The Environmental Health Program of the Pan American Health Organization has established goals to be able to comply with the resolutions of the Board of Directors and the Executive Committee. As an integral part of the Environmental Health Program, the Pan American Center for Human Ecology and Health (ECO) must contribute to the achievement of these goals. Generally speaking, there is a scarcity of toxicology professionals in the Region of the Americas. In order to ameliorate this situation, it is suggested that activities in the areas of training professionals, conducting research, dissemination of information, and publishing of educational materials be undertaken. It is proposed that the "Joint Toxicology Network at the Regional Level" be created. The objectives of such a network would be the promotion and encouragement of activities in the area of toxicology; assistance to countries in identifying their needs; encouragement of information exchange, publication and training in toxicology; and support of the Toxicology Information Centers. In order to achieve the Network objectives, it is suggested that activities be undertaken by the national groups belonging to the network.
Environmental Health ; International Cooperation ; Latin America ; Pan American Health Organization ; organization & administration ; Toxicology ; organization & administration

OBJECTIVE: This study investigates the impact of multimorbidity on work through a literature review of longitudinal studies.METHODS: A systematic review was carried out in the databases Lilacs, SciELO, PAHO, PubMed/Medline, Scopus, Web of Science, and Cochrane. There were no restrictions regarding the year of publication or language to maximize the identification of relevant literature. The quality of studies was assessed by the protocol STrengthening the Reporting of OBservational studies in Epidemiology (STROBE).RESULTS: An initial database search identified 7522 registries, and at the end of the analysis, 7 manuscripts were included in the review. Several studies have demonstrated direct and indirect impacts of multimorbidity on the health of workers. For this, the number of missed days due to health-related issues was evaluated, as well as the reduction in work productivity of the unhealthy worker, vulnerability of the worker with multimorbidity regarding higher indices of dismissal and recruitment difficulties, and incidence of early retirement and/or receipt of benefits due to disabilities.CONCLUSIONS: Multimorbidity has a negative impact on work, with damages to quality of life and work productivity, worsening the absenteeism/presenteeism indices, enhancing the chances of temporary or permanent leaves, and lowering employability and admission of individuals with multimorbidity.
Comorbidity ; Efficiency ; Epidemiology ; Incidence ; Longitudinal Studies ; Pan American Health Organization ; Publications ; Quality of Life ; Registries ; Retirement

PURPOSE: Bacillus Calmette-Guerin(BCG) lymphadenitis is one of the most common complications of BCG vaccination. The involved lymph nodes usually subside spontaneously, but they may become enlarged and form an abscess. Treatment of these infants is controversial. The Pan American Health Organization recommends local isoniazid or rifampicin instillation for patients with suppurative BCG lymphadenitis. METHODS: The study group comprised 37 patients who presented with BCG lymphadenitis over the last three years. BCG lymphadenitis was diagnosed if the affected patient developed an ipsilateral axillary or supraclavicular lymphadenitis, with no other identifiable cause for the lymphadenitis. We used rifampicin instillation therapy for patients with suppurative BCG lymphadenitis. RESULTS: Lymphadenitis regressed spontaneously in three patients. Thirty four patients showed a progression to abscess formation. Among 34 patients with suppurative lymphadenitis, drainage developed spontaneously during the follow-up period in nine patients before therapy. Twenty five patients received needle aspiration and local rifampicin instillation therapy. Reaspiration was performed in seven patients. One of these patients still has large lymph nodes after the second attempt. CONCLUSION: Needle aspiration and local rifampicin instillation therapy into the node is a safe and effective form of treatment for suppurative BCG lymphadenitis.
Abscess ; Bacillus* ; Drainage ; Follow-Up Studies ; Humans ; Infant ; Isoniazid ; Lymph Nodes ; Lymphadenitis* ; Mycobacterium bovis ; Needles ; Pan American Health Organization ; Rifampin* ; Vaccination