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Objective: Psychological suffering in patients with Malignant Mesothelioma (MM) is different from the one experienced by patients with other cancers due to its occupational or environmental etiology and its peculiar symptomatology and prognosis (i.e., poor prognosis, reduced effectiveness of the therapies, poor quality of residual life, and advanced age at the time of diagnosis). Therefore, the Mesothelioma Psychological Distress Tool‐Patients (MPDT‐P) has been developed to evaluate the specific profile of psychological suffering in this population. This paper describes the item selection, factor analysis, and psychometric evaluation of the revised MPDT‐P. Methods: The analyses of the current work aimed to confirm the factorial structure found in the first version of the MPDT‐P. In the case of nonfit, it aimed to find an alternative structure and causes of nonfit in the model. The search for the fit of the factorial model was conducted using a Bayesian approach. Results: The two‐factor model reported in the first version of the instrument did not fit the data. Confirmatory Bayesian analyses showed adequate fit for the three‐factor solution. Based on the content of the items, we labeled the factors as dysfunctional emotions, claims for justice, and anxieties about the future. Conclusions: Integrating the MPDT‐P into clinical practice could help clinicians gain insight into the specific suffering related to MM and investigate potential differences related to different occupational and environmental exposure contexts. [ABSTRACT FROM AUTHOR]

Telomere length can be maintained either by the telomerase enzyme or by alternative lengthening of telomeres (ALT), which is based on telomeric recombination. However, both mechanisms are inactive in most human somatic cells. ATRX has been previously identified as an ALT repressor gene. Nonetheless, TP53 is also deficient in most ALT cell lines, and previous works showed that it is an inhibitor of homologous recombination (HR). Despite this, the role of p53 as an ALT repressor has not been previously examined. Therefore, we investigated the effects of p53 and ATRX inhibition on normal human fibroblasts (devoid of any mutation), in the presence or absence of X‐ray‐induced telomeric damage. Performing immunofluorescence with antibodies for RAD51, H2AX, and TRF1 (for studying HR‐mediated DNA damage repair) and CO‐FISH (for telomeric sister chromatid exchanges), we observed that HR is a normal mechanism for the repair of telomeric damage, present also in noncancer cells. Moreover, we discovered that telomeric HR, as for HR in general, is significantly inhibited by p53. Indeed, we observed that inhibition of p53 drastically increases telomeric sister chromatid exchanges. We also confirmed that ATRX inhibition increases telomeric recombination. In particular, we observed an increase in crossover products, but a much higher increase in noncrossover products. [ABSTRACT FROM AUTHOR]

Objective: This study was undertaken to refine the spectrum of SCN1A epileptic disorders other than Dravet syndrome (DS) and genetic epilepsy with febrile seizures plus (GEFS+) and optimize antiseizure management by correlating phenotype–genotype relationship and functional consequences of SCN1A variants in a cohort of patients. Methods: Sixteen probands carrying SCN1A pathogenic variants were ascertained via a national collaborative network. We also performed a literature review including individuals with SCN1A variants causing non‐DS and non‐GEFS+ phenotypes and compared the features of the two cohorts. Whole cell patch clamp experiments were performed for three representative SCN1A pathogenic variants. Results: Nine of the 16 probands (56%) had de novo pathogenic variants causing developmental and epileptic encephalopathy (DEE) with seizure onset at a median age of 2 months and severe intellectual disability. Seven of the 16 probands (54%), five with inherited and two with de novo variants, manifested focal epilepsies with mild or no intellectual disability. Sodium channel blockers never worsened seizures, and 50% of patients experienced long periods of seizure freedom. We found 13 SCN1A missense variants; eight of them were novel and never reported. Functional studies of three representative variants showed a gain of channel function. The literature review led to the identification of 44 individuals with SCN1A variants and non‐DS, non‐GEFS+ phenotypes. The comparison with our cohort highlighted that DEE phenotypes are a common feature. Significance: The boundaries of SCN1A disorders are wide and still expanding. In our cohort, >50% of patients manifested focal epilepsies, which are thus a frequent feature of SCN1A pathogenic variants beyond DS and GEFS+. SCN1A testing should therefore be included in the diagnostic workup of pediatric, familial and nonfamilial, focal epilepsies. Alternatively, non‐DS/non‐GEFS+ phenotypes might be associated with gain of channel function, and sodium channel blockers could control seizures by counteracting excessive channel function. Functional analysis evaluating the consequences of pathogenic SCN1A variants is thus relevant to tailor the appropriate antiseizure medication. [ABSTRACT FROM AUTHOR]

Background: An enlarged right atrium (RA) is a challenging anatomy that can limit the successful use of His bundle pacing (HBP). It is unknown whether new implantation tools could help overcome these challenges. Methods: Consecutive patients with RA volume index >25 mL/m2 in men and >21 mL/m2 in women underwent permanent HBP. We used a stylet‐driven lead (SDL) with an extendable helix delivered via a dedicated delivery sheath (Selectra 3D, Biotronik) as a first attempt. In case of failure, a second attempt was performed with the same lead but with a different delivery curve. Finally, a lumen‐less lead (LLL) was also available as a third attempt. Results: The study cohort included 24 patients (median age 75.7 years [interquartile range, 70.9–79.0], 88% men) with a RA volume of 49 mL/m2 (45–54). Using SDL, HBP was achieved with a single sheath curve in 17 patients (71%). The second attempt with the same lead but a different sheath was successful in four more patients (SDL success 87%). The fluoroscopy time increased significantly when the second attempt was necessary (8 min [6–11] vs. 15 min [13–17], p <.001). In the remaining three patients, HBP was further attempted with a LLL leading to a final procedural success of 96%. No lead dislodgment nor significant increase in pacing threshold was observed at 1‐month (1.2 [0.7–1.7] V@1.0 ms vs. 1.1 [0.8–1.7] V@1.0 ms, p =.939). Conclusion: The availability of different dedicated delivery systems for HBP can improve procedural outcomes even in challenging circumstances, such as in patients with right atriomegaly. [ABSTRACT FROM AUTHOR]

Background: The aim of this work was to evaluate the impact of the restrictions put in place to control the COVID‐19 pandemic on new diagnoses of malignant mesothelioma (MM) in Italy. Methods: Twelve of the 21 Italian malignant mesothelioma CORs (regional operating centres) participated. The study included all cases of MM with microscopic confirmation; cases without microscopic confirmation and death certificate only (DCO) were excluded. For each case, information on sex, date of birth, tumor site, morphology, and date of diagnosis was retrieved. We compared the number of incident cases in 2020 with 2019, looking at the overall picture and for four periods: pre‐pandemic (January–February), first wave (March–May), low incidence (June–September), and second wave (October–December). Results: A total of 604 cases were registered: 307 in 2019 and 297 in 2020. In the 2020 pre‐pandemic period, the incidence was higher than in the same months in 2019 (+45%); there was no significant change during the first wave (+1%) or in the low‐incidence period (−3%), while a decrease was observed during the second wave (−32%). However, the data were not homogeneous across the country: the increase in the pre‐pandemic period concerned mostly the regions of northern (+61.5%) and central Italy (+43.5%); during the first wave, MM diagnoses increased in the northern (+38.5%) and central (+11.4%) regions but decreased in the southern regions (−52.9%). All these differences are compatible with random fluctuations. Conclusion: The COVID‐19 pandemic had little or no impact on new MM diagnoses, and variations were not homogeneous throughout the country. [ABSTRACT FROM AUTHOR]

Objective: To develop a short, flexible, and comprehensive tool to measure psychological distress in caregivers of malignant mesothelioma (MM) patients: the Mesothelioma Psychological Distress Tool—Caregivers version (MPDT‐C). Methods: Based on a systematic review of the relevant literature, aspects associated with caregiver distress were derived. Expert researchers/clinicians developed a pool of items for each identified aspect. Content validity was assessed through a multiple mixed‐methods approach. A multicenter study was conducted to explore the factorial structure of the 47‐item MPDT‐C through Bayesian factor analysis. Results: The Bayesian exploratory factor analysis revealed an underlying three‐factor structure. Factors were labeled Secondary Traumatic Stress, Engagement in Caring, and Meaningful Cognitive Restructuring. All scales showed sufficient reliability and corrected item–total correlations. Females scored higher than males for Engagement in Caring. Conclusions: Taking care of malignant mesothelioma patients is a stressful process that influences the caregiver's physical, emotional, and social wellbeing. Our study offers preliminary evidence in support of the adequate psychometric properties of the MPDT‐C, and these should now be replicated. Results suggest that the MPDT‐C is a reliable tool with which to detect the psychological distress of this traumatized population. [ABSTRACT FROM AUTHOR]

The article describes the case of an echo-guided approach to determine the appropriate primary curve width of a new delivery sheath for His bundle pacing (HBP) implant in a 75-year-old man right atriomegaly (RA). Topics discussed include the health condition of the patient such as his hypertension, mellitus diabetes type 2 and paroxysmal atrial fibrillation, discovery of significant reduction in left ventricle ejection in the patient, and importance a careful pre-procedural assessment of RA.

Introduction: Histological studies reported that the His bundle (HB) is partitioned into narrow cords by collagen running in its long axis, providing the anatomical setting necessary for its longitudinal dissociation. Further confirmations came from the demonstration that direct HB pacing normalizes the QRS axis and duration in subjects with proximal HB lesions causing bundle branch block. However, there is no evidence of the possibility of selective HB partitions pacing destined to the composition of branches and fascicles. Methods and Results: We describe a case of intra‐Hisian left bundle branch block in which permanent distal HB pacing corrects left ventricular delay and produces different QRS morphology at different voltage outputs, as an expression of different selective HB compartments recruitment. Conclusion: This case would strengthen the limited data in the literature about HB longitudinal dissociation. [ABSTRACT FROM AUTHOR]

Background: The interatrial conduction time (IACT) is relevant for atrioventricular delay optimization in cardiac resynchronization therapy (CRT) devices. However, this information cannot be easily used as it requires invasive measurements. We tested whether electrical activation of left atrium (LA) could be detected in CRT devices with left ventricular (LV) sensing and used to estimate IACT. Methods: The presence of LA activation on LV channel was evaluated in consecutive patients implanted with CRT and quadripolar LV leads whose sensing was temporarily set in the most proximal polarity (Ring LV4‐housing). Estimates of IACT during sinus rhythm and atrial pacing were measured and compared with the values obtained with invasive catheterization of coronary sinus. Results: Among six patients (50% female; mean age 73.3 ± 4.9 years) included in the analysis, four (66%) had a visible LA signal on the LV channel. The mean IACT measured with device electrograms was 71 ± 8 ms and 133 ± 15 ms during sinus rhythm and atrial pacing, respectively. These values were equivalent to the measurements obtained during invasive catheterization. Both patients without evidence of LA activation had an LV lead with a short total interelectrodes distance (46 mm) resulting in a significant anatomical distance between Ring LV4 and LA. Conclusions: In CRT devices with left ventricular sensing, LA signal could be detected and used to estimate IACT especially if long‐spaced electrodes are used. [ABSTRACT FROM AUTHOR]

Epigallocatechingallate (EGCG) is the major polyphenol in green tea, to which many anticancer features, such as antioxidative, antigenotoxic, and antiangiogenetic properties, are attributed. Moreover, it is also well known as a telomerase inhibitor. In this work, we have chronically treated U251 glioblastoma cells with low, physiologically realistic concentrations, of EGCG, in order to investigate its effects both on telomeres and on genome integrity. Inhibition of telomerase activity caused telomere shortening, ultimately leading to senescence and telomere dysfunction at 98 days. Remarkably, we have observed DNA damage through an increase of phosphorylation of γ‐H2AX histone and micronuclei also with doses and at timepoints when telomere shortening was not present. Therefore, we concluded that this DNA damage was not correlated with telomere shortening and that EGCG treatment induced not only an increase of telomere‐shortening‐induced senescence but also telomere‐independent genotoxicity. This study questions the common knowledge about EGCG properties, but confirms the few works that indicated the clastogenic properties of this molecule, probably due to DNA reductive damage and topoisomerase II poisoning. Environ. Mol. Mutagen., 60:683–692, 2019. © 2019 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Background: Growing evidence indicates that the exposure to high heat levels in the workplace results in health problems in workers. A meta‐analysis was carried out to summarize the epidemiological evidence of the effects of heat exposure on the risk of occupational injuries. Methods: A search strategy was conducted to retrieve studies on the effects of climate change on occupational injury risk. Among the 406 identified, 5 time‐series and 3 case‐crossover studies were selected for meta‐analysis. Results: Pooled risk estimates for time‐series and case‐crossover studies combined, and then separated, were 1.005 (95%CI: 1.001‐1009), 1.002 (95%CI: 0.998‐1.005), and 1.014 (95%CI: 1.012‐1.017), respectively. Subgroup analyses found increased risks (not statistically significant) for male gender, age <25 years and agriculture. Conclusions: The present findings can orient further research to assess the effects of heat at workplace and consequently to establish better health policies for managing such exposure in at‐risk regions. [ABSTRACT FROM AUTHOR]

Background: Nickel (Ni) compounds have been classified as carcinogenic to humans. The aim of the study is to evaluate exposures to Ni at workplaces in Italy. Methods: Data on Ni compounds were collected from an occupational exposure registry. Statistical analysis was carried out for exposure‐related variables. The number of workers potentially exposed was estimated for selected industrial sectors. Concurrent exposures with other occupational carcinogens were investigated using two‐step cluster analysis. Results: Overall 10 083 measurements were analyzed during 1996‐2016, having a geometric mean of 2.93 μg/m3. Most exposures occurred in manufacture of metal products (50%) and among metal finishing machine operators (46%). A total of 56 046 workers potentially exposed to Ni was estimated. Concurrent exposures were frequently detected, mainly with chromium VI and cobalt compounds. Conclusions: Systematic recording of occupational exposures provides a data source that allows recognition of high risk situations for workers' health and helps improve exposure assessment in epidemiologic studies. [ABSTRACT FROM AUTHOR]

The applications of Terahertz (THz) technologies have significantly developed in recent years, and the complete understanding of the biological effects of exposure to THz radiation is becoming increasingly important. In a previous study, we found that THz radiation induced genomic damage in fetal fibroblasts. Although these cells demonstrated to be a useful model, exposure of human foetuses to THz radiation is highly improbable. Conversely, THz irradiation of adult dermal tissues is cause of possible concern for some professional and nonprofessional categories. Therefore, we extended our study to the investigation of the effects of THz radiation on adult fibroblasts (HDF). In this work, the effects of THz exposure on HDF cells genome integrity, cell cycle, cytological ultrastructure and proteins expression were assessed. Results of centromere‐negative micronuclei frequencies, phosphorylation of H2AX histone, and telomere length modulation indicated no induction of DNA damage. Concordantly, no changes in the expression of proteins associated with DNA damage sensing and repair were detected. Conversely, our results showed an increase of centromere‐positive micronuclei frequencies and chromosomal nondisjunction events, indicating induction of aneuploidy. Therefore, our results indicate that THz radiation exposure may affect genome integrity through aneugenic effects, and not by DNA breakage. Our findings are compared to published studies, and possible biophysical mechanisms are discussed. Environ. Mol. Mutagen. 59:476–487, 2018. © 2018 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to evaluate the occupational health risks in the Italian National Priority Contaminated Sites (NPCSs). Methods: Established cases of occupational diseases in 2010‐2014 were extracted from the Italian National Institute for Insurance against Accidents at Work (INAIL) archives. Standardized incidence ratios with 95% confidence intervals were estimated by site and by disease group separately for genders. Results: In the 44 NPCSs evaluated, 11 015 cases of occupational diseases (8877 in men and 2138 in women) were ascertained. Overall, an excess of occupational diseases with respect to expected cases of 24.2% was found in men residing in NPCSs. An increased occurrence was detected in 21 NPCSs for men and in eight for women. Conclusions: The findings suggest a role of occupational diseases in the health profile of NPCSs, reinforcing the need for a permanent surveillance system. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study is to present the results of a systematic review of published research that focuses on psychological aspects of malignant mesothelioma patients and asbestos‐exposed people. Methods: Our research includes primary studies published between 1980 and 2016, using information from the Cochrane Library, the Psychology Behavioral Sciences Collection, PsychINFO, PubMed, PubGet, PubPsych, and Scopus, in compliance with PRISMA guidelines. Results: We identified 12 papers that investigated the psychological distress and care needs of mesothelioma patients, and nine papers for asbestos‐exposed subjects. Conclusions: This paper highlights the paucity of studies on the psychological distress and care needs of mesothelioma patients and asbestos‐exposed subjects. It confirms that malignant mesothelioma is associated with the physical, emotional, and social functioning of patients, while also suggesting that the risk of developing asbestos‐related diseases among asbestos‐exposed subjects is associated with high levels of psychological distress, despair, and mental health difficulties. [ABSTRACT FROM AUTHOR]

Background: Sinonasal cancer (SNC) is a rare tumor with predominant occupational etiology associated with exposures to specific carcinogens. The aim of this study is to describe SNC cases recorded in Italy in the period 2000‐2016. Methods: Clinical information, occupational history, and lifestyle habits of SNC cases collected in the Italian Sinonasal Cancer Register were examined. Age‐standardized rates were estimated. Results: Overall, 1529 cases were recorded. The age‐standardized incidence rates per 100 000 person‐years were 0.65 in men and 0.26 in women. Occupational exposures were predominant among the attributed exposure settings, primarily to wood and leather dusts. Other putative causal agents included chrome, solvents, tannins, formaldehyde, textile dusts, and pesticides. Many cases had unknown exposure. Conclusions: Epidemiological surveillance of SNC cases and their occupational history is fundamental for monitoring the occurrence of the disease in exposed workers in industrial sectors generally not considered at risk of SNC as well as in non‐occupational settings. [ABSTRACT FROM AUTHOR]

Genotoxic effects of therapeutic ultrasound are poorly documented, when compared with the wide use of this physical agent. The aim of this work was to investigate the clastogenic and aneugenic potential of 1 MHz ultrasound, employing intensities (200 and 300 mW/cm2) above the cavitational threshold, but in the range of those normally used in therapeutics. Both normal fibroblasts (AG01522) and tumoral cells (MCF‐7) were sonicated. While no effects on viability were noted, significant increases of CREST‐negative micronuclei (indicative of clastogenesis) and CREST‐positive micronuclei (indicative of aneuploidy) were detected. Clastogenesis was confirmed by increases of γ‐H2AX foci, while increases of spindle anomalies confirmed the induction of aneuploidy. Our results confirm previous works that showed ultrasound‐induced DNA breakage. Moreover, our experiments show that the known effect of ultrasound‐induced damage to microtubules is also able to damage the mitotic spindle and induce aneuploidy. On the overall, this work highlights the importance to further investigate the potential risks related to therapeutics US. Environ. Mol. Mutagen. 59:60–68, 2018. © 2017 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Introduction Peritoneal mesothelioma, a very rare and lethal malignancy, has not been investigated as extensively as pleural mesothelioma, although the role of asbestos exposure in its occurrence is well-known. Data from Italy are relevant, as it was the largest European asbestos producer, and asbestos was widely used in many economic activities. Methods A population-based mortality and incidence analysis was performed in Italy. Data sources were the National Multiple-causes-of-death Database (1995-2010) and the Italian Mesothelioma Register (1993-2008). Results We found an increasing trend of age standardized mortality rates in men, but no clear trend in women; moreover, we showed significant risks of death in several northern regions, formerly heavy asbestos users; finally, mortality/incidence ratios similar for both genders (about 0.8) were estimated. Conclusions The study, based on national data, showed a higher risk of mortality from and incidence of peritoneal mesothelioma in areas with formerly heavy exposure to asbestos. Am. J. Ind. Med. 58:1050-1058, 2015. © 2015 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

A low grain protein content (GPC) and flour strength (W) are desirable traits for wheat (Triticum aestivum L.) for biscuit production. Nitrogen fertilization is the main factor that affects storage proteins. The aim of this study was to compare the effect of different commonly applied N fertilization strategies on the quality requirements of common wheat intended for biscuits production. Field experiments were set up over three growing seasons at three sites in northwestern Italy on two wheat cultivars. Three N rates (100, 130, and 170 kg N ha−1), applied split as ammonium nitrate, have been compared to a slow release fertilizer, applied only at tillering (130 kg N ha−1). The leaf greenness, grain yield, grain and flour protein content, and W were affected directly by the rate of N distributed as ammonium nitrate in several of compared agro‐environments. Taking in account the same N rate, the application of a slow release fertilizer resulted in a significantly lower GPC (4%), W (6%), and flour stability measured through the Brabender farinograph (10%) compared to the split fertilization with ammonium nitrate, while no difference was observed for ear density and grain yield. Suitable rheological parameters of wheat for biscuits could be achieved through the split application of ammonium nitrate only at low N rate, but this could limit their productive performances. Conversely, the fertilization strategy of applying a slow release fertilizer at tillering is able to better satisfy the qualitative requirements for biscuit production, without causing any grain yield loss. [ABSTRACT FROM AUTHOR]

Background The costs of productivity loss due to occupational cancer mortality are rarely investigated. An estimate of occupational cancer deaths in Italy in 2006 and an approximation of the resultant costs from medical and non-medical expenditures together with figures of remuneration lost are provided. Methods Occupational cancer deaths, obtained from the application of the attributable fraction (AF) to mortality data (source: Italian National Institute of Statistics), were used to calculate the Potential Years of Life Lost (PYLLs), the Potential Years of Working Life Lost (PYWLLs) and the costs of the loss of productive life. The health care costs for any cancer was applied to the estimated number of occupational cancer cases to obtain the total cost. Results Around 8,000-8,500 deaths/year from occupational cancer are estimated to occur in Italy, corresponding to 170,000 PYLLs and more than 16,000 PYWLLs, leading to around 360,000,000 euros in indirect economic loss. Health care costs of occupational cancer are estimated at 456,000,000 euros. Conclusions Occupational cancer is of major concern in terms of mortality and economic productivity loss. Preventive efforts in evaluating ongoing risks and current exposures are strongly recommended to health policy-makers. Am. J. Ind. Med. 56:1272-1279, 2013. © 2013 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Background Polycyclic aromatic hydrocarbons (PAHs) are generally present in the workplace environment as complex mixtures and often difficult to identify a priori. Objectives The aim of this study is to evaluate the level and coverage of occupational exposure to PAHs in Italy. Methods Data were collected from exposure registries of companies with mandatory reporting to the National Workers' Compensation Authority. Statistical analyses were carried out on the retrieved information and the number of workers potentially exposed was estimated for some industrial sectors. Results Overall 12,849 measurements of exposure levels to individual PAHs were selected from the database of registries in the period 1996-2010. Most exposures occurred in the manufacture of chemicals (N = 5,383, 51%), and the occupational group most frequently measured was chemical-processing-plant operator (N = 3,930, 31%). Measurements were associated to various PAHs, including benzo[ a]pyrene, benzo[ a]anthracene, benzo[ b]fluoranthene, benzo[ k]fluoranthene, dibenz[ a,h]anthracene, and benzo[ j]fluoranthene. Overall, 39,230 workers were estimated as potentially at risk of exposure to PAHs in the selected industrial sectors. Conclusions This study summarized data recorded in the Italian occupational exposure database and identified specific exposure patterns to PAHs. The systematic recording of occupational exposures is a source of data that allows the recognition, control, and prevention of high-risk situations for workers' health. Am. J. Ind. Med. 56:897-906, 2013. © 2013 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Due to the large scale use of asbestos (more than 3.5 million tons produced or imported until its definitive banning in 1992), a specific national surveillance system of mesothelioma incident cases is active in Italy, with direct and individual anamnestic etiological investigation. In the period between 1993 and 2004, a case-list of 8,868 pleural MM was recorded by the Italian National Register (ReNaM) and the modalities of exposure to asbestos fibres have been investigated for 6,603 of them. Standardized incidence rates are 3.49 (per 100,000 inhabitants) for men and 1.25 for women, with a wide regional variability. Occupational asbestos exposure was in 69.3% of interviewed subjects ( N = 4,577 cases), while 4.4% was due to cohabitation with someone (generally, the husband) occupationally exposed, 4.7% by environmental exposure from living near a contamination source and 1.6% during a leisure activity. In the male group, 81.5% of interviewed subjects exhibit an occupational exposure. In the exposed workers, the median year of first exposure was 1957, and mean latency was 43.7 years. The analysis of exposures by industrial sector focuses on a decreasing trend for those traditionally signaled as 'at risk' (asbestos-cement industry, shipbuilding and repair and railway carriages maintenance) and an increasing trend for the building construction sector. The systematic mesothelioma surveillance system is relevant for the prevention of the disease and for supporting an efficient compensation system. The existing experience on all-too-predictable asbestos effects should be transferred to developing countries where asbestos use is spreading. [ABSTRACT FROM AUTHOR]

Background Occupational Cancer Monitoring (OCCAM) is an Italian organization that monitors occupational cancers, by area and industrial sector, by retrieving cases and employment history from official databases. OCCAM previously estimated a relative risk (RR) of lung cancer of about 1.32 among 'metal treatment' workers in Lombardy, northern Italy, potentially exposed to chrome and nickel. In the present study, lung cancer risk was estimated among electroplating workers only. Methods Lombardy electroplating companies were identified from descriptions in Social Security files. Lung cancer risk was evaluated from 2001 to 2008 incident cases identified from hospital discharge records. Results The RR for lung cancer among electroplating workers was 2.03 (90% CI 1.33-3.10, 18 cases) for men; 3.00 (90% CI 1.38-9.03, 4 cases) for women. Conclusions Electroplaters had higher risks than 'metal treatment' workers. Although the risks were due to past exposure, case histories and recent acute effects indicate a present carcinogenic hazard in some Lombardy electroplating factories. Am. J. Ind. Med. 55:1-4, 2012. © 2011 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Background An epidemic of asbestos-related diseases is ongoing worldwide. Mortality from malignant pleural neoplasms in Italy was analyzed, to estimate the health impact of asbestos at national and local level. Methods Mortality from ICD-9 code 163 was considered, in the time-window 1995-2002, using National Bureau of Statistics data. National and regional standardized rates and municipal Standardized Mortality Ratios (SMR) were calculated. Municipal clusters were identified by applying Spatial Scan Statistics procedure. Relative risks (RR) express the ratio of risk within the cluster to the risk outside the cluster. Results The national standardized annual mortality rate was 1.9 per 100,000. Significant clusters corresponded to asbestos-cement industries (Casale Monferrato: RR = 11.63), shipyards (Monfalcone, RR = 7.43), oil refineries (Falconara, RR = 2.52), petrochemical industries (Priolo, RR = 3.81). Conclusions The present study confirms malignant pleural neoplasms mortality as a suitable indicator of asbestos exposure at geographic level. In addition to asbestos-cement industries and shipyards, other industrial settings are associated with pleural neoplasm mortality. Am. J. Ind. Med. 55:11-24, 2012. © 2011 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

The article focuses on the cancer cases that are occupational in origin, the cofounders and the confusion it implicates. It mentions cofounders of cancer such as smoking and diet that can mislead the analysis of the origin of the disease. It suggests that medical literature should focus on latency and accumulative dose and must not dismiss a case at once and concludes that the cofounders are responsible for it will mislead the gauge on the attributed risk an occupation has.

The article presents a study which analyzes the compensated cases of occupational cancer claims in the industrial sector in Italy from 1994-2006. It states that the claims were analyzed based on the Italian Workers' Compensation Authority (INAIL) data. It investigated mesothelioma and lung cancer from asbestos and nasal cavities cancer from wood and leather dust. Result shows that 85% of the compensated claims happened in 2000-2006.

The article presents a study which examines the occupational exposure to crystalline silica and estimates the number of workers at high risk of exposure in Italy. The study identified the industrial sectors at risk of silica exposure by selecting the sector that employed people who were compensated for silicosis in 2000-2004. The enterprises and workers at risk of silica exposure were selected from the Italian database of workplaces. Results of the study show the need to reinforce preventive measures and to control exposure in these sectors.

Objectives: To get insight in the mechanism of exercise-induced ST-segment elevation (STE) in patients with Q/QS waves at the electrocardiogram (ECG). Methods: We performed exercise stress test in 13 patients with anterior acute myocardial infarction treated by successful primary percutaneous coronary intervention (PCI). Results: Compared to rest, an additional STE 1 mm in one or more precordial ECG leads during exercise occurred in nine patients (69%), in the absence of symptoms. Conclusions: In acute myocardial infarction (MI) patients, treated by primary PCI and showing optimal coronary blood flow restoration at angiography, STE can still be induced by exercise in Q/QS wave ECG leads. This finding lends further support to the theory that exercise-induced STE in this clinical context is unlikely to represent by itself transient myocardial ischemia or viability. [ABSTRACT FROM AUTHOR]

Gastrointestinal stromal tumors (GISTs) are among the most common mesenchymal tumors of the gastrointestinal tract. Diagnosis of GIST on ultrasound examination can be difficult because of their similarity in appearance to gynecological neoplasms. We present two cases of GIST originating from the small bowel and the stomach, which were preoperatively misdiagnosed as a uterine leiomyoma and an ovarian tumor, respectively. The ultrasonographic differential diagnosis of these pelvic masses is discussed. [ABSTRACT FROM AUTHOR]

Discusses ways to maintain the balance of power between bidders and the targets of corporate takeovers in the United States. Reasons for the shift against the target and its management to the bidder; Corporate management efforts to alter the corporate by-laws and its financial structure and the creation of various classes of voting stock; Need for the U.S. Congress to conduct a fundamental review of takeovers. INSETS: Fighting Greenmail;BUSINESS AND SOCIETY REVIEW EXTRAVAGANCE OF THE YEAR AWARD;Bonus Baby of 1984.

Objectives: In Italy, asbestos was used intensively until its ban in 1992, which was extended for asbestos cement factories until 1994. The aim of this study was to evaluate the dose-response between asbestos exposure and asbestosis mortality across a pool of Italian occupational cohorts, taking into account the presence of competing risks., Methods: Cohorts were followed for vital status and the cause of death was ascertained by a linkage with mortality registers. Cause-specific (CS) Cox-regression models were used to evaluate the dose-exposure relationship between asbestosis mortality and the time-dependent cumulative exposure index (CEI) to asbestos. Fine and Gray regression models were computed to assess the effect of competing risks of death., Results: The cohort included 12,963 asbestos cement workers. During the follow-up period (1960-2012), of a total of 6961 deaths, we observed 416 deaths attributed to asbestosis, 879 to lung cancer, 400 to primary pleural cancer, 135 to peritoneal cancer, and 1825 to diseases of the circulatory system. The CS model showed a strong association between CEI and asbestosis mortality. Dose-response models estimated an increasing trend in mortality even below a CEI of 25 ff/mL-years. Lung cancer and circulatory diseases were the main competing causes of death., Conclusions: Asbestos exposure among Italian asbestos-cement workers has led to a very high number of deaths from asbestosis and asbestos-related diseases. The increasing risk trend associated with excess deaths, even at low exposure levels, suggests that the proposed limit values would not have been adequate to prevent disability and mortality from asbestosis., (© 2024 Wiley Periodicals LLC.)

Background: Asbestos is a known human carcinogen and is causally associated with malignant mesothelioma, lung, larynx and ovarian cancers., Methods: Cancer risk was studied among a pool of formerly asbestos-exposed workers in Italy. Fifty-two Italian asbestos cohorts (asbestos-cement, rolling-stock, shipbuilding, and other) were pooled and their mortality follow-up was updated to 2018. Standardized mortality ratios (SMRs) were computed for major causes of death considering duration of exposure and time since first exposure (TSFE), using reference rates by region, age and calendar period., Results: The study included 63,502 subjects (57,156 men and 6346 women): 40% who were alive, 58% who died (cause known for 92%), and 2% lost to follow-up. Mortality was increased for all causes (SMR: men = 1.04, 95% confidence interval [CI] 1.03-1.05; women = 1.15, 95% CI 1.11-1.18), all malignancies (SMR: men = 1.21, 95% CI 1.18-1.23; women = 1.29, 95% CI 1.22-1.37), pleural and peritoneal malignancies (men: SMR = 10.46, 95% CI 9.86-11.09 and 4.29, 95% CI 3.66-5.00; women: SMR = 27.13, 95% CI 23.29-31.42 and 7.51, 95% CI 5.52-9.98), lung (SMR: men = 1.28, 95% CI 1.24-1.32; women = 1.26, 95% CI 1.02-1.53), and ovarian cancer (SMR = 1.42, 95% CI 1.08-1.84). Pleural cancer mortality increased during the first 40 years of TSFE (latency), reaching a plateau thereafter., Conclusions: Analyses by time-dependent variables showed that the risk for pleural neoplasms increased with latency and no longer increases at long TSFE, consistent with with asbestos clearance from the lungs. Peritoneal neoplasm risk increased over all observation time., (© 2023 The Authors. American Journal of Industrial Medicine published by Wiley Periodicals LLC.)

Background: The Italian National Mesothelioma Register (ReNaM) was set up at the Istituto Superiore Prevenzione e Sicurezza Lavoro (ISPESL), in Rome, in accordance with Art. 36 of Italian Legislative Decree No. 277 [1991]., Methods: Five Italian regions, Piedmont, Liguria, Emilia-Romagna, Tuscany, and Apulia, agreed to record mesothelioma cases according to guidelines established by ISPESL, to define exposure to asbestos and transmit the data systematically to ISPESL., Results: Four hundred and twenty-nine mesothelioma cases, diagnosed in 1997, are recorded. The standardized annual incidence rate for definite pleural mesothelioma is 1.51 per 100,000 inhabitants (2.26 for males and 0.79 for females). Exposure was defined for 198 mesotheliomas with a histological diagnosis: 125 (63%) refer to occupational exposure, 10 (5%) to environmental exposure, and 5 (2.5%) to household exposure., Conclusions: Despite the ReNaM's work, many limitations still have to be overcome. Clear-cut information on asbestos exposure is available for a limited number of cases; and differing regional procedures in collecting and evaluating mesotheloma cases exist. At this stage the identification and evaluation of a large number of cases of mesothelioma is a worthwhile result. This epidemiological surveillance, currently being extended to other regions, will enable us to better assess the impact and diffusion of this disease in future, and to monitor more closely the effects of ceasing asbestos use in 1992, and the efficacy of preventive measures since mid '70s. Am. J. Ind. Med. 45:55-62, 2004., (Copyright 2003 Wiley-Liss, Inc.)