Caracterización de hábitos de higiene y ambientes en lugares de atención integral a población infantil

RESUMEN Objetivo: Identificar hábitos de higiene de niños y cuidadores para la prevención y el control de enfermedades infecciosas en lugares de atención en Bogotá, Colombia; asimismo, caracterizar las bacterias en las superficies de estos ambientes. Método: Se diseñaron, validaron y aplicaron dos instrumentos para evaluar hábitos saludables y se tomaron muestras de superficies en cocinas, baños, salones, colchonetas y juguetes de 230 lugares. Las bacterias aisladas fueron clasificadas por metodologías automatizadas. Resultados: Se aislaron 699 bacterias, donde el mayor porcentaje de crecimiento fue en cocinas (36%). Estos resultados contrastan con lo observado, donde se evidenció que la mayoría de las cocinas se encontraron limpias (80%). La encuesta reportó que 93% de los cuidadores reconocen lavarse las manos antes de manipular alimentos y 23% informó utilizar elementos de protección para la manipulación de alimentos. Conclusión: Se evidencia la necesidad de acompañar e intervenir los hábitos de higiene y de cuidado del ambiente en lugares de atención a población infantil

The Danish National Chronic Myeloid Neoplasia Registry

Marie Bak,1 Else Helene Ibfelt,2 Thomas Stauffer Larsen,3 Dorthe Rønnov-Jessen,4 Niels Pallisgaard,5 Ann Madelung,6 Lene Udby,1 Hans Carl Hasselbalch,1 Ole Weis Bjerrum,7 Christen Lykkegaard Andersen1,7 1Department of Hematology, Zealand University Hospital, University of Copenhagen, Roskilde, 2Research Centre for Prevention and Health, Rigshospitalet Glostrup, University of Copenhagen, Glostrup, 3Department of Hematology, Odense University Hospital, Odense, 4Department of Hematology, Vejle Hospital, Vejle, 5Department of Surgical Pathology, Zealand University Hospital, University of Copenhagen, Roskilde, 6Department of Surgical Pathology, Zealand University Hospital, University of Copenhagen, Næstved, 7Department of Hematology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark Aim: The Danish National Chronic Myeloid Neoplasia Registry (DCMR) is a population-based clinical quality database, introduced to evaluate diagnosis and treatment of patients with chronic myeloid malignancies. The aim is to monitor the clinical quality at the national, regional, and hospital departmental levels and serve as a platform for research. Study population: The DCMR has nationwide coverage and contains information on patients diagnosed at hematology departments from January 2010 onward, including patients with essential thrombocythemia, polycythemia vera, myelofibrosis, unclassifiable myeloproliferative neoplasms, chronic myelomonocytic leukemia, and chronic myeloid leukemia. Main variables: Data are collected using standardized registration forms (so far up to four forms per patient), which are consecutively filled out online at time of diagnosis, after 2-year and 5-year follow-ups, and at end of follow-up. The forms include variables that describe clinical/paraclinical assessments, treatment, disease progression, and survival – disease-specific variables – as well as variables that are identical for all chronic myeloid malignancies. Descriptive data: By the end of 2014, the DCMR contained data on 2,690 patients with an inclusion rate of ~500 patients each year. Since the registry was established, annual reports have shown consistently high national coverage and data completeness, ≥90% and ≥88%, respectively. Conclusion: The DCMR is a national database used for monitoring the quality of patient care in patients with chronic myeloid malignancies, but until validation has been conducted, the data must be used with caution. However, the DCMR is a valuable data source accessible to clinicians and researchers. Keywords: myeloproliferative disorders, database, treatment, health care quality assurance, outcome assessment, epidemiology, researc

OP0232 TREATMENT WITH METHOTREXATE AND RISK OF LUNG DISEASE IN PATIENTS WITH RHEUMATOID ARTHRITIS: A NATIONWIDE POPULATION-BASED COHORT STUDY FROM DENMARK

Background:Methotrexate (MTX) is the recommended first-line drug in EULAR and ACR treatment guidelines for rheumatoid arthritis (RA) and hence the most commonly prescribed DMARD in the treatment of this group of patients. However, lung disease is considered a potential adverse effect of MTX treatment.Objectives:To investigate the risk of interstitial lung disease (ILD) and acute and chronic respiratory failure in RA patients treated with MTX and other medications.Methods:From the Danish National Patient Register (DNPR) and the clinical DANBIO Register for rheumatic diseases, we retrieved data on RA patients registered between 1997 and 2015. Information on ILD and respiratory failure outcomes was obtained from DNPR, and information on redeemed prescriptions for MTX and other medications was obtained through linkage to the Danish Prescription Register. Associations between MTX and lung disease outcomes were analyzed in Cox regression models adjusted for age, calendar time, sex and use of other medications possessing the potential for pulmonary toxicity. Standardized Incidence Ratios (SIRs) of lung disease were calculated to compare RA patients to the general population.Results:Of the 30,512 RA patients identified, 60% patients had redeemed at least one prescription for MTX, 35% had redeemed a prescription for sulphasalazine, 6% had redeemed a prescription of either amiodarone or nitrofurantoin, and 27% had not received any of the included drugs at the end of the 5-year follow-up for ILD and respiratory failure. MTX treatment was not associated with an increased risk of lung disease (≥1 redeemed prescription(s) compared to no prescriptions), HR 1.00 (95% CI 0.78 to 1.27) for ILD and 0.54 (95%CI 0.43 to 0.67) for respiratory failure at 5-year follow-up (Table). The SIR was 3-4 times increased for ILD in MTX-treated RA patients, but this was no different from the RA population in general compared to the background population.Table.Hazard ratios (HR) with 95% confidence intervals (95%CI) for the risk of interstitial lung disease (ILD) and acute or chronic respiratory failure in 30,512 patients with rheumatoid arthritis up to 5 years after diagnosis.ILD (incl. drug-induced cases)1 year of follow up5 years of follow upEvents, NHR (95% CI)Events, NHR (95% CI)Methotrexate, ≥1 redeemed prescription(s) vs. none621.03 (0.71 to 1.48)1661.00 (0.78 to 1.27)Sulphasalazine, ≥1 redeemed prescription(s) vs. none210.88 (0.54 to 1.43)901.14 (0.89 to 1.48)Amiodarone and/or nitrofurantoin, ≥1 redeemed prescription(s) vs. none10.57 (0.08 to 4.10)70.65 (0.31 to 1.38Women72Ref.155Ref.Men551.51 (1.06 to 2.16)1301.74 (1.38 to 2.21)Acute or chronic respiratory failure1-year of follow up5-years of follow upEvents, NHR (95% CI)Events, NHR (95% CI)Methotrexate, ≥1 redeemed prescription(s) vs. none360.48 (0.32 to 0.73)1580.54 (0.43 to 0.67)Sulphasalazine, ≥1 redeemed prescription(s) vs. none140.70 (0.39 to 1.26)991.09 (0.86 to 1.38)Amiodarone and/or nitrofurantoin, ≥1 redeemed prescription(s) vs. none63.01 (1.31 to 6.94)221.33 (0.86 to 2.06)Women71Ref.239Ref.Men381.07 (0.72 to 1.59)1201.04 (0.83 to 1.29)Conclusion:RA patients had an increased risk of ILD compared to the general population, but that risk was not further increased in patients treated with MTX compared to non-MTX treated.Disclosure of Interests:None declared</jats:sec

Socioeconomic position and survival after cervical cancer:influence of cancer stage, comorbidity and smoking among Danish women diagnosed between 2005 and 2010

BACKGROUND: In an attempt to decrease social disparities in cancer survival, it is important to consider the mechanisms by which socioeconomic position influences cancer prognosis. We aimed to investigate whether any associations between socioeconomic factors and survival after cervical cancer could be explained by socioeconomic differences in cancer stage, comorbidity, lifestyle factors or treatment. METHODS: We identified 1961 cases of cervical cancer diagnosed between 2005 and 2010 in the Danish Gynaecological Cancer database, with information on prognostic factors, treatment and lifestyle. Age, vital status, comorbidity and socioeconomic data were obtained from nationwide administrative registers. Associations between socioeconomic indicators (education, income and cohabitation status) and mortality by all causes were analysed in Cox regression models with inclusion of possible mediators. Median follow-up time was 3.0 years (0.01–7.0). RESULTS: All cause mortality was higher in women with shorter rather than longer education (hazard ratio (HR), 1.46; 1.20–1.77), among those with lower rather than higher income (HR, 1.32; 1.07–1.63) and among women aged<60 years without a partner rather than those who cohabited (HR, 1.60; 1.29–1.98). Socioeconomic differences in survival were partly explained by cancer stage and less by comorbidity or smoking (stage- and comorbidty- adjusted HRs being 1.07; 0.96–1.19 for education and 1.15; 0.86–1.52 for income). CONCLUSION: Socioeconomic disparities in survival after cervical cancer were partly explained by socioeconomic differences in cancer stage. The results point to the importance of further investigations into reducing diagnosis delay among disadvantaged groups