[Repetitive movements of the upper limbs: results of exposure evaluation and clinical investigation in refinishing ceramic ornaments]. / Movimenti repetitivi degli arti superiori: risultati della valutazione dell'esposizione e dell'indagine clinica nella rifinitura di ceramiche artistiche.

An evaluation was made of the degree of exposure to risk and the frequency of disorders attributable to biomechanical overload of the upper limb in workers performing finishing operation on ceramic vases and cups in a ceramics factory. The risks were first evaluated against a checklist, then subsequently an assessment was made of the tasks found to feature the highest risks, using an ergonomic analysis method, which identified activities associated with a large number of actions per minute (> 50). The 22 female workers performing the tasks in question underwent a risk-targeted physical examination which included an electroneurographic test using surface electrodes. The clinical test detected an extremely high frequency of carpal tunnel syndrome cases, in addition to other upper limb disorders. In particular, nine female workers (41%) were found to be suffering from carpal tunnel syndrome, and five (22%) from other pathologies of the upper limbs (4 scapulo-humeral periarthritis, 1 epicondylitis). As a result of the findings arising out of this study, immediate preventive measures were adopted; moreover, it has become evident that further epidemiological studies on larger sample populations are needed.

Risk factors for transient ischemic attacks in middle-age. A population-based case-control study.

A case-control study was based on "unselected" transient ischemic attacks (TIAs) in a middle-aged Italian population. The identified cases included 52 prevalent and 25 incident TIAs. There was an incidence rate ratio (female/male) of 1.8 for definite cases. Comparison with the whole population for medical history of hypertension, diabetes and heart attack showed age/sex-adjusted odds ratios of 4.3, 2.1, 7.9 for incident cases. The results were similar when a more detailed investigation of risk factors was performed with all the cases and a random sample of the controls. Moreover, female sex had an odds ratio for incident cases of 3.3 (95% confidence interval 1.0-11.3) after adjustment for age and presence of all the main risk factors. The presence of at least one cardiopathy showed an odds ratio of 8.3 for incident cases (95% confidence interval 2.4-28.4).

[Spatial identification of an excess of cerebral tumors in a highly industrialized small area: results of a case-control study]. / Identificazione spaziale di un eccesso di tumori cerebrali in una piccola area fortemente industrializzata: risultati di uno studio caso-controllo.

A case-Control Study for the association between Central Nervous System Malignancies and residence in a small area within the municipality of Campi Bisenzio (Florence, Italy) has been performed following a spontaneous reporting of three cases of brain cancer. All incident cases of SNC tumours diagnosed in the period 1973-82 with histological or radiological confirmation among residents in the study area are recruited as cases. Five controls for each case, matched by sex and age (+ - 1 year), are randomly chosen from demographic files in the municipality. The residential history for each subject enrolled in the study is recorded from the same demographic files. The relative risk for ever resident in the 46-50 electoral sections relative to never resident was 7.33 (C.I. 95% 2.6-20.3). A trend for duration of residence was also relevant (less than 5 years RR = 2.1, 5-10 years RR = 8.4, more than 10 years RR = 11.3; chi-square for trend = 41 p = 0.00002).

Transient ischemic attacks in the community: occurrence and clinical characteristics. A population survey in the area of Florence, Italy.

A simple self-administered questionnaire was mailed to a population sample of 8,626 (40-65 years old) to identify transient ischemic attacks (TIAs) that occurred in the previous 12 months. This study was conducted in a well-defined, medically controlled geographic area. 75.4% of the questionnaires were returned. The procedure identified 52 TIA cases (43 definite and 9 uncertain). The 12-month period prevalence for TIAs was 6.6 per 1,000 (95% confidence limits of 4.8-8.9) among the respondents. The annual incidence rate for first TIAs was 3.1 per 1,000 (95% confidence limits of 1.9-4.7). Our results differ from those reported in hospital series or in population surveys based on clinical records, with higher incidence and prevalence rates, female preponderance and higher frequency of vertebrobasilar attacks.

[Role of two-dimensional echocardiography in the diagnosis of embolic cardiopathy in patients with transient cerebral ischemia attacks]. / Ruolo dell'ecocardiografia bidimensionale nella diagnosi di cardiopatia embolizzante nei pazienti con attacchi ischemici cerebrali transitori.

Cardiac sources of emboli have been frequently described in patients with Transitory Ischemic Attacks (TIAs). The aim of our study was to assess the value of two-dimensional echocardiography (2D-E) in the investigation for possible cardiac aetiology of TIAs. As an offshoot of a larger epidemiologic study which aimed at determining the period prevalence of TIAs in 6.504 subject(s) of the general population aged between 40-65, fifty subjects with TIA (group A) and 66 controls (group B) were studied. A heart disease was found in 20/50 s. (40%) in group A (coronary artery disease: 5; hypertensive heart disease: 4; mitral valve prolapse: 5; left ventricular aneurysms: 2; aortic valve disease: 2; aortic valve prosthesis: 1; atrial fibrillation: 1) and in 5/66 s. (7.5%) in group B (p less than 0.01) (coronary disease: 2; hypertensive heart disease: 1; mitral valve prolapse: 2). A potential source of emboli was present in 11 s. in group A (22%) and in 2 s. in group B (3%) (p less than 0.01). In 4/50 s. in group A and in 1/66 in group B the diagnosis was obtained by means of 2D-E only, because other clinical signs and ECG data were negative. 2D-E could only confirm the diagnosis in the remaining cases, with no additional information (i.e., no intracavitary masses were seen). In conclusion there is a high prevalence of heart disease in patients with TIA over 40 years of age. A cardiac source of emboli may be suspected in a substantial number of cases. Nevertheless the value of routine 2D-E in disclosing an otherwise undetected source of emboli is rather low.

Multiple sclerosis among shoe and leather workers: an epidemiological survey in Florence.

The observation of many multiple sclerosis (MS) cases among shoe and leather workers prompted a survey of the risk of MS in this working population. Eighty-one patients with definite or probable MS alive in Florence on May 1st 1976 were interviewed regarding their occupation at onset of the disease. Five of the 41 patients working at the time had worked in shoe a leather factories. The relative risk for these workers was 4.87 compared to the general populations and 4.91 compared to the active population, both results being significantly different from one. This survey indicates an increased risk of MS among shoe and leather workers. Organic solvents, contained in large quantities in the glues used, may be involved in the pathogenic mechanism through a possible interference with the immune system.

Another possible precipitating factor in multiple sclerosis: the exposure to organic solvents.

Recent clinical observations seem to indicate that a possible correlation may exist between the appearance of inflammatory diseases of the nervous system and exposure to organic solvents. In certain cases the patients could not be distinguished, either from the clinical or laboratory point of view, from typical cases of multiple sclerosis. These observations raise the problem of a possible action of organic solvents on the immunological responses, already described in different pathological conditions as a further possible precipitating factor in MS.