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Biomedical subjects

G Pesola

Publications and source records attributed to G Pesola.

9 recordsLinked to original sources
PubMed1998

Auditory dysfunction in occupational noise exposed workers.

Occupational noise-induced hearing loss (NIHL) is well known to be an epidemiologically relevant problem. The subjects affected with NIHL show alteration of hearing thresholds as well as a worsening of the cochlear analysis functions and, usually, an impaired speech discrimination in presence of background noise. The study has evaluated the relationships between hearing threshold and equivalent exposure lever per day (Lepd), age and working seniority in a homogeneous sample of occupationally noise exposed workers. Three subgroups were also selected to study the most important cochlear functions as well as nerve and central functions. The first subgroup (Nn) contained normal hearing workers exposed to non-hazardous noise, while the second (Bn) contained workers exposed to high level continuous noise during their work day without clinical evidence of NIHL. The third subgroup (Bd) included subjects affected with the typical 4 kHz notch exposed to the same noise conditions than subgroup Bn. The results show that the hearing impaired subjects have the worst overall cochlear performance; however also the normal hearing workers exposed to hazardous noise have worse performance than subgroup Nn, relatively to high frequency thresholds, frequency resolution, TEOAEs, DPOAEs, stapedial acoustic reflex dynamic parameters. The results suggest that these measures could be used in the monitoring of the NIHL as indicators of subtle alterations of the hearing function.

Acoustic Impedance Tests↗
PubMed1991

Insulin secretion and action in patients with pancreatic cancer.

The authors investigated insulin secretory capacity and insulin action in 11 preoperative patients with pancreatic carcinoma and 15 age-matched and weight-matched healthy subjects (C). Five patients were classified as diabetic (D), two as impaired glucose tolerant (IGT), and four as nondiabetic (ND). Postabsorptive serum insulin levels (mean +/- SE, in uU/ml) in D (12 +/- 2), IGT (17 +/- 7), and ND (10 +/- 2) were comparable. After administration of 100 g of oral glucose, peak insulin achieved in D (60 +/- 11) was lower than in IGT (101 +/- 26) and ND (83 +/- 20), whereas peak insulin levels in IGT and ND were significantly (P less than 0.05) higher than in C (45 +/- 6). Comparable insulin response to nonglucose stimuli was documented in all subjects using the slow arginine infusion test with mean serum insulin of 27 +/- 4 in D, 28 +/- 6 in IGT, 34 +/- 10 in ND, and 32 +/- 5 in C. In six patients (P) and six controls, insulin action was assessed by the euglycemic hyperinsulinemic clamp technique, with glucose turnover rates estimated by [3-3H]glucose infusion. Steady-state plasma glucose concentrations were maintained at 92 +/- 3 (P) and 91 +/- 1 mg/dl (C). After insulin infusion at the rate of 1.0 mU/kg/min, comparable high physiologic insulin levels were observed in P (73 to 104 uU/ml) and in C (81 to 103 uU/ml). Postabsorptive rates of endogenous glucose appearance (Ra) were higher in P (2.86 to 3.02 mg/kg/min) than in C (1.50 to 2.80 mg/kg/min). At high physiologic insulin concentrations, negative Ra values were documented in all subjects, and complete suppression of Ra was assumed. Total body glucose use (M) was consistently lower in P (3.90 to 6.40 mg/kg/min) than in C (6.98 to 10.40 mg/kg/min), consistent with a state of insulin resistance. Patients with pancreatic cancer manifest insulin resistance by virtue of a decrease in total body glucose use (M) and decreased insulin response to glucose due to either inherent beta cell dysfunction or decreased islet cell mass. The latter is not identifiable by histologic morphology.

Adenocarcinoma↗
PubMed1991

The effect of graded doses of insulin on peripheral glucose uptake and lactate release in cancer cachexia.

With the euglycemic clamp technique, we evaluated the effects of graded doses of insulin on glucose turnover rates and forearm lactate balance in five weight-losing patients with cancer before surgery and five age- and weight-matched healthy volunteers (control subjects). Insulin was infused sequentially at increasing rates of 0.5 (low physiologic), 1.0 (high physiologic), and 4.0 (supraphysiologic) mU/kg.min for 120 minutes each. Concurrently, rates of glucose appearance and disappearance were derived from [3-3H] glucose infusion. The mean postabsorptive rate of glucose appearance in patients (2.9 +/- 0.1 mg/kg.min) was significantly higher (p less than 0.02) than that of control subjects (1.98 +/- 0.16 mg/kg.min). Complete suppression of endogenous glucose production occurred at high physiologic insulin concentrations. With progressive insulin infusion, the rate of glucose disappearance increased to 3.6 +/- 1.2, 8.7 +/- 0.8, and 13.7 +/- 1.1 mg/kg/min in control subjects and 2.9 +/- 0.4, 5.3 +/- 0.3, and 10.9 +/- 0.9 mg/kg.min in patients, significantly different from that of control subjects (p less than 0.05) during the intermediate (high physiologic) insulin infusion. A comparable slight increase in arterial plasma lactate concentration was observed in both groups with progressive hyperinsulinemia. Baseline peripheral lactate flux was identical in patients (-272 +/- 56 nmol/100 gm.min) and in controls (-271 +/- 57 nmol/100 gm.min). Progressive physiologic hyperinsulinemia resulted in significantly (p less than 0.05) augmented peripheral lactate efflux in patients (-824 +/- 181 nmol/100 gm.min) compared with control subjects (-287 +/- 64 nmol/100 gm.min). Supraphysiologic insulin abolished this increased lactate efflux in patients. Postabsorptive rates of endogenous glucose appearance in weight-losing patients with cancer were elevated, but complete suppression was achieved with insulin concentrations in the physiologic range. Total body glucose use was diminished in these patients, consistent with a state of insulin resistance. This impaired insulin action on peripheral glucose use was associated with an increase in peripheral lactate release in patients.

Adult↗
PubMed1990

Effect of epinephrine on amino acid and energy metabolism in humans.

Epinephrine was infused for 8.5 h into five normal, healthy, young adult men on four different occasions at 0, 0.5, 1, and 2 micrograms/min to elevate circulating levels of epinephrine into the high physiological range as seen in stress and trauma. Energy expenditure, heart rate, and blood pressure were measured at hourly intervals. [1-13C]leucine, [ring-2H5]phenylalanine, and [2-15N]glutamine were infused during the last 3.5 h to follow essential amino acid and glutamine kinetics. This design was adapted to study the effects of epinephrine on energy and protein metabolism after acute and temporary metabolic responses to epinephrine had occurred. Plasma glucose was significantly increased by approximately 20 mg/dl from 83 mg/dl (saline infusion) at all levels of epinephrine infusion. Amino acid levels were depressed with epinephrine infusion, with the largest drop occurring for the essential amino acids (-27% at the 2.0-micrograms/min dose). Energy expenditure was increased with epinephrine infusion in a dose-dependent fashion (+17% increase at 2.0 micrograms/min infusion). These effects were sustained for the duration of 8.5 h epinephrine infusion. There was no significant change in leucine or phenylalanine flux, indicative of protein breakdown, or in leucine oxidation. Glutamine flux was significantly (but modestly, +7%) increased at only the 2.0-micrograms/min infusion rate. Changes in kinetics that altered amino acid levels were not apparent by 7 h of epinephrine infusion (the beginning of the plateau period for the tracer infusion study). Although epinephrine can produce long-term elevations of metabolic rate, its effects on protein metabolism are minimal beyond acute changes affecting amino acid levels.

Adult↗
PubMed1987

Sarcoidois presenting with pericardial effusion.

Cardiac involvement has been reported at autopsy in 20% of patients with sarcoidosis. Involvement of the pericardium with sarcoidosis is rare, with a reported rate of 3% or less at autopsy. We report a case of sarcoidosis with a pericardial effusion which responded dramatically to 30 mgs of prednisone a day with resolution of the effusion, weight gain, and normalization of his temperature curve. The diagnosis of sarcoidosis was established by the typical pathologic changes in biopsies of lymph nodes, liver and bone marrow. All other causes of granulomatous disease and pleural effusion were absent. Pericardial involvement is a rare complication of sarcoidosis and steroid therapy may be effective in treatment.

Adult↗
PubMedDate not supplied

[Clinico-statistical investigation about cement dermatitis in Italy].

To define the prevalence of cement dermatitis (allergic contact dermatitis-ACD-and irritant contact dermatitis-ICD), two retrospective studies have been carried out in Italy: the first one based on the analysis of dermatitis cases ascribable to cement as defined by INAIL (Italian Institute for Industrial Accidents Insurance) from 1984 to 1992; the second one by surveying cement dermatitis cases in workers in the building industry aged between 16 and 70 carried out by Istituto di Clinica Dermatologica dell'Università di Bari from 1988 to 1994. The survey on INAIL data showed that in the years take into account 5,290 dermatitis cases included in item 41 of the occupational diseases table have been defined. About 80% of these cases have been observed in workers working as bricklayers and floor-layers. Therefore, given the remarkable exposure to cement in these professions, the prevalence of cement dermatitis in Italy has been estimated to 6 cases/province/year, even though it has not been possible recognize the clinical form of cement dermatitis. Moreover, the study showed that disabling cutaneous after-effects eligible for compensation have been observed in 30% of the cases defined by INAIL. The allergologic study carried out by Clinica Dermatologica has not only defined the incidence of contact dermatitis (ACD and ICD), in building workers, but it has also extrapoled dermatitis cases due to cement. As a whole, in the years taken into account, 166 occupational or mixed ACD cases and 77 occupational or mixed ICD have been diagnosed. The incidence of contact dermatitis ascribable to cement has equalled 79% among ACD and 88% among ICD, with a ratio of about 2 to 1 in favour of allergic forms. Among the chemicals tested, potassium bichromate showed the highest frequency of cases positive to patch tests. The skin site the most affected by cement dermatitis is hand, followed by upper limbs, lower limbs and feet. In the province of Bari, in the years taken into account, an average incidence of 28.4 cases per year of the two forms of cement dermatitis has been observed.

Adolescent↗
PubMedDate not supplied

The influence of amalgam fillings on urinary mercury excretion in subjects from Apulia (southern Italy).

The purpose of this study was to assess the role of dental amalgams and diet upon urinary mercury (U-Hg) excretion. 98 subjects (50 men and 48 women) not exposed to inorganic mercury, for either occupational or environmental reasons, and living in coastal and inland districts of Apulia (Southern Italy) were considered. All the subjects were administered a questionnaire with questions concerning life style, medical history, and occupational activity. Dental amalgams were evaluated with respect to their number and their surface areas. Urinary mercury was measured by the cold vapour atomic absorption technique. Expressed in terms of arithmetic mean, U-Hg excretion was found to amount to 1.03 micrograms/g creatinine (5th and 95th percentile: 0.31 and 2.40; range 0.30-3.25). Multiple linear regression analysis showed that, of the several tested independent variables (dental amalgams, age, body mass index, consumption of tuna, bass, swordfish, etc.), only the number of amalgam fillings (T = 5.25; p = 0.025) and the number of restored surfaces (T = 2.33; p = 0.020) were found liable to affect urinary mercury excretion in a significant manner. In conclusion, the results of this study confirm the primary role of amalgam fillings in affecting urinary mercury excretion in those subjects who are not occupationally exposed to inorganic mercury, The resulting urinary mercury levels can no doubt be taken as the reference values for the population of Apulia.

Adolescent↗
PubMedDate not supplied

[Dental amalgams and urine elimination of mercury in workers exposed to low concentrations of inorganic mercury].

The aim of the research was to assess the contribution of dental amalgams and other non-occupational factors of exposure to inorganic mercury (diet, etc.) to the quantity of mercury excreted with urine in workers exposed to low level concentrations of inorganic mercury. Two groups of workers (Groups I and II) were studied who were exposed to low and different environmental concentrations of inorganic mercury. These two groups were compared with a group of subjects not occupationally exposed to mercury in the same geographical area (Group III). All subjects were administered a questionnaire concerning personal data, lifestyle, recent removal and/or insertion of dental amalgam fillings, presence of nasal obstruction or bruxism and consumption of fish. The number of amalgam-filled teeth was established for each subject. Mean environmental exposure to inorganic mercury was 0.0087 mg/m3 for Group I and 0.0030 mg/m3 for Group II. Urinary excretion in the 3 groups was 4.2 +/- 2.8 micrograms/l for Group I, 3.0 +/- 2.1 micrograms/l for Group II and 1.6 +/- 1.2 micrograms/l for Group III. The results showed that of the factors of exposure to inorganic mercury, only occupational exposure (T = 9.18; p = 0.000) and the number of amalgam-filled teeth (T = 2.03; p = 0.043) were able to influence significantly urinary excretion of mercury; the sources of non-occupational exposure did not appear to play any role. The contribution of each amalgam filling to urinary mercury excretion was calculated to be 0.08 microgram/l. Occupational exposure therefore, even at low level doses, is still the main cause of urinary mercury excretion in workers exposed to inorganic mercury; of the non-occupational exposure factors, a significant role is played by amalgam dental fillings, whose contribution needs to be taken into consideration in order to make a correct interpretation of the results of biological monitoring of exposed workers.

Adult↗