A very rare case of duodenal hemolymphangioma presenting with iron deficiency anemia

AbstractINTRODUCTIONIntraabdominal lymphangiomas account for less than 5% of all lymphangiomas and small intestinal hemolymphangioma is a very rare benign tumor.PRESENTATION OF CASEHere we describe the first case of primary ulcerated duodenal hemolymphangioma in a 24-year-old woman, causing occult bleeding from gastrointestinal tract. She presented with an unexplained refractory iron-deficiency anemia and gastroduodenoscopy revealed an ulcerated and polypoid lesion of the second portion of the duodenum. Partial resection of the duodenum was thus performed and the final pathological diagnosis was hemolymphangioma.DISCUSSIONThere were only two reports, one of a hemolymphangioma of the pancreas invading to the duodenum and another of a small intestinal hemolymphangioma, presenting with gastrointestinal bleeding until May 2012.CONCLUSIONThe aim of this case report is to highlight the difficulty in making an accurate preoperative diagnosis and describe the surgical management of an unusual location for a very rare tumor. To arrive at a definitive diagnosis and exclude malignancy, partial resection of the duodenum was considered to be the required treatment

The Relationship between Work, Health and Job Performance for a Sustainable Working Life: A Case Study on Older Manual Employees in an Italian Steel Factory

Background: Supporting and retaining older workers has become a strategic management goal for companies, considering the ageing of the workforce and the prolongation of working lives. The relationship between health and work is especially crucial for older workers with manual tasks, considering the impact of long-standing health impairments in older age. Although different studies investigated the relationship between work ability and job performance, few studies have analysed the impact of workers’ capability to balance between health and work demands, including managerial and organisational support (work-health balance). Considering health as a dynamic balance between work and health demands influenced by both individual and environmental factors, we assess the mediator role of work-health balance in the relation between work ability and job performance, both self-reported and assessed by the supervisor. Methods: The study utilises data from a case study of 156 manual workers, who were 50 years old or older and employed in a steel company in Italy. Data were collected inside the company as an organiational initiative to support age diversity. Results: The findings show that work-health balance partially mediates the relationship between work ability and self-rated job performance, while it does not mediate the relationship with job performance as rated by the supervisor. Supervisor-rated job performance is positively associated with work ability, while it decreases with the increasing perceived incompatibility between work and health. Conclusion: A perceived balance between health and work is a strategic factor in increasing manual older workers’ job performance. For older workers, not only the perceived capability to work is important but also the organisational health climate and supervisor’s support. More studies are needed to verify if managers overlook the importance of health climate and support, as strategic elements that can foster performance for older employees.publishedVersionPeer reviewe

Medijacijska uloga ravnoteže između posla i zdravlja u odnosu između percipirane radne sposobnosti i afektivnoga zadovoljstva poslom

The rising age of retirement may result in a larger number of workers with health problems. This is important since health is a key element in all aspects of life, including work. Although much research has been carried out into how work-life balance influences occupational health, very few studies have focused on how the ability to balance health needs and work demands (work-health balance) affects different organizational variables such as perceived work ability and affective job satisfaction. In a context in that the age of retirement is constantly rising, it is vital to explore those factors may help extend people’s working life in a balanced manner. The aim of this study was, therefore, to explore the mediating role of work-health balance in the relationship between perceived work ability (physical and mental) and affective job satisfaction. Using a cross-sectional sample of 294 workers aged 39 years and over, the study analysed the mediating role of the different dimensions of work-health balance (health climate, work-health incompatibility and external support) in the relationship between work ability (physical and mental) and affective job satisfaction. The data suggest that the health climate and work-health incompatibility dimensions mediate the relationship between work ability (physical and mental) and affective job satisfaction. Our findings are consistent with the current understanding of the role played by the balance between occupational health and the well-being of older workers.Sve kasnija dob odlaska u mirovinu mogla bi rezultirati većim brojem zaposlenika sa zdravstvenim problemima. Taj je podatak važan jer je zdravlje ključan element svih aspekata života, uključujući i zaposlenje. Iako su mnoga istraživanja ispitivala utjecaj ravnoteže između posla i života na zdravlje na radnome mjestu, mali se broj istraživanja usmjerio na ispitivanje utjecaja sposobnosti za balansiranje zdravstvenih potreba i radnih zadataka (ravnotežu između posla i zdravlja) na različite organizacijske varijable poput percipirane radne sposobnosti i afektivnoga zadovoljstva poslom. U uvjetima u kojima je dob umirovljenja u stalnome porastu ključno je ispitati čimbenike koji bi mogli pomoći u produljenju čovjekova radnoga vijeka na uravnotežen način. Stoga je cilj ovoga istraživanja bio istražiti medijacijsku ulogu ravnoteže između posla i zdravlja u odnosu između percipirane radne sposobnosti (mentalne i tjelesne) i afektivnoga zadovoljstva poslom. Korištenjem kros-sekcijskoga uzorka od 294 zaposlenika iznad 39 godina starosti u istraživanju je analizirana medijacijska uloga različitih dimenzija ravnoteže između posla i zdravlja (zdravstvena klima, nekompatibilnost posla i zdravlja te vanjska podrška) u odnosu između radne sposobnosti (mentalne i tjelesne) te afektivnoga zadovoljstva zdravljem. Podaci pokazuju da su zdravstvena klima i nekompatibilnost posla i zdravlja medijatori odnosa između percipirane radne sposobnosti (mentalne i tjelesne) i afektivnoga zadovoljstva poslom. Dobiveni su nalazi u skladu s trenutačnim razumijevanjem uloge koju ima ravnoteža između zdravlja na radnome mjestu i dobrobiti starijih zaposlenika

Infarct size, inflammatory burden, and admission hyperglycemia in diabetic patients with acute myocardial infarction treated with SGLT2-inhibitors: a multicenter international registry

Background: The inflammatory response occurring in acute myocardial infarction (AMI) has been proposed as a potential pharmacological target. Sodium-glucose co-transporter 2 inhibitors (SGLT2-I) currently receive intense clinical interest in patients with and without diabetes mellitus (DM) for their pleiotropic beneficial effects. We tested the hypothesis that SGLT2-I have anti-inflammatory effects along with glucose-lowering properties. Therefore, we investigated the link between stress hyperglycemia, inflammatory burden, and infarct size in a cohort of type 2 diabetic patients presenting with AMI treated with SGLT2-I versus other oral anti-diabetic (OAD) agents. Methods: In this multicenter international observational registry, consecutive diabetic AMI patients undergoing percutaneous coronary intervention (PCI) between 2018 and 2021 were enrolled. Based on the presence of anti-diabetic therapy at the admission, patients were divided into those receiving SGLT2-I (SGLT-I users) versus other OAD agents (non-SGLT2-I users). The following inflammatory markers were evaluated at different time points: white-blood-cell count, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), neutrophil-to-platelet ratio (NPR), and C-reactive protein. Infarct size was assessed by echocardiography and by peak troponin levels. Results: The study population consisted of 583 AMI patients (with or without ST-segment elevation): 98 SGLT2-I users and 485 non-SGLT-I users. Hyperglycemia at admission was less prevalent in the SGLT2-I group. Smaller infarct size was observed in patients treated with SGLT2-I compared to non-SGLT2-I group. On admission and at 24 h, inflammatory indices were significantly higher in non-SGLT2-I users compared to SGLT2-I patients, with a significant increase in neutrophil levels at 24 h. At multivariable analysis, the use of SGLT2-I was a significant predictor of reduced inflammatory response (OR 0.457, 95% CI 0.275-0.758, p = 0.002), independently of age, admission creatinine values, and admission glycemia. Conversely, peak troponin values and NSTEMI occurrence were independent predictors of a higher inflammatory status. Conclusions: Type 2 diabetic AMI patients receiving SGLT2-I exhibited significantly reduced inflammatory response and smaller infarct size compared to those receiving other OAD agents, independently of glucose-metabolic control. Our findings are hypothesis generating and provide new insights on the cardioprotective effects of SGLT2-I in the setting of coronary artery disease. Trial registration: Data are part of the ongoing observational registry: SGLT2-I AMI PROTECT. Clinicaltrials: gov Identifier: NCT05261867

Outcomes in diabetic patients treated with SGLT2-Inhibitors with acute myocardial infarction undergoing PCI: The SGLT2-I AMI PROTECT Registry

Aims: To investigate in-hospital and long-term prognosis in T2DM patients presenting with acute myocardial infarction (AMI) treated with SGLT2-I versus other oral anti-diabetic agents (non-SGLT2-I users). Methods: In this multicenter international registry all consecutive diabetic AMI patients undergoing percutaneous coronary intervention between 2018 and 2021 were enrolled and, based on the admission anti-diabetic therapy, divided into SGLT-I users versus non-SGLT2-I users. The primary endpoint was defined as a composite of cardiovascular death, recurrent AMI, and hospitalization for HF (MACE). Secondary outcomes included i) in-hospital cardiovascular death, recurrent AMI, occurrence of arrhythmias, and contrast-induced acute kidney injury (CI-AKI); ii) long-term cardiovascular mortality, recurrent AMI, heart failure (HF) hospitalization. Results: The study population consisted of 646 AMI patients (with or without ST-segment elevation): 111 SGLT2-I users and 535 non-SGLT-I users. The use of SGLT2-I was associated with a significantly lower in-hospital cardiovascular death, arrhythmic burden, and occurrence of CI-AKI (all p < 0.05). During a median follow-up of 24 ± 13 months, the primary composite endpoint, as well as cardiovascular mortality and HF hospitalization were lower for SGLT2-I users compared to non-SGLT2-I patients (p < 0.04 for all). After adjusting for confounding factors, the use of SGLT2-I was identified as independent predictor of reduced MACE occurrence (HR=0.57; 95%CI:0.33–0.99; p = 0.039) and HF hospitalization (HR=0.46; 95%CI:0.21–0.98; p = 0.041). Conclusions: In T2DM AMI patients, the use of SGLT2-I was associated with a lower risk of adverse cardiovascular outcomes during index hospitalization and long-term follow-up. Our findings provide new insights into the cardioprotective effects of SGLT2-I in the setting of AMI. Registration: Data are part of the observational international registry: SGLT2-I AMI PROTECT. ClinicalTrials.gov Identifier: NCT05261867

An Italian Multicenter Perspective Harmonization Trial for the Assessment of MET Exon 14 Skipping Mutations in Standard Reference Samples

Lung cancer remains the leading cause of cancer deaths worldwide. International societies have promoted the molecular analysis of MET proto-oncogene, receptor tyrosine kinase (MET) exon 14 skipping for the clinical stratification of non-small cell lung cancer (NSCLC) patients. Different technical approaches are available to detect MET exon 14 skipping in routine practice. Here, the technical performance and reproducibility of testing strategies for MET exon 14 skipping carried out in various centers were evaluated. In this retrospective study, each institution received a set (n = 10) of a customized artificial formalin-fixed paraffin-embedded (FFPE) cell line (Custom METex14 skipping FFPE block) that harbored the MET exon 14 skipping mutation (Seracare Life Sciences, Milford, MA, USA), which was previously validated by the Predictive Molecular Pathology Laboratory at the University of Naples Federico II. Each participating institution managed the reference slides according to their internal routine workflow. MET exon 14 skipping was successfully detected by all participating institutions. Molecular analysis highlighted a median Cq cut off of 29.3 (ranging from 27.1 to 30.7) and 2514 (ranging from 160 to 7526) read counts for real-time polymerase chain reaction (RT-PCR) and NGS-based analyses, respectively. Artificial reference slides were a valid tool to harmonize technical workflows in the evaluation of MET exon 14 skipping molecular alterations in routine practice

Systematic Review of Intervention Studies to Foster Sustainable Employability Core Components: Implications for Workplace Promotion

This review aims to outline the effectiveness of employer-initiated workplace interventions in promoting sustainable employability (SE), which means developing workers’ capabilities to foster productivity, health, and valuable work in the long term. A systematic search of the literature is performed in three databases covering the period from January 1999 to February 2022. Fourteen studies are included. Considering SE core components, all interventions cover the valuable work component in terms of content, and the majority also cover the health component. Interventions addressing at least three SE components have more positive effects on SE outcomes. More positive effects are found for valuable work outcomes. Overall, the findings highlight the importance of developing workplace interventions considering a comprehensive model of SE and promoting an organizational culture for SE. Future directions and limits are discussed