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Biomedical subjects

S Porru

Publications and source records attributed to S Porru.

At least 37 records · Page 2Linked to original sources
PubMed1990

Significance and validity of a shortened lead chelation test.

We evaluated the chelation test in 38 subjects exposed to lead or with suspected lead exposure, comparing the values of lead excretion at the 3rd h (PbU EDTA/3-h) and at the 24th h (PbU EDTA/24-h) after EDTA administration. Good correlation exists between PbU EDTA/3-h and PbU EDTA/24-h (r = .86) and between them and the main biological indicators of dose and effect of lead. When a second chelation test was performed in 15 subjects, a slightly better r coefficient (.93) was observed between the two tests, without reaching statistical significance. It seems difficult, in terms of the type of exposure that we considered, to use the 3-h test, on an individual basis, to predict the PbU EDTA/24-h values.

Adult↗
PubMed1989

Urinary mutagenicity tests in lead-exposed workers.

Urinary mutagenic activity detected by the bacterial fluctuation assay, using Salmonella typhimurium TA98 and Escherichia coli WP2 uvrA with and without metabolic activation (S9 mix), was studied in a group of 21 workers exposed to inorganic lead and a control group of 22 non-occupationally exposed subjects. Occupational exposure to inorganic lead had no effect on urinary mutagenicity in the strains considered, with or without metabolic activation. In smokers (exposed and non-exposed), urinary mutagenic activity appeared to increase compared to non-smokers (exposed and non-exposed), only with Salmonella typhimurium TA98 in the presence of S9 mix.

Adult↗
PubMed1985

Mature and immature synaptosomal membranes have a different lipid composition.

Subfractionation of the optic tectum in chick embryos results in the isolation of two fractions enriched in synaptosomes (fraction A and fraction B). In chicks after hatching, this fractionation results in the isolation of a single synaptosomal fraction (fraction B) and of a fraction enriched in myelin membranes devoid of synaptosomes (fraction A). The lipid composition of synaptosomal fractions (A and B) and corresponding synaptosomal plasma membranes has been analyzed and compared to the lipid composition of similar fractions isolated from 2-3 day-old chicks. The phospholipid composition of fraction A in embryos was mainly represented by phosphatidylcholine (PC) and phosphatidylethanolamine (PE). The PE content was significantly lower than that of PC, which accounted for by approximately 50%. Sphingomyelin (SP) and phosphatidylinositol (PI) accounted for by only 6% of the total membrane phospholipids. Fraction A isolated from the young chicks showed many significant changes. PC accounted for by approximately 40% and PE made up 35%. The amount of phosphatidylserine (PS) and SP increased. These data parallel our previous morphological observations, which showed that fraction A contains immature synaptosomes in embryos but myelin membranes and no synaptosomes in the young chicks. Fraction B has been shown to contain synaptosomes at all stages considered. It possessed in embryos a lipid composition similar to fraction A, except that PC content was higher in young embryos. The analyses on membrane fractions confirmed these results. On the contrary, this fraction showed many significant changes after hatching. The content of PC was significantly reduced, PE/PC ratio was significantly increased as well as ethanolamine plasmalogen (PLE) content. The percentage of PS, PI and SP were increased. The composition of fatty acids of the total fraction of phospholipids was also examined. The results parallel the observations on phospholipid classes.

Age Factors↗
PubMed1984

Effects of corticosterone on chick embryonic retinal cells in culture.

Corticosterone has been shown to affect several patterns of glial cell and neuronal development. We have previously reported that exogenously administered corticosterone preferentially accumulated into the retinas of 8-day-old chick embryos. Moreover, we observed that it affects muscarinic cholinergic binding. Thus, we investigated the effect of different concentrations of corticosterone on retinal cells in culture. Retinas were dissected from 8-day-old embryos, dissociated and cells plated on salt-precipitated collagen. At day 5, cultures were treated with corticosterone (from 10(-9) M to 10(-7) M) for 24 h. Controls received either Dulbecco's Modified Eagle Medium (DMEM) plus 10% fetal calf serum (FCS) or DMEM only. Results show that the main effect of the hormone was inhibition of neuronal process outgrowth. Also cell aggregation, flat cell proliferation and confluency are altered in hormone-treated cultures. All these effects are reversible and can be attributed to hormone effect and not to serum deprivation.

Animals↗
PubMedDate not supplied

[A report of 3 cases of pleural mesothelioma with unusual asbestos exposure].

The occurrence of malignant pleural mesothelioma (MT) is a sentinel event in occupational and environmental medicine. The association of pleural MT and asbestos exposure is well documented and it is well known that no threshold can be demonstrated below which there is no risk of developing MT. During the period 1994-1998, 3 patients were referred from the Pneumology Division to the Occupational Medicine Department of the Spedali Civili in Brescia. They had MT and they had a peculiar asbestos exposure. A thorough occupational and environmental history was taken by means of a standardized questionnaire. The first patient was environmentally exposed to crocidolite when she lived near an asbestos mine in Australia. The second was a teacher and the third was a goldsmith and both were occupationally exposed to asbestos. The case descriptions revealed the importance of a standardized evaluation of occupational and environmental exposure to asbestos. In this way otherwise ignored asbestos exposures can be identified therefore avoiding an underestimation of MT attributable to asbestos. The role of the occupational physician, both in hospital referrals and while taking standardized histories, is also stressed along with the importance of this contribution on the one hand to the epidemiological recording of sentinel events and on the other to the etiological definition of the cases, which was in fact our principal aim.

Aged↗
PubMedDate not supplied

[Medical surveillance and occupational identification of workers exposed to repeated movements of the upper limbs].

Repetitive motions of the upper limb at work can induce muskulo-skeletal alterations, therefore a specific medical surveillance is needed, according to the intensity of risk. In low risk conditions, the medical surveillance is aimed at the identification of hyper-susceptible individuals and the administration of specific information programs. When the risk intensity is higher, medical surveillance should add the recognition of early symptoms and signs of muskulo-skeletal disturbances, in order to remove workers showing early alterations from the exposure and allow medical rehabilitation. The diagnostic protocols with the adequate instrumental evaluation are provided, and the required legal reporting is discussed.

Arm↗
PubMedDate not supplied

[A pilot study on training and information of workers exposed to biomechanical overload of the upper limb].

Health education (HE) is very important in the prevention of occupational diseases, particularly when exposure to risk factors can be reduced through working procedures and hygienic behaviours. This pilot study refers to a HE program for prevention of work related muscle-skeletal disorders of upper limbs, carried out in two groups of 15 and 12 workers, respectively employed in trimming and assembling of plastic and metal parts. The first phase of the program consisted of worksite inspections and video recording of working procedures, characteristics of tools and machinery. This was followed by an informative meeting with the workers, which began with the administration of a multiple choice questionnaire, designed to evaluate the baseline knowledge about risk factors, work related muscle-skeletal disorders of upper limbs, working specific procedures and preventive actions. Questionnaires and video recording were repeated after two months in the second phase of the program, as subjective and objective methods of evaluation of HE effectiveness. In both groups, the questionnaire score was significantly increased after the program and a clear improvement was shown in the correct working procedures. This HE program contributed to increase the level of knowledge of the workers and fostered the adoption of working behaviours suitable to reduce the strain for the upper limbs.

Adult↗
PubMedDate not supplied

[Job fitness definitions in workers exposed to biological risks in a health care environment: highlights of a case report].

The definition of the specific job fitness for individual clinical cases often requires significant detailed investigation by the occupational physician. Such professional commitment is particularly important when biological risks in health care personnel are concerned. In fact, besides correct diagnostic procedures and the specific risk assessment implications, the level of competence of the worker, the safety of patients, work organization, risk perception and health education are also especially relevant. The aim of this paper is to report the case of a young nurse employed in the haematology section of the division of internal medicine, who was in charge of preparing and administering antineoplastic drugs. Risk assessment and a thorough clinical evaluation were performed in order to make a job fitness decision, with specific reference to biological risks. The nurse was suffering from membranous glomerulonephritis and was therefore being treated with various immunosuppressant agents. When she came to occupational physician, risk assessment showed that the preparation and administration of the antineoplastic drugs was not safely performed; the clinical picture showed moderate leukopenia while the kidney disease was functionally controlled. The worker was judged unfit to manipulate antineoplastic or perform activities in divisions at high biological risk. Recommendations were given to follow standard precautions and to follow up the case after cessation of immunosuppressant therapy. The case dealt with a specific biological risk assessment in health care settings and with the need to obtain through knowledge of the clinical state of the subject. Such information is necessary to assess job fitness, also giving recommendations related to employer's and employee's responsibility. The case report also provided the opportunity of underlining the role of the occupational physician in the management of cases of particular clinical relevance and of stressing the necessity of continuing scientific updating in order to reach sound conclusions.

Adult↗
PubMedDate not supplied

[Injuries with biological risk in a major hospital: analysis of a caseload].

This article report preliminary data on injuries involving risks from biological agents occurred in healthcare workers of a major hospital over a 5-years period ('96-'00). The role of Occupational Competent Physician is underlined. Injuries' database, archives of occupational diseases, discharge diagnosis and notification of transmissible infectious diseases were consulted. 200 injuries (3/4 percutaneous) were on average registered yearly, with a decreasing trend. Subjects had a mean age of 34 years and 7 years of length of employment at the hospital. 60% of exposures occurred in nurses and 43% workers belonged to surgical areas. Serological data of the "source patients" were available for 1/3 of the cases and 35% of them were bloodborne viruses infected; 1 seroconversion for HCV was registered. On the whole, our results are similar to data from national and international literature. However a few factors limited the data collection and interpretation, mainly the lack of computer formats and different ways of coding and filing the information. The periodical analysis of injuries is useful to the Occupational Physician, particularly for educational intervention and sanitary surveillance of workers. Moreover, the Occupational Physician plays an important role in injuries prevention, especially in spreading the information on Standard Precautions, evaluating the human factor, reducing the "under-reporting" of accidents, counselling, evaluating prognosis and resuming work.

Accidents, Occupational↗
PubMedDate not supplied

[Proposal of a health education program].

Since 1987 at the Spedali Civili of Brescia the problem of anaesthetic gases pollution in operating surgery rooms was managed by means of periodical environmental monitoring and maintenance of the anaesthesiological equipments. The mean nitrous oxide concentrations were generally reduced to values below the limits indicated by the Italian Ministry of Health. On the contrary, a low participation of the operating room personnel was observed in the health surveillance program and this phenomenon is clearly evidenced by the progressive decrease of the number of medical examinations. In order to clarify the usefulness of health surveillance programs and to promote the adoption of "less pollutant" behaviour, a Health Education Program was planned by the Medical Administration, in collaboration with the Occupational Health Service and the Department of Anesthesiology and Intensive Care. This program will be performed at different times, including the administration of a questionnaire, the participation at information meetings, the distribution of brochures and the evaluation of environmental and biological exposure data before and after the education program.

Anesthesia, Inhalation↗
PubMedDate not supplied

[Bladder cancer and occupational activity].

Bladder cancer is important in Occupational Medicine and in Occupational Epidemiology. Multicentric studies and pooled analysis have contributed in the last few years to the identification and characterization of several risk factors for bladder cancer, both occupational and non-occupational. Currently, it is a research priority the study of genetic susceptibility and its interaction with environmental and occupational exposure to the various bladder cancer risk factors. Bladder cancer management entails a few aspects that directly involved the Occupational Phisycian in different activities such as biological monitoring of chemicals, known or suspected bladder carcinogens, health surveillance, fitness for work, the return to work of the bladder cancer patients and finally epidemiological surveillance and health promotion.

Humans↗
PubMedDate not supplied

Malignant mesothelioma and the working environment: the viewpoint of the occupational physician.

BACKGROUND: Firm scientific evidence supports the causal association between malignant mesothelioma (MM) and occupational exposure to asbestos. Risk attributable to occupation varies from 30 to 80% across different populations. The existence of a threshold level below which there is no risk of MM is still debated. A prompt and thorough assessment of exposure is essential to evaluate and manage MM cases, from diagnostic and epidemiological points of view. OBJECTIVES AND METHODS: To highlight the multiple areas of intervention by Occupational Physicians (OP) in MM evaluation and management, to describe an experience of OP in the province of Brescia. RESULTS: The main areas of interest of the OP are exposure assessment, diagnosis (clinical, etiological), medico-legal issues, social consequences, preventive strategies, risk communication, scientific dispute/uncertainties. By means of an active search, the Brescia MM registry, managed by OP belonging to the local health authority observed 309 MM from 1977 to 2003; the local Institute of Occupational Health, hosted in a hospital of national relevance, evaluated about 200 MM in the last decade. The main outcomes of OP activity are the high percentage of direct interviews, individual case management, expert exposure assessment, etiological diagnosis, counselling, medico-legal assistance, better knowledge of occupational risks, enhanced cooperation among health professionals (oncologists, pathologists, surgeons, pneumologists, general practitioners and OP), important contribution to Registries and to epidemiology (estimates of attributable risks, incidence, survival rates), with positive social and scientific consequences (insurance agencies, trade union organizations, public events, teaching opportunities). CONCLUSIONS: This experience highlights the multifaceted role of OP in active research and evaluation of MM cases, in the context of a multidisciplinary approach.

Adult↗
PubMedDate not supplied

Malignant mesothelioma in 2004: How advanced technology and new drugs are changing the perspectives of mesothelioma patients. Highlights from the VIIth Meeting of the International Mesothelioma Interest Group.

Malignant mesothelioma (MMe) is a seemingly uncommon tumour whose incidence has in fact increased steadily and progressively over the last 30 years. Indeed, an actual "epidemic" is expected in the next 20 years, with over 1300 new cases a year till 2020 at least. Despite unquestionable improvement in the diagnostic methods at our disposal and the availability of new treatment strategies, the prognosis of MMe patients remains dramatically poor. For all the above reasons, translational research is the key to success; indeed, ever increasing knowledge of the molecular mechanisms underlying MMe pathogenesis could lead (and is actually leading) to new, hopefully more active, treatment options. To foster discussion among investigators working in this field, and to exchange different viewpoints concerning the newest advances in MMe pathogenesis and treatment, the VII International Mesothelioma Interest Group (IMIG) meeting was held in Brescia (Italy) between 24 and 26 June 2004 in cooperation with the Italian Group for the Study and Therapy of MMe (GIMe). The aim of this report is to summarize the most significant advances in the different disciplines applied to MMe presented and discussed during the IMIG meeting and how these advances will be changing the perspective of patients with MMe.

Angiogenesis Inhibitors↗
PubMedDate not supplied

Fitness for work in difficult cases: an occupational medicine experience in a University Hospital.

BACKGROUND: Fitness for work (FW) in certain clinical cases poses significant professional challenges for Occupational Physicians (OPs). OBJECTIVES: to discuss the role of a public Institute of Occupational Medicine (IOM) in FW, thorough description of clinical cases. METHODS: the IOM at the University of Brescia is a public clinic available to general practitioners, OPs, other specialists, insurance companies, health authorities, employers, trade unions. IOM expert opinion on FW may be requested by OPs, employers or workers. In each case, occupational and clinical histories are taken, physical examinations, laboratory and instrumental tests might be performed, and technical and clinical documentation is acquired; expert opinions from other specialists might also be sought. Risk assessment (RA) stems from worksite inspections and information from company health and safety representatives, or health authorities. RESULTS: a few peculiar clinical cases are reported: tremors in a dental hygienist trainee, chorioretinitis in a welder, spasmofilia in a nursing aide, obstructive sleep apnoea in a steel worker, epilepsy in a metal engineering worker, as well as a number of cases fom the same workplace. CONCLUSIONS: FW judgement made by a IOM had several advantages from clinical and RA aspects. Work restrictions may not always be evidence based and it might be difficult to balance rights and duties of patients, employers and OPs; the IOM's wider experience, case discussion with the relevant parties, scientific and technical documentation of diagnostic and FW processes, strengthen the role of the IOM in dealing with difficult cases and as a guarantee from technical and ethical viewpoints.

Adult↗
PubMedDate not supplied

From clinical activities to didactics and research in occupational medicine.

BACKGROUND: The daily practice of Occupational Physicians in the mot industrialized countries suggests that the frequency of traditional occupational diseases is progressively lowering, their gravity is decreasing, and the etiological factors are changing. This trend should be quantitatively and qualitatively verified with ad hoc studies. The information is particularly relevant for Academic Institutions where medical students and residents in occupational medicine are trained. OBJECTIVES: To analyse the trends of clinical diagnoses and health surveillance activities conducted in the last 15 years by an Italian Institute of Occupational Health, and to gain information on the most relevant topics to be taught in academic program and to be addressed with future research. METHODS: Data sources were represented by the computerised registration of a) diagnostic activities and b) health surveillance programs, conducted by the Institute of Occupational Medicine of the University of Brescia, a highly industrialized area in Northern Italy. The observation period was from 1990 to 2005. The health surveillance programs regarded workers pulled from an iron foundry, a veterinary institute, a health departments for the assistance of elderly subjects, a nursery schools and a municipal department for road maintenance. RESULTS: Diagnostic activities were conducted on 9080 subjects, who had been referred for suspected occupational disease. The diagnosis of occupational disease was confirmed for 3759 cases. Multiple diseases were diagnosed in 1554 subjects, yielding the total number of 5721 occupational diseases. The most frequent diagnoses accounted for allergic skin disease (23.4%), followed by pneumoconiosis (20.4%), chronic obstructive pulmonary disease (15.9%), noise hearing loss (7.1%), musculoskeletal disorders (6.9%), respiratory allergies (6.9%), cancer (5.9%), miscellaneous (6.4%). When limited to the last quinquennium, the analysis showed a definite increase of muskuloskeltal disorders, cancer, and, although at a lesser extent, diseases due to psychosocial factors. The analysis of the health surveillance programs regarded 1207 workers, and showed that various non occupational diseases caused limitation to individual work fitness. The most frequent conditions were musculoskeletal disorders (65%) and skin diseases (14%). CONCLUSIONS: The results from these two investigations are important not only for the didactic program run by the Institute, but also because they indicate the most relevant topics to be addressed with future research, at least at a local level.

Academies and Institutes↗
PubMedDate not supplied

[Occupational cancer. The role of the occupational physician in systematic search and aetiological diagnosis of lung cancer. Analysis of a case list].

BACKGROUND: About 15% of lung cancers (LC) might be attributable to occupation. However, clinical practice shows that LC percentage for which occupational aetiology is recognized is lower than expected. OBJECTIVES: To address the role of Occupational Physicians (OP) in systematic search and aetiological diagnosis of LC. METHODS: The search was carried out at a university hospital in Brescia, northern Italy, a highly industrialized area with many workers potentially exposed to occupational lung carcinogens. Through short occupational history forms, physicians of various departments refer all new cases of primary LC to OP When occupational exposure to lung carcinogens is presumed, the OP evaluates the case at the occupational health clinic and sends clinical reports to notifying physicians, containing aetiological diagnosis and indications for medico-legal obligations. RESULTS: Before 1998, few cases were referred to the OP and even less were compensated. The search yielded 1502 LC; after screening, full occupational health evaluation was performed in 693 cases: occupational aetiology was recognized in 182 (26%). Risk factors were silica, asbestos, polycyclic aromatic hydrocarbons, truck driving, painting, road paving; many workers were exposed to multiple carcinogens. 48 cases were compensated, many others are under litigation. CONCLUSIONS: A systematic LC search made it possible to: reach an aetiological diagnosis and reduce the gap between expected LC and those reported/compensated; inform health authorities and undertake preventive action in workplaces; detect sentinel events; provide epidemiological data at community level; promote cooperation among health professionals (oncologists, surgeons, pneumologists, general practitioners, plant OP); increase teaching opportunities for medical students, those taking a specialisation course in occupational health; provide counselling and expert opinions for individual subjects, trade unions, employers, law courts.

Adult↗
PubMedDate not supplied

[The evaluation of occupational exposure to carcinogenic substances: limit values and risk assessments].

Considering that nowadays there is no unanimity about the possibility of adopting environmental and/or biological limit values in occupational exposure to carcinogens, some aspects are discussed about the mechanism of action of carcinogens, their metabolism and problems deriving from the possible multiple exposures, interactions and speciation of the different compounds. After the analysis of the results obtained by means of two different approaches by the American Conference of Governmental Industrial Hygienist and the Environmental Protection Agency of the United States, the authors examine some aspects of the qualitative and as far as possible quantitative comparison for the 16 substances included in both lists and they discuss how the mathematical models are used in the process of carcinogenic risk evaluation. Finally, it is considered the possible application even in occupational carcinogenesis of a model such as the one of the EPA.

Carcinogens↗