[An analysis of appeals against the ruling of the occupational physician's lodged to the Department of Prevention and Safety in the Working Environment--Health Prevention and Occupational Epidemiology Operative Unit within the A.S.P. Palermo (Palermo Health Authority), years 2008-2010]. / Analisi dei ricorsi "avverso giudizio del Medico Competente (M.C.)" inoltrati all'U.O.S. "Prevenzione Sanitaria e Epidemiologia occupazionale" del Servizio di Prevenzione e Sicurezza negli Ambienti di Lavoro" dell'ASP di Palermo nel periodo 2008-2010.

The purpose of this study is to analyze the appeals against a "suitability judgment for work" lodged to the U.O.S. "Health Prevention and Occupational Epidemiology Operative Unit" of Department of Prevention and Safety in the Working Environment within the ASP Palermo (U.O.S.), from 2008 to 2010. Studying the appeals gives an indirect view on the occupational physician activity and allows to monitor their actions, analysis aims at highlighting those issues around which any planning and implementation of coordination activities should be focused.

[EEG evaluation of patients undergoing extracorporeal circulation under analgesic and electrohypoalgesia with auricular acupuncture]. / Valutazione eegrafica in pazienti sottoposti a CEC in anestesia analgesica e in elettroipoalgesia con auricolo-agopuntura.

Electroencephalograms recorded 12 hours before and 12 hours after heart surgery in ECC and moderate hypothermia (30 degrees) are evaluated. Two groups of patients were studied: - the first group was composed of those undergoing analgesic anaesthesia; - the second group of those undergoing electroencephalograms by means of auricular acupuncture. In the first group the postoperative EEG was dominated by long "theta" and "delta" waves characteristic of the deep sedation of analgesic anaesthesia. In the second the EEG displayed a "theta" rhythm interspersed with trains of "alpha" waves, similar to that of a tired, but alert person. The pathological traces with signs of diffused, hemispheric or cerebral distress, do not bear any relationship to the type of anaesthesia, but to the type of disease, which had increased the probability of thrombo-embolic, and/or ischaemic risk.

[Surgical treatment of postinfarctual left ventricular aneurysm (author's transl)]. / Trattamento chirurgico dell'aneurisma ventricolare sinistro postinfartuale.

Ventricular aneurysm is a frequent complication of myocardial infarction, but its diagnostic and prognostic implications are not fully defined. A surgical series of 66 ventricular resections for symptomatic left ventricular aneurysm is analyzed. Pts. age varied between 26-29 years; the interval between the episode of infarction and operation from 2 mos. to 12 years. Indication for surgery was angina in 53% of the cases, heart failure in 23%, arrhythmias in 15%, angina and failure in 9%. In 55 cases surgical findings were consistent with true aneurysm in the anatomical sense, in 11 cases with a wide area of wall akinesia. In 24 cases endocavitary thrombosis was present. In 23 cases aneurysmectomy was the only surgical procedure, with closure of acquired VSD in 1 case and mitral valve prosthesis in 2 cases. In 43 cases aorto-coronary bypass grafting was associated (single bypass in 18, double in 23, triple in 2). Operative technique underwent modifications in time, in relation to the use of local and general hypothermia, of cardioplegia, of early aortic cross-clamping. Surgical mortality was of 7.5% (5 cases); the actuarial courve, including operative mortality, showed survival of 88% at 1 year and of 78% at 5 years interval. Correlation between mortality and clinical symptomatology, hemodynamic data and surgical findings was not statistically significant; a statistically highly significant correlation was found between mortality and operative technique. The results are interpreted and discussed in relation to the diagnostic definition of the problem, to the criteria of indication to surgery and to the operative technique.