Piedmont, Italy
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D'Ovidio F.,University of Turin | d'Errico A.,ASL TO | Costa G.,University of Turin
Social Science and Medicine | Year: 2015

Objective of this study was to assess the risk of coronary heart disease (CHD) associated with the combination of employment status and child care among women of working age, also examining the sex of the offspring. Only two previous studies investigated the effect of double burden on CHD, observing an increased risk among employed women with high domestic burden or providing child care, although the relative risks were marginally or not significant.The study population was composed of all women 25-50 years old at 2001 census, living in Turin in families composed only by individuals or couples, with or without children (N=109,358). Subjects were followed up during 2002-2010 for CHD incidence and mortality through record-linkage of the cohort with the local archives of mortality and hospital admissions. CHD risk was estimated by multivariate Poisson regression models.Among employed women, CHD risk increased significantly by 29% for each child in the household (IRR=1.29) and by 39% for each son (IRR=1.39), whereas no association with the presence of children was found among non-employed women or among employed women with daughters. When categorized, the presence of two or more sons significantly increased CHD risk among employed women (IRR=2.23), compared to those without children.The study found a significant increase in CHD risk associated with the presence of two or more sons in the household, but not daughters, among employed women. This is a new finding, which should be confirmed in other studies, conducted also in countries where the division of domestic duties between males and females is more balanced, such as the European Nordic countries. © 2015 Elsevier Ltd.

Iacconi C.,University of Pisa | Caldarelli C.,ASL TO
Acta Otorhinolaryngologica Italica | Year: 2012

Nerve sheath tumours arising from the sympathetic chain are extremely rare and are a diagnostic challenge. We report the case of a 31-year-old man who presented with an asymptomatic right cervical swelling. He was evaluated with sonography, CT, MR and angiography. Surgical excision of the lesion was performed, and histological examination revealed a schwannoma. The differential diagnosis of such tumours and their management are discussed.

PubMed | University of Turin, Ivrea Community Hospital, A.S.L. TO and Local Health Authority Turin 4 Asl To4
Type: Journal Article | Journal: La Radiologia medica | Year: 2016

To evaluate the usefulness of a contouring course in reducing inter- and intraobserver variability in the definition of the larynx as organ at risk (OAR).Within the Rete Oncologica Piemonte-Valle dAosta network, a contouring course focusing on larynx delineation was proposed. Twenty-six radiotherapist technicians (RTTs) experienced in delineating OARs were asked to contour larynx before and after the training. An expert radiation oncologist defined the reference volume for educational purpose. The contoured volumes obtained before and after the course were compared using descriptive statistics (mean value, standard deviation-SD, and coefficient of variation-COV) of volumes and maximum diameters. Conformity index (CI), dice coefficient (DC), and percentage of overlap were used to evaluate the spatial accuracy of the different volumes compared to the reference. Further analysis regarding the variation in the centre of mass (COM) displacement was performed.The mean volume was 40.4cmThis study shows an improvement in larynx definition after the contouring course with lower interobserver variability and major consistency compared to the reference volume. Other specific educational activities may further increase the quality of radiation therapy contouring in this setting.

PubMed | SPISAL, ASL TO and University of Padua
Type: Journal Article | Journal: American journal of industrial medicine | Year: 2016

Literature suggests that more research is needed to clarify the effect of workplace inspections by governmental officers on injury rates. This paper aims to compare comprehensive and partial inspections in Italian manufacturing companies.Survival analysis was applied to the period free from injuries following inspection by means of the Kaplan-Meier method and of Cox models.Kaplan-Meier curves show that, compared to companies with a partial inspection, companies which had a comprehensive inspection had a higher survival through the entire period. Adjusting for confounders, the Cox model confirms a significant preventive effect of comprehensive inspection for companies with 10-30 employees, but not for those with >30 employees.The results suggest that the effect on injuries is greater if all aspects of safety are addressed during the inspection instead of focusing on a single aspect. These findings are interesting because they can help in planning effective prevention activities.

PubMed | ASL TO, Local Health Authority No and University of Padua
Type: Evaluation Studies | Journal: Occupational and environmental medicine | Year: 2016

According to Italian law, prevention of injuries in the workplace falls under the National Health System Service of Prevention, Health and Safety at Work (SPISAL). In a sample of about 5000 industrial firms in the Veneto region (North-Eastern Italy), the study examines the impact of SPISAL safety programmes on injuries.The study is based on the before-and-after comparison of injury rates in 795 industrial settings that were subject to SPISAL interventions and 4186 reference firms, which were all manufacturing industries with >10 employees; construction companies were excluded. The time window (2001-2007) was chosen in order to have 8 quarters of observation before and 8 after the intervention. The National Institute for Workers Compensation provided data on injuries and plants, while SPISAL gave information on interventions carried out. The preintervention and postintervention rates of injuries were compared by means of interrupted time series analyses, estimating the rate ratio (RR) with a 95% CI.Inspection after injury reduced by 24% (RR=0.76; 95% CI 0.65 to 0.90; p=0.001) all injuries, and by 36% (RR=0.64; 95% CI 0.50 to 0.83; p=0.001) severe injuries (fatalities, lost workdays >30, degree of permanent disability >0). These changes occurred immediately and persisted for 2years. The effects of programmed inspections were never significant.It can be presumed that, after a severe injury, the employees raised their standard of what they considered good work safety and, at the same time, the employers were pushed to improve the work environment as a result of the sudden attention from the workplace hygiene and safety authority and court authority. Inspection after injury was an effective strategy; however, confirmatory evidence is needed.

PubMed | University of Rome La Sapienza, ICP hospital, University of Bari, Stallergenes Italy and 2 more.
Type: | Journal: Journal of inflammation research | Year: 2016

In patients polysensitized to pollen allergens, the priming effect, by which the sensitivity of the nasal mucosa to an allergen is increased by the previous exposure to another allergen, is a known phenomenon. This study was aimed at evaluating the degree of nasal inflammation, assessed by nasal cytology, in children with allergic rhinitis (AR) from ragweed pollen according to being monosensitized or polysensitized.The study included 47 children. Of them, 24 suffered from AR caused by sensitization to grass pollen and ragweed pollen (group A) and 23 were sensitized only to ragweed pollen (group B). In all patients, the severity of AR was assessed according to the Allergic Rhinitis and Its Impact on Asthma guidelines, and comorbidities were also evaluated.In group A, 16.7% of children had a mild intermittent AR, 4.2% a moderate-to-severe intermittent, 33.3% a mild persistent, and 45.8% a moderate-to-severe persistent; in group B, 26.1% of children had a mild intermittent AR, 0% a moderate-to-severe intermittent, 52.2% a mild persistent, and 21.7% a moderate-to-severe persistent. No significant difference was detected in the number of the considered comorbidities between the two groups. The cell counts of neutrophils, eosinophils, lymphocytes/plasma cells, and mast cells were high but not significantly different in the two groups.These findings show that the degree of nasal inflammation found in children with ragweed-induced AR is not influenced by additional allergy to grass pollen and confirm the previously reported absence of priming effect in ragweed allergy.

PubMed | University of Genoa, Sacro Cuore Don Calabria Hospital, University of Novara, Scroce E Carle Hospital and 4 more.
Type: Journal Article | Journal: La Radiologia medica | Year: 2016

The use of imaging to maximize precision and accuracy throughout the entire process of radiation therapy (RT) delivery has been called Image-guided RT (IGRT). RT has long been image guided: in fact, historically, the portal films and later electronic megavoltage images represented an early form of IGRT. A broad range of IGRT modalities is now available and adopted. The target location may be defined for each treatment fraction by several methods by localizing surrogates, including implanted fiducial markers, external surface markers or anatomical features (through planar imaging, fluoroscopy, KV or MV computed tomography, magnetic resonance imaging, ultrasound and X-ray imaging, electromagnetic localization, optical surface imaging, etc.). The aim of the present review is to define practical recommendations for IGRT.

Bena A.,ASL TO | Leombruni R.,University of Turin | Giraudo M.,ASL TO | Costa G.,University of Turin
American Journal of Industrial Medicine | Year: 2012

Background: Occupational injuries research and surveillance is important for prevention and public health protection. A new occupational surveillance system based on linkage of work histories calculated from the Italian National Social Security Institute (INPS) and occupational injuries provided by the National Insurance Institute for Occupational Injuries (INAIL) was created and assessed. Methods: It has been extracted a 1% sample of individuals from INPS. For each subject, a detailed description of the career has been compiled between 1985 and 2004, and matched on an individual basis to work injuries between 1994 and 2003. It has been calculated injury rates and risks by economic activity, gender, age, job tenure, country of birth, and firm size. Results: The linkage success is very high both in engineering than in the construction sector. The comparison with Eurostat statistics is very positive. The injury risks calculated by job tenure, country of birth, and firm size are consistent with literature. The high injury rate for short work contracts remain unvaried also after controlling by age. Conclusions: It is finally possible to describe injuries based on some main characteristics of the recent changes in the labor market, such as precarization, ageing of workers, migration, that databases currently available in Italy do not allow. The sample is longitudinal and can contribute to describing the development of the phenomena over time. The Ministry of Health is completing procedures to extend the sample and to increase the health outcomes for which a follow-up is available. © 2012 Wiley Periodicals, Inc.

Civardi C.,NeuroLogica | Pisano F.,Neurologia Riabilitativa | Delconte C.,Neurologia Riabilitativa | Collini A.,ASL TO | Monaco F.,NeuroLogica
Neurological Sciences | Year: 2015

Corticobasal syndrome is characterized by asymmetric cortical sensorimotor dysfunction and parkinsonism; an altered cortical excitability has been reported. We explored with transcranial magnetic stimulation the motor cortical excitability in corticobasal syndrome, and the effects of slow repetitive transcranial magnetic stimulation. With transcranial magnetic stimulation, we studied two corticobasal syndrome patients. We determined bilaterally from the first dorsal interosseous muscle: relaxed threshold, and contralateral and ipsilateral silent period. We also evaluated the contralateral silent period after active/sham slow repetitive transcranial magnetic stimulation on the most affected side. At T0 the silent period was bilaterally short. On the most affected side, active slow repetitive transcranial magnetic stimulation induced a short lasting prolongation of the contralateral silent period. In corticobasal syndrome, transcranial magnetic stimulation showed a reduction cortical inhibitory phenomenon potentially reversed transiently by slow repetitive transcranial magnetic stimulation. © 2015, Springer-Verlag Italia.

PubMed | U.S. Environmental Protection Agency and ASL TO
Type: Journal Article | Journal: American journal of industrial medicine | Year: 2016

This study investigated mortality in a cohort of 1,988 male workers at a chemical manufacturing plant (1981-2011) and evaluated the quality of the results obtained using administrative databases.Information about the workers was obtained from the archives of the Italian National Institute for Social Insurance. Vital status and causes of death were ascertained through record linkage with electronic archives and follow-up mailing. Regional reference rates were used to calculate standardized mortality ratios (SMRs) and 90% confidence intervals (CI).The analysis showed increased SMR for selected cancers of a priori interest: respiratory system (SMR: 126.8; 90%CI: 105-152), pleura (330.5; 90%CI 164-596), and non-Hodgkin lymphoma (196.1; 90%CI 102-342).The results indicate an effect of hazardous exposures among workers in this chemical manufacturing plant. Using administrative databases to construct historical cohorts is an efficient method in time and resources, for estimating the risk of mortality and generating hypotheses. Am. J. Ind. Med. 59:866-876, 2016. 2016 Wiley Periodicals, Inc.

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