Evaluation of obesity in healthcare workers.

BACKGROUND: Obesity is an international social problem. OBJECTIVES: This study was aimed at evaluating the relationship of overweight and obesity with social dynamics and correlated biological indicators. SUBJECTS AND METHODS: The study was carried out on a group of healthcare workers employed in a large hospital in the province of Messina (Sicily, Italy). A total of 1010 subjects (377 men and 633 women) aged between 16 and 64 years, living in the province of Messina since birth. The educational level, BMI (Body mass index), arterial blood pressure and ECG of each subject was examined. RESULTS: The results showed that 52% of the men and 66.5% of the women were of normal weight, while the men showed greater susceptibility to overweight (M 33.2% > F 16%). Obesity was found in both sexes (M 13.3%, F 13.6%). Moreover, it was observed that arterial blood pressure tends to increase with age and body weight, and that the incidence of overweight falls as educational level rises. CONCLUSIONS: The study supports the hypothesis that there is a growing incidence of overweight and obesity in subjects of working age employed in the healthcare sector.

Ageing, hormonal behaviour and cyclin D1 in ductal breast carcinomas.

Owing to the gradual modification of breast tissue in postmenopausal women, there can be differential effects on local oestrogen receptor (ER) expression, with potential impingement on the biological behaviour of cancer cells in the ageing. A series of 45 ductal carcinoma (DC) cases were selected in postmenopausal women who were not being treated with HRT. Immunohistochemical analyses were performed for hormone receptors and Ki67 expression. Fluorescence in situ hybridisation (FISH) analysis was carried out to study CCND1 amplification. The selected population was subdivided into three groups by age and was subjected to statistical studies: linear model analysis, estimation of relative incidence (RI), multivariate analysis, and nonparametric tests were performed to investigate whether there were any links between age and molecular variables in DCs. The results show a low rate of proliferation and high ER expression in the oldest age group. In the same group a close correlation was found between high ER expression and CCN in the older age group D1 amplification (P=0.000), as was a more advanced phenotype in terms of tumour size and presence of positive lymph nodes than in the other age groups considered. The results suggest that ductal breast cancer has a favourable molecular prognosis, especially in extreme old age. In particular, there is an inverse correlation between ageing and proliferation rate despite the presence of an accentuated proliferation stimulus (high ER with CCD1 amplifications) in the oldest group relative to the other groups considered.

[Epidemiology and risk factors in osteoarthritis: literature review data from "OASIS" study]. / Epidemiologia e fattori di rischio dell'osteoartrosi: review della letteratura e dati dal progetto OASIS.

Ostheoarthritis (OA) is a social disease characterized by pain, inflammation and stiffness due to an involvement of articular cartilage, soft tissues and bone. OA is the most common rheumatic disease, every age can be affected but prevalence increases dramatically with age with a greater incidence in subjects between 40 and 50 years of age. Hip OA has an important correlation with weight, genetic factors, sex, previous traumas, occupational factors and age. People older than 35 have a prevalence of hip OA of 10.8% that becomes 35.4% in people older than 85. Knee OA has a great correlation with weight ,life style and physical activity. An Italian study demonstrated that the prevalence of this kind of OA is highest in subjects older than 65 that becomes 44% in people older than 80. In this report we explain the results of a study conducted in the South of Italy called the OstheoArtrithis Southern Italy Study (OASIS) that involved 456 doctors and 1782 patients of three different regions. The mean age of these patients was 66.3 years and we evaluated prevalence of hip, knee, hand and spine OA and correlated it to sex, age, weight and BMI. We also evaluated what kind of drugs were used for these patients. Knee OA is the most common subset of OA, the one that requires the highest number of examinations and the one that causes the greatest disability. The most common used drugs are Fans and Coxibs. Condroprotectors were not used much, probably because they are not considered to be very effective.

Affective correlates of occupational exposure to whole-body vibration. A case-control study.

BACKGROUND: Exposure to whole-body vibrations (WBV) represents a highly diffuse occupational risk. Some studies report that chronic exposure to WBV induces a significant increment in the modifications of the cognitive and emotional area. The aim of this study was to investigate the long-term effects of WBV exposure on the neuropsychic and behavioural system. METHODS: The study population consisted of 137 male subjects, mean age 45.7 years, working as drivers of mechanical trolleys and occupationally exposed to WBV of a frequency below 2 m/s2. The Profile of Mood States was administered to all subjects in a maximum time of 10 min and in the same operative conditions. The results were compared with those of a homogeneous control group by means of an innovative statistical technique. RESULTS: The results show a significant difference in the response to the neurobehavioural test. The exposed group showed, in fact, a higher score compared with the controls for all 6 factors. In particular, the scores for factors F (fatigue-inertia), D (depression-dejection) and T (tension-anxiety) were more elevated, expressing a significant alteration of the psycho-affective status. Moreover, statistical analysis showed a correlation between exposure time and the score obtained for all factors in the exposed group. CONCLUSION: This study indicates that occupational exposure to WBV is associated with alterations of mood status and that these modifications are directly proportional to exposure time. Furthermore, our results show that psychological tests commonly used in psychopathologic diagnostics can be useful in monitoring alterations of psycho-emotional status determined by physical stressors.

Factors influencing pain, physical function and social functioning in patients with osteoarthritis in southern Italy.

The aim of this study was to assess factors influencing bodily pain (BP), physical function (PF) and social functioning (SF) in patients with osteoarthritis (OA) from southern Italy A total of 1,782 patients (mean age 66.08 years, 570 men and 1,212 women) with knee, hip, spine or hand OA underwent a structured assessment comprising demographic data and the Short Form 36 (SF-36) BP, PF and SF scales. Separate multiple linear regression models were employed for statistical analysis. The mean disease duration was 9.18 years and the mean body mass index (BMI) was 27.06. The mean BP, PF and SF scores of 34.93 (SD 19.37), 63.58 (SD 26.53) and 47.89 (SD 21.83) for the study subjects were substantially lower than those expected for the general Italian population. Subjects who were younger with a shorter disease duration and lower BMI had better PF and SF Younger subjects with a lower BMI and a longer disease duration had less BP. Female sex was associated with more BP, worse SF and better PF. In conclusion, demographic and disease-related factors influence BP, PF and SF in southern Italian patients with OA.

A comparative study: TTS Vs wave V after exposure to noise.

The pattern of recovery from noise exposure was monitored, with regards to the behaviour and electrophysiology in 25 normal-hearing subjects, at 4 KHz frequency for 30 min. Fatiguing stimulus was an octave band noise with centre frequency of 3 KHz. Subject's behaviour following to the auditory fatigue was studied by temporary threshold shift (TTS) paradigm. In the electrophysiological study, the auditory fatigue was measured as a shift of the wave V latency in the auditory brainstem responses (ABR) after noise exposure. This shift was measured at 40 dB nHL stimulus intensity ("Logon" with centre frequency at 4 KHz). The ABR recordings started immediately after cessation of noise exposure and threshold measurements 2 min later. The recovery of latency shift began immediately after the exposure and ended faster than the auditory threshold. From a practical point of view it means that in order to measure maximal values of latency shift, the ABR recordings should be performed immediately after cessation of noise exposure.

Effects of noise on functional cardiovascular parameters: a follow-up study.

The aim of this follow-up design study is to give a contribution to the knowledge of the controversial relations between noise and functional cardiovascular parameters. The study population consisted of 757 male employees working for 5 different firms in the oil chemical area (refining and distribution of fuel) with different qualifications--345 workers, 212 drivers, 200 clerks--and thus exposed to 3 different levels of noise (85-90 dBA, 80-85 dBA and < 80 dBA respectively). Heart rate, systolic and diastolic blood pressure were monitored 3 days a week at the beginning of the working shift, for a period of 12 years. The analysis of the data obtained indicates that all the 3 parameters under observation tend to increase progressively with the age and working age of the subjects. In the comparison between the 3 levels of exposure, heart rate results not affected by the exposure to noise; systolic blood pressure results sensitive only for the discrimination of the effects due to exposure, showing a statistically significant difference only between clerks on one side and workers and drivers on the other; diastolic blood pressure is highly influenced by the level of exposure to noise, showing significantly different slopes for the 3 groups. In conclusion, blood pressure is a parameter definitely more reliable for the correlation to the level of exposure, while heart rate cannot be considered a marker of exposure to noise.

Neurobehavioral evaluation in humans exposed to hydrocarbons: a new statistical approach.

BACKGROUND: Epidemiological researches showed a significant increase in the alterations of the cognitive and emotional sphere in subjects exposed to hydrocarbons. This paper deals with a study carried out on a group of male workers between the ages of 35 and 40, who had been working as external workers in a large refinery. METHODS: All the subjects worked in short shift rotation and were exposed to hydrocarbons during the loading of tank trucks. The response data reported by this investigation are compared to data of different male subjects who had also been working at the refinery for the same period of time, but as administrative day workers, and were certainly not exposed to the hydrocarbons. The nonparametric statistical analysis was carried out by a new nonparametric approach based on multivariate permutation tests. RESULTS: Results show a significant difference in the response to neurobehavioral tests. The exposed group showed behavioral tendencies towards anxiety and depression that the nonexposed group did not. CONCLUSIONS: The study shows that occupational exposure to hydrocarbons is associated with neurobehavioral modifications, and that the use of psychometric tests can be useful for monitoring the psychosomatic consequences by exposure to hydrocarbon microdoses.

Is there a group of early surgery aneurysmal SAH patients who can expect to achieve a complete long-term neuropsychological recovery?

There is a significant controversy regarding the effect of early surgical intervention for microsurgical aneurysm clipping on long-term cognitive recovery. Although new strategies in surgical and medical management have progressively reduced the morbidity and mortality rates related to subarachnoid haemorrhage (SAH), the overall quality of life of aneurysm patients has been reported to remain unsatisfactory. In fact, even in the presence of a good neurological recovery following an aneurysmal SAH, patients may show persistent emotional and psychological disturbances. The aim of this study was to analyse the long-term cognitive, neuropsychological and emotional status of a group of patients, subjected to early surgery aneurysm treatment, and having SAH characteristics generally considered predictive of a favourable outcome. Patients were submitted to a complete battery of neuropsychological tests designed to assess a full range of cognitive and attentional functions. The results of the neuropsychological evaluation did not detect evidence of any significant cognitive deterioration as compared to control volunteers and to the published age-adjusted test norms. These results indicate that early aneurysm surgery, coupled with modern microneurosurgical techniques and aggressive medical management is associated with a good neurological outcome and a full recovery of cognitive, neuropsychological and emotional performances in a subset of patients with favourable clinical characteristics.

Neurotoxicity induced by lead levels: an electrophysiological study.

The object of the present study was to evaluate, with the aid of visual evoked potentials (VEPs), modifications induced in the optic nerve by lead, and to investigate the relationship between blood lead levels (PbB) and modification of the VEP. We studied a sample of 300 men with PbB values between 17 and 60 micrograms/100 ml. Our study demonstrates that alterations in the latency of the VEP are dependent on PbB levels, though there is not a directly proportional relationship.

Neurotoxicity induced by exposure to toluene. An electrophysiologic study.

The object of the present study was to evaluate, with the aid of electrophysiologic techniques, the alterations induced in the auditory nervous system by exposure to toluene in a group of rotogravure workers. From 300 workers who were apparently in good health but were professionally exposed to toluene, we selected a sample of 40 workers of normal hearing ability. They were examined with an adaptation test studied by the brainstem auditory evoked potential technique with 11 and 90 stimulus repetitions a second. The results were compared with those in a group of workers of the same age but not professionally exposed to solvents. Our study demonstrates that exposure to toluene is able to induce a statistically significant alteration in the electric responses with both 11 and 90 stimuli repetitions. This alteration can be explained as a toluene exposure-induced modification, of physiologic stimulus conduction mechanisms, even in the absence of any clinical sign of neuropathy. Furthermore, such a modification could be observed in the electric responses of the entire auditory system, from peripheral receptors to brainstem nuclei.

[An analysis of the circadian frequency in the onset of acute myocardial infarct]. / Analisi della frequenza oraria dell'insorgenza dell'infarto miocardico acuto.

The purpose of this study was to evaluate if the occurrence of acute myocardial infarction (AMI) follows a regular pattern during the day and, if so, to assess any difference according to sex and patients' age. To determine 24-hour trend of AMI onset, clinical recordings of patients admitted to the CCU for AMI over a period of 8 years were reviewed: 427 patients (310 men and 117 women, aged 24-95 years), with a first AMI and in whom the time of onset of cardiac pain due to MI could be accurately established by history, were selected. Analysis of hourly distribution of the event was performed using a mathematical model based on Whittaker's method for periodic phenomena. It showed the occurrence is cyclic with 2 waves with periods of 6 and 12 hours in all age groups in men an women. No statistical differences were found between observed figures of periods and values calculated by Fourier analysis. The overall occurrence of MI showed a regular pattern with 4 peaks at 4.00 am, 10.00 am, 4.00 am and 10.00 pm. This periodic behaviour is nearly the same both in men and in women. The occurrence of MI is maximal in the morning (34.2% in men, and 35.9% in women); the minimum was recorded during the evening in male patients over 70 years and during the night in the other age groups; it was recorded during the afternoon and the night in women.(ABSTRACT TRUNCATED AT 250 WORDS)

[Water quality and microbiological status of the distribution system: traditional parameters and emerging parameters]. / Qualità dell'acqua e stato microbiologico alla distribuzione: parametri tradizionali e parametri emergenti.

Most pollution of drinking water is caused by inadequacy of the uptake and distribution systems, by insufficient upkeep of the sewage system and by defects or breaks in the disinfection processes. This may be the cause of waterborne epidemic outbreaks and therefore it is necessary carry out routine controls by simple and rapid tests for the detection of intestinal organisms. In the light of minor hepatitis A epidemics occurred in the town of Messina, we have carried out a study to determine the drinking water quality. To this end, in addition to the traditional tests recommended by CEE and required by the 8/2/1985 DPCM (37 degrees C and 20 degrees C viable count, total and faecal coliforms and faecal streptococci), we have carried out P. aeruginosa, coliphages and gram-negative endotoxins tests, in 74 water samples drawn on way in and way out of the tanks and along the piping system. Only 12.5% of the sixteen water samples drawn on way in (before disinfection system) was in compliance with the law. 75% of these samples showed positivity for faecal streptococci. The water quality was lower in the fourteen water samples drawn on way out of the tanks (7.1% was in compliance with the law). The percent of positivity along the piping system for total and faecal coliforms and for faecal streptococci was 34.1, 15.9 and 59.1 respectively. Coliphages were always absent. P. aeruginosa was almost always present in way in water (93.7%). Moreover this microorganism was recovered in 85.7% of the samples drawn on the way out and in 77.3% along the piping system. In the same drawing places endotoxins were present at high percentage (100%, 85.7% and 90.9%). These values come from high test sensitivity and poor water quality. Finally we have pointed out the importance of all the parameters examined. The significance of coliform bacteria is known, but we consider very important, as organisms indicative of pollution, the enterococci, since they P. aeruginosa may survive long time in fresh water though it is not autoctone, but, in general, of faecal origin. Several soluble antigens of this microorganism as well as enterococci show positive LAL tests (1-5-6). The endotoxin content in fresh water reflects the degree of bacterial contamination. We believe, therefore, it is needed to fix an upper limit to endotoxins in drinking water. Coliphages concentrations could be correlated with enteric virus concentrations but the ratio of coliforms to coliphages is about 100:1. Therefore this indicator of viral pollution is helpful only for highly polluted surface waters.

[Study of seminal fluid. Critical evaluation of various laboratory parameters]. / L'esame del liquido seminale. Valutazione critica dei vari parametri di laboratorio.

The various humoral and morphological parameters on which examination of seminal fluid is based are considered. Two groups of causes that may modify normal fertility are pointed out: one concerns functional changes of the gonad and/or of the accessory glands, the other the ejaculatory phase and specifically the modalities for collecting the ejaculte. In this regard, stress is laid on how the first fraction of split ejaculate not only possesses biochemical characteristics different to those of the second fraction, but also presents a much higher sperm concentration and, hence, greater fertilizing capacity. It is therefore clear that separate examination of the two fractions may point to states of "latent" subfertility which global examination cannot spot.