RESUMO Introdução: As isotiazolinonas são substâncias amplamente utilizadas como conservantes (biocidas) em produtos industriais, domésticos e cosméticos. São conhecidas há mais de quarenta anos como alergénios prevalentes causadores de dermatite de contacto em contexto profissional e extraprofissional. Relata-se um caso de dermatite de contacto alérgica profissional não exclusiva. Caso Clínico: Homem de 47 anos de idade, técnico de manutenção elétrica industrial desde há 28 anos, referenciado à consulta de Alergologia Cutânea do Serviço de Dermatologia do Hospital de Braga, por lesões crónicas em placas, eritematosas e pruriginosas, localizadas no dorso e dedos das mãos, com agravamento durante a atividade profissional. Foi relatada pelo trabalhador uma melhoria clínica com o afastamento do local de trabalho em períodos de descanso e férias, mas com agravamento mais recente após aplicação de produtos de uso pessoal e doméstico. Por suspeita de dermatite de contacto foram realizados testes epicutâneos, com a série padrão do Grupo Português de Estudos das Dermatites de Contacto e três séries complementares - bateria de cosméticos, óleos de corte e conservantes. A leitura dos testes efetuada às setenta e duas horas e revelou as seguintes reações positivas: metilIisotiazolinona (+++); Kathon CG® (+++) e octilisotiazolinona (+). No seguimento do trabalhador, obteve-se melhoria clínica com substituição de todos os produtos domésticos que possuem estes biocidas na sua composição. Por indicação do seu Médico do Trabalho, foi efetuada uma avaliação dos detergentes industriais, que confirmaram a presença de isotiazolinonas, tendo o empregador procedido à sua substituição. Discussão/Conclusão: Com o aumento do número de casos desde os anos oitenta de dermatite de contacto causadas por isotiazolinonas, a sua legislação tem vindo a sofrer várias alterações. Contudo, estas substâncias continuam a ter um papel importante, particularmente a nível industrial, pela grande eficácia como conservantes. No caso deste trabalhador, a eliminação do uso de todos os produtos identificados com a presença das substâncias sensibilizadoras foi a medida implementada mais acessível e praticável, tanto a nível de produtos de uso pessoal e doméstico como de uso profissional. A nível da saúde ocupacional, quando esta medida não é possível, é necessário implementar outras que diminuam o risco para a saúde dos trabalhadores, tanto coletivas, como individuais, se as primeiras não forem suficientes. É ainda imprescindível manter uma vigilância contínua e adequada da Segurança e Saúde dos trabalhadores através de programas de prevenção de risco e promover a literacia sobre os fatores de risco a que estes estão expostos através de ações de formação e informação. A monitorização da tendência de dermatite de contacto alérgica a estas substâncias continua a ser relevante na atualidade.

ABSTRACT Introduction: Isothiazolinones are substances widely used as preservatives and biocides in industrial, household and cosmetic products. They have been known for over 40 years as prevalent allergens that cause contact dermatitis in a professional and extra-professional context. This article reports a case of non-exclusive occupational allergic contact dermatitis. Case report: A 47-year-old man, industrial electrical maintenance technician for 28 years, was referred to the Dermatology Department of Hospital de Braga, due to chronic erythematous, papular and titillating lesions on the back of the hands and fingers, worsening during professional activity. It was reported by the worker a clinical improvement during periods of rest and vacations and more recent aggravation with cosmetics products for personal and domestic use. Due to suspected contact dermatitis, epicutaneous tests were performed with the standard series of the Portuguese Group for the Study of Contact Dermatitis and also three complementary series- battery of cosmetics, cutting oils and preservatives. The reading was done at 72h and revealed the following positive reactions: methylIisothiazolinone (+++); Kathon CG™ (+++) and octylisothiazolinone (+). In the follow-up of the worker, clinical improvement was obtained with the replacement of all household products and cosmetics that contained these biocides in their composition and after his occupational physician medical advice, an evaluation of industrial detergents was carried out, which confirmed the presence of isothiazolinones, that the employer promptly replaced. Discussion/Conclusion: After an increase of cases since the 1980s of contact dermatitis caused by isothiazolinones, the legislation has undergone several changes. However, these substances continue to play an important role, particularly at an industrial level, due to the great effectiveness they have as preservatives and biocides. In the case of this worker, the elimination of the use of all products (personal and professional) identified in its composition with sensitizing substances was the most accessible and practicable implemented measure. In occupational health, when this measure is not possible, it is necessary to implement other measures that reduce the health risk of workers through protective collective and individual equipments. It is essential to keep a constant and adequate health screenings through risk prevention programs and also promote literacy on the risk factors to which they are exposed through training workshops and information actions. Monitoring the tendency of allergic contact dermatitis to these substances continues to be relevant today.

Abstract Background Among non-motor symptoms of Parkinson’s disease (PD), anxiety occurs in up to 67% of patients. Clinically, PD patients report worsening of tremors in anxiogenic situations. Objective The aim of this study was to evaluate the association between motor symptoms and anxiety in PD patients and compare their performances with those of healthy volunteers. Methods Fifteen volunteers with PD and 15 healthy volunteers without clinically significant psychiatric disorders were evaluated. Both groups were subjected to a simulated public speaking test (SPST). The following parameters were measured: visual analog mood scale (VAMS), items related to tremors of UPDRS, bradykinesia tests, blood pressure, and heart rate. Results Results of repeated measures ANOVA indicated a significant effect on group × phase interaction (F3.7,105.6 = 2.56; p = 0.046) for VAMS anxiety factor. Regarding tremors, ANOVA indicated significant differences in group × phase interaction (F4.5,121 = 2.88; p = 0.021) and between the groups (F1,27 = 45.88, p < 0.001), with differences in the anticipatory phase, performance, and post-speech, compared with those in the baseline. There were no significant differences between the groups with regard to other factors of VAMS, physiological measurements, and bradykinesia. Discussion Worsening of tremors occurred during SPST, particularly in phases with higher anxiety scores.

Abstract Background DSM-5 introduced some modifications on Posttraumatic Stress Disorder (PTSD) criteria. The instruments developed for the assessment of aspects related to PTSD needed a reformulation, as was the case of the Posttraumatic Stress Disorder Checklist (PCL). Objectives To present the process of transcultural adaptation of the three forms of the PCL-5 to Brazilian Portuguese, as well as its face validity. Methods The procedure involved independent translations, a synthesis version, back translation by an independent translator, evaluation by the original author, analysis by an expert committee, and a pretesting study (10 subjects with/without experience of a traumatic situation). The last two steps formed the face validity procedure. Results The synthesis version was approved by the original author and the agreement percentage by the expert committee was excellent, with only two items showing < 90%. The pretesting study showed that the Brazilian version was well understood and linguistically and culturally accepted by the participants, which did not make significant suggestions for changes. Discussion Transcultural adaptation of the PCL-5 for Brazilian Portuguese followed a rigid and standardized procedure. Therefore, after having its face validity assessed by an expert committee and by the target population, it is apt to be used.

Objective: To describe the incidence and evolution of sickness absence (SA) for non-occupational and occupational illness/injury in the population of workers in Catalonian Health Centers based on the definition of a set of common indicators. Methods: The study population consisted of 25,964 workers from 30 health centers in Catalonia, during 2009-2012. Information on SA episodes was obtained from records of the Directorate of Human Resources. SA indicators were defined, and SA incidence rates and temporal evolution were calculated, depending on the length and type of episode, and the size and activity of health centers. Results: SA incidence rates for non-occupational illness and injury showed a decreasing trend during 2009-2012. Smaller centers had lower SA rates for non-occupational conditions than larger centers (p<0.001). Social health centers had higher SA rates of non-occupational illness and injury, especially those with a very short duration (p<0.001). Primary care centers had the lowest SA occupational illness and injury rates, with the highest rates occurring in the social health centers, especially long-term centers (p<0.001). Conclusions: The differences in incidence rates of SA detected by type of activity of the health centers could be due to differences in working conditions.

Objetivo: Describir la incidencia y evolución de la incapacidad temporal (IT) por contingencias comunes y profesionales en la población trabajadora de los centros sanitarios de Cataluña. Métodos: La población de estudio estuvo constituida por los 25.964 trabajadores de 30 centros sanitarios de Cataluña, durante el período 2009-2012. La información sobre los episodios de IT se obtuvo de los registros de las Direcciones de Recursos Humanos. Se definieron unos indicadores de IT, y se calcularon las tasas de incidencia de IT y la evolución temporal, según la duración y tipo de episodio, y el tamaño y actividad de los centros sanitarios. Resultados: La evolución temporal de las tasas de incidencia de IT por contingencia común mostró una tendencia a la disminución en el período 2009-2012. Los centros de pequeño tamaño tuvieron tasa de IT por contingencia común inferior que los de mayor tamaño (p<0,001). Los centros sociosanitarios son los que presentaron mayores tasas de IT por contingencia común, especialmente la de muy corta duración (p<0,001). Los centros de atención primaria tuvieron las tasas más bajas de IT por contingencia profesional siendo la más elevada la de los centros sociosanitarios, especialmente la de larga duración (p<0,001). Conclusiones: Las diferencias observadas en las tasas de incidencia de IT según el tipo de actividad del centro sanitario podrían deberse a diferencias en las condiciones de trabajo.

RESUMO Objetivo Realizar uma revisão atualizada dos estudos que avaliaram o delirium como fator de risco para o desenvolvimento de demência em idosos. Métodos A revisão foi realizada utilizando-se a base de dados do PubMed, com o seguinte cruzamento de descritores: risk factors and (delirium or acute confusional state) and dementia. Apenas estudos do tipo coorte publicados entre janeiro de 2000 a maio de 2015 foram considerados. Resultados Foram selecionados oito estudos de acordo com os critérios de inclusão e exclusão. Todos os estudos apontaram para um aumento do risco de demência ou declínio cognitivo após a ocorrência de delirium, apesar das diferenças entre os estudos em relação à causa do delirium. Conclusões Os estudos atuais apontam para uma clara associação entre delirium e aumento do risco de demência. Dessa forma, psiquiatras e médicos generalistas precisam ficar atentos aos indícios de declínio cognitivo após a ocorrência do delirium em idosos.

ABSTRACT Objective To perform an update review of the studies that evaluated delirium as a risk factor for developing dementia in older adults. Methods A review was performed using PubMed database, crossing the following descriptors: risk factors and (delirium or acute confusional state) and dementia. Only cohort studies published from January 2000 to May 2015 were considered. Results We selected eight studies according to the inclusion and exclusion criteria. All studies pointed to an increased risk of dementia or cognitive decline after the occurrence of delirium, despite the differences between the studies in relation to the cause of delirium. Conclusions Recent studies indicate a clear association between delirium and increased risk of dementia. Therefore, the psychiatrists and general practitioners need to pay attention to the evidence of cognitive decline after the occurrence of delirium in older adults.

Neste trabalho estudou-se a utilização de esgotos domésticos tratados na criação do peixe ornamental molinésia (Poeciliasp.), observando o desempenho zootécnico e avaliando-se o bem-estar dos peixes cultivados. Foram testados três tratamentos: ET - abastecido com esgoto tratado em lagoas de estabilização; ED - abastecido com esgoto tratado e água de poço diluídos em iguais proporções; AB - abastecido com água de poço. Por meio dos resultados dos parâmetros físico-químicos, observou-se que o esgoto doméstico tratado em lagoas de estabilização oferece condição para se realizar o cultivo da espécie, com melhor desempenho quando diluído em água. Em todos os parâmetros de rendimento zootécnicos avaliados, o tratamento que utilizou o esgoto tratado diluído foi o que apresentou os melhores resultados. Dentre os indicadores de bem-estar observados, apenas a avaliação histopatológica foi capaz de fornecer resultado conclusivo, o qual apontou o tratamento que utilizou esgoto tratado diluído como o que proporcionou maior conforto à espécie cultivada. As características ornamentais dos peixes cultivados não sofreram influência do uso do esgoto doméstico tratado, observando-se que os padrões de coloração e formato de nadadeiras não foram alterados.

This work evaluated the treated sewage reuse in ornamental molly fish creation, evaluating the zootechnical performance and animal welfare. Three treatments were tested: ET - supplied with treated sewage; ED - supplied with sewage and raw water in the same proportion; AB - supplied with raw water. The physical-chemical results indicated that the treated sewage from stabilization ponds was adequate for the species cultivation only when diluted in raw water. Among the welfare indicators, only histopathological evaluation was able to provide conclusive results, which showed that the treated sewage diluted treatment was the best in terms of comfort for the cultivated species. The ornamental characteristics of farmed fish were not influenced by the use of treated sewage, in which the patterns of color and shape of fins were not changed.