[Integrated approach to the promotion of health and safety in agriculture: a pilot study in the Cremona area]. / Approccio integrato per la promozione della salute e sicurezza in agricoltura: studio pilota nella provincia di Cremona.

The agricultural sector in Cremona country is made up of many small farms and this makes it difficult to realease the principles of health and safety at work. In this experience an innovative platform for information and training, in which the agricoltural trade unions are privileged partner of public institutions in the road map for continuous improvement, has been tested. In a first phase, the availability of expert technicians to check the consistency of the application of safety standards has been offered by the trade associations free of charge to 100 farms. The critical points and problems were identified using specific checklists and a custom proposal to solve them was proposed. In a second phase, farms participating in the project have been officially inspected by the local public health authority. The comparison between the data collected in the two phases allowed to ascertain a good effectiveness and efficiency of the preventive intervention plan experienced.

Monitoring the trend of overweight children in Cremona (anni 1990-1998).

AIM: To evaluate the trend of infantile obesity in the school-aged population of Cremona over time. METHODS: The weight and height of all children aged 6, 9 and 11 attending schools within the health district of Cremona were measured for 9 consecutive years (January 1990-March 1998), giving a total of 17,730 measurements. Pupils whose bodyweight was 20% above the mean weight for stature and sex given by NCHS canthimetric classes were defined as obese. In addition, three degrees of obesity were defined: slight obesity (20-29% excess bodyweight), moderate obesity (30-50%) and severe obesity (over 50%). RESULTS: This study showed the trend of the increasing prevalence of infantile obesity in the zone in question: it rose from an overall level of 6.1% to 13.6% in 1998. The increase regarded all age groups; levels were three times higher in older children, but obesity had more than doubled in 6-year-olds. With regard to the three classes of obesity, there was a particularly striking increase in moderate obesity, whereas the cases of severe obesity remained constant. CONCLUSIONS: These data underline the need for more incisive educational and preventive work in the field of infantile obesity to be carried out as soon as possible.

[Anomalies of the trunk. An analysis of their prevalence in young athletes]. / Anomalie del tronco. Analisi della prevalenza nel giovane sportivo.

BACKGROUND: To evaluate the influence of some sports (swimming, tennis, soccer, artistic gym, classical dance, basket, volley) on the development of the musculoskeletal system in prepuberal children. METHODS: From January 1994 to December 1997, 3,765 students of the 4th and 6th class of primary schools in the area of the health district of Cremona, underwent orthopaedic screening. The prevalence of kyphosis, hyperlordosis and back asymmetry in children playing and not playing sports were compared. Statistical analysis was performed using X2-test. RESULTS: The incidence of hyperlordosis was significantly lower in boys playing soccer while the incidence of back asymmetry was higher in girls playing basketball. Tennis was found not to be a suitable sport for either male or female prepuberal children. Swimming was the best sport for females whereas males who swan registered a higher incidence of hyperphosis compared to the control group. In females the incidence of hyperlordosis did not correlate with any of the sports considered whereas the incidence in boys playing soccer and swimming showed a decrease. Hyperkyphosis in females can be reduced by swimming and volleyball, in males by playing basketball. CONCLUSIONS: The results obtained suggest the importance of an orthopaedic evaluation of children who want to take up sports.

[The neuroleptic malignant syndrome (NMS). A report of a clinical case with a protracted and recurrent course. A review of the literature]. / Sindrome maligna da neurolettici (SMN). Descrizione di un caso clinico a decorso protratto e recidivante. Rassegna della letteratura.

Neuroleptic malignant syndrome (NMS), characterized by catatonic behavior, generalized muscular rigidity, hyperthermia and autonomic dysfunction, can suddenly arise in patients treated with neuroleptic agents and carries a high mortality rate even today. A case of NMS due to i.m. therapy with haloperidol decanoate is reported in this paper, characterized by sustained course and a severe relapse due to a different therapy with another neuroleptic agent. The patient however, after a prolonged remission from the relapse, was able to resume long term therapy with neuroleptic drugs. The importance of monitoring blood levels of CPK during the follow-up and the effectiveness of therapy with bromocriptine and dantrolene in confirmed. Although the patient presented a good clinical response, she developed permanent cerebral and muscular damage. A wide review of the literature on NMS is reported to throw light on this syndrome, whose recognition and prompt diagnosis are necessary to reduce mortality.

[Vasopressin-sensitive diabetes insipidus. Case histories]. / Diabete insipido vasopressino-sensibile. Contributo casistico.

Twelve patients, aged 16-66 years, affected by cranial diabetes insipidus either idiopathic or secondary (head injuries, histiocytosis X, metastatic tumors, pituitary or hypothalamic surgery) were studied. Diagnosis was made on the basis of both dehydration test and sensitivity to exogenous vasopressin. The relationship between plasma and urine osmolality at the end of the dehydration test was evaluated (and its usefulness for diagnostic purpose confirmed). According to this test two different conditions, namely partial and complete, of cranial diabetes insipidus were defined. All the patients underwent the following diagnostic procedures: skull x-ray, evaluation of visual fields, encephalic CT-scan. Idiopathic central diabetes insipidus incidence was found to be 33.3% of all cases, with a sharp prevalence for male sex; the median age of onset was 12.5 years. In our experience the frequency of idiopathic condition was similar to that reported in most recent literature confirming a decreasing incidence, most likely due to the use of more sophisticated diagnostic procedures.

[Nosographic and diagnostic classification of congenital thrombocytopathies. Clinical interpretative notes]. / Inquadramento nosografico e diagnostico delle trombocitopatie congenite. Spunti interpretativi clinici.

Substantial progress has been made in recent years in the understanding of platelets and their functions. This has permitted a more reasonable classification of congenital platelet diseases, primarily thanks to the standardization of haemostasis and platelet function tests. A comparison is made between the pictures best defined in 17 cases studied at the S. Matteo Polyclinic in recent years. This brought out certain contradictions and suggested that further study in greater depth is required.