Analytical challenges in doping control: Comprehensive two-dimensional gas chromatography with time of flight mass spectrometry, a promising option.

Doping control screening based on the enhanced resolution of comprehensive two-dimensional (2D) gas chromatography hyphenated to time of flight mass spectrometer was investigated. The identification of anabolic agents (clenbuterol, norandrosterone, epimetendiol, two methyltestosterone metabolites and 3'-hydroxystanozolol) contained in a spiked urine sample (2ng/ml) was demonstrated. Special emphasis was given to 3'-hydroxystanozolol, mainly considering the difficulty in its detection. In contrast to conventional GC-MS approaches that must use single-ion monitoring, the GC x GC-TOFMS method enabled the identification of that metabolite through the deconvolution of the full mass spectrum and also resolved the co-eluted peaks of 3'-hydroxystanozolol and an endogenous component.

[Risk assessment in upper limb overload]. / Studio del sovraccarico biomeccanico dell'arto superiore attraverso l'applicazione di quattro diversi metodi di valutazione del rischio.

One of the most important factors of the work-related musculoskeletal disorders of the upper extremities (WMSDs) is the biomechanical overload. The purpose of this study is to evaluate the possibility to predict the upper limb repetitive stress, according to risk assessment procedures. In order to this aim, we gathered clinical-anamnestic data and risk assessment considerations of a cohort of workers in a car industry.

[Breathing sleep disturbances and occupational medicine: study of 20 clinical cases]. / Disturbi respiratori del sonno e medicina del lavoro: considerazioni su 20 casi clinici.

During 2004, in the Center for Sleep Disorders, a questionnaire including Epworth sleepiness scale (ES) was administered to 120 subjects; 20 male subjects of this group with elevated score (ES >14) were selected and submitted to polysomnography. Subjects, all in working age, were represented by 3 (15%) shift-workers, 9 (45%) drivers, 17 (85%) industrial workers (among those 5 building workers) and 3 (15%) employers. By polysomnography, moderatelsevere OSAHS was diagnosed in all subjects (40% moderate, 60% severe). CPAP (Continuous Positive Airway Pressure) therapy led to an improvement of clinical symptoms since the first month. Counselling of Occupational Medicine Physician with the Center for Sleep Disorders, was useful to direct the action of Competent Doctor, especially for jobs requiring high vigilance (drivers or shift-worker). The pass certificate for jobs with an high risk (alone, in high places, heavy means drivers) cannot avoid to evaluate this pathology, that is often associated to other related risk factors (obesity, hypertension, diabetes), because it compromises both the specific suitability and the protection of common health and safety.

Reconstrucción mamaria: injerto autólogo del complejo areola pezón / Breast reconstruction: nipple areola complex utologous graft

Presentar la experiencia en la utilización del injerto autólogo del complejo areola-pezón en la cirugía reconstructiva de la mama. Se analizan retrospectivamente las pacientes con cáncer de mama ingresadas para tratamiento quirúrgico en el Servicio de Cirugía II, del Hospital Central de Maracay, entre abril 1986 y abril 2001. Sólo 20 pacientes de un total de 178 (11,2 por ciento) fueron sometidas a variados procedimientos de reconstrucción y donde el complejo areola pezón fue retirado y luego utilizado como injerto. Pasos de la técnica son presentados señalando aspectos relacionados con la selección. La edad promedio fue de 41 años (24-58 años). Utilizando distintas técnicas de reconstrucción mamaria, doce de ellos con cirugía radical preservadora de piel, cuatro con técnica periareolar y ocho con trazado de mastopexia. A todo este grupo se le colocó prótesis subpectoral; tres casos reconstruidas con TRAM Flap, las cinco restantes con latissimus dorsi con adición de prótesis en cuatro de ellos. Ocho casos (40 por ciento), venían de recibir quimioterapia de inducción. El injerto autólogo de areola y pezón fue utilizado en todos los casos. Hubo epidermolisis e infección con pérdida de injerto en un caso, en otro, pérdida parcial, requiriendo ser reconstruidos en forma diferida con injerto de piel de zona pigmentada. La enorme ventaja y el impacto psicológico de una reconstrucción inmediata es evidente. El complejo areola-pezón utilizado como injerto, ofrece una alternativa válida y segura, sin riesgo de recidiva dando un aspecto más natural