RESUMO
Infertility is a well-known late complication in patients receiving hematopoietic stem cell transplantation (HSCT). We previously reported that total body irradiation (TBI) with ovarian shielding reduces the radiation dose to the ovaries to 2.4 Gy - one-fifth of the dose compared to conventional TBI - and preserves fertility without increasing the risk of relapse. Exposure to the uterus and ovaries can reportedly affect pregnancy and childbirth. However, the dose constraint of the uterus that causes infertility remains unknown. Herein, we report the pregnancy and birth outcomes of 2 patients who gave birth following TBI with ovarian shielding and evaluated the dose to the uterus using a dose-volume histogram. Case 1 involved a 30-year-old woman with acute myeloid leukemia who underwent HSCT at 21 years of age with a uterus mean dose (D mean) of 7.0 Gy. She had a natural pregnancy and elective cesarean section at 38 weeks of gestation due to hypertensive disorders of pregnancy. She gave birth to a normal-birthweight infant. Case 2 involved a 32-year-old woman with T-cell acute lymphoblastic leukemia who underwent HSCT at 30 years of age with a uterus D mean of 7.6 Gy. Her baby was delivered at full term with normal birthweight. These results indicate that a uterus D mean between 7.0 and 7.6 Gy does not have a significant impact on pregnancy and delivery with the ovarian function being preserved for patients who received TBI with ovarian shielding after puberty.
RESUMO
Short sleep duration is a serious problem that not only enhances the risk of various mental and physical disorders, but also affects the productivity in the workplace. However, in terms of studies focused on workers, there are few reports that evaluated sleeping conditions in an objective way. The purpose of this study is to implement sleep health education in the workplace in terms of primary prevention of mental health disorder and then to investigate the subjective and objective effectiveness of the education using self-administered questionnaires (sleep duration, ESS, AIS, PHQ-9, SF-8) and an activity monitor (MTN-210). Study design is a quasi-randomized controlled trial. Sleep health education was provided through three 50-min lectures (total 150 min) as a single cycle for five months in the Intervention group. We obtained baseline data and then six months later. The study analyzed 70 subjects (36 Intervention group, 34 Control group). The weekday sleep duration for the Control group decreased by 12.9 min, whereas that of the Intervention group increased by 14.3 min (difference of 27.2 min), resulting in a significantly increase in score for the Intervention group. The present study suggests that sleep health education may be beneficial for good sleep habits in workers.