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1.
Occup Med (Lond) ; 70(2): 127-130, 2020 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-31974578

RESUMO

BACKGROUND: Sleep disorders are highly prevalent among university students. In particular, the symptoms of sleep disorders are more prevalent among healthcare students. AIMS: To assess the prevalence of risk factors of insomnia and sleep disorders and to examine the correlations between them among nursing and medical students. We also compared the effects of shift work during internship. METHODS: The sample was 417 healthcare students; 202 of them were nursing students, and the remaining 215 were medical students. We used a self-administered questionnaire to assess the risk factors for insomnia (i.e. age, BMI, tobacco consumption, physical activity and perceived stress, using the General Health Questionnaire-12). We also used the Sleep and Daytime Habits Questionnaire and Epworth Sleepiness Scale to assess the prevalence of sleep disorders and daytime sleepiness. RESULTS: A higher percentage of nursing students than medical students were aged 25 years or older, engaged in inadequate levels of physical activity and consumed tobacco. With the exception of tobacco consumption among nursing students, high scores on the GHQ-12 were the only risk factor associated with daytime and nighttime symptoms and poor sleep quality. There was no significant association between the symptoms of sleep disorders and shift work including night shifts. CONCLUSIONS: Since sleep disorders are highly prevalent among healthcare students, early detection and management is recommended. This will decrease the risk of harm to students and patients, due to medical mistakes.


Assuntos
Transtornos do Sono-Vigília/epidemiologia , Estudantes de Medicina/estatística & dados numéricos , Estudantes de Enfermagem/estatística & dados numéricos , Adulto , Índice de Massa Corporal , Exercício Físico , Feminino , Humanos , Internato e Residência/estatística & dados numéricos , Masculino , Prevalência , Fatores de Risco , Jornada de Trabalho em Turnos , Estresse Psicológico , Inquéritos e Questionários , Uso de Tabaco
2.
Reumatismo ; 71(2): 62-67, 2019 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-31309775

RESUMO

Systemic sclerosis (SSc)-related Raynaud's phenomenon (RP) and digital ulcers (DU) can impair health-related quality of life (HRQoL). The aim of our study was to estimate HRQoL in SSc patients treated with two different intravenous (IV) iloprost (ILO) regimens and in patients not treated with IV ILO. 96 consecutive SSc patients were enrolled in a pragmatic, prospective and non-randomized study, and divided into 3 groups: not requiring therapy with IV ILO (N=52), IV ILO once monthly (N=24) or IV ILO for 5 consecutive days every 3 months (N=20). Patients were followed up for three months. We assessed HRQoL using the generic preference-based questionnaire EQ-5D-5L. We conducted multiple regression analyses to estimate, in each treatment group, the mean general health (GH) and the mean utility index of the EQ-5D-5L, adjusting for possible confounders. The mean adjusted utility index and GH score, after three months' follow-up, were not different in the three groups: IV ILO was able to make patients requiring IV ILO similar to those not requiring it. Moreover, there was no difference in this model between the two ILO regimens (1 day monthly vs 5 consecutive days every 3 months). The two different IV ILO regimens (the most appropriate regimen was decided according to patients' characteristics and needs) were able to stabilize HRQoL in RP secondary to SSc non-adequately controlled by oral therapy.


Assuntos
Iloprosta/administração & dosagem , Qualidade de Vida , Escleroderma Sistêmico/tratamento farmacológico , Administração Intravenosa , Efeitos Psicossociais da Doença , Esquema de Medicação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
3.
J Viral Hepat ; 25(7): 791-801, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29406608

RESUMO

Different strategies of DAAs treatment are currently possible both pre- and postliver transplantation (LT). Clinical and economic consequences of these strategies still need to be adequately investigated; this study aims at assessing their cost-effectiveness. A decision analytical model was created to simulate the progression of HCV-infected patients listed for decompensated cirrhosis (DCC) or for hepatocellular carcinoma (HCC). Three DAAs treatment strategies were compared: (i) a 12-week course of DAAs prior to transplantation (PRE-LT), (ii) a 4-week course of DAAs starting at the time of transplantation (PERI-LT) and (iii) a 12-week course of DAAs administered at disease recurrence (POST-LT). The population was substratified according to HCC presence and, in those without HCC, according to the MELD score at listing. Data on DAAs effectiveness were estimated using a cohort of patients still followed by 11 transplant centres of the European Liver and Intestine Transplant Association and by data available in the literature. In this study, PRE-LT treatment strategy was dominant for DCC patients with MELD<16 and cost-effective for those with MELD16-20, while POST-LT strategy emerged as cost-effective for DCC patients with MELD>20 and for those with HCC. Sensitivity analyses confirmed PRE-LT as the cost-effective strategy for patients with MELD≤20. In conclusion, PRE-LT treatment is cost-effective for patients with MELD≤20 without HCC, while treatments after LT are cost-effective in cirrhotic patients with MELD>20 and in those with HCC. It is worth reminding, though, that the final choice of a specific regimen at the patient level will have to be personalized based on clinical, social and transplant-related factors.


Assuntos
Antivirais/economia , Antivirais/uso terapêutico , Análise Custo-Benefício , Hepatite C Crônica/tratamento farmacológico , Transplante de Fígado , Adulto , Idoso , Carcinoma Hepatocelular/cirurgia , Feminino , Hepatite C Crônica/complicações , Humanos , Cirrose Hepática/cirurgia , Masculino , Pessoa de Meia-Idade , Fatores de Tempo
4.
Am J Transplant ; 15(7): 1817-26, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26086300

RESUMO

Preliminary studies on HCV-cirrhotics listed for transplant suggest that sofosbuvir in combination with ribavirin is very effective in promoting viral clearance and preventing disease recurrence. Unfortunately, the high cost of such treatment (€46 500 per 12 weeks of treatment) makes its cost-effectiveness questionable. A semi-Markov model was developed to assess the cost-effectiveness of sofosbuvir/ribavirin treatment in cirrhotic patients without HCC (HCV-CIRRH) and with HCC (HCV-HCC) listed for transplant. In the base-case analysis, the incremental cost-effectiveness ratio for 24 weeks of sofosbuvir/ribavirin was €44 875 per quality-adjusted life-year gained in HCV-CIRRH and €60 380 in HCV-HCC patients. Both results were above the willingness to pay threshold of €37 000 per quality-adjusted life-year. Our data also show that in order to remain cost-effective (with a 24-week treatment), any novel interferon-free treatment endowed with ideal efficacy should cost less than €67 224 or €95 712 in HCV-cirrhotics with and without HCC, respectively. The results shows that sofosbuvir/ribavirin therapy, given to patients listed for transplant, is not cost-effective at current prices despite being very effective, and new, more effective treatments will have little economic margins to remain cost-effective. New interferon-free combinations have the potential to revolutionize the treatment and prognosis of HCV-positive patients listed for transplant; however, without sustainable prices, this revolution is unlikely to happen.


Assuntos
Antivirais/economia , Análise Custo-Benefício , Hepacivirus/patogenicidade , Hepatite C/economia , Hepatite C/prevenção & controle , Transplante de Fígado/efeitos adversos , Complicações Pós-Operatórias , Idoso , Antivirais/uso terapêutico , Feminino , Seguimentos , Hepatite C/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Anos de Vida Ajustados por Qualidade de Vida , Recidiva
5.
Prev Med ; 64: 75-80, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24732715

RESUMO

OBJECTIVE: The aim of this study is to assess whether family history of coronary heart disease (CHD) and education as proxy of social status improve long-term cardiovascular disease risk prediction in a low-incidence European population. METHODS: The 20-year risk of first coronary or ischemic stroke events was estimated using sex-specific Cox models in 3956 participants of three population-based surveys in northern Italy, aged 35-69 years and free of cardiovascular disease at enrollment. The additional contribution of education and positive family history of CHD was defined as change in discrimination and Net Reclassification Improvement (NRI) over the model including 7 traditional risk factors. RESULTS: Kaplan-Meier 20-year risk was 16.8% in men (254 events) and 6.4% in women (102 events). Low education (hazard ratio=1.35, 95%CI 0.98-1.85) and family history of CHD (1.55; 1.19-2.03) were associated with the endpoint in men, but not in women. In men, the addition of education and family history significantly improved discrimination by 1%; NRI was 6% (95%CI: 0.2%-15.2%), raising to 20% (0.5%-44%) in those at intermediate risk. NRI in women at intermediate risk was 7%. CONCLUSION: In low-incidence populations, family history of CHD and education, easily assessed in clinical practice, should be included in long-term cardiovascular disease risk scores, at least in men.


Assuntos
Doença das Coronárias/etiologia , Saúde da Família , Anamnese , Fatores Socioeconômicos , Adulto , Idoso , Glicemia/análise , Doenças Cardiovasculares/epidemiologia , Colesterol/sangue , Comorbidade , Doença das Coronárias/epidemiologia , Diabetes Mellitus/epidemiologia , Escolaridade , Feminino , Humanos , Hipertensão , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Medição de Risco/métodos , Fumar/epidemiologia , Acidente Vascular Cerebral/epidemiologia
6.
Acta Chir Belg ; 113(6): 406-14, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24494467

RESUMO

OBJECTIVES: to investigate the utility of assessing Health-Related Quality of Life (HRQoL) in a large group of subjects participating in a screening program for aneurysm and the relationship between HRQoL, diagnosis of aneurysm and related risk factors. METHODS: subjects involved in this screening program were submitted the EQ-5D questionnaire to report their own HRQoL. HRQoL was reported also a second time by the subjects who were diagnosed with aneurysm during screening and who returned for a monitoring follow up visit a few months later. We evaluated compliance with HRQoL data collection and performed multiple regression analyses in order to investigate the possible relationship between demographic and clinical data with HRQoL. RESULTS: 1,633 subjects screened (6.1% diagnosed with aneurysm) and 125 subjects diagnosed with aneurysm and attending a follow-up visit reported their HRQoL. Completion of the EQ-5D questionnaire was well accepted by both physicians and subjects undergoing screening. HRQoL was not significantly different between the screening and followup visits, on adjusting for age and sex. At the screening visit, HRQoL was associated with ASA class, heart condition, BMI and respiratory diseases. No associations were found at the follow-up visit. CONCLUSION: Assessing HRQoL in screening programs is feasible and well accepted and add useful information on health of large numbers of subjects from general population. This could be considered as a routine approach to optimizing the informative role of screening programs in guiding other investigations or interventions.


Assuntos
Nível de Saúde , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Aneurisma da Aorta Abdominal/epidemiologia , Aneurisma da Aorta Abdominal/prevenção & controle , Feminino , Humanos , Masculino , Programas de Rastreamento , Fatores de Risco , Inquéritos e Questionários
7.
Med Lav ; 104(5): 359-67, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24180084

RESUMO

BACKGROUND: Even if the contagious nature of tuberculosis was universally accepted during the nineteenth century, its transmission to health care workers (HCWs) was initially denied by the scientific community. Working among TB patients was not considered dangerous for healthy adults, so the potential risks for HCWs were branded as unwarranted "phthisiophobia" (fear of contracting tuberculosis). OBJECTIVES: This study aims at analyzing the problem of tuberculosis transmission among health care workers from an historical perspective, particularly highlighting the contribution made by the Italian Occupational Medicine community. METHODS: Scientific literature and historical sources on different theories regarding tuberculosis transmission were investigated, specially focusing on the period at the turn of the 19th and 20th centuries. RESULTS: At the beginning of the twentieth century, Luigi Devoto (1864-1936), an Italian pioneer in the field of Occupational Medicine, was one of the first scientists to conduct research on the transmission of tuberculosis among nurses. Since the 1920s several studies, conducted mainly on medical and nursing students, confirmed the risk for HCWs. However an international consensus on this issue was only achieved during the 1950s, when the institution of mandatory chest radiographs on admission for all patients significantly decreased the cases of tuberculosis among HCWs. CONCLUSIONS: Devoto was one of the first scholars who postulated the transmission of tuberculosis to HCWs. He also theorized that hospital personnel with active disease could also be a source of contagion to patients. Nowadays, "third party risk" and latent tuberculosis infection pose a new challenge for occupational physicians in hospitals.


Assuntos
Atitude Frente a Saúde , Pessoal de Saúde , Transmissão de Doença Infecciosa do Paciente para o Profissional/história , Transmissão de Doença Infecciosa do Profissional para o Paciente/história , Medicina do Trabalho/história , Transtornos Fóbicos/história , Tuberculose/história , Tuberculose/transmissão , Vacina BCG , Busca de Comunicante , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/história , Infecção Hospitalar/transmissão , Cultura , Surtos de Doenças/história , Medo , Infecções por HIV/epidemiologia , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , História do Século XV , História do Século XVI , História do Século XVII , História do Século XVIII , História do Século XIX , História do Século XX , História Antiga , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Itália/epidemiologia , Recursos Humanos em Hospital/psicologia , Recursos Humanos em Hospital/estatística & dados numéricos , Risco , Teste Tuberculínico , Tuberculose/diagnóstico , Tuberculose/epidemiologia , Tuberculose/psicologia , Vacinação/história
8.
G Chir ; 34(3): 70-3, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23578409

RESUMO

INTRODUCTION: Endoscopic hernia repair methods have become increasingly popular over the past 15 years. Nonetheless, there is no consensus regarding an optimal fixation method. Transabdominal sutures and titanium tacks or staples are the most traditional ones. CASE REPORT: We present a case of mechanic small bowel obstruction due to mesh migration occurring one year and a half after incisional hernia repair with polytetrafluoroethylene mesh fixed by spiral tacks. DISCUSSION: Titanium spiral tacks are dangerous because of their sharp components, which can damage organs such as the small intestine, by causing microperforations. The type of prosthesis used has also contributed to the intraluminal migration, since polytetrafluoroethylene mesh is very flexible and poorly integrates in the abdominal wall. CONCLUSION: A prosthesis of a different material combined with a different fixation system such as absorbable tacks, biological glue, or mechanical tacks without sharp components, would have obviated mesh migration.


Assuntos
Migração de Corpo Estranho/complicações , Doenças do Íleo/etiologia , Obstrução Intestinal/etiologia , Telas Cirúrgicas/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade
9.
Neuroepidemiology ; 39(1): 35-42, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22777532

RESUMO

BACKGROUND: We compared rates and case fatality from a population-based stroke register in Northern Italy between 1998 and 2004 to assess changes over time and to evaluate changes in case diagnosis and management. METHODS: The WHO Multinational Monitoring of Trends and Determinants in Cardiovascular Disease criteria were used to identify suspected fatal or nonfatal events occurring among residents 35-74 years of age. Data on in-hospital treatments, symptoms and diagnostic tools were extracted. Out-of-hospital deaths were also investigated. The annual average relative change (ARC) in death rate, attack rate and case fatality were derived from Poisson models. RESULTS: Death rates due to ischemic stroke (IS) decreased [men: ARC -12.7, 95% confidence interval (CI) -21.3 to -3.2; women: ARC -14.0, 95% CI -23.3 to -3.5]. These reductions are attributable to decreases in case fatality; attack rates of nonfatal IS increased (men: ARC 3.6, 95% CI 0.5-6.7; women: ARC 4.1, 95% CI 0.0-8.2). IS patients showed a higher prevalence of dyslipidemia and hypertension and underwent MRI more frequently in 2004. Both findings may explain the increased proportions of less severe cases. Case fatality and attack rates for hemorrhagic strokes (HS) were stable, with an observed increased prevalence of patients under anticoagulant/antiplatelet treatments. CONCLUSIONS: In this low-IS-incidence population, death rates decreased substantially during the investigated period. More accurate diagnostic tools increase the probability of detecting less severe cases. HS remains a frequently fatal disease with a stable incidence.


Assuntos
Isquemia Encefálica/epidemiologia , Hemorragias Intracranianas/epidemiologia , Sistema de Registros/estatística & dados numéricos , Acidente Vascular Cerebral/epidemiologia , Adulto , Idoso , Comorbidade , Dislipidemias/epidemiologia , Feminino , Humanos , Hipertensão/epidemiologia , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Mortalidade , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Fatores de Tempo
10.
G Ital Med Lav Ergon ; 34(3 Suppl): 774-6, 2012.
Artigo em Italiano | MEDLINE | ID: mdl-23405776

RESUMO

Construction has been one of the first sectors in which an organized system of occupational health protection has been implemented, as shown by the Egyptian physicians caring for workers and artisans in building sites. During the Middle Ages, first examples of accident prevention legislation in this field may be found among the Lombards. In the same period, craft organizations led to greater social recognition of skilled workers, without a improvement in their health conditions. Ramazzini accurately described some risks of stonemasons and brick-makers (chemical and microclimatic hazards). In the following centuries, the Industrial Revolution led to a population growth in metropolitan areas and increased employment as well as accidents in the construction sector, as demonstrated by some ex-voto paintings in churches. This phenomenon became more evident in postwar recovery, forcing Italy to adopt modern accident prevention rules. Nowadays Italian legislation, complying with EU directive, provides new challenges for occupational physician.


Assuntos
Indústria da Construção , Saúde Ocupacional/história , História do Século XVIII , História do Século XIX , História do Século XX , Humanos , Itália
11.
G Ital Med Lav Ergon ; 34(3 Suppl): 537-9, 2012.
Artigo em Italiano | MEDLINE | ID: mdl-23405710

RESUMO

Vaccinal prophylaxis is a preventive action which is compulsory, if available and useful for health protection of workers exposed to biological work risk. Definition andrealization of compulsory vaccinal campaigns is assigned by law to Occupational Health Doctor. We report a research carried out in 135 firms of building sector on 2158 workers exposed to biological work risk and concerning their vaccinal status against Tetanus and Hepatitis B. We found that only in a part of firms a plan of vaccination has been activated among workers exposed to biological work risk and, if activated, these plans frequently were partial and incomplete. Vaccinal protections among workers therefore resulted insufficient especially among foreigners workers and among workers active in first aid and emergency work teams. We think that a more active role of Occupational Health Doctors in promotion and realization of vaccinal campaigns is necessary for medico-legal and scientific reasons.


Assuntos
Indústria da Construção , Hepatite B/prevenção & controle , Exposição Ocupacional/legislação & jurisprudência , Exposição Ocupacional/prevenção & controle , Saúde Ocupacional/legislação & jurisprudência , Tétano/prevenção & controle , Vacinação/legislação & jurisprudência , Humanos , Itália
12.
G Ital Med Lav Ergon ; 34(3 Suppl): 106-8, 2012.
Artigo em Italiano | MEDLINE | ID: mdl-23405592

RESUMO

Occupational Health Doctors active in building sector firms frequently have to evaluate residual workers' osteomuscular function in patients coming back to work after an accident happened during work time or free time. Definition of their specific individual work suitability is usually carried out utilizing semeiotic tests in which subjective evaluation of every single Medical Doctor is real important in definition of final results and this fact can cause legal controversies. In our research we describe the application of computerised movement analysis on 10 workers of building sector. In every patient examined this technical method has been able to study objectively the tridimensional ranges of motion of most important osteomuscular districts. The possibility to have an objective evaluation of residual osteomuscular function has a relevant importance both in definition of workers' work suitability at the moment in which they start again their activities and in possible future legal conflicts.


Assuntos
Indústria da Construção , Diagnóstico por Computador , Doenças Musculoesqueléticas/diagnóstico , Doenças Profissionais/diagnóstico , Retorno ao Trabalho , Fenômenos Biomecânicos , Humanos , Sensibilidade e Especificidade
13.
G Ital Med Lav Ergon ; 34(3 Suppl): 159-61, 2012.
Artigo em Italiano | MEDLINE | ID: mdl-23405608

RESUMO

Use of barrier creams among workers exposed to chemical risk has changed during last years and actually seems not to be very largely widespread even if there are not many up to date data about it. We report a research carried out evaluating effective presence in pharmacological market of barrier creams, their chemical characteristics, their composition, their prize. We analyzed the prescription of barrier creams made by 45 Occupational Doctors active in 2730 firms, their knowledge of chemical and pharmacological aspects which can make the difference among creams. We also considered motivations of their frequent or rare barrier cream prescription.


Assuntos
Emolientes , Exposição Ocupacional/prevenção & controle , Saúde Ocupacional , Difusão , Humanos
14.
G Ital Med Lav Ergon ; 34(3 Suppl): 518-20, 2012.
Artigo em Italiano | MEDLINE | ID: mdl-23405705

RESUMO

A relevant part of deadly work accidents and of severe work accidents reported in national specific statistics coming from INAIL is until today caused by workers' falls during their at height work activities. Medical evaluation of eventual workers' hyper susceptibility to fall caused by balance alterations, if included in medical surveillance, is frequently carried out by medical doctors using different subjective tests included in different clinical protocols. Use of a computerized stabylometric footboard on the contrary allows to obtain objective and reproducible data concerning vestibular function which, associated with traditional clinical medical evaluation, seem to better detect eventual presence of balance disturbances, especially those non clinically perceivable by workers and therefore more dangerous. We report results evidenced in a research carried out in a group of 185 workers engaged in building firms and having work tasks including phases of at height work.


Assuntos
Indústria da Construção , Saúde Ocupacional , Equilíbrio Postural/fisiologia , Avaliação da Capacidade de Trabalho , Diagnóstico por Computador , Humanos
15.
G Ital Med Lav Ergon ; 34(3 Suppl): 628-30, 2012.
Artigo em Italiano | MEDLINE | ID: mdl-23405735

RESUMO

Our research describes activities of Occupational Health carried out during last year in University of Milan Bicocca by Occupational Doctors. We describe results of medical surveillance in 1153 employees or students exposed to occupational risks for health and safety. We report results obtained, technical difficulties, organizational problems, and preventive actions decided to improve functionality of our activity. Students seem to be less protected and consequently seem to have higher professional safety and health risks.


Assuntos
Saúde Ocupacional/legislação & jurisprudência , Vigilância da População , Universidades , Humanos , Itália , Universidades/legislação & jurisprudência , Universidades/organização & administração
16.
G Ital Med Lav Ergon ; 34(3 Suppl): 635-7, 2012.
Artigo em Italiano | MEDLINE | ID: mdl-23405737

RESUMO

Our research describes a medical surveillance, not included in usual Occupational Health activities, carried out in last year among Red Cross Volunteers active in Monza e Brianza Provincial Committee. This medical surveillance has been managed according to internal rules of Red Cross and national specific Laws. We report data concerning medical examination of 1285 volunteers, their consequences on their voluntary activities, problems arisen during and after medical controls. Starting from results of our medical controls, we evaluated legal and organizational possibilities of evolution of medical surveillance of Red Cross Volunteers specifically and more generally of Civil Protection Volunteers, considering specific new law recently promulgated which seem partially not homogeneous with 81/08 Decree.


Assuntos
Saúde Ocupacional/legislação & jurisprudência , Vigilância da População , Cruz Vermelha , Voluntários/legislação & jurisprudência , Voluntários/organização & administração , Humanos , Itália
17.
G Ital Med Lav Ergon ; 34(3 Suppl): 756-8, 2012.
Artigo em Italiano | MEDLINE | ID: mdl-23405771

RESUMO

Urinary evaluations of drug consumption among workers having high risk of accident became compulsory in Italian legislation few years ago. We report results of 322.110 single urinary drug detections carried out between 2008 and 2011 on 35.789 subjects. We verified technical difficulties arisen during laboratory detections and organizational difficulties evidenced by Occupational Doctors during collections of samples. We screened 701 positive samples (1.96%), mostly to Cannabinoids and Cocaine, verified using first and second level screening according to national law. Many patients referred regular or irregular use of medicines active on Central Nervous System frequently ignoring their collateral effects. After the evidence of a positive result, during a second medical visit, many workers referred assumption of "natural diet supplements" acquired not in traditional commercial distributors. In two cases we have had the possibility of analyzing these supplements which have shown the presence of law concentrations of drugs in their compositions.


Assuntos
Acidentes de Trabalho/prevenção & controle , Saúde Ocupacional/legislação & jurisprudência , Detecção do Abuso de Substâncias/legislação & jurisprudência , Detecção do Abuso de Substâncias/métodos , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/urina , Humanos , Itália , Fatores de Risco
18.
G Ital Med Lav Ergon ; 34(3 Suppl): 286-8, 2012.
Artigo em Italiano | MEDLINE | ID: mdl-23405644

RESUMO

The survey was aimed at developing a method and providing valuable tools to be used for risk assessment in dental practices and for the implementation of preventive and protective measures. For these purposes general (inspection card for the definition of risk level for health and safety) and specific tools (check-lists) were used. In each dental office chemical and physical hazards (noise and hand-arm vibration) were assessed. Adequate levels of security were achieved, even if workers' training was evidenced as a critical element. In the 90% of cases, rooms for specific use were available and suitable according the law. The risk of work-related stress was acceptable in almost all the analyzed dental offices. Chemical and specific physical hazards appeared to be below the action level. Biological risk doesn't seem to be a critical element, even though its control could be further improved.


Assuntos
Consultórios Odontológicos , Exposição Ocupacional/prevenção & controle , Saúde Ocupacional , Inquéritos Epidemiológicos , Humanos , Medição de Risco
19.
G Ital Med Lav Ergon ; 34(3 Suppl): 709-11, 2012.
Artigo em Italiano | MEDLINE | ID: mdl-23405758

RESUMO

The workload, the quality of professional relationships and emotional involvement have a significant impact on distress and burnout in health care-workers; this impact has an hight variability among the different environments and different care facilities (hospital, erderly nursing homes, home care). The risk assessment of work-related stress performed in 2010 in a homecare agency highlighted organizational problems related to the content/context of work and risk factors for health and safety. High turn-over is evidenced as critical among the "sentinel events". The level of job-strain was moderate, even if some critical issues were evidenced especially in the group of physiotherapists; nurses were configured as a homogeneous group with a low level of job-strain. In informative meetings the workers identified the discomfort related to the time for transferring patients from their homes in a high-traffic metropolitan area was identified as the most critical aspect.


Assuntos
Pessoal de Saúde , Agências de Assistência Domiciliar , Doenças Profissionais/epidemiologia , Estresse Psicológico/epidemiologia , Humanos , Medição de Risco
20.
G Ital Med Lav Ergon ; 34(3 Suppl): 283-5, 2012.
Artigo em Italiano | MEDLINE | ID: mdl-23405643

RESUMO

This study assessed the immunisation status against hepatitis B in healthcare students and residents, before their hospital internship, as suggested by the "National Immunization Prevention Plan 2012-2014". The concentration of antibodies against hepatitis B was measured in 2,491 subjects (70.90% women), born between 1980 and 1993 and visited between January 1st 2000 and July 15th 2012. Personal and serologic data were collected for each subjects. Individuals with antibody less than 10 mIU/mL (327, 13.3%) were given a booster dose and re-tested 2 months later. The multivariate logistic regression evidenced that immunization is influenced by the gender, the age at first vaccination, the time elapsed between first vaccination and antibody measurement. This study confirms the importance of measuring the concentration of antibodies against hepatitis B among healthcare students, even if they have previously been vaccinated, according to the "National Immunization Prevention Plan 2012-2014".


Assuntos
Atenção à Saúde , Vacinas contra Hepatite B , Imunização Secundária , Estudantes , Adulto , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Adulto Jovem
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