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Biomedical subjects

S Mattioli

Publications and source records attributed to S Mattioli.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

Wernicke's encephalopathy during total parenteral nutrition: observation in one case.

A patient operated for toxic megacolon secondary to ulcerative colitis developed a Wernicke syndrome (thiamine deficiency) during the postoperative period despite the administration of the usually recommended doses of vitamin B1 during total parenteral nutrition (TPN) treatment. Vitamin B1 deficiency should be checked in order to evaluate the patients' nutritional condition before starting TPN, especially those suffering from severe chronic malnutrition. Routine administration of vitamin B1 in repletion doses may be reasonably proposed in order to avoid the development of a Wernicke syndrome which is potentially lethal in a short time if not recognized and corrected in time.

Adult↗
PubMedDate not supplied

Bladder cancer monitoring using two novel urinary markers.

Bladder cancer shows extreme variability in its behavior. Even the superficial forms, when surgically treated, are characterized by a high recurrence rate and therefore regular and intensive post-treatment monitoring is an important aspect of the management of this tumor. The standard follow-up of patients with a bladder cancer history is based on cystoscopic examination of the internal bladder, which is an invasive procedure causing discomfort to the patient. In this context, the availability of a non-invasive laboratory test which measures circulating markers associated with bladder cancer could facilitate with monitoring of patients and could be of help in understanding the metastatic potential of bladder tumors, especially the superficial forms.

Antigens, Neoplasm↗
PubMedDate not supplied

BTA-TRAK combined with urinary cytology is a reliable urinary indicator of recurrent transitional cell carcinoma (TCC) of the bladder.

This study evaluated the diagnostic accuracy of BTA-TRAK in combination with urinary cytology (UC) in the follow-up of patients with a history of transitional cell carcinoma (TCC) of the bladder. The overall sensitivity of BTA-TRAK, UC and the two tests combined for the detection of recurrences was 82.7% (48/58), 84.2% (48/57) and 91.2% (52/57), respectively. BTA and UC showed comparable sensitivity for superficial recurrences (76.7% (33/43) and 78.5% (33/42), respectively) and for invasive recurrences (100% (15/15)); when the two tests were used in combination, the sensitivity for superficial lesions increased to 88% (37/42). BTA-TRAK was more sensitive than UC for G1 recurrences (81.2% (13/16) vs. 68.7% (11/16)), and when the two tests were combined the sensitivity increased to 87.5% (14/16). The sensitivity of the combination was 100% (15/15) for G3 lesions. The differences in urinary BTA-TRAK levels between patients with recurrences and those without evidence of disease were statistically significant (Wilcoxon's test, p<0.05); among patients with recurrences BTA levels were significantly higher in the invasive and poorly differentiated subtypes. In the series of patients studied by us, BTA-TRAK combined with UC was shown to be a non-invasive, accurate test to predict TCC recurrences. Periodic measurement of BTA-TRAK combined with urinary cytology seems to provide additional information for the monitoring of patients treated for TCC; however, due to the presence of false positive and false negative results, this test cannot replace cystoscopy. In a selected group of patients it could, if combined with cytology and ultrasonography and if correctly used and interpreted, orient the timing and indication for cystoscopy.

Adult↗
PubMedDate not supplied

[Biomechanical overload diseases: epidemiologic data].

Work-related musculoskeletal disorders are a major problem for industrialised societies, particularly in view of the elevated prevalence of low back pain (LBP) and carpal tunnel syndrome (CTS) among manual workers. Epidemiological studies show that work-related risk factors, such as lifting, twisting, bending, exposure to whole body vibration, and prolonged postures are prominent risk factors for LBP. For CTS, repetitive movements, hand-arm vibrations and use of forceful hand movements appear to be the major work-related risk factors. Psychological and psychosocial factors can also affect the onset of both disorders. This review provides an overview of the main evidence in the scientific literature on these issues.

Biomechanical Phenomena↗
PubMedDate not supplied

[Progress of studies promoted by the MODS collaborative group].

In industrialised countries, carpal tunnel syndrome (CTS) is considered an epidemic work-related disease. We have set up the MODS (Malattie Occupazionali Da Sovraccarico biomeccanico, biomechanical overload-related occupational diseases) collaborative group, formed by epidemiologists, ergonomists and occupational physicians to investigate CTS in Italy, applying the methods that epidemiologists commonly use to understand epidemics. Several studies are already ongoing. Two different descriptive studies based on current hospitalisation data are in the reporting phase. A pilot case-control multicentre study (260 cases and 520 controls in 13 centres) is in the final phase of data collection. A longitudinal study on a cohort of 3000 subjects exposed to different risk factors has reached the third year of follow-up. Moreover, a surveillance system has been set up to cover selected districts of the Emilia Romagna region. These studies will generate new information about the prevalence and incidence of CTS in Italy, along with identification of regional, high-risk job titles and work sectors, and the relative influence of non-occupational factors.

Adolescent↗
PubMedDate not supplied

[Work-related musculoskeletal disorders and diseases of the arm].

Among work-related diseases, musculoskeletal disorders of the upper extremities have obtained increasing attention in recent last decades. Because of their relevance, the Italian Society of Occupational Medicine and Industrial Hygiene has decided to draw up a set of National Guidelines on the subject. This paper discusses their production and contents, including definitions, rationale, physiopathogenesis, occupational physician's contribution to biomechanical overload risk evaluation, medical surveillance of exposed workers.

Arm↗
PubMedDate not supplied

[OCTOPUS: longitudinal study on carpal tunnel syndrome and work].

Carpal tunnel syndrome (CTS), the commonest nerve entrapment syndrome, is one of the most frequent occupational disorders related to manual work. Both occupational and personal risk factors make it difficult to recognize the true origin of its occurrence and to devise prevention strategies. Most of the information available about occupational CTS originates from cross-sectional studies on various job titles, where the prevalence of the disease has been reported to vary between 0.6% and 61%. Few longitudinal studies are available on occupational CTS. Consensus has been reached about the criteria to diagnose CTS in epidemiological studies. However, different methods are used by different investigators to assess exposure to repetition and force, the two factors which appear to be most important in originating the disease. This could help explain the difficulty in establishing a sound exposure-effect relationship (an indispensable basis for setting exposure limits). To help fill the gap in knowledge regarding occupational CTS incidence and its relationship to occupational exposure we are performing a large longitudinal multisector study, denominated OCTOPUS. OCTOPUS has been designed to assess the incidence of CTS in a large cohort of workers employed in different sectors and exposed to different level of repetitive and forceful manual work and to relate the incidence of the disease to the possible casual factors and their variation over time. Herein, the study protocol is described.

Carpal Tunnel Syndrome↗
PubMedDate not supplied

[Carpal tunnel syndrome among supermarket cashiers].

We studied Carpal Tunnel Syndrome prevalence in part time and full time female supermarket cashiers and in a control group (female primary school teachers). Subjects underwent a clinical examination in which information about personal, physiological, pathological and occupational factors were collected by a physician with a questionnaire and a self-administered Katz's hand diagram. The study protocol included median nerve conduction studies (NCS) for each worker, performed bilaterally according to the palmar technique described by J. Kimura. Case definition of Carpal Tunnel Syndrome was based on the combination of typical symptoms (classic/probable or possible) and electrodiagnostic findings according to the Consensus Criteria for the Classification of Carpal Tunnel Syndrome published by Rempel et al. in 1998. Biomechanical risk for upper limb was assessed by a group of trained observer using videotape and scales of hand activity level (HAL) and normalized peak of force (PF) proposed by the American Conference of Governmental Industrial Hygienists (ACGIH): supermarket cashier job tasks resulted on the threshold limit value line, confirming high biomechanical risk factors for CTS. Both symptoms and case prevalence resulted higher in supermarket cashiers than in control group and in full time cashiers if compared with part time ones. This difference between groups of part-/full-time cashiers could be due to total hours of exposure during the week and/or to the amount of recovery time between work sessions. Further longitudinal study could give more information about the role of different biomechanical risk factors in the onset of cumulative trauma disorders of the upper limb.

Adult↗
PubMedDate not supplied

[Evidence-based medical surveillance in occupational health].

One of the major issues in Public Health is the effective allocation of resources to appropriate and efficient interventions. Medical surveillance is a part of the complex management of prevention in the Occupational Health and Safety field. The aim of the study is to present the efficacy and effectiveness of medical surveillance through an overview of articles and reviews (only one systematic review) found on scientific electronic databases (PubMed and Embase). Although the literature reports a lack of data, two main themes were selected and discussed: the quality of preventive actions and the cost-effectiveness of medical surveillance.

Evidence-Based Medicine↗
PubMedDate not supplied

[Effectiveness studies in the Italian Society of Occupational Medicine and Industrial Hygiene congresses (1989-2003)].

BACKGROUND: Knowledge of the results of studies on effectiveness of preventive interventions is a fundamental requirement in occupational medicine. OBJECTIVES: The aim of this review was to identify Italian scientific production regarding this issue in the proceedings of the Italian Society of Occupational Medicine and Industrial Hygiene congresses over the last fifteen years. METHODS: An initial selection of the communications on intervention effectiveness studies was performed on the basis of titles, aims, tables and figures of each single presentation. A further selection was made via full reading of the previously selected communications. The selected articles were classified by type of strategy discussed, production sector, study design and several other criteria. RESULTS: 108 studies were selected out of the 3215 papers (3.4%) published in the congress proceedings examined (1989-2003). More than half of these discussed technical control strategies. In the vast majority of cases, the study design was a pre- and post-evaluation of effectiveness, and the 6 (non-randomised) trials concerned vaccination programmes. Almost a quarter of the studies on accident prevention regarded the effectiveness of training programmes. Only 5 studies could be detected in Medline as articles later published in international journals. CONCLUSIONS: On the basis of the Italian Society of Occupational Medicine congress proceedings over the last 15 years, the percentage of communications concerning effectiveness of preventive interventions in occupational health was 3.4%. Intervention effectiveness papers published in congress proceedings seem to reveal a quite unexpected production of effectiveness evaluation studies. Nonetheless, recommendations need to be made to improve study design and to promote effective prevention and control strategies.

Accidents, Occupational↗
PubMedDate not supplied

Occupational (and non-occupational) risk factors for musculoskeletal disorders.

BACKGROUND: Musculoskeletal disorders are an important cause of disability and absence from work in industrialized countries. A number of studies reported the importance of occupational, personal and psycho-social factors in the aetiology of these work-related disorders. OBJECTIVES AND METHODS: To stress the complex relationships existing between risk factors, reporting findings from reviews and original studies regarding two of the most significant musculoskeletal disorders: carpal tunnel syndrome (CTS) and low back pain (LBP). CONCLUSIONS: More detailed epidemiological studies are needed to explore the interactions between risk (and protective) factors, since these can play the role of determinants, confounders or effect modifiers.

Carpal Tunnel Syndrome↗
PubMedDate not supplied

[Spinal pathology in self-employed truck drivers].

The truck driver's work requires sitting in a fixed posture for prolonged periods when driving. Such conditions involve exposure to whole body vibrations. In addition, during loading and unloading operations, often done by hand, there is a further excess load on the spine. The paper presents the results of an investigation on the frequency of spinal disorders among self-employed truck drivers. A total of 606 truck drivers belonging to a trade union were interviewed and 63 subjects using the methods proposed by the "Ergonomics of Posture and Movement Research Unit" of the "Clinica del Lavoro" of Milan were examined. There was an elevated frequency of herniated disk and the risk was 4 times higher compared to the control population. The frequency of functional spondyloarthropathy of the cervical and lumbar segments was particularly high, especially in the older age classes (71.4% and 35.7%). The authors conclude that disease of the lumbar spine leads in a very large number of cases to permanent working incapacity among truck drivers before pensionable age.

Adult↗
PubMedDate not supplied

Urothelial cell changes due to busulfan and cyclophosphamide treatment in bone marrow transplantation.

Since the administration of cyclophosphamide and busulfan can cause hemorrhagic cystitis and changes in urothelial cells, an investigation was carried out to see whether patients undergoing bone marrow transplantation (BMT) who were treated with these drugs showed such urothelial changes and whether exfoliative urinary cytology can contribute to the early diagnosis and monitoring of such changes. Morphologic and morphometric analyses were performed on cytocentrifuged, Papanicolaou-stained preparations of 700 samples from 107 patients. Various degrees of urothelial cell changes were found in 30.8% of the cases. These changes consisted mainly of a considerable increase in the size of the nucleus and of a cytoplasm that was often bizarrely shaped. Even the structures of the nucleus and the cytoplasm changed. The results of this study showed that exfoliative urinary cytology permits an early diagnosis and monitoring of urothelial cell changes related to the administration of busulfan and cyclophosphamide in connection with BMT.

Adolescent↗
PubMedDate not supplied

Brain stem encephalitis in a patient with gastroduodenal and cardiovascular dysfunction: a case report.

The authors describe a case of a 38-year-old woman suffering from long-standing epigastric pain, abdominal fullness and vomiting due to functional alteration of gastroduodenal motility. Following a surgical procedure, a supraventricular tachyarrhythmia and hemodynamic disturbances suddenly appeared and led to death in a few hours. A histopathological study carried out on the brain stem revealed inflammatory lesions suggestive of a viral infection, whereas the study of the conduction system of the heart did not show any alterations. A clinicopathological correlation is suggested between the clinical picture and anatomical lesions of the tegmental region.

Adult↗
PubMedDate not supplied

[Personal approach in the surgical treatment of cancer of the gallbladder].

The part played by surgery in the treatment of gallbladder cancer is conditioned by the delay in diagnosis and the rapid spread of the disease to non operable structures rather than to any particularly intrinsic malignity. In the face of a clinically ascertained cancer or one recognized at surgical exploration, exeresis is essential if possible. Cholecytectomy completed by cuneiform hepatic resection and extensive locoregional lymphadenectomy offers adequate radicality with acceptable risk. Vaster operations have high operative mortality which is out of proportion to the results possible, 43 personal cases are reported.

Cholecystectomy↗