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The aim is to assess socio-occupational (SO) class differences in incident coronary and stroke. Methods. In a prospective fixed-cohort study 2959 35-74 year old men free from coronary (CHD) and stroke events were recruited in four population-based cohorts from 1986 to 1994 and followed-up until the end of 2002 to ascertain first CHD and stroke events. At baseline, major cardiovascular risk factors were investigated according to a standardised protocol. SO classes were based on current or last employment. Age-adjusted and multi-factors-adjusted risk ratios (RR) and 95% CI were calculated from Poisson regression models. Results. In 11-year median follow-up, the cohorts accumulated 33,926 person-years and generated 168 first major CHD events and 56 stroke events. Non-manual workers showed the lowest incident rates of both endpoints, and were considered as the reference category. Higher relative risks of CHD events were foundfor lower administrators and professionals, unskilled manual workers (UMW) and self-employed. Higher relative risks of stroke were found for skilled manual workers and UMW. Higher relative risks of CVD (either CHD or stroke) were found for lower administrators and professionals, skilled and unskilled manual workers and self-employed. Adjustments for major risk factors (cholesterol, systolic blood pressure, cigarette smoking, diabetes) did not modify the RRs. Conclusion. The higher risk of major cardiovascular events among lower SO classes is confirmed. Higher relative risks of CHD among lower administrators and professionals, and self-employers were also found. Further studies are needed to assess the etiologic role of job stress conditions.

With the introduction in Italy of the Law regarding alcohol abuse and addiction (Law No.125/01), new tasks and responsibilities were assigned to occupational physicians. This law establishes that in working activities with a high risk of industrial accidents, or which may cause a risk for the safety and health of others, workers are forbidden to consume alcoholic beverages during working hours. In addition, occupational physicians are asked to play a key role in testing workers for alcohol levels. In March 2006 a specific list of job titles was issued which makes the law effective.The application of this law gives rise to various consequences and ambiguities, in particular for occupational physicians, mainly concerning the identification of workers with alcohol problems, the subsequent control of such workers, including proposals for valid rehabilitation programmes, and assessment of residual work fitness. All these aspects can, to some extent, produce conflicts between privacy rights and the need to ensure the health and safety of workers and third parties. A specific screening package is proposed for the identification of alcohol abuse as well as methods to overcome some of the constraints. Specific and effective guidelines need to be issued by scientific societies and health authorities.

This bulletin is a true technical guide which studies the classification and characteristics of geomembranes and the constraints to which the geomembrane is exposed. It presents various recommendations as regards to idea, construction and use. These recommendations help to avoid certain little problems which marked the development period of these techniques. Two chapters deal with the restoration of the concrete masks and with the dam weights at the aid of geomembranes., Ce bulletin est un véritable guide technique qui étudie la classification et les caractéristiques des géomembranes et les contraintes auxquelles la géomembrane est exposée. Il présente diverses recommandations en matière de conception, de construction et d'utilisation. Ces recommandations peuvent permettre d'éviter certains désagréments qui ont marqué la période de développement de ces techniques. Deux chapitres traitent de la réhabilitation des masques en béton et des barrages poids à l'aide de géomembranes.

Wilson's disease, a rare autosomal recessive disorder, has been recently mapped to the long arm of chromosome 13 (q14.1). In this study, we carried out linkage analysis between three chromosome 13 DNA markers, D13S1, D13S10, D13S2, the locus for the red cell enzyme esterase D (ESD), and the Wilson's disease locus (WND) in 17 Wilson's disease families of Italian descent, mostly from Sardinia. We confirmed a tight linkage [theta = 0.00, Z (theta) = 4.07] between the WND and ESD loci, and provided suggestive evidence for linkage [theta = 0.00, Z(theta) = 1.85] of the WND locus with D13S10. Multipoint linkage analysis indicated the following order: centromere-D13S1-D13S10-WND-ESD-D13S2. RFLP analysis at these two loci in our families allowed us either to define the carrier status (50%) or to exclude the homozygous state (25%) in the great majority of unaffected sibs.

The aim is to assess socio-occupational (SO) class differences in incident coronary and stroke. Methods. In a prospective fixed-cohort study 2959 35-74 year old men free from coronary (CHD) and stroke events were recruited in four population-based cohorts from 1986 to 1994 and followed-up until the end of 2002 to ascertain first CHD and stroke events. At baseline, major cardiovascular risk factors were investigated according to a standardised protocol. SO classes were based on current or last employment. Age-adjusted and multi-factors-adjusted risk ratios (RR) and 95% CI were calculated from Poisson regression models. Results. In 11-year median follow-up, the cohorts accumulated 33,926 person-years and generated 168 first major CHD events and 56 stroke events. Non-manual workers showed the lowest incident rates of both endpoints, and were considered as the reference category. Higher relative risks of CHD events were foundfor lower administrators and professionals, unskilled manual workers (UMW) and self-employed. Higher relative risks of stroke were found for skilled manual workers and UMW. Higher relative risks of CVD (either CHD or stroke) were found for lower administrators and professionals, skilled and unskilled manual workers and self-employed. Adjustments for major risk factors (cholesterol, systolic blood pressure, cigarette smoking, diabetes) did not modify the RRs. Conclusion. The higher risk of major cardiovascular events among lower SO classes is confirmed. Higher relative risks of CHD among lower administrators and professionals, and self-employers were also found. Further studies are needed to assess the etiologic role of job stress conditions.

We report two cases of duodenal ulcer (DU) identified at endoscopy in a pair of dizygotic twins; their outstanding clinically recognizable features were a very early onset, a great familiar occurrence, a lack of triggering conditions (drugs, burns, stress, sepsis, respiratory distress), normal serum levels of gastrin and pepsinogen I, inadequate response to medical treatment with H2-receptor antagonists, but satisfactory response to associated therapy with H2-receptor antagonists and sucralfate. Results of this study show that examined twins were affected by a form of early-onset primary DU, probably inherited like an autosomal dominant disorder with high degree of penetrance, associated with normal serum pepsinogen I and gastrin; in this form of Du a decreased tissue resistance of duodenal mucosa is likely more important, pathogenically, than an increased peptic secretion. At present long-term prognosis of our patients is unknown.