[Risk assessment method for psychosocial factors at workplace: a North-West Tuscany area project].

The rising awareness of psychosocial risks at workplace means that it is ever more important to prepare methods to assess psychosocial factors in occupational environment. This project of north west tuscany area has the aim to realize an instrument for a gradual risk assessment for this kind of factors without the support of specialists. A decisional flow chart helps to approach the risk assessment step by step on the basis of company features, management and organization problems and company symptoms of stress.

Carpal tunnel syndrome and ulnar neuropathy at the elbow in floor cleaners.

Objective: To determine the occurrence of carpal tunnel syndrome (CTS) and ulnar neuropathy at the elbow (UNE) in a cohort of floor cleaners and to check differences between workers with and without CTS.

Methods: All female floor cleaners of three major hospitals in Tuscany (Italy) were contacted. Clinical and electrophysiological severity of CTS and UNE were evaluated with standardized scales and symptoms were assessed with the self-administered Boston Questionnaire (BQ); demographic and non-occupational factors and durations of current and previous occupations were recorded.

Smooth blood pressure control obtained with extended-release felodipine in elderly patients with hypertension: evaluation by 24-hour ambulatory blood pressure monitoring.

Objective: To assess, by smoothness index (SI), distribution of the antihypertensive effect of extended-release (ER) felodipine over 24 hours in elderly patients with hypertension.

Methods: After a 4-week washout phase, 35 elderly patients (mean age 69 +/- 4 years) with mild-to-moderate hypertension received 2 weeks' treatment with ER felodipine 5mg once daily. The dosage of ER felodipine was doubled to 10 mg/day and given for a further 2 weeks in non-responders (sitting clinic blood pressure > 140/90mm Hg).

[Evaluation of the efficacy and tolerance of doxazosin vs. enalapril inaged patients with light to moderate arterial hypertension].

The above study was performed as a single blind trial in 70 elderly patients (average age 66 years) who were randomized into two groups of 36 and 34 subjects respectively. After clinical and laboratory evaluation without treatment for at least two weeks, the two groups were treated with enalapril 5-10 or 20 mg daily plus doxazosin at the dosage of 1-2-4- or 8 mg daily; they were observed for 24 weeks. During the trial, pressure values, both systolic and diastolic, were seen to diminish significantly in both groups.

[Peripheral vascular damage in hypertension].

The authors relate the pathophysiologic, hemodynamic and pharmacologic aspects of peripheral vascular damage in arterial hypertension. Particular attention is paid to the role of structural and functional changes both large elastic and muscular arteries (macroangiopathy) and small resistance vessels (microangiopathy) in the determinism and maintenance of arterial hypertension. These changes include impaired arterial wall compliance, vascular hyperactivity to agonists due to both hypertrophy and hyperplasia of smooth muscle cells, and endothelial dysfunction seen as an increase in endothelial permeability as well as an impaired release of relaxing and contracting factors.

Diuresis and intensive saluresis.

Intensive saluresis, intended as an exceptional though real and practicable therapeutic approach, has made unimaginable progress possible in different sectors of Internal Medicine relating to hydrosaline balance alterations such as chronic and acute renal failure, nephrosic syndrome, refractory heart failure, acute pulmonary edema and ascites. We are proud to be the first who followed a path that assured patients compensation beyond "classic" therapeutic possibilities, and undoubtedly better quality of life, as well.

[The treatment of refractory hyperlipoproteinemias].

The authors have studied a group of 25 patients treated with an HMG-CoA reductase inhibitor associated with DEAE-dextran, a safe and useful drug for the treatment of dyslipidemia. The patients were selected from a group of subjects previously submitted to long-term treatment with an HMG-CoA reductase inhibitor only who had failed to achieve normal cholesterol blood levels. The combined treatment with DEAE-dextran (1.

[A large case load of patients with dyslipidemia: effects of treatment with deae-dextran].

The authors report the results of an open trial in 859 dyslipidemic patients, performed with the cooperation of general practitioners, treated with isocaloric diet and daily doses of 3 g deae-dextran for 3 months. Deae-dextran was effective in reducing cholesterol and triglyceride blood levels and in controlling body weight. The drug was very well tolerated and no significant side effects were registered during treatment with deae-dextran.

Life quality in patients under hypotensive treatment.

The authors studied the life quality in a group of 74 patients--31 males and 43 females--affected with essential hypertension of World Health Organization I or II degree. All patients began treatment with frusemide at a dose of 25 mg once a day. The 35 non-responsive patients to frusemide were then treated, by random selection, with captopril at a dose of 25 mg twice a day, or nadolol at a dose of 80 mg once a day, for three months.

Clinical pharmacology of loop diuretics: a comparative study.

The authors performed two studies to clarify the characteristics, analogies and differences of three loop diuretics (furosemide, bumetanide and piretanide) aiming at more precise indications for their clinical use. In the first study, they compared bumetanide and piretanide by the method of compensated diuresis; in the second, they tested the three loop diuretics' efficacy in refractory ascites. The authors demonstrated that with the three substances analogous results were obtained when administered at equivalent doses and that only intensive diuresis was able to resolve refractory ascites.

Controlled trial on three beta-blockers: antihypertensive efficacy and effect on the hypertensive heart disease.

Treatment of 66 hypertensive patients with three different beta-blockers (atenolol 100 mg once a day; oxprenolol 80 mg twice a day; nadolol 80 mg once a day) for six months resulted in a significant reduction in blood pressure and heart rate, the maximum with nadolol, a significant amelioration in pre-ejection period/left ventricular ejection time ratio expressing the haemodynamic performance of the left ventricle with atenolol and nadolol, and a significant reduction left ventricular hypertrophy as expressed by the Romhilt-Estes index with all three drugs, but especially with nadolol.

Clinical pharmacology of hypertension: amelioration of left ventricular performance by treatment with labetalol.

Treatment of 23 hypertensive patients with labetalol at 200 mg twice daily for 3 months resulted in a 15-17% reduction in diastolic and systolic blood pressure, a significant amelioration in the PEP/LVET ratio expressing the haemodynamic performance of the left ventricle, and a significant reduction in its hypertrophy as expressed by the Romhilt-Estes index.

Long-acting and short-acting diuretics in the treatment of hypertension.

A single-blind trial was carried out in 36 people with mild to moderate hypertension to compare the efficacy and tolerance of long-term treatment with furosemide and chlorthalidone. After a 30-day wash-out period, patients were treated for 6 months with a single daily dose of either 25 mg furosemide or 50 mg chlorthalidone. They were then crossed over to the alternative drug, after a 15-day wash-out period, for a further 6 months.