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R Fonte

Publications and source records attributed to R Fonte.

35 records · Page 2Linked to original sources

[Work and alcohol: considerations on a caseload of patients undergoing treatment].

An enquiry into alcohol dependent subjects admitted to the clinical wards of the first section of Occupational Medicine belonging to Medicina Preventiva Occupazionale e di Comunità of University of Pavia for an alcohol disaddiction treatment has been performed through a phone interview. 289 patients have been contacted and time elapsed from admission to interview was one to three years. The questions focused alcohol abstinence, occupational position before and after admission, any improvement in the work sphere (relationship with the collegues), any feeling of empowerment of the work abilities and any increase in the responsibilities load. From our results we can conclude that alcohol disaddiction carried on during admission has positively contributed to the reinstatement of alcoholics patients.

Alcoholism↗

[High resolution computerized tomography in the diagnosis of asbestosis].

The clinical observation, the work history, the analysis of pulmonary function tests and, mainly, the conventional x-ray chest radiograms have represented, til now, the diagnostic basis for pneumoconiosis (silicosis, mixed dust pneumoconiosis, asbestosis). Recently, the high resolution chest tomography (HRCT) has been introduced into the diagnostic procedures: such method seems to have its main application in the assessment of incipient clinical pictures of pneumoconiosis, particularly when characterized by normal pulmonary function tests. Asbestos fibers exposed workers were submitted to both radiologic methods. The great majority of them had already been recognized to be affected by asbestosis. A considerable statistical agreement (Cohen K) was observed between radiographic and tomographic I.L.O. classes. In conclusion, high resolution chest tomography doesn't appear to be an indispensable test for the diagnosis in admitted subjects, but we underline its importance in the evaluation of pleural thickenings.

Aged↗

[High resolution computerized tomography in the diagnosis of silicosis and mixed dust pneumoconiosis].

The clinical observation, the work history, the analysis of pulmonary function tests and, mainly, the conventional x-ray chest radiograms have represented, til now, the diagnostic basis for pneumoconiosis (silicosis, mixed dust pneumoconiosis, asbestosis). Recently, the high resolution chest tomography (HRCT) has been introduced into the diagnostic procedures: such method seems to have its main application in the assessment of incipient clinical pictures of pneumoconiosis, particularly when characterized by normal pulmonary function tests. 75 silica- and mixed dust exposed workers were submitted to both radiologic methods. The great majority of them had already been recognized to be affected by asbestosis. The statistical analysis (Cohen K) showed a satisfactory agreement between radiographic and tomographic I.L.O. classes. However, high resolution tomography appeared to be more accurate in the assessment of less severe clinical pictures. In conclusion, we underline the importance of high resolution chest tomography in the evaluation of individual clinical cases, particularly when forensic problems are involved.

Adult↗

[Early effects of exposure to anesthetic gases and vapors. A critical review on the suitability of several indicators of the effect].

Apart from a risk excess of liver disease among operating theatre personnel and of spontaneous abortion in women exposed during pregnancy, no definitive conclusion can be drawn regarding health impairment among anaesthesiology staff. However, many studies pointed out that several adverse effects occur as a consequence of experimental, therapeutic and occupational exposure to inhalation anaesthetics. This paper reviews the early changes of the organ systems (hepatobiliary, renal, cardiac, hematopoietic, reproductive systems; immunologic functions; cytogenetic effects), which are considered to follow anaesthetics exposure, to evaluate their possible use as biological indices of effect. The liver microsomal enzyme system has received particular attention with the aim of clarifying the mechanisms involved in anaesthetics hepatotoxicity. An increased microsomal enzyme activity was observed in experimental conditions and in humans. This inductive effect, which reflects metabolic changes affecting liver function, is commonly considered the earliest sign caused by exposure to several chemicals (other than anaesthetics) and may be evaluated by means of biomarkers, among which the measurement of urinary D-glucaric acid excretion is a well established non-invasive tool. Urinary D-glucaric acid excretion represents the most promising early metabolic effect of the exposure to anaesthetics. However, its measurement is not yet suitable as an index of effect for use in biomonitoring practice. The main aspects to be studied in the future are the following: (i) the evaluation of urinary D-glucaric acid excretion in the acute and chronic exposure to low-dose anaesthetics to check the existence of a dose-response relationship; (ii) the study of other parameters (urinary enzymes, immunological profile, chromosome aberrations) in selected groups of exposed and control subjects, in which both exposure and confounding factors (age, gender, life style, former diseases) as well as concomitant occupational exposures should be carefully taken into account.

Adult↗

[Alcohol and work: comments on a clinical case load].

The relationship between alcohol and work was studied in a group of 260 voluntary patients (186 male and 74 female) admitted to the unit of Medicina del Lavoro, Pavia University for alcohol rehabilitation. The highest incidence of alcohol abuse was found in non-working subjects (pensioners, unemployed, housewives) although the start of excessive drinking takes place after beginning a working activity; a cause-effect relationship between these two factors can not be clearly determined, however. It is true that the stress provoked by this new condition (introduction to the work experience) can, in certain subjects, be a contributing factor in alcohol abuse. The increasingly lower age of initiation to alcohol reconfirms the need for prevention and instruction even at scholastic level.

Adolescent↗

[Men and home environment: when the wife exercises an extra-familial activity].

The study examines the views of men towards the division of household duties when the female partner is employed outside the home. A variety of behaviour ranging from a complete refusal to participate in domestic activity to an equal division of household tasks is demonstrated. The main determining factors seem to be: socio-cultural level and age group. The woman's right to persue a career was recognized mainly by men in middle to upper social class in the 25-30 age group who participate in household duties. It is evident that, even in the case of domestic collaboration, women have the ultimate responsibility for household tasks. In that men tend to choose the more gratifying duties (es. cooking, child care).

Adaptation, Psychological↗

[Thyroid function in bronchial asthma].

The Authors report the results of an investigation on association between bronchial hyperreactivity to metacholine in asthmatic subjects and subclinical dysfunction of the thyroid gland. Although the T4 and free T3 values were higher in the control group than in asthmatic patients, all the hormone dosage results were within the normal range. These findings show that asthma is not associated with changes in thyroid function.

Adolescent↗

[Female alcoholism and household conditions].

Alcoholism in women, above all in housekeepers, tends to destroy both families and society. This kind of alcoholism is frequently based on neurosis and depression. Alcoholism in women is supposed to be caused by: genetic factors, psychological factors and social factors. Therefore these components are linked both to neuroendocrinology of female and the way of life of housekeepers.

Alcoholism↗

[Hodgkin's disease and occupation].

In order to discuss the hypothesized existence of occupational risk factors in the etiology of Hodgkin's disease (HD), the available literature data are reviewed. The occupations most often considered to be at increased risk of the disease are woodworking, school teaching, hospital occupations and occupations entailing exposure to chemicals. The association between HD and employment in wood industry suggest that exposure to unknown occupational factors may play a role as etiologic agent in this disease. A number of chemical substances that are regularly used may be suspected as causative factors. There are many discrepancies among the results of the studies on the association between school teaching and HD. To date no certain conclusion may be drawn from the presented data. However it has been suggested that the reported excess risk for HD among teachers may be explicable by social class gradient for the disease. The existence of risk factors other than viral may explain the excess risk among physicians and nurses. Because of the characteristics of some highly reactive chemicals their etiologic role may not be underestimated. An association between HD and occupations entailing exposure to various chemicals (organic solvents, benzene, phenoxy acids, chlorophenols) was shown; however no definitive conclusion may be drawn. There are increasing findings that point out the importance of the association between some occupations and development of HD. In spite of the evidence of a link between exposure to various chemicals and HD, there is a clear need to evaluate dose-response relationship between specific type and amount of chemicals and the disease, in order to provide some of the answer we need about the etiology of HD.

Benzene↗

[Chronic respiratory symptomatology and obstructive syndrome in workers of a chemical industry].

The main purpose of the study was to asses the frequency and distribution of chronic bronchitis, bronchial asthma and airflow obstruction among workers employed in the chemical industry. Our special interest was focused on finding out the high risk groups in various plants and an attempt had been made to determine to what extent the occurrence of symptoms could have been attributed to the occupational exposure after excluding age and smoking habit as confounding variables. The epidemiological data concerned 4717 male workers of the chemical complex situated near Cracow, Poland. The epidemiological study covered interviews, spirometric testing and anthropometric measurements. Environmental assessment had been done done simultaneously in all occupational post over the whole chosen week in all shifts. The symptoms of chronic bronchitis and bronchial asthma as well as airflow obstruction occurred most frequently in older persons and in those being smokers. The prevalence rates of bronchial asthma and airflow obstruction was higher than in the general population of inhabitants of Cracow and this substantial excess could be attributed to the specific occupational environment. The detailed analysis performed showed in a clear way that chronic bronchitis is not a risk factor in the development of airflow obstruction but taking into account the fact that bronchial asthma had negative impact on the natural history of airflow obstruction, industrial physicians should take up adequate prophylactic measures concerning persons with asthmatic symptoms or its history in the past. The most intriguing results of our study give an evidence that styrene and methyl methacrylate develop strong harmful effect on the lung tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗

[The psychosocial problems in a population of emigrant Italian workers].

The psycho-social problems of a group of 365 Italian emigrants to Switzerland, admitted to psychiatric hospitals, were studied. It was found that non professional subjects (housewives, unemployed, retired) and manual workers (builders, waiters, factory workers) were more likely to suffer from psycho-social disorders. Only 11.1% of those studied had received a secondary education, therefore it could be assumed that subjects having a low technical and cultural level were less prepared, psychologically, for their new situation and were thus more susceptible to psycho-social disorders. The most frequent diagnoses were found to be: affective disorders, alcohol addiction, opiate addiction and schizophrenia. The study revealed that emigrants ran a greater risk of first time admittance to psychiatric wards whereas the local population had a greater number of relapses. In conclusion it is stressed that assistance with an aim to improve work, social and relationship conditions and to integrate the emigrants into their host society can reduce some forms of psycho-social disorders.

Adult↗

[A new environmental pathology: styrene-induced rhinitis].

We describe the case of a 36 ys aged woman complaining of symptoms of oculorhinitis with itching, occasional dyspnea and laryngeal constriction. The patient related her symptoms with the emission of dusts and steam from a factory in the neighbourhood producing manufactures using polyester resins dissolved in styrene. No bronchospastic response was obtained after challenge with methacoline and ultrasonic nebulization of distilled water, which instead provoked a significant increase of nasal resistance. The inhalation challenge with styrene produced a dual nasal response. To our knowledge this is the first case of non occupational neighbourhood rhinitis provoked by styrene.

Adult↗

[Indoor pollution: a report of 2 clinical cases of occult carbon monoxide poisoning].

A large part of the general population is potentially exposed to excessive concentrations of carbon monoxide (CO), both in the domestic and work environment. Beside acute, often fatal poisoning, the possibility of occult intoxication should be considered; this condition can affect people who are often unaware of the existence of a toxic exposure in their homes or work places. We describe two non-smoking patients, husband and wife, 53 and 57 years old, respectively, who suffered cephalea, nausea and neurobehavioural disturbances during a period of approximately one year; these symptoms were reported to improve or disappear on several occasions during the patients' absence from home. Careful anamnesis suggested a protracted exposure to nonlethal concentrations of CO contaminating the patients' bed-chamber from the misfunctioning flue of the heating system. It was not possible to measure carboxyhaemoglobinemia until approximately 24 hours since the last presumptive exposure. The levels found were therefore relatively low (4-5%), yet higher than the reference values for normal non-smoking subjects. Carboxyhaemoglobin concentrations almost returned into the normal range during the period of hospitalization. These two cases exemplify how low level CO exposure may cause aspecific pathological manifestations that are often misdiagnosed or overlooked.

Air Pollution, Indoor↗

Drinking habits and occupational exposure to inhalation anesthetics at low doses.

The aim of this study was to evaluate certain indicators which are an expression of hepatic (serum aminotransferases activities) and hematologic (erythrocyte mean corpuscular volume) changes among health care personnel exposed to inhalation anaesthetics (nitrous oxide and isoflurane). A total of 172 subjects employed in a single hospital were divided into four groups according to exposure and drinking habits: group (i) non drinkers and unexposed subjects, group (ii) drinkers and unexposed subjects, group (iii) non drinkers and exposed subjects, group (iv) drinkers and exposed subjects. No change in aminotransferases activity or in mean erythrocyte size was detected, which could be regarded as the result of anesthetics exposure. Increased aspartate aminotransferase values among unexposed drinkers were related to alcohol intake. This observation was confirmed by the relationship between AST behaviour and quantitative alcohol intake. Hence, when studying any effect involving functions related to the biotransformation of xenobiotics, in which the liver plays a primary role, the importance of establishing the exact daily amount of ethanol intake is stressed.

Adult↗

[Employment and alcohol: analysis of a clinical casuistic].

The relationship between alcohol and work was studied in a group of 537 voluntary patients (393 male and 144 female) admitted to the department of Medicina del Lavoro, Pavia University for alcohol rehabilitation. The highest incidence of alcohol abuse was found in non-working subjects (pensioners, unemployed, housewives) although the start of excessive drinking takes place after beginning a working activity; a cause-effect relationship between these two factors can not be clearly determined, however. It is true that the stress provoked by this new condition (introduction to the work experience) can, in certain subjects, be a contributing factor in alcohol abuse. The increasingly lower age of initiation to alcohol reconfirms the need for prevention and instruction even at scholastic level. We can deduce how no working condition, low age and low education can constitute makers of risk for alcohol abuse.

Adolescent↗

[Evaluation of trends in occupational pathology in clinical cases].

The study considered all patients admitted to the 1st Division of Occupational Medicine, Department of Preventive, Occupational and Community Medicine of the University of Pavia between January 1st 1989 and December 31st 1995 with a diagnosis of occupational disease. It was useful in illustrating the evolution of occupational disease as regards both changes in etiology and in the symptoms and systems involved. A decrease in the number of occupational diseases diagnosed from 1993 to 1995 was revealed, but it is difficult to draw any significant conclusions from these data since the need for hospitalization when diagnosing this type of disease has diminished greatly. Changes in legislation which have obliged employers to take precise preventive measures could also be partly responsible for this downward trend. The patients were, in almost all cases, at an initial stage of their disease. This is reassuring as far as the therapeutic and legal need for an early diagnosis is concerned. However, it remains unknown how often the causal relationship between work and disease was not suspected and therefore how many cases did not arrive to observation. Finally, the study confirmed the disappearance of some occupational diseases, such as benzene intoxication, common in the past, and the increase in "emerging" pathologies like allergies.

Humans↗