O que significa “Mão Diabética” e qual o papel da Saúde Ocupacional?

2020 ◽  
Vol 10 ◽  
pp. 1-22
Author(s):  
Diana Costa ◽  
Filipe Gonçalves
Keyword(s):  
Metabolic Syndrome ◽  
Occupational Health ◽  
Work Performance ◽  
Information Science ◽  
Metabolic Diseases ◽  
Cochrane Library ◽  
Western World ◽  
Occupational Health Services ◽  
Early Screening ◽  
Limited Joint Mobility

Introduction / background / objective As the workforce ages and rates of metabolic diseases increase, it is likely that more cases of “diabetic hand” manifestations will appear in Occupational Health services. While some health professionals know how to quickly track the “diabetic foot”, the “diabetic hand” is often undervalued, diagnosed in isolation, without recognition or association with the high prevalence of metabolic syndrome, especially in the Western world. These manifestations have an impact on functionality, and inevitably affect work performance, and should be subject to screening, monitoring and intervention by occupational health teams, in order to enhance the function and minimize the negative impacts that they cause both individually and collectively. Thus, the main objective of this work is to elaborate a review on the concept of “diabetic hand” and what is the implication that it can have in the worker’s health and Occupational Health practice. Methodology It is a Scoping Review, initiated through a search in the PUBMED (Medline), EBSCO (Cinahl; Medline; Cochrane; Library Information Science & Technology Abstracts; Nursing Allied Health Collection; MedicLatina) and RCAAP databases, conducted in the months of July and August of 2020, covering all articles (in Portuguese and English languages), with no limit of time, that could explain the concept of diabetic hand. The search words used were: “diabetic hand” ou “cheiroarthropathy”. Results Several conditions have been linked to the concept of diabetic hand, namely cheiroarthropathy (limited joint mobility and stiffness), Dupuytren’s contracture, trigger finger (flexor stenosing tenosynovitis), and carpal tunnel syndrome. Conclusions These manifestations share mechanisms with the classic complications of diabetes, and the recognition that microvascular changes occur concomitantly may provide insights for early screening of metabolic biomarkers. Acknowledging so can contribute to reduce disability (delay hand and fist related manifestations’ progression), and also to reduce future morbidity of workers (minimizing the risks of metabolic diseases), helping to maintain a more capable and productive workforce, where corrective measures and early treatments can be implemented. The diabetic hand may be a concept of interest, then can be further addressed soon, as the complications of metabolic syndrome (and associated comorbidities) increase worldwide.

A general framework for assessing fitness for work

2019 ◽  
pp. 1-24
Author(s):  
John Hobson ◽  
Julia Smedley
Keyword(s):  
Occupational Health ◽  
Work Performance ◽  
Health Assessment ◽  
Occupational Health Services ◽  
Factors Affecting ◽  
Fitness For Work ◽  
Work Health ◽  
Recent Trends ◽  
The Individual

The opening chapter of Fitness for Work provides an introduction to the book and sets out a framework for assessing fitness for work. It considers the relationship between work and health including the prevalence of disability and its impact on employment. The role of occupational health services, the various professions working in the field, and how they function are described. Guidance is provided on consent, confidentiality, occupational health reports, and communicating with the employer and other health professionals. The occupational health assessment itself is considered with detailed sections on the consultation, functional assessment, objective tests, and assessing the workplace. Factors affecting work performance are considered as well as matching the individual to the job, rehabilitation, making accommodation and adjustments, and return to work. The chapter concludes by considering recent trends and developments with particular regard to the most recent government initiatives, specifically Improving Lives: the Future of Work, Health and Disability.

Quando suspeitar de Síndrome Metabólica no Exame Físico e qual a relevância para a Saúde Ocupacional?

2020 ◽  
Vol 10 ◽  
pp. 1-20
Author(s):  
Diana Costa ◽  
Filipe Gonçalves
Keyword(s):  
Insulin Resistance ◽  
Health Care ◽  
Metabolic Syndrome ◽  
Primary Health Care ◽  
Occupational Health ◽  
Health Services ◽  
Work Organization ◽  
Occupational Health Services ◽  
Primary Health ◽  
Work Accidents

Introduction / background / objective In a western world marked by a high prevalence of metabolic changes related to metabolic syndrome (obesity, cardiovascular diseases, type 2 diabetes mellitus, high blood pressure, dyslipidemia), it is essential to know where to look and recognize early signs. In companies, it is common to find workers with various risk factors that characterize metabolic syndrome since the environment and work organization can have an influence (such as inappropriate food choices in cafeteria or vending machines, work organization and stress, or shift work and its impact on circadian rhythm). Its consequences will cause more illnesses, more work accidents and bigger losses for companies. Therefore, in occupational health services, there is another way to invest in the development of health and well-being, in addition to the direct prevention of occupational diseases and accidents at work, by analyzing the worker from a global point of view throughout his life, and acting in synergy with Primary Health Care. The main objective of this work is to elaborate a review of the cutaneous manifestations that can provide clues during the physical exam, having as main focus the metabolic syndrome. Methodology It is a Scoping Review, carried out in the EBSCO databases (CINAHL, MEDLINE, Nursing & Allied Health Collection: Comprehensive, Cochrane Database, MedicLatina), PUBMED and RCAAP, in the period of June 2020. The keywords used were: “Skin manifestations”, “Signs on the skin”, “Insulin resistance”, “Metabolic syndrome”. Results Several signs suggestive of metabolic syndrome or insulin resistance were found, namely acanthosis nigricans, acrochordons/skin tags, xanthelasmas, eruptive xanthomas, diagonal earlobe crease/ Frank’s sign, some inflammatory skin manifestations (acne, hidradenitis suppurativa) and autoimmune (psoriasis, vitiligo). Conclusions It is essential to encourage lifestyle changes that address Metabolic Syndrome. Empowering or reminding professionals of non-invasive assessment techniques for signals recognition, can contribute to helping the team to detect metabolic manifestations early, simply by looking at the skin of those they care for. This approach can be an asset in occupational health services, which are at the forefront of monitoring adults, and whose disease course can be controlled or even reversed with early diagnosis and intervention. In fact, analyzing the worker in his entire definition of health (adding Preventive Medicine / Nursing to Curative) and working in synergy with Primary Health Care, will end up influencing the productivity of companies (by avoiding sick leave due to illness, or even reducing work accidents).

scholarly journals The Association Between Gallstone Disease and Metabolic Syndrome Related Abnormalities: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Peiwu Jiang ◽  
Zhongkai Ni ◽  
Shifei Huang ◽  
Xiaowen Li ◽  
Ye Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Metabolic Syndrome ◽  
English Language ◽  
Metabolic Diseases ◽  
Meta Analysis ◽  
Gallstone Disease ◽  
Cross Sectional Study ◽  
Cochrane Library ◽  
Cross Sectional ◽  
The Metabolic Syndrome

Abstract BackgroundBile excretion is one of an important metabolite excretion pathway of human body. In recent years, it has been reported that metabolic diseases are associated with the occurrence of GSD (Gallstone Disease). The main purpose of this systematic review is to examine the relationship between metabolic syndrome and cholelithiasis, including components of the metabolic syndrome such as abnormal blood glucose regulation, hyperlipidemia, and obesity.MethodsPubmed, Cochrane library and embase were searched for all English language articles for the following relevant keywords: Metabolic Syndrome, Reaven Syndrome X, Biliary Calculi, Cholelithiasis Gallstones. Case-control study, cross-sectional study and cohort study were included .Pooled relative risks (RRs) or odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were calculated. The pooled mean differences of the outcome measures were compared between patients with and without MetS.ResultsAfter screening, a total of 5 cross-sectional studies and 1 cohort studies were included in the meta-analysis. The 6 studies evaluated a total of 49101 people，of whom 9055 had MS and 2308 had GSD. There is a significant correlation between MS and GSD (z=6.65, p = 0.000), and it’s more significant in female. All studies displayed increasing odds of GSD with increasing number of MetS traits, where patients with three or more MetS traits tended to have a higher prevalence of nephrolithiasis.ConclusionsOur review shows a definite association of MetS with GSD, and the more the components of MetS, the higher the prevalence of GSD. Although not as obvious as women, men also support this conclusion.

337. Occupational Health Services Showing Effect on Finnish Dairy Farms

1999 ◽  
Author(s):  
P. Kalliokoski ◽  
J. Kangas ◽  
M. Kotimaa ◽  
K. Louhelainen
Keyword(s):  
Occupational Health ◽  
Health Services ◽  
Dairy Farms ◽  
Occupational Health Services

Uric Acid in Metabolic and Cerebrovascular Disorders: A Review

2020 ◽  
Vol 18 (6) ◽  
pp. 610-618
Author(s):  
Francesca Cortese ◽  
Pietro Scicchitano ◽  
Anna M. Cortese ◽  
Giovanni Meliota ◽  
Andrea Andriani ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Uric Acid ◽  
Cerebrovascular Disorders ◽  
Haemorrhagic Stroke ◽  
Cerebrovascular Diseases ◽  
Healthcare Research ◽  
Cochrane Library ◽  
Close Link ◽  
Mesh Terms ◽  
Active Inflammation

Background: Several studies showed a close link between metabolic syndrome (MetS), type 2 diabetes (T2DM) and cerebrovascular diseases. There is considerable debate regarding the role of uric acid (UA) as a risk factor in these conditions. Objective: The aim of this narrative review is to discuss the links between UA, MetS, T2DM and cerebrovascular disease. Methods: An extensive review has been conducted based on the scientific literature published in English, and indexed in MEDLINE (through PubMed), EMBASE, the Cochrane Library, the Agency for Healthcare Research and Quality, and Google Scholar from January to May 2019. Additional relevant studies published after the initial review were also considered during the period of June 2019-October 2019, during which, this manuscript was written. The Mesh Terms considered were: uric acid, antioxidant, oxidant, metabolic syndrome, diabetes, cerebrovascular diseases, stroke, haemorrhagic stroke, neurocognitive disorders, and their combinations. Results: The literature review shows a dose-dependent inflammatory action of UA, which occurs with serum concentrations >4 mg/dl (>0.24 mmol/l), representing one of the contributors to the chronic inflammatory process that underlies metabolic and cerebrovascular diseases. Conclusion: UA, which is associated with arterial hypertension and cardiovascular diseases, represents one of the indicators of oxidative homeostasis. Increasing concentrations represent a status of active inflammation which is observed with metabolic and cerebrovascular diseases.

scholarly journals The effects of assisted reproduction technologies on metabolic health and disease

2020 ◽  
Author(s):  
Maria Florencia Heber ◽  
Grażyna Ewa Ptak
Keyword(s):  
Metabolic Syndrome ◽  
Health Outcomes ◽  
Metabolic Diseases ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Postnatal Life ◽  
Metabolic Alterations ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
The Individual

Abstract Background The increasing prevalence of metabolic diseases places a substantial burden on human health throughout the world. It is believed that predisposition to metabolic disease starts early in life, a period of great susceptibility to epigenetic reprogramming due to environmental insults. Assisted reproductive technologies (ART), i.e., treatments for infertility, may affect embryo development, resulting in multiple adverse health outcomes in postnatal life. The most frequently observed alteration in ART pregnancies is impaired placental nutrient transfer. Moreover, consequent intrauterine growth restriction and low birth weight followed by catch-up growth can all predict future obesity, insulin resistance, and chronic metabolic diseases. Scope of the review In this review, we have focused on evidence of adverse metabolic alterations associated with ART, which can contribute to the development of chronic adult-onset diseases, such as metabolic syndrome, type 2 diabetes, and cardiovascular disease. Due to high phenotypic plasticity, ART pregnancies can produce both offspring with adverse health outcomes, as well as healthy individuals. We further discuss the sex-specific and age-dependent metabolic alterations reflected in ART offspring, and how the degree of interference of a given ART procedure (from mild to more severe manipulation of the egg) affects the occurrence and degree of offspring alterations. Major conclusions Over the last few years, studies have reported signs of cardiometabolic alterations in ART offspring that are detectable at a young age but that do not appear to constitute a high risk of disease and morbidity per se. These abnormal phenotypes could be early indicators of the development of chronic diseases, including metabolic syndrome, in adulthood. The early detection of metabolic alterations could contribute to preventing the onset of disease in adulthood. Such early interventions may counteract the risk factors and improve the long-term health of the individual.

scholarly journals Improvement of the module for occupational diseases in the structure of occupational health record

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Iancheva ◽  
T Kundurzhiev ◽  
N Tzacheva ◽  
L Hristova
Keyword(s):  
Public Health ◽  
Occupational Health ◽  
Health Services ◽  
Occupational Disease ◽  
Occupational Diseases ◽  
National Level ◽  
Working Environment ◽  
Occupational Health Services ◽  
Health Record ◽  
Disease Module

Abstract The study is based on the National Science Program 'eHealth in Bulgaria (e-Health)', funded by the Ministry of Education and Science. Partnership Contract No. D-01-200/16.11.2018 Issue Occupational health is closely linked to public health and health system. In Bulgaria there are many software products related to the registration and reporting of occupational health. Description of the Problem It is necessary to study all the determinants of occupational health, including the risks of diseases and accidents in the occupational environment, social and individual factors. The establishment of electronic systems for registering and monitoring both the health status of each worker and the possible hazards in the work environment is associated with the introduction and use of the occupational health record of each worker. Results The methodology for improving the module for occupational diseases in the structure of the occupational health record in Bulgaria has been developed. The classifications are in compliance with the legislation in the country and the requirements of the developing Eurostat methodology for European statistics on occupational diseases are applied. The occupational health record will serve both employers and physicians working in Occupational Health Services. Lessons The occupational disease module in the structure of the occupational health record will contribute to the statistical comparability of occupational disease data at regional and national level. Not only will the registration of the harmful factors of the working environment and the diseases related to the work process, but also the introduction of timely measures to ensure good occupational and public health. Key messages Through the occupational disease module, the structure of the occupational health record introduces the possibility of taking adequate measures to ensure good occupational health. The occupational health record will serve both employers and physicians working in Occupational Health Services.

Association between the FINDRISC score and the risk of metabolic syndrome and hepatic steatosis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Godoi Bernardes Da Silva ◽  
R Dias Santos ◽  
M Sommer Bittencourt ◽  
J.A.M Carvalho ◽  
M Franken ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Hepatic Steatosis ◽  
Longitudinal Analysis ◽  
Metabolic Diseases ◽  
Low Cost ◽  
Cross Sectional ◽  
Predictive Values ◽  
Cross Sectional Analysis ◽  
The Cross ◽  
Sectional Analysis

Abstract Introduction The Finnish Diabetes Risk Score (FINDRISC) was developed in Europe to predict type 2 diabetes mellitus (T2DM) risk without need of laboratory tests. Small cross-sectional studies analyzed the association between RF with metabolic syndrome (MS) or hepatic steatosis (HS). Our objective was to test the association of FINDRISC with MS or HS, in a transversal and longitudinal way. Methods In 41,668 individuals (age 41.9±9.7 years; 30.8% women) who underwent health evaluation between 2008 and 2016 in a single centre in Brazil, we tested the transversal association between FINDRISC and MS or HS, in multivariate models. The same analyzes were performed longitudinally in non-diabetic subgroups, followed for 5±3 years, to test the predictive value of FINDRISC and the incidental risk of MS (n=10,075 individuals) or HS (n=7,097 individuals), using logistic regression. Models were adjusted for confounders such as sex, use of medications for dyslipidemia, smoking, and baseline plasma levels of glucose, creatinine and lipids. A receiver operating characteristic (ROC) curve was used to evaluate the discriminative and predictive values of FINDRISC for MS and HS. Results In the cross-sectional analysis, 2,252 (5%) individuals had MS and 14,176 (34%) HS. In the longitudinal analysis, there were 302 cases of incidental MS (2%) and 1,096 cases of HS (15%). FINDRISC was independently associated with MS and HS in the cross-sectional analysis (respectively, OR 1.27, 95% CI: 1.25–1.28, P<0.001; and OR 1.21, 95% CI: 1.20–1.22, P<0.001, per FINDRISC unit) and in longitudinal analysis (respectively, OR of 1.18, 95% CI: 1.15–1.21, P<0.001; and OR of 1.10, 95% CI: 1.08–1.11, P<0.001, per FINDRISC unit). In comparison with individuals with low FINDRISC, those with moderate, high and very high values showed significant and proportional increases of the 12 to 77 fold in the chance of current SM (P<0.001) and 3 to 10 fold in the chance of HS (P<0.001). During follow-up, these increases were 3 to 10 fold in the chance of incidental MS (P<0.001) and 1 to 3 fold in the chance of HS (P<0.001). The AUC from cross-sectional analysis for MS and HS were respectively 0.82 (95% CI 0.81–0.83) and 0.76 (95% CI 0.75–0.76), and in longitudinal analysis 0.73 (95% CI 0.70–0.76) and 0.63 (95% CI 0.61–0.65), respectively. Conclusion FINDRISC was associated with the presence and onset of MS and HS, but it predicted better metabolic syndrome risk than hepatic steatosis. Therefore, this simple, practical and low-cost score can be useful for population screening and identification of subgroups of individuals at higher risk future metabolic diseases. Funding Acknowledgement Type of funding source: None

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