Investigating self-reported health by occupational group after a 10-year lag: results from the total Belgian workforce

Background

Belgium lacks a systematic overview of health differences by occupation. This is the first study to examine self-reported health among 27 occupational groups in Belgium with a lag time of 10 years.

Methods

Individual data are derived from an anonymous linkage between the 1991 and 2001 Belgian census. The total working population (25–55 years) is selected from the 1991 Belgian census. Self-reported health (1?=?fair or (very) bad health; 0?=?(very) good health) was obtained from the 2001 census. Logistic regression analysis was used to analyse the health of 1.5 million men and 1.0 million women by occupational group in 1991. The active sex-specific population in 1991 and 2001 was the reference group. Controls include age, activity status and housing status at the time of 2001 census.

Results

Both male and female workers in physically demanding occupations were more likely to report poor health. The three occupations with the highest age-adjusted Odds Ratios (OR) were extraction and building trade workers (OR_male 2.08 95% Confidence Interval (CI) 2.05–2.10; OR_female 2.15 CI 1.93–2.40); services elementary workers (OR_male 2.06 CI 2.03–2.10; OR_female 2.37 CI 2.34–2.41); and labourers in construction, manufacturing and transport (OR_male 1.90 CI 1.86–1.93; OR_female 2.21 CI 2.12–2.29). Men and women in teaching, scientific, health-related and managerial positions had the lowest age-adjusted ORs for poor self-reported health. The pattern in occupational health differences remained the same after controlling for activity status and socio-economic position.

Conclusions

Occupational health inequalities are apparent after a lag time of 10 years. The identification of types of workers in poor health provide valuable insights to future health promotion strategies in the Belgian workforce.

     

Efficacy of FODMAP Elimination and Subsequent Blinded Placebo-Controlled Provocations in a Randomised Controlled Study in Patients with Ulcerative Colitis in Remission and Symptoms of Irritable Bowel Syndrome: A Feasibility Study

Background: Patients with inflammatory bowel disease (IBD) and symptoms of irritable bowel syndrome (IBS) may be intolerant to fermentable carbohydrates (FODMAPs). The aim of this study was to test the feasibility of eliminating and subsequently reintroducing FODMAPs in patients with IBS symptoms as part of the IBD manifestation and to compare the severity of IBS symptoms and pain, bloating and quality of life (QoL). Methods: An eight-week randomised open-label FODMAP elimination with double-blinded, crossover provocations of FODMAP and placebo. Diet patients were on a low-FODMAP diet for eight weeks with blinded two-week provocations after two and six weeks. Questionnaires, blood and stool samples were collected. Results: Patient enrolment was challenging. Nineteen participants were included in the study. Eliminating low FODMAP for two weeks resulted in significant decreases in pain and bloating scores (p < 0.003), whereas there were no statistical differences in pain scores between diet patients and controls. Pain and bloating scores increased, returning to baseline levels after two weeks of double-blinded provocations with placebo, (p > 0.05). Conclusions: The results document the possibility of performing a randomised controlled study following the gold standard for testing food intolerance with blinding of the Low FODMAP diet. Recruitment of participants was challenging.     

Bioinformatic identification of FGF,p38-MAPK,and calcium signalling pathways associated with carcinoma <Emphasis Type="Italic">in situ</Emphasis>in the urinary bladder

Background  

Carcinoma in situ (CIS) is believed to be a precursor of invasive bladder cancer. Identification of CIS is a valuable prognostic factor since radical treatment strategies can be offered these patients before the disease becomes invasive.     

Body mass index and prognostic markers at radical prostatectomy

OBJECTIVE: Obesity is increasing rapidly in Western countries. Approximately 40% of adult Danes are overweight and approximately 15% of these are obese. Epidemiological studies of obesity in relation to prostate cancer have provided conflicting results. Therefore, we examined correlations between body mass index (BMI) and clinicopathological prognostic markers, biochemical recurrence and operative morbidity in patients who had undergone radical prostatectomy. MATERIAL AND METHODS: The sample consisted of 293 Danish men treated with radical prostatectomy between 2000 and 2005 at Aarhus University Hospital. BMI was calculated as an indicator of obesity. Prospectively collected clinical and pathologic data from this population were used. RESULTS: The median BMI value was 26.2 kg/m(2) (range 19.6-41.7 kg/m(2)), which is slightly above the upper limit of normal. Currently accepted prognostic markers, such as prostate-specific antigen level, Gleason score and pT class, showed no statistically significant correlations with BMI. Patients with biochemical recurrence were evenly distributed among four different BMI quartiles and there was no difference in the length of hospitalization, indicating no differences in pre- or postoperative morbidity. Computations were repeated using only patients with the lowest (19.6-21.3 kg/m(2)) and highest (34.2-41.7 kg/m(2)) BMI values but statistically significant correlations were still not found. CONCLUSIONS: Several American studies have shown that obesity can lead to prostate cancer becoming more aggressive. The results of the present study involving a Danish prostate cancer population do not substantiate this or suggest any connection between BMI and operative morbidity. A possible explanation is that Danish obesity problems are not yet as severe as those in the USA.     

Characterization of repetitive DNA in the Mycoplasma genitalium genome: possible role in the generation of antigenic variation.

We have characterized a family of repetitive DNA elements with homology to the MgPa cellular adhesion operon of Mycoplasma genitalium, a bacterium that has the smallest known genome of any free-living organism. One element, 2272 bp in length and flanked by DNA with no homology to MgPa, was completely sequenced. At least four others were partially sequenced. The complete element is a composite of six regions. Five of these regions show sequence similarity with nonadjacent segments of genes of the MgPa operon. The sixth region, located near the center of the element, is an A+T-rich sequence that has only been found in this repeat family. Open reading frames are present within the five individual regions showing sequence homology to MgPa and the adjacent open reading frame 3 (ORF3) gene. However, termination codons are found between adjacent regions of homology to the MgPa operon and in the A+T-rich sequence. Thus, these repetitive elements do not appear to be directly expressible protein coding sequences. The sequence of one region from five different repetitive elements was compared with the homologous region of the MgPa gene from the type strain G37 and four newly isolated M. genitalium strains. Recombination between repetitive elements of strain G37 and the MgPa operon can explain the majority of polymorphisms within our partial sequences of the MgPa genes of the new isolates. Therefore, we propose that the repetitive elements of M. genitalium provide a reservoir of sequence that contributes to antigenic variation in proteins of the MgPa cellular adhesion operon.     

Variation in general practice prostate‐specific antigen testing and prostate cancer outcomes: An ecological study

Knowledge is sparse about the consequences of variation in prostate‐specific antigen (PSA) testing rates in general practice. This study investigated associations between PSA testing and prostate cancer‐ related outcomes in Danish general practice, where screening for prostate cancer is not recommended. National registers were used to divide general practices into four groups based on their adjusted PSA test rate 2004–2009. We analysed associations between PSA test rate and prostate cancer‐related outcomes using Poisson regression adjusted for potential confounders. We included 368 general practices, 303,098 men and 4,199 incident prostate cancers. Men in the highest testing quartile of practices compared to men in the lowest quartile had increased risk of trans‐rectal ultrasound (incidence rate ratio (IRR): 1.20, 95% CI, 0.95–1.51), biopsy (IRR: 1.76, 95% CI, 1.54–2.02), and getting a prostate cancer diagnosis (IRR: 1.37, 95% CI, 1.23–1.52). More were diagnosed with local stage disease (IRR: 1.61, 95% CI, 1.37–1.89) with no differences regarding regional or distant stage. The IRR for prostatectomy was 2.25 (95% CI, 1.72–2.94) and 1.28 (95% CI, 1.02–1.62) for radiotherapy. No differences in prostate cancer or overall mortality were found between the groups. These results show that the highest PSA testing general practices may not reduce prostate cancer mortality but increase the downstream use of diagnostic and surgical procedures with potentially harmful side effects.     

A small-molecule inhibitor of Bcl-XL potentiates the activity of cytotoxic drugs in vitro and in vivo

Inhibition of the prosurvival members of the Bcl-2 family of proteins represents an attractive strategy for the treatment of cancer. We have previously reported the activity of ABT-737, a potent inhibitor of Bcl-2, Bcl-X(L), and Bcl-w, which exhibits monotherapy efficacy in xenograft models of small-cell lung cancer and lymphoma and potentiates the activity of numerous cytotoxic agents. Here we describe the biological activity of A-385358, a small molecule with relative selectivity for binding to Bcl-X(L) versus Bcl-2 (K(i)'s of 0.80 and 67 nmol/L for Bcl-X(L) and Bcl-2, respectively). This compound efficiently enters cells and co-localizes with the mitochondrial membrane. Although A-385358 shows relatively modest single-agent cytotoxic activity against most tumor cell lines, it has an EC(50) of <500 nmol/L in cells dependent on Bcl-X(L) for survival. In addition, A-385358 enhances the in vitro cytotoxic activity of numerous chemotherapeutic agents (paclitaxel, etoposide, cisplatin, and doxorubicin) in several tumor cell lines. In A549 non-small-cell lung cancer cells, A-385358 potentiates the activity of paclitaxel by as much as 25-fold. Importantly, A-385358 also potentiated the activity of paclitaxel in vivo. Significant inhibition of tumor growth was observed when A-385358 was added to maximally tolerated or half maximally tolerated doses of paclitaxel in the A549 xenograft model. In tumors, the combination therapy also resulted in a significant increase in mitotic arrest followed by apoptosis relative to paclitaxel monotherapy.