ABSTRACT
Background & objectives: High-altitude pulmonary oedema (HAPE) continues to challenge the healthcare providers at remote, resource-constrained settings. High-altitude terrain itself precludes convenience of resources. This study was conducted to evaluate the rise in peripheral capillary saturation of oxygen (SpO2) by the use of a partial rebreathing mask (PRM) in comparison to Hudson's mask among patients with HAPE. Methods: This was a single-centre, randomized crossover study to determine the efficiency of PRM in comparison to Hudson's mask. A total of 88 patients with HAPE referred to a secondary healthcare facility at an altitude of 11,500 feet from January to October 2013 were studied. A crossover after adequate wash-out on both modalities was conducted for first two days of hospital admission. All patients with HAPE were managed with bed rest and stand-alone oxygen supplementation with no adjuvant pharmacotherapy. Results: The mean SpO2on ambient air on arrival was 66.92�.8 per cent for all patients with HAPE. Higher SpO2values were achieved with PRM in comparison to Hudson's mask on day one (86.08�15 vs. 77.23�09%) and day two (89.94�96 vs. 83.39�93%). The difference was more pronounced on day one as compared to day two. Interpretation & conclusions: Mean SpO2values were found to be significantly higher among HAPE patients using PRM compared to those on Hudson's mask. Further studies to understand the translation of this incremental response in SpO2to clinical benefits (recovery times, mortality rates and hospital stay) need to be undertaken.
ABSTRACT
Previous studies have revealed that eye contact with either air pollutants or adverse indoor and/or outdoor environmental conditions can affect tear film composition and ocular surface components. These effects are mediated by selective binding of the environmental agents to ocular surface membrane receptors, leading to activation of pro inflammatory signaling pathways. The aim of the current review was to examine the published evidence associated with environmental factors and ocular surface disease and dry eye. Specifically, the reader will appreciate why it is possible to refer to them as mediators of Environmental Dry Eye Disease (EDED), a singular clinical entity inside DED context, directly caused by pollutants and/ or adverse climatic conditions. The indicators and clinical findings are described along with EDE differential diagnosis in its acute and the chronic phases. Based on strong existing evidence of clinical reports and epidemiological observations regarding DED and environmental factors we conclude that there is a straight cause-and-effect relationship between ambient stresses and DED. International standards and web-based tools are described for monitoring worldwide environmental conditions referring localities and populations susceptible to EDED. This information is beneficial to health providers to pinpoint the individuals and predisposed groups afflicted with DED. Such insights may not only improve the understanding and treatment of DED but also help to identify the contributing factors and lower the frequency and progression of EDED.
Diversos estudos têm demostrado que o contato ocular com poluentes ambientais afeta a composição do filme lacrimal e de estruturas da superfície ocular. Tais efeitos são mediados pela ligação de agentes ambientais com receptores na superfície ocular, levando a ativação de mediadores pró inflamatórios. Esta revisão propõe uma avaliação das evidências publicadas, que associam fatores ambientais as doenças de superfície ocular e ao olho seco. O leitor compreenderá que é possível inferir olho seco ambiental como uma entidade singular dentro do contexto da doença olho seco, diretamente causado pela exposição a poluentes e/ou condições climáticas adversas. Serão descritos os indicadores e achados clínicos, assim como o diagnóstico diferencial das fases aguda e crônica. A avaliação de relatos clínicos e observações epidemiológicas demonstra uma forte associação entre olho seco e fatores ambientais. O conhecimento sobre parâmetros internacionais e ferramentas de monitorização das condições ambientais no mundo, permite identificar localidades e populações mais suceptívies ao olho seco ambiental e pode auxiliar na identificação de indivíduos acometidos e grupos predispostos. E desta forma, melhorar o entendimento e tratamento dessa condição, diminuir os fatores associados, sua frequência e progressão.
Subject(s)
Humans , Dry Eye Syndromes , Environmental Illness , Environmental Pollutants/adverse effects , Lacrimal Apparatus DiseasesABSTRACT
Nos últimos anos, é diária a veiculação de informações acerca de catástrofes ambientais e seus impactos ecológicos e sociais, o que torna relevante pesquisar a interface saúde e meio ambiente. O objetivo deste estudo foi discutir o estado da arte construído pela enfermagem na temática ambiental, na base de dados Medline, no período de 1997 a 2010. Trata-se de uma revisão sistemática qualitativa, processada em junho de 2010, e que resgatou 35 referências, sendo 16 delas analisadas. Construíram-se como categorias de análise: Riscos ambientais; Concepção de meio ambiente e ações de enfermagem; Meio ambiente como ambiente de trabalho da enfermagem; Interação indivíduo-meio ambiente e sua influência no processo saúde/doença; e A formação em enfermagem e sua relação com a questão ambiental. Concluiu-se que a produção na área é limitada, pontual, vinculada a entrevistas e reflexões, as quais funcionam como pontos de mutação; resta saber quantos são os sensibilizados.
Given the information about environmental disasters and their ecological and social impacts broadcast daily in recent years, it is important to research at the health-environment interface. This study aimed to discuss the state-of-the-art knowledge constructed by nursing on environmental issues in the Medline database from 1997 to 2010. This qualitative, systematic review, performed in June 2010, found 35 references, 16 of which were examined. The analytical categories constructed were: Environmental hazards; The conception of environment and nursing actions; Environment as nurses working environment; Interaction between individual and environment and its influence on health-disease processes; and Nursing training and its Relation to environmental issues. It was concluded that production in the field is limited, occasional, and connected with interviews and critical thinking, which function as turning points. It remains to know how many people are aware of them.
Actualmente, es diaria la vinculación de informaciones acerca de catástrofes ambientales y sus impactos ecológicos y sociales, lo que torna relevante investigar la interface salud y medio ambiente. Esa exploración bibliográfica pretende discutir el estado de la arte construido por la enfermería en la temática ambiental, en la base de datos Medline, en periodo de 1997 a 2010. Es una revisión sistemática cualitativa, procesada en junio de 2010, que rescató 35 referencias, siendo 16 de ellas analizadas. Las categorías de análisis: Riesgos ambientales; Concepción de medio ambiente y acciones de enfermería; Medio ambiente como ambiente de trabajo de enfermería; Interacción individuo-medio ambiente y su influencia en el proceso salud enfermedad; y La formación en enfermería y su relación con la cuestión ambiental. Se concluyó que la producción en esta área es limitada, puntual, vinculada a entrevistas y reflexiones, las cuales funcionan como puntos de mutación; falta saber cuantos son los sensibilizados.
Subject(s)
Humans , Nursing Care , Environmental Illness , Nursing , Environment , Environmental Health/standards , Intersectoral Collaboration , Review Literature as Topic , ResearchABSTRACT
Pesticides are poisons designed to kill living organisms considered pests. Costa Rica have used these substances for pest control in agriculture for more than half a century since the first records of importation into the 1970s the use of these has been increasing. Today, Costa Rica remains one of the countries of Central America with the highest rates of pesticide use Objective: The present study is to analyze the policies, rules and practices related to Costa Rican agricultural chemicals, in the light of international practice and case study of banana workers affected by the use of pesticides. Development: The study establishes the agreement of the national policy, standards, regulatory instruments, control and monitoring of pesticide applications in relation to the existing internationally. Conclusion: In Costa Rica about 25 000 workers were exposed to the product Nemagon in the banana. In addition, women and children of banana workers affected by the toxicity of these products...
Los plaguicidas son sustancias tóxicas diseñadas para eliminar organismos vivos considerados plagas. En Costa Rica se han utilizado para el control de plagas en la agricultura por más de medio siglo y desde los primeros registros de importación en los años setenta el uso de estos ha ido en aumento. Hoy en día, Costa Rica continúa como uno de los países de la región centroamericana con los mayores índices de uso de plaguicidas. Objetivo: El presente estudio tiene como finalidad analizar las políticas, las normas y las prácticas costarricenses relacionadas con los agroquímicos, a la luz de la práctica internacional y del estudio de caso de los trabajadores bananeros afectados por el uso de plaguicidas. Cuerpo: El estudio establece la concordancia del sistema nacional en materia de políticas, normas, instrumentos reguladores, control y monitoreo de la aplicación de pesticidas, en relación con el existente en el ámbito internacional. Conclusión: En Costa Rica unos 25 000 trabajadores fueron expuestos al producto Nemagón en la zona bananera. Además, las mujeres y los niños de los trabajadores bananeros fueron afectados por la toxicidad de estos productos...