[Investigation on health status of silica exposed workers in "cotto Fiorentino" companies]. / Indagine sullo stato di salute degli esposti a silice nelle aziende del cotto Fiorentino.

The manufactured in "cotto" is typical of Chianti Fiorentino with about 400 employees. In 2005. the UF PISLL encountered an exposure to silica more than TLV, particularly for some tasks; were prescribed interventions of prevention and was undertaken an investigation of the occupational health status with occupational health physician. We observed 227 workers, 208 males and 19 females, with average age of 43 years and average age working of 15 years. The habit of smoking tobacco was higher than for the general population. The assessment of exposure to silica has been detected for 59 workers (mean 0.05 mg / mc); at pulmonary function testing resulted: 10 with airway obstruction and 4 airflow limitation; by 140 chest X - ray acquired 1 was interstitial pulmonary disease and 1 was bronchopneumonia. Among the diseases not related to exposure to silica, emerging 42 cases of low back pain, 28 hearing loss, 7 with hypertension. Non uniformity in health surveillance and diagnostic criteria highlights the need to cooperate between occupational doctor in public prevention and control service and qualified occupational doctor to ensure a standard of quality in the prevention of disease in exposed to silica.

Osteoarticular tuberculosis in a general hospital during the last decade.

OBJECTIVE: To study clinical features of skeletal tuberculosis diagnosed in our laboratory over the last 10 years. METHODS: We carried out a retrospective observational study of 26 patients with osteoarticular tuberculosis recording clinical and microbiological data. RESULTS: Pain was the main clinical presentation. The median time from the onset of symptoms to the diagnosis was 8 months. Synovial fluid was the most common sample obtained. Bone disease and previous or concurrent pulmonary tuberculosis were the most important predisposing factors. The tuberculin test reaction was positive in 83.3% of the patients. The outcome was favorable in 69% of the patients. Weight-bearing joints were the most commonly involved sites. CONCLUSIONS: A high degree of suspicion is still needed to avoid a delayed diagnosis that might complicate the outcome.

[Utility of IgG subclasses in the diagnosis and follow up of hydatidosis]. / Utilidad de las IgG fraccionadas en el diagnóstico y seguimiento de la hidatidosis.

BACKGROUND: The aim of the study is to evaluate the IgG subclasses for the diagnosis and follow-up of hydatidosis disease. MATERIAL AND METHODS: 82 serum of 50 patients previously diagnosed of hydatidosis disease, were studied. This patients were divided into different groups depending on their symptomatology, and 10 serum of healthy individuals were tested for an indirect hemagglutination, and IgG subclasses were studied in all positive cases by an ELISA. RESULTS: IgG1 subclass was positive in 81 out of 82 patients. IgG2 and IgG3 subclasses were positive in 94.4% of symptomatic patients, in 100% of patients with calcified cyst or who had had no radical surgery, and in 0% of patients with calcified cyst or who had had radical surgery. CONCLUSION: IgG1 and IgG4 subclasses can be used together for hydatidosis diagnosis, due to their high specificity and sensibility. IgG4 subclass becomes negative soon if there is a good clinical response by the patient, turns to be positive when there is a disease recrudescence, and keeps positive when residual cyst are left. All this makes IgG4 subclass a good marker in the hydatidosis follow-up.