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The authors have gone through the complaints concerning all the cases of shoulder accidents at work filed by the Genoa office of the Italian Workers' National compensation Agency (INAIL) during the two years' period 2006-2007, reviewing in particular those somehow affecting rotator components. The aim of this paper is to assess the real role played by the occupational trauma in the rotator cuff tear. The data gathered so far have shown, on the one hand, a high prevalence of pre-existing inflammatory and degenerative diseases and, on the other, a rather modest influence of the trauma which, for this reason, has usually borne, as an immediate medico-legal consequence, the rejection of a cause-effect relationship between the accident and the rotator cuff lesion, without taking into any account whether the worker was likely to be affected by an occupational disease (ex table Ministerial Decree n. 81 April 9th 2008- item 78). In such cases a systematic and in-depth investigation of the occupational case history is suggested, in order to highlight the possible pre-existence of a former biomechanical overload of the upper limbs, so as to allow the physician to detect a pathology often misdiagnosed.

The diagnosis of decompression sickness may be difficult, particularly when patients present with atypical clinical manifestations after dives going on uneventfully and with full adherence to safety parameters. The case reports involve two divers who presented with transient global amnesia (TGA) immediately after surfacing from otherwise regular dives during which they had been breathing hyperoxic mixtures (Nitrox). A wide spectrum of symptoms of neural dysfunction following hyperoxic mixtures have been reported, including cases of memory impairment related to previous generalized convulsions. After a review of the literature, however, we found no previous reports of TGA, which is very unlikely to result from an epileptic mechanism, as an adverse effect of breathing hyperoxic mixtures.

Here we describe the case of a 41-year-old woman with a history of Cushing disease who had previously undergone unsuccessful neurosurgery, followed by stereotactic radiosurgery. More than 4 years after this treatment, she presented severe visual impairment, which started in the left eye and was documented by neuro-ophthalmic evaluation. Radiological assessment by contrast-enhanced magnetic resonance (MR) imaging initially suggested the diagnosis of glioma of the optic nerve and the patient started corticosteroid treatment (first with prednisone, 80 mg/day, followed by dexamethasone, 8 mg/day). Despite the therapy, vision in the left eye rapidly worsened until light was no longer perceptible; similar symptoms and signs also developed in the right eye, evolving to complete temporal hemianopsia. The clinical evidence was confirmed by the rapid progression of the MR picture, which showed homogeneous enhancement of the chiasm and optic nerves. On the basis of these findings, the original diagnosis of glioma was excluded, and radiation-induced optic neuropathy was diagnosed. As corticosteroids had proved inefficacious, hyperbaric oxygen (HBO) therapy was promptly instituted and vision steadily started to improve. This improvement was documented and confirmed by the progressive recovery of the visual field in the right eye and the changes in the sequential follow-up MR scanning. Optic neuropathy is an infrequent but dramatic complication of radiation therapy. Symptoms develop, on average, 12 months after treatment, and the onset may be acute and characterized by the progressive loss of vision in one or both eyes. HBO has already been used to treat this complication, but its efficacy is still controversial. Here, in addition to describing this particular case, which presented a significantly delayed radiation injury of the optic pathways, we provide a brief literature review and discuss some important points.

The effect on pulmonary diffusing capacity of intermittent exposure to hyperbaric oxygen was evaluated in four subjects after 35-38 years from beginning of diving activity. Exposure was of 4600-6000 hours. Pressure till 4 ATA. No remarkable impairment of lung diffusing capacity was found

Twenty three male subjects 21 to 53 aged were undergone to lung diffusion test using breath holding method. Each subject was tested three times in different days. The results were evaluated by Bartlett's Chi-square test and by Kendall's coefficient of concordance. Correlation between the CO distribution and diffusion index (R&DCO), the Helium distribution index (RHe), the time of breath holding and the volume of "single breath" was found. It seems it will be possible to improve the inter-personal estimation to 1.25% about.

Before a research about normals values of lung diffusing capacity for CO in Italian people, the Authors investigate if different concentration of Helium in respiratory gases could have any influence on data. Experiments were performed by testing 8 male subjects. Each one repeated lung function tests three times using gas mixtures with different Helium percentage. Results were evaluated by meaning of t Studnt's and Bartlett's Chi-square tests. Results show no significant difference.

MMF is considered one of the most sensitive parameter to point out initial decay of small airways that should appear prematurely in smokers as compared with non smokers. To verify the above we tested male subjects apparently free from any respiratory disease. They were classed into two groups of equal number: the first group of smokers, the second one of non smokers. We did not find any statistically significant difference between the two groups: this is probably due to the young age of the subjects and consequently to the relative short period of exposure to tobacco smoke.