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Biomedical subjects

G Costa

Publications and source records attributed to G Costa.

At least 415 records · Page 23Linked to original sources
PubMedDate not supplied

Mortality of a cohort of road construction and maintenance workers with work disability compensation.

BACKGROUND: Surveillance systems of occupational mortality are useful tools to identify cases of diseases suspected as occupational and to monitor their occurrence over time, in space and in population subgroups. Many surveillance systems make use of administrative data in which information about occupations and/or economic sectors of the subjects enrolled is reported, such as death certificates, hospital discharge data, census data, tax and pension records, and workers' compensation archives. OBJECTIVES: In the present study we analyzed the mortality of a cohort of road construction and maintenance workers enrolled through the Italian national archive of work disability compensations, also in order to evaluate the possible use of this administrative source to monitor occupational mortality. METHODS: 8,000 subjects (7,879 males) receiving a disability compensation while working in the "road construction and maintenance" sector were identified from INAIL (National Institute for Insurance of Accidents at Work) archives. Vital status of these subjects was ascertained using the information available in INAIL archives and in the national tax register. For those found to be deceased from INAIL or tax archives, or without any information on vital status, a mail follow-up was started. We considered as observation period the years from 1980 to 1993. A record linkage with the ISTAT (Italian Institute of Statistics) national mortality registry was performed and the cause of death was retrieved for 964 out of 1,259 subjects. The analysis was restricted to males, leaving altogether 863 observed deaths with ascertained cause (84.7% of 1,019 total male deaths). SMR for overall mortality and PMR for specific cause mortality were computed, using the general Italian male population as reference. RESULTS: Overall mortality was significantly reduced (SMR = 79.0; 95% CI = 74.2-84.0). Proportional mortality analysis revealed significant excess risks for all malignant tumours (332 deaths, PMR = 1.08) and for digestive diseases (87 deaths, PMR = 1.34), while mortality for cardiovascular diseases was significantly decreased (288 deaths, PMR = 0.90). Among specific causes of death, significant excess mortality was found for cancer of testicles (2 deaths, PMR = 5.98), liver and biliary ducts (32 deaths, PMR = 1.40), and for silicosis (10 deaths, PMR = 3.07) and cirrhosis (64 deaths, PMR = 1.40). CONCLUSIONS: The excess mortality observed for all cancers, digestive diseases and silicosis, and the decreased risk for cardiovascular diseases are in agreement with the results of other studies conducted on workers in road construction and maintenance. As expected, the low overall mortality and the reduced risk from cardiovascular diseases indicate that these workers present a strong "healthy worker effect".

Cause of Death↗
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[Work schedule and accidents among subjects digging tunnels for the new high speed railway network in Toscana].

We analysed the temporal distribution of all the accidents occurred in the last 4 years among the workers engaged in tunnel digging for the new high speed railway network. The frequency and severity rates show significant differences according to work shifts and time of occurrence, with particular reference to hour of the day, hour of duty, day of the week, day of duty, and month of the year).

Accidents, Occupational↗
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[Cardiopathy and stress-inducing factors].

BACKGROUND: There is wide consensus on the association between work stress and cardiovascular disease, ischaemic heart disease and hypertension in particular, both from the clinical and epidemiological point of view. OBJECTIVES: The aim of this article was to review the most recent data on these topics found in the international literature on occupational health and cardiology. METHODS: A literature review was performed. RESULTS AND CONCLUSION: The relationship between stress and cardiovascular diseases is mediated by several direct and indirect mechanisms and is related not only to high cognitive and emotional stress but especially to poor coping strategies, which are strongly influenced by lack of control over working conditions and lack of social support. This entails high costs both for the individual and society, not only in terms of workers' health and well-being, but also as regards work ability and performance efficiency, with negative consequences on production and services. Some working activities, where public health is also at stake (such as train, bus and lorry drivers, air pilots and traffic controllers), deserve special attention, due to the well-documented prevalence of job-related cardiovascular disease.

Adaptation, Psychological↗
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[Flexibility of working hours and health: towards ergonomics of working time].

The search for ways and methods able to increase the "flexibility" of working hours deal with several forms of intervention that depend on political choices and work management, according to specific interests and needs of the companies, the individual worker and the whole society. The main problem on the carpet is to evaluate whether that interferes with worker's health and well-being. According to the data of the last European Survey on Working Conditions (EURF 2000), it appears the workers engaged in working hours different from the traditional day work are nowadays the vast majority of the population; moreover, organisational forms which allow more flexibility, that is more autonomy, in working time arrangement are associate to better health and well-being.

Data Interpretation, Statistical↗
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Flexibility of working hours in the 24-hour society.

The 24-hour Society undergoes an ineluctable process towards a social organisation where time constraints are no more restricting human life. The borders between working and social times are no more fixed and rigidly determined, and the value of working time changes according to the different economic and social effects you may consider. Shift and night work, irregular and flexible working hours, together with new technologies, are the milestone of this epochal passage. What are the advantages and disadvantages for the individual, the companies, and the society? What is the cost/benefit ratio in terms of health and social well-being? Coping properly with this process means avoiding a passive acceptance of it with consequent maladjustments at both individual and social level, but adopting effective preventive and compensative strategies aimed at building up a more sustainable society. Flexible working times now appear to be one of the best ways to cope with the demands of the modern life, but there are different points of view about labour and temporal 'flexibility" between employers and employees. For the former it means a prompt adaptation to market demands and technological innovations; for the latter it is a way to improve working and social life, by decreasing work constraints and increasing control and autonomy. Although it can be easily speculated that individual-based 'flexibility" should improve health and well-being, and especially satisfaction, whereas company-based flexibility" might interfere negatively, the effective consequences on health and well-being have still to be analysed properly.

Adult↗
PubMedDate not supplied

Occupational stress: risk assessment and fitness for work.

The multidimensional and multifaceted aspects of the problem render the role and activity of the Occupational Health Physician (OHP) extremely complex and delicate, as both appraisal and implications cover a number of different domains (psychology, physiology, sociology, economy, work organisation and law), both in terms of risk assessment and stress evaluation, at collective and individual level. In this context, it is not only important to quantify the "external" work load, but mainly the individual "response", which in most cases is the crucial factor of the imbalance. that is, risk assessment has to be made more in "relative" terms rather than according to "absolute" criteria, and not only from the perspective of medical surveillance, but above all from that of risk prevention. When a health disability potentially connected to stress has to be assessed, there are three steps: a) stress exposure must be clearly assessed, both directly and indirectly; b) disease must be clearly identified; c) the biological plausibility of the relationship between stress and disease must be carefully checked, taking into account that stress disorders are typically psychosomatic and multi-causal. Consequently, cooperation with a psychologist and an accurate psycho-diagnostic approach are necessary, as well as consultation with other specialists and pertinent laboratory and instrumental tests.

Disability Evaluation↗
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[An integrated course in occupational medicine. A proposed teaching program based on the new organization of the degree course in medicine and surgery].

The curriculum of Italian Medical School of the Faculty of Medicine has been recently renewed at a national level. Considering the numerous innovations introduced, a new role has been attributed to the teaching of occupational health, particularly occupational medicine. Occupational Medicine is usually regarded as a part of community medicine and, despite the fact that occupational disease may be in decline in industrially developed countries, the increasing concern regarding environmental pollution related health effects, stress the relevance of the methodologies already formulated within the occupational health disciplines. Of all environmental factors, occupational medicine has contributed largely to the knowledge about the health effects of occupation and its role in the complex problem at work related to today's medical students as a way of introducing the appreciation of worldwide environmental effects and how to measure, monitor and modify them. In this article the content of the occupational health course is revised and according to the principles of modern medical pedagogy, the teaching is divided in primary and secondary objectives and organized to the resolution of real problems. The importance of the relevant evidences of clinical occupational medicine is discussed and their insertion into other clinical disciplines is proposed. The knowledge of distribution, recognition, management and prevention of the major occupational diseases is a final target of the teaching. The introduction of innovative teaching methods such as factory visits, case history discussion or role playing exercises is suggested as an integrated, multidisciplinary approach able to promote the preventive attitude of students. The efficacy of the teaching has to be evaluated with appropriate methods every time, to verify both informative and formative aspects.

Curriculum↗
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[Pancreatic pseudocysts: the surgical timing].

Forty-three cases of pancreatic pseudocysts (PPC) are reviewed. Various emergency and elective surgical therapeutical options have been employed: while external drainage has confirmed to represent the best procedure in emergency occurrences, cystojejunostomy has proved to be the treatment that better provides both optimal functional results and minimal mortality/morbidity in elective situations. Our study also confirms that the thickness of the pseudocystic wall is the only feature apt to determine whether or not a PPC is susceptible of internal surgical derivation, and that abdominal ultrasound scanning is the most sensitive and reliable diagnostic method to ascertain this prerequisite, thus providing a well-timed strategy for elective derivative operations.

Adult↗
PubMedDate not supplied

[Anatomopathologic and clinical correlations of squamous carcinoma of the larynx and the hypopharynx].

The most important problem in the diagnosis of neoplastic diseases is not only to identify its malignant nature but also the degree of aggressiveness since differences in prognosis and therapy exist in cancer as well. A short review of the literature regarding correlations between histologic degree of carcinoma and prognosis is presented. A total of 105 laryngectomy samples are presented taken by bilateral neck dissection following the principles employed for laryngeal or hypopharyngeal carcinoma. Reference is made to the following parameters: extension and site of primitive tumor; cellular (WHO), nuclear (Black) and structural (Carlon) gradings; histologic host response as judged by the presence and degree of lymphoid infiltration and fibrous stromal reactions around the primary tumor. Host response was related to structural grading. Regional nodes were studied for metastases. Nodal metastases were related to cellular, nuclear and structural grading. Clinical and statistical analysis proved that Carlon's grading, based on structural organization of the tumor, seen as a manifestation of its cellular cohesiveness, is a more discriminating system of malignancy than the others. The most organoid growth patterns (Structural grades 1 and 2) did not present any node metastases. They can be regarded as manifestations of "low grade malignancy tumors". The least organoid and non organoid growth patterns (Structural grades 3 and 4) showed higher levels of node metastases (Grade 3: 35.2%; Grade 4: 58%; p = 0.01). Necrosis was found only in Grades 3 and 4 and was associated with node metastases in 70%. Structural grading could be the guideline to better management of laryngeal carcinoma in terms of choice of surgical treatment (type of laryngectomy; neck dissection).

Aged↗
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[Shift-work and housekeeping interference].

In Italy, within the last ten years, an increasing number of women have been involved on shift and night-work not only in the tertiary sector, but also in the industrial one. This has been made possible by the promulgation of Law 903/1977, concerning parity in treatment of both men and women in questions of employment. The work agreements for women night-work have gradually increased over the period 1980-1986 passing from 194 in 1980 to 357 in 1986, with approximately 10000 more women involved each year. The sectors mostly involved in these last years have been the textile, food and mechanical ones. The present study reports the major problems complained by the women shiftworkers as concerns their difficulties in family and social life, and refers the case of a group of women abruptly introduced to night work in a food industry, where they had been previously engaged only on day-work for many years. During the first year of night-work the absenteeism among this group tripled (29.8 days per year on average) with respect to the previous years. The impact on shift and night-work appeared to have been the most disruptive of the whole condition of this group of women, with negative effects on their personal, family and working life. High absenteeism, increasing psychosomatic complaints, worsening of the subjective health status, sleep disturbances, difficulties in family relationships were the main consequences. The women with heavier family commitments, namely those married with children, showed the worst effects.

Adult↗
PubMedDate not supplied

Effects of cannabis resin on learning by repetition in the rat.

Studies were made of the effects of cannabis resin in differing doses on a type of learning by repetition, using the water-filled maze technique, and on the conditioned avoidance reflex in the rat. When administered at a dose corresponding to 0.5 mg of delta9-THC per kg, the resin led to improved learning in both the types of test employed; opposite effects were observed with the higher dose (corresponding to 5 mg of delta9-THC per kg). These effects are probably attributable to complex reciprocal action between the active constituents of the resin, particularly THC, and the metabolisms of the cerebral monoamines and c-AMP.

Animals↗
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The influence of cannabis on glucoregulation.

The effects of the administration of cannabis resin in different doses on haematic glucose levels, on plasmic IRI and on the amount of ammonia in the blood have been studied in dogs which had not been fed or had been fed intravenously with glucose. The results show that such resin leads to an increase in haematic glucose, accompanied by a reduction in plasmic IRI and an increase in ammonia levels. In addition, a decrease is observed in the tolerance of glucose administered intravenously.

Ammonia↗
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[Syndactylia associated with multiple malformation syndromes. Observation of a new symptomatologic complex in 3 brothers].

Hand and feet malformations are often part of complex malformation associations. The present paper reports on a family whose three sibs (two males and one female) are affected with symmetric soft tissue syndactyly involving both fingers and toes, fifth finger clinodactyly, a pattern of dysmorphism including down slanting palpebral fissures, long flat nasal saddle, out turned nostril openings ("Greek warrior helmet"-like profile), dysplastic teeth, and, in addition, severe growth retardation, microcephaly, severe mental deficiency with immaturity of cerebral activity of EEG, hypergonadotropic hypogonadism and some skeletal anomalies. All cases show large secondary constriction in one of the chromosome 1 pair (1qh+).

Abnormalities, Multiple↗