[Work-related musculoskeletal diseases: experience of INAIL of the Apulia region 1998-2001]. / Patologie muscolo-scheletriche di origine professionale: esperienze INAIL della regione Puglia 1998-2001.

The insurance recognition of Work related Muscolo Skeletal Disorders (WMSDs) has been introduced in Italy by the sentences of Constitutional Court n. 179/1988 and 208/1988. Afterwards the National Insurance Institute against work injuries (INAIL) tried to make homogeneous, in the different INAIL regional Departments, the diagnostic protocol of the work related illness associated with repetitive manual activities. Since 1998, indeed, a clinical diagnostic protocol has been used in the different departments. This report describes the Work related Muscolo Skeletal Disorders submitted to the Apulian INAIL Regional Direction in the period 1998-2001. Among 84 cases of disease reported to the Regional Direction, 21 were recognised as professional illness, the most part of which in workers employed in services sector and mining activities. The most represented disease was carpal tunnel syndrome and it was more recurrent in men than in women, in which the first symptoms were earlier than in men. The most represented risk factor, both in reported and in recognised cases, was the presence of repetitive working movements of the upper extremities, or the combination of the previous one with other risk factors such as high frequency of working activities, postural risk, strength demand, vibrations, climatic conditions. The development of specific diagnostic criteria, the detailed job analysis and the use of specific questionnaires seem to be the main elements for the WMSDs diagnosis and for the recognition of their professional etiology.

[Analysis of occupational injuries using the new database developed for prevention in the workplace]. / L'analisi degli infortuni sul lavoro attraverso "i nuovi flussi" informativi per la prevenzione nei luoghi di lavoro.

In Italy occupational injuries still represent a serious medical, social, and economic issue in spite of the improvement in working conditions, and an improved attention to occupational safety from both legislators and employers. In Apulia we have evaluated the new data record by INAIL (National Institute for Insurance against Occupational Injuries) reporting the occupational injuries occurred in 2000 and compensated within the following year. The new data record represents a remarkable improvement, from the epidemiological point of view, compared to the old one. However, the statistical analysis is still not completely comparable to the international epidemiological indicators. Nevertheless, the coming data base will contain the first data codified in conformity with the new European recording system "ESAW/3" adopted by INAIL since January 1st 2002.

[Gastric localization of sarcoidosis]. / Localizzazioni gastriche in corso di sarcoidosi.

Sarcoidosis is a systemic granulomatous disease of unknown etiology, characterized by an immunological disorder with accumulation of activated lymphocytes and macrophages in all the organs and apparatus. The intrathoracic lymphnodes and the lung remain the most common sites of such disease. The gastrointestinal sarcoidosis, particularly of the stomach, is very rare. The stomach may be the primitive or the secondary (systemic sarcoidosis) site of sarcoid granuloma. The endoscopic aspects of the gastric mucosa are variable: localized or diffused hyperemia, single or multiple ulcers, aspects of atrophic gastritis with easy bleeding during contact, rigid mucosa and so on. Generally asymptomatic, the disease may show symptoms as pain in the epigastrium, nausea, vomiting, haematemesis and so on. The wide range of gastric pathologies resembling sarcoidosis both on a histological level and on a clinic-endoscopical one (syphilis, histoplasmosis, Crohn's disease, stomach cancer) require an extremely accurate diagnosis above all for the setting out of the therapy with steroids which are the most appropriate drugs (prednisone). Three out of thirty-two patients observed for respiratory problems, already affected by cutaneous and pulmonary sarcoidosis, started suffering from gastric symptoms of different kind: pain in the epigastrium, haematemesis, weight loss, nausea and post-prandial vomiting. Gastroscopy and biopsy, with histopathologic examination of gastric mucosal specimens taken from the most suspicious sites, confirmed the diagnosis of sarcoidosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Improved diagnostic procedures in allergic RAST negative rhinitis.

Patients affected by cutinegative, RAST negative, chronic hyperreactive rhinitis showed in 15/28 cases positive intradermal tests, nasal provocation test and RAST on nasal fluids. In 13/28 cases high IgE on nasal samples could be observed and seldom were the intradermal tests positive, but in no case were the nasal provocation or nasal RAST positive. Delayed and late positive provocation tests showed different features from early reactions. Criteria of positivity and checks during provocation tests look critical. The occurrence of sinusitis and polyposis can change clinical features. Mediators released from tissues lead to bronchial hyperreactivity.

Airway hyperreactivity and menstrual cycle in asthmatic patients.

Healthy women and infertile asthmatic patients do not show any change in IgE, circulating eosinophils, sensitivity to metacholine, lung volumes. Allergic asthmatic patients tested in periods without allergen load and drug intake showed contrasting cycle related changes in aspecific hyperreactivity. Such changes are not directly related to hormonal levels. Circulating mediators are likely to explain observed pathways.