No difference in self reported health among coalminers in two different shift schedules at Spitsbergen, Norway, a two years follow-up

This study was performed among coal miners in the remote location Svea, Spitsbergen. The shift schedule used to be 7 d on and 7 d off. The aim of this study was to investigate possible changes in health after a voluntary implementation of a new shift schedule, with periods of 14 d on and 14 d off, for 74 percent of the workers in 2007. A questionnaire was distributed to all employees before and two times after the new shift schedule, comprising questions on type of work, shift schedule, pain, sleep, stress and coping. Ninety nine percent of the employees responded; 274 in 2006, 307 in 2007 and 312 in 2008. Work neither in the 14/14 shift nor 7/7 shift was related to any change in the health after these two years. The coping index for workers in the 14/14 shift improved.     

SEOM clinical guidelines for the treatment of head and neck cancer (2017)

Head and neck cancer (HNC) is defined as malignant tumours located in the upper aerodigestive tract and represents 5% of oncologic cases in adults in Spain. More than 90% of these tumours have squamous histology. In an effort to incorporate evidence obtained since 2013 publication, Spanish Society of Medical Oncology (SEOM) presents an update of HNC diagnosis and treatment guideline. The eighth edition of TNM classification, published in January 2017, introduces important changes for p16-positive oropharyngeal tumours, for lip and oral cavity cancer and for N3 category. In addition, there are new data about induction chemotherapy and the role of immunotherapy in HNC.     

Menstrual characteristics and night work among nurses

Night work has been associated with adverse effects in terms of reproductive health.Specifically, menstruation has been suggested to be negatively impacted by night work,which again may influence fertility. This study investigated whether working nights isrelated to menstrual characteristics and if there is a relationship between shift workdisorder (SWD) and menstruation. The study was cross-sectional, response rate 38%. Thesample comprised female nurses who were members of the Norwegian Nurses Association; below50 yr of age, who were not pregnant, did not use hormonal pills or intrauterine devicesand who had not reached menopause (n=766). The nurses answered a postal survey includingquestions about night work and menstrual characteristics. Fifteen per cent reported tohave irregular menstruations. Thirty-nine per cent of the nurses were classified as havingSWD. Logistic regression analyses concerning the relationship between irregularmenstruations and night work did not show any associations. Furthermore, no associationswere found between cycle length or bleeding period and night work parameters. Noassociations were found between menstrual characteristics and SWD.     

Alcohol Use,Injuries, and Prenatal Visits During Three Successive Pregnancies Among American Indian Women on the Northern Plains Who have Children with Fetal Alcohol Syndrome or Incomplete Fetal Alcohol Syndrome

Introduction The purpose of the study was to compare three sequential pregnancies of American Indian women who have children with FAS or children with incomplete FAS with women who did not have children with FAS. Methods Two retrospective case-control studies were conducted of Northern Plains American Indian children with fetal alcohol syndrome (FAS) (Study 1) or incomplete FAS (Study 2) in 1981–1993. Three successive pregnancies ending in live births of 43 case mothers who had children with FAS, and 35 case mothers who had children with incomplete FAS were compared to the pregnancies of 86 and 70 control mothers who did not have children with FAS, respectively, in the two studies. Prenatal records were abstracted for the index child (child with FAS or incomplete FAS) and siblings born just before and just after the index child, and comparable prenatal records for the controls. Results Compared to the controls, significantly more case mothers used alcohol before and after all three pregnancies and during pregnancy with the before sibling and the index child. Mothers who had children with FAS reduced their alcohol use during the pregnancy following the birth of the index child. All Study 1 case mothers (100%) and 60% of Study 2 case mothers used alcohol during the pregnancy with the index child compared to 20 and 9% of respective control mothers. More study 1 case mothers experienced unintentional injuries (OR 9.50) and intentional injuries during the index pregnancy (OR 9.33) than the control mothers. Most case mothers began prenatal care in the second trimester. Conclusions Alcohol use was documented before, during and after each of the three pregnancies. Women of child-bearing age should be screened for alcohol use whenever they present for medical services. Mothers who had a child with FAS decreased their alcohol consumption with the next pregnancy, a finding that supports the importance of prenatal screening throughout pregnancy. Women who receive medical care for injuries should be screened for alcohol use and referred for appropriate treatment. Protective custody, case management and treatment services need to be readily available for women who use alcohol.     

Number of births, interpregnancy interval, and subsequent pregnancy rate after a diagnosis of inflammatory rheumatic disease in Norwegian women.

OBJECTIVE: To study female reproduction, i.e., number of births, subsequent pregnancy rate, and interpregnancy interval after diagnosis of inflammatory rheumatic disease. METHODS: In a national population based cohort study, reproduction in mothers with rheumatic disease, registered with the Medical Birth Registry of Norway 1967-1995, were compared to mothers without such diagnoses. RESULTS: After diagnosis, women with rheumatic disease had a statistically significant lower mean number of births, a shorter time span of reproduction, longer interpregnancy intervals, and a reduced subsequent pregnancy rate. CONCLUSION: Altered reproduction observed in women with a rheumatic disease might reflect various mechanisms not accounted for in this study, but possibly related to the disease process, functional impairment, or medical treatment.     

Laparoscopic management of median arcuate ligament syndrome

Median arcuate ligament syndrome is a rare disorder resulting from luminal narrowing of the celiac trunk. The classic management of median arcuate ligament syndrome involves the surgical division of the median arcuate ligament fibers in order to decompress the celiac trunk. This has traditionally required an upper midline incision. A few authors have described a successful laparoscopic release of celiac artery compression syndrome. Laparoscopy provides a less invasive, but equally effective method for decompressing the celiac trunk.     

Secondary aortoduodenal fistulas: report of 7 cases

PURPOSE: Aortoduodenal fistulas are the most frequent aortoenteric fistulas. They may be primary (occurring after aneurysms of the native aorta) or secondary (occurring after aortic prosthesis). Aortoduodenal fistulas are a rare complication of aortic prostheses. They may be caused by prosthesis infection or due to inadequate prosthesis. METHODS: We report seven observations that emphasize issues pertaining to either diagnosis or therapy. RESULTS: The delay of occurrence is variable, with a mean of 3 years as reported in the literature. Clinical picture includes upper digestive tract hemorrhage, sometimes fever, abdominal pain or mass. Though difficult, diagnosis can be achieved through gastric endoscopy or CT-scan. Additional diagnostic procedures are often not useful and should not be numerous. Surgical procedures help guide the diagnosis and constitute the main part of the treatment with suture of the duodenum and vascular prosthesis. According to previous works, our observations including prolonged follow-up of the patients suggest that the best vascular treatment is extra-anatomic axillo-bifemoral bypass, while simple suture and prosthesis replacement lead to poor results. CONCLUSION: Mortality related to aortodigestive fistulas is high (five out of seven patients in the present study) and requires prevention, including more particularly delicate surgery and antibiotic therapy in case of any episode of infection. Aortoduodenal fistulas must be suspected whenever a patient with aortic prosthesis has digestive bleeding or unexplained fever.     

Post-Traumatic Thoracic Outlet Syndromes

This retrospective study aims to clarify the mechanisms, frequency, symptoms, treatment, and outcome of post-traumatic thoracic outlet syndromes. A total of 13 patients (7 men and 6 women) with a mean age of 41±16 years were studied. Underlying injuries resulted from sports, road, and household accidents. Bone lesions were pseudarthrosis, hypertrophic callus, and luxations. Congenital anomalies were observed in five patients (38%). Vascular lesions included aneurysm of the subclavian artery or vein, acute ischemia, and subclavian vein thrombosis. Operative treatment involving orthopedic and/or vascular surgery was indicated in all patients. Post-traumatic thoracic outlet syndrome occurs in young subjects after violent trauma. Vascular complications are frequent and severe. Treatment achieves good results but benefits may be diminished by bone or nerve involvement.Presented at the Eighteenth Annual Meeting of the Societe de Chirurgie Vasculaire de Langue Française, Toulouse, France, May 21-24, 2003.