Pulse oximetry curves in healthy children living at moderate altitude: a cross-sectional study from the Ecuadorian Andes.

BACKGROUND: In populations above 3,000 meters above sea level (m.a.s.l.) normal values of oxygen saturation (SpO2) above 90% have been reported. Few studies have been conducted in cities of moderate altitude (between 2,500 and 3,000 m a.s.l). We set out to describe the range of SpO2 values measured with a pulse oximeter in healthy children between 1 month and 12 years of age living in an Ecuadorian Andean city. METHODS: A cross-sectional study was carried out in Quito, Ecuador, located at 2,810 m a.s.l. SpO2 measurement in healthy children of ages ranging from 1 month to 12 years of age residents in the city were recorded by pulse oximetry. Age and gender were recorded, and median and 2.5th and 5th percentile were drawn. Non parametric tests were used to compare differences in SpO2 values by age and gender. RESULTS: 1,378 healthy children were included for the study, 719 (52.2%) males. The median SpO2 for the entire population was 94.5%. No differences were observed between SpO2 median values by age and gender. The 2.5th percentile for global SpO2 measurements was 90%, in children under 5 years of age was 91% and it was 90% in children older than 7. CONCLUSIONS: Our results provide SpO2 values for healthy children from 1 to 12 years old residents in Quito, a city of moderate altitude. The SpO2 percentile curve could contribute as a healthy range for the clinical evaluation of children residing at this altitude.

Hazard functions to describe patterns of new and recurrent sick leave episodes for different diagnoses.

OBJECTIVES: This study aims to identify the hazard functions that describe the occurrence patterns of new and recurrent sick leave (SL) episodes for mental, respiratory, and musculoskeletal diagnoses. METHODS: The data come from a cohort of workers in the Hospital das Clínicas da Universidade Federal de Minas Gerais, Brazil, including all employees working ≥ 20 hours per week, whose first employment relation with the hospital started between 1 January 2000 and 31 December 2007 (N=1579). We created 15 samples corresponding to combinations of diagnoses causing SL and the number of previous episodes already suffered. We fitted Weibull, log-normal, and log-logistic models by resampling and selected the model having the lowest Akaike information criterion in the greatest number of resamples. RESULTS: Differences were observed in the probability distributions associated with the process generating a SL. Diagnosis showed important differences in terms of risk intensity: mental episodes were the least frequent. There were differences in risk intensity and shape of the function over time depending on the episode number, particularly between the first episode and recurrences. In addition, these differences varied by diagnosis. CONCLUSIONS: In most of the samples analyzed, we identified a mixture of distributions, implying a need to revise the statistical methods of analysis for SL occurrence with the aim of obtaining consistent estimates of the risk and the associated factors.

Previous sick leaves as predictor of subsequent ones.

PURPOSE: There is evidence that a history of sick leave (SL) increases the risk of suffering a new episode. However, little is known about the effect of the number of previous SL on subsequent ones. The aim of this paper was to quantify the effect of prior episodes on the risk of experiencing a new one and the effect on the duration of episodes, by diagnosis. METHODS: Prospective study. Sample comprises 1,542 workers from a university hospital, whose first contract started during 2000-2007. RESULTS: The studied workers accumulated 5,138 episodes, 21,250 days of absence and 45,324.2 months of follow-up. For all the causes, recurrence density was higher than incidence density. The higher the number of prior SL, the greater is the hazard of presenting a new episode. This is particularly true for episodes due to mental and behavioral disorders, diseases of the skin and subcutaneous tissue, and diseases related to nervous system. The adjusted hazard of suffering an SL episode due to mood disorders was increased 21.44 times when the worker had previously had one SL. The corresponding figures were 14.58 and 13.92 for SL due to skin and mucous membrane diseases and due to neurotic or stress-related disorders, respectively. CONCLUSIONS: The results obtained provide evidence that having suffered previous SL episodes implies a significant increase in the risk of experiencing a new one. High recurrence density of certain diagnoses should be interpreted as a general indication that something is wrong in the occupational setting.

Anos de vida perdidos por mortalidade: um dos componentes da carga de doenças / Years of life lost by mortality: a component of the burden of disease

Objetivo: Calculou-se a carga de doença devida à mortalidade, os anos de vida perdidos por "morte prematura" (AVP), nos Estados do Rio Grande do Sul e Santa Catarina, comparando alguns resultados com o Brasil. Métodos: Baseou-se nos anos de vida ajustados em funçäo da incapacidade (AVAI), indicador que agrega mortalidade e morbidade em uma medida global. As populaçöes de estudo foram os óbitos de residentes nos Estados em 1994 e no Brasil em 1993. Resultados: Embora a maior carga por mortalidade seja imposta por causas ligadas a um estágio mais avançado da transiçäo epidemiológica, tanto o Rio Grande do Sul como Santa Catarina, mas principalmente o Brasil, sofrem importante carga por doenças do subdesenvolvimento. As lesöes representam o segundo grupo nos Estados e terceiro no Brasil. Conclusäo: O indicador permite comparar agravos de alta e baixa letalidade, sendo instrumento útil na gestäo e controle social das políticas e açöes de saúde