LYME PERICARDITIS LEADING TO TAMPONADE

We report the case of a 62-yr-old man who presented with Lymepericarditis leading to cardiac tamponade shortly followed byan arthritis. IgM and IgG antibodies to Borrelia burgdorferiwere demonstrated in serum by indirect immunofluorescence. Borreliaburgdorferi was demonstrated and identified in pericardial fluidby indirect immunofluorescence using serum from a patient withproven Lyme disease and by a monoclonal antibody immuno-goldsilver stain. Spirochetes were also found in synovial biopsiesusing a silver stain. The tamponade was treated with pericardiocentesis;the arthritis was treated with intravenous ceftriaxone (2 gonce daily) for 14 days. The patient recovered completely withindays of commencing treatment. This case report demonstratesthat borrelial infection may lead to pericarditis and cardiactamponade. KEY WORDS: Borrelia burgdorferi infection, Arthritis, Pericarditis, Tamponade     

Job stress, absenteeism and coronary heart disease European cooperative study (the JACE study): Design of a multicentre prospective study

Background: The motives, objectives and design of a multicentreprospective study on job stress, absenteeism and coronary heartdisease in Europe (the JACE study) is presented in this paper.Some specific gaps in the reviewed literature are explicitlytapped into by the JACE study. Its objectives are i) to comparethe distributions of the Karasek job stress scales for the samebroad categories of occupations in different European countries(in males and females), ii) to study the predictive power ofthe job stress scales and the job strain model for one yearof sickness absence (in males and females) and iii) to studythe predictive power of the job stress scales and the job strainmodel for a three year incidence of coronary heart disease (Inmales only). Methods: In answering these questions, relationsare studied controlling for gender, age, level of education,company size, physical work risks and shift work, as well astraditional risk factors for CHD (i.e serum cholesterol, serumHDL cholesterol, smoking habits and blood pressure). The JACEstudy is a Biomed 1 concerted action. The JACE group consistsof eight participating centres from six countries, i.e. fromBelgium and Sweden (two centres), France, Italy, Spain, Swedenand The Netherlands (each one centre). The coordination of thegroup is in Brussels. The participating centres brought in over15, 000 European workers to test the hypotheses.     

A hard day's night: a longitudinal study on the relationships among job demands and job control, sleep quality and fatigue

This prospective four-wave study examined (i) the causal direction of the longitudinal relations among job demands, job control, sleep quality and fatigue; and (ii) the effects of stability and change in demand–control history on the development of sleep quality and fatigue. Based on results of a four-wave complete panel study among 1163 Dutch employees, we found significant effects of job demands and job control on sleep quality and fatigue across a 1-year time lag, supporting the strain hypothesis (Demand–Control model; Karasek and Theorell, Basic Books, New York, 1990). No reversed or reciprocal causal patterns were detected. Furthermore, our results revealed that cumulative exposure to a high-strain work environment (characterized by high job demands and low job control) was associated with elevated levels of sleep-related complaints. Cumulative exposure to a low-strain work environment (i.e. low job demands and high job control) was associated with the highest sleep quality and lowest level of fatigue. Our results revealed further that changes in exposure history were related to changes in reported sleep quality and fatigue across time. As expected, a transition from a non-high-strain towards a high-strain job was associated with a significant increase in sleep-related complaints; conversely, a transition towards a non-high-strain job was not related to an improvement in sleep-related problems.