Alcoholic polyneuropathy: a clinical and epidemiological study.

In the present study, we investigated the frequency of polyneuropathy in a sample of 296 alcoholics who were admitted to the 'S. Maugeri' Medical Centre for detoxification from October 1997 to November 1999. Results revealed a high frequency of polyneuropathy in the sample under study.

[Small cell carcinoma of the prostate. Description of a case].

The case of a 73-year-old man with metastatic small cell carcinoma (SCC) of the prostate is described. Seric neuron-specific enolase (NSE) was enhanced (75.4 ng/mL), while the prostate-specific antigen (PSA) was in the normal range.

[Alcoholism at the work setting].

Alcoholism is a nation-wide problem because of the variability and severity of its associated phenomena. In Western European countries, according to the WHO, the use of alcohol is the direct or indirect cause of approximately 20% of hospital admissions of male adults of working age. In Italy, the number of lost working days due to sickness is four times greater in drinkers, as is the risk of serious accidents.

[High resolution computerized tomography in the diagnosis of silicosis and mixed dust pneumoconiosis].

The clinical observation, the work history, the analysis of pulmonary function tests and, mainly, the conventional x-ray chest radiograms have represented, til now, the diagnostic basis for pneumoconiosis (silicosis, mixed dust pneumoconiosis, asbestosis). Recently, the high resolution chest tomography (HRCT) has been introduced into the diagnostic procedures: such method seems to have its main application in the assessment of incipient clinical pictures of pneumoconiosis, particularly when characterized by normal pulmonary function tests. 75 silica- and mixed dust exposed workers were submitted to both radiologic methods.

[High resolution computerized tomography in the diagnosis of asbestosis].

The clinical observation, the work history, the analysis of pulmonary function tests and, mainly, the conventional x-ray chest radiograms have represented, til now, the diagnostic basis for pneumoconiosis (silicosis, mixed dust pneumoconiosis, asbestosis). Recently, the high resolution chest tomography (HRCT) has been introduced into the diagnostic procedures: such method seems to have its main application in the assessment of incipient clinical pictures of pneumoconiosis, particularly when characterized by normal pulmonary function tests. Asbestos fibers exposed workers were submitted to both radiologic methods.

[Work and alcohol: considerations on a caseload of patients undergoing treatment].

An enquiry into alcohol dependent subjects admitted to the clinical wards of the first section of Occupational Medicine belonging to Medicina Preventiva Occupazionale e di Comunità of University of Pavia for an alcohol disaddiction treatment has been performed through a phone interview. 289 patients have been contacted and time elapsed from admission to interview was one to three years. The questions focused alcohol abstinence, occupational position before and after admission, any improvement in the work sphere (relationship with the collegues), any feeling of empowerment of the work abilities and any increase in the responsibilities load.

Allergic and Irritant Glove-related Diseases in Health Care Workers and Their Prevention.

Because the widespread use of gloves by health care workers has induced an increase of both irritant and type I or type IV allergic glove-related diseases, the Italian Society of Preventive Medicine for Health Care Workers set up a working group to collect information about glove composition and to standardize procedures for the diagnosis and prevention of glove-related disease and job-fitness evaluation of employees who will be wearing gloves. In addition, the group made recommendations for educational programs focusing not only on users but also on purchasers, who presently favor glove selection for economic reasons. The group's recommendations are summarized in a consensus document, but cannot be considered definitive.

[Professional anamnesis and information: considerations on a clinical case].

Work history and information about risks represent two main instances in occupational medicine, the first one in order to formulate the diagnosis of occupational disease, the second one for the health education of workers. As far as this is concerned we describe the clinical case of a patient admitted for a cutaneous manifestation of suspected allergic nature. After a careful evaluation of the work related risk factors it turned out to be a cutaneous rash caused by exposure to dimethylformammide and concomitant consumption of alcohol.

[Evaluation of trends in occupational pathology in clinical cases].

The study considered all patients admitted to the 1st Division of Occupational Medicine, Department of Preventive, Occupational and Community Medicine of the University of Pavia between January 1st 1989 and December 31st 1995 with a diagnosis of occupational disease. It was useful in illustrating the evolution of occupational disease as regards both changes in etiology and in the symptoms and systems involved. A decrease in the number of occupational diseases diagnosed from 1993 to 1995 was revealed, but it is difficult to draw any significant conclusions from these data since the need for hospitalization when diagnosing this type of disease has diminished greatly.

Occupational asthma, rhinitis and urticaria due to piperacillin sodium in a pharmaceutical worker.

A 28 year old man with no history of atopy was referred to our hospital for possible work-related asthma. He had been employed in the production section of a pharmaceutical company for 2 yrs, and in the last 2 months he had complained of dyspnoea, wheezing, chest tightness, symptoms of rhinitis and a cutaneous rash when exposed to powdered antibiotics. Symptoms disappeared after being transferred to the packaging section.

[Employment and alcohol: analysis of a clinical casuistic].

The relationship between alcohol and work was studied in a group of 537 voluntary patients (393 male and 144 female) admitted to the department of Medicina del Lavoro, Pavia University for alcohol rehabilitation. The highest incidence of alcohol abuse was found in non-working subjects (pensioners, unemployed, housewives) although the start of excessive drinking takes place after beginning a working activity; a cause-effect relationship between these two factors can not be clearly determined, however. It is true that the stress provoked by this new condition (introduction to the work experience) can, in certain subjects, be a contributing factor in alcohol abuse.

[Acute alcoholic myopathy].

A case of acute alcoholic myopathy in a subject with a 20 year history of alcohol abuse is described. The condition emerged during an episode of delirium tremens and had a quickly deadly outcome. The rapid evolution of the clinical situation accompanied by variation in the biohumoral indices (CPK, LDH, myoglobin) is stressed and although this prevented from obtaining anatomopathological samples of the rhabdomyolisis, the specific diagnosis was made with reasonable certainty.

Bronchial responsiveness to ultrasonic fog in occupational asthma due to toluene diisocyanate.

To determine the validity of ultrasonic nebulization of distilled water (UNDW, "fog") in comparison with methacholine challenge, in the assessment of toluene diisocyanate (TDI) asthma, we evaluated 75 subjects exposed to TDI with work-related respiratory symptoms. Subjects were submitted to bronchial challenge with methacholine at first, thereafter to UNDW inhalation and to specific challenge with TDI. The diagnosis of TDI-asthma was made in 30 of 75 patients (40 percent) who developed a bronchoconstrictive response to the specific challenge (reactors).

[The psychosocial problems in a population of emigrant Italian workers].

The psycho-social problems of a group of 365 Italian emigrants to Switzerland, admitted to psychiatric hospitals, were studied. It was found that non professional subjects (housewives, unemployed, retired) and manual workers (builders, waiters, factory workers) were more likely to suffer from psycho-social disorders. Only 11.

[Indoor pollution: a report of 2 clinical cases of occult carbon monoxide poisoning].

A large part of the general population is potentially exposed to excessive concentrations of carbon monoxide (CO), both in the domestic and work environment. Beside acute, often fatal poisoning, the possibility of occult intoxication should be considered; this condition can affect people who are often unaware of the existence of a toxic exposure in their homes or work places. We describe two non-smoking patients, husband and wife, 53 and 57 years old, respectively, who suffered cephalea, nausea and neurobehavioural disturbances during a period of approximately one year; these symptoms were reported to improve or disappear on several occasions during the patients' absence from home.

[A new environmental pathology: styrene-induced rhinitis].

We describe the case of a 36 ys aged woman complaining of symptoms of oculorhinitis with itching, occasional dyspnea and laryngeal constriction. The patient related her symptoms with the emission of dusts and steam from a factory in the neighbourhood producing manufactures using polyester resins dissolved in styrene. No bronchospastic response was obtained after challenge with methacoline and ultrasonic nebulization of distilled water, which instead provoked a significant increase of nasal resistance.

Occupational asthma: fate and management after the diagnosis.

The clinical and socio-professional fate of subjects with occupational asthma is not univocal. We re-examined twenty-nine subjects diagnosed in our center as suffering from this disease an average 14 months, SE 1.54 after the diagnosis.

[Early effects of exposure to anesthetic gases and vapors. A critical review on the suitability of several indicators of the effect].

Apart from a risk excess of liver disease among operating theatre personnel and of spontaneous abortion in women exposed during pregnancy, no definitive conclusion can be drawn regarding health impairment among anaesthesiology staff. However, many studies pointed out that several adverse effects occur as a consequence of experimental, therapeutic and occupational exposure to inhalation anaesthetics. This paper reviews the early changes of the organ systems (hepatobiliary, renal, cardiac, hematopoietic, reproductive systems; immunologic functions; cytogenetic effects), which are considered to follow anaesthetics exposure, to evaluate their possible use as biological indices of effect.

[Alcohol and work: comments on a clinical case load].

The relationship between alcohol and work was studied in a group of 260 voluntary patients (186 male and 74 female) admitted to the unit of Medicina del Lavoro, Pavia University for alcohol rehabilitation. The highest incidence of alcohol abuse was found in non-working subjects (pensioners, unemployed, housewives) although the start of excessive drinking takes place after beginning a working activity; a cause-effect relationship between these two factors can not be clearly determined, however. It is true that the stress provoked by this new condition (introduction to the work experience) can, in certain subjects, be a contributing factor in alcohol abuse.

[A follow-up study of 304 cases of suspected pathology caused by benzene seen in 1950-71].

A group of 304 subjects admitted to the Institutes of Occupational Health of Milan and Pavia (Italy) between 1951 and 1970 for suspected benzene intoxication were retrieved from hospital records and their mortality experience was examined up to 31 December, 1986. The aims of the study were: 1) to estimate, in quantitative terms, the risk associated with benzene exposure in that area in the time period considered (these risks had already been reported, but merely as case reports); 2) to investigate the possibility of an increased frequency of neoplasms other than leukaemia; and 3) to further investigate the exposure history of these subjects. In the absence of data on the population at risk, mortality was analysed via the mortality odds ratio (MOR) method.

[Acute accidental poisoning by mercury vapors in the home environment].

The authors report 2 cases of acute mercury intoxication due to accidental breakage of barometer on to a lit gas ring. Within 24-48 hours the subjects developed neurological, gastrointestinal and dermatological symptoms. A 24-hour urine sample contained 600 and 400 micrograms of mercury per liter respectively (reference value 0.

[Thyroid function in bronchial asthma].

The Authors report the results of an investigation on association between bronchial hyperreactivity to metacholine in asthmatic subjects and subclinical dysfunction of the thyroid gland. Although the T4 and free T3 values were higher in the control group than in asthmatic patients, all the hormone dosage results were within the normal range. These findings show that asthma is not associated with changes in thyroid function.

[Men and home environment: when the wife exercises an extra-familial activity].

The study examines the views of men towards the division of household duties when the female partner is employed outside the home. A variety of behaviour ranging from a complete refusal to participate in domestic activity to an equal division of household tasks is demonstrated. The main determining factors seem to be: socio-cultural level and age group.

[Depression and home environment].

The Authors consider the higher frequency of depressive disorders in women and examine the correlations between psychopathological expressions of depression and women's social and cultural roles. The condition of life at home, that is peculiar to housewife, sometimes can be a psychopathological risk factor or psychosocial stressor, as well as other work conditions (whether the woman is employed or not), that have to be examined in relation to each person, according to the individual's biological, psychosocial and cultural features.