[Syncope and work: role of the occupational physician and global risk stratification]. / Sincope e rischio lavorativo: ruolo del medico del lavoro e stratificazione globale del rischio.

Safety risk for subjects suffering from syncope while working has not been as yet addressed by occupational medicine. The present study was aimed at evaluating a new developed methodology for job tasks risk stratification in patients with syncope. During a work-shop on syncope and occupational risk, 149 occupational physicians (OP) with about 10 years of clinical experience were asked to fulfil a Visual Analogue Scale (VAS) concerning the doctor's estimated potential damage (D) to the worker and the probability of a damage to occur (P) should syncope take place during the job task. Five job tasks characterized by different risk for safety (1, driving; 2, toxic products handling; 3, job performed closed to hot surfaces o free flames; 4, surgical activity; 5, office job) were identified. OP correctly stratified the risk associated to the different job tasks in patients with syncope. Unexpectedly, task #3 was given a risk similar to that obtained in drivers. This might be of paramount clinical and social importance when patients with syncope have to return to their job tasks.

[Syncope and occupational risk survey: the role of continuing education and multidisciplinary approach]. / Indagine conoscitiva sulla percezione del problema sincope in relazione al rischio lavorativo nella pratica clinica: ruolo della formazione e dell'approccio multidisciplinare.

Syncope is a common disorder characterized most of the times by a positive clinical outcome. However, it may turn to a life threatening event even for working colleagues and third party when occurring during an high risk job. We have recently found that, out of 670 patients admitted to the Emergency Department (ED) for syncope, about 50% were potential workers, being their age between 18 and 65 years. Also, we found that in this group of patients syncope recurrence was as high as 11% at 6 months. It is unknown how physicians address the problem of the occupational risk in patients suffering from syncope and how occupational aspects are taken into account in the clinical judgment before work readmission. One hundred eighty five doctors (149 occupational physicians, OP), participating in a work-shop on syncope, were asked to fulfill a questionnaire about their clinical experience and their attention to the occupational aspects in patients after syncope. Despite long lasting clinical experience, 41% of OP did not scrutinize syncope as a relevant symptom in their daily activity. 65% of the other specialists were used to address the occupational risk aspects in their syncope patients. A multidisciplinary approach involving continuing education on safety at work might reduce work accidents due to syncope relapse and promote a safe and suitable re-employment of patients with syncope. scrutinize syncope as a relevant symptom in their daily activity. 65% of the other specialists were used to address the occupational risk aspects in their syncope patients. A multidisciplinary approach involving continuing education on safety at work might reduce work accidents due to syncope relapse and promote a safe and suitable re-employment of patients with syncope.

Studies of Venezuelan encephalitis in migrating birds in relation to possible transport of virus from South to Central America.

All of 13 species of northward migrating shorebirds and 7 species of songbirds captured on the Pacific coast of Guatemala during April and May of 1974--1976 were susceptible to infection with small doses of either an epizootic or an enzootic strain of Venezuelan encephalitis (VE) virus. They produce moderate to high levels of viremia for 2--4 days post-inoculation; levels high enough to infect both epizootic and enzootic vector mosquitoes. Viremias were often sufficient even on the 3rd day after inoculation, a time that might represent the end of a migratory flight, assuming that the physiological state of the birds after capture reflected that during migratory flight. Birds of many taxa react similarly to infection with strains of VE virus, and have the potential for being moderately to highly effective amplifying hosts. However, whether northward migrating birds could have been the agents for the introduction of the epizootic Ecuadorian strain that initiated the middle-American epizootic of 1969--1971 is less clear. Data are not available for the extent, rates or routes of migration between the region of Ecuador and Central America, but the best information on the real speed of migration from elsewhere indicates that even warblers that fly more slowly than shorebirds could make the flight in 72 hours or less. Still, that there are geographically segregated subtypes of VE virus suggests that avian transport has been of minimal importance over long time spans. The role of inactivated vaccines in the middle-American epizootic remains an open question.