Biochemical and haemodynamic indicators of stress in truck drivers.

In order to investigate the extent of stress reaction during driving, this study was carried out on truck drivers engaged in long distance work. For each driver, epinephrine, norepinephrine, and cortisol were measured in urine, and dynamic ECG and blood pressure were monitored. The excretion rates of catecholamines showed great individual differences in the size of variations related to driving conditions. Epinephrine excretion rates were particularly high when weather and traffic conditions were more stressful. A relationship was found between epinephrine urinary levels and state-anxiety scores. Urinary excretion of norepinephrine was generally increased at the end of the working day and while driving in fog. The pattern of cortisol was not affected by the stress related to driving. The highest mean heart rates were monitored during difficult traffic and bad weather conditions.

[Appendectomy without inversion of the stump. A valid alternative. Our experience in 690 cases]. / L'appendicectomia senza affondamento del moncone. Una valida alternativa. Nostra esperienza su 690 casi.

The paper reports the Authors' ten year experience on simple ligation in appendicectomy. After having reviewed the various surgical procedures, the Authors report their clinical experience and, considering the good postoperative results with this method, regard this procedure as an alternative to the technique of ligation with inversion of the stump in appendicectomy.

Liver iron overload and desferrioxamine treatment of porphyria cutanea tarda.

The aim of this paper is to evaluate invasive and non-invasive indices of iron store and compare the effectiveness of different ferrodepletive protocols in 150 patients with porphyria cutanea tarda (PCT). Iron removal was performed either by intensive phlebotomy (22 cases) or slow subcutaneous and high intravenous doses of desferrioxamine (18 and 5 cases, respectively), and several laboratory parameters were studied; among these, oligo-elements and urinary porphyrins (detected by HPLC) were taken into account before and after the treatments. Serum iron, transferrin saturation, ferritin (RIA) and nuclear magnetic resonance results were compared with invasive findings in order to detect the metal deposition in liver tissue (atomic absorption concentration, optic or electron-microscopic detection). Liver iron overload was observed in 95% of cases. Full normalization of the disease took place by all the treatments, even if it required slightly more time in the phlebotomy group. We may conclude that ferrodepletive treatments are highly effective in PCT and, considering the fact that siderosis and liver damage always accompany the disease, these treatments are proposed as first choice in such cases.