Polymorphic markers in the 5alpha-reductase type II gene and the incidence of prostate cancer

In the prostate, the enzyme encoded by the SRD5A2 gene (5alpha-reductase) converts testosterone to dihydrotestosterone, a potent androgen that has been hypothesized to play a role in the genesis of prostate cancer. Several polymorphisms have been identified in the SRD5A2 gene, including a valine-to-leucine substitution (V89L) at codon 89, a variable number of TA dinucleotide repeats and a missense substitution at codon 49 resulting in an amino acid substitution of alanine with threonine (A49T). To investigate the influence of these polymorphisms on prostate cancer risk, we conducted a case-control study nested within the Beta-Carotene and Retinol Efficacy Trial. Genotypes were determined by PCR-based capillary electrophoresis using genomic DNA isolated from 300 cases and 300 controls matched on the basis of race, age at enrollment (within 5 years), enrollment study center and year of randomization. There was no association between V89L genotypes and prostate cancer risk. The age- and race-adjusted odds ratio (OR) associated with the VL and LL genotypes were 1.06 (95% confidence interval (CI) = 0.75-1.49) and 0.99 (95% CI = 0.57-1.73), respectively, as compared to the VV genotype. The age- and race-adjusted odds ratio for men having 1 TA(9) or TA(18) allele was 0.98 (95% CI = 0.64-1.48) when compared to men without TA repeats. The corresponding odds ratio for men without the TA(0) alleles was 0.68 (95% CI = 0.21-2.19). The age- and race-adjusted odds ratio associated with having at least 1 T allele at codon 49 was 1.11 (95% CI = 0.58-2.11), as compared to the AA genotype. Our results do not support the hypothesis that the V89L and A49T polymorphisms in the SRD5A2 gene are related to the risk of prostate cancer, but are compatible with the suggestion from earlier studies that men who are homozygous for the TA(9) or (18) alleles and men who have the TA(9)/TA(18) genotype are at a modestly reduced risk.     

The Occupational Medicine Post-Graduate School of Milan

From its very foundation, post-graduate work for medical doctors has been the main objective of the "Clinica del Lavoro". This completion of the doctor's training has, in the course of the past century, moved in time with the evolution of Occupational Medicine as a science: new developments in the field, the results of experimentation and research carried out in the Clinic, have immediately been passed on to young doctors. The professionals trained in the Clinic have always been considered the very best and have been sought after by the most important medical facilities in the country. Since the beginning of the last century, when Luigi Devoto began to evaluate the infectious, poisonous, and deficiency pathologies connected with the workplace, to the post-war years of rapid growth, when Enrico Vigliani studied and prepared our doctors to deal with dust-related pulmonary diseases, metal-based poisons, and many other problems connected with the transformation of an agricultural society to an industrial society, and up to the present years, which have been characterized by the post-industrial new economy, the "Clinica del Lavoro" has always taught and put into practice the motto of Luigi Devoto: "Occupational medicine is not a part of medicine, but rather a particular way to practice medicine".     

Production of specific retinal S antigen antibodies in patients with retinal detachment

One hundred patients with retinal detachment (61 primary operations and 39 reoperations) were studied for titers of autoantibodies to human retinal S antigen using the enzyme-linked immunosorbent assay technique (ELISA). There was no statistically significant difference when comparing the group of patients with primary retinal detachment with the control group. However, a statistically significant increase in anti-S titers was recorded when a comparison was made between the group of reoperated patients and the control group (²,P < 0.001) and between the group of reoperated subjects and the group of patients operated on for the first time (²,P < 0.005).Presented at the XVth Meeting of the Club Jules Gonin, Copenhagen, 10–15 August 1986     

The N2N instrument to evaluate healthy work environments: an Italian validation

Objectives

The aims of the study were to (a) validate N2N Healthy Work Environment tool, (b) assess the healthiness of work environments as perceived by nurses themselves and (c) identify the factors associated with Italian nurses’ perception of work environment healthiness.

Methods

The linguistic and cultural adaptation of USA-N2N Healthy Work Environments was achieved through a process of forward/backward translation. Content validity was assessed by three expert nurses. The stability of the instrument was checked with a test/retest evaluation. The instrument psychometric properties, the confirmatory factor analysis as well the healthiness of the work environment and its determinant factors were evaluated with a sample of 294 nurses.

Results

The content and face validity of the N2N Healthy Work Environment instrument was confirmed. The instrument demonstrated good internal consistency (α of 0.82), excellent stability values (ρ > 0.70) and high levels of acceptability (response rate: 96.4 %). The confirmatory factor analysis has corroborated the existence of two factors as documented in the original instrument (Mays et al. in J Nurs Manag 19:18–26, 2011). Eighty-seven (29.6 %) nurses perceived the work environment where they work as “healthy”. Working under a functional model of care delivery (χ² 24.856, p 0.000) and being responsible for one project or more (χ² 5.256, p 0.021) were associated with healthy environments.

Conclusions

The instrument—valid and reliable, short in the number of items, easy to understand and based on international standards—allows a systematic assessment of the healthiness of the environment and might provide not only the opportunity to evaluate the effects of new organizational models and interventions, but also the possibility to activate a process of self-analysis and a process of ongoing review. The instrument can be used to systematically check the healthiness of Italian working environments, allowing for organizational diagnosis, targeted interventions and international comparisons.     

Sublethal Effects of Waterborne Herbicides in Tropical Freshwater Fish

The study evaluated the sublethal effects of the herbicides glyphosate (Roundup) and diuron (Hexaron) and the mixture of them, used extremely in agriculture, through biomarkers in fish. The glutathione S-transferase activity increased (74%) and catalase activity decreased (37%) at the higher exposure concentration of Hexaron in comparison to the control group, suggesting an activation of this metabolism route. Membrane damage was observed at the higher exposure of Roundup and in the mixture group compared to the control group, which can be related to the nuclear alterations observed in these exposed groups. The cholinesterase activity was also inhibited (37%) in mixture group compared to the control group and no gill morphology damage was found. The results suggested a potential synergic effect in some analysed parameters.     

Continuing medical professional development in Uruguay as the country faces the 21st century]

This paper outlines the evolution of the concept of continuing medical professional development in Uruguay, as that professional development has progressed from independent and varied efforts that were not coordinated or evaluated to a plan that is aimed at improving the quality of educational activities and programs and making them accessible to all the physicians in the country. In contrast to countries where scientific societies and medical associations preside over continuing professional development, in Uruguay the Graduate School of the School of Medicine of the University of the Republic has taken on managing and developing this process. The key objective of this process is for the Graduate School to work in conjunction with other leading players in professional development to create a national system of continuing medical professional development. This system should be interinstitutional and include both public and private entities. By having the key public institutions (the Graduate School and the Ministry of Public Health) working with private entities (medical associations, scientific societies, and health care institutions), there should be an adequate balance of interests. The national professional development system should work in the most decentralized manner possible and should be based on a network of units distributed around the entire country, but with centralized coordination. The system's interinstitutional character should ensure high technical and ethical standards as well as a balance among the governmental, commercial, professional, and university components. This system should serve as the basis for extending this activity to all health personnel in Uruguay. While the national system is still being finalized, the Graduate School has implemented a process of accrediting institutions that are involved in continuing professional medical development. The aim of this accreditation process is to improve the educational offerings for physicians and to generate practical experience that will serve the future system.     

Asbestos risk in the textile industry: final confirmation of data from the Lombardy Mesothelioma Registry

BACKGROUND: Cases of mesothelioma in non-asbestos textile workers have been frequently reported but the identification of asbestos dispersion sources in the workplaces has never been adequately performed. During 3 years of activity of the Mesothelioma Register for Lombardy, 40 cases (10.8% of all cases) were collected in textile workers engaged in all types of productive activities. The hypothesis that a significant asbestos risk for textile workers appeared not negligible. OBJECTIVES: The research was aimed at the identification of asbestos dispersion sources in textile factories. METHODS: Specific information was collected by technicians, maintenance personnel and other experts and direct inspections were carried out in numerous workplaces that had not yet undergone significant changes with respect to the past. Also the industrial machinery utilised in the previous 40-50 years was thoroughly examined. RESULTS: Epidemological evaluation of the recorded cases showed a widespread distribution in the different phases of textile production. Inspections also showed that a large amount of asbestos had been regularly used applied to the ceilings and also to the walls of factories in order to avoid both condensation of steam and reflection of noise. In addition, asbestos had also been widely used to insulate water and steam pipes. The braking systems of most of the machines also had asbestos gaskets, and on several looms some brakes operated continuously in order to keep the warp in constant tension. CONCLUSIONS: Our observations confirmed that since production techniques in the textile industry required working in damp and warm conditions with the noise of the rapidly moving machines, asbestos was very often used because of its absorbent and soundproofing qualities and its resistance to friction. We demonstrated that asbestos was thus widely used in the industry and this certainly produced considerable fibre dispersions in the atmosphere of the workplaces. Asbestos risk must therefore be recognised for all those who have worked in the textile industry in the recent past and, as a result, cases of mesothelioma must be considered occupational diseases.