ABSTRACT
Background: There is growing interest in the treatment and return-to-work of workers with labor related mental illnesses. Aim: To perform a systematic review of practices and interventions that improve return to work. Material and Methods: Systematic literature review. Thirty articles were selected for in- depth analysis. Results: Self efficacy perception, work motivation, a lower age and a better socioeconomic status were identified as worker-related return to work facilitators. Among work environment facilitators, good communication practices, supervisor support, a good assessment and modification of work load, adjustment of expectations, a good relationship between employers and employees and positive work experiences were identified. Treatment may improve return to work using a multidisciplinary approach, reducing stress and identifying psychosocial determinants of mental problems rather than symptoms and providing a timely health care. Conclusions: Return to work of workers with labor related mental illnesses requires a constant sharing of information between health care workers, employers and employees to identify common therapeutic objectives.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , White People/genetics , Genetic Loci , Lipoprotein(a)/blood , Lipoprotein(a)/genetics , Polymorphism, Single Nucleotide , Cohort Studies , Europe , Genetic Association Studies , Genotype , Oligonucleotide Array Sequence Analysis , PhenotypeABSTRACT
Se establecieron las características más sobresalientes de la lipoproteína (a), así como los mecanismos patogénicos de esta partícula lipoproteínica relacionados con la aterotrombogénesis. La lipoproteína (a) [Lp (a)], descubierta por Kare Berg en 1963, posee una composición similar a la de la lipoproteína de baja densidad (LDL). En su estructura también presenta a la apolipoproteína (a) [apo (a)], la cual está unida a la apo B100 mediante un enlace disulfuro. El aspecto más interesante de la biología de la Lp (a) lo constituye, sin dudas, la sorprendente homología estructural que existe entre el plasminógeno y la apo (a); esta apolipoproteína, además, es la responsable de las propiedades metabólicas y bioquímicas de la lipoproteína (a). Por su estructura peculiar y la correlación existente entre los niveles elevados de la Lp (a) y el desarrollo de complicaciones aterotrombóticas, esta lipoproteína se ha convertido en el objeto de numerosas investigaciones
Subject(s)
Apolipoproteins A , Arteriosclerosis , Lipoprotein(a)/genetics , Lipoprotein(a)/metabolism , Lipoprotein(a)/ultrastructure , Risk FactorsABSTRACT
BACKGROUND: Plasma lipoprotein (a) levels in the Indian population are varied; this study was undertaken to determine the relationship between plasma lipoprotein (a) levels and their phenotypes in a group of south Indian patients with coronary artery disease. METHODS AND RESULTS: A total of 104 patients with angiographically proven coronary artery disease were compared with 104 age- and sex-matched controls with no risk factors such as hypertension, diabetes and smoking. Lipoprotein (a) levels were measured by an in-house ELISA method and its phenotyping was done by SDS agarose gel electrophoresis. Plasma lipoprotein (a) levels were significantly elevated in patients with coronary artery disease as compared to controls (33.4+/-26.1 mg/dl v. 21.4+/-12.8 mg/dl; p<0.01). Lipoprotein (a) phenotyping showed that low-molecular weight isoforms were found only in 19.2% of the patients with coronary artery disease and their plasma lipoprotein (a) levels were significantly elevated compared to coronary artery disease patients with higher molecular weight isoforms (50.9+/-34.2 mg/dl v. 29.24+/-20.06 mg/dl; p<0.001). CONCLUSIONS: Plasma lipoprotein (a) levels are significantly elevated in patients with coronary artery disease as compared to controls. The commoner phenotype in a South Indian population is the larger apolipoprotein (a). in which the lipoprotein (a) levels are lower. Hence the contribution of lipoprotein (a) phenotype to the lipoprotein (a) levels in our population, if any, is modest.
Subject(s)
Case-Control Studies , Confidence Intervals , Coronary Artery Disease/blood , Female , Humans , India/ethnology , Lipoprotein(a)/genetics , Male , Middle Aged , Odds Ratio , PhenotypeABSTRACT
Se midieron las concentraciones séricas y la distribución de frecuencia de lipoproteína (a) en 71 niños caucásicos y 41 pehuenches (de 6 a 15 años de edad) que habitan en la zona del Alto Bío-Bío, VIII Región geopolítica de Chile. Adicionalmente se registraron las isoformas de apolipoproteína (a) en 50 de los participantes. Las concentraciones de lipoproteína (a) fueron 10,5 ñ 6,2 y 21,3 ñ 34,5 mg/dl, respectivamente, en los niños pehuenches y caucásicos (p< 0,001). La distribución de las frecuencias de ambos grupos mostró inclinación hacia las concentraciones más bajas de una curva normal. La prevalencia de concentraciones séricas de lipoproteína (a) consideradas riesgosas en términos de enfermedades cardiovasculares (> 30 mg/dl) fue de 21,1 por ciento y 7,3 por ciento, respectivamente, para niños caucásicos y pehuenches. En los caucásicos se observó una correlación inversa entre el tamaño de la isoforma de apolipoproteína (a) y la concentración plasmática de lipoproteína (a) (r=0,77), lo que fue menos claro en la población pehuenche (r=0,33)