[Psychiatric support of healthcare workers undergoing periodic health assessment]. / Supporto psichiatrico ai lavoratori della sanità sottoposti a sorveglianza sanitoria periodica.

INTRODUCTION: An integrated mental health surveillance program was developed by the department of occupational medicine at S. Chiara University Hospital in Pisa, Italy, in order to better assist and treat hospital staff suffering from psychiatric disorders in a preventive medical setting. MATERIAL AND METHODS: During the occupational medical surveillance of 4000 employees of S. Chiara Hospital in Pisa (Italy), 30 health care workers with psychiatric disorders were included in our program, which provided psycho-educational support and pharmacological treatment. Measures of effectiveness were: Clinical Global Impression (CGI scale) and a comparison between the average number of lost workdays due to mental illness before and after treatment. RESULTS: At the end of the observation period there was a decrease in the CGI severity score with a improved CGI score ranging from 1 to 2 and a reduction in absenteeism, from an annual average of 36.70 to 25.10 lost workdays. CONCLUSION: Our outcome measures data seem to indicate that a preventive medicine setting can offer effective psychiatric support that is better accepted and tolerated by health care workers and that this approach may reduce absenteeism.

Optimization of a glucose biosensor setup based on a Ni/Al HT matrix.

An amperometric glucose biosensor was developed using an anionic clay matrix of hydrotalcitic nature (Ni/Al-NO3 HT) as enzyme support, which was electrochemically synthesized at -0.90 V versus SCE, using a rotating disk Pt electrode to assure homogeneity of the electrodeposition suspension. The biorecognition element was glucose oxidase (GOx) immobilized on HT during the electrosynthesis, which was followed by cross-linking with glutaraldehyde vapours to avoid the enzyme release. The performances of the biosensor, in terms of sensitivity to glucose calculated from the slope of the calibration curve, are dependent on parameters related to the electrodeposition. An experimental design was applied to detect the optimal conditions of electrosynthesis in order to optimize the glucose biosensor performance. The factors taken into account were enzyme concentration and Ni/Al molar ratio. A full factorial design was performed to study linear interactions between factors and their quadratic effects and the optimal setup was evaluated by the isoresponse curves. The significant factors were enzyme concentration (linear and quadratic terms) and the interaction between enzyme concentration and Ni/Al molar ratio. Under the optimized electrodeposition conditions, the reproducibility of the biosensor fabrication was very good, being the RSD of the sensitivity about 5%.

[Evaluation of a series of serum mesothelin in patients with pleural malignant mesothelioma]. / Valutazione di dosaggi seriati di mesotelina sierica in pazienti affetti da mesotelioma maligno della pleura.

Pleural Malignant Mesothelioma (MM) is a highly aggressive neoplasm with a poor survival rate, hard diagnosis and treatment. The incidence of MM in Western Europe countries is expected to increase drammatically in the next 10-15 years. In spite of this drammatic scenario, at this time the only instruments for screening and early diagnosis are based on radiological tests with evident ethical and economical problems. For this reason, some authors are evaluating biological indicators with the significance of screening and early diagnosis markers. One of the most promising marker is serum mesothelin (SMRP). SMRP levels appeares to be significantly related to MM and its clinical (diagnostic/prognostic) usefulnes has been suggested. The purpose of this research is to show SMRP trend in relation both to the course of the disease and the response to therapies in some Epithelioid MM patients. The analysis of SMRP levels in these patients suggests that it may be a useful marker for monitoring the response to treatment. In fact, it was observed that SMRP increases in patients who did not respond to therapy, it tends to remain stable when therapies results into a clinical stabilization, while it decreases after surgical procedure and in case of clinical improvement.

[Management of latex allergy in the Pisa University Hospital: analysis of data deriving from the Registry filing both allergic patients and employees]. / Gestione dell'allergia al lattice naturale nell'Azienda Ospedaliero-Universitaria Pisana: analisi dei dati relativi alla istituzione dei registri dei pazienti e dei dipendenti allergici.

Recently, Tuscany regional government has promulgated (Regional law n. 464/07) guidelines for setting up suitable sanitary rooms for patients allergic to latex. These guidelines enforced the managers of the Tuscany Local Health Units to promote educational activities and a correct methodology for the safe management of both health workers and patients who need latex-free diagnostical and/or therapeutical procedures. An other Regional law (n.345/05) had previously enforced all the Tuscany Local Health Units managers to implement and update a Registry of every latex-allergic patients ever hospitalized in their own local facilities. Since 2002 a multi-disciplinary task force of health operators, lead by the Preventive Medicine Section, has been elaborating and implementing a plan for the safety of latex-allergic patients of the Pisa University Hospital, along with a Registry where each of these patients were recorded. Moreover, since 2005 under the responsabilities of the staff of the Preventive Medicine Section, another Registry has been implemented and updated. In this Registry all the Hospital employees who have been diagnosed a latex allergy, through the medical exams performed within the occupational medical surveillance activity, have been filed. In this study we report the results of this preventive activity both aimed at patients and heatlh operators safety.

[Experience of a centre for the study of occupational adjustment disorders referred to psychological harassment-related diseases at the workplace]. / Esperienza di un centro per lo studio dei disturbi da disadattamento lavorativo in tema di patologie mobbing correlate.

BACKGROUND: The rising awareness of psychological harassment at the workplace means that it is ever more important to collect clinical data and test tools to assess psychiatric disease connected with this phenomenon. OBJECTIVES: The aim of the study was to assess the experience gained by the centre for work maladjustment of the University Hospital of Pisa on a sample of patients, using the methods proposed by the centre at the Clinica del Lavoro "Luigi Devoto". MATERIALS AND METHODS: The patients were submitted to a diagnostic protocol consisting of work history, medical examination, psychological assessment, psychiatric examination, subjective questionnaires, mood scale and Neutest. The analysis was made in two phases in which 109 subjects were examined to check occupational stress effects in the period March 2002 - July 2004, after which 50 subjects were selected (45.9%) with the adaptation disorder and a history of adverse working conditions. RESULTS: The data gathered showed a slight predominance of workers from the public administration sector. The most representative range of duration of the psychological violence varied from 6 months to 2 years (46%). From close examination of the causes of the maladjustment disorders, structural changes in organization appeared to be the most frequent (13 cases). Among patients with positive diagnosis of disorder caused by psychological violence at the workplace, three situations were prominent: attitude to being a social outcast, behaviour to ignore proposals, and professional declassing. CONCLUSIONS: The multidisciplinary approach was culturally very stimulating and fundamental in reaching a final diagnosis of occupational disease: diagnosis of bullying at work and related disease was possible only thanks to the fact that three specialists agreed on the aetiological role of psychological harassment at the workplace. Our experience confirms that psychological harassment can cause health impairment and the most common diagnosis is maladjustment disorder.

Clinical evaluation of patients treated by resection of bone tumor in the limbs with reconstruction.

A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal apparatus is presented. A total of 8 parameters from 0 to 5 were graded with points assigned. Each parameter has a number of functional criteria to better assess the result. The highest score allowed is 100. The system was developed to permit a simpler approach for the examiner, with less time needed to provide data, and yielding data that is more objective.

Fibre-optic sensors in health care.

Biomedical fibre-optic sensors are attractive for the measurement of physical, chemical and biochemical parameters and for spectral measurements directly performed on the patient. An overview of fibre-optic sensors for in vivo monitoring is given, with particular attention paid to the advantages that these sensors are able to offer in different application fields such as cardiovascular and intensive care, angiology, gastroenterology, ophthalmology, oncology, neurology, dermatology and dentistry.

Circular-array optical-fiber probe for backscattering photon correlation spectroscopy measurements.

A miniaturized probe comprising a circular array of optical fibers coupled to a graded-index microlens has been designed for analyzing colloidal solutions by photon correlation spectroscopy (PCS). The system's suitability for PCS measurements was validated by experimental testing performed in bulk solutions and small drops of monodisperse and bimodal test colloidal solutions.

Fiber-optic sensor for simultaneous and independent measurement of vibration and temperature in electric generators.

A fiber-optic sensor designed to operate inside high-power electric plants is presented. The probe is based on a fiber-optic proximity sensor that detects the light intensity modulation induced by an elastic transducer. The nonlinear response of the optical head is exploited in an original manner to obtain the simultaneous and ndependent measurement of temperature and vibration at 100 Hz. The particular working principle provides an intrinsically lead-insensitive response.

Fiber-optic thermometric probe utilizing GRIN lenses.

A multimode optical fiber thermometer is described, which makes use of a single fiber for light guiding and a thermochromic solution as a differential absorption temperature transducer. The probe has a novel design and utilizes graded-index microlenses to achieve high coupling efficiency between fiber and transducer. Technical data of the electrooptic unit, along with the working principle of the probe are presented, and calibration tests of the thermometer are given.

Fiber optic vibration sensor for remote monitoring in high power electric machines.

A novel fiber optic vibration sensor is presented, based on the motion detection of an elastic cantilever by means of the optical triangulation technique. The sensor was designed to work at a fixed frequency of 100 Hz for applications in high power electrical plants where insulation and EM immunity requirements make fiber optic sensing the most suitable choice. The working linear range reaches a peak amplitude of 0.25 mm; resolution is 0.1 microm; accuracy is better than +/-3%; and sensitivity is 10 mV/microm. Design details and experimental results are reported.

Large core diameter fiber-optic branching coupler.

A technique based on evanescent wave coupling is used to construct branching couplers utilizing large core PCS fibers. Details of the construction technique are given along with the values of the characteristic parameters measured on two sets of couplers.