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Aim: to describe the mortality risk for all causes and chronic diseases among people living in the industrial district of Viadana (Mantua), where wooden furniture factories producing formaldehyde and wood dust are situated., Design: mortality for the years 1996-2005 among residents in the municipalities where the industrial plants are located (exposed areas) was compared with the mortality among people living in the areas without plants (non-exposed areas)., Main Outcomes: standardized mortality ratios (SMR), using as reference the total population of the Province of Mantua., Results: overall mortality risk was slightly higher in the non-exposed areas and in the district of Viadana than in the Province of Mantua. Mortality risk for all cancers in the exposed areas was lower than in the Province of Mantua (SMR=0.93; 95% IC 0.87-0.99). Mortality for prostate cancer was significantly increased in the exposed areas compared to non-exposed areas (RR=1.83; 95% IC 1.08-3.09) and to the Province of Mantua as a whole (SMR=1.39; 95% IC 1.06-1.79). Mortality maps suggest a higher mortality risk for prostate cancer, mainly among exposed areas. An excess of mortality for leukaemia (non-statistically significant) and for respiratory diseases (statistically significant) was found in Gazzuolo and Sabbioneta, both located in the exposed area., Conclusion: no statistically significant excess risk of mortality for cancer of upper aerodigestive tract was found among residents in municipalities where wood dust and formaldehyde producing factories were active. The increased mortality risk for prostate cancer and leukaemia needs to be deeply analyzed.

The present study aims at assessing the role of epidemiology on health decision-making processes in the public administrations of the Veneto region, north-eastern Italy. In 2003 a questionnaire was mailed to chief-executives of local public health organizations (21 Local Health Units, 2 Public Hospitals), and 18 responded. All public health organizations were practicing Epidemiology, but only 4 had dedicated services. Sixty-two people were working as epidemiologists in public health, but only half played the role for most of their Full Time Employment. Personal educational qualifications were mainly degree in Medicine (62%) and Statistical Sciences (23%). Among physicians, 78% was specialized in Hygiene and Preventive Medicine. The head office of most public health organizations (15 out of 18) appraised epidemiology as fundamental with regard to the health decision-making process, however two thirds of them reported that the epidemiological informative needs were only little or not at all satisfied. To improve the situation, most Public Health Organizations intended to perform educational activities and to use external advisors. In conclusion, Public Health Organizations of the Veneto region appreciated the importance of epidemiology in the health decision-making process. However, few resources were devoted to this field so that informative needs were only partly satisfied.

Background: Informed consent must be obtained from all patients undergoing medical procedures, especially when these imply a significant risk of severe adverse events. However, as for interventional cardiology, recall of information has been shown to be poor. In this study we evaluated the usefulness of an audiovisual support, in adjunct to the standard written informative form, in obtaining: (a) effective patient information before invasive coronary procedures, and (b) patient familiarization with the cath lab team, equipment, and the main procedural phases., Methods: The audiovisual informative support was carried out through explicative interviews to the operators of the cath lab, animations, and realistic visualization of the procedural phases. Patient information was evaluated with a multiple-choice questionnaire. Self-assessment of the patient's emotional state was also evaluated using a semiquantitative scale., Results: Patients receiving the audiovisual support in adjunct to written informative form showed a significantly lower rate of erroneous answers at the multiple-choice questionnaire with respect to patients receiving just written informative form (1.1 +/- 1.0 vs. 3.2 +/- 1.7; p < 0.001). Moreover, patients informed through the audiovisual support showed a slight, although statistically significant, reduction in semiquantitative indexes of anxiety (p = 0.0021) and experienced pain (p = 0.034)., Conclusions: The use of an audiovisual support may favor patient's adequate information prior to written consent and, when prepared by the cath lab team operators, it may optimize his emotional state through a "familiarization effect".

The results of the European Community Respiratory Health Survey (ECRHS) represent one of the most important contributions to the understanding of the risk factors for asthma and its natural history in young adult population. ECRHS has documented up to tenfold regional differences in the prevalence of respiratory symptoms, asthma, atopic sensitisation and bronchial responsiveness: the UK, the USA, Australia and New Zealand had the highest rates. The ECRHS data highlighted the importance of childhood exposure on atopic sensitisation, showing that factors associated with exposure to micro-organisms in childhood reduce the likelihood to be atopic in adulthood. Local results documented the presence of an increasing trend in asthma and allergy from rural to urban sites. The association found between the use of gas cooking with subjective and objective markers of respiratory morbidity in women, raised the hypothesis that exposure to indoor pollutants, such as NO2, could increase the susceptibility for asthma. ECRHS data also allowed a retrospective analysis of asthma occurrence, pointing out that the incidence has increased in the last generations. Furthermore, the analysis of asthma incidence by sex and age suggested a potential role of airway calibre, in addition to hormonal factors, in explaining the greater susceptibility to asthma in women than in men after the age of fifteen.

The present paper addresses mortality from urinary diseases (ICD9 codes 580-599) in the Italian pediatric population aged 0-19 years, in the period 1979-91. Mortality data were obtained from the Italian National Statistical Institute (ISTAT). A total number of 522 deaths were recorded among people aged 0-19 years, amounting to 0.33% of all casualties. Half of these deaths were due to renal failure (ICD9 codes: 584-586). While mortality from all causes decreased by 35% among the Italian pediatric population, mortality from urinary diseases remained stable during the same period, and even increased in the age range 0-4 years (from 3.47 per million person-years in 1979 to 9.83 per million person-years in 1990; p < 0.001). This outbreak in mortality was entirely due to an increase in casualties from acute renal failure (ICD9 code: 584). In conclusion, since the increase in mortality from urinary diseases among Italian children aged 0-4 years takes place in the presence of a substantial drop in mortality from all causes, attention should be paid to this problem and surveillance systems should be reinforced.

From Rutstein's sentinel events list, causes were selected which are regarded as most amenable to medical intervention. Considerable variation in mortality between Health Districts (in Northern Italy) was found in most of these diseases. This substantial variation should be examined further in order to discover the true causes of unnecessary deaths. Using such indexes as an alarm indicator could be very useful in monitoring the quality of care and in allocating resources.

A brief presentation is made of the theory underlying the multistage model of Armitage and Doll and its implications in assessing the effect of exposure to a carcinogen. The theory foresees different relationships between cancer risk and the dependent time variables (time from beginning of exposure, age at start of employment, duration of exposure and time since end of exposure) according to whether the carcinogen acts in the early or late stages of the process of cell transformation leading to tumour formation. The trend in risk of death from lung cancer was studied in a cohort of workers exposed to hexavalent chromium followed up between 1948 and 1985. The results, referred to the multistage model, indicate that hexavalent chromium probably acts in the later stages of the cell transformation process; the implications of this hypothesis for prevention and/or occupational safety strategies are discussed.

In spite of the recent and substantial improvements in MR technique, some problems still exist relative to its applications in routine clinical exams in pediatric ophthalmology. The main problems are: inadequate MR equipment, long examination time, and MR inability to demonstrate intraocular calcifications. Ocular and orbital ultrasound (US) studies are highly operator-dependent, and US utility has been especially described in evaluating ocular, but not orbital, lesions. In order to verify the actual role of CT in pediatric ophthalmology, the CT scans of 58 children with ophthalmologic pathologies, performed over a 2-year period, were reviewed and compared with definitive diagnoses. Seven separate CT findings for each pathologic condition were independently analyzed and correlated with histology. In agreement with other CT series, optic nerve gliomas were invariably intraconal, whereas histiocytosis-X, Ewing's sarcoma, olfactory neuroblastoma (esthesioneuroblastoma), metastatic neuroblastoma and nephroblastoma were extra-conal. Rhabdomyosarcoma, principally extraconal, frequently involved the intraconal and preseptal spaces, with permeative destruction of the osseous orbit and frequent intra/extracranial spread. Orbital spread was mainly observed in vascular tumors. CT showed great accuracy in evaluating punctuate calcifications in retinoblastomas and in metastatic neuroblastomas, and bone fragments within a zone of destruction in histiocytosis-X. Various characteristics of CT attenuation values were observed in pathologic tissues, and high attenuation and marked contrast enhancement were particularly observed in metastatic neuroblastomas and rhabdomyosarcomas. In congenital orbital abnormalities and inflammatory diseases, CT readily detected ocular malformations (microphthalmos and colobomata).(ABSTRACT TRUNCATED AT 250 WORDS)

The Authors examine a group of alcoholics, recording for each patients somatosensory, auditory and visual potentials, in order to check the presence in different systems of nervous fibers of subclinic alterations; they separate a group of patients with clinic polyneuropathie and a group without polyneuropathie. Subclinic alterations are confirmed in different measure in the two groups. Vit. B12 and pholic acid are also dosed in the serum.