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ABSTRACT: 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. Therapy with etoposide and carboplatin induced a temporary partial remission, with fairly good quality of life and decrease of the NSE levels (down to 15.0 ng/mL). The patient died approximately 12 months after the initial diagnosis. The case confirms that prostatic SCC (a rare and very aggressive neoplasm) is usually diagnosed in an advanced stage. Treatment is problematic, however chemotherapy may prolong survival allowing, at least temporarly, an acceptable life quality. NSE measurement is useful to differentiate SCC from the more common adenocarcinoma (typically associated with elevated PSA values) and for follow-up.
Recenti progressi in medicina 12/2000; 91(11):567-70.
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Allergy 03/1997; 52(2):231-2. · 6.27 Impact Factor
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ABSTRACT: 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. The onset of the condition was not foreseeable because of the absence of an accurate history of the subject's alcohol abuse on his admission and of significant biohumoral data indicating the existence of an alcohol correlated pathology.
Recenti progressi in medicina 12/1994; 85(11):537-9.
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ABSTRACT: 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). Sensitivity and specificity of UNDW alone, methacholine alone, and of the combination of the two tests were determined with the results of the specific challenge with TDI as the "gold standard." Both frequency and severity of bronchoconstrictive response to UNDW (FEV1 decrease > or = 15 percent) and the degree (PD15 FEV1) and frequency of bronchial hyperresponsiveness to methacholine were significantly higher in TDI reactors than in nonreactors. The UNDW had higher specificity (82.2 percent vs 51.1 percent) but lower sensitivity (40 percent vs 76.7 percent) than methacholine. The combination in parallel (positivity of any of the two challenges) of methacholine and UNDW challenge did not change sensitivity to a great extent (80 percent vs 76.7 percent), whereas combination in series (positivity of both challenges) had considerably greater specificity (86.7 percent vs 51.1 percent) than methacholine alone. We conclude that in the assessment of TDI-asthma, the validity of UNDW challenge alone is limited since it is insufficiently sensitive. Instead, combining UNDW and methacholine challenge when methacholine is positive improves our ability in identifying subjects with TDI-asthma diagnosed with the specific challenge. This procedure constitutes a first objective confirmation of a suggestive history of TDI-asthma that is useful for clinical purposes. However, especially for medicolegal purposes, the definitive diagnosis requires the specific challenge.
Chest 10/1993; 104(4):1127-32. · 5.25 Impact Factor
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ABSTRACT: 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 0.1-6.9 micrograms/L); blood concentration of mercury was 130 and 100 micrograms per liter (reference value 1.7-9.9 micrograms/L). The patients were treated with penicillamine and daily excretion of mercury was monitored. The residual sources of pollution in the kitchen were identified and bonificated.
Giornale italiano di medicina del lavoro 10/1989; 11(5):209-13.
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ABSTRACT: The authors examine cases of occupational diseases diagnosed between 1982 and 1988 in patients admitted to "Divisione di Medicina del Lavoro I Sezione di medicina del Lavoro del Dipartimento di Medicina preventiva, occupazionale e di comunità dell'Università di Pavia". The most frequent syndromes concerns the auditory apparatus (having losses or deafness due to noise) and the respiratory system, whereas new safety regulations have given rise to the disappearance of benzene-induced hematologic abnormalities. Most of, the "classical" features of occupational diseases have disappeared, since early diagnosis has permitted the adoption of opportune technical and sanitary measures. The authors emphasize the necessity for role of Occupational Medicine (ever following the sentences 179 and 206 of the "Corte Costituzionale") to be not prevention, but also diagnosis, treatment and rehabilitation; therefore there is a need, all over the country, for adequate structures for the diagnosis and treatment of the occupational diseases.
Giornale italiano di medicina del lavoro 06/1988; 10(3):99-106.
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ABSTRACT: Two cases of occupational asthma due to styrene are described. The subjects complained of cough, breathlessness, and symptoms of asthma when coming into contact with styrene; in patient 1 the respiratory reaction was followed by a late cutaneous rash. The symptoms disappeared when the subjects were away from work on weekends or holidays. In both cases, inhalation challenge with styrene produced an immediate bronchospastic reaction which was followed by a late cutaneous rash in patient 1. Prior administration of disodium cromoglycate (40 mg from a spinhaler) prevented the respiratory reactions completely, but failed to prevent the late skin response in case 1. Styrene removal was followed by complete disappearance of the symptoms. We conclude that styrene can be a primary cause of occupational asthma.
Journal of occupational medicine.: official publication of the Industrial Medical Association 01/1988; 29(12):957-60.
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Recenti progressi in medicina 10/1986; 77(9):418-9.
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ABSTRACT: The AA. describe two cases of occupational asthma in the wood industry. Bronchial provocations tests (BPT) showed that the sensitizing agents were not only TDI, but also the "base" of the painting system used in the varnishing. The AA. discuss on the method of stimulation in performing BPT.
Giornale italiano di medicina del lavoro 12/1983; 5(6):259-61.
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ABSTRACT: In order to evaluate the effect of nifedipine, a calcium channel blocker, upon specific bronchial responses to isocyanates, 5 subjects with occupational asthma due to TDI were examined. Each subject was exposed to an atmosphere containing 0.01 ppm of TDI in an inhalation chamber for 15 minutes; the test was repeated on a different day 45 minutes after administration of placebo or nifedipine (20 mg sublingually) in a random fashion. Our data show an effectiveness of nifedipine at the above mentioned dose in preventing the responses arising immediately or within one hour after the exposure (cases n. 1, 2, 3, 4, 5). For preventing late responses it was necessary to repeat the administration of nifedipine (10 mg sublingually) 2 hours after the exposure (cases n. 4 and n. 5). The mechanism by which nifedipine prevents bronchial responses to isocyanates has not been elucidated.
Giornale italiano di medicina del lavoro 12/1983; 5(6):247-50.
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ABSTRACT: An electromyographic (EMG) investigation was performed on 216 workers of a viscose rayon plant with different degrees of exposure to CS2. In the light of the data supplied by the survey the AA. maintain that meedle EMG is able to detect, probably better than other test, changes of PNS even if they are very slight, and to select subjects having a higher risk of suffering from neuropathies. Nevertheless, also because of its sensitivity, EMG seems to be less specific than other electrophysiological parameters such as maximal motor conductions velocity (MMCV), that is significantly altered in exposed people. Muscular changes may be connected to a specific effect of CS2 less surely than MMCV change. However, they might be considered as pointing to a predisposition to PNS illness and it seems advisable to eclude these subjects from CS2 exposure.
Giornale italiano di medicina del lavoro 10/1983; 5(5):199-202.
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ABSTRACT: 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. The disorder was often clinically asymptomatic and demonstrable only on electroneurographic investigation. Significant correlations were found between polyneuropathy, the duration of alcoholism, the type of alcoholic beverage consumed (wine) and the presence of liver disease and macrocytosis.
Alcohol and Alcoholism 36(5):393-400. · 2.95 Impact Factor
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ABSTRACT: 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. From our results we can conclude that alcohol disaddiction carried on during admission has positively contributed to the reinstatement of alcoholics patients.
Giornale italiano di medicina del lavoro ed ergonomia 21(1):54-7.
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ABSTRACT: 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. The great majority of them had already been recognized to be affected by asbestosis. A considerable statistical agreement (Cohen K) was observed between radiographic and tomographic I.L.O. classes. In conclusion, high resolution chest tomography doesn't appear to be an indispensable test for the diagnosis in admitted subjects, but we underline its importance in the evaluation of pleural thickenings.
Giornale italiano di medicina del lavoro ed ergonomia 21(4):271-7.
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ABSTRACT: 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. The great majority of them had already been recognized to be affected by asbestosis. The statistical analysis (Cohen K) showed a satisfactory agreement between radiographic and tomographic I.L.O. classes. However, high resolution tomography appeared to be more accurate in the assessment of less severe clinical pictures. In conclusion, we underline the importance of high resolution chest tomography in the evaluation of individual clinical cases, particularly when forensic problems are involved.
Giornale italiano di medicina del lavoro ed ergonomia 21(4):278-86.
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ABSTRACT: 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. In addition, alcohol accounts for 5% of disability payments. In the authors' experience, alcohol abuse is a widespread problem in the work setting, however its social and medical impact is still underestimated.
Giornale italiano di medicina del lavoro ed ergonomia 22(1):47-51; discussion 62-3.
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ABSTRACT: 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.
Recenti progressi in medicina 80(7-8):430-3.
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ABSTRACT: 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.
Giornale italiano di medicina del lavoro 11(3-4):145-8.
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ABSTRACT: 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. The woman's right to persue a career was recognized mainly by men in middle to upper social class in the 25-30 age group who participate in household duties. It is evident that, even in the case of domestic collaboration, women have the ultimate responsibility for household tasks. In that men tend to choose the more gratifying duties (es. cooking, child care).
Giornale italiano di medicina del lavoro 11(3-4):153-5.
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ABSTRACT: 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. The increasingly lower age of initiation to alcohol reconfirms the need for prevention and instruction even at scholastic level.
Giornale italiano di medicina del lavoro 13(1-6):65-9.
