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Biomedical subjects

T L Guidotti

Publications and source records attributed to T L Guidotti.

At least 73 records · Page 4Linked to original sources
PubMed1987

Occupational health for hospital workers.

Hospitals present a variety of infectious, chemical and physical hazards to their workers. Important pathogens include AIDS, hepatitis B and rubella viruses and Mycobacterium tuberculosis. Ethylene oxide is probably the greatest chemical hazard, but anesthetic gases, antineoplastic drugs and skin irritants or sensitizers are significant hazards as well. Hospitals also have poor safety records. A well-organized occupational health service that includes a physician, or a nurse with medical backup, and good records saves more than it costs.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Occupation-related burns: five-year experience of an urban burn center.

Mortality from burns in the United States has not improved appreciably since 1955 among men, and the rate of decline among women appears to be slowing. Although one-quarter of all serious burns result from occupational accidents, few systematic epidemiologic studies of occupational burns have been conducted. We reviewed 232 cases of occupational burns among the 1,076 civilians seen as outpatients or admitted to the Regional Burn Treatment Center of the University of California Medical Center in San Diego from 1977 to 1982. Scalds were the most common type of burn overall and in women, but flame-related burns resulted in the highest average percent body surface area burned and were more common in men; tar-related, flame-related, chemical, and electrical burns affected men almost exclusively. Electrical burns were disproportionately severe, as measured by time lost from work, fatalities, and permanent disability, in relation to their frequency and amount of body surface area involved. Contact burns were more frequent in younger persons. Hispanics were overrepresented compared with their representation in the general population. Occupational associations included scalds due to hot grease among restaurant workers, tar burns among roofing workers, electrical burns among farm workers, and injuries reflecting hazards to firefighters and electricians. The number of days off work after hospitalization correlated closely with the number of days hospitalized, which in turn correlated significantly with percentage of body surface area burned.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents, Occupational↗
PubMed1986

Occupational cancer.

When cancer is possibly related to occupation, the family physician's task is to put the matter in perspective by educating the patient and carefully documenting the appearance of the tumor and the patient's work history. Occasionally, physicians are the first to recognize new associations between chemicals and cancer and can help to bring hazards under control.

Asbestos↗
PubMed1985

Competition and despecialization: an analytical study of occupational health services in San Diego, 1974-1984.

Occupational health care services are changing in response to rapid changes in health care organization generally; this trend is not reflected in the occupational medicine literature. San Diego is a large and rapidly developing metropolitan area with a balance of heavy, light, and service industries and is relatively isolated and self-contained in health services, making it useful for monitoring health services trends. We examined local trends in the supply of health services as reflected by facilities, manpower, and other indicators between 1974 to 1984. We also assembled findings of local market surveys and certain other sources into a profile of occupational health care resources in the metropolitan area. Corporate medical departments did not keep up with the growth of industry over the decade; freestanding "industrial medicine clinics," by contrast, began with a single facility and proliferated to 13. In the last three years, freestanding "urgent care centers" entered the health care market in force and now outnumber industrial medicine clinics. Despite an overall massive increase in the number of physicians in the area, occupational physicians with specialty credentials or eligibility remained few and primarily based in institutions, while the number of uncertified physicians and of medical groups accepting occupational medicine referrals increased considerably. Employers reported approval of acute care, traditional screening, and employee assistance services far more often than of preventive services, but if they approved of a service, they usually provided it, except in the case of employee assistance services. We conclude that the role of preventive services and of trained personnel in delivering occupational health care is declining, rather than increasing, in the face of competition and changes in the general health care system. Corporate and in-plant medical services are not keeping up with the growth of industry, and no class of health facility matched the growth of industrial medical clinics except urgent care centers, with which they are beginning to compete. The implications of this study for occupational medicine as a specialty, for the standards of patient care, and for the role of prevention is a matter of grave concern if they reflect national trends. Further studies of occupational health services are urgently needed to assess the significance of these findings.

Ambulatory Care Facilities↗
PubMed1985

Oxidant gas injury to the lung: a discussion on the functional implications.

Acute toxic inhalation by the oxidant gases, particularly ozone (O3), nitrogen dioxide (NO2) and oxygen (O2) at high tension, has been assumed to be no more than a chemical burn of the epithelial surface. More recently, oxidant toxic inhalation has been appreciated as a complex process involving biochemical, morphological and functional changes which are qualitatively similar although inducible by different agents. Recent advances in pulmonary pathophysiology, inhalation toxicology and particularly endothelial biology now challenge the validity of a theoretical framework which seemed almost complete just 5 years ago. Considerable attention has been paid in recent years to the biochemical events occurring at the moment of and immediately following exposure to the oxidant gases. Progress in elucidating the initial events has been rapid and promises a more complete picture in the near future. Studies of the pathophysiologic mechanisms associated with toxic inhalation by the oxidant gases have been relatively static, however. In this discussion, implications of recent findings in related fields were examined in an effort to identify new hypotheses and directions for investigation.

Air Pollutants↗
PubMed1985

Occupational health monitoring and surveillance.

The design of monitoring and surveillance programs is advancing rapidly. Surveillance is a strategy to determine a group experience with a particular disease outcome, while monitoring focuses on the overall health experience of the group. Screening tests for early detection of abnormalities related to exposure are selected on the basis of sensitivity, specificity and the prevalence of the abnormality. Family physicians are increasingly involved in these programs, and must understand their rationale and legal framework.

Epidemiologic Methods↗
PubMed1985

[A contemporary model of environmental health sciences: its application in the recruitment of faculty and in academic development].

The authors describe the development and application of an intellectual model fitted to the environmental health sciences. The model became the basis for the design of a new study plan in addition to providing the strategy for recruitment of the faculty for the new School of Public Health of the San Diego State University in San Diego, California. They give an account of the circumstances leading up to the establishment of this institution, the gradual consolidation of the different health science programs into a single school with graduate studies leading to masters degrees in six main fields: environmental health, occupational health, epidemiology, maternal and child health, health services administration, and health development. The authors see the beginning of a redefinition of the function of the basic sciences represented in environmental health in the light of new knowledge and technology, and believe that all fields of knowledge (microbiology, parasitology and health development) will contribute as a unified whole to increase the capacity of public health to place both biological and environmental health problems in a context that society can control.

California↗
PubMed1984

Water and health.

The systems protecting the quality of drinking water in the United States are deteriorating. Many urban water and sewer systems are obsolete. Industrial wastes are imposing a burden on wastewater treatment facilities. In the U.S., outbreaks of water-borne disease are primarily limited to enteritis associated with viruses or Giardia. Issues in the contamination of drinking water by toxic substances include disposal practices, accidental contamination, agricultural runoff and chlorination byproducts. Physicians must support stringent enforcement of water quality standards.

Humans↗
PubMed1984

Occupational lung diseases.

Clinical evaluation of a patient with occupational lung disease requires determining the pathophysiologic process, identifying the agent that is or was responsible, determining the prognosis and level of disability, assessing how the disease can be controlled or limited, and investigating the extent to which other workers may be affected. These conditions include the pneumoconioses, toxic inhalation, occupational asthma, hypersensitivity pneumonitis, industrial bronchitis, fume fevers and cancer. The family physician is in a good position to recognize these problems in the community.

Family Practice↗
PubMed1983

Unjustified employee concern aroused by a direct-service toxicologic testing laboratory.

A rising concern for personal health and fitness on the part of employees is a positive development with great potential for personal well-being. When misdirected into fads and exploitive practices, however, this concern can be a source of unnecessary anxiety and confusion. This brief report describes a problem that may become more common in our increasingly health-conscious society.

Diagnostic Errors↗