MALATTIE DELL'APPARATO LOCOMOTORE, MEDICINA FISICA E RIABILITATIVA E DEGLI AMBIENTI DI LAVORO E CHIRURGIA PLASTICA Nuovo canale 3

8 CFU - 1° Semester

Teaching Staff

TEACHER NOT YET ALLOCATED - Module MALATTIE DELL'APPARATO LOCOMOTORE - MED/33 - 2 CFU
MATTEO CIONI - Module PHYSICAL MEDICINE AND REHABILITATION - MED/34 - 2 CFU
VENERANDO RAPISARDA - Module Occupational Medicine - MED/44 - 2 CFU
ROSARIO EMANUELE PERROTTA - Module Plastic and Reconstructive Surgery - MED/19 - 2 CFU

Learning Objectives

PHYSICAL MEDICINE AND REHABILITATION
Activities and diagnostic care in the field of Physical Medicine and Rehabilitation of the general and special functional impairments resulting from amputations, orthopedic and rheumatologic diseases, with the use of aids, orthotics, physical therapy and medications.
Occupational Medicine
The aim of the course is to provide information and knowledge about workplace-related pathologies (accidents and illnesses) as well as to become familiar with prevention principles, with particular reference to risk assessment and preventive measure adoption.

Students will have to learn methods and techniques to collect work history, identify environmental and occupational risks and possible relationships with genetic, demographic, socio-economic, psychological and cultural factors, related to health or illness statuses, as well as to look into the possible non-specific effects of occupational risk factors, especially for degenerative chronic diseases.

The main etiologically diagnostic aspects of occupational medicine will be dealt with, and so will the epidemiology of con-causally work-related diseases. Also, the most frequent professional diseases and work accidents will be classified. The main analysis method and work risk assessment instruments will be provided, that is limit exposure levels, environmental/biological monitoring and healthcare surveillance. Also, occupational risk in/formation, safety and health law guidelines in work places, primary and secondary prevention of occupational diseases, role and duties of the competent physician will be discussed.
Plastic and Reconstructive Surgery
Knowledge of basic techniques in Plastic Surgery, treatment of the main tumors, malformation and traumatic diseases and related reconstructive procedures.

Detailed Course Content

PHYSICAL MEDICINE AND REHABILITATION
1) Clinical evaluation of the patient (head, trunk, upper and lower limbs), joint and muscle balance sheet.

2) International Classification of Functioning, Disability and Health (ICF).

3) Rehabilitation of persons with amputations

Principles of epidemiology of amputations and frequency of amputations. Prevention of amputations. Levels of amputation. The stump (surgical preparation and bandage) .The post-operative pain, pain after healing, pain caused by dentures, phantom limb pain. Principles of rehabilitative intervention (how to avoid retractions muscle-tendon, muscle strengthening and stretching, postures). Autonomy and transfers. Re-education journey. Principles of the prosthesis structure (socket, socks, jock strap and pylon, mechanical components).

4) Prevention of falls and rehabilitation of patients with outcomes of fractures or osteoarthritis:
Falls: anticipatory postural reactions and feedback, parachute reaction syndrome "fear of fall", prevention of falls, walking aids aids for ADL, training falls,
rehabilitation to the outcomes of fractures and osteoarthritis: passive mobilization, postural exercises, muscle strengthening, active assisted physiotherapy, proprioceptive exercises, use of Canadian crutches, hydrokinesiotherapy.Physical therapy: types of physical energy, ultrasound, sonophoresis, magnetic therapy, laser therapy, thermotherapy exogenous and endogenous, cryotherapy, electrotherapy stimulation (rectangular faradic, exponential, triangular, exponential triangle), Kotz currents, currents analgesic (TENS, diadynamic monophase , diphase, interference).Adapted physical activity. Ergonomics and joint protection.
5) Rehabilitation intervention in the patient with bedsores
Type of skin lesions. International Classification of skin lesions. Factors favoring bedsores. Action of the cutting forces. Headquarters of bedsores. Operations to be performed on the patient with bedsores. How to handle the patient.
6) Patient Rehabilitation burned: functions of the skin, classification of burns, etiology, lesion types, therapeutic postures, static orthotics, orthotic dynamics, use of a static table, use of walking aids, hypertrophic scars, massage, stretch bodice.
7) Rehabilitation of people with low back pain syndrome Hypomobility.The pain in the rehabilitation pathologies. Effect of pain on mobility. vicious circle of inactivity. ergonomic principles. Treatment: rest, physical therapy, exercise, medication, infiltration and epidural injections, spinal orthoses (soft collars, stiff collars, shrouds). Corsets canvas and metal slats. Adapted Physical Activity (APA).
Occupational Medicine
History and evolution of Occupational Medicine: prevention service legislation and organization; work accidents and professional diseases insurance practices. Risk assessment procedure; exposure times and limit levels/values.

Primary and secondary prevention principles. Healthcare surveillance and duties of competent physician. Biological monitoring procedures. General and individual preventive practices and first aid action organization. Biological risk and vaccinations. Physical risks: noise, vibrations, ionizing-non-ionizing radiations, microclimate and compressed atmosphere. Ergonomy principles: postures and work. Workstation, shift and night work risks. Assessment of risks in manual loads handling and in repetitive movements of upper limbs with associated pathologies. Organizational wellness and its associated work stress. Health promotion in working places.

Main dust/fibre and professional allergene exposure–related pathologies; indoor and outdoor pollutants. Exposure risks to chemical, mutagen and carcenogenic agents.

Principles of Industrial Hygiene and hints of Statistics. Risks in the main working cycles. Guidelines on safety and health in working places.
Plastic and Reconstructive Surgery
Basic Techniques in Plastic Surgery; treatment and diagnosis of skin neoplastic lesions; treatment of traumatic hand injury; malformative syndromes of the cephalic, genital, breast and limb district; breast reconstruction; canalicular pathologies of the upper limb; treatment and physiopathology of the burned patient; knowledge and treatment of chronic skin lesions of the lower limbs and pressure lesions; microsurgery.

Textbook Information

PHYSICAL MEDICINE AND REHABILITATION
1) Joel A. DeLisa, Bruce M. Gans, Nicholas E. Walsh . Physical Medicine and Rehabilitation: Principles and Practice, Volume 1-2.Vth edition, Lippincott Williams & Wilkins, 2012

2) Brotzman S.and Wilk K.E.. Handbook of Orthopaedic Rehabilitation, 2nd Edition. Elsevier. 2007
Occupational Medicine
- David Koh, Ken Takahashi. Textbook of Occupational Medicine Practice. 3rd Edition ISBN: 978-981-4329-57-6
- Antonio Mutti, Massimo Corradi: "Lezioni di Medicina del Lavoro". Nuova Editrice Berti, 2014 (ISBN 978-88-7364-627-3)
- Per Alberto Bertazzi: "Medicina del lavoro". Raffaello Cortina Editore, 2013 (ISBN 978-88-6030-633-3)
- Enrico Pira, Canzio Romano, Paolo Carrer: "Manuale di medicina del lavoro". Minerva Medica, 2016 (9788877118431)
Plastic and Reconstructive Surgery
Manuale di chirurgia plastica, ricostruttiva ed estetica Scuderi, Rubino ISBN: 9788829926503 Piccin 2014

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