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Biomedical subjects

D Talini

Publications and source records attributed to D Talini.

32 records · Page 2Linked to original sources
PubMed1986

Specific bronchial reactivity to toluene diisocyanate: dose-response relationship.

20 patients with toluene diisocyanate (TDI)-induced asthma were examined in order to assess their threshold of response to TDI during specific bronchial provocative tests (BPT). Specific bronchial hyperresponsiveness was evaluated by performing, on different days, specific BPT with increasing concentrations of TDI until a positive response was obtained; the threshold of response to TDI (low: 0.02-0.05 ppm; moderate: 0.1 ppm; high: 0.2-0.25 ppm) and the pattern of positive response were evaluated in comparison with some clinical features of the disease. The threshold of airway response to TDI was low in 9, moderate in 7 and high in 4 patients. No evident relationship was observed between the threshold of response to TDI and the pattern of positive response to the lower TDI concentration (immediate in 5, late in 8 and dual in 7 subjects) or other clinical features (duration of asthmatic symptoms, smoking habits, cessation of work, nonspecific bronchial hyperresponsiveness to methacholine); however, 6 out of 9 patients with low threshold had nonspecific bronchial hyperreactivity in comparison with 6 out of 11 patients with moderate or high threshold. In 10 out of 13 patients who performed two positive BPT with different TDI concentrations, the pattern of response was the same either at lower and at higher TDI concentrations; 3 subjects who had a late reaction at the lower concentration showed a dual reaction to the higher TDI concentration. A relationship between the degree of the specific bronchial reaction (% fall in FEV1 from baseline value) and TDI concentration during BPT was observed for the immediate reaction but not for the late reaction.

Asthma↗
PubMed1986

[Bronchopneumopathy caused by wheat flour: analysis of clinical cases].

We studied 31 subjects exposed to wheat (mean work duration: 33 years) with chronic bronchopulmonary disease. 19 subjects complained of chronic cough and phlegm, 5 of symptoms of bronchoconstriction not associated to chronic cough and phlegm; 7 subjects complained of oculo-rhinitis. Subjects with symptoms of bronchoconstriction had a longer mean age and work duration than the other ones. Pulmonary function tests showed a slight decrease of mid-expiratory flow rate with respect to reference values. Skin reactivity to common allergens and to allergenic extracts of wheat flour and grain was low, but a relevant number of dubious responses (weal: 3-4 mm) to specific allergens was observed. Bronchial hyperresponsiveness to methacholine or bethanechol was observed in 17 out of 30 subjects, and a positive response to occupational-type specific bronchial provocative test (sBPT) was elicited in 10 out of 30 subjects. There was a low relationship between positive response to sBPT and symptoms of bronchoconstriction or skin reactivity to specific allergens. These observations suggest that a high prevalence of chronic bronchitis and/or chronic airway limitation is showed in workers long-term exposed to wheat flour, in front of a low prevalence of skin reactivity to flour and grain. Occupational-type sBPT might induce in these patients a non immunological positive response to wheat flour by means of a not completely known mechanism.

Adult↗
PubMed1985

[Respiratory pathology caused by exposure to solvents in the shoe industry: description of 3 clinical cases].

Clinical and functional respiratory features of three shoe factory workers exposed to organic solvents from glue or other adhesives are described. All subjects complained of chronic cough, dyspnea and wheezing when exposed to non specific bronchial stimuli, and showed a non specific bronchial hyperresponsiveness to methacholine; symptoms and bronchial hyperreactivity persisted some years after the cessation of work. In two cases the onset of the symptoms was ascribed to the occupational exposure to glue activators (containing usually a considerable percentage of chlorinated hydrocarbons as dichloromethane or methilenedichloride). We supposed that occupational exposure to large amounts of glue solvents in shoe factory might cause a chronic airway impairment with non specific bronchial hyperresponsiveness.

Adult↗
PubMedDate not supplied

[Asthma in hairdressers: a report of 5 cases].

The paper reports 5 cases of bronchial asthma in hairdressers exposed to bleaching dusts containing potassium and ammonium persulphate. All subjects complained of asthmatic symptoms at diagnosis, and underwent measurement of non-specific bronchial hyperresponsiveness to methacholine, skin prick tests for common allergens, PEF monitoring during 2 weeks at work, specific bronchial challenge (SBC) test with bleaching dust, and assessment of airway inflammation by induced sputum technique. All subjects were reassessed during a follow-up of 1 to 5 years. All subjects were negative for skin prick tests, but 3 showed an abnormal PEF variability at work (Maximal Amplitude > 10%, in at least half of the monitoring period). All subjects showed a positive airway response to SBC with bleaching dust, and 4 subjects did not react to the control tests with lactose dust. One subject only showed a high percentage of eosinophils (> 3%) in the induced sputum, while all were hyperreactive to methacholine (PD20FEV1 < 0.3 mg). During the follow-up, 2 subjects stopped working and 4 were treated by inhaled corticosteroids and bronchodilators. All subjects reported a significant improvement in asthmatic symptoms, related partly to the reduction of occupational exposure in the workplace and to the efficacy of anti-inflammatory treatment. In conclusion, similar findings were observed in these 5 cases of hairdresser asthma: absence of atopy, positive response to SBC, mild changes in PEF and variable percentages of eosinophils in induced sputum. Pharmacological treatment, associated with reduction of occupational exposure, could improve asthmatic symptoms, despite continuing the job.

Adult↗
PubMedDate not supplied

[The occupational risk in IRCCS of Neurosciences].

The results of meta-analysis carried out on all documents for the valuation of the risk, recorded by IRCCS of Neuroscience, has led to identify a risk matrix for the medical personnel of the Scientific Institute of Neuroscience. Such analysis allowed to tackle the day to day risk faced by hospital staff. As a general rule the IRCCS of Neurosciences distinguishes themselves as structures of mainly neurologic typology and as structures of more typical psychiatric interest. In the first case the analogy with the traditional Hospital structures are more noticeable, in the second case instead the kind of patients and the particular relations between the health worker and the patient himself may represent an important differentiation factor. This is, above all, evident on the biological risk; for it's determinism has an important rule the interpersonal relationship between the health worker and the patient. Concerning other risk factors such as the chemical and the allergic one, it is noticeable a closed analogy with the actual Hospital reality. On work organization level, manual handling of patients is often necessary and also the relatives risks. In this kind of structures the stress factor is of the greatest importance, it should therefore have a strong consideration on the valuation of risk by the IRCCS.

Academies and Institutes↗
PubMedDate not supplied

[Knowledge of occupational risk in IRCCS of Neurosciences].

A Professional Multicentric Audit, concerning Staff knowledge level about security on workplaces, was conducted by way of a standardized questionnaire given to 1022 (26.4%) IRCCS professional staff pertaining to Neurobiology. Four were the principal tasks of the questionnaire investigating the "sensibility" and "consciousness" concerning risk prevention on workplaces. It came out that there is a great variability in the knowledge level on this field, even if the "medium value" is "pretty good".

Academies and Institutes↗
PubMedDate not supplied

[Phenomenon of occupational accidents of workers of IRCCS of Neurosciences].

On the basis of information collected from ten IRCCS, it has emerged altogether that the accident are not much frequent. Accident statistics indices from 1994 to 1998 were respectively: frequency rate 21.36, incidence rate 3.32, severity rate 0.24. In the "Neurology" Institutes we have above all needlestick injuries and cufs to the arms and hands. The workers most exposed are doctors, trained nurses, technicians. In the "Psychic" Institutes we have falling, impact, lifting and physical contact accidents. The injuries are contusions to legs and head. The most exposed workers are therapists and rehabilitation educators.

Academies and Institutes↗
PubMedDate not supplied

Risk factors for chronic respiratory disorders in a sample of farmers in middle Italy.

OBJECTIVE: To evaluate the prevalence of respiratory symptoms in agricultural workers in a rural area of Tuscany and to relate them to some occupational risk factors. SUBJECTS AND METHODS: A cross sectional study was performed on a sample of 461 agricultural workers from two rural area of Tuscany. All subjects underwent to respiratory questionnaire, pulmonary function test and skin prick tests. Occupational risk factors were evaluated as response to questions related to 11 specific jobs, most of them related to cow-shed works. RESULTS: Subjects had high mean age and a long work duration. Smoking habit was significantly associated with symptoms of chronic bronchitis, while atopy was significantly associated with chronic cough, phlegm and dyspnea. In comparison with a control group of workers which did not report any occupational risk factors (reference group), logistic analysis showed that most symptoms were significantly associated with some specific jobs related to animal breeding, taking into account differences due to age, smoking habit, atopy and district. Mean pulmonary function tests were in the normal range, without any significant relationship with different risk factors, except smoking habit. Increased work duration was associated with significant decrease of pulmonary function. CONCLUSION: Symptoms of chronic bronchitis were frequent in this population of farmers of Middle Italy. The analysis of risk factors confirms a relevant role for some specific occupational risk factors, related to jobs in the cow-shed, in the development of respiratory disorders.

Agriculture↗
PubMedDate not supplied

Prognosis of occupational asthma induced by isocyanates.

Several studies on the prognosis of isocyanate-induced asthma show that a significant proportion of patients continue to experience asthmatic symptoms and nonspecific bronchial hyperresponsiveness after cessation of work, and that further exposure to isocyanates in sensitized subjects leads almost invariably to persistence of respiratory symptoms and of bronchial hyperresponsiveness and the deterioration of airway function. Specific bronchial reactivity to isocyanates may change after cessation of work; however, some subjects continue to be sensitive to TDI several months after cessation of work. The determinants of an unfavourable prognosis for asthma seem to be the same as those for other types of occupational asthma due to low molecular weight compounds (i.e. red cedar asthma): long duration of exposure before the onset of asthma, long duration of symptoms before diagnosis, airway obstruction, and dual airway response after specific challenge tests. Also, single acute exposure to high levels of TDI in the workplace (spills) can result in persistent nonspecific bronchial hyperresponsiveness. Potential mechanisms of persistence of symptoms and of nonspecific bronchial hyperresponsiveness may be chronic inflammation, bronchial smooth muscle alteration, autonomic nervous system disregulation.

Asthma↗
PubMedDate not supplied

[A cross-sectional epidemiological study of symptoms and respiratory physiology in a sample of workers in shoe manufacture].

The prevalence of respiratory symptoms and functional abnormalities has been evaluated in a sample of 350 workers (186 males and 164 females, mean age: 35.1 and 36.6 years respectively) employed in 24 factories of the shoes industry in the area of Pisa, exposed to airway irritants (solvent vapours, leather dusts and fumes). Each subject performed C.N.R. questionnaire of respiratory symptoms and diseases, and measurement of Forced Vital Capacity and derived indices. A mild prevalence of respiratory symptoms (chronic cough: 9.3% and 8.5% in males and females respectively; chronic phlegm: 14.6% and 6.8%; persistent wheeze: 2.1% and 1.7%; dyspnea of 1st degree: 23.3% and 39.0%) was reported, more frequently in smokers than in non smokers. Subjects with longer job duration in the shoe industry showed a trend to have a higher prevalence of chronic phlegm than subjects with shorter job duration; on the contrary, the last ones had a higher prevalence of rhino-conjunctivitis. A higher prevalence of attacks of shortness of breath and dyspnea of 2nd degree in males, and dyspnea of 1st degree in females was observed in workers to high risk job (to shear, to use adhesive, etc.) with respect to workers employed in low risk job (to assembly, to store etc). Mean spirometric values where in the normal range. Subdividing the subjects in groups with different smoking habit and job duration, a mild effect of the occupational exposure in groups with the same smoking habit could be observed for FEV1 and MEF50 particularly.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Specific bronchial provocation tests with flour in the diagnosis of occupational bronchial asthma].

The gold standard in the diagnosis of occupational asthma is the specific bronchial provocation test (sBPT), but other diagnostic criteria have been proven to have a similar sensitivity, mainly in asthma due to high molecular weight compounds. In order to assess wether some clinical findings can predict the positive response to sBPT, we studied 37 subjects (14 millers and 23 bakers) with suspected occupational asthma who underwent sBPT with wheat flour dust (dust exposure in a small cabin: geometric mean 12.1 mg/m3 for up to 30 min). A positive response to sBPT (FEV1 > 20%) was elicited in 20 subjects (11 early, 4 late, and 5 dual responses). There was no significant difference between subjects with positive or negative sBPT as regards mean age, smoking, length of employment, duration of symptoms, atopy (skin positivity to one or more common allergens) and PD20FEV1 methacholine. The percentage of subjects with work-related symptoms was significantly higher in subjects with positive sBPT with respect to subjects with negative sBPT (81% versus 41.2%, p < 0.01 by chi 2 test); furthermore, FEV1 was significantly lower in subjects with positive sBPT. The percentage of positive skin response to wheat flour extract (mean wheal diameter > or = 3 mm) was mildly but not significantly higher in subjects with positive sBPT (68.4% versus 41.2%). None of the following clinical factors (age < 35 years, asthma symptoms pre-existing occupational exposure, non smokers, atopy and bronchial hyperresponsiveness to methacholine), alone or in combination, were associated with higher prevalence of positive sBPT. We conclude that the response to sBPT in subjects with suspected occupational asthma due to flour dust can not be adequately predicted by other clinical, allergologic and functional data. Therefore, sBPT with flour dust should always be performed in subjects with suspected occupational asthma.

Adult↗