Occupational exposure to physical agents: the new Italian database for risk assessment and control.

This article presents the new Italian database of physical agents, which is available at http://www.portaleagentifisici.it. It supports in risk assessment employers who have to comply with Italy's Legislative Decree 81/2008 (transposing into law European Union Directives 2003/10/EC, 2002/44/EC, 2004/40/EC and 2006/25/EC). The database currently contains measurements and declared European Community (EC) values from over 2540 machines; in particular, the database hosts data on mechanical vibration from over 1430 hand-held power tools (e.g., pneumatic and electric hammers, chainsaws, grinders, drills, sanders and saws) and from over 1020 whole-body machines (e.g., buses, fork lifts and wheel tractors). The database is continuously updated as soon as new experimental and declared data are acquired.

Endothelin-1 and acute myocardial infarction: a no-reflow mediator after successful percutaneous myocardial revascularization.

AIMS: No-reflow after a primary percutaneous coronary intervention (PCI) is associated with a high incidence of left ventricular (LV) failure and a poor prognosis. Endothelin-1 (ET-1) is a potent endothelium-derived vasoconstrictor peptide and an important modulator of neutrophil function. Elevated systemic ET-1 levels have recently been reported to predict a poor prognosis in patients with acute myocardial infarction (AMI) treated by primary PCI. We aimed to investigate the relationship between systemic ET-1 plasma levels and no-reflow in a group of AMI patients treated by primary PCI. METHODS AND RESULTS: A group of 51 patients (age 59+/-9.9 years, 44 males) with a first AMI, undergoing successful primary or rescue PCI, were included in the study. Angiographic no-reflow was defined as coronary TIMI flow grade < or =2 or TIMI flow 3 with a final myocardial blush grade < or =2. Blood samples were obtained from all patients on admission for ET-1 levels measurement. No reflow was observed in 31 patients (61%). Variables associated with no-reflow at univariate analysis included culprit lesion of the left anterior coronary descending artery (LAD) (67 vs. 29%, P=0.006) and ET-1 plasma levels (3.95+/-0.7 vs. 3.3+/-0.8 pg/mL, P=0.004). At multivariable logistic regression analysis, ET-1 was the only significant predictor of no-reflow (P=0.03) together with LAD as the culprit vessel (P=0.04). CONCLUSION: ET-1 plasma levels predict angiographic no-reflow after successful primary or rescue PCI. These findings suggest that ET-1 antagonists might be beneficial in the management of no-reflow.