Sociodemographic and labor conditions and the presence of musculoskeletal symptoms in workers in a market in a Colombian municipality.

Introduction: Although informal employment is increasing, there is still little evidence of musculoskeletal symptoms in workers with precarious jobs in marketplaces and of how these symptoms are related to their labor conditions and risks. Objective: To identify sociodemographic and labor conditions and ergonomic risks associated with musculoskeletal symptoms in workers from a marketplace in a Colombian municipality in 2017. Methods: Cross-sectional study of a 2017 census of 194 workers. A survey was applied, and labor and environmental records were collected. Univariate, bivariate and multivariate analyses were performed, with statistical tests with 95% confidence level. Results: Women (56.7%) and workers older than 30 years (75.4%) predominated; 90.7% of participants worked 8 hours a day or more; 52.8% worked from 1 to 5 days a week; and 33.9% had been working in the profession for > 20 years. Moreover, 86.6% had semi-stationary sales position; 43.8% were overweight, and 18.8% obese. Also, 60.6% presented with some type of musculoskeletal symptom, the most prevalent of which was joint pain (37.7%). Selling meat (PRA = 2.36), merchandise/pots (PRA = 1.40), harvest/perishable products (PRA = 1.26), and working from 8 to 11 hours a day (PRA = 1.76) explained higher prevalence of musculoskeletal symptoms. Conversely, moving (PAA = 0.5) and lifting (PRA = 0.75) heavy objects explained lower prevalence of these symptoms. Conclusions: Greater musculoskeletal symptoms were related to older age, lower schooling, fewer days of work, working from 8 to 11 hours, and selling meat, merchandise/pots, and harvest/perishable products. These conditions, once identified, will facilitate promotion and prevention actions to improve the living and health conditions of marketplace workers.

Multimorbilidad en adultos mayores con empleos con subsistencia en las calles y aceras de Medellín, Colombia, 2016 / Multimorbidity in older adults with subsistence jobs on the streets and sidewalks of Medellín, Colombia, 2016

Objetivo: Determinar las condiciones laborales, hábitos y estilos de vida relacionadas con la multimorbilidad de adultos mayores con empleos con subsistencia en el centro de Medellín-Colombia, 2016. Material y Métodos: Estudio transversal con fuentes primarias de información a un censo de 686 trabajadores, encuestados previa toma de consentimiento informado, el año 2016. Para este estudio se tomaron 153 trabajadores con ≥ 60 años. Análisis univariado, bivariado y multivariado, para estudiar su multimorbilidad y factores asociados a su labor. Resultados: 77,0% tenía entre 60-69 años; fundamentalmente hombres, 56,0% ganaba <500.000 pesos colombianos. Tenian >20 años en su oficio. El 62,0% presentó multimorbilidad, fundamentalmente por diabetes; hipertensión; obesidad y sintomatología depresiva. Explicaron mayor prevalencia de multimorbilidad (p<0,05) trabajar cerca de aguas residuales (RPA=3,38. IC=1,27;8,96), no tener horario para el consumo de alimentos (RPA=3,01. IC=1,25;7,27) y consumir alimentos en soledad (RPA=3,28. IC=1,31;8,18). Conclusión: Las condiciones que explican multimorbilidad en estos trabajadores, pueden ser revertidas con acciones de promoción de la salud y prevención de la enfermedad, lideradas por el Estado y con su participación activa (AU)

Objective: To determine the working conditions, habits and lifestyles related to the multimorbidity of older adults with subsistence jobs in the center of Medellín-Colombia, 2016. Material and Methods: Cross-sectional study with primary sources of information to a census of 686 workers, surveyed After obtaining informed consent, in 2016. For this study, 153 workers aged ≥60 years were taken. Univariate, bivariate and multivariate analysis, to study their multimorbidity and factors associated with their work. Results: 77,0% were between 60-69 years old; mainly men, 56,0% earned <500,000 Colombian pesos. They were > 20 years old in their trade. 62,0% presented multimorbidity, mainly due to diabetes; hypertension; obesity and depressive symptoms. They explained a higher prevalence of multimorbidity (p<0,05) working near wastewater (RPA=3,38.CI=1,27; 8,96), not having a schedule for food consumption (RPA=3,01.CI=1,25;7,27) and consuming food alone (RPA=3,28.CI=1,31; 8,18). Conclusion: The conditions that explain multimorbidity in these workers can be reversed with health promotion and disease prevention actions, led by the State and with its active participation (AU)

Factores tempranos asociados a apendicectomía negativa / Early factors associated with negative appendectomy

Objetivo: analizar características predictoras de apendicectomía negativa (AN) en una cohorte de pacientes llevados a cirugía durante el año 2018 en una institución de salud de alta complejidad de la ciudad de Medellín, Colombia. Materiales y Métodos: seguimiento retrospectivo a una cohorte basada en registros médicos. Se analizaron pacientes adultos sometidos a apendicectomía. Se estimó la tasa de AN y se describieron características clínicas, paraclínicas y sociodemográficas. Se analizaron predictores de AN mediante el modelo lineal generalizado familia binomial, enlace logarítmico. Se presentan razones de riesgo (RR) observadas y ajustadas junto con intervalos de confianza del 95% (IC95%). Para el modelo multivariado se estimó el área bajo la curva del operador receptor (ROC). Resultados: la tasa de AN fue de 5,2%. No se solicitó tomografía computarizada (TC) de abdomen en el 48,9% de los casos, 4,1% de los pacientes presentaron disuria. Entre los factores estudiados, la disuria, no solicitud de TC, edad y leucocitosis, se asociaron significativamente con mayor riesgo de AN. Resaltan particularmente los pacientes que presentaron disuria y no les fue solicitado TC, en quienes el riesgo ajustado de AN fue de 30,3% (RR = 17,31; IC95% 5,00 ­ 59,87). ROC fue 0,834. Conclusiones: los pacientes llevados a cirugía sin TC y que se presentaron con disuria, particularmente los de mayor edad, concentraron el mayor riesgo de AN. Considerar estas características al definir el manejo quirúrgico del paciente con sospecha de apendicitis aguda, puede contribuir a disminuir las AN..(Au)

Objective: to analyze predictive characteristics of negative appendectomy (NA) in a cohort of patients who underwent surgery during 2018 in a high complexity healthcare institution in the city of Medellín, Colombia. Materials and Methods: retrospective follow-up to a cohort of adult patients who underwent appendectomy. The rate of NA was estimated and the clinical, paraclinical and sociodemographic characteristics were described. The analysis of predictors of NA was carried out using the generalized linear model binomial family, logarithmic link. Observed and adjusted risk ratios (RR) are presented along with 95% confidence intervals (95% CI). For the multivariate model, the area under the receiver operator curve (ROC) was estimated. Results: the NA rate was 5.2%. Abdominal computed tomography (CT) was not requested in 48.9% of the cases, 4.1% of the patients had dysuria. Among the factors studied, dysuria, nonrequest for CT, age and leukocytosis were significantly associated with a higher risk of NA. Is worth noting that the adjusted risk of NA of the patients who presented with dysuria and those in which no CT was requested, was 30.3% (RR = 17.31; 95% CI 5.00 - 59.87). ROC was 0.834. Conclusions: patients who underwent surgery without CT and presented with dysuria, particularly the older ones, had the highest risk of NA. Considering these characteristics when defining the surgical management of patients with suspected acute appendicitis can help reduce NA..(Au)