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Psychosocial factors (PSF) are leading among the new risks and modern challenges in providing safe and healthy conditions at work. Due to the high mental strain, inspectors are at highest risk for stress at work. The aim of the present study was to make a comparative analysis of PSFs in control activities, rate them and investigate subjective perception of stress at work. Two exhaustive cross-sectional studies were conducted consecutively, involving 338 and 355 inspectors, respectively, working at two organizations with control activities. The inspectors were men and women aged from 24 to 70. The statistical processing of data utilized the SPSS software version 17, at a significance level of p<0.05. A number of common characteristics were found in the activities, the composition and structure of different groups of government staff: the number of women was greater (58% и 62.6%), with people over 40 years of age prevailing (67.3% и 70.9%), and the group with specialized work experience of 6 to 10 years comprised the greatest number of people. We found reliable differences in the answers concerning task requirements and activity organization. Rating PSF, one of the groups of inspectors placed “insufficient time to perform the check-up” in the first place, whereas the other one reported “conflicts while performing the check-up”. PSFs exert an influence on the cognitive functions of inspectors, change their behaviour and emotional reactions and result in more frequent complaints of health deterioration. We found difference in the subjective stress perception depending on gender, age and duration of work experience as an inspector.


Polycystic kidney disease is an autosomal dominant genetic disorder (ADPKD) associated with arterial hypertension, as a common and early manifestation. However, the combination of hypertension and hypokalemia is very rare in these patients and may have another cause. We present a case of a 45 years old man with ADPKD associated with primary hyperaldosteronism. Unilateral suprarenal macroadenoma on abdominal CT scan, severe hypokalemia and low activity of plasmatic renin led to diagnosis.


Double anueploidy, involving both trisomy 18 and Klinefelter syndrome at the same time, is a rare event, in which the features of Edwards syndrome dominate the clinical picture. We describe a patient, who was diagnosed in the 8th gestational week with a seemingly normal intrauterine pregnancy with “chorionic bump”. In the 12th week the following abnormalities were diagnosed by ultrasound: Increased nuchal translucency (4.7 mm), increased anteroposterior diameter of the fourth ventricle and increased diameter of the third ventricle of the brain, mesocardia and cardiomegaly. The CVS karyotype revealed 48,XXY,+18 karyotype. In our opinion, the increased anteroposterior diameter of the fourth ventricle of the brain in this fetus was probably an early manifestation of the Dandy-Walker malformation (unproven because of early pregnancy termination), which is typical of Edwards syndrome fetuses. We consider the increased anteroposterior diameter of the fourth ventricle of the brain in the first trimester fetus as an indication for fetal karyotyping and further detailed imaging studies.

Gastroenterol 1999;94:766-72. 8. Garcia BG, Orna JG, Gutierrez EA, et al. Prevalence and predictive factors of parietal cell antibody positivity in autoimmune thyroid disease. Endocrinol Nutr 2010;57:49-53. 9. Weetman AP. Non-thyroid autoantibodies in autoimmune thyroid disease. Best Pract Res Clin Endocrinol Metab 2005;19:17-32. 10. Segni M, Borrelli O, Pucarelli I, et al. Early manifestations of gastric autoimmunity in patients with juvenile autoimmune thyroid diseases. J Clin Endocrinol Metab 2004;89:4944-8. 11. Jacobson DL, Gange SJ, Rose NR, et al. Epidemiology and

P, Fontanella A, Mayer M, De Vincenzo A, Terracciano LM, D’Armiento M, et al. Elevated serum aminotransferase activity as an early manifestation of gluten-sensitive enteropathy. J Pediatr 1993;122:416-9. 7. Kaukinen K, Halme L, Collin P, Färkkilä M, Mäki M, Vehmanen P, et al. Celiac disease in patients with severe liver disease: Gluten-free diet may reverse hepatic failure. Gastroenterology 2002;122:881-8. 8. Abdo A, Meddings J, Swain M. Liver abnormalities in celiac disease. Clin Gastroenterol Hepatol 2004;2:107-12. 9. Volta U. Liver dysfunction in celiac disease

severe heart failure- an unusual early manifestation of leptospirosis: a case report; BMC Res Notes; 2015 Mar 13; 8:80. Doi: 10.1186/s13104-015-1031-1 13. Elias Maroun et al; Fulminant Leptospirosis (Weil's disease) in an urban setting as un overlooked cause of multiorgan failure: a case report; J Med Case Reports; 2011 Jan 14; Doi: 10.1186/1752-1947-5-7 14. Agrawal VK, Bansal A, Pujani M; A rare case of leptospirosis with isolated lung involvement; Indian J Crit Care Med. 2015 Mar;19(3):174-6. 15. Balakrishnan T, Moore A, Krishnamoorthy S, Davies G, Ka Ho Lee P; Weil

-controlled type 2 diabetes: importance of maneuvers in echocardiographic screening for preclinical diabetic cardiomyopathy. Diabetes Care. 2001; 24:5-10. 15. Schannwell CM, Schneppenheim M, Perings S, Plehn G, et al. Left ventricular diastolic dysfunction as an early manifestation of diabetic cardiomyopathy. Cardiology. 2002; 98: 33-39. 16. Paillole C, Dahan M, Paycha F, et al. Prevalence and significance of left ventricular filling abnormalities determined by Doppler echocardiography in young type I (insulindependent) diabetic patients. Am J Cardiol. 1998;64:1010-1016. 17

control: a longitudinal study. European Journal of Endocrinology 2007; 157: 481-9. 35. Morales A, Wasserfall C, Brusko T, Carter C, Schatz D, Silverstein J, Ellis T, Atkinson M. Adiponectin and leptin concentrations may aid in discriminating disease forms in children and adolescents with type 1 and type 2 diabetes. Diabetes Care 2004; 27(8): 2010-14. 36. Bechtold A, Dirlenbach I, Raile K, Noelle V, Bonfig W, Schwarz HP. Early manifestations of Type 1 diabetes in children is a risk factor for changed bone geometry: Data using peripheral quantitative computed tomography

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