Headache in a population of hospital workers.

Headache prevalence is very high, especially during working life. Hospital workers are expected to be particularly careful with health problems. Few data are available about the dimension of the headache-related problems among hospital workers, including disease awareness and diagnostic delay. 502 subjects employed in our hospital (doctors, nurses, technicians, administrative employees) were enrolled over a 3-month period and submitted to a questionnaire about the presence of headache, its characteristics and time spent from disease onset to diagnosis. We used the ID-migraine test, a validated tool, to obtain a correct migraine diagnosis based on a three-question test. Age and education were collected as continuous variables while the other variables (sex, presence of headache, presence of migraine, diagnosis put by the general practitioners) were encoded as binary. The difference of the distribution of the analyzed variables in tables was evaluated with χ (2) test. The data were analyzed with SPSS 13.0 for Windows systems. In the analyzed population (mean age 40.15 ± 11.0 years; males 60.7 %), 216 patients complained of headache (43.1 %) and 77 (15.4 %) were diagnosed as migraineous at the in-hospital evaluation. Among the 216 cephalalgic patients, the majority (59.7 %, p < 0.0001 at χ (2) test) did not refer to their general practitioner. Of the 77 patients affected by migraine, 55.8 % referred to their general practitioner, but only 27 (35.1 %) received a definite migraine diagnosis. Fifty subjects (64.9 %) were still undiagnosed and unevaluated at the moment of our survey (p < 0.0001 at χ (2) test). Headache prevalence was very high in this population of hospital workers. Diagnostic errors and delays were frequent. Unexpectedly, self-awareness of the headache was very low. Headache, particularly migraine, is a relevant cause of loss of working days and low productivity. Our findings suggest the necessity to program initiatives aimed to raise the awareness of headache in order to improve diagnostic and therapeutic possibilities.

[Chondrocalcinosis and diabetes mellitus. The clinico-statistical data]. / Condrocalcinosi e diabete mellito. Rilievi clinico-statistici.

Chondrocalcinosis is an important, common, age-related joint disease. Its characteristic is the deposit of calcium pyrophosphate dihydrate crystals in hyaline and fibrous cartilages. Occasionally, it is a familial disorder; more often, it is a sporadic disease of adults sometimes in association with hormonal and metabolic disorders. The relationship between CC and diabetes mellitus (DM) is disputed. In this study the prevalence of radiographic CC (knee and/or wrist) in 184 DM patients was evaluated. For comparison two matched groups without DM were studied: i) 184 consecutive unselected out-patients seem in Rheumatology Department of Ancona University with X-rays of knee and/or wrist; ii) 184 consecutive unselected outpatients observed in a Radiology Department with X-rays of knee and/or wrist. No statistical difference was found between the prevalence of CC in DM patients vs controls. Moreover 113 CC patients were studied. No statistical difference was observed between the prevalence of DM and impaired glucose tolerance in CC patients vs controls. These results may suggest that there is no relationship between CC and diabetes mellitus, as other studies have recently shown.

[Chronic perirenal hematoma following an overlooked kidney injury. Problems in diagnosis]. / Ematoma perirenale cronico successivo a trauma renale misconosciuto. Problema in diagnosi.

Five cases of chronic perirenal hematoma are reported. Preoperative tests were performed to assess the malignant or benign nature of the lesions which were observed some time after the dramatic episode which marked their onset. The varying characteristics of the disease showed by different imaging techniques (urography, arteriography, US, CAT) are such that only surgery can remove all doubts in the majority of cases.