Acrylates are plastic materials formed by the polymerization of monomers, which are recognized as powerful sensitizers that may cause allergic contact dermatitis both in occupational and non-occupational environment. In the occupational setting, the most exposed workers are the dentists, dental technicians, prosthesis technicians, printers, painters, fiberglass workers and nail technicians. We describe four cases of occupational allergic contact dermatitis in nail technicians caused by acrylic compounds that illustrate numerous clinical manifestations. Clinical manifestations ranged from edema, erythema, scaling and fissuring fingertips to erythematous patches around the chin, mandible and abdomen. Patch testing results revealed positive reaction to 2-hydroxyethyl methacrylate in all patients. Of the four patients, two changed jobs, one stopped exposure because of pregnancy and one patient continued working, showing no improvement, despite undergoing treatment. These cases underline the importance of improvement of preventive measures in the workplace.
Bilayer and multi-layer tablets are enjoying growing popularity among original drug and generic product manufacturers. Multi-layer tablets have many key benefits compared to classic immediate-release tablets. The use of such solid oral dosage forms simplifies dosing regimens in combination therapy, and thus improves patient compliance. However, the technology of multilayer tablets is demanding and requires precise choice of excipients and production parameters with regard to each technological step. The main benefits of multi-layer tablets, certain aspects of their production and the challenges encountered during the compression process are reviewed in this paper.
During periodic occupational medical checkup, in a sample including all employees from two high schools, a secondary school and a kindergarten, we administered through voluntary completion, questionnaires which assessed the employees’ occupational stress in terms of individual characteristics, anxiety, sense of self-efficacy, work ability, emotional exhaustion and health status (using ShortForm 36 questionnaire). A number of 233 questionnaires were returned. Only the occupational stressor represented by communication with superiors correlates significantly negatively with work ability in all four units. Work ability and communication with superiors also have average scores which differ significantly and are concordant in all four units. In the secondary school, work ability has the highest average value and the lowest average value of “communication with superiors” stressor. The same values are decreasing for WAI in order, from high school 2 to high school 1 and kindergarten while the stressor represented by communication with superiors has increasing values in order from high school no 2 to high school no. 1, and kindergarten. These results show that programmes to reduce occupational stress in school units should primarily address the school unit leadership in order to improve their communication with employees.
Acetaminophen and caffeine, popular therapeutic substances used to relieve pain or alleviate the symptoms of cold. The aims of the study were the comparison of granules, in terms of dissolution rate and moreover the development of spectrophotometric method to the simultaneous determination of both active pharmaceutical ingredients (APIs) in granules. The granules were tested by two pharmacopoeial methods of dissolution for solid dosage forms, and the dissolution profiles for each formulation were compared. A method of simultaneous determination of two medicinal substances by the double calibration method using derivative spectrophotometry was used. Considering the dissolution process carried out in the paddle apparatus, it was shown that more than 80% of acetaminophen and caffeine were released from each of the preparations in a clearly shorter time than 10 minutes. Carrying out the basket test, substances dissolved gradually, much slower than in the paddle method. The time required to release 80% of both active substances from majority of tested preparations was from 30 to 45 minutes. Application of the first derivative spectrophotometric method allows simultaneous determination of acetaminophen and caffeine in the mixture, without the need to separate them first.
Increasing interest has been focused on the Epstein-Barr Virus (EBV)-associated cancers, including oropharyngeal cancer (OPC) and gastric cancer (GC). Different cytokines, growth factors and proteins take part in oncogenesis. The aim of our study was to generate a comparison of interleukin 10 (IL-10) and transforming growth factor β (TGF-β) levels, as well as latent membrane protein (LMP-1), Epstein-Barr virus capsid antigen (EBVCA), Epstein-Barr virus nuclear antigen (EBNA) and early antigen (EA) frequency in the serum of patients with GC and OPC. The study involved 50 patients with diagnosed GC and 50 patients with OPC. All studied patients were EBV positive. Fresh-frozen tumor tissue fragments were tested using nested PCR assay for EBV DNA detection. Sera from all individuals were investigated using ELISA tests to detect the presence of EBVCA IgG, EBNA IgG, EA IgG, as well as to determine the levels of IL-10 and TGF-β. The obtained results were subjected to statistical analysis. In patients with GC, the levels of TGF-β and IL-10 were significantly higher than in OPC patients. However, the frequency and level of EBVCA, EBNA and EA in patients with OPC and GC were not significantly different. In contrast, TGF-β and IL-10 levels were significantly higher in EBVaGC, as compared to OPC, suggesting their role in gastric carcinogenesis. The differences in frequency of LMP-1 detection in patients with OPC and GC may suggest different mechanism of oncogenesis. Further studies are required to clarify the role of Epstein-Barr virus in cancer development.
Hydrogen sulphide, a highly toxic gas, can be used in crenotherapy to balance all metabolic processes (minerals, fats and proteins). The main aims of this study were to correlate the weather characteristics with the atmospheric H2S level and to evaluate the antidote activity of B12 Vitamin in the case of prolonged exposure to this compound. 46 volunteers, people from the medical staff of an important Romanian thermal water spring spa, with professional exposure at H2S, were enrolled in this study; numerical data about their blood pressure, atmospheric H2S concentration and about the weather conditions were collected every month for one year. The results indicate an improvement in the blood pressure of volunteers treated with Vitamin B12; no significant correlation between the concentration of total urinary sulphur and the concentration of atmospheric H2S level was found.
Employees with diabetes and nephropathy need special medical surveillance that involves occupational medicine specialists. However, diabetes is not a unique phenotype and each patient need to be carefully assessed. Age, gender, body mass index, renal function impairment (eGFR, creatinine, urea, uric acid), indicators of diabetes control (fasting glycaemia and HbA1C), the presence of co-morbidities, dyslipidaemia, level of serum albumin and total protein, cytokines and other inflammatory markers should be considered in a comprehensive evaluation of the severity of the chronic kidney disease and of the treatment plan. Chronic kidney disease in type 2 diabetes has many facets and various degrees of severity; therefore, permanent communication between the occupational medicine specialist and the treating physician should be maintained. For this purpose, this article reviews the current pathological mechanisms proposed for the explanation of the chronic kidney disease, the diagnostic and the general therapeutic recommendations and also the possible occupational interventions in patients with type 2 diabetic nephropathy.
In many large cohort studies, the night shift constitutes a risk factor for developing cardiovascular disease and diabetes in workers. Current screening tests for people working in night shift include fasting glycaemia and electrocardiography. In fact, there are few studies focused on the description of the electrocardiographic changes after the night shift. This article describes the protocol of the “ECG modifications induced by the disturbance of the circadian rhythm in night-shift workers (ECGNoct)” study, which was initiated by the National Institute for Infectious Diseases “Prof. Dr. Matei Balș”. Nurses represent the target population.
The protocol includes a full medical and occupational history, lifestyle habits (smoking, alcohol, nutrition), anthropometric and blood pressure measurements, blood tests (fasting glycemia, total cholesterol, triglycerides and high density lipoprotein cholesterol) and electrocardiogram recording. For nurses working in (night) shifts, we will record the electrocardiogram before and soon after the night shift. A cross sectional study will analyze the incidence of the metabolic syndrome criteria, the cardio-metabolic diseases and the electrocardiographic modifications and will compare the results between the group of nurses working and the group of nurse who do not. Based on these results, a longitudinal study will test the hypothesis that night shift increases the risk for cardio-metabolic diseases and that the electrocardiographic modifications precede the clinical symptoms. The results of the study will provide data on the association of night shifts and other non-occupational risk factors with the cardio-metabolic diseases in this specific population of healthcare workers that potentially will integrate into the occupational medicine policies.
Early amniotomy is one of the main interventions to enhance the labor progress and prevent dystocia in pregnant women. However, the efficacy of amniotomy has not been approved via labor-related indices and outcomes and has remained a subject for debate and future research. The present study was conducted to evaluate the effect of early amniotomy on labor indices and outcomes in nulliparous women. This randomized clinical trial was performed on 151 singleton pregnant women who were referred to Besat Hospital in Sanandaj, Iran, from March 2016 to March 2018. Participants were randomly divided into an early amniotomy (EA) group and a control group. Duration of the first and second phases of labor, corioamionit, dystocia rate, Apgar score at the first and fifth minutes, prolonged labor and post-partum haemorrhage were evaluated and compared between the two groups. Data were recorded in a checklist and analysed using SPSS Version 23. The p value <0.05 was considered significant. Results showed that labor indices such as duration of the first and second phases, Apgar score one and five minutes after delivery and frequency of prolonged labor, foetal distress and postpartum haemorrhage were significantly improved in patients of the early amniotomy group, compared with the control group (p≤0.05). Early amniotomy significantly decreased the total labor duration without significant increase in the rate of maternal and neonatal complications.
Understanding the factors influencing the rationing of nursing care is crucial for any quality control intervention in healthcare services. Occupational factors such as workload, night shifts, management style and organization of work have a potential influence. There are few studies specifically designed to evaluate these factors in relation with nurses’ work. In this study, we investigate several occupational factors influencing the quality of work in a sample of hospital nurses in order to identify the most important influencers of stress at work. The article describes the conceptual framework of the study, the population, the methods and the expected results. We also present a brief review of recent studies related to occupational risk factors and the perceived quality of care provided by Romanian nurse population.