Aims
We aimed to assess carpal tunnel syndrome (CTS) prevalence in transthyretin (TTR)‐related and light‐chain amyloidosis (AL), comparing it to the general population, adjusted for age and gender. ...In TTR‐related amyloidosis (ATTR) we investigated (i) CTS prevalence in relation to genotype, cardiac amyloidosis (CA), age and gender; (ii) CTS role as an incremental risk factor for CA; (iii) temporal relationship between CTS and CA; and (iv) CTS prognostic role.
Methods and results
Data from 538 subjects (166 hereditary ATTR, 107 wild‐type ATTR, 196 AL amyloidosis, and 69 TTR mutation carriers; 64% male, median age 62.4 years), evaluated at our centre (Bologna, Italy), were analysed and compared to a published cohort of 14.9 million people, in which incidence rates of CTS had been estimated. CTS prevalence was highest in ATTR patients with CA (20.3% vs. 4.1% in the general population), while it was comparable to the general population when CA was absent and in AL patients. CTS standardized incidence rates were markedly elevated in ATTR males in the eighth decade of life (13.08 in hereditary ATTR, 15.5 in wild‐type ATTR). The risk of developing CA was greater in ATTR patients with CTS; the probability of having CTS was highest 5–9 years prior to CA diagnosis. CTS was an independent mortality risk factor in ATTR.
Conclusions
Compared to general population the adjusted prevalence of CTS is higher among elderly men with ATTR; CTS is a prognostic marker in ATTR, independently of cardiac involvement, and precedes CA diagnosis by 5–9 years. The awareness of this association and time delay offers the possibility of an early pre‐clinical ATTR‐CA diagnosis.
In the past few years, companies have started considering the adoption of upper-limb occupational exoskeletons as a solution to reduce the health and cost issues associated with work-related shoulder ...overuse injuries. Most of the previous research studies have evaluated the efficacy of these devices in laboratories by measuring the reduction in muscle exertion resulting from device use in stereotyped tasks and controlled conditions. However, to date, uncertainties exist about generalizing laboratory results to more realistic conditions of use. The current study aims to investigate the in-field efficacy (through electromyography and perceived exertion), usability, and acceptance of a commercial spring-loaded upper-limb exoskeleton in cleaning job activities. The operators were required to maintain prolonged overhead postures while holding and moving a pole equipped with tools for window and ceiling cleaning. Compared to the normal working condition, the exoskeleton significantly reduced the total shoulder muscle activity (∼17%), the activity of the anterior deltoid (∼26%), medial deltoid (∼28%), and upper trapezius (∼24%). With the exoskeleton, the operators perceived reduced global effort (∼17%) as well as a reduced local effort in the shoulder (∼18%), arm (∼22%), upper back (∼14%), and lower back (∼16%). The beneficial effect of the exoskeleton and its suitability in cleaning settings are corroborated by the acceptance and usability scores assigned by operators, which averaged ∼5.5 out of 7 points. To the authors' knowledge, this study is the first to present an experience of exoskeleton use in cleaning contexts. The outcomes of this research invite further studies to test occupational exoskeletons in various realistic applications to foster scientific-grounded ergonomic evaluations and encourage the informed adoption of the technology.
pleural mesothelioma is a rare cancer in the general population, but it is more common in subjects occupationally exposed to asbestos. Studies with asbestos fiber quantification in pleural tissue are ...scarce: for this reason, we aimed at undertaking a scoping review to summarize the evidence provided by studies in which asbestos fibers were determined by electron microscopy (SEM or TEM) in human pleural tissues, whether normal or pathologic.
A scoping review of articles that quantified asbestos fibers in human pleural tissue (normal or pathologic) by electron microscopy (SEM or TEM), in subjects with asbestos exposure (if any) was performed.
The 12 studies selected comprised 137 cases, out of which 142 samples were analyzed. Asbestos fibers were detected in 111 samples (78%) and were below the detectable limit in 31 samples (22%). The concentration of asbestos fibers detected in the positive samples was distributed from as low as 0.01 mfgdt (millions of fibers per gram of dry tissue) up to 240 mfgdt. However, the minimum concentration of fibers overlaps in the three types of tissues (normal pleura, pleural plaque, mesothelioma) in terms of magnitude; therefore, it is not possible to distinguish a definite pattern which differentiates one tissue from the other.
The studies included were heterogeneous as to the representativeness of the samples and analytical techniques; the possibility of false negatives must be considered. It would be desirable to systematically search for asbestos fibers to fill the knowledge gap about the presence of asbestos fibers in normal or pathological pleural tissue in order to better understand the development of the different pleural diseases induced by this mineral.
Background
Ionizing radiation and mesothelioma have been examined among personnel employed in nuclear power plant and patients treated by external beam radiation therapy (EBRT). The association is ...still controversial; the purpose of this review is to summarize the scientific evidence published in the literature regarding the relationship between ionizing radiation and incidence of mesothelioma and, if possible, estimating strongness of the association by meta‐analysis of extracted data.
Methods
Articles included in the systematic review were retrieved by searching among the three main scientific databases: PubMed, Scopus, and Embase. The literature search was conducted in June 2021. A meta‐analysis of random effects was conducted, stratified by exposure (EBRT, occupational exposure). The heterogeneity of the summary relative risks (RRs) was assessed using I2 statistics. Publication bias was evaluated graphically through the funnel plot.
Findings
The exposure to ionizing radiation could be a risk factor for mesothelioma: both for exposure to high doses for short periods (EBRT) (RR of 3.34 95% confidence interval, CI 1.24–8.99) and for exposure to low doses for a prolonged duration (exposure working) (RR of 3.57 95% CI 2.16–5.89).
Conclusions
Despite the low number of mesotheliomas in the general population, the steadily increased risk among individuals exposed to radiation is still worth considering.
The exposure to ionizing radiation could be a risk factor for mesothelioma: both for exposure to high doses for short periods (external beam radiation therapy) (relative risk RR of 3.34 95% confidence interval, CI 1.24–8.99) and for exposure to low doses for a prolonged duration (exposure working) (RR of 3.57 95% CI 2.16–5.89).
Airborne-mediated microbial diseases represent one of the major challenges to public health. Ultraviolet C radiation (UVC) is among the different sanitation techniques useful to reduce the risk of ...infection in healthcare facilities. Previous studies about the germicidal activity of UVC were mainly performed in artificial settings or in vitro models. This study aimed to assess the sanitizing effectiveness of a UVC device (SanificaAria 200, Beghelli, Valsamoggia, Bologna, Italy) in 'real-life' conditions by evaluating its ability to reduce microbial loads in several hospital settings during routine daily activities. The efficacy of the UVC lamp in reducing the bacterial component was evaluated by microbial culture through the collection of air samples in different healthcare settings at different times (30 min-24 h) after turning on the device. To assess the anti-viral activity, air samplings were carried out in a room where a SARS-CoV-2-positive subject was present. The UVC device showed good antibacterial properties against a wide range of microbial species after 6 h of activity. It was effective against possible multi-drug resistant microorganisms (e.g.,
spp.,
spp.) and spore-forming bacteria (e.g.,
spp.). In addition, the UVC lamp was able to inactivate SARS-CoV-2 in just one hour. Thanks to its effectiveness and safety, SanificaAria 200 could be useful to inactivate airborne pathogens and reduce health risks.
ObjectivesTo assess the association between occupational exposure to asbestos and the risk of cholangiocarcinoma (CC).MethodsWe conducted a case–control study nested in the Nordic Occupational Cancer ...(NOCCA) cohort. We studied 1458 intrahepatic CC (ICC) and 3972 extrahepatic CC (ECC) cases occurring among subjects born in 1920 or later in Finland, Iceland, Norway and Sweden. Each case was individually matched by birth year, gender and country to five population controls. The cumulative exposure to asbestos (measured in fibres (f)/ml × years) was assessed by applying the NOCCA job-exposure matrix to data on occupations collected during national population censuses (conducted in 1960, 1970, 1980/81 and 1990). Odds ratios (OR) and 95% CI were estimated using conditional logistic regression models adjusted by printing industry work.ResultsWe observed an increasing risk of ICC with cumulative exposure to asbestos: never exposed, OR 1.0 (reference category); 0.1–4.9 f/mL × years, OR 1.1 (95% CI 0.9 to 1.3); 5.0–9.9 f/mL × years, OR 1.3 (95% CI 0.9 to 2.1); 10.0–14.9 f/mL × years, OR 1.6 (95% CI 1.0 to 2.5); ≥15.0 f/mL × years, OR 1.7 (95% CI 1.1 to 2.6). We did not observe an association between cumulative asbestos exposure and ECC.ConclusionsOur study provides evidence that exposure to asbestos might be a risk factor for ICC. Our findings also suggest that the association between ECC and asbestos is null or weaker than that observed for ICC. Further studies based on large industrial cohorts of asbestos workers and possibly accounting for personal characteristics and clinical history are needed.
Abstract
Background
Asbestos is a mineral present in nature and it has been used for years in numerous settings. Asbestos enters the bloodstream and lymphatic system mainly through breathing.
...Objectives
Studies with asbestos fiber’s quantification in human tissues are scarce except for the lung. This article summarizes asbestos studies in some extra-abdominal tissues.
Methods
A scoping review of articles that quantified asbestos fibers in extra-abdominal tissues (lymph nodes, pharynx, larynx, trachea, heart) by electron microscopy (Scanning—SEM or Transmission—TEM) was performed.
Results
The 10 studies selected comprised 52 cases, out of whom 108 samples were analyzed. Mostly samples were lymph node tissues (102), followed by larynx (3) and myocardium (3). No studies were found that determined the presence of asbestos in the pharynx or trachea. The concentration of asbestos fibers detected in the lymph nodes was from 0.003 million fibers per gram of dry tissue (mfgdt) up to 7400 mfgdt, in the larynx the range was from 0.5 mfgdt up to 3.6 mfgdt, in myocardium no asbestos fibers were detected.
Discussion
The studies included were heterogeneous in terms of case and sample characteristics and analytical techniques. As subjects exposed to asbestos are often positive for fibers in thoracic lymph nodes, we suggest that whenever a human tissue sample is analyzed for asbestos presence, the relevant draining lymph node should be concomitantly studied.
The underlying purpose of this commentary and position paper is to achieve evidence-based recommendations on prevention of work-related musculoskeletal disorders (MSDs). Such prevention can take ...different forms (primary, secondary and tertiary), occur at different levels (i.e. in a clinical setting, at the workplace, at national level) and involve several types of activities. Members of the Scientific Committee (SC) on MSDs of the International Commission on Occupational Health (ICOH) and other interested scientists and members of the public recently discussed the scientific and clinical future of prevention of (work-related) MSDs during five round-table sessions at two ICOH conferences (in Cape Town, South Africa, in 2009, and in Angers, France, in 2010). Approximately 50 researchers participated in each of the sessions. More specifically, the sessions aimed to discuss new developments since 1996 in measures and classification systems used both in research and in practice, and agree on future needs in the field. The discussion focused on three questions: At what degree of severity does musculoskeletal ill health, and do health problems related to MSDs, in an individual worker or in a group of workers justify preventive action in occupational health? What reliable and valid instruments do we have in research to distinguish 'normal musculoskeletal symptoms' from 'serious musculoskeletal symptoms' in workers? What measures or classification system of musculoskeletal health will we need in the near future to address musculoskeletal health and related work ability? Four new, agreed-upon statements were extrapolated from the discussions: 1. Musculoskeletal discomfort that is at risk of worsening with work activities, and that affects work ability or quality of life, needs to be identified. 2. We need to know our options of actions before identifying workers at risk (providing evidence-based medicine and applying the principle of best practice). 3. Classification systems and measures must include aspects such as the severity, frequency, and intensity of pain, as well as measures of impairment of functioning, which can help in prevention, treatment and prognosis. 4. We need to be aware of economic and/or socio-cultural consequences of classification systems and measures.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Peritoneal tissue is the second most affected site by malignant mesothelioma linked to asbestos exposure. This scoping review aims to summarize the findings of the studies in which asbestos fibers in ...the peritoneum were quantified by electron microscopy, occasionally associated with spectroscopy, both in neoplastic and non-neoplastic tissue. The 9 studies selected comprised 62 cases, out of whom 100 samples were analyzed. Asbestos fibers were detected in 58 samples (58%). In addition, 28 cases had diagnosis of peritoneal mesothelioma. For 32 cases, a lung tumor sample was available: 28/32 samples analyzed presented asbestos fibers; 18/32 reported amphiboles with a range from not detected to 14.2 million fibers per gram of dry tissue (mfgdt); 18/32 reported chrysotile, with a range of 0 to 90 mfgdt. The studies were heterogeneous for type of samples, analytical technology, and circumstances of exposure to asbestos. To evaluate asbestos fibers in the peritoneum and to better understand the association between asbestos exposure and malignant peritoneal mesothelioma, it is desirable that the search for asbestos fibers becomes a routine process every time peritoneal tissue is accessible.
Idebenone (IDB) (2,3-dimethoxy-5-methyl-6-(10-hydroxydecyl)-1,4-benzoquinone) is a compound synthesized in the early 1980s. Initially developed for the treatment of cognitive disturbances and ...Alzheimer’s disease, IDB is now studied for Friedreich’s ataxia, Leber’s hereditary optic neuropathy (LHON), or Duchenne muscular dystrophy. The greatest disadvantage of IDB is its low solubility in water, resulting in low bioavailability. Galenic preparations of IDB in customized doses are common for pediatric patients, which can often prove to be the only option for access to therapy. As an antioxidant, the chemical stability of IDB is an essential guarantee for exerting the desired antioxidant action. Stability studies are essential to know the effect of storage conditions of a galenic product. For the first time, a stability-indicating LC-MS method has been developed to define the stability of IDB suspensions in SyrSpend® Sugar-Free Unflavored (Fagron), a carrier phase formulated for setting up suspensions of active pharmaceutical ingredients (APIs) insoluble or poorly insoluble in water and compatible with it. The proposed method was validated for linearity, accuracy, specificity, robustness, matrix effect and recovery, limit of detection (LOD), limit of quantification (LOQ), and repeatability.