Aportes navales al inicio de la investigación en medicina tropical en el siglo XIX / Naval contributions at the beginning of the tropical medicine research in the 19th century

Resumen En la segunda mitad del siglo XIX, el inicio de la investigación en medicina tropical se vio favorecido con aportes de empresas navieras, como la Compañía Holandesa de las Indias Orientales, siendo quizás el más importante su gestión apoyando la creación en China del Servicio Marítimo Imperial de Aduanas (1854-1950), impuesto al débil gobierno chino por los cónsules de Inglaterra, Francia y EEUU, para establecer tasas regulares en todos sus puertos, que pronto amplió sus funciones a la información de mareas, tifones y clima, terminando por crear en 1863 un Servicio Médico para detectar epidemias y establecer cuarentenas. Este Servicio Médico editó una revista, Medical Reports, en la cual publicaron distinguidos investigadores, como Patrick Manson, Padre de la Medicina Tropical. Comentamos algunos informes aparecidos en ella, para conocer su real importancia en el desarrollo de la medicina tropical.

Abstract In the second half of the 19th century, the beginning of the research on tropical medicine was favored with contributions from shipping companies, like Dutch East India Company, being perhaps the most important of these its collaboration in the creation of the China Imperial Maritime Customs Service (1854-1950), imposed by consuls from England, France and USA, on the weak Chinese government in order to establish regular taxes in all its ports, soon expanding its functions with reports on tides, typhoons and weather, ending up creating a medical service in 1863 to detect epidemics and establish quarantines. This medical service published a Journal, the Imperial Maritime Customs Medical Reports, where they wrote distinguished investigators, such as Patrick Manson, Father of Tropical Medicine. We comment in some reports of this journal, to get an idea about its real importance in the development of tropical medicine.

Scientific evidence of dockworker illness to nursing clinical reasoning / Evidencias científicas de enfermización del trabajador portuario para el razonamiento clínico de la enfermería / Evidências científicas de adoecimento do trabalhador portuário para o raciocínio clínico da enfermagem

Abstract OBJECTIVE To identify scientific evidence of occupational illness of dockworkers published in the literature. METHOD systematic review of the literature, developed according to the Cochrane method. The databases searched were: Cochrane, LILACS, MEDLINE/PubMed, CINAHL and SciELO. Studies from 1988 to 2014 were selected. The data were analyzed according to the level of evidence and Strengthening the Reporting of Observational Studies in Epidemiology. RESULTS We included 14 studies, in which 11 (78.6%) were from international journals. The year of 2012 showed greater number of studies. All studies were classified as: Level of Evidence 4, highlighting lung cancer, musculoskeletal and ischemic diseases, causal link in chemical risks. CONCLUSION The development of preventive measures should especially include chemical exposure of workers applying the clinical reasoning of nurses' environmental knowledge to care for illnesses.

Resumen OBJETIVO Identificar evidencias científicas de enfermización ocupacional del trabajador portuario publicadas en la literatura. MÉTODO Revisión sistemática de la literatura, planteada conforme al método Cochrane. Las bases de datos investigadas fueron Cochrane, LILACS, MEDLINE/PubMed, CINAHL y SciELO. Fueron seleccionados artículos publicados de 1998 a 2014. Los datos fueron analizados conforme al Nivel de Evidencia y Strengthening the Reporting of Observational Studies in Epidemiology. RESULTADOS Fueron seleccionadas 14 publicaciones, de las que 11 (78,6%) fueron de revistas internacionales. El año del 2012 reunió mayor número de publicaciones en el período de estudio. Todas las publicaciones pertenecían al Nivel de Evidencia 4, destacando el cáncer pulmonar, las enfermedades osteomusculares e isquémicas, con nexo causal en los riesgos químicos. CONCLUSIÓN La elaboración de medidas preventivas debe prever especialmente la exposición química del trabajador, aplicando al razonamiento clínico del enfermero un conocimiento ambiental para la asistencia a las enfermizaciones.

Resumo OBJETIVO Identificar evidências científicas de adoecimento ocupacional do trabalhador portuário publicadas na literatura. MÉTODO Revisão sistemática da literatura, construída conforme o método Cochrane. As bases de dados pesquisadas foram Cochrane, LILACS, MEDLINE/PubMed, CINAHL e SciELO. Foram selecionados artigos publicados de 1988 a 2014. Os dados foram analisados conforme o Nível de Evidência e Strengthening the Reporting of Observational Studies in Epidemiology. RESULTADOS Foram selecionadas 14 publicações, das quais 11 (78,6%) de revistas internacionais. O ano de 2012 reuniu maior número de publicações no período de estudo. Todas as publicações pertenciam ao Nível de Evidência 4, destacando o câncer pulmonar, doenças osteomusculares e isquêmicas, com nexo causal nos riscos químicos. CONCLUSÃO A elaboração de medidas preventivas deve prever especialmente a exposição química do trabalhador, aplicando ao raciocínio clínico do enfermeiro um conhecimento ambiental para a assistência aos adoecimentos.

Los cuerpos militares como hito social del cuidado para la enfermería naval / Military bodies as a social milestone of care for naval nursing

En las últimas décadas la enfermería en México ha realizado investigaciones que buscan recuperar su identidad disciplinar con base en la historiografía de distintos gremios de enfermeras indagando sobre sus orígenes y antecedentes históricos para definir los elementos ontológico y epistemológicos que les caracterizan. Tal es el caso de la Enfermería Naval que a través de su historia, describe la evolución profesional como gremio, con el objetivo de construir la primera historiografía sobre la formación de enfermeras navales en el medio militarizado, contribuyendo a su vez con el acervo histórico de la enfermería en México. La historia de este gremio se construyó con base en la fenomenología descriptiva e interpretativa, para ello se efectuó análisis de contenido de fuentes históricas documentales, periódicos, fotografías, videos, microfilms, entrevistas a profundidad e inclusive una historia de vida, entre las cuales se categorizaron temas y subtemas definiendo como ejes teóricos: los orígenes de la sanidad en el ejército, la iniciación de la enfermería en la Armada y la evolución de las enfermeras navales al servicio de sus milicias. Los resultados han revelado que los cuidados de enfermería hacia las milicias marítimas en México, datan desde el siglo XVIII principalmente en los puertos de Veracruz y Acapulco; así también, que a lo largo del siglo XX mediante fenómenos sociales como: la profesionalización de los marinos militares, la Segunda Guerra Mundial, el crecimiento económico de la zona marítima mexicana, la proporción de ayuda humanitaria a población en situación de catástrofe natural y el apoyo en los procesos de seguridad nacional, es como la enfermería naval mexicana ha evolucionado su práctica profesional. Se concluye que el gremio de enfermeras navales ha evolucionado en su disciplina, a través de estudiar, adaptar y articular su práctica profesional con su población de estudio que son los cuerpos militares marítimos, incrementando su nivel educativo a partir de la existencia de su escuela y consolidando su reconocimiento en el ámbito militar mediante la adaptación de sus cuidados en cuyo ambiente, representa la parte humana de la Armada de México.

On last decades the nursing in Mexico has done research with the intention of recovering its identity as a discipline based on the historiography of different nurses guilds, inquiring about their origins and historical background in order to define the ontologic and epistemological elements that characterize them. Such is the case of the Naval Nursing that through its history, describes the professional evolution as a guild, with the objective of building the first historiography about the formation of naval nurses inside the military scope, and at the same contributing with the nursing historical heritage of Mexico. The History of this guild was constructed based on the descriptive and interpretative phenomenology, for this was performed an analysis of the content of historical documental sources, newspaper, photographs, videos, microfilms, interviews in depth and even a life story, among which topics and subtopics were categorized, defining as theoretical axis: Origins of health in the army, the beginnings of the nursing in the Army and the evolution of the naval nurses to the services of their militias. The results have revealed that the nursing attentions toward the militias in Mexico dating mainly from the XVIII century in the Veracruz and Acapulco ports; also that along the XX century due to social phenomena as: the professionalization of the marines, the Second World War, the economic growth in the Mexican maritime area, the portion of humanitarian help given to the population at natural disaster and the support on the national security process, is how the Mexican naval nursing has evolved its professional practice. I conclude that the guild of the naval nurses has evolved in its discipline, through knowing, attending and articulating its professional practice with its study population which are the maritime military corps, increasing its educational level since the foundation of its school and consolidating its recognition in the military scope through adapting its care representing the human part of the Mexican Navy. Keywords: Military, naval nursing, care.

Health status of thyroid and related influencing factors in seamen in Zhoushan, China / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the health status of the thyroid and related influencing factors in the seamen in Zhoushan, China.</p><p><b>METHODS</b>A total of 136 coastal seamen (coastal group), 104 deep-sea seamen (deep-sea group), and 272 base staff (base group) who underwent physical examinations in 2014 were selected. Questionnaire survey and ultrasound were performed, and levels of thyroid hormone and urinary iodine were measured.</p><p><b>RESULTS</b>Compared with the coastal group and the base group, the deep-sea group had a significantly higher rate of abnormal ultrasound findings (49.04% vs 30.88%/28.67%, P<0.05), as well as a significantly higher rate of abnormal serum free thyroxine (FT4) (25.00% vs 9.56%/6.25%, P<0.05). The logistic regression analysis showed that in the coastal group, the risk factors for thyroid abnormality on ultrasound were obesity shown by body mass index (BMI) (OR=2.55, 95% CI=1.13~4.13) and annual working time>6 months (OR=4.25, 95% CI=2.02~8.26) (both P<0.05); in the deep-sea group, the risk factors for thyroid abnormality on ultrasound were obesity shown by BMI (OR=3.45, 95% CI=1.28~7.02) and annual working time>6 months (OR=5.33, 95% CI=3.18~9.23) (both P<0.05).</p><p><b>CONCLUSION</b>The thyroid abnormality in deep-sea seamen is caused by various reasons and is correlated with annual working time, working environment and area, and iodine nutritional status.</p>

Offshore training in navy personnel is associated with uninvestigated dyspepsia / 华中科技大学学报（医学）（英德文版）

To investigate the known and new factors associated with uninvestigated dyspepsia (UD), we surveyed 8600 Chinese navy personnel with offshore training shorter than 1 month or longer than 9 months per year. All respondents were required to complete a questionnaire covering demographics, the Chinese version of the Rome III survey, eating habits, life styles, and medical and family history. The response rate was 94.3% (8106/8600) with 4899 respondents qualified for analysis, including 1046 with offshore training and 3853 with onshore training. The prevalence of UD was higher in the offshore group than in the onshore group (12.6% vs. 6.9%, P<0.001), with a general prevalence of 8.1%. The subjects with offshore training were more likely to suffer from UD and postprandial distress syndrome (OR=1.955, 95% CI 1.568-2.439, P<0.001 and OR=1.789, 95% CI 1.403-2.303, P<0.001, respectively). The multivariate logistic regression analysis showed UD was associated with offshore training (OR=1.580, 95% CI 1.179-2.118, P=0.002), family history (OR=1.765, 95% CI 1.186-2.626, P=0.005) and smoking (OR=1.270, 95% CI 1.084-1.488, P=0.003), but not with alcohol drinking. The association between dysentery history and UD was undetermined/borderline (P=0.056-0.069). In conclusion, we identified offshore training as a new factor associated with UD, and also confirmed 2 known associated factors, family history and smoking.

Habituation of seasickness in adult during a long voyage / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To observe the habituation of seasickness in non marine subjects during a long voyage.</p><p><b>METHODS</b>A crew of 106 staffs of the Hospital Ship Ark Peace was included in this study. There were 59 male and 47 female with an age ranged from 23 to 53 years (mean 37.2 years). They all took part in the Mission Harmony 2011 for medical service in four countries around the Caribbean Sea. Questionnaires and visual analogue scales (VAS) were used to investigate the prevalence and degree of the seasickness in different periods.</p><p><b>RESULTS</b>The prevalence of seasickness was 72.64% in the initial period of voyage. The prevalence and degree of seasickness in female and in staff with motion sickness history were higher and more severe than that in male and in staff without motion sickness history(P < 0.05). After two weeks, the prevalence and degree of seasickness decreased, which meant habituation of seasickness occurred. With the voyage going longer, the prevalence and degree of seasickness were further decreased, but the severe sea condition make the prevalence and degree of seasickness worse. The rate of habituation of seasickness was 62.33%, and the habituation rate of seasickness in male (76.92%) was higher than that in female (47.37%) (χ(2) = 7.161, P = 0.007).</p><p><b>CONCLUSIONS</b>The habituation of the seasickness occurred after two weeks in a long voyage. Male are easier to get habituation of seasickness than female. The severe sea condition influences the prevalence and degree of seasickness.</p>

Risk prediction of coronary artery disease among naval forces

Coronary artery disease [CAD] risk factors seem to cluster in some occupational groups. The present study was designed to investigate CAD risk factors among naval forces as an example of a high risk sector and to construct a risk prediction model for the disease. A case control study was carried out at the general naval hospital [GNH] in Alexandria. The study included 250 male consecutive naval CAD cases with a control group of 250 males matches for age, occupational level, sociodemographic characteristics and, free from CAD. All participants were subjected to a questionnaire about personal data, occupational history and exposures, occupational and leisure physical activity, dietary habits, smoking, and medical history. Anthropometric measurements, sifting blood pressure, and lipid profile were determined by the standard methods. Results revealed that occupational sedentary activity and perceived occupational noise were the significantly reported special occupational characteristics together with other conventional risk factors among CAD naval cases verses controls [p< 0.000 and < 0.009 respectively]. Logistic regression analysis with the dependent variable as being a CAD case showed independently significant effects for family history of premature CAD, history of hypertension, smoking, history of diabetes mellitus, body mass index [BMI], leisure physical activity, fish consumption, and HDL-cholesterol. A risk prediction model utilizing these variables was constructed with an overall correct percent of 74.6%. Application of the model expresses the risk of having CAD in an individual eligible with criteria of the study population. These results are of special importance for design of preventive programs for CAD in similar high risk occupational groups

Radar radiation damages sperm quality / 中华男科学杂志

<p><b>OBJECTIVE</b>To study the effects of radar radiation on sperm quality.</p><p><b>METHODS</b>A total of 348 infertile seamen were divided into 4 experimental groups according to their different lengths of exposure to radar radiation: Group 1 (n = 128) exposed for 12-36 months, Group 2 (n = 58) 37-72 m, Group 3 (n = 47) 73-108 m, Group 4 (n = 19) 109 m or more and Group 5 (n = 96) 48 m or more but free from the exposure for 6 months by then. Another 35 non-marine normal males were recruited as Control Group 1, and the first four experimental groups (n = 252) were taken as Control Group 2. Semen samples were collected from the subjects and analyzed statistically.</p><p><b>RESULTS</b>Compared with the normal control, sperm concentration, sperm motility and the percentage of grade a sperm were significantly lower (P < 0.01), and the percentages of grade d and abnormal sperm significantly higher (P < 0.01) in the experimental groups. In Group 5, obvious recovery was noted in sperm morphology (P < 0.01) and motility (P < 0.05), but significant differences were seen with the normal control group in sperm concentration (P < 0.05), sperm motility and the percentage of grade a and b sperm and that of abnormal sperm (P < 0. 01).</p><p><b>CONCLUSION</b>Radar radiation damages sperm quality, as shown in the reduction of sperm motility and elevation of sperm abnormality. Cease from the exposure may effect an easy recovery in sperm morphology.</p>

Ciguatera fish poisoning in industrial ship crewmembers: a retrospective study in a seaport general practice in Trinidad and Tobago

The objective of this study was to outline the epidemiology of Ciguatera fish poisoning as seen in a general practice serving two industrial seaports in Trinidad and Tobago, in order to highlight the potential public health implications. A retrospective study was undertaken of all the cases of Ciguatera fish poisoning identified between November 1, 1992 and October 31, 1998 in a seaport general practice to identify signs, symptoms and treatment. An investigation of one outbreak was undertaken. Four outbreaks affecting 42 male ship crewmembers were identified. The suspect fish were caught in northern Caribbean waters en route to Trinidad and Tobago. The most common early symptoms were diarrhoea, vomiting, abdominal cramps, pruritus and tiredness. In the third outbreak, dysaesthesia was common. Progression to muscular weakness, ataxic gait, unsteadiness and other neurotoxic signs were seen in moderate to severe disease. Hypotension was an important prognostic sign in the initial case. Treatment was symptomatic and supportive and included vitamins B12 and BCO, folic acid, prostigmine, steroids and antihistamines as indicated. In the investigation of the second outbreak, the relative risk of 'eating fish meat' was 5 (95 CI 1.45, 17.27, p < 0.0001). Abdominal symptoms, pruritus, and muscle weakness with a history of consuming a fish-meal were diagnostic indicators of 'ciguatera fish poisoning.' All cases were industrial ship crewmembers. It is suggested that increased clinician awareness with early and appropriate treatment, and focussed public health intervention may help limit the potential public health impact of ciguatera poisoning in industrial ship crewmembers and other fish-consuming communities in the future

Medical support for the North East Line Mass Rapid Transit project by the Republic of Singapore Navy's Naval Medicine Hyperbaric Centre

Naval Medicine Hyperbaric Centre (NMHC) was approached by the Land Transport Authority (LTA) to provide medical support for the North Eastern Line MRT Project. The medical support provided by NMHC focused on providing training, audits and ensuring that safety and health infrastructure were in place even before the commencement of compressed air tunnelling. The extensive use of the EPBM (Earth Pressure Balance Machine) tunnelling machines for the first time in Singapore necessitated a reassessment of the medical support system and paradigm that was based primarily on the older form of tunnelling. The survey results showed that human exposure to compressed air works with the use of EPBM was minimal and no decompression illness was reported. However, there was still a total of 28 cases of barotrauma that were reported which were mainly from the tunnels dug using the open face compressed air tunnelling method. As such, medical providers should still exercise careful planning for the medical support of compressed air works.

A vigilância em saúde na indústria naval: o caso dos trabalhadores em atividade de pintura em um estaleiro do Rio de Janeiro / The surveillance in health in the naval industry

Estuda o controle e a alta incidência de silicose entre os trabalhadores na indústria naval no Estado do Rio de Janeiro, desencadeada a partir da denúncia de um único trabalhador, deu início a um processo de vigilância em saúde que vem rompendo com o modelo burocrático e ineficiente historicamente estabelecido. Da indignaçäo dos trabalhadores com a omissäo das empresas e a conivência do Estado, nas questöes afetas à saúde decorrente da organizaçäo e o processo de trabalho, ao envolvimento de um amplo espectro institucional, que mobiliza de Sindicato de Trabalhadores ao Ministério Público do trabalho, tem sido possível construir uma prática que permite ampliar as discussöes a este respeito, e portanto, abrindo uma perspectiva com a possibilidade de algum resultado mais efetivo na soluçäo de tais problemas. Neste contexto, que se constrói um novo modelo de vigilância em saúde do trabalhador, realizou-se este estudo, que busca discutir as condiçöes em que se executam as atividades de pintura em um estaleiro no Estado do Rio de Janeiro, a partir de elementos relacionados ao inquérito de morbidade, exames clínicos, avaliaçäo de indicadores biológicos de exposiçäo e exames laboratoriais e análises clínicas complementares - e à avaliaçäo ambiental - através de amostras coletadas em diferentes situaçöes de trabalho - assim como à percepçäo dos trabalhadores quanto a seu mundo laboral. A articulaçäo institucional envolvendo instituiçöes públicas, sindicatos de trabalhadores e a própria empresa constituiu-se em elemento fundamental para viabilizaçäo de todo o trabalho. A partir desta articulaçäo foi possível também constituir uma equipe profissional de caráter interdisciplinar, que elaborou e executou as intervençöes no interior do estaleiro, em três diferentes fases no intervalo de aproximadamente um ano.

Determinantes de lesöes do trabalho em tripulantes do sistema Ferry-Boat / Causes of accidents or works lesions among the Ferry-Boat crew

Esta pesquisa tem como objeto identificar e analisar os determinantes de acidentes ou "lesöes do trabalho" em tripulantes do Sistema Fery-Boat. Buscou-se identificar, também, a frequência e a gravidade das "lesöes" ocorridas nos tripulantes e a relaçäo entre "lesöes do trabalho" e alcoolismo. O referencial teórico trata da navegaçäo marítima e a saúde dos tripulantes; do trabalho e dos acidentes ou lesöes do trabalho relativos aos tripulantes marítimos, além de uma discussäo sobre alcoolismo e acidentes do trabalho. Os dados, objeto de análise, säo de fontes secundárias e primárias, todos obtidos no Consórcio Marítimo da Bahia - COMAB, através de documentos e de história de vida (como técnica) aplicada com quatro tripulantes marítimos, quatro conviventes (familiares) e dois líderes da Empresa. Os resultados, identiificados através dos registros da Empresa e dos depoimentos, evidenciam que as condiçöes de trabalho dos tripulantes marítimos säo precárias necessitando de investimentos para superá-las. Além do mais, revelam diferentes determinantes dos acidentes ou lesöes do trabalho, destacando os de âmbito individual, social, institucional e cultural. Destes determinantes, chamou a atençäo o alcoolismo que, embora näo assumido pelos atores sociais, tanto o discurso destes como o dos conviventes e dos líderes sugerem a sua relaçäo com o trabalho e, possivelmente, com o acidente sofrido pelo trabalhador. Este é, portanto, um estudo que oferece subsídios para que a Marinha Mercante possa repensar os acidentes ou lesöes do trabalho como um problema social

Hipertensäo arterial na triagem para o serviço militar / Arterial hypertension in military service trial

Os autores observaram uma populaçäo especial de hipertensos entre os jovens de 18 anos, que se apresentaram para o serviço militar, e analisaram os fatores de risco associados aos grupos, como: idade, relaçäo peso e altura, história patológica pregressa e história familiar. Este grupo revelou ser de 3,48 por cento dos rapazes que se apresentaram para o serviço militar

Plan conjunto de acciones de salud cívico navales frontera colombo-peruana. 1993 / Joined plan of health actions civic naval frontier colombo-peruana. 1993

El plan incluye una programación periódica de vacunación, educación en salud, control y prevención de las patologías tropicales especialmente malaria, empleo de sales de rehidratación oral, saneamiento ambiental básico, planificación familiar y tratamientos ambulatorios médicos y odontológicos de acuerdo al perfil epidemiológico