Workability, quality of life and cardiovascular risk markers in aging nightshift workers: a pilot study.

BACKGROUND: In aging healthcare professionals, multiple stressors such as night work may affect life and work satisfaction and risk for chronic diseases (e.g. cardiovascular disease [CVD]). In this pilot study we compared workability, quality of life (QoL), and CVD risk markers between night shift and day workers. METHODS: We included 70 hospital employees (mean age 52 ±â€¯4 years, 91.4% female): 32 rotating night shift workers (> 3 nights/month) and 38 permanent day workers. In addition to sociodemographic, lifestyle, and sleep characteristics, we assessed i) workability index (WAI), ii) QoL (World Health Organization Quality of Life [WHOQOL-Bref]) and iii) CVD risk markers, i.e. carotid ultrasound measurements, and biomarkers (NTproBNP, CRP, IL­6, LDL, ferritin, copper, zinc, and selenium). WAI, QoL, and CVD risk markers were compared between night and day workers. In a subgroup of participants (N = 38) with complete data, we used quantile regression analysis to estimate age and multivariate adjusted differences in biomarker levels. RESULTS: We found no differences in the domains of QoL (physical health, psychological, social relationships, and environment) and WAI scores between night and day workers. Night shift workers were less likely to report excellent workability than day workers, although differences were not statistically significant. Night shift workers reported more sleep problems (73.1% vs. 55.6%) and tended to have lower zinc levels and higher inflammatory markers (CRP, IL­6, ferritin), but differences were not significant after adjusting for potential confounders. CONCLUSIONS: Workability, QoL and CVD markers did not significantly differ between rotating night shift and day workers in this small pilot study. Sleep problems and inflammatory marker levels carry implications for occupational health.

Immunoglobulin g4-related disease mimicking unresectable gallbladder cancer.

Immunoglobulin G4 (IgG4)-related disease is a novel disease entity that can involve diverse organs, causing specific diseases, including autoimmune pancreatitis, sclerosing cholangitis, cholecystitis, inflammatory aortic aneurysm, and inflammatory pseudotumor. IgG4-related disease is characterized by elevated serum IgG4 concentrations, abundant IgG4 lymphoplasmacytic infiltration, and dramatic steroid responses. It is clinically important to differentiate this rare disease from primary sclerosing cholangitis and cholangiocarcinoma, because the treatment and prognosis of these two diseases are completely different. However, the preoperative diagnosis is challenging, and the disease is frequently misdiagnosed. If the serum level of IgG4 is within the normal range, the diagnosis of IgG4-related disease is more difficult. This article reports on a 59-year-old man with IgG4-related disease mimicking unresectable gallbladder cancer with normal serum IgG4 concentrations.

Presence of coronary artery disease increases the risk of biliary events in patients with asymptomatic gallstones.

BACKGROUND AND AIM: Propensity score indicates a probability of having a confounding factor. It is used to match each patient with the closest propensity score between two groups, which is known as propensity score matching. This study aimed to evaluate the gallstone-related biliary events, defined as biliary colic and acute cholecystitis between coronary artery disease (CAD) and non-CAD patients using propensity score matching. METHODS: This retrospective cohort study evaluated 267 asymptomatic gallstone patients with CAD and 459 asymptomatic gallstone patients without CAD from March 2003 to December 2009 at two tertiary teaching hospitals in the Republic of Korea. After propensity score matching, total 378 patients, including 126 in study group (with CAD) and 252 in control group (without CAD), were evaluated. RESULTS: During a median follow-up of 47 months, overall gallstone-related biliary event rate was 33.5% in the study group and 27.5% in the control group. The 5-year cumulative rates were 25.3% versus 17.7% in gallstone-related biliary event and 10.9% versus 1.6% in acute cholecystitis (study versus control group). After propensity score adjustment, the risk of gallstone-related biliary events in the CAD patients significantly increased (hazard ratio 2.11, 95% confidence interval 1.14-3.90, P = 0.017 in matched patients). CONCLUSION: In patients with asymptomatic gallstones, the coexistence of CAD can increase the risk of gallstone-related biliary events, particularly acute cholecystitis. Therefore, gallstone patients with CAD should be carefully monitored, even if they are asymptomatic.