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Objectives: to estimate the impact of daily exposure to extreme air temperatures (heat and cold) on cause-specific mortality in Italy and to evaluate the differences in the association between urban, suburban and rural municipalities., Design: time series analyses with two-stage approach were applied: in the first stage, multiple Poisson regression models and distributed lag non-linear models (DLNM) were used to define the association between temperature and mortality; in the second one, meta-analytic results were obtained by adopting BLUP (Best Linear Unbiased Prediction) coefficients at provincial level, which were then used to estimate the Attributable Fractions of cause-specific deaths., Setting and Participants: cause-specific deaths from 2006to 2015 in Italy have been analysed by region and overall., Main Outcome Measures: 5,648,299 total deaths included. Fractions (and relative 95% empirical confidence interval) of deaths attributable to increases from 75th to 99th percentiles of temperature, for heat, and decreases from 25th to 1st percentile, for cold., Results: the overall impact of air temperature on causespecificmortality is higher for heat than for cold. When considering heat, the attributable fraction is higher for diseases of the central nervous system (3.6% 95% CI 1.9-4.9) and mental health disease (3.1% 95% CI 1.7-4.4), while considering cold, ischemic disease (1.3% 95% CI 1.1-1.6) and diabetes (1.3% 95% CI 0.7-1.8) showed the greater impact. By urbanization level, similar impacts were found for cold temperature, while for heat there was an indication of higher vulnerability in rural areas emerged., Conclusions: results are relevant for the implementation and promotion of preventive measures according to climate change related increase in temperature. The available evidence can provide the basis to identify vulnerable areas and population subgroups to which address current and future heat and cold adaptation plans in Italy.

Introduction: Air pollution and extreme temperatures have been associated with multiple adverse health effects, especially on the cardiovascular and respiratory systems. The evidence of a relationship between daily exposures and mortality from metabolic, nervous and mental causes needs to be strengthened. The aim of this study is to investigate the association between daily exposure to fine particulate matter (PM2.5) and extreme temperatures (heat and cold) with cause-specific mortality in the entire Italian population., Methods: The daily counts of deaths from natural, cardiovascular, respiratory, metabolic, diabetes, nervous and mental causes were provided by Istat at the municipal level for the period 2006-2015. Through the application of machine-learning models based on satellite data and spatiotemporal variables, population-weighted exposures to daily mean PM2.5 (2013-2015) and air temperature (2006-2015) were estimated at municipality level. Time-series models adjusted for seasonal and long-term trends were applied, and associations between the above exposures and different causes of death at the national level were estimated., Results: The study found a marked effect of PM2.5 on deaths from nervous causes, with a % increase of risk (IR%) of 6.55% (95% confidence interval: 3.38%-9.81%) per PM2.5 increases of 10 µg/m3. The study also highlighted significant effects of low and high temperatures on all study outcomes. The effects were greater for high temperatures. In particular, the effects of heat, expressed as a % increase in risk per temperature increase from the 75th to the 99th percentile, show the highest associations with mortality from nervous causes (58.3%; 95%CI: 49.7%-67.5%), mental causes (48.4%; 95%CI: 40.4%-56.9%), respiratory causes 45.8%; 95%CI: 39.7%-52.1%) and metabolic causes (36.9%; 95%CI: 30.6%-43.5%)., Discussion: The study showed a strong association between daily exposure to PM2.5 and extreme temperatures, especially heat, with mortality outcomes, especially those under-investigated, such as diabetes, metabolic, nervous and mental causes.

Summary: In the steel industry polychlorodibenzodioxins (PCDD), polychlorinated dibenzofurans (PCDF) and polychlorinated biphenyls (PCBs) may be present deriving from the fusion of ferrous and non-ferrous scrap, as well as for the thermal decomposition of the plastic materials (thermoplastic and thermosetting resins) contained therein and not removed before melting at high temperatures. The aim of the study was to assess in 52 workers of a secondmelting steel plant the PCBs exposure deriving from the manual handling of ferrous scrap waste eventually contaminated. The population was divided by production department (scrap, casting and office). Static air sampling of PCDD, PCDF, PCBs and biological monitoring of serum dioxin-like PCBs (DL-PCBs) were performed. The comparison of serum DL-PCB values between workers from the scrap department and those from the casting did not find any statistically significant differences (Mann- Whitney U test). The range of serum DL-PCBs was 7.74-78.55 ng/g lipids with an average of 24.21 ng/g lipids, much lower than the reference values measured in the Italian general population in 2011. Mean and median TEQ WHO 1998 of DL-PCBs were 0.22 pg/g lipids and 0.15 pg/g lipids respectively. The low concentrations of serum DL-PCBS in the studied population can be explained by the progressive reduction of environmental PCBs contamination., Competing Interests: The authors of this article have no conflict of interests to disclose., (Copyright© by GIMLE.)

The spread of electronic cigarettes (e-cigs) and of the so-called heat-not-burn (HnB), also known as heated tobacco products, presented as a less harmful alternative to traditional cigarettes, required further in-depth studies to demonstrate the real benefits or possible risks linked to this type of habit among smokers and possible new smokers. There are numerous harmful substances produced by these devices, such as metals, organic compounds, and aldehydes. The presence of formaldehyde is particularly worrying: its indoor concentration is 2.7, 1.2, and 40 µg/m3 for HnB, e-cigs, and traditional cigarettes, respectively. The evidence of this substance, which numerous epidemiological studies have already shown to be harmful to health (in particular, the International Agency for Research on Cancer classified it as a group 1 carcinogen), would lead to the need to modify the legislation with more restrictive rules on the use of these devices in public environment and in particular in the presence of more susceptible subjects, such as minors and pregnant women.

In order to find the optimal value of the hot water temperature to be reached so that there is no Legionella spp. at the dispensing points, 920 samples of water at temperature between 54 and 60 Celsius degree were analyzed at the Lugo and Faenza hospitals (Ravenna). Thought the analysis of the linear trendline results indicate that the temperature required is close to 60 degrees but as it's difficult to maintain in old plants, a careful patient's risk assessment needs to be carried out and therefore install antibacterial membrane filters at the dispensers.

This aim of the study was to identify effective levels of ClO2 for control of Legionella spp. contamination in the hot water (45-55 °C.) distribution system of a 579-bed hospital in Ravenna (Italy). Overall, 663 hot water samples were collected from the hospital's sinks and shower taps and were analyzed. Trend line analysis, which describes the trend in the number of positive samples collected according to disinfectant concentration, shows that the lowest number of positive samples was achieved with concentrations of ClO2 between 0.22 and 0, 32 mg /l.

A number of factors, for example water temperature, can encourage the growth of microorganisms such as Legionella spp in spa facilities. Individuals who attend this type of facility are often subjects at risk for infection who are undergoing inhalation therapy and hot tub treatments. A very accurate management of these facilities is therefore required to avoid infection by Legionella spp. The purpose of this study was to verify the current Italian national and Apulia regional legislation regarding the control of contamination by Legionella spp. in spa facilities.

Toxic chemicals such as benzene, polycyclic aromatic hydrocarbons, dioxins, and ultra fine particles were found in the smoke produced by wood combustion. Emission factors confirm that, to produce the same energy amount, many more pollutants are emitted by wood than by natural gas. Biomass burning produces a relevant deterioration of air quality inside and outside houses, notably due to emissions of fine and ultra fine dust (PM10, PM2.5) according to reviewed studies. Important improvements in emission quality are obtained with the use of more efficient household heating systems, both in developed and in developing countries. Numerous studies have assessed the possible health effects produced by wood smoke, providing sufficient evidence that the indoor exposure to wood smoke, even in developed countries, can have adverse effects on human health. In 2010 IARC classified wood smoke as a possible human carcinogen. In Europe, electricity generation from biomass combustion is increasing (12% each year) thanks to incentives provided to reduce greenhouse gas emissions and use of fossil fuels.Today adequate studies to assess the environmental and health effects of emissions from power plants fuelled by solid biomasses are still needed.

Surface disinfection together with cleaning practises and aseptic procedures are established measures for effective prevention of infectious diseases reducing infection risks. In this study, we evaluated the bactericidal effectiveness in vitro of the electro-medical device Sani System, an over-heated saturated dry-steam disinfection system, against predetermined bacterial load dried on inert surfaces. In particular we have tested different materials, representative of operating rooms furnishing and walls commonly used in healthcare setting, with Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii. As a result of treatment, the mean bacterial load on all the test surfaces was reduced by a factor of 102 in the contact plate experimental study and by a factor of 10 in the total bioburden experimental study. The Sani System Polti proved to be efficacious in killing 100% of the bacteria in all experimental conditions, therefore it could help to reduce the risk of spreading nosocomial infections in healthcare facilities.

The authors analyse some technical and professional aspects of disinfection in Milan at the beginning of XXth century, and the work of Vittorio Maragnoli. Also the use of HCN vapours in disinfestation is here analysed.

Cleaning and shaping the root canals play an important role to remove the organic debris within the endodontic system. The result, however, must be maintained over time through an effective root canal fillings preventing the entry of micro-organisms and tissutal fluid in the root canal system. Recently new materials have been introduced on the market, hence alternatives techniques for the root canals obturation have been developed and proposed. Even if cold lateral condensation is still considered the technique to refer to, there are numerous alternatives that use heat to achieve optimal adaptation of gutta-percha to the root canal space. The purpose of this work is to emphasize the positive aspect and points of weaknesses of different methods used for filling the root canals in order to allow the clinician to carry out choices as possible based on scientific evidence. Although many clinical trials still have not identified the superiority of one obturation technique over the others, the importance of this stage is objectively primary, so much that in the clinical practice we can notice an increasing success of endodontic treatment.

In accordance with European Union regulations, from 5 February until 15 December 2008, sampling and analysis activities were conducted in Italy to assess the extent of contamination caused by thermotolerant Campylobacter in broiler chickens farmed nationwide. The survey involved 48 poultry slaughterhouses distributed across eleven regions of Italy, where the caeca and carcasses of 393 slaughter batches were sampled. A total of 284 batches (72.3%) gave positive results for Campylobacter spp. as follows: 52.1% were contaminated by C. jejuni, 55.6% by C. coli and 1.1% by C. lari. C. jejuni and C. coli were isolated together in 37 batches (13% of positive results). Campylobacter spp. was isolated only from the caeca in 251 slaughter batches (63.9%) including caecal isolates of C. jejuni (48.2%), C. coli (50.6%), and C. lari (1.2%). Carcasses from 182 batches (46.3%) were contaminated by C. jejuni in 40.7% of cases, C. coli in 57.7% and the absence of C. lari from all batches examined. The contamination level observed in the carcasses ranged between 10 and 1.6 × 10(7) cfu/g.

Spa therapy is one of the most commonly used non-pharmacological approaches for many rheumatic diseases. In Fibromyalgia Syndrome (FS) it may be useful for the chronic widespread musculoskeletal pain. Because of the unknown aetiology and the not clear understood pathogenesis, there is no standard therapy regimen for FS. Also the mechanisms of action of spa therapy are not completely known, but most probably the benefits could be derived from mechanical, physical and chemical factors. Muscle tone and pain intensity can be positively influenced by mud packs and thermal baths. The review of international data from 2000 to 2007 confirms that spa therapy should be a valid tool in the multidisciplinary approach of the Primary FS.

Introduction: The Italian Heat Health Watch Warning System (HHWWS) was set up following the over 3000 excess deaths which occurred in Italy during the heat wave of 2003, In June 2005 the warning system issued a heat warning in various Italian cities., Methods: A case control study was performed in one of these cities (Bari) in order to identify individual and environmental risk factors as well as preventive strategies for reducing mortality during future heat waves. Cases were defined as subjects aged <65 years who had died during the heat wave and whose death certificate listed one of the following as the cause of death: heat, cardiovascular or cerebrovascular disorders, neurocognitive disorders, dehydration or fever/infection not otherwise specified. For each case, three age-matched controls were randomly selected among individuals followed by the same general practitioner as the case. All variables significantly associated with mortality (<0.1) in the univariate analysis were entered into a conditional logistic regression model and the population attributable fraction (PAF) was calculated for significant variables (at p<0.05)., Results: Twenty cases and sixty controls were included in the study. In 17 cases (89%) death had occurred at home and 11(55%) of these were cardiovascular- related deaths. At the multivariate analysis, the factors significantly associated with mortality risk during the heat wave were: having a functioning air conditioner at home [OR:0.09(95% CI 0.01-1.00)], having an Activities of Daily Living score <2 [OR:21.0(95%CI 1.81-242.47)] and having been hospitalized the year preceding death [OR:18.1(95%CI 2.04-160.51)]., Conclusions: Public health interventions during heat waves should include the provision of access to an air conditioned environment. Subjects with impaired health (especially if recently hospitalized) and with significant limitations in their activities of daily living are probably at higher risk during heat waves.

This study evaluated the presence and extent of contamination with Legionella spp. in the hot water distribution systems of three hospitals in Catania (Italy). In total, 291 hot water samples were collected between September 2002 and August 2005 and these were examined in order to monitor the hospital distribution systems and evaluate the efficacy of decontamination measures. L. pneumophila was detected at variable concentrations up to over 10000 UFC/L at several collection sites in some hospital buildings and branches of the water distribution system while other buildings/branches were found to be free of contamination. The most frequently isolated serogroup was L. pneumophila serogroup 3, occasionally associated with serogroups 4, 5 and 6. Molecular typing of Legionella strains by pulsed-field gel electrophoresis of genomic DNA restriction fragments identified four different genotypes, each recovered from a different branch of the distribution system. Decontamination procedures, including shock hyperchloration and two different thermal shock methods, performed between October 2003 and August 2005, led to only temporary reductions in contamination. In fact, previous concentrations of the same L. pneumophila serogroup were found within 3 to 8 months of decontamination. In order to prevent and monitor Legionella infections, sterilizing filters were installed in water taps of all wards with high-risk patients and urinary antigen testing was performed on all patients diagnosed with nosocomial pneumonia. No cases of Legionella pneumonia were identified in 2005.

No laws currently exist regarding the treatment of spa pool water, since it is not completely logical that these should have the same requirements as normal swimming pools. The problem arises especially with regards to the use of chlorine as a disinfectant, which may actually annulate the therapeutic effects of spring waters by altering their physical-chemical characteristics. Possible choices may be represented by frequent replacement of pool water, which may be easily achievable for small pools but more difficult to implement for larger pools, or by alternative disinfection methods such as ozone or ultraviolet rays. The efficacy of these methods must be shown through frequent chemical and microbiological analyses and future, to be hoped-for laws or guidelines, will need to be aimed at defining safety performance standards rather than prescribing analytical intervention and control methods. Beyond the choice of disinfection method, it is extremely important to highlight some relevant hygienic measures that bathers should take and that play a fundamental role in preventing infectious diseases which may be acquired in pools. The most important of these include: showering before entering the pool, wearing slippers around the pool, not urinating in the pool, not bathing if affected by diarrhea, wearing a bathing cap, avoiding the use of contact lenses while bathing and avoiding exchanging towels. Pool managers have the important role of avoiding overcrowding of the facilities and ensuring that all technological systems function properly.

Aim: Heat shock proteins (HSPs), induced by thermal stress, make the cells more resistant to following stress. We aimed to verify if rats heating reduces the production of TNF-alpha in a model of acute respiratory distress syndrome (ARDS)., Methods: We divided 34 Wistar rats in Group A and Group B. The rats of Group A received thermal shock and tracheal instillation of lipopolysaccharide (LPS), the rats of Group B only tracheal instillation of LPS. All the rats have been then subdivided in 6 subgroups sacrificed at different times after instillation of LPS: A30 and B30 at 30 min, A90 and B90 at 90 min and A180 and B180 at 180 min. We dosed the serum concentration of TNF-alpha and the values of every subgroup have been compared with the Student t-test., Results: The serum concentration of TNF-alpha in the subgroup A90 resulted significantly lower than in the subgroup B90., Conclusions: The exposure to thermal stress resulting in the production of HSPs reduced the concentration of TNF-alpha in this model of ARDS.

Aim: The aim of the study was to evaluate the reaction exothermia of 2 relining resins for temporary crowns. The resins used were Duralay, a methacrylate-based resin, and Protemp II, a bisacrylic resin., Methods: The coronal parts of an adult molar and of an impacted one were used. Abutments were obtained from the crowns, while the radicular part was sectioned in order to insert a thermocouple into the pulpal chamber. During the experiment the tooth with the polymerising resin was put into an oral cavity simulator to keep a constant temperature. The thermal increase during polymerisation of the 2 resins was recorded for 6 minutes at 5 seconds intervals and with 1 and 2.5 mm dentin thickness (n = 10). Data were statistically analysed by variance analysis with Scheffe test., Results: The intrapulpal thermal increase was significantly higher in relation to the type of resin (Duralay p < 0.0001), thickness (1 mm p < 0.0001) and type of dentin (young dentin p < 00001)., Conclusions: In order to protect the pulp, during the direct relining of a temporary crown, it is recommendable to choose the best combination among resin, type of dentin and its residual thickness, besides adequate cooling techniques.

Background: The present study deals with the main methods for assessment of hot environments: i.e., WBGT, SWreq and PHS. It is stressed how the WBGT index, which is strictly empirical, although a very practical tool for the assessment of the hot environments, can only be used for a rough evaluation of heat stress, and especially for a not very high metabolic rate (M<175 W/m2). On the contrary, the SWreq method, which is based on both subject-environment heat exchange and the effect of clothing, allows a better assessment of the work situation with a general reduction of the exposure limits with respect to WBGT, especially in non-uniform environments (ta not equal to tr). However, it should be noted that application of SWreq is required by the ISO standard 7243 when the WBGT limit values are exceeded., Methods: In this study interest was extensively focused on the "Predicted Heat Strain" method, highlighting via a special software the differences in heat stress assessment related to this new approach, which will be adopted by the ISO in the next revision of standard 7933., Results: The PHS method, unlike SWreq, allows the prediction of the time-response of the main physiological variables of interest (i.e., skin temperature, core temperature and sweat rate). Moreover thanks to better modelling of heat exchanges, the PHS method allows account to be taken of both movement and clothing effects, resulting in even more reduced exposure.

Following the unusually hot summer this year and the dramatic news from neighboring countries such as France, the Italian Minister of Health requested an epidemiologic mortality study during summer 2003, to investigate whether there had been an excess of deaths in Italy, particularly for the elderly population. Communal offices, which provide vital statistics, were asked for the number of deaths among resident people, occurred from June 1 to August 31, for 2003 and 2002, for the 21 Italian regions capitals. A mortality increase of 3,134 deaths was observed for 2003; most of them (92%) were people aged 75 years and older. The highest increases were observed in the North Western cities (Turin, Milan, Genoa). The relationship between mortality and climatic indexes (T. max, Humidex) was investigated and a clear correlation was observed.

The Argon Beam Coagulator has gained his space in surgery thanks to its operative characteristics, that are very useful in sealing the bleeding parenchymal tissue with minimal injury to the surroundings. The aim of the present study is that of evaluate the physical properties of the instrument in its coagulation action. The experimental study with the Birtcher 6000 Argon Beam Coagulator has been designed to measure the top temperature that develops right where the Argon beam meets the tissue, while operating. Using a laser guided telethermometer, the searching of that temperature was uneasy right on the operatory field because of the unwilling movements of the operator hand and those of the patient himself. Therefore a similar protocol was made on a piece of meat coming from the butcher. At the longest application of the beam coagulation on the same point the developed temperature was never higher than 100 degrees C whilst a complete coagulation effects. The advantage of the Argon Beam coagulation are therefore to seal the diffuse bleeding without injury to this adjacent tissues, never exposed to a temperature higher than that of boiling water. The advantages are also evident in comparison with the more usual spray electrosurgery that is instead characterized by a wide carbonisation also with this spray option.

The aim of this study was to test the effects of the iodine bromide water of the thermal baths of Salsomaggiore on patients suffering from specific nonseasonal rhinitis (Dermatophagoides Farinae and Dermatophagoides Pteronyssinus). The patients, 80 in all, were divided in two groups (group A and group B). All of the patients underwent rhinoscopic examination, anterior rhinomanometry, prick test, rast screening, total IgE assay together with that of the other immunoglobulins (IgA, IgM, IgG), mucociliary clearance evaluation and were asked to evaluate their degree of nasal obstruction, before and after 30 days of treatment. Group A carried out the experiment by applying endonasal Acqua Sal spray seven times a day for 30 days; group B used oily drops for the same time and with the same frequency. At the end of the trial period, the patients in group A showed a 100% improvement in their subjective perception of their symptomatology, in comparison with a 33% improvement in the control group. A characteristic decrease in the IgE and increase in the IgA was observed in the serum of the patients who had been treated with Acqua Sal spray. Iodine bromide water has a general and local anti-inflammatory effect, which is also due to the activation of the corticosurrenal system (with a relative increase in cortisol). The cleansing action of hypertonic water in the nasal cavities must also be cited, as it minimizes contact between the mucosa and allergens.

Background: Body temperature tends to increase during conventional haemodialysis; this might interfere with normal cardiovascular response to dialytic ultrafiltration, thus facilitating the occurrence of symptomatic hypotension. Putative factors responsible for changes in thermal balance during haemodialysis include heat load from the dialysis bath, reduction in convective heat loss secondary to skin vessel vasoconstriction, heat overproduction due to central stimulation by bioincompatibility reactions to the filter membranes. The aim of the present study was twofold: to define thermal energy balance (ET) during dialysis and to investigate the effect of membrane bioincompatibility on energy balance, Methods: We measured ET in 12 patients (9M, 3F) during two identical dialysis sessions, differing only in the membrane composition of the filters used: cuprophane 1.3- 1.6 mq and LF polysulphone 1.3- 1.6 mq. Thermal energy balance studies were performed by the Blood Temperature Monitor (Fresenius Medical Care) under conditions in which the core temperature of the patients was maintained unchanged from the start to the end of the dialysis procedure., Results: Arterial blood temperatures were constant, while dialysate and venous blood temperatures progressively decreased (from 36.9 to 35.4 C and from 36.5 to 35.1 C for cuprophane; from 36.9 to 35.2 and from 36.9 to 35.1 for polysulphone membrane). Mean thermal energy transfer was negative (removal of energy from the patients to the extracorporeal circuit) with both filters, equal to 146 KJ with cuprophane and to 163 KJ with polysulphone. When a stepwise multiregression analysis was applied, hourly energy transfer (ET) was significantly and independently correlated with both ultrafiltration rate (UF=% b.w.) and heart rate changes (HR) according to the equation: ET= -92.03+41.29 UF+1.04 HR (p<0.0003). Conclusions. In this study we present experimental evidence that increased body temperature during dialysis is not caused by heat load from the dialysis bath, nor by heat over production secondary to bioincompatibility reactions. Consequently, haemodynamic responses to dialytic ultrafiltration may be regarded as the main regulatory factor of thermal balance.

Background: The aim of the present study is to evaluate the risk of a possible thermal stress of the pulpal tissue during the fabrication of a temporary crown when using the direct technique., Methods: For this study, 7 different brands of acrylic resin including Acrylic type and Bis-Gma type have been tested. At this purpose one series of in vitro experimental trials were performed. The trials have evaluated the temperature increase inside the pulp chamber of an extracted tooth during the fabrication of a provisional crown. The temperatures reached by the resins tested were measured using a digital thermometer connected with a thermal probe., Results: The temperatures measured during the experimental trials show a different ability by the 7 tested resins to produce heat. Indeed, while the polymethylmethacrylate resins show higher increments rate of temperature, the Bis-Gma resins produce less dramatic increase along with lower temperatures peaks., Conclusions: Testing the 7 different resins has proved that there is an actual risk to cause lesions to the pulpal tissue during the placement of a provisional crown when using the direct technique. The materials which show a reduced exothermal reaction are: IsoTemp and Protemp II.

Background: Technological progress in the endodontic field has allowed the creation of innovative nickel-titanium endodontic instruments, made with a superelastic alloy with a reduced modulus of elasticity. The elastic properties of the NiTi alloy can undergo significant variations in connection with mechanical movements and cyclic fatigue induced on the instruments caused by their repeated usage, especially in canals which are anatomically difficult to shape. The state of tension of the instrument determines a deformation of the geometry of the files and, therefore, a modification in their properties. Similarly to mechanical stress, thermal treatments can influence the properties of the alloy. The aim of the study is to subject the NiTi alloy to repeated thermomechanical cycles, examining the influence of the mechanical and thermal stress on the temperature at the beginning and end of the martensite transformation, on the increase of recovery of deformation during the cooling phase and on the change in the internal structure of the material., Methods: The instruments (30 ProFile Maillefer) were subdivided into 5 groups: Group I, composed of 6 new ProFiles submitted to 14 sterilization cycles in an autoclave for 30 minutes each; Group II, formed by 6 unused ProFiles subjected to one sterilization cycle in an autoclave; Group III made up of 6 new ProFiles used as controls; Group IV made up of 6 ProFiles submitted to clinical use on endodontic simulators in plexiglas for a total time of 240 seconds; Group V consisting of 6 ProFiles used on endodontic simulators for a total time of 480 seconds. All the above mentioned samples were tested using a thermomechanic dynamic analyzer (DMTA) produced by Rheometric Scientific., Results: The files from Group III (control) show an elastic deformation curve typical of nickel-titanium instruments. The samples from Groups IV and V subjected to sequential use on endodontic simulators evidenced modifications in their elastic behaviour compared to the control instruments. The operative use caused modifications in the original properties of the alloy, with a reduction in elasticity proportional to the number of uses. The instruments that underwent 14 cycles of sterilization in the autoclave (I group) present dynamic analysis curves which are different compared to the new unsterilized ProFiles. After 14 cycles there is a modification in the response of the instruments to thermodynamic stress., Conclusions: Both the samples undergoing repeated mechanical stress on Plexiglas endodontic simulators and those sterilized in the autoclave at thermodynamic analysis show significant modification in modulus of elasti- city. The different taper does not influence the experimental results, there not being any significant differences found in the elastic behaviour between ProFiles.

In this work we take under examination the aromatic polycyclic hydrocarbons (APHs) as a class of organic micropolluting agents which have a considerable impact in the life and in the working environment of man. The authors decided to expressly start this study by proposing the changes pattern cause by APHs according to their chemical-physical reactivity characteristics, in order to realise a qualitative and quantitative evaluation of their toxicologic impact. Therefore, the specific aspects of chemism (reactions of substitution, aromatic electrophilia and addition) of these organic micropolluting agents are studied with particular reference to their chemical structure and to the properties which are the main important cause of every effect of diffusion both in productive environments and of toxicity in the human body. In this way, come toxicologic risk sources, responsible, within some technological cycles for the APHs emission in the working areas, are identified, shown and evaluated; carrying factors, not much investigated till now, which represent a synergic effect to the introduction and absorption of the APHs by the human body. For the necessity of a useful environmental monitoring which could be applied to different matrices, the techniques and the methods useful for carrying out sampling and analytical evaluation in a correct way, are introduced as well. Lastly, the Authors stress on the engagement and discuss the measures of prevention and protection, technically performable on the basis of the chemico-physical-granulometric properties of APHs, with the goal of safeguarding at best health of people occupationally exposed.

The principles of electrosurgery are based upon well defined physical grounds, explaining the type and extent of the lesions induced by the electric current. Technological evolution has led to the creation of dedicated equipment, allowing efficient use of electrosurgical cutting and coagulation of tissues, both in open and endoscopic surgery. Electrovaporization is the thermal effect obtained when an alternating high power-high frequency current (300 W, 400-500 kHz) is applied to the tissue using an electrode with particular geometric aspects. The main feature is the presence of higher and lower current density zones. The first induce electrovaporization, whilst the second produce simultaneous hemostatic coagulation of the rims. New effective vaporizing electrodes have been recently introduced into clinical practice. Their use in the endoscopical treatment of bladder outlet obstructions, a stimulating alternative to standard resection or laser applications, is currently under evaluation.

The results of a study carried out on 90 subjects exposed to vibratory trauma of the hand-arm compared to a non-risk control group of 54 subjects are reported. All subjects underwent a medical and neurological examination and Doppler ultrasound of the upper limbs, plethysmography of the hands, electromyography of the bilateral median nerve area and T.T.T. (Thermal Threshold Tester) evaluation of the thermal threshold, were performed. Workers exposed to risks show a higher threshold for hot/cold sensitivity compared to those not exposed. This increase is earlier compared to the onset of vascular and neurophysiological changes detected by plethysmography, Doppler ultrasound and electromyography. Thermal threshold evaluation by T.T.T. would seem to be a useful test for monitoring workers exposed to vibrations.

A dramatic shortage of kidneys available for transplantation, due do the widespread reduction in consent, has urged us to explore alternative sources of kidney harvesting, in the attempt to reduce the current gap between the small number of donations and the large number of patients on waiting-list. We set our attention on non-heart-beating donors (NHBD). In the "first step" of our research, we tested an experimental technique, by using commercial pigs' kidneys, that has been useful to determinate the maximum warm ischemic time that a kidney of NHBD could tolerate. Parameters of this research were the resistance of the kidney in perfusion machine and the renal scintigraphy. Our results permitted to establish that the maximum warm ischemic time that a kidney of NHBD could tolerate, is 50 minutes (p > 0.001). This experimental technique could be employed to remove every doubt about the effective condition of NHBD kidney before the transplant, in the outlook, by using those kidneys, to reduce the organ shortage.

Objective: To determine the efficiency, during general anaesthesia, of four commercially available HMEs, with particular attention to the change of performances due to the new modifications introduced by the manufacturers., Design: Comparisons of the performances of each HMEs with psychometric method in terms of T degree C, RH (%), AH (mgH2O/1) of inhaled and expired gases., Patients: A sample of 28 patients under general anesthesia longer than 150 minutes, undergone elective urological surgery. Patients with cardiological, respiratory and metabolic impairments have been excluded., Measurements and Results: The measurements of T degree C, RH and AH have been performed with thermometric probes every minute. The collected data have been analyzed by Student's "t"-test for unpaired data., Conclusions: The obtained data show that a good conditioning of the inhaled gases is possible, although only few HMEs satisfy the requirements indicated in the ISO and BSI standards.

Therapeutic muds have been applied-at "Terme dei Papi", Viterbo-to 30 subjects with subchronic extra-articular rheumatism (S.I.R., Italy 1986). Favourable effects have been obtained in a great majority of subjects treated. Improvement was obtained concerning provoked pain, spontaneous pain as well as function of sprained joints.

Hot (44) and cold (30) caloric test are the most common tool to investigate canal activity. Many authors, otherwise, have pointed out that this method is very long needing about five minutes of interval among the irrigations and that it is often troublesome for the patient that is exposed four times to a vertigo. To investigate vestibular function some of these authors tried to use the hot monothermal test alone but results were poor. The aim of this study was to propose a shorter and a less troublesome method of investigation and to introduce a new diagnostic possibility not pointed out with traditional caloric test. We have tried to determine some new reliable diagnostic criteria modifying confidential value of the hot monothermal test and considering the eventual presence of the nystagmus and its direction during the cold simultaneous test; on the basis of this results we are able to distinguish a normal vestibular function from a labyrinthine preponderance or a directional preponderance or an aspecific disfunction. When the vestibular function is normal or when there is a labyrinthine preponderance our results are in total accord with those achieved with the traditional bithermal test. Therefore we suggest to use always the hot monothermal test associated with the cold simultaneous test, performing the two cold irrigations in additions, only in the case of a directional preponderance or an aspecific disfunction.

Since cell adhesiveness is very important in the metastatic process and because both hyperthermia and treatment with Retinol can modify the fluidity of the lipid components of the plasma membrane (and therefore its receptor distribution), we investigated if a hyperthermic treatment (at 42 degrees C or 44 degrees C, for one hour) of HTC hepatoma cells, preceded or followed by treatment with 5 microM Retinol, could alter cell adhesiveness to Laminin or to Fibronectin-coated substrata. Hepatoma cells, after such treatments, were collected and processed by Auerbach's method. In the control cells thermal treatment alone caused a decrease of adhesiveness to Laminin but no change in that to Fibronectin. When treatment with Retinol was carried out before hyperthermia, the cells showed an increased adhesiveness to Laminin and a decreased adhesiveness to Fibronectin. Instead, when treatment with Retinol was performed in cells previously thermo-selected, a decrease of adhesiveness to both tested ligands was observed.

The aim of this study was to investigate if the association of both hyperthermic and Retinol treatment of HTC hepatoma cells could be useful in antitumor therapy. Treatment with 5 microM Retinol was carried out before or after hyperthermia (42 degrees C or 44 degrees C, one hour; in the latter case it was performed in cells already thermo-selected. We took into consideration two parameters, i.e. the number of the collected vital cells (evaluated by the trypan blue-exclusion test) and the clonal efficiency of these cells (calculated as number of colonies obtained from 250 cells cultured for 5 days). Thermal treatment alone caused a decrease of the number of the collected vital cells and of their clonal efficiency only in the cell cultures incubated at 44 degrees C. Instead the control thermo-selected cells, both at 42 degrees C and at 44 degrees C, showed both decreased clonal efficiency and yield of the vital cells. Compared with the control cultures treated with 0.1% Ethanol, used as vitamin A solvent, only cell cultures treated with Retinol before hyperthermia showed a decreased number of collected viable cells, nevertheless their clonal efficiency was unchanged.

The effect of preheated (37 degrees C) mixture of 0.5% bupivacaine and fentanyl on peridural anaesthesia have been studied in a double blind randomized clinical trial. Fifty patients of both sexes, ASA I-II, undergoing elective surgery for inguinal hernia repair or radical saphenectomy have been randomly assigned either to the control group (n = 25) receiving 0.5% bupivacaine-fentanyl at room temperature (20 degrees C), or to the group receiving the same anaesthetic mixture preheated for 12 hours up to 37 degrees C (n = 25). The latency period, extension, duration and quality of anaesthetic block were evaluated. A significative difference in the extension of anaesthetic block was detected at 6' (p less than 0.05 for extension up to T10 and T11, p less than 0.025 up to T12), and at 8' (less than 0.05 for extension up to T10). However no difference was observed between the two groups at 10' and later. The use of 0.5% bupivacaine-fentanyl mixture resulted in a short latency period, as previously observed, and its preheating does not seem to affect substantially the parameters evaluated in this study.

Heparin solutions ampoules have been autoclaved at 105 degrees C-110 degrees C-121 degrees C-134 degrees C for 15 minutes. The biological activity has not decreased after the treatment, but a reduction was observed after a storage period of 36 months at room temperature for sterilizing treatments. Analysis of heparin by size exclusion and reversed phase HPLC with the method developed in our laboratories allowed us to demonstrate a substantial stability of the molecular structure. These methods showed to be suitable for a qualitative evaluation of the heparin itself.

The Authors evaluate four different techniques for root canal filling by means of a stereo-microscope analysis of extracted teeth sections. The results indicate that: 1) the single-cone technique shows poor apical seal; 2) the Mc Spadden thermomechanical condensation technique produces good apical seal but often causes overfilling; 3) the vertical condensation and 4) the lateral condensation of gutta-percha confirm their efficacy, nevertheless the Authors recommend the second one because it is easier and request shorter time of execution.

The Authors evaluated mechanic characteristics of open and close titanium coils after two cycles of simulated usage. Coils undergone to thermic autoclaving didn't show any substantial variation in the forces offered compared to those only disinfected, authorizing reusage with igienic guarantees.

A morphological and chemical transformation of the protozoon Leishmania results during the shift from sand fly vector to mammalian host. This is due to the increase in temperature from about 26 degrees to about 35 degrees C. We evaluated the modifications induced by 37 degrees C on stationary phase promastigotes of two different Leishmania species (L. major and L. infantum). L. infantum changed to amastigote-like forms in a greater and quicker way than L. major; this fact could relate with the more elevated spreading capacity of this species in the human body.

The Authors studied in 10 patients during mechanical ventilation the effects of the application of heat and moisture exchanger (HME) in the presence of constant TV and frequency. They observed an increase of PaCO2 and PE, CO2 during the use of HME; this is due to Vd/Vt increase. The Authors conclude that it is mandatory to increase the total ventilation when using HME to avoid dangerous levels of hypercapnia.

The study first assessed the influence of the quantity of resin and the type of matrix on exothermic polymerisation of self-curing resins. The temperature in vitro inside the pulp chamber was then measured during the preparation of a provisional single and multiple sample using different matrices; samples were prepared using a direct technique.