Duodenal carcinoma at ligament of Treitz. Case report and review of the literature.

We report a case of adenocarcinoma of the duodenojejunal angle and remark the rarity of this pathology, the difficulty of diagnosis and treatment peculiar to tumours of the duodenum. This rare tumour is characterized by polymorphic and non specific symptomatology. The possible therapy is surgery. Radio and chemotherapy don't significantly improve survival.

Splenic abscess due to Streptococcus anginosus. Case report.

Splenic abscess is a rare condition. Haematogenous seeding to the spleen from an infection at a distant site, most often endocarditis, is been the most common predisposing condition but an increase has been observed in immuno-compromised patients too. Fever, leukocytosis and left upper quadrant pain are suggestive, but the signs and symptoms of splenic abscesses are often non-specific. Rare is the onset with diarrhoea as in our case. Ultrasound and computed tomography are reliable diagnostic tools. Splenectomy and antibiotics are the treatments of choice. We describe a case of splenic abscess with gas level and peritonitis from dissemination of Streptococcus anginosus (of Streptococcus millerii group) from duodenal ulcer contaminated. It was diagnosed with CT, ultrasound, and abdomen X-ray with contrast then treated with splenectomy and peritoneal lavage.

[Industrial manufacturing of the wool: pathology secondary to the biomechanical involvement of the upper limbs and the course in relation to work tasks]. / Lavorazione industriale dello lana: patologie secondarie all'impegno biomeccanico degli arti superiori (UEWMSDS) e loro evoluzione in relazione alla mansione lavorativa.

In years 2003-2005, 1248 laborers of Zegna Baruffa - Lane Borgosesia Company (establishment of Borgosesia and Vallemosso) have been visited and we selected 102 cases of pathology from upper extremity work-related musculoskeletal disorders in the units with working risk. Subsequently from April 2005 to May 2006 we have controlled the clinical evolution of the enlisted laborers and we noted that in 54% of the cases the clinical symptomatology has been resolved with a rest works and a correct therapy. The diagnosis, the treatment and the change of working duty can resolve a meaningful number of clinical cases.

[Proposal for an outline to be used in the assessment of chemical risk according to the legislative decree 25/20002]. / Proposta di uno schema utilizzabile per la valutazione del rischio chimico ai sensi del decreto legislativo 25/2002.

We present an operative outline for the evaluation of chemical risk in the work environment, according to the legislative decree 25/2002. It includes the following points: identificative data of the company, scope and field of application, description of the working activities, preventive and protective measures, medical report (including biological monitoring), environmental monitoring, conclusive evaluation. The scheme is a quali-quantitative instrument for the employer and his collaborators to establish whether the chemical risk present in the single productive sites can be considered "moderate" or "not moderate".

[Work and alcohol: considerations on a caseload of patients undergoing treatment]. / Lavoro e alcol: considerazioni su una casistica di pazienti in trattamento.

An enquiry into alcohol dependent subjects admitted to the clinical wards of the first section of Occupational Medicine belonging to Medicina Preventiva Occupazionale e di Comunità of University of Pavia for an alcohol disaddiction treatment has been performed through a phone interview. 289 patients have been contacted and time elapsed from admission to interview was one to three years. The questions focused alcohol abstinence, occupational position before and after admission, any improvement in the work sphere (relationship with the collegues), any feeling of empowerment of the work abilities and any increase in the responsibilities load. From our results we can conclude that alcohol disaddiction carried on during admission has positively contributed to the reinstatement of alcoholics patients.

[Occupational asthma caused by cefmetazole and 7-aminocephalosporanic acid: description of a clinical case]. / Asma professionale da cefmetazolo ed acido 7-amino-cefalosporinico: descrizione di un caso clinico.

A case of professional asthma, following exposure to cefmetazole and 7-ACA, occurring in a non atopic subject with remarkable bronchial hyperreactivity, is described. From the diagnostic point of view the execution of specific bronchial stimulation tests was conclusive. It is probable that the occurrence of the illness is due, in this case, to the ability of the inhaled substances to cause inflammation in a subject with bronchial hyperreactivity, without inducing an immunologic mechanism.

[Employment and alcohol: analysis of a clinical casuistic]. / Lavoro e alcol: analisi di una casistica clinica.

The relationship between alcohol and work was studied in a group of 537 voluntary patients (393 male and 144 female) admitted to the department of Medicina del Lavoro, Pavia University for alcohol rehabilitation. The highest incidence of alcohol abuse was found in non-working subjects (pensioners, unemployed, housewives) although the start of excessive drinking takes place after beginning a working activity; a cause-effect relationship between these two factors can not be clearly determined, however. It is true that the stress provoked by this new condition (introduction to the work experience) can, in certain subjects, be a contributing factor in alcohol abuse. The increasingly lower age of initiation to alcohol reconfirms the need for prevention and instruction even at scholastic level. We can deduce how no working condition, low age and low education can constitute makers of risk for alcohol abuse.