Metabolic syndrome: a common problem among office workers

Background:

Metabolic syndrome (MSx) is associated with several health problems. Workers are an important part of any organization.

Objective:

To determine the prevalence of MSx and related variables among office workers.

Methods:

This cross-sectional study evaluated 1488 office workers in Qom province, Central Iran, by using a multi-stage cluster sampling. Diagnosis of MSx was based on blood HDL-cholesterol, triglyceride, and fasting blood sugar (FBS) levels and waist circumference, and blood pressure.

Results:

The overall prevalence of MSx was 35.9% (95% CI 33.5% to 38.3%), higher in men (37.2%) than in women (20.6%), and increased with age. The most common laboratory findings of MSx were hypertriglyceridemia (45.9%) and low HDL-cholesterol level (45.5%). Office workers with MSx had a significantly (p<0.001) higher body mass index than those without MSx. Lack of regular leisure time physical activity (p=0.003), and low intake of fruits (p=0.02) were associated with MSx.

Conclusion:

The prevalence of MSx was very high among office workers. Workplace health improvement programs through identifying and preventing MSx are necessary for improvement of staff's health.

Optimal dose of pre-incision/post-incision gabapentin for pain relief following lumbar laminectomy: a randomized study

BACKGROUND

Gabapentin has been introduced as an effective agent for post-operative pain control. This study aimed to test the effects of pre- and post-incision administration of different doses of gabapentin on post-operative morphine requirement and pain following lumbar laminectomy.

METHODS

In this randomized clinical trial, 175 patients were allocated into seven groups of 25 patients each to receive placebo or gabapentin 600, 900 or 1200 mg pre- or post-incision. Total patient-controlled intravenous morphine consumption during the first 24 post-operative hours, and the time to the first demand for morphine were recorded. Pain score at rest (visual analogue scale) was recorded every 30 min in the first 4 h and then every 2 h until 24 h post-operatively. Side-effects were observed.

RESULTS

In the first 12 h, morphine consumption was less, pain scores were lower and the time to the first demand for analgesia was longer in groups receiving gabapentin 900 or 1200 mg either pre- or post-incision, compared with placebo and gabapentin 600 mg (P<0.001). There was no difference between gabapentin 900 and 1200 mg. Pain score, morphine consumption and time to the first demand for analgesia in equal pre- or post-incision doses of gabapentin were not significantly different. No differences in the side-effects were observed between groups.

CONCLUSION

Gabapentin 900 or 1200 mg, administered either pre- or post-incision, was found to be effective in pain management following lumbar laminectomy. Similar doses of gabapentin provide the same post-operative analgesia whether administered pre- or post-incision.

The Effects of Prostaglandin E1 on Interleukin-6, Pulmonary Function and Postoperative Recovery in Oesophageetomised Patients

The inflammatory reactions and tissue response after oesophagectomy are leading causes of postoperative morbidity and mortality. We evaluated the effects of intraoperative infusion of prostaglandin E1 (PGE1) on interleukin-6 (IL-6) levels, (A-a) DO2, pulmonary function and complications. This randomised double-blind clinical trial study was performed on patients undergoing transthoracic oesophagectomy due to cancer. Thirty patients were randomly allocated to two groups: the PGE1 group (infusion of PGE1, 20 ng.kg−1.min−1) and a placebo group (infusion of normal saline 0.9%). The infusion was started before induction of anaesthesia and continued until the end of the operation. The groups were comparable in basic characteristics and preoperative pulmonary function. Patients in the PGE1 group were discharged significantly earlier from the intensive care unit (72±9 vs 83±17 hours) and hospital (13±4 vs 18±8 days) (P=0.04 and 0.03, respectively). The (A-a) DO2 was significantly less in the PGE1 group at 12 and 24 hours after the operation (P=0.001, P=0.003, respectively). Postoperatively, IL-6 levels were significantly higher in the placebo group than in the PGE1 group. There were no differences in the forced expiratory volume in the first second or forced vital capacity. The findings indicate that infusion of PGE1 attenuates the increase in serum levels of IL-6 in patients undergoing esophagectomy and improves the (A-a) DO2. Stays in the intensive care unit and hospital were shorter in the PGE1 group. However, there were no differences in pulmonary complications.

Safety and efficacy of the combination of high-dose calcitriol, docetaxel and aoledronic acid in hormone-refractory prostate cancer (HRPC): Interim report of a phase II trial

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Background: The purpose of this study is to assess the efficacy and safety of Calcitriol, Docetaxel and Zoledronic acid in patients with metastatic HRPC. The primary endpoint of the study is the toxicity profile. Secondary endpoints include prostate specific antigen PSA response and time to disease progression. Methods: 16 patients with HRPC were enrolled. All patients had confirmed diagnosis of prostate cancer and no previous cytotoxic therapy. All patients signed an informed consent. Patients received oral Calcitriol 0.5μg/kg on day 1 on weekly basis six out of eight-week cycles, Docetaxel 36mg/m2 on day 2 on weekly basis six out of eight-week cycles, and Zoledronic acid 4mg intravenously on weeks 1 and 5 of every 8-week cycle. Results: A total of 52 cycles were administered and toxicity was acceptable. No treatment-related mortality was encountered. No grade IV anemia, neutropenia, thrombocytopenia or diarrhea was reported. No grade IV gastrointestinal toxicities or thromboembolic events were reported. Grade IV infection was seen in 2 (3.8%) cycles (herpetic esophagitis and listeria meningitis). Grade III neutropenia was seen in 2 cycles (3.8%). Grade III diarrhea was seen in 1 cycle (1.9%) and grade II diarrhea in 4 cycles (7.7%). Grade II to III nausea and vomiting was reported in 8 cycles (15.4%). Grade II to III sensory neuropathy was noted after 17 cycles (32.7%). Grade III fatigue was reported in 5 cycles (9.6%). 14 patients were eligible for response analysis. Overall PSA response rate of our patients was 57.2%. Median time to disease progression was 6.5 months (range 2–15). One year survival was 57.1% (8 out of 14 patients). Conclusions: This interim analysis showed that the addition of Calcitriol to Docetaxel showed an acceptable safety profile as compared to Docetaxel regimens alone with less incidence of neutropenia and diarrhea. Previous studies using Docetaxel alone has reported higher incidence of neutropenia reaching 43–56% and grade III to IV diarrhea (10–34%). Our study suggests that Calcitriol might have a protective effect against the Docetaxel toxicities.

No significant financial relationships to disclose.