Construction workers (CWs) are both more exposed to tetanus and at higher risk to be inadequately immunized. Our aim was to evaluate tetanus immunization status and knowledge/attitudes towards ...tetanus vaccination in CWs in Italy. In this field report, the immunization status of 554 unskilled CWs (i.e. labourers). Immunization status was assessed recalling immunization booklets/certificates. Attitudes and knowledge were collected through a standardized questionnaire. In 240/554 CWs, immunization status was inadequate/not documented: in 184 subjects (33.2%), the last vaccination shot was older than 10 years, whereas basal immunization was incomplete in 20 cases, more frequently in foreign-born people (FBP) than in Italian born (IBP) (OR=7.116). In 198 cases (35.7%), an Occupational Physician (OPh) performed last booster, usually with monovalent (T, n=173) vaccine. The main reason for inadequate immunization was having forgotten the periodic booster (148/554; 26.7%), whereas 42 subjects (7.6%) deliberately avoided tetanus vaccine because of personal/religious beliefs, more frequently in FBP than in IBP (OR=3.182). In summary, the prevalence of inadequate immunization status was relatively high (43.4%): the high prevalence of "forgotten boosters" enlightens the key role of OPh in recalling and promoting vaccination policies. Moreover, the inappropriate use of Td vaccine points out the opportunity for educational campaigns in OPh.
This study aims to characterize personal attitudes and knowledge of a sample of Italian occupational physicians (OPhs) towards immunization practice in the case of healthcare workers (HCWs).
A total ...of 90 OPhs (42.2% of males, 57.8% of females, mean age of 50.1±8.3 years old) compiled a structured questionnaire through a telephonic interview. They were asked about the official Italian recommendations for HCWs, their general knowledge of vaccine practice, their propensity towards vaccines (both in general and about specific immunizations), their risk perception about the vaccine-preventable infectious diseases. Eventually, a regression analysis was performed in order to identify factors predictive for vaccine propensity.
Only 12 out of 90 subjects correctly identified all the 7 recommended immunizations. The hepatitis B virus (HBV) vaccine was correctly identified by 95.6% of the sample, and was also associated with the more positive attitude and the more accurate risk perception. Influenza vaccine had the lowest acceptance (75.9%). Eventually, pertussis, measles, parotitis and varicella vaccines were insufficiently recognized as recommended ones (all cases < 50% of the sample). General knowledge of vaccine and knowledge of official recommendations were significantly correlated with the attitude towards immunization practice (r = 0.259, p = 0.014 and r = 0.438, p < 0.0001). In the regression analysis general knowledge (unstandardized coefficient (B) = 0.300, 95% confidence interval (CI): 0.090-0.510, p = 0.006) and risk perception (B = 0.579, 95% CI: 0.155-1.003, p = 0.008) were significant predictors of the propensity to vaccinate.
Vaccinations gaps in HCWs may found their roots in OPhs incomplete knowledge of evidence-based recommendations. Specific training programs and formations courses should then be planned. Int J Occup Med Environ Health 2017;30(5):775-790.
Lactoferrin is a mammalian milk glycoprotein involved in innate immunity. Recent data show that bovine lactoferrin (bLF) prevents late-onset sepsis in preterm very low birth weight (VLBW) neonates.
...This is a secondary analysis of data from a multicenter randomized controlled trial where preterm VLBW neonates randomly received bLF (100 mg/day; group A1), bLF + Lactobacillus rhamnosus GG (10(6) colony-forming units per day; group A2), or placebo (group B) for 6 weeks. Here we analyze the incidence rates of fungal colonization, invasive fungal infection (IFI), and rate of progression from colonization to infection in all groups.
This study included 472 neonates whose clinical, nutritional, and demographical characteristics were similar. Overall, the incidence of fungal colonization was comparable (17.6%, 16.6%, and 18.5% in A1, A2, and B, respectively; P = .89 A1 and .77 A2). In contrast, IFIs were significantly decreased in A1 and A2 (0.7% and 2.0%, respectively) compared with B (7.7%; P = .002 A1 and .02 A2), and this was significantly true both in <1000 g (0.9% A1 and 5.6% A2, vs 15.0%) and in 1001 to 1500 g infants (0% and 0% vs 3.7%). The progression rate colonization-infection was significantly lower in the bLF groups: 3.7% (A1) and 12% (A2), vs 41.9%; P < .001 (A1) and P = .02 (A2). No IFI-attributable deaths occurred in the treatment groups, versus 2 in placebo. No adverse effects or intolerances occurred.
Prophylactic oral administration of bLF reduces the incidence of IFI in preterm VLBW neonates. No effect is seen on colonization. The protective effect on IFI is likely due to limitation of ability of fungal colonies to progress toward invasion and systemic disease in colonized infants.
Background
Tissue engineering is a promising alternative for the development of bone
substitutes; for this purpose, three things are necessary: stem cells, a
scaffold to allow tissue growth and ...factors that induce tissue
regeneration.
Methods
To congregate such efforts, we used the bioresorbable and biocompatible
polymer poly(lactic-co-glycolic acid) (PLGA) as scaffold. For the
osteoinductive factor, we used simvastatin (SIM), a drug with a pleiotropic
effect on bone growth. Mesenchymal stem cells (MSCs) were cultured in PLGA
containing SIM, and the bone substitute of PLGA/SIM/MSC was grafted into
critical defects of rat calvaria.
Results
The in vitro results showed that SIM directly interfered with the
proliferation of MSC promoting cell death, while in the pure PLGA scaffold
the MSC grew continuously. Scaffolds were implanted in the calvaria of rats
and separated into groups: control (empty defect), PLGA pure, PLGA/SIM,
PLGA/MSC and PLGA/SIM/MSC. The increase in bone growth was higher in the
PLGA/SIM group.
Conclusions
We observed no improvement in the growth of bone tissue after implantation of
the PLGA/SIM/MSC scaffold. As compared with in vitro results, our main
hypothesis is that the microarchitecture of PLGA associated with low SIM
release would have created an in vivo microenvironment of concentrated SIM
that might have induced MSC death. However, our findings indicate that once
implanted, both PLGA/SIM and PLGA/MSC contributed to bone formation. We
suggest that strategies to maintain the viability of MSCs after cultivation
in PLGA/SIM will contribute to improvement of bone regeneration.
Carpal tunnel syndrome (CTS) is the most common nerve entrapment syndrome, which since the beginning of the seventies has been linked to the keyboard and visual display unit (VDU). The objective of ...this study was to investigate the prevalence and personal factors associated with CTS in female VDU workers in Italy.
Participants in this study were female adult subjects, working ≥ 20 h/week (N = 631, mean age 38.14±7.81 years, mean working age 12.9±7.24 years). Signs and symptoms were collected during compulsory occupational medical surveillance. The binary logistic regression was used to estimate adjusted odds ratios for the factors of interest.
Diagnosis of CTS was reported in 48 cases (7.6%, 11 of them or 1.7% after a surgical correction) for the incidence of 5.94/1000 person-years. In general, signs and symptoms of CTS were associated with the following demographic factors: previous trauma of upper limb (adjusted odds ratio (ORa) = 8.093, 95% confidence interval (CI): 2.347-27.904), history (> 5 years) of oral contraceptives therapy/hormone replacement therapy (ORa = 3.77, 95% CI: 1.701-8.354) and cervical spine signs/symptoms (ORa = 4.565, 95% CI: 2.281-9.136).
The prevalence of CTS was similar to the estimates for the general population of Italy. Among personal risk factors, hormone therapy, previous trauma of the upper limb and signs/symptoms of the cervical spine appeared to be associated with a higher risk of CTS syndrome. Eventually, the results reinforce interpretation of CTS in VDU workers as a work-related musculoskeletal disorder rather than a classical occupational disease. Int J Occup Med Environ Health 2016;29(6):927-936.
Very little is known regarding the toxicokinetics of inhaled zinc, in particular in the case of female workers and for modern, low exposure settings. Our aim is to evaluate the relationship of ...external zinc levels to those of serum and urine for female workers.
Eleven female workers (age: 41.7±8 years old, body mass index (BMI): 23.5±4.2 kg/m
) in a galvanizing plant were investigated. Exposure assessment consisted of personal/environmental air samples, and measurement of zinc in serum (collected at the end of first shift of the working week (T1)) and urine, collected before the first shift of the working week (T0), T1 and at the end of the last shift of the working week (T2).
Both environmental and personal air samplings for zinc and zinc compounds were below the recommended by the German Research Foundation (Deutsche Forschungsgemeinschaft - DFG) limit values of 2 mg/m
(7.34±2.8 μg/m
and 8.31±2.4 μg/ m
, respectively). Serum (118.6±20.9 μg /dl) and urine zinc levels were within reference values for female Italian subjects: the latter increased from 56.4±33.5 μg/dl at T0, to 59.8±37.0 μg/dl at T1, and ultimately 65.4±34.4 μg/dl at T2, but no significant trend was found. End of shift (Spearman's correlation coefficient p value = 0.027) and differential excretion of urinary zinc (both: T0 vs. T1 and T0 vs. T2) were correlated with airborne zinc concentration (p = 0.002 and 0.006, respectively).
In general, our data suggests that urine may be a useful medium also for female in order to assess zinc exposure. Further studies are required in order to evaluate whether differential excretion may be useful for the biomonitoring of zinc exposure in the workplaces also for male workers. Int J Occup Med Environ Health 2018;31(1):113-124.
Epidemiological studies have shown that employees working with visual display units (VDU) are more likely to complain about musculoskeletal disorders (MSDs). The aim of this study has been to ...evaluate associations among MSDs and individuals and work-related factors.
A total of 1032 VDU workers were assessed about their personal (i.e., age, working history, smoking history, physical activity) and work-related factors (i.e., predominant job tasks performed, work posture). Work environment was evaluated regarding fulfillment of the standard ISO 9241-5:1998. The investigation required a direct observation of participants (in order to accurately assess the prevalence of MSDs) and workstations. Adjusted odds ratios (ORa) were calculated by means of the logistic regression model.
Prevalence of MSDs was relatively high (53%). In general, MSDs were significantly associated with female sex (OR = 2.832, 95% confidence interval (CI): 2.178-3.683), age ≥ 50 years old (OR = 2.231, 95% CI: 1.236-4.026), longer exposure to VDU, both as working history (10-14 years: OR = 1.934, 95% CI: 1.301-2.875; ≥ 15 years: OR = 2.223, 95% CI: 1.510-3.271) and working time (30-39 h/week: OR = 1.537, 95% CI: 1.087-2.273). Inappropriate workstation design was confirmed by the multivariate analysis as a risk factor for MSDs (ORa = 2.375, 95% CI: 1.124-5.018).
Musculoskeletal disorders were significantly associated with individual factors as well as characteristics of work environment. An appropriate design of workstations may significantly reduce their prevalence amongst VDU workers. Med Pr 2016;67(6):707-719.
The inability of the avascular region of the meniscus to regenerate has led to the use of tissue engineering to treat meniscal injuries. The aim of this study was to evaluate the ability of ...fibrochondrocytes preseeded on PLDLA/PCL-T poly(L-co-D,L-lactic acid)/poly(caprolactone-triol) scaffolds to stimulate regeneration of the whole meniscus. Porous PLDLA/PCL-T (90/10) scaffolds were obtained by solvent casting and particulate leaching. Compressive modulus of 9.5±1.0 MPa and maximum stress of 4.7±0.9 MPa were evaluated. Fibrochondrocytes from rabbit menisci were isolated, seeded directly on the scaffolds, and cultured for 21 days. New Zealand rabbits underwent total meniscectomy, after which implants consisting of cell-free scaffolds or cell-seeded scaffolds were introduced into the medial knee meniscus; the negative control group consisted of rabbits that received no implant. Macroscopic and histological evaluations of the neomeniscus were performed 12 and 24 weeks after implantation. The polymer scaffold implants adapted well to surrounding tissues, without apparent rejection, infection, or chronic inflammatory response. Fibrocartilaginous tissue with mature collagen fibers was observed predominantly in implants with seeded scaffolds compared to cell-free implants after 24 weeks. Similar results were not observed in the control group. Articular cartilage was preserved in the polymeric implants and showed higher chondrocyte cell number than the control group. These findings show that the PLDLA/PCL-T 90/10 scaffold has potential for orthopedic applications since this material allowed the formation of fibrocartilaginous tissue, a structure of crucial importance for repairing injuries to joints, including replacement of the meniscus and the protection of articular cartilage from degeneration.
We report iridium-catalyzed C–H borylations for the regioselective synthesis of distally disubstituted calix4arene macrocycles. The atom- and step-economical method led to a broad family of ...calix4arenes in good yields and functional group tolerance. The synthetic utility of the C–H borylation protocol was finally illustrated with several late-stage modifications for the synthesis of elaborate calix4arenes frameworks, otherwise challenging to achieve with commonly employed procedures.
We report iridium-catalyzed C-H borylations for the regioselective synthesis of distally disubstituted calix4arene macrocycles. The atom- and step-economical method led to a broad family of ...calix4arenes in good yields and functional group tolerance. The synthetic utility of the C-H borylation protocol was finally illustrated with several late-stage modifications for the synthesis of elaborate calix4arenes frameworks, otherwise challenging to achieve with commonly employed procedures.We report iridium-catalyzed C-H borylations for the regioselective synthesis of distally disubstituted calix4arene macrocycles. The atom- and step-economical method led to a broad family of calix4arenes in good yields and functional group tolerance. The synthetic utility of the C-H borylation protocol was finally illustrated with several late-stage modifications for the synthesis of elaborate calix4arenes frameworks, otherwise challenging to achieve with commonly employed procedures.
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