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Background: diabetic foot ulcers (DFU) represent the main cause of major amputations and hospitalisations in diabetic patients. The aim of this study was to assess the safety and cost-efficacy of intramuscular injection of peripheral blood mononuclear cells (PBMNCs) in diabetic patients with no-option chronic limb-threatening ischemia (CLTI) and small artery disease (SAD)., Methods: a retrospective study was carried out on a series of type 2 diabetic patients with DFU grade Texas 3 and no-option CLTI and SAD. All patients had undergone at least a previous revascularization and were allocated to a surgery waiting list for major amputation. The principal endpoint evaluated at 90 days was a composite of TcPO 2 values at the first toe ≥30 mmHg and/or TcPO 2 increase of at least 50% from baseline and/or ulcer healing. Secondary endpoints were individual components of the primary endpoint, any serious and non-serious adverse events, and direct costs at one year., Results: the composite endpoint was achieved in nine patients (60.0%); one patient (6.7%) healed within ninety days and 26.7% and 46.7% showed TcPO 2 ≥ 30 mmHg and a TcPO 2 increase of at least 50% at ninety days, respectively. At one year, three (20.0%) patients underwent a major amputation (all diagnosed SAD grade III). One patient died after seven months, and seven patients (46.7%) healed. The overall median and mean cost per patient were EUR 8238 ± 7798 and EUR 4426 (3798; 8262), respectively., Conclusions: the use of PBMNCs implants in no-option CLTI diabetic patients with SAD seems to be of help in reducing the risk of major amputation.

Indoor climate indices and microbiological airborne contamination were evaluated in a department of a general hospital in Bologna only partially equipped with an air conditioning system. To determine the environmental parameters, an ANADATA (LSI) climate analyzer with relative transducers was used. The Effective Temperature (ET), the New Effective Temperature (ET*) and the Fanger indices (PMV-PPD) were calculated using the parameters measured. Microbial count measurements were taken with an S.A.S. (Surface Air System) sampler, to ascertain the total bacterial count at 37 degrees C, and the fungal particle, Staphylococcus aureus and Pseudomonas aeruginosa counts. Carbon dioxide air concentrations were also measured to evaluate the efficacy of air exchange. The Fanger indices were not within the range of thermal comfort in most rooms (52% in winter, 62% in summer). Air microbial counts were higher in the hospital wards and surgeries than in the offices and laboratories. In particular, coagulase-positive staphylococci were present only in the air of the patients' rooms. The microbial contamination was not correlated with the air conditioning system, but probably caused by the turnover in the hospital population, the number of people and their behaviour. However the most important measure to prevent airborne contamination and to reduce the number of microorganisms in the air is an efficient source control. Better management of the air conditioning system, by means of adequate air exchange and thermal adjustment, would lead to a notable improvement in indoor air quality, especially in units with hospitalized patients.

In response to a request from the personnel of a credit bank that had been moved into a new building, an evaluation was made of employee health complaints. The prevalence of symptoms was determined using a self-administered questionnaire. Ventilation effectiveness, contaminant concentrations (which included chemicals and bioaerosols) and microclimate were studied to establish their relationship to environmental discomfort and to the health problems mentioned by the employees. Indoor air quality--which was assessed in different seasons--revealed relatively high levels of carbon dioxide and bioaerosols in areas occupied by employees as compared with other places. Temperature and humidity were considered to be satisfactory. Although a causative agent was not isolated, the authors conclude that an ineffective rate of room air exchange, possibly in interaction with chemical contaminants, may be responsible for the discomfort and, perhaps, for the health symptoms experienced by workers in fully enclosed rooms.

Fourteen welders were examined with the purpose to evaluate the incidence and the type of pathologic changes of the gastrointestinal tract due to the exposure to welding fumes. The medical examination was followed by endoscopic and bioptic study of gastric and duodenal mucosa. The results show the presence of pathologic changes, mainly of flogistic type, in all the microscopic investigations, although the appearance of the mucosa was generally normal. Moreover, the results of this investigation suggest that pathologic changes of gastrointestinal tract could precede those of the respiratory tract.

The Authors have taken under study 6 office buildings and a total of 165 work stations with VDTs. Lighting conditions, postures, indoor climate and air-quality have been evaluated, besides worker's subjective approach sounded by individual questionnaire. Concerning visual comfort, it has been noticed that the most simple and well-known rules are often disregarded, such as avoiding to place a screen in front of a light source because of its glare. Also, operators postures are often incorrect, making problems related to their own fixity worse. Air conditioning systems assure almost excellent conditions for thermal comfort, but air changes are often poor and microbiologic quality suffers from plant's inadequate servicing. Finally, the survey of questionnaires shows a complaint percentage which only partly corresponds with the objective data collected, reflecting instead an uneasiness to the kind of work and its organisation.