The Impact and Burden of Chronic Pain in the Workplace: A Qualitative Systematic Review

Background: Chronic pain (CP) poses a diverse and substantial burden for employees, employers, and society. The deleterious consequences of CP in the workplace are frequently underestimated. Objective: To estimate the burden of CP in the European workplace. Methods: A systematic review following PRISMA statement guidelines was conducted to identify studies reporting work‐related outcomes for people with CP. EMBASE, MEDLINE, EconLit, and Cochrane Library databases were searched up to 18th August 2010. Results: We identified 91 observational studies. Few were specifically designed to investigate the association between CP, productivity, and employment. The focus for this review was studies clearly reporting outcomes relating to the burden of CP on employment status (n = 37), sickness absence (absenteeism, n = 47), and loss of productivity because of reduced ability at work (presenteeism, n = 8). Conclusion: The body of evidence identified from the systematic review indicates that CP has a substantial negative impact on work‐related outcomes, supporting the importance of interventions to reduce the burden of CP. Well‐designed prospective studies specifically assessing the direct consequences of CP on employment are needed to confirm these findings.     

中国女性的年龄相关骨密度、骨丢失率、骨质疏松发生率及参考数据库——多中心合作项目

目的 本研究采用多中心合作调查了中国女性的年龄相关骨密度(BMD)、骨丢失率和骨质疏松发生率.调查结果被用来建立一个BMD参考数据库.用以诊断中国女性的骨质疏松.方法 采用双能X线吸收骨密度测量仪(DXA)测量了北京、上海、广州、成都、南京和嘉兴地区20～89岁女性的腰椎(L1～L4)(n=8 142)和髋部(n=7 290)的BMD值.不同部位骨骼BMD随年龄的变化用三次回归模型拟合来描述.结果 股骨颈和全股骨的BMD峰值出现在30～34岁,脊柱和股骨粗隆部的峰值出现在40～44岁.年轻成人的(YA)的BMD值(均值和标准差(SD)用20～39岁年龄段的平均BMD进行计算)在后前位脊柱、股骨颈、股骨粗隆和全股骨分别为1.116±0.12 g/cm2、0.927±0.12 g/cm2、0.756±0.11 g/cm2和0.963±0.13 g/cm2.85岁老年女性脊柱的BMD减少了32%,股骨减少了30%～35%.骨质疏松的定义是BMD值与本研究组中确立的年轻成人BMD值相比≤-2.5个标准差,在50岁及以上的女性,发生率分别为脊柱28%、股骨任何部位15%、脊柱或者股骨为31%.结论 本研究为中国女性骨质疏松的预防和治疗提供了重要数据,并且建立了一个可供全中国范围内女性骨质疏松诊断使用的可靠的参考数据库.     

A genome-wide scan points to a susceptibility locus for bipolar disorder on chromosome 12

Our previous results pointed to a putative gene for susceptibility to bipolar affective disorder located on the chromosomal region 12q23-q24 that segregated in the Saguenay-Lac-St-Jean population of Quebec. We report here results from a second genome-wide scan based on the analysis of 380 polymorphic microsatellite markers. For the purpose of this analysis, an additional 18 families were recruited from the Saguenay-Lac-St-Jean region and pooled to our previous sample to improve its statistical power, giving a total of 394 sampled individuals. This work confirms the presence of a susceptibility locus for affective disorder on chromosome 12q24 with parametric LOD score value of 3.35 at D12S378 when pedigrees were broken into nuclear families and analysed under a recessive segregation model. This result was supported by neighbouring markers and by a LOD score value of 5.05 at D12S378 under model-free analysis. Other regions of lower interest were indicated on chromosomes 2, 5, 7, 9, 10, 17 and 20.     

Implication of the hypothalamic-pituitary-adrenal axis in the physiopathology of depression

Major alterations of the hypothalamic-pituitary-adrenocortical (HPA) system that can be reversed by successful antidepressant therapy are often seen in depressed patients. Persuasive evidence points to the involvement of a dysfunctional glucocorticoid receptor (GR) system in these changes. Support for this also comes from studies of transgenic mice that express an antisense RNA, complementary to the GR mRNA, and have numerous neuroendocrine characteristics of human depression as well as altered behaviour. Many of these neuroendocrine and behavioural characteristics of the transgenic mice can be reversed by antidepressants. A possible explanation for this is that the antidepressant-induced increase in GRs renders the HPA axis more sensitive to glucocorticoid feedback. This new insight into antidepressant drug action suggests a novel approach to the development of antidepressant drugs.     

Analysis of a variable number tandem repeat polymorphism in the huntingtin interacting protein-1 related gene for anticipation in bipolar affective disorder

The anticipation phenomenon, described as either an increase in disease severity, a decrease in age at onset, or both, in successive generations, has been suggested as a possibility of genetic transmission for bipolar affective disorder. We report here investigation of the stability of intergenerational transmission of a variable number tandem repeat (VNTR) polymorphism, found in the Huntingtin interacting protein-1 related gene (HIP12/HIP1R) that is mapped to the chromosome 12q24.31 region, in nine pedigrees showing decreased age at onset in successive generations. We did not observe any allelic instability but we report a deletion that includes this VNTR polymorphism. Allelic and genotypic association studies should be undertaken to verify the involvement of HIP12/HIP1R in bipolar disorder.