: 12.5-44.0) and for hip prosthesis 2.6 (95% CI: 0.1-14.2) per 1000 post-operative patient-days. No SSIs were reported among the 49 patients with knee prostheses.

Conclusions

The estimated SSIs incidence rates varied between different surgical categories and the different participating hospitals. In some of the participating hospitals and for some of the surgical procedures under surveillance they were rather high in comparison to the reference data for hospitals from EU/EEA countries. It is urgent to expand standardised SSIs surveillance to all Slovenian acute care hospitals with surgical wards to contribute to evidence-based SSIs prevention and control in Slovenia.

Open access

Željko Vojvodić and Danijela Daus Šebeđak

Abstract

Aim

The aim of this study was to determine quantities of antibiotics used mainly or exclusively for urinary tract infections in Croatia between 2005 and 2014, to describe utilisation trends, and general consequences of antibiotic consumption on antimicrobial resistance.

Methods

Antibiotic utilisation data were obtained from annual reports of both the Croatian Drug Agency and Croatian Academy of Medical Sciences. Antibiotic consumption was expressed in DDD/1000 inhabitants/day (DDD TID). Antimicrobial resistance was analysed for E. coli, E. faecalis, E. faecium, P. aeruginosa, Klebsiella spp., P. mirabilis. Descriptive statistics were used to process data and calculate trends.

Results

Overall, utilisation of antibacterials decreased by 4.8% (from 3,35 to 3,19 DDD TID), while trends of individual agents varied substantially – from 87% decline for ceftibuten to 160% rise for levofloxacin. The consumption of quinolones increased by 32.3%. This was mostly due to increased ciprofloxacin consumption (144% raise). Sulfamethoxazole-trimethoprim declined by 57%, while nitrofurantoin increased by 86%. The use of fosfomycin was marginal. Antimicrobial resistance of E. coli increased against quinolones by 54.5%, and against nitrofurantoin by 2–3%. Quinolone resistance of other pathogens (Klebiella spp, Proteus mirabilis), increased variably – between 17.2% (Klebsiella) and 90% (Proteus), while for P. aeruginosa remained the same at 22%.

Conclusion

High rates of antimicrobial utilisation require prescribing restrictions and educational interventions. The increased use of fluoroquinolones is a potentially serious public health threat due to the rapid development of resistance among uropathogens. This threat can be avoided by greater use of nitrofurantoin and fosfomycin.