We present our experiences on 86 patients with acute arterial thrombosis of the legs, undergoing a fibrinolytic treatment with urokinase. Results from the treatment are analyzed according to: the administration way (systemic, locoregional, intrathrombotic), the level of thrombosis (upper or lower legs), the associated morbidity and mortality.

Acute Disease↗

PubMedDate not supplied

[Health risks from infrared emissions from radiant tube heaters in the workplace].

With the exception of domestic rooms, Overhead Radiant Tube Heaters (ORTH) are an effective system for indoor heating (e.g. warehouses, factories, garage workshops, shipyards, greenhouses, schools hall etc.). The growing number of units installed is due to several advantages, such as uniform heating, absence of air movements, energy saving, versatility and safety. Indoor heating is obtained by an infrared emission, which is produced by the circulation of combustion exhaust gases within tubes and is collected by a set of reflecting surfaces located around the tubes. In the present communication, the attention is driven on the characteristics of ORTH infrared emissions, with reference to potential health risks for the exposed people (especially people working within areas heated by this system). A reason for this is represented by the existence of a specific italian regulation (Circolare N. 1322/4134-28.01.1992, Direzione Generale della Protezione Civile-Ministero dell'Interno). Following the last one, ORTH surface temperatures resulting in a spectral emission which includes wavelengths less than 3 microns have to be considered, in the case of ORTHs with thermal power greater than 34.89 kW, as hazardous for exposed people. Although the ORTHs emission spectrum partially covers the near infrared region (0.8-1.4 microns) at 400 degrees Celsius and may adversely affect the retained tissue a gross evaluation of the near infrared energetic flux, weightened on the surface unit, allows to exclude this risk. On the opposite, the results of the same evaluation carried out in the medium and far infrared spectral region at 200 degrees-400 degrees Celsius (the normal temperature range for ORTHs) do not allow to preliminary exclude a thermal risk for eye structures such as lens, near the tube surface at least. In every case, a burn hazard for both corneal tissue and skin is excluded. With the aim to carry out a detailed set of radiometric estimates, some preliminary considerations are furnished concerning the risk assessment for the eye, with reference to the following parameters: emission spectrum, energetic flux, workstation, presence of reflecting surfaces, potential interferences, exposure duration, angle between the incident radiation on eye surface and the optic axis. ACGIH 1992/93 for infrared radiation TLVs are followed as reference standard.

Environmental Exposure↗

PubMedDate not supplied

[Carotid restenosis: clinical significance and indications for reintervention].

Carotid restenosis is defined as a new > 50% diameter-reducing lesion present in sites of previous surgery. The clinical aspects of this complication are strongly connected with their anatomopathologic evolution: fibromuscular hyperplasia in early recurrent disease, atherosclerotic degeneration in the later lesions. Routine postendarterectomy duplex surveillance is able to detect this pathologic evolution. On 570 surgically treated carotid artery a postoperative duplex surveillance was made at 3, 6, 12 months and then yearly. Totally 42 cases of recurrent stenosis (7.3%) were present: in seven cases (16.6%) with a complicated restenosis the patients were symptomatic. In 27 cases (64.2%) restenosis was < 75%, in 8 cases (19.2%) > 75%. Indication to surgery was given for all the complicated restenosis and for high grade stenosis (> 75%). In the 27 cases of restenosis < 75% a conservative therapy together with duplex surveillance was applied: in none of these cases the restenosis increased in an average follow-up of 13.7 months. In the reoperated cases we didn't observe any mortality nor postoperative stroke. With regard to their mainly hyperplastic origin, carotid restenosis are low symptomatic and with a quite benign evolution. Surgical reintervention is to be limited to the symptomatic cases and to the asymptomatic high grade stenosis cases. A particular attention should be reserved to the morphologic characteristics of the lesion in order to detect the atherosclerotic degeneration that might cause cerebral symptoms.

Angioplasty, Balloon↗