ABSTRACT
Even though Obstructive Sleep Apnea Syndrome (OSAS) is one of the main causes of daytime sleepiness with high subsequent risk for causing vehicle accidents, its evaluation is not usually included among the criteria used for the certification of job fitness among professional drivers. In order to assess the feasibility of a screening method that allows the occupational physician to identify the subjects at risk for OSAS which should undergo second level tests (cardiorespiratory monitoring), we recorded and subsequently processed appropriate subjective and objective indicators among 455 professional drivers employed in private transportation companies. Only 17 subjects (47%) out of 36 tested positive underwent cardiorespiratory monitoring (due to technical and organizational difficulties and to the poor compliance of workers). OSAS was confirmed in 15 subjects out of 17 showing an excellent positive predictive value of the screening. Risk management for OSAS is currently unavoidable yet not formally provided by law. Our results show the possibility of completing the health surveillance program with feasible and valuable screening tests. Difficulties (hardly compliant with a timely certification of the job fitness) arise instead as far as second level confirmatory procedures are involved.
Subject(s)
Automobile Driving , Medical History Taking , Occupational Diseases/diagnosis , Population Surveillance , Sleep Apnea, Obstructive/diagnosis , Transportation , Adult , Aged , Cohort Studies , Humans , Middle Aged , Private Sector , Time Factors , Young AdultABSTRACT
In order to investigate the pathogenic mechanism responsible for liver injury associated with chronic alcoholism, we studied the effects of different dietary vitamin E levels in chronically ethanol (EtOH)-fed rats on the activity and mRNA regulation of the manganese superoxide dismutase (MnSOD) enzyme. Evidence is accumulating that intermediates of oxygen reduction may in fact be associated with the development of alcoholic liver disease. Since low vitamin E liver content seems to potentiate EtOH-linked oxidative stress, we studied the effect of EtOH treatment in livers from rats fed a diet deficient or supplemented with vitamin E. Chronic EtOH feeding enhanced hepatic consumption of vitamin E in both groups of EtOH-treated animals, irrespectively of the vitamin E level of the basal diet and the effect was observed in both the microsomal and mitochondrial fractions. Both EtOH-fed groups exhibited increased MnSOD gene expression, while the enzyme activity was enhanced only in the vitamin E-deprived group of EtOH-treated animals. The significant increase in manganese liver content found only in this last group could explain the rise of enzyme activity. In fact, in the absence of a parallel increase of the prosthetic ion manganese, MnSOD mRNA induction was not accompanied by a higher enzymatic activity. These findings support the role of oxidative alteration in the EtOH-induced chronic hepatotoxicity in which MnSOD response might represent a primary defence mechanism against the damaging effect of oxygen radical species.
Subject(s)
Alcoholism , Disease Models, Animal , Ethanol/pharmacology , Food, Formulated , Superoxide Dismutase/drug effects , Vitamin E Deficiency/diagnosis , Vitamin E/pharmacology , Animals , Behavior, Animal/drug effects , Chronic Disease , Male , RNA, Messenger/drug effects , Rats , Rats, WistarABSTRACT
The cholestasis by meloxicam has not been often described. However, we present here the clinic, laboratory, histologic and follow up of a patient with cholestatic hepatitis produced by this drug.
Subject(s)
Analgesics, Non-Narcotic/adverse effects , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Cholestasis/chemically induced , Thiazines/adverse effects , Thiazoles/adverse effects , Aged , Cholestasis/diagnosis , Female , Follow-Up Studies , Humans , Meloxicam , Tomography, X-Ray ComputedABSTRACT
The cholestasis by meloxicam has not been often described. However, we present here the clinic, laboratory, histologic and follow up of a patient with cholestatic hepatitis produced by this drug.
ABSTRACT
Changes in rat liver oxidative stress-related parameters, morphological alterations, as well as circulating and tissue levels of lindane were studied 1-7 days after the administration of a single dose of 60 mg of lindane/kg. One day after lindane treatment, a significant enhancement in the oxidative stress status of the liver was observed, characterized by an increase in thiobarbituric acid reactants production and in the microsomal generation of superoxide radical (O.-2) coupled to cytochrome P450 induction, and a decrement in the activity of superoxide dismutase (SOD) and catalase. Consequently, the O.-2 production/SOD activity ratio was enhanced two-fold. In this condition, light microscopy studies revealed the incidence of liver lesions in periportal areas, together with significant changes at the mitochondrial level observed by electron microscopy, which coincide with the maximal levels of lindane in the liver, adipose tissue, plasma and whole blood. Changes in oxidative stress-related parameters observed after 1 day of lindane treatment regressed to normal from the third day and thereafter, together with the decrement in circulating and tissue levels of the insecticide. It is concluded that morphological and oxidative stress-related changes induced in the liver by acute lindane intoxication are readily reversible, depend on the hepatic content of the insecticide, and seem to be conditioned by the changes in O.-2 generation.
Subject(s)
Hexachlorocyclohexane/toxicity , Liver/drug effects , Oxidative Stress/drug effects , Adipose Tissue/chemistry , Animals , Catalase/drug effects , Catalase/metabolism , Hexachlorocyclohexane/blood , Hexachlorocyclohexane/pharmacokinetics , In Vitro Techniques , Liver/metabolism , Liver/pathology , Male , Microscopy, Electron , Mitochondria/ultrastructure , Organelles/ultrastructure , Rats , Rats, Wistar , Superoxide Dismutase/drug effects , Superoxide Dismutase/metabolism , Thiobarbituric Acid Reactive Substances/metabolism , Tissue DistributionABSTRACT
Clinical, pathological and ultrastructural changes in rats injected ip with extracts of Wedelia glauca are described. Macroscopic changes were congested livers with accentuated centrilobular vascular patterns. Microscopic hepatic lesions had variable degrees of degeneration and lytic necrosis of centrilobular hepatocytes. Ultrastructural liver changes were condensation of nuclear chromatin with loss of perinuclear membranes, enlargement of mitochondria with alteration of limiting membranes, disappearance of cristae and matrical rarefaction. The endoplasmic reticulum was dilated with detachment of ribosomes. Serum activities of aspartate aminotransferase, alanine aminotransferase and lactate dehydrogenase were increased.