Assessment of cardiometabolic risk among shift workers in Hungary

Aim: Shift workers may be at risk of different diseases. In order to assess cardiometabolic risk in shift workers, a cross-sectional study was performed among active workers. Methods: A total of 481 workers (121 men, 360 women) were investigated; most of them were employees in light industry (58.2%) or in public services (23.9%). Past medical history was recorded and physical examination was performed. Questionnaires were used to characterize daily activity. Fasting venous blood sample was collected for measuring laboratory parameters. Data from shift workers (n = 234, age: 43.9 ± 8.1 years) were compared to those of daytime workers (n = 247, age: 42.8 ± 8.5 years), men and women were analyzed separately. Results: In men, systolic blood pressure was higher in shift workers compared to daytime workers (133 ± 8 vs 126 ± 17 mmHg; p < 0.05). In women, weight (73.6 ± 15.5 vs 67.7 ± 13.2 kg; p < 0.001), body mass index (27.5 ± 5.7 vs 25.0 ± 4.3 kg/m2; p<0.001) and the prevalence rate of hypertension in the past medical history (24.4 vs 13.4%; p < 0.01) were higher in shift workers compared to daytime workers. In addition, the proportion of current smokers was higher (37.7 vs 21.7%; p < 0.001) and HDL-cholesterol level was lower (1.56 ± 0.32 vs 1.68 ± 0.36 mmol/l; p < 0.01) in female shift workers than in female daytime workers. Both in men and in women, rotating shift workers spent less time sleeping both on working days and on non-working days, spent less time with sport activity, drank more coffee and they spent less tim

Nafamostat reduces the incidence of post-ERCP pancreatitis : a systematic review and meta-analysis of randomized controlled trials

Pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP). As the management of pancreatitis is limited, clinical approaches focus on the prevention of post-ERCP pancreatitis (PEP). In theory, the serine protease inhibitor nafamostat can reduce circulating inflammatory mediators in pancreatitis. We aimed to investigate the effect of nafamostat in the prevention of PEP in this systematic review and meta-analysis. The protocol for this review was registered in PROSPERO (CRD42022367988). We systematically searched five databases without any filters on 26th September 2022. The eligible population was adult patients undergoing ERCP. We compared the PEP preventive effect of nafamostat to placebo. The main outcome was the occurrence of PEP. We calculated the pooled odds ratios (OR), mean differences (MD), and corresponding 95% confidence intervals (95%CI) and multilevel model. The risk of bias was assessed using the Rob2 tool. Seven randomized controlled trials involving 2,962 patients were eligible for inclusion. Nafamostat reduced the overall incidence rate of PEP [20 mg OR 0.50; 95%CI 0.30-0.82 and 50 mg 0.48; 95%CI 0.24-0.96]. However, the occurrence of mild PEP was significantly reduced only in the subgroup receiving 20 mg nafamostat [OR 0.49; 95%CI 0.31-0.77]. Overall, nafamostat therapy reduced moderate PEP in high-risk patients [OR 0.18; 95%CI 0.0.4-0.84] and mild PEP in low-risk patients [OR 0.32; 95%CI 0.17-0.61]. Nafamostat is an effective therapy in the prevention of mild post-ERCP pancreatitis. Further research is required to determine the cost-effectiveness of this therapy

Endoscopic Type I Tympanoplasty is as Effective as Microscopic Type I Tympanoplasty but Less Invasive - a Meta-Analysis

Endoscopic type I tympanoplasty was originally introduced in the 1990s and the extensive spread of this practice can be easily observed. The conventional technique performed involves the repair of a tympanic membrane perforation, and is defined as microscopic type I tympanoplasty.The aim of this study is the comparison of postoperative outcomes of both the endoscopic and the microscopic type I tympanoplasty.We conducted a meta-analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines.A systematic literature search was performed in the databases of PubMed, Embase, Cochrane Library, Clarivate Analytics-Web of Science, ClinicalTrials. gov, World Health Organization Library, and Scopus by inserting, "myringoplasty OR (tympanoplasty AND perforation)" into the search query. We applied only a "human" filter. We excluded non-English studies. Additional records were identified by checking the references of relevant studies.Comparative studies were included in our analysis. We calculated the pooled odds ratio (OR) with 95% confidence interval (CI) for dichotomous outcomes and weighted mean difference (WMD) with a 95% CI for continuous outcomes. Additionally, we assessed the risk of bias, and estimated the quality of evidence for each outcome.Our systematic search yielded 16 studies (involving 1179 interventions), eligible for analysis. The pooled graft uptake rate (OR: 1.21, CI: 0.82-1.77; I2 =0.0%), the postoperative hearing results (WMD=-1.13; 95% CI: -2.72-0.45; I2 =78.1%) and the operation time (WMD=-21.11; 95% CI: -42.60-0.38; I2 =99.3%), were all comparable among the two techniques. In contrast, the endoscopic type I tympanoplasty outperforms when regarding the pooled canaloplasty rate (OR=7.96; 95% CI: 4.30-14.76; I2 =0.0%, p=1.000) and features an increase in desirable cosmetic results (OR=19.29; 95% CI: 11.37-32.73; I2 =0.0%, p=0.839), when compared with the microscopic approach.Based on our meta-analysis, the surgical outcomes of endoscopic type I tympanoplasty in terms of graft uptake rate, postoperative hearing results and operation time were comparable to the microscopic type I tympanoplasty. In regards to cosmetics, an increase in desirable results was achieved in the endoscopic group, particularly the incidence of canaloplasty which proved to be significantly lower. This article is protected by copyright. All rights reserved