ABSTRACT
BACKGROUND: Pemphigus, an autoimmune blistering disease that affects the skin and mucous membranes, significantly impairs the quality of life (QoL) of affected individuals. While there are a variety of QoL measurement tools available for assessing this disease, there is a lack of studies that specifically evaluate the sexual QoL of patients with pemphigus. OBJECTIVES: This case-control study aims to investigate the impact of the disease on sexual activity as well as its overall effect on QoL. MATERIALS AND METHODS: Fifty pemphigus patients, who were referred to the Dermatology Department at the University Hospital of Brescia in the period March 2019-September 2021, completed several QoL surveys, including the 36-item Short Form Health survey (SF-36), the 12-Item General Health Questionnaire (GHQ-12), the Autoimmune Bullous Disease Quality of Life (ABQOL) and either the International Index of Erectile Function (IIEF) or the Female Sexual Function Index (FSFI). The severity of the disease was assessed using the Pemphigus Disease Area Index (PDAI). Differences in QoL surveys between the case and control groups were analysed using either the t-test or the Wilcoxon-Mann-Whitney test. The correlation between QoL surveys in pemphigus patients and disease severity were analysed using Spearman's coefficient (r). RESULTS: The results revealed a marked impairment in overall QoL among patients with pemphigus compared to the healthy control subjects. Significant differences were observed in various domains of QoL, including physical health, mental well-being, social functioning and, notably, sexual health. Furthermore, disease severity as evaluated by the PDAI showed correlations with specific aspects of health status, and disease-specific QoL demonstrated associations with nearly all domains of health status. No significant correlations were found between sexual activity, mucosal involvement or steroid therapy and PDAI scores or disease-specific QoL measures. CONCLUSION: These findings emphasize the significant impact of pemphigus on patients' well-being, with particular attention to the impaired sexual activity.
Subject(s)
Autoimmune Diseases , Pemphigus , Male , Humans , Female , Quality of Life , Case-Control Studies , Severity of Illness Index , Surveys and QuestionnairesABSTRACT
BACKGROUND: Recently, indoor daylight photodynamic therapy (idl-PDT) has been developed; however, its efficacy and tolerability remain to be assessed. OBJECTIVE: This is a not-inferiority study to compare treatment outcomes of cPDT with a red LED lamp and idlPDT with a polychromatic white LED lamp in adult patients affected by symmetrical AKs of face and/or scalp. METHODS: In this comparative, intra-patient, split-face, randomized clinical trial forty-three adult patients were enrolled. Two contralateral and symmetrical target areas of the face and/or scalp harboring at least 5 AKs were selected and randomized 1:1 to treatment with cPDT and idlPDT. The AKs number and cumulative area were assessed at baseline (T0). Efficacy and cosmetic outcome were assessed 3 months after treatment (T1). RESULTS: Total AKs number and area reduced significantly with both idlPDT (p < .0001) and cPDT (p < .0001) in comparison to baseline. cPDT was more painful (p < .0001) and induced a more severe inflammation (p < .0001). Twenty-nine patients (70.7%) gave their overall preference to idlPDT (p < .001). CONCLUSION: idlPDT may represent an alternative treatment protocol to cPDT for in-office treatment of AKs patients with better tolerability and a not inferior efficacy.
Subject(s)
Keratosis, Actinic , Photochemotherapy , Scalp Dermatoses , Skin Aging , Aminolevulinic Acid/therapeutic use , Humans , Keratosis, Actinic/drug therapy , Photochemotherapy/methods , Photosensitizing Agents/therapeutic use , Scalp , Scalp Dermatoses/drug therapy , Treatment OutcomeABSTRACT
BACKGROUND: Afamelanotide (AFA) is a synthetic analogue of α-melanocyte-stimulating hormone that is approved for the treatment of patients affected by erythropoietic protoporphyria (EPP). AFA induces a "sun free" tanning and changes of acquired melanocytic nevi (AMN) that are generically described as "darkening". OBJECTIVES: To assess clinical and dermoscopic AMN changes during AFA treatment. METHODS: Adult EPP patients treated with two AFA implants 50 days apart were enrolled. They underwent a clinical and dermoscopic examination of all AMN at baseline (T0), and after 5 (T1) and 12 (T2) months from the first AFA implant. The general pattern, symmetry, number, and size of pigmented globules, morphology of the pigment network, and dermoscopic melanoma features were assessed. RESULTS: Fifteen patients were enrolled with 103 AMN. At T1 all reticular and 2-component AMN showed a focal network thickening that returned to baseline by T2. The increase of globules' number was observed at T1 but not at T2. The difference in number was not influenced by patients' age or phototype. Dermoscopic changes suggestive of malignancy were never seen. The development of new AMN was never registered. CONCLUSIONS: AFA treatment induces reversible changes of AMN dermoscopic morphology without findings suggestive of malignant transformation and it does not stimulate the development of new AMN.
Subject(s)
Dermatologic Agents/adverse effects , Nevus, Pigmented/diagnosis , Protoporphyria, Erythropoietic/pathology , alpha-MSH/analogs & derivatives , Adult , Dermatologic Agents/therapeutic use , Dermoscopy , Female , Humans , Male , Middle Aged , Nevus, Pigmented/etiology , Protoporphyria, Erythropoietic/drug therapy , Receptor, Melanocortin, Type 1/metabolism , Sunlight , Time Factors , alpha-MSH/adverse effects , alpha-MSH/therapeutic useABSTRACT
Purpose: The aim of the study was to assess the exposure to Cobalt (Co) and Tungsten (W) in a group of hard metal tool sharpeners through a combined approach of air and biological monitoring, and to evaluate the effectiveness of a control and improvement intervention carried out in collaboration with the medical officers of the local Health Protection Agency, by biomonitoring.Methods: We enrolled 132 workers from 17 companies of the province of Brescia, northern Italy. The study was performed in two phases: (1) an environmental and biomonitoring survey to assess the workers' exposure to Co and W at their usual working conditions; (2) a further biomonitoring survey 3 months after the enforcement of a control and improvement intervention, to assess its effectiveness.Results: Workers were found to be exposed to low concentration of airborne dust containing Co and W but after the intervention we recorded a significant decrease of the urinary concentrations of both Co and W. The extent of the decrease was correlated to the number of preventive industrial hygiene interventions that were carried out.Conclusions: Biological monitoring of Co and W in the hard metal tools manufacturing industry is a sensitive and effective method to evaluate the effectiveness of prevention practices.
Subject(s)
Biological Monitoring/methods , Cobalt/urine , Occupational Exposure/analysis , Occupational Health/standards , Tungsten/urine , Adult , Air Pollutants/analysis , Alloys , Environmental Monitoring , Female , Humans , Italy , Male , Risk ManagementABSTRACT
BACKGROUND: The efficacy for actinic keratosis (AK) clearance of field-directed treatments has been investigated in randomized studies against placebo, but the comparison of results is difficult for several methodological reasons. OBJECTIVES: The present study aims to compare efficacy of MAL-photodynamic therapy (MAL-PDT), ingenol mebutate gel (IMB) and diclofenac plus hyaluronate gel (DHA) on multiple AKs assessing a new performance index of efficacy, the cumulative AK area and evaluating dermoscopical and high-frequency ultrasound (HFUS) changes. METHODS: Patients with ≥5 Olsen II AKs in a 25 cm2 area of the scalp and face were enrolled and randomized to one of the treatment choices. Number of AKs and cumulative area were assessed before and after treatment. Dermoscopy and HFUS were performed on a single AK and surrounding photo-damaged skin in the treatment area. RESULTS: Cumulative AKs area reduced significantly more with PDT compared to other treatment options and with IMB in comparison to DHA. PDT was also the only treatment option that increased at a significant level the dermal density in both target AK and the surrounding skin and decreased significantly the SLEB thickness in the perilesional skin at HFUS. CONCLUSIONS: MAL-PDT is more effective than IMB and DHA for reducing the cumulative AK area which is calculated digitally from 3D pictures and should be the preferred performance index for the evaluation of the efficacy of treatments for AKs, rolling out clinical and dermoscopy evaluation. MAL-PDT improves all HFUS features of chronic photodamages of the dermis of the skin underlying and surrounding the AK spots.
Subject(s)
Keratosis, Actinic , Photochemotherapy , Aminolevulinic Acid/therapeutic use , Dermoscopy , Diclofenac/therapeutic use , Diterpenes , Humans , Keratosis, Actinic/diagnostic imaging , Keratosis, Actinic/drug therapy , Photosensitizing Agents/therapeutic use , Treatment OutcomeABSTRACT
BACKGROUND: There are few studies in the literature correlating the ultrasonographic findings, clinical scoring systems or histological findings in morphoea after ultraviolet (UV)A1 phototherapy. AIMS: To evaluate the quantitative and morphological aspects of high-frequency ultrasonography in the treatment of plaque morphoea in response to UVA1 phototherapy, and to correlate these with clinical and histological scores. METHODS: In total, 17 patients with morphoea were studied. Initially and at study end, high-frequency ultrasonography (50 MHz) was performed on the edge of a morphoea lesion treated with UVA1 phototherapy. A quantitative and qualitative analysis of dermal features was performed and compared with the features of healthy skin. Skin biopsy specimens were obtained from lesions analysed at the beginning and end of the study, assessing dermal sclerosis and dermal inflammatory infiltrate and their distribution. RESULTS: All affected skin showed a statistically significant increase in dermal thickness and hypoechogenicity, corresponding to a reduction in dermal density by ultrasonography compared with healthy skin. Morphological evaluation identified undulations of the dermis in 11 of 17 lesions (64.7%) and in 5 healthy skin areas (29.4%) (P = 0.08), while 'yoyo' figures were identified in 8 lesions (47%) but only 1 healthy skin area (5.9%) (P = 0.02). Ultrasonographic morphological analysis highlighted an improvement in dermal hyperechogenic bands and disappearance of yoyo figures after UVA1 treatment. Histology revealed a reduction in dermal sclerosis and inflammation, although this was not statistically significant. CONCLUSIONS: Ultrasonographic pattern analysis of morphoea is a suitable technique for monitoring UVA1 phototherapy response.
Subject(s)
Scleroderma, Localized/diagnostic imaging , Scleroderma, Localized/radiotherapy , Ultraviolet Therapy/methods , Adult , Aged , Aged, 80 and over , Biopsy , Case-Control Studies , Female , Humans , Male , Middle Aged , Scleroderma, Localized/pathology , Treatment Outcome , Young AdultABSTRACT
Outstanding ZT values registered on single crystals recently renewed the interest of thermoelectric community for SeSn compound. Owing to the strong anisotropy of the phenomenon, so far only single crystals proved to be the suitable for its application. Here we present the production and the characterization of bulk polycrystalline materials processed by open die pressing, aimed at reducing the gap with single crystal materials by taking advantage from the highly texture degree derived by the processing and by the improved phonon scattering promoted by grain boundaries. The resulting bulks display good compaction, improved mechanical properties and strong texture of the phase. Structural and morphological analyses confirmed the successful orientation according to the (400) cleavage plane. The structural transition responsible for the ultra-low thermal conductivity has been investigated and possible irreversible effects on the starting phase due to thermal cycling have been evaluated. Preliminary measurements of thermal conductivity are reported.
ABSTRACT
Magnetite nanoparticles coated with silica, obtained by a sol-gel process in the reverse micelle microemulsion, were characterized and homogeneously suspended in water in order to assay their biocompatibility toward blood cells, in view of a potential medical use of this material. Their hemolytic, pro-thrombotic and pro-inflammatory properties were observed.
Subject(s)
Blood Cells/drug effects , Ferric Compounds/chemistry , Ferric Compounds/pharmacology , Magnetite Nanoparticles , Silicon Dioxide/chemistry , Silicon Dioxide/pharmacology , Humans , MicellesABSTRACT
Peri-implantitis is an inflammatory disease affecting soft and hard tissues surrounding dental implants. As the global number of individuals that undergo restorative therapy through dental implants increases, peri-implantitis is considered as a major and growing problem in dentistry. A randomly selected sample of 588 patients who all had received implant-supported therapy 9 y earlier was clinically and radiographically examined. Prevalence of peri-implantitis was assessed and risk indicators were identified by multilevel regression analysis. Forty-five percent of all patients presented with peri-implantitis (bleeding on probing/suppuration and bone loss >0.5 mm). Moderate/severe peri-implantitis (bleeding on probing/suppuration and bone loss >2 mm) was diagnosed in 14.5%. Patients with periodontitis and with ≥4 implants, as well as implants of certain brands and prosthetic therapy delivered by general practitioners, exhibited higher odds ratios for moderate/severe peri-implantitis. Similarly, higher odds ratios were identified for implants installed in the mandible and with crown restoration margins positioned ≤1.5 mm from the crestal bone at baseline. It is suggested that peri-implantitis is a common condition and that several patient- and implant-related factors influence the risk for moderate/severe peri-implantitis (ClinicalTrials.gov NCT01825772).
Subject(s)
Dental Implants/statistics & numerical data , Peri-Implantitis/epidemiology , Aged , Alveolar Bone Loss/epidemiology , Cross-Sectional Studies , Crowns/statistics & numerical data , Dental Implants, Single-Tooth/statistics & numerical data , Dental Prosthesis Design/statistics & numerical data , Dental Prosthesis, Implant-Supported/statistics & numerical data , Female , Follow-Up Studies , General Practice, Dental/statistics & numerical data , Humans , Male , Mandible/surgery , Middle Aged , Periodontal Index , Prevalence , Retrospective Studies , Risk Factors , Stomatitis/epidemiology , Sweden/epidemiology , Treatment OutcomeABSTRACT
Treatment outcomes in implant dentistry have been mainly assessed as implant survival rates in small, selected patient groups of specialist or university clinical settings. This study reports on loss of dental implants assessed in a large and randomly selected patient sample. The results were aimed at representing evaluation of effectiveness of implant dentistry. Using the national data register of the Swedish Social Insurance Agency, 4,716 patients were randomly selected. All had been provided with implant-supported restorative therapy in 2003. Patient files of 2,765 patients (11,311 implants) were collected from more than 800 clinicians. Information on patients, treatment procedures, and outcomes related to the implant-supported restorative therapy was extracted from the files. In total, 596 of the 2,765 subjects, provided with 2,367 implants, attended a clinical examination 9 y after therapy. Implant loss that occurred prior to connection of the supraconstruction was scored as an early implant loss, while later occurring loss was considered late implant loss. Early implant loss occurred in 4.4% of patients (1.4% of implants), while 4.2% of the patients who were examined 9 y after therapy presented with late implant loss (2.0% of implants). Overall, 7.6% of the patients had lost at least 1 implant. Multilevel analysis revealed higher odds ratios for early implant loss among smokers and patients with an initial diagnosis of periodontitis. Implants shorter than 10 mm and representing certain brands also showed higher odds ratios for early implant loss. Implant brand also influenced late implant loss. Implant loss is not an uncommon event, and patient and implant characteristics influence outcomes (ClinicalTrials.gov NCT01825772).
Subject(s)
Dental Implants/statistics & numerical data , Dental Restoration Failure/statistics & numerical data , Aged , Alveolar Ridge Augmentation/statistics & numerical data , Dental Care/statistics & numerical data , Dental Prosthesis Design/statistics & numerical data , Dental Prosthesis, Implant-Supported/statistics & numerical data , Female , Follow-Up Studies , Humans , Male , Middle Aged , Periodontitis/epidemiology , Registries , Smoking/epidemiology , Survival Analysis , Sweden/epidemiology , Treatment OutcomeABSTRACT
The aim of this research was to investigate a tough polymer to develop 3D scaffolds and 2D films for tissue engineering applications, in particular to repair urethral strictures or defects. The polymer tested was a graft copolymer of polylactic acid (PLA) synthesized with the rationale to improve the toughness of the related PLA homopolymer. The LMP-3055 graft copolymer (in bulk) demonstrated to have negligible cytotoxicity (bioavailability >85%, MTT test). Moreover, the LMP-3055 sterilized through gamma rays resulted to be cytocompatible and non-toxic, and it has a positive effect on cell biofunctionality, promoting the cell growth. 3D scaffolds and 2D film were prepared using different LMP-3055 polymer concentrations (7.5, 10, 12.5 and 15%, w/v), and the effect of polymer concentration on pore size, porosity and interconnectivity of the 3D scaffolds and 2D film was investigated. 3D scaffolds got better results for fulfilling structural and biofunctional requirements: porosity, pore size and interconnectivity, cell attachment and proliferation. 3D scaffolds obtained with 10 and 12.5% polymer solutions (3D-2 and 3D-3, respectively) were identified as the most suitable construct for the cell attachment and proliferation presenting pore size ranged between 100 and 400µm, high porosity (77-78%) and well interconnected pores. In vitro cell studies demonstrated that all the selected scaffolds were able to support the cell proliferation, the cell attachment and growth resulting to their dependency on the polymer concentration and structural features. The degradation test revealed that the degradation of polymer matrix (ΔMw) and water uptake of 3D scaffolds exceed those of 2D film and raw polymer (used as control reference), while the mass loss of samples (3D scaffold and 2D film) resulted to be controlled, they showed good stability and capacity to maintain the physical integrity during the incubation time.
Subject(s)
Materials Testing , Polyesters/pharmacology , Polymers/pharmacology , Tissue Engineering/methods , Tissue Scaffolds/chemistry , Animals , Calorimetry, Differential Scanning , Cell Death/drug effects , Cell Proliferation/drug effects , Fibroblasts/cytology , Fibroblasts/drug effects , Humans , Mechanical Phenomena/drug effects , Microscopy, Electron, ScanningABSTRACT
The purpose of this study was to evaluate patient-centred outcomes with regard to function and comfort after placement of mini-implants for stabilisation of complete dentures. The trial was designed as a prospective cohort of 12-months duration and involved 21 subjects in the age of 50-90 years having a full denture in the maxilla or the mandible with poor stability during function. Flapless installation of 2-4 narrow-body Dentatus Atlas(®) implants was performed and retention for the existing denture was obtained by the use of a silicone-based soft lining material (Tuf-Link(®)). Patients' judgement of perceived satisfaction with function and comfort of the dentures was recorded at baseline, 1- and 12-months post-treatment using 10-centimetre visual analogue scales (VAS) and a questionnaire. Clinical examination of the conditions of the peri-implant soft tissues was performed at 12 months. Nineteen of the 21 patients were available for the 12-month follow-up examination. The two drop-out subjects lost all implants within 1 month and rejected retreatment. Further six subjects lost 1-2 implants, but were sucessfully retreated by insertion of new implants. Overall satisfaction, chewing and speaking comfort were all markedly improved from pre-treatment median VAS scores of around 4-5 to median scores of 9·0-10 (10 = optimal) at the final examination. The prevalence of positive answers to questions regarding stability/function of the denture increased significantly to almost 100% for all questions. Treatment involving maxillary dentures and the use of short implants (7-10 mm) was associated with an increased risk of implant failure. The results indicate that placement of mini-implants as retentive elements for full dentures with poor functional stability has a marked positive impact on the patients' perception of oral function and comfort as well as security in social life.
Subject(s)
Dental Prosthesis, Implant-Supported , Denture, Complete , Mouth, Edentulous/rehabilitation , Patient Satisfaction , Aged , Aged, 80 and over , Dental Prosthesis Design , Dental Restoration Failure , Female , Humans , Male , Middle Aged , Prospective Studies , Surveys and Questionnaires , Treatment OutcomeABSTRACT
OBJECTIVE: To assess the presence of pulmonary embolism and inflammation after polidocanol foam injection into the peripheral veins of rabbits. METHOD: The animals were treated with polidocanol foam (1 or 3 mg/kg) or vehicle. Early (15 minutes) and late (30 days) animals were evaluated by perfusional lung scintigraphy and histopathological examination. RESULTS: In the control group no alterations were found. After polidocanol foam injection it was observed that an important reduction of pulmonary perfusion in the early periods, was mainly in the left lung (P < 0.001), with consequent embolism in the histological evaluation. In late periods it was observed that the presence of thrombus was with fibrin in small veins, compatible with chronic thrombus and the presence of chronic pulmonary inflammation. CONCLUSIONS: The injection of polidocanol foam in experimental animals can induce venous embolism and chronic inflammatory infiltration.
Subject(s)
Lung/blood supply , Lung/pathology , Polyethylene Glycols/adverse effects , Pulmonary Embolism/chemically induced , Pulmonary Embolism/pathology , Sclerosing Solutions/adverse effects , Acute Disease , Animals , Chronic Disease , Female , Male , Polidocanol , Polyethylene Glycols/pharmacology , Rabbits , Sclerosing Solutions/pharmacology , Time FactorsABSTRACT
The purpose of this work was to investigate the long-term effect of gamma-irradiation treatment on the functional properties of PEG-PDLLA and PEG-PLGA films and to evaluate the cytocompatibility of sterilized samples. Chemical and thermal properties, and cytocompatibility of sterilized films were detected for samples at time zero and after storage at 5 ± 3°C for 60 days. An in vitro degradation study was carried out on polymer samples to examine the effect of sterilization on the degradation performances of co-polymer films. Incubated samples were characterized in terms of film surface structure (SEM), chemical (GPC) and thermal (DSC) properties. The study performed on films upon gamma sterilization showed no significant changes of the PEG-PDLLA and PEG-PLGA film structure, while GPC analysis highlighted that the effect of gamma irradiation was dependent on the Mw and composition of polymers. DSC traces suggested more pronounced gamma-ray effects on the PEG-PLGA multiblock co-polymer. During the stability study important changes in terms of structure surface, thermal properties and cytocompatibility were observed and investigated. Data collected during the in vitro degradation study emphasized the need to know and investigate the degradation performances and behaviour of polymer or polymer systems (as DDS, scaffolds and bandage) treated with gamma rays.
Subject(s)
Cobalt Radioisotopes , Gamma Rays , Polyesters/radiation effects , Polyethylene Glycols/radiation effects , Sterilization/methods , Calorimetry, Differential Scanning , Cell Adhesion , Cell Survival , Cells, Cultured , Chromatography, Gas , Fibroblasts/cytology , Fibroblasts/physiology , Materials Testing , Microscopy, Electron, Scanning , Molecular Weight , Optical Imaging , Polyesters/chemical synthesis , Polyesters/chemistry , Polyethylene Glycols/chemical synthesis , Polyethylene Glycols/chemistry , Surface Properties , Temperature , Time FactorsABSTRACT
The aim of this study was to radiographically analyse long-term changes in (i) overeruption of unopposed molars and (ii) tipping of molars with a mesial edentulous space, and whether there is an interaction between the two events. A further aim was to analyse if loss of alveolar bone height might influence overeruption and tipping. The sample consisted of panoramic radiographs taken at an interval of 12 years of 292 subjects from a prospective population study of women. The panoramic radiographs were scanned and analysed. Changes in tipping, overeruption and alveolar bone height of molars and control teeth were measured. The results showed that unopposed molars were more commonly found in the upper jaw and that unopposed molars showed 4·9 times higher risk of overeruption of ≥2 mm (95% CI 1·5-15·3) than opposed molars during the 12-year observation period. The average overeruption for the unopposed molars was 4·5% (s.d. 7·6), which corresponds to approximately 0·9 mm. The degree of overeruption increased with decreased bone support. Molars with a mesial edentulous space were most prevalent in the lower jaw, but neither an edentulous space nor alveolar bone level/bone level change were found to have a significant effect on tipping of the molars. The average mesial tipping was 0·8° (s.d. 5·6). In conclusion, unopposed molars showed a significantly increased risk for overeruption. Molars facing a mesial edentulous space showed a low risk for mesial tipping, but a significant interaction between overeruption and tipping was identified.
Subject(s)
Alveolar Bone Loss/pathology , Alveolar Process/pathology , Jaw, Edentulous, Partially/pathology , Molar/pathology , Periodontal Attachment Loss/pathology , Periodontal Pocket/pathology , Radiography, Panoramic , Tooth Migration/pathology , Adult , Alveolar Bone Loss/diagnostic imaging , Alveolar Bone Loss/physiopathology , Alveolar Process/diagnostic imaging , Alveolar Process/physiopathology , Female , Humans , Jaw, Edentulous, Partially/diagnostic imaging , Jaw, Edentulous, Partially/physiopathology , Middle Aged , Molar/diagnostic imaging , Molar/physiopathology , Periodontal Attachment Loss/diagnostic imaging , Periodontal Attachment Loss/physiopathology , Periodontal Pocket/diagnostic imaging , Periodontal Pocket/physiopathology , Radiography, Dental, Digital , Reproducibility of Results , Sweden/epidemiology , Tooth Migration/diagnostic imaging , Tooth Migration/physiopathologyABSTRACT
This cross-sectional study was aimed at evaluating in a large sample of male foundry workers the current exposure levels to carcinogenic compounds, including metallic elements [arsenic (As), beryllium (Be), cadmium (Cd), chromium (Cr), nickel (Ni)] and aromatic polycyclic hydrocarbons (PAH) by a biological monitoring approach, using validated biomarkers of exposure. Workers were recruited from 15 aluminium, copper alloy, electric steel and cast iron foundries and provided an end-of-shift urine sample to determine urinary concentrations of As, Be, Cd, Cr, Ni and 1-hydroxypyrene (1-OHP). Metallic elements were determined either by inductively coupled plasma mass spectrometry (Be, Cd and Cr) or by atomic absorption spectrometry (As, Ni), whereas 1-OHP was determined by high pressure liquid chromatography with fluorimetric detection. Most of the determinations fell within the laboratory's reference values. Age and lifestyle habits (smoking, alcohol, diet) played a significant interfering role.
Subject(s)
Carcinogens , Environmental Monitoring , Metallurgy , Metals/adverse effects , Occupational Exposure/adverse effects , Polycyclic Aromatic Hydrocarbons/adverse effects , Cross-Sectional Studies , Humans , Male , Metals/urine , Polycyclic Aromatic Hydrocarbons/urineABSTRACT
OBJECTIVE: The aim of this study was to assess the influence of inclination of the object on the reliability and reproducibility of linear measurements of anatomic structures of the mandible on images obtained using cone-beam CT (CBCT). METHODS: Ten linear dimensions between anatomical landmarks were measured in a dry mandible. The measurements were performed with a manual calliper three times by three observers. The mandible was scanned with Planmeca Promax 3D cone-beam CT (Planmeca Oy, Helsinki, Finland) with the base of the mandible parallel as well as tilted 45° to the horizontal plane. Computer measurements of the linear dimension were performed by three observers. The radiographic measurements were performed four times for each experimental setting. A total of 240 measurements were performed. Reproducibility was evaluated through comparison of standard deviation (SD) and estimation of intraclass correlation coefficient (ICC). The error was estimated as the absolute difference between the radiographic measurements and the mean manual calliper measurements. RESULTS: The mean SD for the radiographic measurements was 0.36 mm for the horizontally positioned mandible and 0.48 mm for the inclined mandible. The ICC between examiners was 0.996 mm, between sessions was 0.990 mm and between CBCT measurements and calliper was 0.992 mm. The overall absolute mean measurement error was 0.40 mm (SD 0.39 mm). The percentage of errors that exceeded 1 mm was 6.7%. CONCLUSION: The results revealed high reliability of measurements performed on CBCT images independently from object position, examiner's experience and high reproducibility in repeated measurements settings.
Subject(s)
Cone-Beam Computed Tomography/methods , Mandible/diagnostic imaging , Cadaver , Cephalometry/methods , Clinical Competence , Humans , Image Processing, Computer-Assisted , Observer Variation , Patient Positioning , Phantoms, Imaging , Reproducibility of Results , SoftwareABSTRACT
BACKGROUND AND OBJECTIVES: The risk assessment for Upper Extremities Work Related Muscle skeletal Disorders (UEWMSDs) remains a complex and open question. For professionals involved in this analysis of fundamental importance appears the use of technical/good practice norms or the guide lines produced by scientific society or association, such as for our country the guide lines published on this theme by the Italian Society of Occupational Medicine and Industrial Hygiene (SIMLII). The objective of this research was to verify and validate the multiple step method suggested by above mentioned guide lines and to compare results obtained by six analysis methods adopted (Washington State Standard, OCRA, HAL, RULA, OREGE and STRAIN INDEX (SI)). METHODS: 439 workstation in 17 manufactures employing 4166 workers for a total of 1396 analysis by different methods were considered, by adopting the following multiple step procedure: preliminary evaluation by Washington State method and OCRA checklist in all the working stations, RULA or HAL as first level evaluation, OREGE or SI as second level evaluation when complexity of work variables or contradictory results emerged. We have also collected data, provided by occupational physicians, about the pathologies of the upper limb. A representative sample of workers was also administered a INRS OREGE questionnaire that investigates the disorders of the upper limb, the subjective perception of risk, psychosocial factors and stress-related disturbs. RESULTS: The preliminary evaluation resulted negative (risk absent) in the 87% of examined work stations and by using checklist OCRA optimal-acceptable condition was found in 57% (the percentage reaches more than 90% when classes of risk absent-very low-low risk classes of the method were considered all together), by HAL in 91% of analysis, by RULA in 90%, by OREGE in 58%; by SI in 67% of examined working position. Five methods have been contemporary used for 31 working position with the following results: 58% at different degree of risk by OCRA, 13% by HAL, 19% by RULA; 13% by OREGE; 10% by SI. Among the main components of the bio mechanical risk the high frequency of working task resulted at first place for 4/5 methods and for checklist OCRA also the evaluation of recovery times. Consistent with the findings from risk assessment, the majority of reports of occupational diseases by occupational physician is localized at the wrist and workers assigned to tasks at risk not always have had occupational diseases. The role of main psychosocial factors was demonstrated in about the 15-20% of working conditions and regarded in particular the working climate, the job maintenance perspective, the time pressure and errors possibility together with the difficulty of help by colleagues and managers and stress related disturbs. DISCUSSION AND CONCLUSION: The preliminary evaluation by State of Washington method appears to be an adequate instrument for identify the working condition at risk. The results of this method appears well correlated with OCRA checklist and HAL. The risk conditions were always confirmed by higher complexity methods (RULA, OREGE, SI). All the adopted methods were in a good agreement in two extreme situations: high risk or absent risk. In the degree of accordance varied on the basis of their rationale and of the role of their different components. A necessary integration of biomechanical analysis appears the evaluation of working conditions and musculoskeletal and psychological disorders collected directly from the workers and the results of health surveillance programs. The recommendations of SIMLII about the critical use of biomechanical methods and about the possible use of more than one of them considering the working characteristics have been confirmed.
Subject(s)
Manufactured Materials/statistics & numerical data , Musculoskeletal Diseases/epidemiology , Musculoskeletal Diseases/etiology , Occupational Diseases/epidemiology , Upper Extremity , Workplace/statistics & numerical data , Biomechanical Phenomena , Female , Humans , Industry , Italy/epidemiology , Male , Musculoskeletal Diseases/diagnosis , Occupational Diseases/diagnosis , Population Surveillance , Practice Guidelines as Topic , Public Health , Risk Assessment/methods , Risk Factors , Stress, Mechanical , Surveys and Questionnaires , Task Performance and Analysis , WristABSTRACT
Within the framework of air quality monitoring, measurements by Earth-observing satellite sensors are combined here with regional meteorological and chemical transport models. Two satellite-derived products developed within the QUITSAT project, regarding significant pollutants including PM(2.5) and NO(2), are presented. Estimates of PM(2.5) concentrations at ground level were obtained using moderate resolution imaging spectroradiometer (Terra-Aqua/NASA) aerosol optical properties. The semi-empirical approach adopted takes into account PM(2.5) sampling and meteorological descriptions of the area studied, as simulated by MM5, to infer aerosol optical properties to PM projection coefficients. Daily maps of satellite-based PM(2.5) concentrations over northern Italy are derived. Monthly average values were compared with in situ PM(2.5) samplings showing good agreement. Ozone monitoring instrument (OMI) (Aura/NASA) NO(2) tropospheric contents are merged using the GAMES chemical model simulations. The method employs a weighted rescaling of the model column in the troposphere according to the OMI observations. The weightings take into account measurement errors and model column variances within the satellite ground pixel. The obtained ground-level concentrations of NO(2) show good agreement with the environmental agencies' in situ.