Work-related stress and Type 2 diabetes: systematic review and meta-analysis.

BACKGROUND: Work-related psychosocial stress has been hypothesized to increase the individual risk of Type 2 diabetes; however, observational epidemiological studies investigating the association between work-related psychosocial stress and Type 2 diabetes have provided an inconsistent picture. AIMS: To evaluate whether work-related psychosocial stress (defined by a work-related stress model or by long work hours) is associated with the risk of Type 2 diabetes. METHODS: A systematic review of the literature was conducted until March 2010. Studies eligible for inclusion were published observational epidemiological studies of adult participants in community or occupational settings if they had a measure of work-related stress on a validated scale or a measure of work hours or overtime assessed prior to, or at the same time as, assessment of Type 2 diabetes status. Where possible, meta-analysis was conducted to obtain summary odds ratios of the association. RESULTS: We located nine studies (four prospective, one case-control and four cross-sectional). The meta-analyses did not show any statistically significant associations between any individual aspect of work-related psychosocial stress or job strain and risk of Type 2 diabetes. CONCLUSIONS: The specific hypothesis that a working environment characterized by high psychosocial stress is directly associated with increased risk of Type 2 diabetes could not be supported from the meta-analysis.

Endocarditis and ulnar artery aneurysm as presenting features of antiphospholipid syndrome and polyarteritis nodosa.

Antiphospholipid syndrome in association with vasculitis is highlighted in this report. The combination of thrombotic and inflammatory processes resulted in endocarditis, aneurysm formation and thrombosis. To our knowledge this is the first presentation of a large vessel aneurysm in these conditions. Anticoagulation and immunosuppression are the treatment modalities of choice.