Association between fixed night work and obesity: a systematic literature review

This systematic review aimed to evaluate the association between fixed night work and overweight or weight gain. PubMed and EMBASE were searched until October 2021 for studies evaluating the association between fixed night work patterns and the risk of overweight or obesity (for cross-sectional designs) or weight gain (for longitudinal designs). The outcomes extracted were mean body mass index (BMI), mean BMI difference, overweight %, obesity %, odds ratio, relative risk, and prevalence ratio. The quality of the report was evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. The protocol was registered at PROSPERO (# 42017080515). In total, 25 studies met the inclusion criteria. All studies were observational, 16 were cross-sectional, three were cohorts (two also had baseline cross-sectional data), and the other eight were cross-sectional at baseline and had longitudinal follow-up studies (six prospective cohorts, one retrospective, one interventional). Most had good reporting quality. The fixed night work definition and weight outcomes varied according to the different studies. Most of them found an association between fixed night work and overweight, obesity, or weight gain. This systematic review reinforces the evidence that fixed night work is associated with overweight or obesity, and prolonged night work exposure leads to weight gain. Future research should be conducted with more accurate measures and a prospective design. Fixed night workers should be monitored and advised, especially those with prolonged exposure.

Risk factors affecting occupational exposure to blood and body fluids among dental students: a cross-sectional study in a Brazilian Federal University

Introduction: Dental students are often exposed to bloodborne pathogens during dental training. Several factors are involved in increased risk of human deficiency, hepatitis B and hepatitis C virus (HIV, HBV, and HCV) infection. However, there are few studies that address the risks and forms of prevention among dental students in Brazil. Methods: A cross-sectional study of occupational exposure to blood or body fluids among dental students of Universidade Federal do Rio Grande do Sul, Brazil, was performed. These students were referred to the Occupational Medicine Department of Hospital de Clínicas de Porto Alegre from January 2007 to April 2015. Analyzed data included type of exposure (needlestick injury, mucosal exposure, and exposure to non-intact skin); source patient status for HBV, HIV and HCV infection, accident during dental training, procedure performed, biological material involved, type of accident, and hepatitis B vaccination and serological protection status. The objective was to know the incidence rate and others characteristics of accidents in order to prevent them. Results: There were 312 accidents during the study period of 8 years and 4 months. Incidence rate was 87,42 exposures per 1000 students year. Source patient was known in 297 of the cases (95.2%), of which 3 were HBsAg reagent, 12 were HIV reagent, and 17 were HCV reagent. The majority of accidents occurred during procedure, but nearly as high as 40% occurred after procedure, of which 63% occurred during instrument cleaning, disinfecting or sterilizing. Most involved sharp instruments were anesthetic syringe needle and curette. Only 48% of dental students knew their antiHBs was > 10 mIU/mL. Conclusions: Dental students should be tested for hepatitis B immune status at the beginning of training, and vaccination should be available to all dental students before they start clinical practice. Work practice controls on sharp devices should be addressed at the beginning and strengthened during dental training. Dental training institutions should review instrumental cleaning process to minimize handling of loose contaminated instruments (AU)

Needlestick accident resulting in occupational transmission of HCV: report of two cases

Occupational transmission of hepatitis C virus (HCV) through needlestick injury is a serious problem worldwide. Occupational transmission of HCV is estimated at an average rate between 0.5% and 0.75%. There are factors associated with increased risk of transmission, such as deep injuries, procedures involving hollow-bore needle placement in the source patient’s vein or artery, and high HCV RNA titer in the source patient. We describe two cases of HCV seroconversion in nursing assistants after different risk needlestick injuries...

Internato em atencao primaria a saude: relato de uma experiencia / Trainning in primary health care: a rotatory discipline experience description

O presente trabalho descreve a experiencia da autora durante seu treinamento em Atencao Primaria a Saude como estagiaria de sexto ano do curso de Medicina da Universidade Federal de Pelotas, RS, enfatizando os atendimentos ambulatoriais realizados no periodo de janeiro a setembro de 1992. Os resultados demonstram uma elevada prevalencia de pacientes do sexo feminino (75 por cento ), sendo os motivos de consulta mais frequente as queixas de origem ginecologica. Observou-se tambem uma reduzida solicitacao de exames complementares (28,1 por cento ). Entre as condutas mais prevalentes esteve a prescricao de medicamentos e a adocao de medidas de carater educativo e preventivo. Compara- se estes dados advindos da pratica ambulatorial com os objetivos previstos pelo estagio, concluindo que os objetivos iniciais foram parcialmente alcancados, destacando o de propiciar o contato do futuro medico com as varias nuancas da pratica medica

Estágio urgência e emergência: projeto integrado de avaliação do ensino médico

Resumo: Este trabalho descreve o nível referido de aquisição de habilidades psicomotoras na área de urgência e emergência, obtidas por estudantes de Medicina do 11º semestre, durante um mês de treinamento no Hospital Municipal de Pronto Socorro de Porto Alegre (HPS-PoA). Questionários contendo uma listagem de habilidades técnicas inquiriam, antes do treinamento e imediatamente após, se os alunos consideravam-se aptos ao desempenho dessas habilidades. Na análise, as habilidades foram agrupadas de acordo com áreas de treinamento: clínica médica, politraumatizados, sutura, traumatologia e hemoterapia. Houve incremento significativo de respondentes que se consideraram aptos em 23 das 32 habilidades listadas. Quanto ao desempenho não houve diferença significativa em 15 das habilidades estudadas. Estes resultados sugerem que o fato do aluno julgar-se apto à execução de uma habilidade não significa que ele a lenha desempenhado durante seu período de treinamento.

Abstract: Urgency and Emergency Rotatory Program: Integrated Project for Undergraduate Medical Evaluation This work describes the opportunities for undergraduate medical students in their 11th semester to acquire basic skills within one month of training at an emergency hospital in Porto Alegre. Questionnaries containing a list of technical skills asked the students both on arrival and immediately after termination of the training programme whether they considered themselves capable to perform those tasks. For the analysis the skills were grouped according to the training area: clinical, politrauma, stitching, traumatology and hemotherapy. Out of 32 skills, 23 showed a significant improvement in the percentage of respondents who considered themselves competent after the training period. As far as performance opportunities, there were no significant changes for 15 of the skills studied. These results suggest that while the trainees might have the "cognitive aptitude" this does not mean they had the opportunity to perform it.