Background Workers in the healthcare sector are at high risk of developing occupational hand eczema mainly due to frequent exposure to irritants and/or allergens. Amongst workers in healthcare, nurses are at higher risk of developing hand dermatitis. Objectives To evaluate the effectiveness of a short educational intervention program in preventing occupational hand eczema in nurse apprentices, using two objective tools, namely TEWL and EH, and the HECSI score. Methods Data regarding professions, wet work exposure, activities performed during working hours, self-reported eczema were collected from 230 nurse students, divided in two study groups: the intervention and the control group (CG). The intervention group (IG) was given education about risks and proper skin care and was provided with cosmeceuticals to be used for skin care during hospital activity. The evaluation of skin properties was performed using questionnaires, HECSI score, measurement of transepidermal water loss (TEWL) and epidermal hydration (EH). Results A number of 139 apprentice nurses completed the study. Of those participants who completed the study, 19.1% from CG and 19.6% from IG reported, at T1, hand eczema in the last 3 months, while at T2 (3 months later), 59.52 % of the CG and only 11.34 % from the IG stated having eczema in the last 3 months. In the IG, results showed an improvement of CM with 17% and of TEWL with 16%, with only a 0.5% improvement of CM in CG and a marked impairment of TEWL by 33%. Conclusion Hand eczema is a common occupational dermatosis affecting the medical staff, even during apprenticeship. Early preventive training programs are effective in reducing the burden of occupational contact dermatitis.
Death in custody is defined as a death taking place in the custody of the police, prison service, involuntary patients in psychiatric institutions or in the custody of other authorities; independent of the cause or manner of death.. In this article we wanted to analyze the main features of the death in custody in Romania. The study was conducted using data obtained from the Romanian National Penitentiary Administration from 2003 to 2008; data was included in, and analyzed using the Microsoft Excel 2007 software. The main results we have obtained are (1) the medium number of prisoners, mortality and morbidity have declined from 2003 to 2008, whilst the mortality and morbidity rates remained almost constant. By analyzing the causes of death we identified a significant decrease in the number of non-violent deaths, whilst the number of violent deaths remained almost constant. The most frequent non-lethal pathologies were respiratory, gastrointestinal and dermatological whilst the most frequently lethal pathologies were cardiovascular and neoplastic. A violent manner of death was identified in a minority of cases, and was usually represented by suicides (by hanging). In conclusion, the matter of death in penitentiaries in Romania is mostly non-violent, with cardiovascular and neoplastic disorders being the most frequent lethal pathologies. The relative number of violent deaths has increased in the last years, suggesting the need for more strict rules and regulations.
Several definitions of the case study have been formulated over time, but in the following we will quote a definition that we consider appropriate for the clinical case that we will present, namely: "Case study is a method of direct confrontation of participants with a real, genuine situation, taken as a typical example, representative of a set of problematic situations and events that require a diagnosis and decision ". In reference to this definition, we emphasize that the importance of case presentations in medical practice is unquestionable as it brings to the attention of physicians other new or unusual, particular pathological conditions, difficulties or diagnostic errors, atypical clinical developments or unexpected treatment responses. The purpose of presenting this clinical case is to draw an alarm signal on the simplistic way in which the disease is still being addressed and not the patient in its entirety and to stimulate young doctors to review their own schemes and algorithms of clinical judgment. Particularities of the case to be presented are that the patient under investigation has about 10 months of intense hyper-lobular hyperplastic seizures with atypical development and, although presented to many specialists, the multiple co-morbidities of the patient have hampered the formulation of a diagnosis of certainty. Consequently, no adequate treatment has been established during this period to reduce its pain, so the patient's confidence in the medical act is now seriously altered.
Prisons are known to be injury risk hotpots, with significantly higher rates of violent acts compared to those recorded in the general population. The purpose of this article is to reveal the main characteristics of violence in prisons in Romania, using the databases of the Romanian National Penitentiary Administration and significant samples collected from the Galati penitentiary. The study was conducted using data obtained from the Romanian National Penitentiary Administration from 2003 to 2008, and cases from the casuistry of the Galati Penitentiary. The prevalence of aggressive acts has significantly increased from 2003 to 2008, with a relative increase of about 500% for hetero-aggressive acts and about 50% for auto-aggressive acts. This difference is most likely caused by the fact that self-harm is more profoundly linked to psychological factors and subsequently less linked to external conditions, which only have a minor involvement in the development of the self-aggressive acts.
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