Mechanical power during robotic-assisted laparoscopic prostatectomy: an observational study.

BACKGROUND: Robotic-assisted laparoscopic radical prostatectomy (RALP) requires pneumoperitoneum and steep Trendelenburg position. Our aim was to investigate the influence of the combination of pneumoperitoneum and Trendelenburg position on mechanical power and its components during RALP. METHODS: Sixty-one prospectively enrolled patients scheduled for RALP were studied in supine position before surgery, during pneumoperitoneum and Trendelenburg position and in supine position after surgery at constant ventilatory setting. In a subgroup of 17 patients the response to increasing positive end-expiratory pressure (PEEP) from 5 to 10 cmH2O was studied. RESULTS: The application of pneumoperitoneum and Trendelenburg position increased the total mechanical power (13.8 [11.6 - 15.5] vs 9.2 [7.5 - 11.7] J/min, p < 0.001) and its elastic and resistive components compared to supine position before surgery. In supine position after surgery the total mechanical power and its elastic component decreased but remained higher compared to supine position before surgery. Increasing PEEP from 5 to 10 cmH2O within each timepoint significantly increased the total mechanical power (supine position before surgery: 9.8 [8.4 - 10.4] vs 12.1 [11.4 - 14.2] J/min, p < 0.001; pneumoperitoneum and Trendelenburg position: 13.8 [12.2 - 14.3] vs 15.5 [15.0 - 16.7] J/min, p < 0.001; supine position after surgery: 10.2 [9.4 - 10.7] vs 12.7 [12.0 - 13.6] J/min, p < 0.001), without affecting respiratory system elastance. CONCLUSION: Mechanical power in healthy patients undergoing RALP significantly increased both during the pneumoperitoneum and Trendelenburg position and in supine position after surgery. PEEP always increased mechanical power without ameliorating the respiratory system elastance.

Role of secondary flows in coronary artery bifurcations before and after stenting: What is known so far?

Coronary arteries are uniformly exposed to traditional cardiovascular risk factors. However, atherosclerotic lesions occur in preferential regions of the coronary tree, especially in areas with disturbed local blood flow, such as coronary bifurcations. Over the latest years, secondary flows have been linked to the inception and progression of atherosclerosis. Most of these novel findings have been obtained in the field of computational fluid dynamic (CFD) analysis and biomechanics but remain poorly understood by cardiovascular interventionalists, despite the important impact that they may have in clinical practice. We aimed to summarize the current available data regarding the pathophysiological role of secondary flows in coronary artery bifurcation, providing an interpretation of these findings from an interventional perspective.

Human Osteochondral Explants as an Ex Vivo Model of Osteoarthritis for the Assessment of a Novel Class of Orthobiologics.

Osteoarthritis (OA) is a highly prevalent joint disease still lacking effective treatments. Its multifactorial etiology hampers the development of relevant preclinical models to evaluate innovative therapeutic solutions. In the last decade, the potential of Mesenchymal Stem Cell (MSC) secretome, or conditioned medium (CM), has emerged as an alternative to cell therapy. Here, we investigated the effects of the CM from adipose MSCs (ASCs), accounting for both soluble factors and extracellular vesicles, on human osteochondral explants. Biopsies, isolated from total knee replacement surgery, were cultured without additional treatment or with the CM from 106 ASCs, both in the absence and in the presence of 10 ng/mL TNFα. Tissue viability and several OA-related hallmarks were monitored at 1, 3 and 6 days. Specimen viability was maintained over culture. After 3 days, TNFα induced the enhancement of matrix metalloproteinase activity and glycosaminoglycan release, both efficiently counteracted by CM. The screening of inflammatory lipids, proteases and cytokines outlined interesting modulations, driving the attention to new players in the OA process. Here, we confirmed the promising beneficial action of ASC secretome in the OA context and profiled several bioactive factors involved in its progression, in the perspective of accelerating an answer to its unmet clinical needs.

A Nutritional Approach for the Management of Chemotherapy-Induced Diarrhea in Patients with Colorectal Cancer.

This study aimed to determine if dietary modifications using a nutritional regimen could prevent or reduce the incidence of cancer therapy-induced diarrhea in patients with metastatic colorectal cancer and to evaluate the relationship of Vitamin D blood levels with diarrhea severity. Patients with metastatic colorectal cancer were enrolled. A Mediterranean diet, containing some special limitations aiming to reduce the risk of diarrhea, was administered before and during the entire chemotherapy program. Enrolled patients numbering 60/137 (44%) had diarrhea during chemotherapy. Adherence to the diet was high in 36 (26.3%) patients, medium in 94 (68.6%), and low in 7 (5.1%). Mean adherence to the diet was significantly lower in patients who experienced diarrhea with maximum grade 2−3 compared to those who had no diarrhea or grade 1 diarrhea (score = 5.4 ± 1.9 vs. 7.1 ± 1.5, p < 0.001). Patients with higher adherence to the diet had a lower risk of grade 2−3 diarrhea (odds ratio: 0.5 (95% CI: 0.3−0.7, p < 0.001)). In addition, patients who completed a higher number of chemotherapy cycles had an increased risk of grade 2−3 diarrhea (odds ratio: 1.2 (95% CI: 1.0−1.5, p = 0.02)). Of note, a lower level of Vitamin D correlated with an increased risk of G2-G3 diarrhea (p = 0.03). A diet based on vegetables with a controlled fiber content, Mediterranean Modified Healthy Diet (MMHD), is useful to control the incidence of cancer therapy-induced diarrhea.

Superficial femoral artery stenting: Impact of stent design and overlapping on the local hemodynamics.

BACKGROUND: Superficial femoral arteries (SFAs) treated with self-expanding stents are widely affected by in-stent restenosis (ISR), especially in case of long lesions and multiple overlapping devices. The altered hemodynamics provoked by the stent is considered as a promoting factor of ISR. In this context, this work aims to analyze the impact of stent design and stent overlapping on patient-specific SFA hemodynamics. METHODS: Through a morphing technique, single or multiple stents were virtually implanted within two patient-specific, post-operative SFA models reconstructed from computed tomography. The stented domains were used to perform computational fluid dynamics simulations, quantifying wall shear stress (WSS) based descriptors including time-averaged WSS (TAWSS), oscillatory shear index (OSI), transverse WSS (transWSS), and WSS ratio (WSSRATIO). Four stent designs (three laser-cut - EverFlex, Zilver and S.M.A.R.T. - and one prototype braided stent), and three typical clinical scenarios accounting for different order of stent implantation and overlapping length were compared. RESULTS: The main hemodynamic differences were found between the two types of stent designs (i.e. laser-cut vs. braided stents). The braided stent presented lower median transWSS and higher median WSSRATIO than the laser-cut stents (p < 0.0001). The laser-cut stents presented comparable WSS-based descriptor values, except for the Zilver, exhibiting a median TAWSS ∼30% higher than the other stents. Stent overlapping provoked an abrupt alteration of the WSS-based descriptors. The overlapping length, rather than the order of stent implantation, highly and negatively impacted the hemodynamics. CONCLUSION: The proposed computational workflow compared different SFA stent designs and stent overlapping configurations, highlighting those providing the most favorable hemodynamic conditions.

Role of Diet in the Management of Carcinoid Syndrome: Clinical Recommendations for Nutrition in Patients with Neuroendocrine Tumors.

Nutrition and metabolism are altered in patients with gastroenteropancreatic neuroendocrine tumors, which is related to excessive production of gastrointestinal hormones, peptides, and amines that can cause maldigestion, diarrhea, steatorrhea, and altered gastrointestinal motility. Patients with carcinoid syndrome are at risk of malnutrition due to tryptophan depletion, reduced intake of food, and loss of appetite because of diarrhea and/or flushing. To date, there is limited information on the nutritional issues faced by patients with neuroendocrine tumors, and on what specific recommendations should be made to patients concerning nutrition at various stages of the disease process. Dietary planning should therefore be an integral part of multidisciplinary management for patients with neuroendocrine tumors. Herein, we review current guidance for nutrition in patients with neuroendocrine tumors, focusing on intake of amines and foods to avoid, as well as concurrent medications. We also propose a new and practical food pyramid based on the principles of Mediterranean diet 4.0 that can be easily adapted according to the unmet needs of patients with neuroendocrine tumors at all stages of disease. The overarching goal of the present review is to create greater awareness of nutritional care and considerations that should be given to patients with neuroendocrine tumors.

The role of suction drainage in the management of peri-operative bleeding in Total and Unicomcompartmental knee arthroplasty: a retrospective comparative study.

BACKGROUND: Suction drainage is commonly applied after total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) to reduce hematoma, swelling and to favor surgical wound healing. However, its efficacy remains controversial; thus, the purpose of this study is to evaluate drainage efficiency in the management of postoperative bleeding in TKA and UKA. METHODS: The cohort comprised 134 clinical records of patients affected by knee osteoarthritis (OA) who underwent either TKA or UKA. All the patients were subdivided into 2 groups: the first one with drainage and the second one without drainage (respectively 61 and 73 patients). For each group, hemoglobin levels in the preoperative, first, second and third postoperative day were collected. Postoperative complications such as swelling, bleeding from the surgical wound or the need for blood transfusion, were also recorded. RESULTS: Our results did not show any significant difference of hemoglobin levels in the first (p = 0.715), second (p = 0.203) and third post-operative day (p = 0.467) between the two groups. Moreover, no significant correlation between knee swelling or transfusion rate and the drainage was observed (p = 0.703 and p = 0.662 respectively). Besides, a significant correlation was found between bleeding from the surgical wound and the absence of drainage (p = 0.006). CONCLUSIONS: The study demonstrates how the routine use of suction drainage does not provide substantial benefits in the postoperative blood loss management after TKA or UKA. TRIAL REGISTRATION: ClinicalTrials.gov NCT04508101 , 09/08/2020, Retrospectively registered LEVEL OF EVIDENCE: III.

Cineole-containing nanoemulsion: Development, stability, and antibacterial activity.

1,8-cineole is a monoterpene commonly used by the food, cosmetic, and pharmaceutical industries owing to its flavor and fragrances properties. In addition, this bioactive monoterpene has demonstrated bactericidal and fungicidal activities. However, such activities are limited due to its low aqueous solubility and stability. This study aimed to develop nanoemulsion containing cineole and assess its stability and antibacterial activity in this context. The spontaneous emulsification method was used to prepare nanoemulsion (NE) formulations (F1, F2, F3, F4, and F5). Following the development of NE formulations, we chose the F1 formulation that presented an average droplet size (in diameter) of about 100 nm with narrow size distribution (PdI <0.2) and negative zeta potential (∼ - 35 mV). According to the analytical centrifugation method with photometric detection, F1 and F5 formulations were considered the most stable NE with lower droplet migration velocities. In addition, F1 formulation showed high incorporation efficiency (> 80 %) and TEM analyses demonstrated nanosized oil droplets with irregular spherical shapes and without any aggregation tendency. Antibacterial activity assessment showed that F1 NE was able to enhance the cineole action against Staphylococcus aureus, Enterococcus faecalis, and Streptococcus pyogenes. Therefore, using a simple and reproducible method of low energy emulsification we designed a stable nanoemulsion containing 1,8-cineole with improved antibacterial activity against Gram-positive strains.

Quantitative Lung Ultrasound: Technical Aspects and Clinical Applications.

Lung ultrasound is increasingly used in emergency departments, medical wards, and critical care units-adult, pediatric, and neonatal. In vitro and in vivo studies show that the number and type of artifacts visualized change with lung density. This has led to the idea of a quantitative lung ultrasound approach, opening up new prospects for use not only as a diagnostic but also as a monitoring tool. Consequently, the multiple scoring systems proposed in the last few years have different technical approaches and specific clinical indications, adaptable for more or less time-dependent patients. However, multiple scoring systems may generate confusion among physicians aiming at introducing lung ultrasound in their clinical practice. This review describes the various lung ultrasound scoring systems and aims to clarify their use in different settings, focusing on technical aspects, validation with reference techniques, and clinical applications.

A multi-residue analytical method for extraction and analysis of pharmaceuticals and other selected emerging contaminants in sewage sludge.

Sewage sludge is a by-product of wastewater treatment processes, and may be employed in agriculture as a fertilizer or in forestry for land reclamation. It is an important source of nutrients but its reuse can arouse concern on account of the wide range of contaminants that are retained and may persist during treatments. Information on the emerging contaminants (ECs) in sewage sludge in Italy is limited. The present study developed and applied a reliable analytical method for the analysis of 44 ECs in sewage sludge. ECs were extracted by accelerated solvent extraction followed by a clean-up step on solid-phase cartridges. High performance liquid chromatography coupled to mass spectrometry was used for analysis. The ECs, selected on the basis of their use and documented presence in the environment, were 42 pharmaceuticals belonging to 12 therapeutic categories and 2 perfluorinated substances. The method performance was good, with recoveries higher than 70%, good repeatability (<20%) and sensitivity in the low ng g-1 range, allowing measurement of the analytes selected. The method was applied for analysis of sludge from 12 wastewater treatment plants in Italy. The most abundant compounds were antibiotics, anti-inflammatories and antihypertensives and ranged up to 5 µg g-1 (ciprofloxacin). Seasonal differences were found for some antibiotics and anti-inflammatory drugs as well as some differences - in terms of concentration - with other European countries. This is the first Italian study to investigate the presence of a large number of ECs in sewage sludge and the results may be useful to drive future regulatory actions.

Prevalência e perfil de sensibilidade antimicrobiana de bactérias isoladas de pacientes internados em Unidade de Terapia Intensiva de um hospital universitário do Sertão de Pernambuco / Prevalence and profile of antimicrobial sensitivity of bacteria isolated from patients hospitalized in an Intensive Care Unit of a university hospital in Hinterland of Pernambuco

O objetivo desse trabalho foi determinar a prevalência e o perfil de sensibilidade das espécies bacterianas isoladas de pacientes internados na Unidade de Terapia Intensiva (UTI) de um hospital universitário do Sertão de Pernambuco. Foi realizado um estudo retrospectivo através da análise descritiva dos resultados do diagnóstico microbiológico laboratorial do próprio serviço, provenientes de hemoculturas, uroculturas e aspirados traqueais dos pacientes internados na UTI, durante o período de janeiro a junho de 2019. No total, 394 amostras clínicas foram obtidas, divididas entre hemoculturas, uroculturas e aspirados traqueais; destas, 144 foram positivas para espécies bacterianas. O aspirado traqueal foi o material clínico com maior percentual de culturas positivas (67,4%). A bactéria mais prevalente isolada dos indivíduos na UTI foi Acinetobacter baumannii (22,9%), seguida de Pseudomonas aeruginosa (19,2%), Staphylococcus aureus (16,7%), Klebsiella pneumoniae (15,2%) e Staphylococcus coagulase negativa (SCN- 8,3%). A maioria das espécies isoladas apresentou um perfil de sensibilidade reduzido aos fármacos beta-lactâmicos, especialmente ampicilina, penicilina e carbapênemicos, independente da amostra clínica. Os bacilos Gram-negativos (BGN) apresentaram elevada sensibilidade à colistina. As informações deste estudo permitem reconhecer a frequência das espécies de bactérias mais isoladas envolvidas em infecções relacionadas à assistência à saúde (IRAS) na UTI e poderão nortear o tratamento das infecções e diminuir a pressão seletiva de bactérias multirresistentes, servindo como modelo assistencial na vigilância, bem como no controle das IRAS.(AU)

The aim of this study was to determine the prevalence and sensitivity profile of bacterial species isolated from patients admitted to the Intensive Care Unit (ICU) of a university hospital in Hinterland of Pernambuco. A retrospective study was carried out through the descriptive analysis of the results at the microbiological laboratory diagnosis of the service itself, from blood cultures, urine cultures and tracheal aspirates of patients admitted to the ICU, during the period from January to June 2019. A total of 394 clinical samples were obtained, divided between blood cultures, urocultures and tracheal aspirates, of which 144 were positive for bacterial species. Tracheal aspirate was the clinical material with the highest percentage of positive cultures (67.4%). The most prevalent bacterium isolated from individuals in the ICU was Acinetobacter baumannii (22.9%), followed by Pseudomonas aeruginosa (19.2%), Staphylococcus aureus (16.7%), Klebsiella pneumoniae (15.2%) and Staphylococcus coagulase-negative (SCN- 8.3%). Most isolated species showed a reduced sensitivity profile to betalactam drugs, especially ampicillin, penicillin and carbapenems, regardless of the clinical sample. Gram-negative bacilli (GNB) were highly sensitive to colistin. The information in this study allows us to recognize the frequency of the most isolated bacterial species involved in healthcare-associated infections (HAIs) in the ICU and may guide the treatment of infections and reduce the selective pressure of multiresistant bacteria, serving as an assistance model in surveillance as well as in the control of HAIs. (AU)

Urinary Bladder Test Device to Integrate Basic Ultrasound Training for Nurses.

Ultrasound is a useful tool for integrating clinical assessment with a bedside reliable imaging technique, but it requires adequate training. Ultrasonographic training involves examination performed on human models, in which many pathologic findings are not always readily available for the trainee to observe. The possibility of creating test objects that reproduce pathologic images allows the provision of training courses with those elements that are not always available. Our aims were to describe how to create a urinary bladder test object and to test its image quality and usefulness. Thus, we compared computed volume with the actual filling volume for five different devices to assess their reliability in volume estimation. Moreover, we evaluated the image quality and teaching utility using a 5-point Likert-type questionnaire among a group of learners. Computed bladder volume had excellent correlation with actual filling volume (p < 0.001, R2 = 0.9874). Trainees judged the ultrasound exploration realistic and considered the device useful in understanding ultrasound images and improving ultrasound skills. In conclusion, our device contributes to ultrasound training by providing a realistic ultrasound image, improving image understanding and skill development and allowing reliable bladder volume estimation.

Combined ultrasound-CT approach to monitor acute exacerbation of interstitial lung disease.

BACKGROUND: Lung ultrasound is a bedside non-irradiating tool for assessment and monitoring of lung diseases. A lung ultrasound score based on visualized artefacts allows reliable quantification of lung aeration, and is useful to monitor mechanical ventilation setting, fluid resuscitation and antibiotic response in critical care. In the context of interstitial lung diseases associated to connective tissue disorders, lung ultrasound has been integrated to computed tomography for diagnosis and follow-up monitoring of chronic lung disease progression. CASE PRESENTATION: This case describes a severe acute exacerbation of interstitial lung disease associated to dermatomyositis-polymyositis requiring prolonged extra-corporeal life support. Lung ultrasound score was performed daily and allowed monitoring and guiding both the need of advanced imaging as computed tomography and immunosuppressive therapy. CONCLUSIONS: This case suggests lung ultrasound may be a useful monitoring tool for the response to immunosuppressive therapy in acute severe rheumatic interstitial lung disease, where chest X-ray is poorly informative, and transportation is at high risk.

GenoSurf: metadata driven semantic search system for integrated genomic datasets.

Many valuable resources developed by world-wide research institutions and consortia describe genomic datasets that are both open and available for secondary research, but their metadata search interfaces are heterogeneous, not interoperable and sometimes with very limited capabilities. We implemented GenoSurf, a multi-ontology semantic search system providing access to a consolidated collection of metadata attributes found in the most relevant genomic datasets; values of 10 attributes are semantically enriched by making use of the most suited available ontologies. The user of GenoSurf provides as input the search terms, sets the desired level of ontological enrichment and obtains as output the identity of matching data files at the various sources. Search is facilitated by drop-down lists of matching values; aggregate counts describing resulting files are updated in real time while the search terms are progressively added. In addition to the consolidated attributes, users can perform keyword-based searches on the original (raw) metadata, which are also imported; GenoSurf supports the interplay of attribute-based and keyword-based search through well-defined interfaces. Currently, GenoSurf integrates about 40 million metadata of several major valuable data sources, including three providers of clinical and experimental data (TCGA, ENCODE and Roadmap Epigenomics) and two sources of annotation data (GENCODE and RefSeq); it can be used as a standalone resource for targeting the genomic datasets at their original sources (identified with their accession IDs and URLs), or as part of an integrated query answering system for performing complex queries over genomic regions and metadata.

Pre-operative and post-operative kinematic analysis in total knee arthroplasty. A pilot study.

INTRODUCTION: Total knee replacement is the treatment of choice in knee osteoarthritis. Despite this, there is still a percentage of unsatisfied patients. Recently, prosthetic designs have been developed to improve the kinematics of the prosthetic knee. MATERIALS AND METHODS: Between June 2016 and November 2016 we enrolled 26 patients underwent to total knee arthroplasty divided in two groups (A and B) treated respectively with Journey 2 implant and the Attune impltant. Each patient was evaluated with functional scores (KOOS and KSS) and with kinematic analysis using the Bioval System. RESULTS: In the group A, compared to the pre-operative, the flexion of the operated knees is significantly increased (31.27°±3.13° → 35.02°±2.1°) as well as that of the unoperated knee (34.34°±2.8° → 35.39°±3.5°). The pre/post-operative comparison of the muscles' activation timing showed an improvement for the unoperated side, which is closed to the physiological pattern, while the operated side showed an incorrect activation of all the investigated muscles. CONCLUSIONS: The Journey 2 prosthesis seems to reach better results in rotational flexion, rotational freedom and muscles activation during free walking. Furthermore, it seems that with this prosthesis the patient can feel his "new prosthetic knee" more similar and closer to the physiological one. More studies are needed to confirm these results.

Pharmacokinetics of cisplatin during open and minimally-invasive secondary cytoreductive surgery plus HIPEC in women with platinum-sensitive recurrent ovarian cancer: a prospective study.

OBJECTIVE: Evidences from animal models seem to suggest that minimally invasive surgery may enhance cisplatin diffusion when the drug is administered in the context of post-operative hyperthermic intraperitoneal chemotherapy (HIPEC). The present study evaluates the cisplatin pharmacokinetic profile in a prospective series of women with platinum sensitive recurrent epithelial ovarian cancer treated with open secondary cytoreductive surgery (O-SCS) or minimally-invasive secondary cytoreductive surgery (MI-SCS). METHODS: Cisplatin levels were assessed at 0, 20, 40, 60, and 120 minutes in: 1) blood samples, 2) peritoneal perfusate, and 3) peritoneal biopsies at the end of HIPEC. Median Cmax has been used to identify women with high and low drug levels. Progression-free survival (PFS) was calculated as the time elapsed between SCS+HIPEC and secondary recurrence or last follow-up visit. RESULTS: Nine (45.0%) women received MI-SCS, and 11 (55.0%) O-SCS. At 60 minutes, median cisplatin Cmax in peritoneal tissue was higher in patients treated with MI-SCS compared to O-SCS (Cmax=8.262 µg/mL vs. Cmax=4.057 µg/mL). Furthermore, median cisplatin plasma Cmax was higher in patients treated with MI-SCS compared to O-SCS (Cmax=0.511 vs. Cmax=0.254 µg/mL; p-value=0.012) at 120 minutes. With a median follow-up time of 24 months, women with higher cisplatin peritoneal Cmax showed a longer PFS compared to women with low cisplatin peritoneal levels (2-years PFS=70% vs. 35%; p-value=0.054). CONCLUSIONS: We demonstrate for the first time that minimally invasive route enhances cisplatin peritoneal tissue uptake during HIPEC, further evaluations are needed to confirm the correlation between peritoneal cisplatin levels after HIPEC and survival. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01539785.

Perfuorooctane Sulfonate (PFOS), Perfluorooctanoic Acid (PFOA), Brominated Dioxins (PBDDs) and Furans (PBDFs) in Wild and Farmed Organisms at Different Trophic Levels in the Mediterranean Sea.

The present study shows the results of perfuorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA), brominated dioxins (PBDDs) and furans (PBDFs) measured in several marine fish and seafood of commercial interest at different trophic levels of the food chain. The aims were to investigate the level of the contamination in Mediterranean aquatic wildlife, and in farmed fish, to assess human exposure associated to fishery products consumption. Samples of wild fish were collected during three different sampling campaigns in different Food and Agriculture Organization (FAO) 37 areas of the Mediterranean Sea. In addition, farmed fish (gilthead sea bream and European sea bass) from off-shore cages from different marine aquaculture plants. Results showed contamination values of PFOS and PFOA were lower than those detected in sea basins other than the Mediterranean Sea. Concentration values of PFOS were generally higher than those of PFOA; moreover, levels in farmed fish were lower than in wild samples from the Mediterranean Sea. Intake of PFOS and PFOA through fishery products consumption was estimated to be 2.12 and 0.24 ng/kg·BW·day, respectively, for high consumers (95th percentile). Results of 2,3,7,8-substituted congeners of PBDDs and PBDFs were almost all below the limit of detection (LOD), making it difficult to establish the contribution of these compounds to the total contamination of dioxin-like compounds in fish and fishery products.

(Eco)toxicological maps: A new risk assessment method integrating traditional and in silico tools and its application in the Ledra River (Italy).

Contaminants giving rise to emerging concern like pharmaceuticals, personal care products, pesticides and Endocrine Disrupting Chemicals (EDCs) have been detected in wastewaters, as reported in the literature, but little is known about their (eco)toxicological effects and consequent human health impact. The present study aimed at overcoming this lack of information through the use of in silico methods integrated with traditional toxicological risk analysis. This is part of a pilot project involving the management of wastewater treatment plants in the Ledra River basin (Italy). We obtained data to work up a global risk assessment method combining the evaluations of health risks to humans and ecological receptors from chemical contaminants found in this specific area. The (eco)toxicological risk is expressed by a single numerical value, permitting the comparison of different sampling sites and the evaluation of future environmental and technical interventions.

[Mobile miniature X-ray evaluation and pneumoconiosis: the role of the Clinica del Lavoro in Milan (1941-1948)]. / La valutazione schermografica delle pneumoconiosis (1941-1948): il ruolo della Clinica del Lavoro di Milano.

Since the end of the 19th century, X-rays have been used to detect lung diseases. In Italy, 207,096 miniature chest radiographs were taken from 1941 to 1948. Traditional radiographs gave better results, but miniature chest radiographs were useful for screening. Indeed, the development of mobile miniature chest radiography units resulted in an improvement in mass X-rays screening for the detection of penumoconiosis. These mobile miniature units were mounted on a bus chassis, a solution that allowed to easily reach workers. The authors analyze some models of X-ray wagon units used by the "Clinica del Lavoro" in Milan in the 1950s. From the point of view of medical museology, the preservation of these devices requires appropriate spaces.