bluuebunny/crossref_metadata_2025 huggingface dataset:
ATTITUDE OF STUDENTS OF HEALTH PROFESSIONS TOWARDS A HEALTH CARE WORKERS’ MANDATORY VACCINATION: A MULTI-CENTER CROSS-SECTIONAL SURVEY
Authors: Cedrone Fabrizio , Santangelo Omar Enzo , Provenzano Sandro , Alagna Enrico , Dallagiacoma Giulia , D'Ambrosio Angelo , Voglino Gianluca , Gianfredi Vincenza
Published: February 2025

Introduction. Seasonal influenza epidemics represent a cost that affects companies in terms of sick leave and lost productivity, therefore vaccination can improve occupational health. The vaccination of Healthcare Workers (HCW) has a dual function because in addition to protecting the workers, it also protects the most fragile patients. The students of medical and nursing degree courses, as well as other health professions, attend the workplace daily and are similar to workers inLegislative Decree 81/08. The purpose of this research is to assess the prevalence of students who are in favor of the introduction of a mandatory vaccination for healthcare workers, and to investigate what factors predispose them to be favorable. Methods. We performed a multi-center cross-sectional study using a validated questionnaire in a sample of students from different university courses from October 10th 1, 2017 to September 30th, 2018. For qualitative variables, absolute and relative frequencies, and for categorical variables Pearson's Chi-square test (X}) were calculated. A multivariable logistic regression model was used.Results. A total of 3131 questionnaires were completed by 2132 women and 999 men. The prevalence of students who are favorable to the introduction of a mandatory flu vaccination is 87.3% and that this data is linked to the female gender (aOR 1.52 CI 95% 1.12-2.06), being a medical student compared to nursing (aOR 2.14 CI 95% 1.45-3.17), coming from central Italy (aOR 3.08 C1 95% 2.11-4.51) and northern Italy (aOR 3.09 Cl 95% 2.12-4.49) compared to Southern Italy and the Islands, wanting to get vaccinated for the next season (aOR 6.37 CI 95% 3.73-10.88), declaring to have a good/excellent level of knowledge on vaccine-preventable diseases (aOR 1.44 Cl 95% 1.04-1.99), planning a recommendation based on ministerial indications (aOR 2.12 CI 95% 1.28-2.30) and having received requests for clarification on vaccinations (aOR 2.02 C1 95% 1.44-2.85).Discussion. The sample of university students showed to be largely in agreement with the introduction of mandatory vaccination for HCW, which is important for the prevention of influenza virus in the workplace. To increase adherence of healthcare workers to vaccination campaigns against seasonal influenza in the workplace, it is necessary that operative strategies are implemented with educational messages.
EFFICACY OF SODIUM HYPOCHLORITE IN THE DEGRADATION ANTINEOPLASTIC DRUGS BY NMR SPECTROSCOPY
Authors: Sciubba Fabio , Spagnoli Mariangela , Iavicoli Sergio , Asaro Gaia , De Luca Alessio , Guglielmi Gaspare , Delfini Maurizio
Published: February 2025

Antineoplastic drugs are used to treat cancer, having their therapeutic effect by inhibiting the cell division process. Although cancer cells, due to their rapid growth, are more sensitive to the toxic effects of chemotherapeutic agents, healthy cells and tissues may also be damaged. Many studies show acute and chronic toxicity both in patients treated with chemotherapy and in exposed workers. In fact, exposure to these substances can also be linked to the formation of different types of secondary tumors. The International Agency on Research on Cancer (IARC) included some antineplastic drugs in Group 1 (carcinogenic to humans), in Group 2A (probable carcinogens for In recent years, many studies have evidenced the presence of antineoplastic drug contamination on work surfaces, materials and floors and based on these observations, international and national guidelines have been published to limit occupational exposure, with particular attention to procedures post-preparation of chemotherapy to limit as much as possible the accumulation of contaminated residues.The aim of the following study is to determine the effectiveness of the degradation of four antineoplastic drugs: 5-fluorouracil, azacitidine, cytarabine and irinotecan using a low concentration of sodium hypochlorite solution (0.115%). The analytical platform used to monitor the degradation course of the substances under examination was hydrogen nuclear magnetic spectroscopy (H NMR). In the same experimental conditions the effectiveness of the degradation of the same antineoplastic drugs with a 99.9% ethanol solution was also evaluated. The study showed that the best degradation efficiency (> 90% ) is obtained with the hypochlorite solution after 15 minutes.
PAIN DIAGNOSIS AND TREATMENT ACCORDING TO THE PAIN GENERATING FACTORS
Authors: Demartini Laura , Bonezzi Linda , Bonezzi Cesare
Published: February 2025

Chronic pain impacts on many aspects of patient life affecting autonomy, sleep, social activities and also employment. Adequate pain control is often challenging in patients with chronic pain, despite the availability of many medications and interventional techniques. Limitations to successful pain treatment are the poor understanding of contributing mechanisms and the lack of a mechanism based approach in clinical practice.The purpose of this article is to identify the factors contributing to pain generation in order to guide a personalized treatment. We analyze tissue specificity for chemical and physical stresses potentially causing pain, the changes that occur in the peripheral and central pain pathways during disease, the stimuli that, acting on a pathological pain pathway, can trigger pain. The pain generating factors should be recognized in each patient and addressed with pharmacological, rehabilitation and invasive interventions.
ASBESTOS EXPOSURE AND RELATED DISEASES AMONG FRICTION PRODUCTS WORKERS (1971-2016)
Authors: Barbieri Pietro Gino , Mirabelli Dario , Madeo Egidio , Somigliana Anna
Published: February 2025

Worldwide studies have been published on the mortality of workers employed in asbestos-based materials for the production of clutches and brakes. However no one of these studies is related to Italian cases. Furthermore, not even surveys have been conducted in Italy to characterize the correlation between asbestos exposures and the possible occurring of asbestos-related disease. Our46 objectives are the following: i) to assess and quantify the asbestos exposure cases, il) to describe the nature and the frequency of asbestos-related diseases among blue collar employees of an important factory producing brakes and clutches with chrysotile asbestos content from 1971 to 1993 and iti) to provide preliminary data on cumulative asbestos exposure estimated using lung fibre burden analysis. Critical appraisal of airborne asbestos fibre measurements and identification of cases of asbestos-related diseases between the blue collar employees, either notified to the local health authority or recovered from the Italian national Mesothelioma registry was investigated. Lung fibre burden analysis using the lung tissue samples from two deceased blue collar employees was also performed. Airborne asbestos fibre measurements (carried out in 1982) suggested asbestos fibres average concentrations of about 0.3 f/ml, while all 1992 measurements showed results below 0.1 f/ml.Furthermore, since 1988, we identified four cases of pleural plaques, three cases of asbestosis and seven cases of lung cancer. No case of malignant mesothelioma was found. In both lung cancer cases, analysed to measure the lung fibre burden, commercial amphiboles were absent or in limited concentration but chrysotile and, especially, tremolite asbestos were present in noticeable amount. In conclusion, since 1971 and up to early1980s, exposure to chrysotile asbestos and talc, likely contaminated by tremolite, had been significant and comparable to levels causing asbestosis long-term risk. No case of malignant mesothelioma was found, that is consistent with the absence of amphiboles and with the lower risk of mesothelioma associated with the chrysotile asbestos. However a subset of the blue collar employees, the ones employed later on, could still have not reached the full risk condition, and so being still at risk of developing malignant mesothelioma. In the two lung cancer cases studied, the lung fibre burden was essentially made of chrysotile and tremolite. Lastly, lung cancer occurrence in the population of blue collar employees has been likely underestimated and the correct determination of lung cancer risk should be done through the mortality analysis of this population.
Covid-19 emergency management activities promoted by an university hospital in Northern Italy
Authors: Lago Paolo , Albano Giuseppe , Toscani Marco , Albera Roberto , Grugnetti Anna Maria , Dell'Olivo Bianca
Published: February 2025

Background. In December 2019, a Coronavirus 2019 epidemic (COVID-19) was reported, caused by a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which occurred in the city of Wuhan, Hubei province, China.Perceived risk of contracting diseases has led many Governments and Healthcare Organizations to implement a variety of control and protection measures for the population, in particular for health professionals who have made contact with positive Covid-19 patients. In this publication, we have carried out a review of the information available, in order to share the prevention and protection measures for health and safety at work, which a University Hospital of Pavia, in Northern Italy, has remodulated, according to the changed scenario in which professionals finds themselves carrying out their profession in the post lockdown, in account to the specificity of processes and methods of work organizing, which overall, they serve to characterize risks, in order to be able to prevent them in the best possible way for patients, visitors and healthcare professionals.
COVID-19 AND WORK ENVIRONMENT: LEGISLATIVE DEVELOPMENTS ABOUT THE ROLE OF THE OCCUPATIONAL PHYSICIAN IN THE EMERGENCY MANAGEMENT AND IN THE SARS-COV-2- RELATED WORK ACCIDENTS NOTIFICATION
Authors: Garzaro Giacomo , Declementi Michael , Frammartino Roberto , Godono Alessandro , Ihab Mansour , De Piano Maria Luigia , Ciocan Catalina , Bergamaschi Enrico
Published: February 2025

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and its associated disease (COVID-19) represent a global health emergency that requires integrated and multidisciplinary intervention by international medical and scientific communities, in support of the national governments. In Italy many public health measures have been adopted to contain the transmission of the disease, which also involved occupational physicians. The regulatory path has had a rapid evolution due to the trend of infections and progressive scientific evidence: the most recent 96 Circular from the Ministry of Labor and Social Policies and the Ministry of Health provides for the termination of the "exceptional health surveillance" activity, the management and protection of fragile individuals by activating the medical examination on request of the employee and excludes the old age, without comorbidities, as a specific condition of risk of serious complication of SARS-CoV-2 infection.For preventive and insurance purposes, COVID-19 usually represents a generic biological risk, for which the same measures must be adopted for the entire population. In the Inail Circular no. 13 of April 3, 2020, however, it is stated that professional categories that perform front office duties are considered exposed to a higher risk, as well as, health professionals, can be considered exposed to a specific risk. From January Is to July 31st 2020, 51,363 cases of infection from SARS-CoV-2 were reported to INAIL as an accident. In the same period INAIL noticed a decrease in reports of accidents and occupational disease overall, correlated to the effects of lockdown and smart working.
[THE NATIONAL CENTRE FOR ONCOLOGY HADRONTHERAPY (CNAO): STATUS AND PERSPECTIVES]
Authors: Rossi Sandro
Published: February 2025

A complex particle accelerator has been built at the Italian National Centre for Oncological Adrotherapy in Pavia, called synchrotron, which is able to decompose atoms and create beams of particles to be directed to tumour cells in order to destroy them. It is the hadrontherapy, a very advanced radiation therapy for the treatment of X-ray resistant or inoperable tumours. In particular, the CNAO synchrotron in Pavia is the only one in Italy capable of extracting carbon ions from the atom, which are the most powerful particles capable of destroying the DNA of cancer cells while preserving the surrounding healthy tissues. Hadrontherapy has been recently included by the Italian Ministry of Health into the essential levels of assistance, recognizing its scientific validity. All Italian citizens can access treatments within the National Health System, according to defined modalities. More than 50 patients are treated at CNAO every day and to date more than 2300 cancer patients from all over Italy have been able to benefit from hadrontherapy.The article will illustrate the technological innovation of the centre in Pavia and will focus on the most interesting research and development projects.
[HEALTH SURVEILLANCE OF EXPOSED PERSONS IN AN HADRONTHERAPY CENTRE]
Authors: Delogu Alberto
Published: February 2025

The Centro Nazionale di Adroterapia Oncologica (CNAO) of Pavia is the only Italian structure capable of administering therapeutic radiotherapy treatments with heavy particles (carbon ions, protons) accelerated; in addition to this, it hosts significant research activity, both as basic research and for health-related applications.From the perspective of radioprotection, the most significant risk profile is that linked to external irradiation, from three categories of sources: accelerated external beams (in addition to the treatment beams there are conventional linear accelerators), materials activated following irradiation during treatment or during research activities, unstable isotopes used for diagnostic purposes. The CNAO building has been designed and built to guarantee maximum safety both to the operator and to the patient or visitor, with widely redundant systems in order to exclude the occurrence of accidental irradiation, and to minimize the risk of exposure to activated materials. The cohort of workers shows "atypical" characteristics for healthcareG Ital Med Lav Erg 2020; 42:4 facilities due to the absolute disproportion between classified and unclassified personnel, the homogeneity of training paths, and demographic characteristics. The health surveillance of the exposed, all classified in category B pursuant to Legislative Decree 230/95, is based on the adoption of the AIRM Protocol, tempered on the specific characteristics of the work process. The main critical issues related to the health surveillance of the exposed CNAO workers come from the energies used, with significant activation capacity, and from the presence of personnel in training.
[Monoclonal gammopathy of undetermined significance (MGUS) and ionising radiation]
Authors: Taino Giuseppe , Buonocore Concetta , Stanga Andrea , Imbriani Marcello
Published: February 2025

The term monoclonal gammopathy refers to a clinical condition characterized by the presence in serum and/or urine of clonal immunoglobulins, i.e. homogeneous immunoglobulins, structurally identical both as a heavy chain and as a light chain, produced by a B cell clone. The prevalence of MGUS is low in young subjects (less than 2% of patients with MGUS are less than 40 years of age, while in the population aged over 50 years it is relatively high (3.2%) and increases considerably with age. Although historically considered to be a benign condition, patients with MGUS are at risk to develop multiple myeloma over time. Therefore, MGUS may be framed as a preneoplastic stage of the plasma cell that precedes the possible development of a multiple myeloma.In a limited percentage of cases, it can be considered the asymptomatic pre-malignant stage preceding multiple myeloma (MM) on a probabilistic basis. Few studies have assessed the prevalence of MGUS in people occupationally exposed to pesticides. Several other studies on atomic bomb survivors in Hiroshima and Nagasaki have revealed a possible association with exposure to ionizing radiation.Routine laboratory tests performed on the subjects exposed to the risk factors studied appear to be indicated for workers from the age of 50 years. The finding of a GMUS in the absence of further laboratory alterations is the most frequent finding and does not require further action, if it is not to plan include blood chemistry tests at least every two years. In this situation, no restrictions appear to be justified on the work activity involving the risk of exposure to IR or pesticides. In case of concurrent presence of alterations that may be indicative or suggestive of an increased risk of evolution in a neoplastic way a close periodicity - every 3-6 months - of haematological checks is recommended. In such cases, it appears justified to move away from activities involving exposure to ionizing radiation for a period of time which should be evaluated on the basis of the evolution of the picture and the progress of laboratory tests during the monitoring period.
[The new AIRM guidelines for people exposed to ionising fields: health surveillance and suitability assessment]
Authors: Moccaldi Roberto
Published: February 2025

This report illustrates some points relating to the health surveillance of workers exposed to electromagnetic fields (EMF) contained in the new Guidelines on EMFs. A working group from AIRM (Italian Association of Medical Radiation Protection) is currently implementing these guidelines. The report focus in particular on two specific aspects, critical to set up and carry out a correct Health Surveillance (HS): 1. Identification of the exposed workers (who will undergo Health Surveillance); 2. Health Surveillance contents.Considering the peculiar characteristic of the agents at risk, the identification of workers to undergo health surveillance (not specified in the legislation), should involve an assessment of the exposure levels as well as the specific health condition of each "worker at particular risk". Health surveillance programs, to be applied in case of greater exposure, will be focus on identifying sensitive risk groups who should undergo more frequent health checks.
[Case law on occupational diseases caused by radio frequencies]
Authors: Polichetti Alessandro
Published: February 2025

In the last decade, at the conclusion of some civil proceedings concerning appeals against INAIL (the Italian workers' compensation authority), some Italian courts have recognised the occupational origin of tumours in workers exposed to radiofrequency electromagnetic fields (RF EMFs) emitted by wireless phones, despite the fact that a causal role of electromagnetic fields in oncogenesis has not been demonstrated.In some cases, workers' exposures were combined with those due to other RF EMF sources or with exposures to extremely low frequency magnetic fields (ELF MFs). For the sake of completeness, the case of exposure of a worker to ELF MFs only is also considered.These judgements have been widely covered by the media which, on the contrary, have virtually ignored those in which the causal link between occupational exposure to electromagnetic fields and tumours has not been recognised. The author of this communication is aware of two of these "negative" judgements in that he was, in both cases, one of the court-appointed expert witnesses.A key point to understand the scientific bases for the Judges' decisions is how the TARC classifications of ELF magnetic fields (ELF MFs) and radio frequency electromagnetic fields (RF EMFs) as "possibly carcinogenic to humans", and more generally the body of scientific evidence on electromagnetic fields and tumours, have been taken into account in the judgements and court- appointed expert witnesses' reports. The 2009 judgement of the Court of Appeal of Brescia preceded the IARC classification of radio frequency electromagnetic fields in 2011. The judgement of Brescia was confirmed by the Court of Cassation in 2012, but since the Court of Cassation decides on the legitimacy of the judgements without entering into their merits, the fact that this decision was taken after the lARC classification is irrelevant.All other judgements, subsequent to the publication of the TARC monographs, cited the TARC classifications.The bases for the two "negative" judgements of the Courts of Cremona and Milan were as follows: 1) when an agent is classified as "possibly carcinogenic to humans", a causal link between exposure and cancer has not been generally demonstrated, therefore 2) it is not possible to conclude that a tumour was "more likely than not" (as required in civil litigation (4)), caused by the agent in question whatever the worker's level of exposure.On the contrary, the court appointed expert witnesses' report on the Ivrea proceeding states that "in the present case there is an association between a rare tumour and an exposure as rare as the use since 1995 of high-emission cellular telephony. The rarity of the circumstance is indicative of a causal association". This and other arguments underlying the "positive" judgements.
[Job satisfaction measurement scales: a critical review]
Authors: Faraci Palmira , Magnano Paola , Valenti Giusy Danila
Published: February 2025

Introduction. Job satisfaction is very significant in the field studies of occupational wellbeing. A vast number of published studies have suggested a link between job satisfaction levels and both organizational behavior and physical and mental health. The detection of effective intervention strategies needs an accurate assessment. Therefore, the problem of choosing precise measurement instruments takes place.Objectives. The present paper is aimed to provide a framework about the characteristics of available measures of job satisfaction, in its globality, as a unit, as well as in its component parts. Methods. A critical review was conducted, systematically describing instruments as classified into single-item scales, one-dimensional scales, and multidimensional scales.Psychometric qualities and structural features are indicated for each presented measure.Results. From literature-based analysis a large amount of existing instruments emerged, with some differences referring to their validity, reliability, and practical usefulness. Overall, we presented 23 self-report scales, 7 of which are addressed to a global evaluation, whereas 14 are multidimensional. Some scales are specifically developed to be used in healthcare, medical, and nursing areas.Conclusions. An accurate method for evaluation is at the bottom of the development of effective programs for the prevention of work related risk factors. This overview might be helpful as a guidance tool for determining if an instrument is suitable for a specific purpose.
[Burnout assessment in the staff of the haematology department of a teaching hospital]
Authors: Mannocci Alice , Sestili Cristina , Carlevale Federico , Minotti Clara , De Giusti Maria , Villari Paolo , Foà Roberto , Cartoni Claudio , La Torre Giuseppe
Published: February 2025

"Helping professions" are characterized have intense involvement between operator and user. Working in such circumstances can lead to a typical emotional stress called "burnout". The aim of this study was to evaluate the perceived 46 state of physical and mental health, and verify the existence of burnout among health care workers of Hematology unit in a Teaching Hospital. Anonymous questionnaires were administered to healthcare professionals (physicians, nurses, health care workers). It includes socio demographic variables, the Maslach Burnout Inventory (MBI) and SF12 also. The MBI captures three dimensions of burnout: emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (RP); whereas the SF12 defines two quality of life scores:Mental Score (MCS) and Physical Score (PCS).Of 120 operators 70 individuals responded to the study.The questionnaire shows that the burnout levels were high in the followed part of the sample: 40% have high level of EE; 24% of DP; 15% of RP. The correlation analysis between SF12 and MBI undelines followed significance: r = -0.576 with p<0.001 between EE and MCS; r = 0.557 with p<0.001 between EE and DP.The three multivariate analysis refer that: the EE is associated indirectly to PCS and MCS with p<0.05; the DP is directly and significantly (p<0.05) associated to MCS, "years of work" and to female gender. The RP dimension no underlines significant associations with variables studied.The findings were consistent with the type of work and assisted patients (chronic patient, often with poor prognosis and low expectations in terms of care and survival) that contribute to stressful situations. Personal fulfillment, instead, seems to be quite high in this contest. The relatively small sample couldn't represent the world of health care workers in hematological units, but there is no doubt that a systematic assessment of burnout, to investigate the causes of burnout are main elements to identify the potential solutions to address the phenomenon. Additional investigations of the MBI dimensions using biggest samples would be useful to confirm the results in order to generate burnout reduction measures by institutional and national policies.
Assessment of functional status and rehabilitative strategies in occupational therapy: role of the Groningen Activity Restriction Questionnaire
Authors: Giambelluca Eliana , Panigazzi Monica , Saade Abdo , Imbriani Marcello
Published: February 2025

Background and Purpose. The Groningen Activity Restriction Scale (GARS) is a self-reported non-diseasespecific instrument for measuring patients' disability in Activity of Daily Living (ADL) and Instrumental Activity of Daily Living (IADL). In literature, several studies have demonstrated high psychometric properties of GARS for disability assessment.The aim of this study was to evaluate the use of GARS administered and scored by the occupational therapists, rather than self-reported by the patient, as a tool for measuring disability in adult patients treated with occupational therapy. Methods. A inter-operator reliability and correlation study was conducted among 31 people (mean age 70.6+13.1 years), admitted to inpatient Occupational Therapy rehabilitation service of ICS Maugeri, Pavia, from May through September 2018. ADL and IADL dependency indices were measured with GARS, which was assessed by three independent occupational therapists during admission of patients to occupational therapy rehabilitation service. Other measures included demographic characteristics and healthcare resource utilization.Therefore, a single occupational therapist performed a second evaluation of patient's performance using GARS at the discharge from treatment, in order to identify any changes in patient's functional abilities after rehabilitation treatment; the results obtained were compared with those detected by the functional independence measures (FIM). Statistical analysis was conducted by Cohen's k coefficient and Pearson's p correlation coefficient. Results. The statistical analysis showed a discrete reliability and responsiveness of GARS (Coen's k = 0.531), due to a moderate correlation between GARS and FIM instruments (Pearson's p = 0.359) for evaluating the effectiveness of occupational therapy interventions.Conclusions. Even if conducted by occupational therapists, GARS is a useful tool for measuring disability in ADL and IADL, which can help clinicians to develop a customized plan of care in occupational therapy, improving patient's management and clinical outcome.
[Rehabilitation medicine and appropriateness criteria: between chronicity, multimorbidity and complexity]
Authors: Scrutinio Domenico , Carone Mauro
Published: February 2025

In the last two decades, population aging has led to a substantial increase in the number of people living with moderate-to-severe disability and, consequently, an increased demand for rehabilitation care. It is estimated that, currently, 2.8 million people live with severe disability in Italy. Although greater access to rehabilitation care is required to meet the needs of disabled patients, the capacity to provide rehabilitation has not changed over the last years and fails to meet current rehabilitation needs. Efforts should be devoted for aligning the capacity to provide rehabilitation care to the increased demand for rehabilitation care.
[The ICD-ICF outpatient pathway in occupational therapy]
Authors: Panigazzi Monica , Capodaglio Edda Maria , Prestifilippo Elena , Traversoni Silvia , Quaccini Claudia , Imbriani Marcello
Published: February 2025

The Complex Ambulatory Macroactivity (MAC, Macroattività Ambulatoriale Complessa) has recently been included among the therapeutic and diagnostic Specialized Rehabilitation services issued by the Lombardy Region health institutes. Within Maugeri Scientific Clinical Institutes, our Occupational Physiatrics and Ergonomics Service is actively involved in the organic redefinition of rehabilitative pathways in the light of functional and patient-centered interpretation, typical of ICF (International Classification of Functioning). The article describes the assumptions, criteria and procedures that support the MAC system, proposing a modeling that can be inserted into the modern and complex system of health services.
[Ageing of the working population, ICD-ICF clinical model and Occupational and Rehabilitation Medicine]
Authors: Imbriani Marcello , Taino Giuseppe , Panigazzi Monica , Capodaglio Edda Maria , Oddone Enrico , Ergonomia, Tossicologia e Rischi ambientali Dipartimento di Medicina del Lavoro,
Published: February 2025

The aging of the active population is more and more increasing in advanced western societies. This phenomenon also implies a constant increase in the average age of workers in various productive sectors, not least that of health. In this, in fact, alongside the known occupational risks, more and more frequently we are witnessing the emergence of chronic-degenerative pathologies connected with aging, even with symptoms that do not determine an unsuitability for work. In fact, within a scientific landscape accounting little evidence on the effectiveness of complex rehabilitation programs, the use of the ICD / ICF system in therapeutic programming should produce an important turning point, providing health professionals with a conceptual paradigm that supports both the functional assessment and the rational planning of therapeutic interventions, also contributing to the advancement of specialist knowledge.The present work shows how an effective collaboration between occupational physicians and rehabilitation specialists canG Ital Med Lav Erg 2019; 41:2 effectively participate in the evaluation of the patient / worker even in the elderly, with particular regard to the return to work, taking full advantage of the classification and diagnostic tools implemented in the ICD and ICF systems.
[Implementation of the ICD-ICF model in rehabilitation medicine: presentation of a clinical case in rehabilitation cardiology]
Authors: Masnaghetti Sergio , Gramegna Federica , Mariani Paola , Salvaneschi Giulia Contardina , Sarzi Braga Simona
Published: February 2025

This patient entered a Cardiac Rehabilitation Program after coronary artery bypass graft. Concomitant diseases and the degree of disability have been coded according to International Classification of Functioning (ICF). Rehabilitation multidisciplinary program has been started (physician, nurses, physiotherapist and nutritionist); atrial fibrillation, anaemia, pleural effusion, surgical wounds inflammation were treated. Educational program allowed a better knowledge of the diseases the patient is bearing; low functional capability diagnosed at admittance improved thanks to the coordinated intervention of professionals involved. Coding diseases and disabilities at admission ensured a detailed identification of patient's issues and allowed the identification and the proposal for a targeted rehabilitation program.The improvement of medical ICF codes b280, b810 and b820, of physiotherapeutic codes b235, d450, d4551 and d455 and of nursing codes b280, b810 and b820 depends on the marked reduction of disability level (Figure 1).
[Implementation of the ICD-ICF model in rehabilitation medicine: presentation of a clinical case in respiratory rehabilitation]
Authors: Lastoria Cinzia , Cirio Serena , Cirio Raffaella , Ceriana Piero , Vitacca Michele
Published: February 2025

We present the clinical case of a 74 years old patient undergoing tracheotomy for persistent hypercapnic respiratory failure after lower right lobectomy surgery, performed as a result of pulmonary cancer recurrence. The patient was transferred to the Department of Respiratory Sub Intensive Care for respiratory weaning, decannulation and cycle of motor and respiratory physiotherapy. The joint evaluation of physicians, nurses and physiotherapists has allowed the identification of ICD-9 and ICF codes of the severe disability shown by the patient in the first days of hospital stay (respiratory failure due to pneumonia that need invasive mechanical ventilation by tracheotomy, prolonged immobility, muscular deconditioning and inability to perform even the simplest activities of daily life; it required also artificial nutrition by naso gastric tube). ICF codes as respiratory functions (respiratory system functions, additional respiratory functions, sensations associated with cardiovascular and respiratory functions, moving with aids, walking, vestibular functions, muscle strength, tolerance to physical exercise, personal care, performing the routine daily sleep functions, energy and drive functions), were particularly compromised at admission. Medical intervention (antibiotic therapy based on microbiological isolations, optimization of inhalatory therapy, management of intestinal complications and cardiological which required cardiological treatment remodulation in order to obtain better heart rate control and better blood pressure control allowed a clear improvement of general and respiratory clinical conditions. The simultaneous physiotherapists' intervention (weaning not only from invasive mechanical ventilation but also from tracheotomic cannula and oxygen therapy, stationary and cycloergometer with arms and exercise training) and nurses'intervention (medication of pressure injuries, surveillance of the sleep-wake rhythm, management of the daily routine) allowed a gradual improvement of both motor and respiratory ability with a consequent indipendence in activities of daily living. Important were also psychological counseling and intervention of speech therapists (removal of naso gastric tube, once excluded dysphagia also by videofluoroscopy). During a long lasting clinical improvement, coincident with patient's discharge to home, has been assessed disability through ICF codes, largely improved under medical, nursing and physiotherapist profile.​
[Assessing the risk of exposure to EMFs with particular regard to the protection of sensitive persons]
Authors: Falsaperla Rosaria , Mattei Eugenio , Censi Federica , Bogi Andrea , Pinto Iole , Calcagnini Giovanni
Published: February 2025

Assessment of the risk due to exposure to emf with particular reference to the protection of sensitive subjects. Purpose. The work illustrates useful elements for the risk assessment for workers exposed to electromagnetic fields, also in reference to sensitive subjects such as those with active implantable medical devices (AIMD).Methods. The approach introduced by Legislative Decree 81/08 for risk assessment does not explicitly include operational criteria and specific measures for the protection of sensitive subjects. In the case of workers with DMIA, the employer may refer to relevant harmonized technical standards.Results. They are shown the results of in vitro tests performed on pacemakers following the indications of the technical reference standard and employing sources of electromagnetic fields that, due to the type of signal emitted, do not allow to exclude an a priori influence on the operation of the device. Conclusions. Workers at particular risk are generally protected if the requirements established for the population are respected. This measure may, under certain conditions, not be sufficient, making it necessary to carry out more in-depth and individual assessments. However, the cases illustrated here for AIMD showed interference phenomena only in limited experimental configurations despite the levels of the electric and magnetic fields generated by the sources exceeding the limits for the general population.
[Health surveillance of EMF-exposed workers at particular risk]
Authors: Gobba Fabriziomaria
Published: February 2025

Present knowledge on the conditions possibly inducing a particular sensitivity to EMFs, and the relevant mechanisms involved, are presented and discussed. On the basis of the knowledge presented, the criteria that should be applied for the health surveillance of the workers in whom these conditions have been identified, are discussed.
[Limitations and potential of combined epigenetic and transcriptional analysis on a large scale to identify therapeutic targets in cardiovascular diseases]
Authors: Paolillo Roberta , Boccella Nicola , D'Apice Stefania , Esposito Giovanni , Perrino Cinzia
Published: February 2025

Cardiovascular diseases are the major cause of morbidity and mortality worldwide. Given the complex pathophysiology of cardiovascular diseases, an experimental approach capable of identifying multiple signaling networks activated in the heart upon pathological conditions could be particularly effective to identify new diagnostic, prognostic or therapeutic targets. Latest generation techniques now allow high-resolution investigations of the entire genome, the proteome and the cellular metabolome, as well as epigenetic modifications and associated gene expression profiles.In particular, the integration of epigenomic and transcriptomic data in the normal or pathological heart is a promising approach to identify novel molecular targets. These methods, although promising and innovative, can present several technical and analytical pitfalls. Here we will briefly describe these aspects and possible strategies to optimize the search for new diagnostic or therapeutic targets for cardiovascular diseases in the post-genomic era.
Francesco Candura (1929-2019)
Authors: Oddone Enrico
Published: February 2025

Not available.
Clinical outcomes of dental implants placed in the augmented maxillary sinus: A 5-year retrospective study
Authors: Naseri Roohollah , Ghadirian Amin , Shirani Mohammadjavad
Published: February 2025

Background:

Factors influencing the success of an implant placed in augmented maxillary sinus need to be recognized. The aim of this study was to investigate the effect of various oral health conditions and treatment plan details on the clinical and radiographical outcomes of implants placed in the augmented sinus.

Materials and Methods:

In this clinical retrospective study, 39 participants (81 implants) that received dental implants after sinus lifting between January 2005 and July 2016 were evaluated. All the participants were examined by an operator clinically and radiographically in a blinded manner. A checklist including oral health and host condition, implant and prosthesis characteristics, and surgical approach variables was completed for each participant. The effect of these variables on probing depth (PD), marginal bone loss, bone formation in sinus, and patient satisfaction was analyzed using analysis of covariance models. P <0.05 was considered statistically significant.

Results:

Survival rates after surgery and restoration placement were 93% and 100%, respectively. PD was found to be significantly higher in restorations with infragingival finish lines over 1.5 mm and in implants with score “2” for gingival index. Moreover, more bone formation was observed in implants with score “0” compared with score “2” for gingival index. In addition, the participants with plaque score “0” reported significantly more satisfaction than the participants with score “2” for plaque index.

Conclusion:

Inflamed gingiva was associated with more PD and less peri-implant bone formation in maxillary sinus. In addition, more patient satisfaction was reported by participants that had better plaque control.
Current trends in pediatric cardiac surgery and their impact on intensive care
Authors: Das Debasis , Das Shubhadeep
Published: February 2025

Recent advancements in pediatric cardiac surgery have significantly influenced the management of congenital heart disease (CHD) patients in intensive care units (ICUs). These developments include earlier surgical interventions, increasing complexity of procedures, and the rising prevalence of surgeries in neonates, premature infants, and low-birth-weight babies. Complex repairs, nonsternotomy approaches, such as minimally invasive surgeries and heart failure management with mechanical circulatory support, present unique challenges in postoperative care, including respiratory support, infection prevention, and management of low-cardiac output state (LCOS) and multiorgan dysfunction. In resource-limited settings, delayed presentations and fiscal constraints further complicate ICU management. Innovations such as protocol-based treatment, integration of artificial intelligence, and multidisciplinary collaboration are revolutionizing care strategies. This narrative review highlights the trends in pediatric cardiac surgery, their direct impact on ICU practices, and future directions aimed at improving survival rates, reducing complications, and enhancing the quality of care for CHD patients.
Barriers to family education, a potential room for improvement of readmission in pediatric intensive care unit
Authors: Mohamed Nasser Ezzat , Hammoud Ehab , AbdelMassih Antoine Fakhry
Published: February 2025

It is increasingly evident that family education is an important determinant of healthcare quality in pediatric practice. Re-admission, whether to the hospital or intensive care, is a topic that has not been extensively researched and is significantly connected to the education of families. Obstacles to family education, particularly in intensive care settings, include the brief duration of patient stays and the intricate nature of their conditions. Family education in ward patients, is easier, as physicians are available daily, and there is no duplicity in the speech given to parents, it is worth mentioning that the complexity of patients, admitted solely to the ward is relatively milder than intensive care patients. In contrast, intensive care patients have relatively higher complexity and a shorter stay, and the availability of a single physician for counseling is not ensured. Overcoming these barriers with tailored programs and ready-made materials can improve overall readmissions and reduce the costs of the respective healthcare facility.
Automated spontaneous breathing trial performance tool is associated with improved outcomes following pediatric cardiac surgery: A single-center retrospective study from Alabama, USA
Authors: Clark Matthew G. , Borasino Santiago , Zaccagni Hayden J. , Payne Shannon , Raper Justin , Loberger Jeremy , Hock Kristal M. , Asfari Ahmed
Published: February 2025

Background:

Extubation failure is associated with significant morbidity, including prolonged time on ventilator and longer hospital length of stay (LOS). Extubation readiness is assessed with a variety of tools. Using algorithmic analysis, we developed a spontaneous breathing trial (SBT) performance tool based on near real-time clinical and ventilator data. We present analysis before and after SBT tool implementation on patients undergoing cardiopulmonary bypass surgery.

Subjects and Methods:

Retrospective study of patients <21 years old admitted to tertiary cardiac intensive care unit (CICU) June 2019–January 2023. Time to first extubation, total time of ventilation (TOV), LOS, and extubation failure rates before and after deployment of SBT tool after adjusting for age, presence of syndrome, and surgical complexity were compared.

Results:

Seven hundred and eighty-seven surgical hospitalizations included, 581 preintervention and 206 postintervention. No significant differences in distribution of age groups, frequency of syndrome diagnosis, or surgical complexity between both groups. SBT tool deployment was associated with a 30% reduction in postoperative TOV (incidence rate for post-SBT tool is 0.7 times incidence rate for pre-SBT tool, P < 0.0001) and postoperative LOS by 20% (0.81, P < 0.01). Neonatal subgroup analysis (n = 145) showed SBT tool implementation not associated with a decrease in TOV but was associated with lower extubation failure, 0% versus 13% (P < 0.01).

Conclusions:

Deployment of physiology-based, real-time, automated SBT tool in a single pediatric CICU was associated with decreases in TOV and LOS as well as a decrease in extubation failure among neonates.
Invasive aspergillosis in a child with bronchial asthma: A case report
Authors: Vyasam Siva , Kuruvilla Aby , Jayaram Jyothi , Angurana Suresh Kumar , Bhatia Anmol , Solanki Shailesh
Published: February 2025

Invasive aspergillosis (IA) is a life-threatening infection observed in children with immunodeficiency. IA is uncommon in bronchial asthma (BA). Here, we report a case of a 5-year-old immunocompetent female who was treated with systemic steroids for acute exacerbation of BA and later developed IA with dissemination. Despite aggressive management, the patient succumbed to the illness. This case highlights the importance of considering IA in children with underlying predisposing factors and clinical worsening despite appropriate antibiotic therapy. Early diagnosis and prompt initiation of antifungal therapy are crucial in improving outcomes.
Laser-assisted Excision of Lower Lip Mucocele Using Hydrocolloid Impression Material in an Adolescent Patient
Authors: Jayakrishnan Jijin Mekkadath , Thabsheera P. P. , Zahra Fathimath , Vijayan Anu
Published: February 2025

The mucocele is a common lesion of the oral mucosa, which is the outcome from an alteration of the salivary gland due to the accumulation of benign mucous containing cystic lesions mainly of traumatic origin. The boundaries of the cavity consist of compressed collagen fibril bundles with mucin. Clinically, it is a soft, bluish, transparent cystic swelling, commonly occurring in lower lip, followed by the buccal mucosa and floor of the mouth. Histologically, two types existed: one is the extravasation type and another is the retention type. This report presents a 16-year-old male patient reported with the chief complaint of painless swelling in the lower lip. Complete excision has been the easiest way of treatment choice along with laser therapy. The main advantages are minimal intraoperative bleeding and swelling and post-operative pain and very less surgical time, scarring and coagulation.