Adding Water to the Mill: Olmesartan-Induced Collagenous Sprue-A Case Report and Brief Literature Review.

Collagenous sprue (CS) is a distinct clinicopathological disorder histologically defined by a thickened subepithelial band (Freeman, 2011). It is a rare condition which has been recently observed in a significant proportion of sprue-like enteropathy associated with olmesartan, a novel entity described by Rubio-Tapia et al. in 2012. CS is historically associated with a poor prognosis (Marthey et al., 2014). However, histological and clinical improvements have been described in most studies with concomitant usage of corticosteroids and/or gluten-free diet (Marthey et al., 2014). We report a unique case of olmesartan-induced collagenous sprue in a 79-year-old man that showed complete histological and clinical remission with the sole withdrawal of the incriminating drug. The literature on this topic is briefly reviewed.

Noise as an explanatory factor in work-related fatality reports.

Noise exposure in the workplace is a common reality in Québec, Canada as it is elsewhere. However, the extent to which noise acts as a causal or contributive factor in industrial work-related accidents has not been studied thoroughly despite its plausibility. This article aims to describe the importance or potential importance, during investigations looking into the specific causes of each work-related fatal accident, of noise as an explanatory factor. The written information contained in the accident reports pertaining to contextual and technical elements were used. The study used multiple case qualitative content analysis. This descriptive study was based on the content analysis of the 788 reports from the Commission de la santé et de la sécurité du travail du Québec [Workers' Compensation Board (WCB)] investigating the fatal work-related accidents between 1990 and 2005. The study was descriptive (number and percentages). Noise was explicitly stated as one of the explanatory factors for the fatal outcome in 2.2% (17/788) of the fatal accidents, particularly when the work involved vehicular movement or the need to communicate between workers. Noise was not typically considered a unique cause in the accident, notably because the investigators considered that the accident would have probably occurred due to other risk factors (for example, disregard of safety rules, shortcomings in work methods, and inadequate training). Noise is an important risk factor when communication is involved in work. Since noise is ubiquitous and may also interfere with vigilance and other risk factors for accidents, it may be a much more important contributing factor to accidents than is currently recognized.

[The association between psychosocial work demands and mental health problems in Quebec: a gender-based analysis]. / Contraintes psychosociales de travail et problèmes de santè mentale au Québec: une analyse différenciée selon le sexe.

OBJECTIVE: The objective of the study was to conduct a gender-based analysis of associations between certain psychosocial work demands and certain mental health problems in Québec. METHODS: The study comprised 2,877 workers, with a response rate of 78%. Data collection was conducted by means of computer-assisted interviews, mainly in person. The mental health problems retained in the model were: psychological distress, a major episode of depression, and a positive score on the global depression index. The psychosocial work demands measured were: level of decision latitude, of psychological job demands and of social support. A set of job and personal characteristics were also measured. FINDINGS: In all, 41% of Québec workers have a low level of decision authority and 46% experience low skill discretion at work. Moreover, 45% reported having little social support and 40% high psychological job demands. The findings show that 25% of the population studied had experienced a level of psychological distress during the month preceding the survey, and during the previous 12 months, 4% had had a major episode of depression and 6.4% a score on the global depression index indicating depression. These indicators seemed more marked among women compared to men. The findings of the multivariate analysis showed that among women, low skill discretion surprisingly appeared to be a protective factor against a major episode of depression. CONCLUSION: The reasons for these differences between the sexes are discussed and seem related to such factors as more unfavourable working conditions for women, as well as double workloads (home and work), and a relationship to work that differs from that of men.