Psychosis in Epilepsy vs Late-Onset Schizophrenia: A Case Report.

Psychotic disorders can have a primary or secondary origin. Primary psychosis includes pathologies such as paranoid schizophrenia, acute psychotic episodes, schizoaffective disorder, and other chronic psychiatric disorders. However, in secondary psychosis, there is an organic cause that explains the appearance of psychotic symptoms, such as those secondary to the consumption of psychoactive substances or some neurological or systemic diseases. Psychosis in epilepsy falls under secondary psychosis. It may present as hallucinations and delirium reminiscent of some primary psychoses such as schizophrenia. We present the case of a 57-year-old female suffering from temporal lobe epilepsy who developed psychotic symptoms and whose definitive diagnosis was a challenge given the similarities between some alternative diagnoses, mainly between interictal psychosis of epilepsy and late-onset schizophrenia. We also review the relevant literature. We consider that more studies are required to clarify the relationship between epilepsy and psychosis.

Evaluación de la exposición de ciclistas a la contaminación del aire: una revisión de la literatura / Evaluation of cyclists exposure to air pollution: a literature review

RESUMEN Objetivos Describir e interpretar las metodologías y resultados de los principales estudios relacionados con el monitoreo de contaminación atmosférica en ciclistas. Métodos Se buscaron y analizaron las investigaciones a nivel nacional e internacional de los últimos diez años en las bases de datos Cochrane, Scopus, Embase, Science Direct y Pubmed. La búsqueda se realizó de Agosto a Septiembre del año 2017 usando los siguientes descriptores de búsqueda para MeSH: air pollution, bicycling, environmental exposure, enviromental health, inhalation exposure, environmental pollutants, transportation, public health y toxicology, y para DeCS: contaminación del aire, ciclismo, exposición a riesgos ambientales, contaminantes ambientales, inhalación, transportes, salud pública y toxicología. Resultados Se identificaron diecinueve artículos publicados elegibles. La mayoría de los estudios se realizaron en Europa y Estados Unidos. En Latinoamérica se han reportado cuatro estudios. Otros estudios buscaban comparar la exposición en distintas rutas en bicicleta, comparar trayectos de una misma ruta, y otros determinar la relación distancia vs exposición. De igual manera, variables como el tráfico vehicular, la distancia a las fuentes de emisión y el tipo de ciclorruta, juegan un papel fundamental en la exposición a contaminantes en ciclistas. Conclusiones Se encontraron diversas variables que influyen de forma directa o indirectamente en la exposición a la contaminación del aire de los usuarios de bicicleta, así como algunos factores que pueden reducir la exposición a estos contaminantes.(AU)

ABSTRACT Objectives To describe and interpret the methodologies and results of the main studies related to the monitoring of exposure of cyclists to air pollution. Methods Research and analysis of national and international research of the last ten years in the Cochrane, Scopus, Embase, Science Direct and Pubmed databases. The search was conducted in August and September 2017 using the following search descriptors for MeSH: air pollution, bicycle riding, environmental exposure, environmental health, exposure by inhalation, environmental pollutants, transportation, public health and toxicology. For DeCS: air Pollution, cycling, exposure to environmental risks, environmental pollutants, inhalation, transportation, public health and toxicology. Results Nineteen eligible published articles were identified. Most studies were conducted in Europe and the United States. Four studies have been reported in South America. Other studies seek comparisons on different bicycle routes, compare exposure during variations of the same route, and others determine the distance-exposure relationship. In the same way, variables such as vehicular traffic, distance to the emission sources and the type of bike path, play a fundamental role in the exposure to pollutants in cyclists. Conclusions Several variables were found that influence, directly or indirectly, the cyclists exposure to air pollution, as well as some factors that can reduce this exposure.(AU)

[Evaluation of cyclists exposure to air pollution: a literature review]. / Evaluación de la exposición de ciclistas a la contaminación del aire: una revisión de la literatura.

OBJECTIVES: To describe and interpret the methodologies and results of the main studies related to the monitoring of exposure of cyclists to air pollution. METHODS: Research and analysis of national and international research of the last ten years in the Cochrane, Scopus, Embase, Science Direct and Pubmed databases. The search was conducted in August and September 2017 using the following search descriptors for MeSH: air pollution, bicycle riding, environmental exposure, environmental health, exposure by inhalation, environmental pollutants, transportation, public health and toxicology. For DeCS: air Pollution, cycling, exposure to environmental risks, environmental pollutants, inhalation, transportation, public health and toxicology. RESULTS: Nineteen eligible published articles were identified. Most studies were conducted in Europe and the United States. Four studies have been reported in South America. Other studies seek comparisons on different bicycle routes, compare exposure during variations of the same route, and others determine the distance-exposure relationship. In the same way, variables such as vehicular traffic, distance to the emission sources and the type of bike path, play a fundamental role in the exposure to pollutants in cyclists. CONCLUSIONS: Several variables were found that influence, directly or indirectly, the cyclists exposure to air pollution, as well as some factors that can reduce this exposure.

OBJETIVOS: Describir e interpretar las metodologías y resultados de los principales estudios relacionados con el monitoreo de contaminación atmosférica en ciclistas. MÉTODOS: Se buscaron y analizaron las investigaciones a nivel nacional e internacional de los últimos diez años en las bases de datos Cochrane, Scopus, Embase, Science Direct y Pubmed. La búsqueda se realizó de Agosto a Septiembre del año 2017 usando los siguientes descriptores de búsqueda para MeSH: air pollution, bicycling, environmental exposure, enviromental health, inhalation exposure, environmental pollutants, transportation, public health y toxicology, y para DeCS: contaminación del aire, ciclismo, exposición a riesgos ambientales, contaminantes ambientales, inhalación, transportes, salud pública y toxicología. RESULTADOS: Se identificaron diecinueve artículos publicados elegibles. La mayoría de los estudios se realizaron en Europa y Estados Unidos. En Latinoamérica se han reportado cuatro estudios. Otros estudios buscaban comparar la exposición en distintas rutas en bicicleta, comparar trayectos de una misma ruta, y otros determinar la relación distancia vs exposición. De igual manera, variables como el tráfico vehicular, la distancia a las fuentes de emisión y el tipo de ciclorruta, juegan un papel fundamental en la exposición a contaminantes en ciclistas. CONCLUSIONES: Se encontraron diversas variables que influyen de forma directa o indirectamente en la exposición a la contaminación del aire de los usuarios de bicicleta, así como algunos factores que pueden reducir la exposición a estos contaminantes.

Assessment of hematological parameters in workers exposed to organophosphorus pesticides, carbamates and pyrethroids in Cundinamarca 2016-2017 / Evaluación de parámetros hematológicos en trabajadores expuestos a pesticidas organofosforados, carbamatos y piretroides, Cundinamarca 2016-2017

ABSTRACT Objective To establish hematotoxic alterations through clinical and paraclinical exploration in workers who are exposed to organophosphorus pesticides, carbamates and pyrethroids (OPCP) due to their work in production, packaging, distribution and fumigation processes in Cundinamarca-Colombia between 2016 and 2017. Materials and Methods A cross-sectional descriptive epidemiological study was carried out on a sample of 92 workers from six companies, mostly aged between 18 and 30 years, of which 61 % were males and 39 % females, and 71 % were workers in the operational area and 29 % in the administrative area. Univariate, bivariate and multivariate analyses were performed. Results Clinical exploration reported findings in 17 % of the sample group, of which only 2 % presented with erythrocyte cholinesterase outside the reference range. The values of hematological parameters such as peripheral blood smear (PBS) and complete blood count (CBC) were outside the range in 15 % and 47 % of the sample, respectively. Discussion The results suggest that there are hematological alterations in this group that could possibly be associated with chronic exposure to OPCP.

RESUMEN Objetivo Determinar las alteraciones hematotóxicas a través de una exploración clínica y paraclínica, en trabajadores que por su oficio se exponen a pesticidas organofosforados, carbamatos y piretroides (POCP), en procesos de producción, envase, distribución y fumigación, en el departamento de Cundinamarca Colombia. Metodología Se realizó un estudio epidemiológico descriptivo de corte transversal. Se realizó un análisis univariado, bivariado y multivariado. La muestra se conforma por 92 trabajadores de seis empresas, la mayoría entre los 18 y 30 años, de los cuales el 61 % son hombres y el 39 % mujeres, 71 % se desempeñan en el área operativa y 29 % en el área administrativa. Resultados Es de resaltar que se tienen hallazgos en la exploración clínica en el 17 % del grupo participante, solo el 2 % presenta la colinesterasa eritrocitaria por fuera del rango de referencia. Los parámetros hematológicos como el frotis de sangre periférica (FSP) presentan valores por fuera de los rangos en el 15 % y el cuadro hemático (CH) tiene valores por fuera de los rangos en el 47 % de las personas. Discusión Los resultados sugieren que existen alteraciones hematológicas en este grupo y que posiblemente podrían estar asociadas con la exposición crónica a POCP.

Assessment of hematological parameters in workers exposed to organophosphorus pesticides, carbamates and pyrethroids in Cundinamarca 2016-2017.

OBJECTIVE: To establish hematotoxic alterations through clinical and paraclinical exploration in workers who are exposed to organophosphorus pesticides, carbamates and pyrethroids (OPCP) due to their work in production, packaging, distribution and fumigation processes in Cundinamarca-Colombia between 2016 and 2017. MATERIALS AND METHODS: A cross-sectional descriptive epidemiological study was carried out on a sample of 92 workers from six companies, mostly aged between 18 and 30 years, of which 61 % were males and 39 % females, and 71 % were workers in the operational area and 29 % in the administrative area. Univariate, bivariate and multivariate analyses were performed. RESULTS: Clinical exploration reported findings in 17 % of the sample group, of which only 2 % presented with erythrocyte cholinesterase outside the reference range. The values of hematological parameters such as peripheral blood smear (PBS) and complete blood count (CBC) were outside the range in 15 % and 47 % of the sample, respectively. DISCUSSION: The results suggest that there are hematological alterations in this group that could possibly be associated with chronic exposure to OPCP.

Síndrome de quemarse por el trabajo en profesionales de enfermería, Bogotá, Colombia / Burnout syndrome among nursing professionals, Bogotá, Colombia / A síndrome de esgotamento profissional em enfermeiros, Bogotá, Colômbia

Objetivo: describir el Síndrome de Quemarse por el Trabajo (SQT) en profesionales de enfermería de los servicios de Urgencias y de la Unidad de Cuidado Intensivo de tres hospitales de Bogotá 2011-2013. Métodos: estudio de tipo descriptivo transversal, en el que se aplicó el "Cuestionario de Evaluación del Síndrome de Quemarse por el Trabajo" (CESQT), instrumento validado y que se adquirió para este estudio. Se preservaron los aspectos éticos. Los datos se procesaron en programa estadístico SPSS; asimismo, se emplearon procedimientos estadísticos para el análisis de los mismos. Resultados: participaron en el estudio 114 enfermeros. El 4,1% de los profesionales de enfermería de Urgencias, presenta SQT, aunque los profesionales de UCI tienen riesgo de desarrollar el síndrome. El SQT (p=0,009) y las subescalas de desgaste psíquico (p=0,034) e indolencia (p=0,004) difieren significativamente según el servicio en donde laboran estos profesionales. Conclusiones: los profesionales de Urgencias presentan SQT. Se debe profundizar en las consecuencias negativas que este síndrome genera en las instituciones, en los profesionales, en los pacientes, sus familias y en la sociedad en general. De ahí la importancia de generar intervenciones y asegurar ambientes laborales saludables que fortalezcan el cuidado de pacientes y la salud de estos profesionales.

Objective: to describe the burnout syndrome among nurses at the emergency services and intensive care units of three hospitals in Bogotá 2011-2013. Methods: a descriptive, cross sectional study using the "Assessment Questionnaire for the Syndrome of Burning Oneself Out At Work" (CESQT), which has been validated and was acquired for this study. Ethical aspects were preserved, and data were processed in the SPSS statistics software. Similarly, statistical procedures were used for the data analysis. Results: one hundred and fourteen nurses participated in the study, and 4.1% of the nurses in the emergency services had SBW. Similarly, the professionals from the ICU are at risk of developing the syndrome. The SBW (p=0.009) and the psychological exhaustion (p=0.034) and indolence (p=0.004) subscales differ significantly depending on the service for which these professionals work. Conclusions: emergency professionals have "Syndrome of burning oneself out at work" (SBW). The understanding of the negative consequences that this syndrome generates in different contexts such as institutions, professionals, patients, families and society in general should be deepened. Thus, it is important to create interventions and ensure healthy work environments which strengthen patient care as well as the health of these professionals.

Objetivo: Descrever a Síndrome de Esgotamento Profissional em profissionais da enfermagem dos serviços de Urgências da Unidade de Terapia Intensiva de três hospitais de Bogotá entre 2011 e 2013. Metodologia: É um estudo descritivo transversal, para o qual se utilizou o "Questionário de Avaliação da Síndrome de Esgotamento Profissional": um instrumento validado, especialmente adquirido para esta pesquisa. Preservaramse aspectos éticos. Os dados foram processados no programa estatístico de nome SPSS. Também se utilizaram procedimentos estatísticos para analisar esses dados. Resultados : Neste estudo participaram 114 enfermeiros. 4,1% dos enfermeiros profissionais de Urgência tem Síndrome de Esgotamento Profissional, embora os profissionais da UTI têm risco de sofrer a síndrome. A Síndrome de Esgotamento Profissional (p = 0,009) e as subescalas de Esgotamento Psíquico (p = 0,034), e a Indolência (p = 0,004) diferem significativamente dependendo do serviço onde trabalhem os profissionais. Conclusão: Os profissionais de Urgências sofrem da Síndrome de Esgotamento Profissional. É necessário pesquisar mais sobre as consequências negativas que esta síndrome gera nas instituições, nos profissionais, nos pacientes, nas suas famílias e na sociedade completa. Por isso é tão importante gerar intervenções e garantir ambientes de trabalho saudáveis, para fortalecer o atendimento dos pacientes e a saúde dos trabalhadores.

Medidas de control de tuberculosis en una institución de salud de Bogotá D.C / Control measures against tuberculosis in a health care providing institution in Bogotá D.C / Medidas de controle da tuberculose numa instituição de saúde de bogotá D.C

Objetivo: evaluar la implementación de medidas de control, de tipo administrativo, ambiental y de protección respiratoria, de la infección de tuberculosis en un hospital de III nivel de atención en la ciudad de Bogotá D.C. Metodología: estudio de tipo descriptivo, transversal. Para la recolección de datos se aplicó una herramienta de autorreporte a 158 trabajadores de la salud del hospital, se realizó una entrevista estructurada al responsable del programa institucional de control de tuberculosis y una visita de observación de un experto en salud y seguridad laboral a las diferentes áreas de trabajo, para indagar por la implementación de medidas de control de infección de tuberculosis en la institución. Resultados: el responsable del programa institucional de control de tuberculosis y 158 trabajadores de la salud del hospital objeto de estudio reportaron una deficiente implementación de medidas de control de tuberculosis, de tipo administrativo, ambiental y de protección respiratoria en la institución, lo cual fue corroborado por el experto. Conclusiones: la deficiente implementación de medidas de control de infección de tuberculosis en instituciones de la salud, y algunas condiciones de trabajo presentes pueden favorecer la exposición ocupacional de los trabajadores de la salud al Mycobacterium Tuberculosis.

Objective: to evaluate the implementation of tuberculosis infection control measures in administrative, environmental and respiratory protection equipment in a third level hospital in Bogota D.C. Methodology: a descriptive, cross-sectional study. Data were collected through a self-reporting instrument applied on 158 health care workers. The chief officer of the institutional program for tuberculosis control participated in a structured interview. In addition, an expert in occupational health and safety conducted an observational visit to the different workplaces in order to inquire on the implementation of tuberculosis infection control measures at the health facilities. Results: both, the chief officer of the institutional program for tuberculosis control and the 158 health care workers reported a lack of tuberculosis infection control measures at the administrative and environmental levels, as well as in the matters concerning respiratory protection equipment. This was confirmed by the expert. Conclusions: Certain working conditions coupled with poor implementation of tuberculosis infection control measures in health care institutions may favor the health care workers’ occupational exposure to Mycobacterium Tuberculosis.

Objetivo: Avaliar a implementação de medidas de controle de tipo administrativo, ambiental e de proteção respiratória relacionadas com a infeção de tuberculose num hospital nível III de atenção na cidade de Bogotá D.C. Metodologia: Estudo descritivo transversal. Na recolecção de dados para saber mais sobre as medidas de controle de tuberculose na instituição aplicou-se uma ferramenta de autoavaliação a 158 trabalhadores de saúde desse hospital. Também realizou-se uma entrevista estruturada à pessoa responsável pelo programa institucional de controle da tuberculose. Além disso, observou-se a um profissional de saúde e segurança laboral nas suas diferente áreas de trabalho. Resultados: A pessoa responsável pero programa institucional de controle de tuberculose e os 158 trabalhadores de saúde do hospital estudado evidenciaram implementar deficientemente na instituição as medidas de controle de tuberculose de tipo administrativo, ambiental e de proteção respiratória. A evidencia foi apoiada pelo profissional. Conclusões: Implementar deficientemente as medidas de controle de infecção de tuberculose nas instituições de saúde e outras condições de trabalho poderia favorecer a exposição ocupacional dos trabalhadores de saúde ao Mycobacterium Tuberculosis.

Evaluación de indicadores programáticos: la necesidad de un enfoque social de la tuberculosis / Indicators of programmatic evaluation: the need for a social approach of tuberculosis

La tuberculosis (TB) continúa siendo en el escenario epidemiológico mundial un problema de salud pública. Resultados parciales del proyecto "Evaluación de indicadores del programa de tuberculosis del municipio de Tumaco"; convocatoria 525-2011, Programa Jóvenes Investigadores e Innovadores "Virginia Gutiérrez de Pineda" financiado por Colciencias y la Universidad Nacional de Colombia. OBJETIVO: evaluar indicadores del Programa de Control de Tuberculosis del Municipio de Tumaco-Nariño durante el periodo comprendido entre 2010-2012. METODOLOGIA: estudio cuantitativo de alcance descriptivo y transversal retrospectivo, conforme a los procesos relacionados con la ética en investigación. RESULTADOS : el porcentaje de curación disminuyó de 86% a 81,5%; por su parte, registraron aumentos progresivos los fracasos (2,7% a 3,7%), transferidos (8,3% a 11,2%); la incidencia aumentó de 21,4 (2010) a 26,2 (2012 cohorte a junio) así como la cobertura de asesoría y oferta de prueba voluntaria de VIH (85% a 90%). CONCLUSION:los resultados evidencian debilidades programáticas que pueden aumentar el riesgo de MDR y por ende el control en la cadena de transmisión. Se resalta la necesidad de fortalecer aspectos programáticos que contemplen las condiciones de vulnerabilidad social de los afectados y el desarrollo de acciones desde un enfoque social integral.

The tuberculosis remains as a public health issue in the epidemiologic field worldwide. Partials results of the project "Evaluación de indicadores del programa de tuberculosis del municipio de Tumaco"; paper call 525 - 2011, Program "Jóvenes Investigadores e Innovadores: Virginia Gutiérrez de Pineda" funded by Colciencias and the Universidad Nacional de Colombia. OBJECTIVE: to evaluate the indicators of the tuberculosis control program of the Tumaco municipality in Nariño, Colombia during the period from 2010 to 2012. METHODOLOGY: a quantitative, retrospective, cross-sectional descriptive study complying with the related processes of research ethics. RESULTS :the cure rate decreased from 86% to 81.5%, while failures showeda progressive increase (2.7% to 3.7%) as did transferred patients (8.3% to 11.2%). Similarly, incidence increased from 21.4 (2010) to 26.2 (2012 June cohort) as well as the coverage of hiv counseling and the offer of voluntary HIV testing (85% to 90%). CONCLUSSION: the results point to programmatic weaknesses which can increase the risk of MDR and thusthe control in the transmission chain. Additionally, the authors emphasize the need to strengthen programmatic aspects which take into account the social vulnerability conditions of the individuals affected as well as theimplementation of actions from acomprehensiveand social approach.

Occupational exposure to air pollutants: particulate matter and respiratory symptoms affecting traffic-police in Bogotá / Exposición ocupacional a contaminantes atmosféricos: material particulado y síntomas respiratorios en policías de tránsito de Bogotá

Objectives Quantifying personal exposure to particles less than 10 micrometres in diameter (PM10) and determining the prevalence of respiratory symptoms in traffic-police officers working in Bogotá's metropolitan area. Methods This was a cross-sectional study of 574 traffic-police officers divided into two groups (477 traffic-police and 97 police working in an office). They were given a questionnaire inquiring about respiratory symptoms, toxicological medical evaluation, lung function tests and personal PM10 monitoring. The differences between groups were found using stratified analysis (i.e. comparing odds ratios). Multivariate analysis of factors related to symptoms and diagnosis of respiratory alteration was also performed. Results Respiratory symptoms concerned a higher prevalence of cough, expectoration and rhinosinusitis in the traffic-police group. Medical examination revealed that the traffic-police group had higher nasal irritation prevalence; lung function tests showed no difference. Mean PM10 levels were higher for the traffic-police group (139.4 μg/m³), compared to the office work group (86.03 μg/m³). Discussion PM10 values in both groups did not exceed allowable limits for respirable particles in the workplace according to ACGIH standards. Traffic-police exposed to air pollution had an increased risk of developing respiratory symptoms and signs, thereby agreeing with the results of this and other studies. Personal monitoring is a valuable tool when quantifying the concentration of PM10to which an individual has been exposed during a normal workday. This study contributes towards further research in to the effects of PM10 in populations at risk.

Objetivos Cuantificar la exposición personal a partículas menores de 10 micras (PM10) y determinar la prevalencia de síntomas respiratorios en policías de tránsito que trabajan en el área metropolitana de Bogotá. Métodos Estudio transversal de 574 policías divididos en dos grupos (477 policías de tránsito y 97 policías de oficina). Se les aplicó cuestionario sobre síntomas respiratorios, evaluación médica toxicológica, pruebas de función pulmonar y monitoreo personal a PM10. Las diferencias entre los grupos se hallaron mediante análisis estratificado y calculo Odds Ratio. Se realizó análisis multivariado de factores relacionados con los síntomas y diagnósticos de alteración respiratoria. Resultados Síntomas respiratorios como tos, expectoración y rinosinusitis tuvieron mayor prevalencia en los policías de tránsito. El examen médico mostró mayor prevalencia de signos de irritación nasal en los policías de tránsito. Pruebas de función pulmonar no mostraron diferencias. Los niveles promedio de PM10 fueron mayores en el grupo de tránsito (139,4 g/m³) comparados con el de oficina (86,03 g/m³). Discusión Los valores de PM10 en ambos grupos no exceden los límites permisibles de partículas respirables en el lugar de trabajo por la ACGIH. Los policías de tránsito expuestos a la contaminación del aire tienen mayor riesgo de desarrollar síntomas y signos respiratorios, como lo muestran este y otros estudios. El monitoreo personal es una herramienta valiosa para cuantificar la concentración de PM10a la cual un individuo está expuesto durante la jornada laboral. Este estudio contribuye a una mayor investigación sobre los efectos de PM10 en las poblaciones en riesgo.

Cuantificación de hidrocarburos policíclicos aromáticos urinarios en policías de tránsito del área metropolitana de Bogotá / Quantifying polycyclic aromatichydrocarbons in urine samples taken from traffic police working in Bogota's metropolitan area

Objetivos Cuantificar niveles urinarios de 1-hidroxipireno (1-OHP) y 3-hidroxibenzo [a] pireno (3-BAP) metabolitos de hidrocarburos policíclicos aromáticos (HAP) de interés toxicológico y relacionar su detección con el grado de exposición a material particulado de tamaño menor a 10 micras (PM10) u otros factores, en una población de Policías de Tránsito ocupacionalmente expuestos en el área metropolitana de Bogotá D.C. Métodos Se realizó un estudio de corte transversal en 524 Policías de Tránsito de los cuales 413 desarrollaban funciones operativas y 111 administrativas. Se tomaron muestras de orina de todos los individuos incluidos, para la determinación de metabolitos de HAP mediante cromatografía de gases con detección de masas. Se analizó la presencia de factores asociados con la detección de los metabolitos como tabaquismo, consumo de alimentos asados, lugar de residencia y exposición a PM10. Como medida de asociación se calcularon Odds Ratio (OR). Resultados Se encontraron niveles de 1-OHP y 3-BAP superiores en los individuos expuestos con OR significativos para detección de los metabolitos de 6,3 (IC 95% (3,6-11,1)) y 15,6 (IC 95% (6,2-39)), respectivamente. Se hallaron OR significativos para detección de metabolitos de HAP y exposición a PM10, tabaquismo y consumo de alimentos asados. Discusión Existe una asociación importante y significativa entre la exposición laboral a contaminación ambiental y la detección de metabolitos de HAP de importancia toxicológica en muestras de orina. Factores tales como tabaquismo, consumo de alimentos asados recientemente y exposición a PM10 también se encontraron asociados positivamente con la detección de dichos metabolitos pero en menor proporción.(AU)

Objective Quantifying polycyclic aromatic hydrocarbon levels in urine samples taken from a population of traffic police working in the metropolitan area of Bogotá who were occupationally exposed to 1-hydroxypyrene (1-OHP) and 3-hydroxy-benzo [a] pyrene (3-BaP) metabolites from polycyclic aromatic hydrocarbons (PAH) having toxicological interest, related to their detection, and a degree of exposure to particulate material having a size less than 10 micrometres (PM10) and/or other factors. Methods A cross-sectional study was made of 524 traffic police, 413 of whom were engaged in operational and 111 in administrative functions. Urine samples were taken from all the individuals included in the study for determining PAH metabolites by gas chromatography/mass spectrometry (GC/MS). The presence of factors associated with the detection of metabolites was analysed, such as smoking, consuming roasted/grilled food, place of residence and exposure to PM10. The odds ratio (OR) was calculated as a measure of association. Results Higher 1-OHP and 3-BaP levels were found in exposed individuals, having a significant OR for detecting 6.3 ((3.6-11.1) 95 % CI) and 15.6 ((6.2-39) 95 % CI) metabolites, respectively. Significant OR were found for detecting PAH metabolites and exposure to PM10, smoking and consuming roasted/grilled food. Discussion There was an important and significant association between work-related exposure to environmental contamination and detecting toxicologically important PAH metabolites in urine samples. Factors such as smoking, consuming freshly grilled/roasted food and exposure to PM10 were also found to be positively associated with detecting such metabolites, but to a lesser extent.(AU)

[Quantifying polycyclic aromatic hydrocarbons in urine samples taken from traffic police working in Bogota's metropolitan area]. / Cuantificación de hidrocarburos policíclicos aromáticos urinarios en policías de tránsito del área metropolitana de Bogotá

OBJECTIVE: Quantifying polycyclic aromatic hydrocarbon levels in urine samples taken from a population of traffic police working in the metropolitan area of Bogotá who were occupationally exposed to 1-hydroxypyrene (1-OHP) and 3-hydroxy-benzo[a]pyrene (3-BaP) metabolites from polycyclic aromatic hydrocarbons (PAH) having toxicological interest, related to their detection, and a degree of exposure to particulate material having a size less than 10 micrometres (PM10) and/or other factors. METHODS: A cross-sectional study was made of 524 traffic police, 413 of whom were engaged in operational and 111 in administrative functions. Urine samples were taken from all the individuals included in the study for determining PAH metabolites by gas chromatography/mass spectrometry (GC/MS). The presence of factors associated with the detection of metabolites was analysed, such as smoking, consuming roasted/grilled food, place of residence and exposure to PM10. The odds ratio (OR) was calculated as a measure of association. RESULTS: Higher 1-OHP and 3-BaP levels were found in exposed individuals, having a significant OR for detecting 6.3 ((3.6-11.1) 95 % CI) and 15.6 ((6.2-39) 95 % CI) metabolites, respectively. Significant OR were found for detecting PAH metabolites and exposure to PM10, smoking and consuming roasted/grilled food. DISCUSSION: There was an important and significant association between work-related exposure to environmental contamination and detecting toxicologically important PAH metabolites in urine samples. Factors such as smoking, consuming freshly grilled/roasted food and exposure to PM10 were also found to be positively associated with detecting such metabolites, but to a lesser extent.

Occupational exposure to air pollutants: particulate matter and respiratory symptoms affecting traffic-police in Bogotá.

OBJECTIVES: Quantifying personal exposure to particles less than 10 micrometres in diameter (PM10) and determining the prevalence of respiratory symptoms in traffic-police officers working in Bogotá's metropolitan area. METHODS: This was a cross-sectional study of 574 traffic-police officers divided into two groups (477 traffic-police and 97 police working in an office). They were given a questionnaire inquiring about respiratory symptoms, toxicological medical evaluation, lung function tests and personal PM10 monitoring. The differences between groups were found using stratified analysis (i.e. comparing odds ratios). Multivariate analysis of factors related to symptoms and diagnosis of respiratory alteration was also performed. RESULTS: Respiratory symptoms concerned a higher prevalence of cough, expectoration and rhinosinusitis in the traffic-police group. Medical examination revealed that the traffic-police group had higher nasal irritation prevalence; lung function tests showed no difference. Mean PM10 levels were higher for the traffic-police group (139.4 µg/m³), compared to the office work group (86.03 µg/m³). DISCUSSION: PM10 values in both groups did not exceed allowable limits for respirable particles in the workplace according to ACGIH standards. Traffic-police exposed to air pollution had an increased risk of developing respiratory symptoms and signs, thereby agreeing with the results of this and other studies. Personal monitoring is a valuable tool when quantifying the concentration of PM10to which an individual has been exposed during a normal workday. This study contributes towards further research in to the effects of PM10 in populations at risk.

Acupuncture versus venlafaxine for the management of vasomotor symptoms in patients with hormone receptor-positive breast cancer: a randomized controlled trial.

PURPOSE: Vasomotor symptoms are common adverse effects of antiestrogen hormone treatment in conventional breast cancer care. Hormone replacement therapy is contraindicated in patients with breast cancer. Venlafaxine (Effexor), the therapy of choice for these symptoms, has numerous adverse effects. Recent studies suggest acupuncture may be effective in reducing vasomotor symptoms in menopausal women. This randomized controlled trial tested whether acupuncture reduces vasomotor symptoms and produces fewer adverse effects than venlafaxine. PATIENTS AND METHODS: Fifty patients were randomly assigned to receive 12 weeks of acupuncture (n = 25) or venlafaxine (n = 25) treatment. Health outcomes were measured for up to 1 year post-treatment. RESULTS: Both groups exhibited significant decreases in hot flashes, depressive symptoms, and other quality-of-life symptoms, including significant improvements in mental health from pre- to post-treatment. These changes were similar in both groups, indicating that acupuncture was as effective as venlafaxine. By 2 weeks post-treatment, the venlafaxine group experienced significant increases in hot flashes, whereas hot flashes in the acupuncture group remained at low levels. The venlafaxine group experienced 18 incidences of adverse effects (eg, nausea, dry mouth, dizziness, anxiety), whereas the acupuncture group experienced no negative adverse effects. Acupuncture had the additional benefit of increased sex drive in some women, and most reported an improvement in their energy, clarity of thought, and sense of well-being. CONCLUSION: Acupuncture appears to be equivalent to drug therapy in these patients. It is a safe, effective and durable treatment for vasomotor symptoms secondary to long-term antiestrogen hormone use in patients with breast cancer.

[Chromium levels and their relationship with alterations in the health of tannery workers living and working in Bogotá, Colombia]. / Niveles de cromo y alteraciones de salud en una población expuesta a las actividades de curtiembres en Bogotá, Colombia.

OBJECTIVE: Determining whether chromium levels in urine samples were higher than limits and contrasting them with alterations in the health of people living and working in the San Benito neighbourhood of Bogotá. METHODS The total amount of chromium in urine was measured as a biological marker of exposure in a sample of 827 people. This was contrasted with health alterations attributed to chromium exposition. Exposure was defined by being whether current economic activity was related to working in a tannery. Two groups were defined: being directly exposed (26%) and having potentially high exposure (73%). RESULTS: 6.3% presented >10 ug/L chromium levels (4.64% to 7.96% confidence interval). No significant statistical differences were found between both groups. 34.3% presented a diagnosis of possible attribution to chromium exposure, of whom 23.3% were due to otorhinolaryngologic issues, 6.5% to dermatological ones, 2.9% to ophthalmologic ones and 1.6 % to oral cavity issues. The remaining 65.7% of cases were not related. >10 ug/L levels and living in the particular neighbourhood in question were associated (4.94 odds ratio; 1.18%-20.69% CI). The results suggested a connection between economic activity and health alterations due to chromium components. CONCLUSIONS: The people involved in producing leather have a significant risk of presenting clinical conditions attributed to chromium exposure (4.33 OR; 3.12-6.02 CI). San Benito s inhabitants are being exposed to chromium as if they were actually working in a tannery as they are in daily contact with chromium or its components through non work-related activities, such as environmental contamination. Concern at such exposure should lead to further in-depth studies.

Niveles de cromo y alteraciones de salud en una población expuesta a las actividades de curtiembres en Bogotá, Colombia / Chromium levels and their relationship with alterations in the health of tannery workers living and working in Bogotá, Colombia

Objetivo Determinar si los niveles de cromo en orina están más altos de los permitidos y contrastarlos con alteraciones de salud en personas del barrio San Benito en Bogotá. Métodos En una muestra de 827 personas, se cuantificó cromo total en orina como biomarcador de exposición y se contrastó con alteraciones de salud atribuibles a exposición a cromo. La exposición se definió, por la "Ocupación actual" relacionada con la labor en curtiembres. Se definieron dos estratos: "Directamente expuestos" 26 por ciento y "Potencial alta exposición" 73 por ciento. Resultados Un 6,3 por ciento presentó niveles de cromo >10 ug/L (intervalo de confianza: 4,64-7,96 por ciento). No se encontraron diferencias estadísticamente significativas entre los dos estratos. El 34,3 por ciento presentó diagnósticos posiblemente atribuibles a la exposición a cromo. El 23,3 por ciento otorrinolaringológico; 6,5 por ciento dermatológico; 2,9 por ciento oftalmológico; 1,6 por ciento cavidad oral y el 65,7 por ciento no relacionados. Se halló asociación entre niveles >10ug/L y residir en la zona (OR 4,94 IC:1,2- 20,7 por ciento). Los resultados sugieren asociación entre ocupación y alteraciones de salud atribuibles a la exposición a compuestos de cromo. Conclusiones Las personas que participan del proceso productivo del cuero tienen un riesgo significativo de presentar hallazgos clínicos posiblemente atribuibles a la exposición a cromo, OR 4,33 (3,12-6,02). La población general se esta viendo expuesta de manera no diferente a aquella con ocupación relacionada con las curtiembres, lo que puede deberse a que los habitantes del sector están en contacto con cromo o compuestos por vías diferentes a la ocupacional, como contaminación ambiental.

Objective Determining whether chromium levels in urine samples were higher than limits and contrasting them with alterations in the health of people living and working in the San Benito neighbourhood of Bogotá. Methods The total amount of chromium in urine was measured as a biological marker of exposure in a sample of 827 people. This was contrasted with health alterations attributed to chromium exposition. Exposure was defined by being whether current economic activity was related to working in a tannery. Two groups were defined: being directly exposed (26 percent) and having potentially high exposure (73 percent). Results 6.3 percent presented >10 ug/L chromium levels (4.64 percent to 7.96 percent confidence interval). No significant statistical differences were found between both groups. 34.3 percent presented a diagnosis of possible attribution to chromium exposure, of whom 23.3 percent were due to otorhinolaryngologic issues, 6.5 percent to dermatological ones, 2.9 percent to ophthalmologic ones and 1.6 percent to oral cavity issues. The remaining 65.7 percent of cases were not related. >10ug/L levels and living in the particular neighbourhood in question were associated (4.94 odds ratio; 1.18 percent-20.69 percent CI). The results suggested a connection between economic activity and health alterations due to chromium components. Conclusions The people involved in producing leather have a significant risk of presenting clinical conditions attributed to chromium exposure (4.33 OR; 3.12-6.02 CI). San Benito´s inhabitants are being exposed to chromium as if they were actually working in a tannery as they are in daily contact with chromium or its components through non work-related activities, such as environmental contamination. Concern at such exposure should lead to further in-depth studies.