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Sick Leave (sick + leave)

Distribution by Scientific Domains

Medical Sciences	92%
2 Other Domains	8%

Distribution within Medical Sciences

Dermatology	11%

Selected Abstracts

Relationship between sick leave, unemployment, disability, and health-related quality of life in patients with inflammatory bowel disease

INFLAMMATORY BOWEL DISEASES, Issue 5 2006
Tomm Bernklev BSc
Background: The goal of this study was to determine the rate of work disability, unemployment, and sick leave in an unselected inflammatory bowel disease (IBD) cohort and to measure the effect of working status and disability on the patient's health-related quality of life (HRQOL). Materials and Methods: All eligible patients were clinically examined and interviewed at the 5-year follow-up visit. In addition, they completed the 2 HRQOL questionnaires, the Short Form-36 Health Survey (SF-36) and the Inflammatory Bowel Disease Questionnaire validated for use in Norway (N-IBDQ). Data regarding sick leave, unemployment, and disability pension (DP) also were collected. Results: All together, 495 patients were or had been in the workforce during the 5-year follow-up period since diagnosis. Forty-two patients (8.5%) were on DP compared with 8.8% in the background population. Women with Crohn's disease (CD) had the highest probability of receiving DP (24.6%). A total of 58 patients (11.7%) reported they were unemployed at 5 years. This was equally distributed between men and women but was more frequent in patients with ulcerative colitis. Sick leave for all causes was reported in 47% with ulcerative colitis and 53% with CD, whereas IBD-related sick leave was reported in 18% and 23%, respectively. A majority (75%) had been sick <4 weeks, and a relatively small number of patients (25%) contributed to a large number of the total sick leave days. Both unemployment and DP reduced HRQOL scores, but the most pronounced effect on HRQOL was found in patients reporting IBD-related sick leave, measured with SF-36 and N-IBDQ. The observed differences also were highly clinically significant. Multiple regression analysis confirmed that IBD-related sick leave was the independent variable with the strongest association to the observed reduction in HRQOL scores. Conclusions: Unemployment or sick leave is more common in IBD patients than in the Norwegian background population. The number of patients receiving DP is significantly increased in women with CD but not in the other patient groups. Unemployment, sick leave, and DP are related to the patient's HRQOL in a negative way, but this effect is most pronounced in patients reporting IBD-related sick leave. [source]

Periradicular infiltration for sciatica: a randomized controlled trial. (University Hospital of Oulu, Helsinki, Finland).

PAIN PRACTICE, Issue 4 2001
Spine.
In this study, 160 consecutive, eligible patients with sciatica who had unilateral symptoms of 1 to 6 months duration, and who never underwent surgery were randomized for a double-blinded injection with methylprednisolone bupivacaine combination or saline. Objective and self-reported outcome parameters and costs were recorded at baseline, at 2 and 4 weeks, at 3 and 6 months, and at 1 year. Recovery was better in the steroid group at 2 weeks for leg pain, straight leg raising, lumbar flexion, and patient satisfaction. Back pain was significantly lower in the saline group at 3 and 6 months. Sick leave and medical costs were similar for both treatments, except for cost of therapy visits and drugs at 4 weeks, which were in favor of the steroid injection. By 1 year, 18 patients in the steroid group and 15 in the saline group underwent surgery. Conclude improvement during the follow-up was found in both the methylprednisolone and saline groups. The combination of methylprednisolone and bupivacaine seems to have a short-term effect, but at 3 and 6 months, the steroid group seems to experience a "re-bound" phenomenon. [source]

Allergic contact dermatitis from ethylcyanoacrylate in an office worker with artificial nails led to months of sick leave

CONTACT DERMATITIS, Issue 5 2007
M. Isaksson
No abstract is available for this article. [source]

FS07.1 A survey of occupational hand eczema in Denmark

CONTACT DERMATITIS, Issue 3 2004
Rikke Skoet
Background:, The need for prevention to reduce the number of occupational hand eczema is high. Occupational hand eczema is the most frequently recognised work-related disease in Denmark. Previous findings have shown that almost half of all cases develop a chronic condition with persistent dermatitis, and the annual cost to society is immense. Aims:, The aim of this study was to survey the trends and development of occupational hand eczema in Denmark and thereby help to ensure future successful prevention of chronic disabling occupational hand eczema. Methods:, 758 patients with recognised occupational hand eczema were included prospectively in the period October 2001- November 2002. Data on diagnoses, disease duration, severity, absence from work and occupation was obtained from The Danish National Board of Industrial Injuries and an additional questionnaire was administered by mail. Results:, 621 patients answered the questionnaire (response rate 82%). Irritant contact dermatitis was the most frequent diagnosis and the female/male ratio was 2:1. High prevalence was found in particularly wet occupations. 19 per cent had sick leave more than 5 weeks per year and the mean disease duration was 4.8 years (median 2.1 years). 68.2% had chronic changes. Conclusion:, The results showed a marked gender difference in the pattern of diagnosis and occupation. The impact of occupational hand eczema is still high with prolonged absence from work and a high percentage of chronic disease. The results of the study give important suggestions for future preventive strategies for health authorities. [source]

Clinical and sociodemographic variables associated with the onset of posttraumatic stress disorder in road traffic accidents

DEPRESSION AND ANXIETY, Issue 5 2008
Ramón Coronas M.D.
Abstract Our objective was to identify variables related to the onset of acute posttraumatic stress disorder (PTSD) after a road traffic accident. We evaluated 60 victims of a motor vehicle accident (MVA) in 2004 at 2 months postaccident. Thirty of them had developed PTSD; the other 30 had not developed PTSD. Clinical data, physical injuries, and sociodemographic characteristics were determined in 60 victims. The Davidson Trauma Scale (DTS) and a Structured Clinical Interview for DSM-IV (SCID) were used to evaluate PTSD occurrence. PTSD scores assessed by DTS and SCID at 2 months were significantly and positively associated with female sex, severe physical injuries, perceived social deprivation, and loss of job activity due to the accident. Female sex, severe physical injury, perceived social deprivation, and sick leave were related to the diagnosis of PTSD 2 months after the accident. Depression and Anxiety 0:1,8, 2007. © 2007 Wiley-Liss, Inc. [source]

Relationship between sick leave, unemployment, disability, and health-related quality of life in patients with inflammatory bowel disease

The impact of inflammatory bowel disease on labor force participation: Results of a population sampled case-control study

INFLAMMATORY BOWEL DISEASES, Issue 6 2002
Annelies Boonen
Abstract Introduction Inflammatory bowel diseases are chronic conditions that might cause a severe impact on social life. The aim of the study was to assess employment, chronic work disability, and sick leave in patients with inflammatory bowel disease. Methods A postal questionnaire was sent to 984 patients with inflammatory bowel disease and 1504 controls. Age- and gender-adjusted employment and chronic work disability ratios and rates were calculated using indirect standardization. In subjects in paid employment, proportions of those having an episode of sick leave and lost workdays were analyzed. Logistic regression was used to assess the contribution of age, gender, education, and course of disease. Results The results of 680 (69%) patients and 715 (48%) controls could be analyzed. For the entire group of patients, employment was 6.5% lower, compared with controls (95% CI: 4.0,9.0). Chronic work disability was 17.1% higher than expected (95% CI: 15.1,19.1). In those in paid employment, 62% of patients compared with 53% of controls had experienced one or more episodes of sick leave during the past year (p = 0.002). This resulted in 19.2 versus 11.8 days of sick leave per subject per year for patients and controls respectively (p = 0.002). Relative to controls, the risk of chronic work disability was more increased in younger (p = 0.02) and higher educated (p = 0.02) patients. Course of disease contributed to chronic work disability and sick leave. Conclusion IBD has a significant impact on labor force participation that is higher in CD compared with UC and highest in younger and more highly educated patients. [source]

Obesity in adults and children: a call for action

JOURNAL OF ADVANCED NURSING, Issue 2 2001
Karyn Holm PhD RN FAAN
Obesity in adults and children: a call for action Obesity/overweight in adults and children is a worldwide health problem associated with substantial economic burden as measured by paid sick leave, life and disability insurance rates, and obesity-related physician visits and hospital stays. Overweight/obese people experience hypertension, elevated cholesterol, and type 2 diabetes and suffer more joint and mobility problems than people within the normal weight for height range. While there is need to understand individual behaviors that can be modified to promote weight loss and weight maintenance, there is as great a need to consider contextual factors at the societal level that can impede or even sabotage weight control efforts. In every country with improved living standards people will continue to eat too much and engage in too little physical activity. The call for action is for all modernized societies to alter environments and attitudes to support, rather than hinder, healthy dietary intake and being physically active. [source]

A prospective pilot study of a multidisciplinary home training programme for lateral epicondylitis

MUSCULOSKELETAL CARE, Issue 1 2007
Pia Nilsson PTR
Abstract Objective:,To evaluate a new multidisciplinary structured home training programme for patients with lateral epicondylitis compared to conventional attendance. Design:,This study utilized a prospective non-randomized design to compare the effect of a home exercise programme against a pragmatic approach to managing patients with lateral epicondylitis in a primary care setting in Sweden. Subjects:,A total of 78 patients, presenting to their general practitioner with lateral epicondylitis were recruited from two separate geographical areas. The patients were divided into two group, 51 entered the intervention group and 27 entered the control group. Methods:,The intervention group was treated with a specific home training programme, ergonomic advice and when necessary wrist and/or night bandages. The control group was treated with conventional treatment, e.g. corticosteroid injections, stretching or no intervention. Pain and function were evaluated by the PRFEQ. An electronic hand-power gauge measured strength and stamina. Sick-leave absence was collected via the regional Social Insurance Office. Results:,After four weeks the intervention group experienced less sick-leave, less pain, better function and returned to work earlier than the control group. After 16 weeks the intervention group still had significantly better function than the control group and were taking less sick-leave. Pain decreased more in the intervention group but this was not significant. There was no difference in grip strength between the two groups. Conclusion:,A structured home training programme can improve function and reduce sick leave in patients with lateral epicondylitis. Copyright © 2006 John Wiley & Sons, Ltd. [source]

MULTIDISCIPLINARY PAIN ABSTRACTS: 47

PAIN PRACTICE, Issue 1 2004
Article first published online: 15 MAR 200
The purpose of this multicenter, randomized, controlled trial was to compare the effect of manual therapy to exercise therapy in sick-listed patients with chronic low back pain. The effects of exercise therapy and manual therapy on chronic low back pain with respect to pain, function, and sick leave have been investigated in a number of studies. The results are, however, conflicting. Patients with chronic low back pain or radicular pain sick-listed for more than 8 weeks and less than 6 months were included. A total of 49 patients were randomized to either manual therapy (n=27) or to exercise therapy (n=22). Sixteen treatments were given over the course of 2 months. Pain intensity, functional disability (Oswestry disability index), general health (Dartmouth Care Cooperative function charts), and return to work were recorded before, immediately after, at 4 weeks, 6 months, and 12 months after the treatment period. Spinal range of motion (Schober test) was measured before and immediately after the treatment period only. Although significant improvements were observed in both groups, the manual therapy group showed significantly larger improvements than the exercise therapy group on all outcome variables throughout the entire experimental period. Immediately after the 2-month treatment period, 67% in the manual therapy and 27% in the exercise therapy group had returned to work. It was concluded that improvements were found in both intervention groups, but manual therapy showed significantly greater improvement than exercise therapy in patients with chronic low back pain. The effects were reflected on all outcome measures, both on short- and long-term follow-up. [source]

The BAMSE Project: presentation of a prospective longitudinal birth cohort study

PEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 2002
Magnus Wickman
The aims of this prospective and longitudinal project are to establish crucial risk factors for asthma and other allergic diseases in childhood, and to study factors of importance for prognosis at already established allergic disease. Socio-economic factors, such as inequality in health, are also to be addressed. The project started in February 1994. To reach sufficient power, 4,000 children had to be included. In November 1996, this number was reached (4,093). Inclusion in the study was made at 3,4 months of age. At that time, and before induction of allergic disease/asthma of the child, a questionnaire focused on exposure, genetics and socio-economic factors was answered. Settled dust was sampled for later analysis of furred animal and mite allergens. When the children were aged both 1 and 2 years, their parents were asked to fill in new questionnaires focusing on respiratory and allergic (skin, gastrointestinal) symptoms, but also key variables of exposure. Cases with asthma are identified and, for every case, two matched controls drawn. During the following winter, the homes of cases and controls were investigated and the temperature, indoor humidity, air change rate and NO2 measured. Two hundred cases (5%) were expected to be identified during the first 2 years of the children's lives. Some 479 homes have now been investigated and 97.7% of the original 4,093 children still remain in the cohort. The 2-year symptom follow-up ended in November 1998. The 4-year follow-up started on 1 September 1998 and was planned to be finished in June 2000. Questionnaires (allergic and respiratory symptoms, key variables of exposure at home and day care) are sent out to all 4,093 families. All children are invited for examination, lung function tests (PEF, flow-volume, MVV and oxygen clearance) and physical performance. Blood is taken from all children (20 ml). Allergy screening is performed and specific IgE examined. Blood cells will be frozen to allow for later DNA extraction. In subsets (children with any allergic and/or respiratory manifestation and controls), markers of inflammation in blood and urine will be examined, as well as eosinophils in nasal smear. Interviews are carried out to assess the severity of asthma, type/periodicity of health care given, asthma medication and parental sick leave when appropriate. As a separate project, financed by the EU, outdoor pollution as risk factors for asthma and allergies are to be studied within the BAMSE cohort. A follow-up of 8,9 years is underway. [source]

Exercises and education as secondary prevention for recurrent low back pain

PHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 1 2001
Margret Grotle Soukup
Abstract Background and Purpose Exercise and education is a common physiotherapy approach in the prevention of low back pain. A Mensendieck exercise programme consisting of exercises and ergonomical education has, in a previous study, been shown to be effective in preventing recurrent low back pain during one-year follow-up. The purpose of the present study was to evaluate the long-term effect of the Mensendieck exercise programme on people with recurrent episodes of low back pain who, when entering the study, had finished treatment for their last episode of low back pain. Method A randomized controlled clinical trial in which 41 women and 36 men were allocated to either a Mensendieck or control group. The Mensendieck subjects received 20 group sessions of exercises and ergonomical education over 13 weeks. The control subjects were not offered any prophylactic therapy, but were free to receive treatment or exercises. Outcome measures were the number of recurrences of low back pain, sick leave, low back function and general functional status. Results At three-year follow-up, 11 subjects had been lost to the study. Survival analysis showed a significant reduction (p=0.02) in subjects experiencing recurrent low back pain in the Mensendieck group compared to the control group. Significant improvements in pain and function scores were reported in both groups. There was no significant difference between the groups in pain, function or sick leave. Conclusion A Mensendieck exercise programme seems efficient in reducing recurrent episodes of low back pain at three-year follow-up, but it did not influence sick leave, pain or function scores. Copyright © 2001 Whurr Publishers Ltd. [source]

Prevalence of building-related symptoms as an indicator of health and productivity

AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 10 2006
Raimo Niemelä PhD
Abstract Background The prevalence of building-related symptoms (BRS) is commonly used to characterize the indoor air quality in office buildings. To analyze the costs of building renovation and the improvement of the indoor environment, it is useful to quantitatively relate the prevalence or intensity of BRS to productivity. The intent of this study is to summarize the links between the BRS and productivity, and demonstrate this linkage in two case buildings. Material and Methods A literature was surveyed for studies that measured simultaneously the prevalence or intensity of BRS and subjectively reported or objectively measured productivity. Case studies in two office environments were performed. An association between the prevalence of BRS and productivity of workers in a call center and in an insurance office were investigated. In the first case study, the productivity was expressed using the direct productivity metrics, namely the number of telephone contacts during active working hours while in the second case, the productivity was assessed by using the data concerning sick leave rates. Results Employees who report more BRS also have more often absences which relate to indoor environment quality (IEQ). Their productivity is lower than those who have better IEQ in their offices. Despite uncertainties related to the data concerning recorded sick leave and self-reported productivity, the number of studies showing an association between BRS and productivity or sick leave suggests that such a relationship exists. The present case studies also demonstrated an association between the BRS and the direct productivity. Based on the data from the call center, a reduction of 10%-units in the prevalence of general symptoms (such as fatigue, headache, nausea, etc.) corresponded with a gain of 1.5% in performance. Based on the findings in the insurance company, a reduction of 10%-units in the prevalence of irritation symptoms corresponded with a decrease of 0.7% in the short-term absenteeism. Conclusions A review of 23 studies suggests that a linkage exists between typical BRS and productivity indicators such as task or work performance or absence from work. Quantitative associations between BRS and productivity were demonstrated in two office environments. Quantitative associations between BRS and economic metrics enable cost-benefits analysis. Am. J. Ind. Med. 2006. © 2006 Wiley-Liss, Inc. [source]

Localised attitudes matter: a study of sickness absence in Sweden

POPULATION, SPACE AND PLACE (PREVIOUSLY:-INT JOURNAL OF POPULATION GEOGRAPHY), Issue 3 2008
Katarina Haugen
Abstract The central issues explored in this article are the importance of geographical location in explaining the attitudes of individuals, and the interplay between these attitudes and overt behaviour. The context is as follows: In the late 1990's, sick-listings in Sweden underwent a substantial increase, causing the public expenses for the general sickness insurance to soar. Moreover, the extent of the usage of the insurance was found to vary significantly across different regions within the country. This development of the sickness insurance generally, and the regional differences specifically, have since been the subject of an intense debate. Differences and/or changes in attitudes toward sick leave within the population have been proposed as possible reasons for the regional variations. Much of the discussion has, however, been based on speculative arguments rather than empirical studies. Using data from a survey conducted in 2005, this research explores whether geographical location influences individual attitudes toward sick leave, and whether these attitudes in turn influence the sickness absence of individuals. The data are analysed using factor analysis, ordinary linear regressions and logistic regressions. The results provide some support for the idea that geographical factors matter to individual attitudes, and that variation in these attitudes is in turn associated with propensity for sickness absence. Copyright © 2008 John Wiley & Sons, Ltd. [source]

Parental Adjustment, Family Functioning, and Posttraumatic Growth Among Norwegian Children and Adolescents Following a Natural Disaster

AMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 2 2010
Gertrud S. Hafstad
This study investigated the degree to which parental symptomatology and characteristics of the family environment related to posttraumatic growth (PTG) among children and adolescents who had been directly exposed to the 2004 tsunami in Thailand. One hundred five 6- to 17-year-olds (M = 11.9 years, SD = 3.3) and their parents (N = 67) were interviewed approximately 10 months and 2 years 5 months after the tsunami. The parents' self-reported PTG was a significant predictor of PTG in their children, suggesting that social processes play a role in the development of PTG in youth. Parental self-reported posttraumatic stress symptoms did not predict PTG in their children nor did youth's ratings of family cohesion, but parental tsunami-related sick leave related to lower levels of PTG reported by their children. Overall, these findings imply that elements of parents' functioning can affect children's positive adaptation after a disaster and highlight the need to assess potential parental influences and those of other sources of support in the child's environment after trauma. Attending to such factors holds salience for efforts to promote adaptation and facilitate PTG. [source]

The impact of follicular (FL) and other indolent non-Hodgkin's lymphomas (NHL) on work productivity,a preliminary analysis

PSYCHO-ONCOLOGY, Issue 5 2009
Matthew C. Cheung
Abstract Introduction: Although much is known about the efficacy, toxicity, and direct costs of treatment for follicular lymphoma (FL), there is no data assessing the impact of this diagnosis on the work productivity of affected individuals. Methods: We conducted a cross-sectional survey study of consecutive patients attending a malignant haematology clinic at a large multi-disciplinary cancer centre. Patients with a diagnosis of FL or other indolent non-Hodgkin's lymphoma completed questionnaires assessing health status, work productivity, and activity impairment. Results: Eighty-four patients completed the survey study (95% response). Patients who continued to work reported a minimal impact on their work productivity (10%±standard deviation SD 20; 0%=no effect and 100%=complete impairment of activity) and on their daily activities (13%±SD 25) attributable to their cancer. Prior to lymphoma diagnosis, over 71% of patients were working while 14% were retired. At the time of survey administration, only 41% of patients were still able to work with a significant proportion of patients having transitioned to retirement (36%), sick leave (10%), or unemployment (4%). On multivariate analysis, significant activity impairment (daily activity impairment>50%) was predicted by poor self-rated health status (OR 32.1; 95% CI: 5.9,174.2; p<0.0001) and active chemotherapy treatment (OR 14.5; 95% CI: 0.91,230.9; p=0.059). Conclusions: Although few patients with indolent lymphoma identified significant impairment in productivity, many were unable to continue employment following diagnosis, needed to miss days from work, or imposed a significant burden on caregivers. The greatest impact on activity is apparent in patients who rate their health status as poor and in those who are currently receiving systemic therapy. Copyright © 2008 John Wiley & Sons, Ltd. [source]

Evaluation of a Program on Systematic Self-Monitoring and Reflection of Health Behavior in Organisations: Results of Two Randomised Controlled Studies on Well-Being and Absenteeism of Employees and Skilled Workers

APPLIED PSYCHOLOGY: HEALTH AND WELL-BEING, Issue 1 2010
Günter Krampen
Effects of a group health promotion program on well-being and absenteeism of employees and skilled workers were tested. The objectives of the program are systematic self-monitoring and reflection on everyday life health behavior as well as the promotion of health- and development-related cognitions and well-being. Randomised group designs were employed to evaluate the program's effects on well-being, psychosomatic complaints, personal regulation of own development, and absenteeism. Program effects were confirmed with reference to these outcome measures administered at the end of the 8-week treatment and at 2-month follow-up in samples of 56 public employees (Study 1) and 39 skilled workers (Study 2). Results demonstrate the effectiveness and usability of the SySeRe program as an economical individual-level health promotion intervention in occupational health psychology with large effect sizes in psychometric measures of well-being and in the reduction of employee sick leave as well. [source]

A randomised double blind trial comparing misoprostol or placebo in the management of early miscarriage

BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 8 2005
F. Blohm
Objectives To study if misoprostol 400 ,g, administered vaginally, increased the successful resolution of early miscarriage compared with placebo. Design Randomised, double blind placebo controlled study. Setting Sahlgrenska University Hospital, Göteborg, Sweden. Sample One hundred and twenty-six women seeking medical attention for early miscarriage. Method Women with a non-viable, first trimester miscarriage were randomised to vaginal administration of misoprostol 400 ,g or placebo. Main outcome measures Main outcome measure was the proportion of successful complete resolution of miscarriage. Secondary outcomes were incidence of infection, bleeding, gastrointestinal side effects, pain, use of analgesics and length of sick leave between groups. Results Sixty-four patients were randomised to misoprostol and 62 to placebo. Eighty-one percent in the misoprostol and 52% in the placebo group had a complete miscarriage within one week of the primary visit (RR 1.57; 95% CI 1.20,2.06). Patients in the misoprostol group reported more pain as assessed on a visual analogue scale (60.4 [31.0] vs 43.8 [37.1] mm; P < 0.007) and required analgesics more often (83%vs 61%, RR 1.35; 95% CI 1.08,1.70). There were no significant differences in the occurrence of gastrointestinal side effects, infection, reduction in haemoglobin or sick leave between the groups. Conclusions Treatment with 400 ,g misoprostol administered vaginally increased the success rate of resolvement of uncomplicated early miscarriages compared with placebo. However, women who received misoprostol experienced more pain and required more analgesics than those who did not. [source]

A history of sexual abuse and health: a Nordic multicentre study

BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 10 2004
Malene Hilden
Objectives To determine if a history of sexual abuse is associated with objective and subjective indicators of health and if certain abusive incidents had a stronger impact on health than others. Design A cross-sectional, multicentre study. Setting Five gynaecological departments in the five Nordic countries. Sample Three thousand five hundred and thirty-nine gynaecology patients. Methods The NorVold Abuse Questionnaire (NorAQ) on abuse history and current health was mailed to all patients who consented to participate. Main outcome measures Reason for index visit at the gynaeocological clinic as well as several questions on health were recorded. General health status was measured as self-estimated health, psychosomatic symptoms (headache, abdominal pain, muscle, weakness, dizziness), number of health care visits and number of periods on sick leave. Result A history of sexual abuse was reported by 20.7% of respondents. A history of sexual abuse was significantly associated with chronic pelvic pain as reason for index visit (P < 0.01), laparoscopic surgery (P < 0.01), psychosomatic symptoms (P < 0.01), self-estimated poor health (P < 0.01), many health care visits (P < 0.01) and high incidence of sick leave (P < 0.01). Several subgroups within the group of sexually abused women were more likely to report poor health: women abused as both children and adults, women who experienced additional emotional and/or physical abuse and women abused by a person they knew. Conclusion Sexual abuse has a profound impact on women's health. Taking a history of sexual abuse seems particularly warranted when the patient presents with chronic pelvic pain or symptoms of a vague and diffuse nature. [source]

Remembering childhood atopic dermatitis as an adult: factors that influence recollection

BRITISH JOURNAL OF DERMATOLOGY, Issue 3 2006
C. Moberg
Summary Background, Atopic dermatitis (AD) is common in the population, and studies have shown that the disease is on the increase. Studies based on hospital records reflect selected populations and may miss less severe cases of AD, and the use of self-reported questionnaires has the drawback of recall bias. Objectives, To investigate some possible factors influencing recall bias when questionnaires are used to establish the prevalence of childhood eczema in an adult population. Methods, A questionnaire regarding past and present eczema was sent to 557 cases (with signs suggesting the diagnosis AD) and 554 matched controls (subjects lacking signs of AD) born during 1960,1969 and identified in school health medical records. Cases and controls were aged 31,42 years at the time of the study and 70·5% returned the questionnaire. Results, Of 403 cases, 29% did not report childhood eczema in the questionnaire. There was a difference between those who did recall their childhood AD (remembering group, RG), and those who did not (forgetful group, FG) in who had documented the diagnostic signs in the school health records. In the RG the signs were reported by both parents and school health personnel in 51% of cases, and in the FG this was true of only 16%. The RG had a higher prevalence of eczema after 15 years of age and of hand eczema. The RG also reported more visits to physicians after the age of 15 years and more time taken as sick leave due to eczema. Conclusions, Several factors influence how well people remember their AD in childhood. These factors include disease activity in adult life, disease severity, and who noticed the eczema in childhood. [source]

Cognitive symptoms, cervical range of motion and pain as prognostic factors after whiplash trauma

ACTA NEUROLOGICA SCANDINAVICA, Issue 4 2010
P. Borenstein
Borenstein P, Rosenfeld M, Gunnarsson R. Cognitive symptoms, cervical range of motion and pain as prognostic factors after whiplash trauma. Acta Neurol Scand: 2010: 122: 278,285. © 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Objectives,,, To evaluate pain, cervical range of motion (CROM) and cognitive symptoms as predictors for poor prognosis defined as sick leave 3 years later. Material and methods,,, In 97 patients CROM, pain intensity and cognitive symptoms were measured immediately following trauma, at 6 months and 3 years. Patients were also asked at 3 years if they had been on sick leave the last 6 months. Results,,, Pain intensity and reduced CROM were not clinically useful as predictors of later sick leave. The best predictors were presence within 96 h after injury of the two cognitive symptoms ,being easily distracted' (odds ratio 8.7,50) and ,easily irritated' (odds ratio 5.3,31). Conclusions,,, Initial pain and reduced CROM may be related to minor tissue damage which often heals while late functionality is more dependent on other factors such as cognitive dysfunction. For patients with whiplash-associated disorders two simple questions should be asked; ,Are you currently easily irritated?' and ,Are you currently easily distracted (e.g. is it difficult for you to follow a conversation if several people are talking in the room at the same time)?'. An affirmative answer to any of these questions indicates an increased risk for poor prognosis defined as sick leave 3 years later. [source]

Randomized clinical trial comparing bipolar coagulating and standard great saphenous stripping for symptomatic varicose veins

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 4 2007
D. Lorenz
Background: Typical side-effects of saphenous stripping for symptomatic varicose veins include painful thigh haematomas, which a new bipolar coagulating electric vein stripper (EVS) may reduce. Methods: In a randomized, single-blind trial at three vascular centres, 99 patients were assigned to EVS and 101 to conventional stripping. The primary outcome was postoperative pain at rest and following physical exercise (climbing stairs). Haematomas were quantified by ultrasonography. Further endpoints were duration of postoperative compression, sick leave and quality of life (measured by the Chronic Lower Limb Venous Insufficiency Questionnaire (CIVIQ) and Short Form 36 (SF-36®)). Results: Mean resting visual analogue scale for pain 24 h after surgery was 1·6 in the EVS group and 3·3 in the conventional stripping group (mean difference 1·7, 95 per cent confidence interval (c.i.) 1·4 to 1·9, P < 0·001). Mean ratings following exercise were 3·3 and 5·5 (mean difference 2·3, 95 per cent c.i. 2·0 to 2·6, P < 0·001) respectively. No patient in the EVS group had a measurable thigh haematoma, compared with 74 patients after conventional stripping (P < 0·001). The EVS significantly decreased the length of compression therapy and sick leave, and produced superior CIVIQ and SF-36 ratings. Conclusion: The EVS was safe and effective in avoiding painful haematomas following varicose vein surgery. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]

Randomized clinical trial and follow-up study of cost-effectiveness of laparoscopic versus conventional Nissen fundoplication,

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 6 2006
W. A. Draaisma
Background: Laparoscopic Nissen fundoplication (LNF) has essentially replaced its conventional open counterpart (CNF). An economic evaluation of LNF compared with CNF based on prospective data with adequate follow-up is lacking. Methods: Data from two consecutive studies (a randomized clinical trial (RCT) of 57 patients undergoing LNF and 46 undergoing CNF that was terminated prematurely, and a follow-up study of 121 consecutive patients with LNF) were combined to determine incremental cost-effectiveness 1 year after surgery. Results: Mean operating time, reoperation rate and hospital costs of LNF were lower in the second series. The mean overall hospital cost per patient was ,9126 for LNF and ,6989 for CNF at 1 year in the initial RCT, and ,7782 in the second LNF series. The success rate of both LNF and CNF at 1 year was 91 per cent in the RCT, and LNF was successful in 90·1 per cent in the second series. A cost reduction of ,998 for LNF would cancel out the cost advantage of CNF. Similarly, if the reoperation rate after LNF decreased from 0·05 to below 0·008 and/or if the mean duration of sick leave after LNF was reduced from 67·2 to less than 61·1 days, the procedure would become less expensive than CNF. Complications, reoperation rate and quality of life after both operations were similar. Conclusion: Including reinterventions, the outcome at 1 year after LNF and CNF was similar. In a well organized setting with appropriate expertise, the cost advantage of CNF may be neutralized. Copyright © 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]

Late results of treatment of anal fistulas

COLORECTAL DISEASE, Issue 2 2007
A. Sygut
Abstract Objective, The aim of this paper was to analyse the results of treatment of anal fistulas retrospectively. Methods, Between 1992 and 2004, 407 patients were operated on for perianal fistula. In the follow-up period, 107 patients were lost, so 300 patients were analysed in the study. The mean follow-up time was 4.2 years. Analysed parameters included: types of surgical procedures in different kinds of fistulas and postoperative complications. Various types of surgical procedures and their effectiveness were described. Late results were assessed taking into account healing time, duration of sick leave, recurrence rate and incidence of anal sphincter dysfunction. Severity of gas and stool incontinence was assessed according to the Cleveland Clinic Incontinence Score. Results, In our study, subcutaneous fistula was diagnosed in 23.3%, inter-sphincteric in 18%, trans-sphincteric in 37.7%, supra-sphincteric in 16% and extra-sphincteric in 5% of patients. Single-tract fistulas were present in 88.7% and multi-tract fistulas were present in 11.3%. Overall, 242 patients had primary fistulas and 58 patients had recurrent fistulas. The most frequently performed procedures were cutting seton (139 patients) and radical fistulectomy (104 patients). Recurrent fistulas developed in 14.3%. Postoperative gas and/or stool incontinence was noticed in 10.7%. The recurrence rate was 5.4% in patients with primary fistula and in 51.7% patients presenting with a recurrent fistula. Gas and stool incontinence developed in 3.7% of patients with primary fistulas and in 39.7% of patients presenting with recurrent fistulas. Recurrence rate was 12% in the patients of single-tract fistulas and 32.4% in the patients of multi-tract fistulas. Postoperative gas and/or stool incontinence occurred in 8.3% of patients of single-tract fistulas and in 29.4% of patients of multi-tract fistulas. Conclusions, The complication rate was 10-fold higher in patients presenting with a recurrent fistula than in those with primary fistulas and threefold higher in patients with multi-tract fistulas than in those with single-tract fistulas. [source]