Anxiety and depression symptoms among gas and oil industry workers

Background

Oil and gas industry workers appear to suffer from anxiety and depression more frequently than the general population.

Aims

To establish the prevalence of depression and anxiety symptoms among offshore workers working for an oil and gas company and to identify the main stressors that lead to symptoms of these disorders.

Methods

One thousand seven hundred and forty-seven workers employed in an offshore oil and gas company in the Middle East completed the Generalized Anxiety Disorder (GAD-7) and Patient Health (PHQ-9) questionnaires. Anxiety and depressive symptoms were estimated from these surveys.

Results

Anxiety and depression symptoms were reported by nearly 15% of workers surveyed. Ordered logistic regression analyses showed that age, rotation length, years of service and local origin (versus expatriate) were significant predictors for symptoms of anxiety. With adjustment for age, older local workers had a lower risk of anxiety symptoms than expatriates.

Conclusions

Younger workers, workers with longer rotations and those with fewer years of service were more likely to report anxiety symptoms. In addition, older local workers and expatriates had a lower prevalence of anxiety symptoms than younger local workers. Future recommendations should address improvements in psychological health of offshore workers in the gas and oil industries.

Malignant mesothelioma presenting as a breast mass

We present a case of a male patient with a breast mass, found to be a malignant mesothelioma. We discuss the diagnostic challenges, the need for heightened awareness in suspected cases, the histological classification of mesotheliomas and the treatments available. We believe this to be the second reported case of a mesothelioma presenting as a breast mass.

Lichens as bioindicators of air quality in Dimitrovgrad (South-Eastern Serbia)

Air pollution detection in Dimitrovgrad has not been done yet. In this work different lichen have been used as a bioindication to establish different air pollution levels. At 18 investigated points 22 lichen taxa have been found. Using the Index of Atmospheric Purity (IAP) it has been found that there are 3 different air pollution zones in Dimitrovgrad: 'lichen desert', 'transitional' and 'normal zone'. The most sensitive lichen taxa in Dimitrovgrad are Evernia prunastra, Ochrolechia pallescens, Parmelia sulcata, and Physcia tenella and the most tolerant are Phaeophyscia orbicularis, Physcia adscendens, Physconia distorta, Physconia grisea, and Xanthoria parietina. .

Bilateral lobar lung transplantation--the first two cases in Belgium

In the last twenty years lung transplantation has become an established treatment for end-stage lung failure refractory to medical management. Over this time, better short and long-term results have been achieved due to improvements in organ procurement, perfusion and preservation strategies, newer immunosuppressant regimes and better post-transplant care. The limiting factor for the number of lung transplantation procedures performed is the shortage of available donor organs. This results in longer waiting times for listed patients, with a substantially increased risk of dying prior to transplantation, especially in the paediatric population. Several surgical strategies have evolved to overcome the donor shortage, with lobar transplantation becoming a viable alternative. We describe our initial experience with two young patients with end-stage cystic fibrosis (CF) who required lung transplantation. Given their small size it was not possible to transplant an entire lung from an adult donor in each hemithorax. We describe lobar transplantation as a technique used to overcome this, in the first such operation in Belgium.

Intermediate term results of total lymphoid irradiation for the treatment of non-specific graft dysfunction after heart transplantation

BACKGROUND

A proportion of heart transplant recipients develop poor graft function in the absence of cellular infiltrate in endomyocardial biopsies or transplant associated coronary artery disease. The condition has a poor prognosis and its aetiology is poorly understood. We report encouraging intermediate term results with total lymphoid irradiation (TLI) in the management of this condition.

METHODS

Eleven adult cardiac transplant recipients who developed severe allograft dysfunction (NYHA class-4) at a median period of 4 months after orthotopic heart transplantation were successfully treated with TLI. Endomyocardial biopsies and coronary angiography were normal in each patient and biventricular failure developed in spite of immunosuppression with Cyclosporin-A, Azathioprine, oral Prednisolone, Cyclophosphamide and intravenous Methylprednisolone therapy. Total lymphoid irradiation was given with standard Mantle and inverted Y-fields over ten treatments to achieve a cumulative dose of 8 Gy.

RESULTS

Each patient had a significant improvement in clinical response and in ventricular performance within 2 months of commencing TLI. Nine patients are currently well (four NHYA class-1, five NHYA class-2) at 4-48 (median 26) months following TLI. Two patients died; one from bacterial septicaemia and one as a consequence of chronic renal failure. Three patients developed opportunistic infection which was successfully treated with appropriate antimicrobial agents. An Ebstein-Barr virus associated lymphoproliferative disorder occurred in one patient and was successfully treated by reduction in immunosuppression and high dose Acyclovir. Two patients developed transient bone marrow suppression.

CONCLUSION

The intermediate term results of TLI in the management of poor graft function in cardiac transplant recipients with normal endomyocardial biopsies and coronary angiography are encouraging. Although complications of opportunistic infection, bone marrow suppression and lymphoproliferative disorder occurred, treatment was successful in each case.