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Background: Contact dermatitis in continuing to be increasingly recognized in pediatric populations, especially in those with atopic dispositions. Exposures in children parallel those seen in adult populations. In fact, as post university career jobs are becoming more difficult to acquire, in many countries youngsters are once again entering apprenticeships to obtain immediate economic remuneration. These apprenticeships come with occupational exposures to allergens. Objectives: To review the most common sensitizers in children and to evaluate the changing tendencies of occupational dermatitis in children. Patients/Materials/Methods: For 16 years, we patch tested 12,719 patients. Of these, 396 (3.11%) were children younger than 16 years old. All children were patch tested with the standard GEIDAC (Spanish Contact Dermatitis Group) test series, or with the standard True-test series. In addition, some of them were tested with specific allergens with additional supplemental allergens as warranted by history Results: Among these 396 patch tested children, 119 (30%) were positive to one or more allergens, 73 girls (61%) and 46 boys (39%). The most common allergens were nickel sulfate, cobalt chloride and mercury ammonium chloride. A second group Additional top allergens included the components of rubber accelerators, potassium dichromate, fragrance mix and 4-phenylenediamine base, para-tertiary butylphenol (PTBP) formaldehyde and isothiazolinone, wool alcohols, Myroxylon pereirae. colophony, colophonium [if you are going to use INCI names for M.p. would be consistent] formaldehyde and Nisopropylphenyl- paraphenylenediamine (IPPD). Conclusions: There was a significant incidence [20%] of our cases was which were related to their job as apprentices. This percentage is much higher than what has been reported in other publications. info:eu-repo/semantics/acceptedVersion

One of the biggest challenges for the management of the emergency department (ED) is to expedite the management of patients since their arrival for those with low priority pathologies selected by the classification systems, generating unnecessary saturation of the ED. Diagnostic decision support systems (DDSS) can be a powerful tool to guide diagnosis, facilitate correct classification and improve patient safety. Patients who attended the ED of a tertiary hospital with the preconditions of Manchester Triage system level of low priority (levels 3, 4 and 5), and with one of the five most frequent causes for consultation: dyspnea, chest pain, gastrointestinal bleeding, general discomfort and abdominal pain, were interviewed by an independent researcher with a DDSS, the Mediktor system. After the interview, we compare the Manchester triage and the final diagnoses made by the ED with the triage and diagnostic possibilities ordered by probability obtained by the Mediktor system, respectively. In a final sample of 214 patients, the urgency assignment made by both systems does not match exactly, which could indicate a different classification model, but there were no statistically significant differences between the assigned levels (S = 0.059, p = 0.442). The diagnostic accuracy between the final diagnosis and any of the first 10 Mediktor diagnoses was of 76.5%, for the first five diagnoses was 65.4%, for the first three diagnoses was 58%, and the exact match with the first diagnosis was 37.9%. The classification of Mediktor in this segment of patients shows that a higher level of severity corresponds to a greater number of hospital admissions, hospital readmissions and emergency screenings at 30 days, although without statistical significance. It is expected that this type of applications may be useful as a complement to the triage, to accelerate the diagnostic approach, to improve the request for appropriate complementary tests in a protocolized action model and to reduce waiting times in the ED.

Background Up to 75% of inpatients with mental disorders smoke, and their life expectancy is decreased by up to 25 years compared to the general population. Hospitalized patients without monitoring after discharge quickly return to prehospitalization levels of tobacco use. The aim of the 061 QuitMental study is to assess the effectiveness of a multicomponent and motivational telephone-based intervention to stop smoking through a quitline addressed to smokers discharged from mental health hospital wards. Methods A pragmatic randomized controlled trial, single blinded, will include 2:1 allocation to the intervention group (IG) and the control group (CG). The IG will receive telephone assistance to quit smoking (including psychological and psychoeducational support, and pharmacological treatment advice if required) proactively for 12 months, and the CG will receive only brief advice after discharge. The sample size, calculated with an expected difference of 15 points on smoking abstinence between groups (IG, 20% and CG, 5%), α = 0.05, β = 0.10, and 20% loss, will be 334 participants (IG) and 176 participants (CG). Participants are adult smokers discharged from psychiatric units of five acute hospitals. Measurements include dependent variables (self-reported 7-day point prevalence smoking abstinence (carbon monoxide verified), duration of abstinence, number of quit attempts, motivation, and self-efficacy to quit) and independent variables (age, sex, and psychiatric diagnoses). In data analysis, IG and CG data will be compared at 48 h and 1, 6, and 12 months post discharge. Multivariate logistic regression (odds ratio; 95% confidence interval) of dependent variables adjusted for potential confounding variables will be performed. The number needed to treat to achieve one abstinence outcome will be calculated. We will compare the abstinence rate of enrolled patients between groups. Discussion This trial evaluates an innovative format of a quitline for smokers with severe mental disorders regardless of their motivation to quit. If effective, the pragmatic nature of the study will permit transfer to routine clinical practice in the National Health System. Trial registration ClinicalTrials.gov, NCT03230955. Registered on 24 July 2017. Electronic supplementary material The online version of this article (10.1186/s13063-018-3106-5) contains supplementary material, which is available to authorized users.