The Occupational Health Nurse and his/here role in the prevention of work-related diseases: results of an observational study.

BACKGROUND: In Italy, health in the workplace is still considered a field for physicians only. In contrast to Europe, the figure of the occupational health nurse is not yet present, due to the absences of contractual and university fields. The present study aimed to carry out a survey for understanding the usefulness of the introduction of the occupational health nurse in the field of prevention and protection of health at work. MATERIAL AND METHODS: The questionnaire was administered via an online survey to health professionals including Students (undergraduate and post-graduate levels) of Nursing Sciences and Midwives, Nurses, Physicians specialized in Hygiene and Preventive Medicine, in Occupational Medicine and Legal Medicine. The questionnaire included 26 questions. The statistical analysis, conducted with SPSS software (release 25.0), has been articulated through the use of frequency tables and contingency tables. Differences in participants' responses were analyzed with the chi-square and Fisher's exact tests, where applicable, considering gender, marital status, presence of sons in families, age, macro-region, and professional activities as potential explanatory variables. RESULTS: After two general reminders, 232 individuals entered the survey, with an overall response rate of 65%. 42.2% of the participants were nurses, aged between 20 and 64 years. Around 70% were females. A low percentage (9.9%) is associated with respondents from northern Italy 53.0% from Center and 37.1% from southern Italy. The questionnaire included four major fields of occupational health nursing. The nursing role for companies (items 8, 12, 13, 14, and 17): the responders approve the introduction of the occupational health nurse in the companies for his/her competences on health promotion and work-related diseases prevention. Utility for companies (items 18, 19, 20 and 21): the usefulness brought by the occupational health nurse to companies is fully shared by the responders. Occupational Health Nurse's action field (items 16, 22, 23 and 24): the answer "yes" has the highest prevalence among the responders, followed by "I don't know". Education (items 25 and 26): Nurses, Physicians and Nursing Students think that the occupational health nurse must have an appropriate university training program, in particular, a master's first degree. Concerning the main focus of the study (opinion on which was the most suitable course of study for the occupational health nurse), 85 (36,6 %) participants answered, "First level Master degree", and 60 (25,9 %) "Advanced training course". CONCLUSIONS: This study wanted to highlight the opinion of professionals on the usefulness of this new nursing figure, projected into the world of occupational medicine. The OHN supports the Physician with his/her professionalism and autonomy in prevention and treatment of work-related diseases, as demonstrated and valued in the rest of Europe. The implementation of advanced courses on occupational nursing, and in particular specific post-graduate degrees, is needed.

Airways humidification during mechanical ventilation. Effects on tracheobronchial ciliated cells morphology.

AIM: Airways humidification during mechanical ventilation (MV) can be performed by means of heat and moisture exchangers (HME). Good performance of selected hygroscopic HME was shown in terms of tracheal temperature and humidity control and low tube obstruction rates. However, few data are available on their effects on tracheobronchial ciliated cells. The purpose of this study was to evaluate the effects of 2 different HME on ciliated cell during MV. METHODS: Twenty consecutive patients undergoing elective surgery lasting <4 h were randomly assigned to be treated with Rusch (Group 1) or Mediflux (Group 2) hygroscopic HME. The morphology of tracheobronchial ciliated cells was evaluated from cytologic smears of endotracheal aspirate. Smears were prepared by using the thin-prep processor, stained using the Papanicolau method and examined in triplicate: recognizable respiratory cells were graded on a six-point scale, according to the normal appearance of cilia, cytoplasm and nucleus. RESULTS: In Group 1, 178.3+37 cells were retrieved from aspirates and , 155.6+58 in Group 2 (NS). The score was 739+241 in Group 1 and 617+329 in Group 2 (NS). Cilia and end plate were undamaged in 80+17% and 81+20% cells respectively in Group 1 and in 56+23% and 62+22% cells respectively in Group 2 (P<0.01 and <0.05). CONCLUSIONS: During MV epithelial tracheobronchial cells can be affected by the humidification device used. Our findings suggest that the 2 HME tested in the present study have a different impact on ciliated cells structure.

Presence of estrogen receptor beta in the human endometrium through the cycle: expression in glandular, stromal, and vascular cells.

The recent discovery of a new isoform of estrogen receptor (ER) beta has prompted the reexamination of estrogen action on target organs. Here, we describe the endometrial expression of human ERbeta and compare its distribution with that of ERalpha in the endometrial functional zone. Using immunocytochemistry with well characterized polyclonal antibodies against ERbeta, we have detected specific ERbeta expression in all endometrial compartments (glandular, stromal, and vascular); the specificity of the immunostaining is confirmed by lack of staining of the uterine sections with anti-ERbeta antibodies previously incubated with peptide preparation. The highest levels of ERbeta expression are observed in epithelial cells during the periovulatory period (days 14 and 15), as well as in stromal cells and cells of the vascular wall in the late-secretory phase; both smooth muscle cells and endothelial cells express ERbeta, as deduced from immunocytochemistry and RT-PCR analysis. ERbeta staining is usually low compared with that of ERalpha, except at days 24-26. The presence of ERbeta in decidualized stromal cells is deduced from immunocytochemistry using antismooth alpha-actin and anti-ERbeta antibodies or from RT-PCR analysis of ERbeta and insulin-like growth factor-BP transcripts in the same cells; the presence of ERbeta-positive stromal cells located close to vascular smooth muscle cells during this period suggests some specific role of this receptor during decidualization. ERalpha is also present in the cells of the endometrial vascular wall, in addition to the nuclei of glandular epithelial and stromal cells. Vascular ERalpha expression is highest during the periovulatory period, suggesting a regulation by estradiol, and a role in vascular function. Moreover, different variations of ERbeta and ERalpha in arterioles might have implications for the modulation of vascular function, possibly of vascular tone, during the menstrual cycle. Finally, these data suggest that ERbeta may have important roles in endometrial function, in addition to the well known role of ERalpha in endometrial proliferation and differentiation.

Blood pressure and isometric exercise. Correlation with anthropometric data and electrolyte urinary excretion in two groups of trained and untrained young men.

Blood pressure (BP) and heart rate (HR) at rest and at the third minute of hand grip exercise (HG), body weight (W), height (H), body index (BI), triceps skinfold (TS), arm circumference (AC), and 24-hour excretion of Na, K, and creatinine were measured in two groups of 50 males 18 to 21 years of age. The subjects were divided in two groups depending on their physical activity. Group 1 included 50 trained subjects who had been regularly engaging in dynamic exercise for at least one month (four one-hour sessions a week); Group 2 included 50 untrained subjects. In Group 1 there was no significant correlation among systolic blood pressure (SBP) and anthropometric data at rest, but it was significantly correlated during HG with W, H, BI, and AC. In Group 2, SBP was significantly correlated only with W and BI at rest, with W, H, BI, and AC during HG. Diastolic blood pressure (DBP) was well correlated, both at rest and during HG, with anthropometric data in both groups studied. No correlation was found between BP and urinary excretion of electrolytes. The BP values appeared to be slightly lower in Group 1 than the ones in Group 2, both at rest and during HG (P less than .05). No significant difference was found in any of the other parameters considered. Our data seem to confirm that regular physical exercise may have a moderate lowering effect on BP both at rest and during exercise; this is independent of any concomitant weight loss.(ABSTRACT TRUNCATED AT 250 WORDS)

Anthropometric data, urinary sodium excretion, and isometric exercise in epidemiological study of arterial hypertension.

Relationships between cardiovascular response to isometric exercise, anthropometric data, and urinary sodium excretion were examined a group of 80 young males aged 19.7 +/- 1.3 years. Diastolic blood pressure (DBP) was well correlated with the anthropometric data both at rest and during hand grip (HG). During hand grip even the systolic blood pressure (SBP) was correlated with height, arm circumference, body weight, and body index. There was no significant correlation between urinary excretion of sodium and BP. The correlation between SBP and some anthropometric measures found during hand grip but not at rest suggests that the sympathetic nervous system may play a role in determining a relationship between excessive body weight and blood pressure increase.