Faecal contamination indicators, Salmonella, Vibrio and Aeromonas in water used for the irrigation of agricultural products.

The faecal contamination indicators (total coliforms, faecal coliforms, Escherichia coli, enterococci) and the genera Salmonella, Vibrio, Aeromonas were investigated in water samples used for irrigation. During 4 months, 52 samples were taken. The methods used were: multiple tube fermentation method for faecal contamination indicators and membrane filtration techniques for salmonella, aeromonas and vibrio. Two samples were positive for Salmonella spp., fourteen for Aeromonas spp. and no samples for Vibrio spp. No correlation was found between aeromonas and the indicators of faecal contamination. Regarding Aeromonas spp., 21.6% of the strains were adhesive and 12.6% cytotoxic: this confirms the possible role of aeromonas in human pathologies. These results are important to determine the quality of irrigation water in relation to human health. In fact, the spray or sprinkler irrigation produces bioaerosol, which can contaminate the crops that are likely to be eaten uncooked. In addition, the flood or furrow irrigation represents a risk to field workers.

Biological monitoring: lichens as bioindicators of air pollution assessment--a review.

Often as part of environmental impact studies and, above all, to obtain authorisations in accordance with prescriptions from the Ministry for the Environment (Italy), surveys and controls that use biological indicators are required. This is because such indicators are valid instruments for evaluating the quality of the air ensuing from the subject (often an industrial plant) of the Environmental Impact Assessment (EIA). In this context, this paper aims to analyse some of the theoretical aspects of biological monitoring and to provide a progress report on the use of lichens as bioindicators of air quality, with a particular eye to the situation in Italy. The object of this paper is that of pointing out the most important lines in the current state of knowledge in this field, evaluating the methodological applications and their advantages/disadvantages with respect to traditional surveying methods.

[Evaluation to the exposure to polycyclic aromatic hydrocarbons, benzene, toluene and xylenes in workers in a power plant fueled with heavy oil]. / Valutazione dell'esposizione ad idrocarburi policiclici aromatici ed a benzene, toluene e xileni di lavoratori di una centrale termoelettrica che utilizza olio combustibile denso.

Occupational exposure to polycyclic aromatic hydrocarbons (PAHs) has been demonstrated in many industrial sectors. However, up to date there are few studies in the literature on PAH exposure in thermoelectric power plants. The study was aimed at the evaluation of personal exposure to PAHs in workers of a power plant fueled with heavy oil. Exposure to polycyclic aromatic hydrocarbons (PAHs) and to benzene, toluene and xylenes (BTX) was evaluated on power plant workers exposed to heavy fuel oil; the control group consisted of office workers of the same power plant. Altogether 39 subjects were studied, for a total of 84 days of monitoring. Personal environmental exposure, cutaneous exposure and urinary concentrations of 1-hydroxypyrene (1-OHP), trans,trans-muconic acid (TTMA) and nicotine were measured. Personal environmental exposure to PAHs was very low; only maintenance workers showed exposure to total carcinogenic PAHs significantly higher than controls (median levels 3.05 and 0.88 ng/m3 respectively). All workers showed very low levels of dermal exposure to PAHs (less than 1 ng). The median 1-OHP urinary concentrations were 0.16, 0.11 and 0.08 mumol/mol creatinine in the groups of exposed workers and 0.08 mumol/mol creatinine in the control group. Neither the exposed workers nor the controls showed a significant increase in 1-OHP urinary concentrations across the shift. The regression analysis showed a significant effect of cigarette smoking on urinary 1-OHP, while no association was observed between occupational exposure and diet. Personal environmental exposure levels to BTX were very low. TTMA urinary concentrations of the exposed subjects were similar to those of the controls. No significant increase in the TTMA urinary concentrations was observed across the shift and, as expected, smokers showed higher values than non-smokers. The study did not show a measurable intake of PAHs and BTX in power plant workers that could be ascribed to occupational exposure, thus confirming the efficacy of the protective measures in force.

C3: Java-based medical record system for cardiology.

This paper describes a system for electronic medical record (EMR) we have developed for use in our health care institution, mainly dealing with diagnosis and treatment of cardiovascular pathologies. This activity is part of the project SPERIGEST, supported by Health Ministry of Italy, for the management of health care delivery, as concerns both clinical and administrative aspects. A networked computer-based information system was realized to integrate the different heterogeneous sources of patient information. Both clinical and administrative patient relevant data are provided from the various systems and stored into a central database. The EMR system was designed using World Wide Web (WWW) technology (Java, HTML). The system is currently under clinical evaluation.

[Non-bioavailability of carcinogenic polycyclic aromatic hydrocarbons contained in coal dust]. / Sulla non biodisponibilità degli idrocarburi policiclici aromatici cancerogeni contenuti nella polvere di carbone.

The aim of the study was to ascertain whether polycyclic aromatic hydrocarbons (PAHs) especially 3,4-benzo(a)pyrene, could be eluted from coal dust that comes into contact with biological fluids or crosses the skin barrier. A fine-grained coal dust with known PAH content was placed into contact with homogenized pig lung or human gastric juices, and also applied to monkey skin, using the cutaneous window method. The results demonstrate that, in the in vitro systems used, PAHs contained in coal dust are not eluted by lung homogenate or gastric juices, nor are they capable of crossing the skin barrier. These results justify and support the interpretation given to the results of experimental carcinogenicity studies on coal dust which never succeeded in demonstrating a higher incidence of cancer, particularly lung cancer, in treated animals.

Rhabdomyosarcoma presenting as acute hematologic malignancy: case report and review of the literature.

The authors describe a case of undifferentiated rhabdomyosarcoma from unknown primary site, presenting as an acute hematologic malignancy with generalized lymphadenopathy, extensive bone marrow involvement and clinical and laboratory features of disseminated intravascular coagulation. Such a peculiar behaviour is known for rhabdomyosarcoma but is rare and can be a serious diagnostic problem for the clinician and the pathologist. The importance of a large spectrum immunohistochemistry as first diagnostic approach to any undifferentiated small-cell malignant tumor is stressed, together with the knowledge of the different immunoreactivity patterns. Desmin, MS-actin and myoglobin are the most reliable markers of this type of myogenic sarcoma.

[Lymph node myofibroblastoma: report of a submandibular case with peculiar morphologic and immunohistochemical characteristics]. / Miofibroblastoma linfonodale: descrizione di un caso a localizzazione sottomandibolare con peculiari caratteri morfologici ed immunoistochimici.

The Authors describe a case of intranodal myofibroblastoma presenting in the submandibular region as a firm, indolent and freely mobile rounded nodule of about 3 cm. in diameter. The nature of this uncommon benign lesion is discussed. The observed histological features are partly different from the cases originally described. A proliferation of moderately pleomorphic spindle cells, which are vimentin and muscle specific actin positive, occupies a large part of a lymph node, sharply separated from the normal tissue. The so called "amianthoid fibres" are however absent and the inflammatory cells are almost exclusively eosinophils, mainly localized at the border between the lesion and the residual lymph node. Some spindle cells also show an unexplained positivity for the S-100 protein. In addition, extranodal extension of inflammation with few spindle cells is present. Such a complex picture has many features in common with the inflammatory pseudotumor of lymph node, another benign cause of lymphadenopathy. For this reason, the Authors suggest the possibility that myofibroblastoma is not a true neoplasm, but, together with the inflammatory pseudotumor, a peculiar type or a different stage of an abnormal lymph node reactivity.

Cardiac alterations in 36 consecutive patients with idiopathic haemochromatosis: polygraphic and echocardiographic evaluation.

Thirty-six consecutive patients with idiopathic haemochromatosis (IH) were studied by electrocardiography (ECG), polygraphy, M-mode and 2-D echocardiography and Doppler-echocardiography. No significant correlations were found between ECG, PEP/LVET ratio and echocardiographic measurements. Left ventricular (LV) enlargement with impaired LV systolic function was present only in three patients (5.5%), of whom two died during iron-depleting therapy because of cardiovascular complications. Compared with controls, echocardiographic abnormalities were significantly more frequent and marked in subjects with higher iron overload than in those in whom it was lower. Ten patients were studied before and after iron depletion, nine of whom had only mild echocardiographic abnormalities at baseline examination. Significant reduction of end-diastolic thickness of the interventricular septum and LV mass (P less than 0.01 and less than 0.02 respectively) was observed. Also the end-diastolic thickness of the LV posterior wall and the end-systolic diameter of the left atrium reduced although not to a significant degree. The increased thickness of ventricular walls without impairment of LV systolic function is probably the first and still reversible cardiac alteration due to iron deposition in the myocardium. Later, with increasing iron overload, LV function becomes impaired and dilated cardiomyopathy develops. Early diagnosis and treatment of IH cardiopathy is needed before irreversible cardiac damage occurs.

[Increase in blood potassium and subsequent normalization: effects on the electrocardiogram. Case report]. / Aumento della potassiemia e successiva normalizzazione: effetti sull'elettrocardiogramma. Descrizione di un caso.

Significant variations in the ECG have been observed in a female aged 77 with heart failure and chronic atrial fibrillation during an occasional increase in blood potassium followed by normalization. The major phenomena observed during hyperkalemia, due to a severe dehydration, were a transient sinus rhythm with atrio-ventricular block followed by atrial activity disappearance and advent of interventricular and fascicular block. Therapeutic normalization of blood potassium leads to a progressive disappearance of intraventricular and fascicular block, a temporary sinus rhythm and finally the return to atrial fibrillation which was the steady state of the patient before the blood potassium imbalance.

Risk factors for vulvar lichen sclerosus.

To assess risk factors for vulvar lichen sclerosus data were collected in a case-control study of 75 cases and 225 age-matched control subjects. Questions concerned personal characteristics and habits, gynecologic and obstetric data, general indicators of sexual habits, and selected dietary habits. The risk of vulvar lichen sclerosus was greater in parous women than nulliparous women, but there was little tendency for the risk to increase with number of births; the finding was not significant when only married women were considered. There was no material difference between cases and control subjects in relation to major indicators of sexual habits (age at first intercourse and number of sexual partners). A smaller proportion of cases was married, but no difference was observed in the distribution of cases and controls with reference to education, smoking habits, body mass index, and previous history of diabetes. There was no association between retinoids and risk of vulvar lichen sclerosus, but intake of carotenoids was inversely and strongly associated with vulvar lichen sclerosus. This apparent protection did not materially change after adjustment for socioeconomic status and other potential confounding factors.

Reproductive factors and the risk of invasive and intraepithelial cervical neoplasia.

The relation between reproductive factors and cervical neoplasia was evaluated in a case-control study of 528 cases of invasive cancer compared with 456 control subjects in hospital for acute conditions unrelated to any of the established or suspected risk factors for cervical cancer, and of 335 cases of cervical intraepithelial neoplasia compared with 262 outpatient controls. The risk of invasive cervical cancer increased with number of livebirths, the estimated multivariate relative risk (RR) being 4.39 in women with five or more births compared with nulliparous women. There was also an inverse relation with age at first livebirth (RR = 0.42 for greater than or equal to 30 vs. less than 20 years) which, however, disappeared after inclusion of parity in multiple logistic regression analysis. Likewise, cases of invasive cervical cancer tended more frequently to report induced abortions. However, this association was not statistically significant after allowance for confounding factors, including parity. No relation emerged with number of spontaneous abortion and age at last pregnancy. When the interaction between parity and sexual habits was analysed, the relative risk increased in subsequent strata of parity with increasing number of sexual partners or decreasing age at first intercourse, thus suggesting an independent effect of sexual and reproductive factors, and hence multiplicative on the relative risk of invasive cervical cancer. No consistent association emerged between the risk of intraepithelial cervical neoplasm and parity, number of abortions and age at first or last birth.

Post-coital contraception: an overview of published studies.

Information from published studies testing the effect of hormonal and mechanical interceptive methods in post-coital contraception was pooled with the aim of assessing the efficacy of various regimens. The pooled failure rates were 0.6% (19/3168 based on four studies) for high-dosage ethinylestradiol, 1.1% (11/975, based on two studies) for other high-dose estrogens, 1.8% (69/3802 based on 11 studies) for combined estro-progestin preparations, 2.0% (20/998 based on three studies) for danazol and 0.1% (1/879 based on nine studies) for intra-uterine devices (IUD). Although this overview has several limitations in terms of over-representation of optimistic results in the literature or absence of direct comparison between treatments in several studies, it suggests that IUD and high-dose ethinylestradiol are more efficacious forms of post-coital contraception than danazol or combined contraceptives.

Risk factors for endometrioid, mucinous and serous benign ovarian cysts.

To evaluate the risk factors for serous, mucinous and endometrioid ovarian cysts, data were collected in a case-control study conducted in the greater Milan area based on 202 women with benign cysts (114 endometrioid and 88 serous or mucinous) of the ovary and 1127 controls. Questions were asked about menstrual and reproductive characteristics, marital status, education, history of various diseases, and lifetime use of oral contraceptives and other hormonal treatments. Higher social class, earlier menarche and longer interval between age at first marriage and first birth, a likely indicator of subfertility, were associated with an increased risk of serous, mucinous and endometrioid cysts. Women with endometrioid cyst were characterized by low parity, less frequent irregular or long menses, more frequent oral contraceptive use and low body mass index, while the most relevant risk factor associated with serous and mucinous cysts was greater age at first birth. The present data point out the epidemiological differences between endometrioid and serous or mucinous cysts. Further, they suggest that analyses of risk factors for epithelial ovarian cancer subdivided by various histotypes may be of interest in order to confirm possible heterogeneities in the aetiology of ovarian epithelial neoplasms.

Airborne mineral fibre concentrations in an urban area near an asbestos-cement plant.

Ambient air concentrations of asbestos and total mineral fibres were measured during the period June-July 1985 at several locations near a large asbestos-cement factory located in the proximity of a northern Italian town. Measurements of the number and type of fibres were made by means of analytical scanning electron microscopy and energy-dispersive X-ray analysis (SEM-EDXA), essentially according to the RTM2 reference method of the Asbestos International Association. Total mineral fibre concentrations (longer than 5 microns) ranged from below detection limit (D.L., i.e. 0.4 fibres per litre (f/1] to 227 f/1 (single value); mean values ranged from 1.3 to 74.0 f/1. However, elemental microanalysis (EDXA) showed that about 65% of fibres were sulfate fibres, 20% were aluminium silicates or other silicates, and only 15% were asbestos fibres (mainly chrysotile and tremolite-group amphiboles). Asbestos concentrations (fibres more than 5 microns in length) were in the range of less than D.L. to 19.1 f/1, mean values ranging from less than D.L. to 11.1 f/1. The results obtained showed large differences in day-to-day concentrations, suggesting that they were affected by the rate of production in the plant and by weather conditions. In particular, wind direction and distance from the source appeared to be of major importance since the highest asbestos fibre concentrations were mostly found at points closer to the source and downwind. When the distance from the source was increased, other local factors appeared to be determining. In addition, the large proportion of non-asbestos mineral fibres and elongated sulfate (or sulfur-containing) particles clearly indicates major contributions from other sources, such as local pollution and natural soil erosion.

[Sampling strategy and analytical problems in work environments]. / Strategia del campionamento e problemi analitici per gli ambienti di lavoro.

The paper reviews the problems involved in sampling and analysis of pollutants in working environments. Special attention is given to the practical consequences of the particular working conditions of to-day, which are characterized by low levels of environmental pollution but are at the same time subject to the presence of mixtures of chemical substances. There is no doubt that the time has come to attempt to reach the greatest possible consensus on these problems (e.g., analytical procedures for complex mixtures). Guidelines and procedures are indicated for the control of indoor pollution and indoor air quality limits are proposed both for long-term (ALTER) and short-term (ASTER) exposures.

Epidemiologic characteristics of women with uterine fibroids: a case-control study.

Risk factors for uterine fibroids were analyzed in a hospital-based case-control study conducted in the greater Milan area, based on 275 women with histologically confirmed fibroids and 722 controls with acute nongynecologic or hormone-related conditions. Questions were asked about menstrual and reproductive characteristics, education, history of various diseases, and lifetime use of oral contraceptives and other hormonal treatments. The risk of uterine fibroids was reduced in parous women relative to nulliparous ones (relative risk 0.6) and in those who were postmenopausal (relative risk 0.1 compared with premenopausal women of the same age). Women with fibroids tended to have an earlier age at menarche and at the last birth, to be more educated, and to use intrauterine devices and oral contraceptives more frequently, although these findings were not statistically significant. Current smoking (but not past smoking) lowered the fibroid risk by about 40%. No associations were found with body mass index, history of spontaneous or induced abortions, and age at first birth.

Industrial hygiene programs for workers' health protection in Italy.

The recent Health and Safety Act devolves the management of workers' health protection to new local authorities named "Local Sanitary Units." The specific program is framed in the existing state regulations and is in agreement with European community politics regarding health risks arising from the industrial use of particular substances like lead, asbestos, benzene, PCBs and others. The rapid industrial growth during recent years put into evidence completely new and numerous risks with the result of both qualitative and quantitative modifications of occupational diseases which existed in the years preceding the second world war. This rapid and remarkable change required a general adjustment in the country, which involved universities, government and industry. At the same time, the need of new relationships between occupational risks and insurance management rose. Beginning in the seventies, the Italian Industrial Hygiene Association [Associazione Italiana Degli Igienisti Industriali (A.I.D.I.I.)] promoted the progress of industrial hygiene in Italy through national and international conferences, continuous educational activities and participation with government standard-setting committees. The trend in A.I.D.I.I. future activities embraces the development of standard evaluation and control procedures and the improvement of research following European guidelines in strict cooperation with correlated European and American organizations.