Burden of disease, pain catastrophizing, and central sensitization in relation to work-related issues in young spondyloarthritis patients.

Introduction: Spondyloarthritis (SpA) is a common rheumatic inflammatory disease and can impact patients' work productivity. We aimed to evaluate the impact of pain catastrophizing and central sensitization on work outcomes in young SpA patients and determine the predictive factors of work productivity loss. Material and methods: We performed a cross-sectional study over 6 months. We included patients aged between 18 and 50 years old, diagnosed with axial or peripheral SpA. Pain catastrophizing and central sensitization were assessed using the Pain Catastrophizing Scale (PCS) and Central Sensitization Inventory (CSI) questionnaire, respectively. Impact of SpA on work productivity and activity impairment during and outside of work was measured with the Work Productivity and Activity Impairment Questionnaire (WPAI: Spondyloarthritis). Results: A total of 72 patients were enrolled, with a median age of 39 years (28.3-46), 65.3% men, and 54.4% working patients. Median scores of activity impairment outside of work, and work productivity loss were 50% (40-70), and 50% (40-60), respectively. Median absenteeism and presenteeism scores were 0% (IQR 0-7), and 100% (IQR 86.5-100), respectively. Regarding work-related outcomes: activity impairment was positively correlated with CSI and PCS; presenteeism was significantly associated with male sex (p = 0.009); and work productivity loss was positively associated with anxiety, depression, and poor quality of life. Multivariate regression analysis identified predictive factors of work productivity loss: male sex, poor quality of life, and prolonged morning stiffness. Conclusions: Assessment of the impact of pain catastrophizing and central sensitization on work-related outcomes in patients with SpA is important to understand the burden of illness and to identify early those in need of interventions in clinical practice.

The Professional Future in Operated Carpal Tunnel Syndrome: A Cross-Sectional Study of Recognized Occupational Cases.

BACKGROUND: Carpal tunnel syndrome (CTS) is frequently present among workers. This syndrome's professional and economic impact makes it a priority in occupational health. We aimed to describe the professional future of workers suffering from occupational CTS after surgery and the factors that could influence their retention at the job. -Methods: A retrospective descriptive study of workers operated on occupational CTS was conducted from 2014 to 2019. The data was collected using pre-established and phone questionnaires to determine their professional future after surgery. RESULTS: We included 99 workers with operated CTS. They had a mean age of 45±6.5 years, were predominantly female (97%), and had two dependent children in 72.7% of cases. They worked as a seamstress in 44.4% of patients with a mean professional seniority of 18±7.2 years. The professional future was a return to work with a job transfer at 44.4% and job maintenance with ergonomic adjustments at 39.4%. A job loss was noticed in 12.2% of cases. Early retirement was noticed in 8.2%, dismissal in 3%, and resignation in 1% of cases. The factors influencing the professional future were age 50 to 59 years (p=0.01) and dependent children (p=0.02). CONCLUSIONS: In our survey, most operated-CTS workers benefited from a job transfer and kept their job with ergonomic adjustments to their work conditions. Therefore, interventions aiming to improve the professional future of workers operated on CTS by ensuring sufficient staff and adjusting workplaces are needed.

Impact of atypical working hours on sleep and mood among healthcare workers.

BACKGROUND: Atypical working hours have raised serious concerns about health effects, such as sleep disorders and psychological repercussions. These schedules are frequent among health professionals having the obligation to ensure the permanence of health services. OBJECTIVE: To assess the impact of atypical working hours on sleep, sleepiness, and mood among health personnel (HP). METHODS: Comparative descriptive cross-sectional study was carried out among HP of a regional hospital in Southern Tunisia from December 2019 to May 2020. Two groups were defined according to their work schedule: group A had a fixed-day work and group B had atypical working hours. The assessment of sleep, sleepiness, and mood was based respectively on the Spiegel questionnaire, the Epworth Sleepiness Scale, and the Hospital Anxiety and Disorder scale. RESULTS: A total of 101 HP in group A and 135 in group B were included. We found signs of pathological sleep in group B: greater delay in falling asleep (78.1% Vs 53.5%; p = 0.002), altered sleep quality (88.1% Vs 56.4%; p = 0.039), and more frequent occurrence of dreams (37% Vs 31.7%; p = 0.033). The quality of sleep was associated with the professional seniority (p = 0.01), the workplace (p = 0.02), and having dependent children (p = 0.04). The mean score of depression was higher in group B (p = 0.02). Depression was associated with the workplace (p = 0.04) and the quality of sleep (p = 0.01). CONCLUSION: The results of this study indicate that atypical working hours generate both sleep and mood disorders in HP. It is vital to encourage the occupational physicians to estimate sleep and mood disorders in HP.

Peritoneal mesothelioma associated with bladder cancer and occupational exposure to asbestos: A case report.

Mesothelioma is a rare tumor usually located on the pleura. In this typical location, it is closely linked to asbestos exposure. However, in other locations such as in peritoneal mesothelioma, the association to asbestos remains unusual.

Fitness for work of hospital personnel in sickness absence.

INTRODUCTION: The evaluation of fitness for work can be conducted upon the employer's request even during the employee's sickness absence. AIM: Determine the contribution of conducting medical examinations to assess the working ability of Charles Nicolle hospital's workers who are on sick leave. METHODS: A descriptive and retrospective study included all the medical records, completed over a two-year period (2013-2014), of Charles Nicolle hospital's personnel who were on sick leave and who consulted the service of occupational medicine and professional pathology to undergo a fitness for work evaluation requested by the employer. RESULTS: Our study was based on a total of 170 cases of sickness absenteeism reported from a population of 133 employees. The average age of the study population was 39 years (+/- 9.5) with a sex ratio of 0.51. The category of nurses was the most represented (44.4 %). The average work seniority was 10.6 years (+/- 8.4). It is worth notifying that in 65.3% of the cases (111/170), medical examinations were conducted on the employees during the time they were off work. However, in the remaining 34.7 % of the cases (59/170), medical examinations were conducted on the employees after they go back to work. Our study showed that among the 111 employees who were subject to a medical examination during their sickness absence, 88 of them, which is the equivalent of 79.3 %, were found to be fit for work. Among those, 8 cases were fit for work but with some restrictions. A temporary unfitness for work was indicated in only 20.7% of the cases (23/111). CONCLUSION: Our study unveiled a discrepancy between sickness absenteeism and fitness for work in Charles Nicolle hospital. Employees on sick leave had the physical and the mental abilities that would allow them to work with some individualized accommodations based on their health-related needs.

[Assessment of nutritional status in patients with primary lung cancer]. / Evaluation de l'état nutritionnel des patients atteints de cancer broncho-pulmonaire primitif.

BACKGROUND: Lung cancer is the leading cause of cancer-related mortality worldwide. Malnutrition is a common problem among patients with cancer, affecting up to 85% of patients with certain cancers and represents a risk factor for poor prognosis. aim: evaluate nutritional status in patients with lung cancer before and during treatment using nutritional risk index. METHODS: it's a prospective study conducted in pneumology IV department in Abderahman Mami hospital, from January to May 2011. 30 male patients with a lung cancer were included. Nutritional status was assessed before and during treatment based on anthropometric measures, biological markers and nutritional risk index (NRI). RESULTS: Mean age of patients was 58 ± 12 years, ranging from 19 to 82 years. 29 patients had non small cell lung cancer and one patient had small cell cancer. Malnutrition was noted in 14 patients (47%) before treatment according to the NRI. It was noted in 23 patients (77%) after three cycles of chemotherapy with severe malnutrition in 8 patients. Relationship between body mass index (BMI) and the NRI was linear, but NRI tends to evaluate more objectively risk of malnutrition in patients with lung cancer. CONCLUSION: Nutritional assessment in patient with lung cancer should be performed systematically, early and repeatedly. Several markers can be used such as BMI and NRI. Nutritional support will reduce morbidity and improve quality of life in patients with lung cancer.