A novel approach to the quantification of aortic root in vivo structural mechanics.

Understanding aortic root in vivo biomechanics can help in elucidating key mechanisms involved in aortic root pathologies and in the outcome of their surgical treatment. Numerical models can provide useful quantitative information. For this to be reliable, detailed aortic root anatomy should be captured. Also, since the aortic root is never unloaded throughout the cardiac cycle, the modeled geometry should be consistent with the in vivo loads acting on it. Achieving such consistency is still a challenge, which was tackled only by few numerical studies. Here we propose and describe in detail a new approach to the finite element modeling of aortic root in vivo structural mechanics. Our approach exploits the anatomical information yielded by magnetic resonance imaging by reconstructing the 3-dimensional end-diastolic geometry of the aortic root and makes the reconstructed geometry consistent with end-diastolic loading conditions through the estimation of the corresponding prestresses field. We implemented our approach through a semiautomated modeling pipeline, and we applied it to quantify aortic root biomechanics in 4 healthy participants. Computed results highlighted that including prestresses into the model allowed for pressurizing the aortic root to the end-diastolic pressure while matching the image-based ground truth data. Aortic root dynamics, tissues strains, and stresses computed at relevant time points through the cardiac cycle were consistent with a broad set of data from previous computational and in vivo studies, strongly suggesting the potential of the method. Also, results highlighted the major role played by the anatomy in driving aortic root biomechanics.

Erratum - Analysis of extracellular superoxide dismutase and Akt in ascending aortic aneurysm with tricuspid or bicuspid aortic valve.

This correct the article published on European Journal of Histochemistry 2014;58:200-206 doi: 10.4081/ejh.2014.2383.

Analysis of extracellular superoxide dismutase and Akt in ascending aortic aneurysm with tricuspid or bicuspid aortic valve.

Ascending aortic aneurysm (AsAA) is a consequence of medial degeneration (MD), deriving from apoptotic loss of smooth muscle cells (SMC) and fragmentation of elastin and collagen fibers. Alterations of extracellular matrix structure and protein composition, typical of medial degeneration, can modulate intracellular pathways. In this study we examined the relevance of superoxide dismutase (SOD3) and Akt in AsAA pathogenesis, evaluating their tissue distribution and protein levels in ascending aortic tissues from controls (n=6), patients affected by AsAA associated to tricuspid aortic valve (TAV, n=9) or bicuspid aortic valve (BAV, n=9). The results showed a significant reduction of SOD3, phospho-Akt and Akt protein levels in AsAA tissues from patients with BAV, compared to controls, whereas the differences observed between controls and patients with TAV  were not significant. The decreased levels of SOD3 and Akt in BAV aortic tissues are associated with decreased Erk1/Erk2 phosphorylation and MMP-9 levels increase. The authors suggest a role of decreased SOD3 protein levels in the progression of AsAA with BAV and a link between ECM modifications of aortic media layer and impaired Erk1/Erk2 and Akt signaling in the late stages of the aortopathy associated with BAV.

[Work-related diseases and the fitness to work in construction industry]. / Malattie lavoro-correlate e giudizio di idoneità lavorativa in edilizia.

The construction industry is characterized by a high number of fatal and nonfatal injuries and even higher prevalence of work-related diseases. The aim of this work is to analyze the results of a research project that has among its objectives the study of the prevalence of work-related diseases and the fitness to work in construction industry. In the period 2003-2011 were evaluated 2069 construction workers, from 218 companies (average age 37.9 years, mean seniority 21.1 years, 17.1 in the construction industry). The prevalence of work-related diseases was 14.06%, in the first place the noise-induced hearing loss, followed by musculoskeletal disorders and entrapment neuropathies. The 24.7% of fitness to work was influenced by the presence of limitations, the 0.6% of the population was not suitable for the specific task. The prevalence of work-related diseases in construction industry is high, with a peak among the elderly, but also significant occurrence among young people. It is important the percentage of the population with health problems that limit the fitness to work.

[WHP: application in an electromechanical company]. / WHP: descrizione dell'esperienza in un'azienda elettromeccanica.

The provincial network of organizations that promote health and participating in the project WHP (Workplace Health Promotion) was born from the collaboration between the ASL of Bergamo and Confindustria Bergamo in the shared conviction that the promotion of the health of the worker is in the interest of all: companies, the public Health Service, workers and their families. According to the World Health Organization, in fact, behavioral factors identified by the project are of fundamental importance to increase the "years of good health" of the population. Through the adoption of effective measures that promote the health of employees, the model proposed by the project and adopted by ABB--Medium voltage department--Dalmine (Bg) wants hence to offer a framework and methodological support for tangible steps in this direction.

[The skin cancer in the construction industry]. / La neoplasia cutanea nel settore edile.

UNLABELLED: The risk factors for the development of cutaneous neoplasms are well-known (skin type, ultraviolet rays, familiar occurrence, etc.) and the exposure to ultraviolet light is probably the most important one. Construction workers, due to the characteristics of the work performed (outdoor work), are exposed to UV rays for most of their workday, often in association with the exposure to chemicals (PAHs, solvents) with a role in promoting skin carcinogenesis. The construction industry is therefore a true "test" for the prevention of skin cancer. MATERIALS AND METHODS: description of skin cancer in the construction workers subject to medical surveillance at the "Territorial Joint Committee of Bergamo" (8 basal cell cancers, 1 squamous cell carcinomas and 4 melanomas). PURPOSE: review of the medical literature data, evaluation of the exposure to multiple risk factors, prevention proposals in a professional field where the "culture of tanning" is still widespread.

[Role of ECG screening and cardiologic examinations in occupational health prevention program for construction workers; results of study in the Province of Bergamo]. / Utilità dell'elettrocardiogramma e degli approfondimenti cardiologici nella sorveglianza sanitaria di una popolazione di operatori edili della Provincia di Bergamo.

Aim of this study was to estimate prevalence of resting electrocardiogram (ECG) abnormalities in men with high physical work demand, like construction workers and the prevalence of secondary related cardiovascular examinations. Several guidelines for cardiovascular risk management recommend an ECG in patients with cardiovascular risk but there are no clear indications about the frequency of resting ECG during evaluation for fitness for work. The results of our study confirm the presence of age-related ECG abnormalities with a similar stratified prevalence distribution in all age-classes. Our fundings intend to contribute to further discussion in occupational health policies and periodical medical evaluations.

[Occupational injuries and lifestyle in construction working population workers: which interaction?]. / Fenomeno infortunistico e stili di vita di una popolazione di lavoratori edili: quale correlazione?

Many factors of organizational, technical, social and human are involved in determining occupational injury. The purpose of this study was to evaluate how the characteristics of the human factor can influence the accident phenomenon. From records of the construction firms involved in the project "Protection of health on construction sites" promoted by CPT Bergamo and Occupational Medicine of Bergamo Hospital were extracted data on lifestyle of workers involved in occupational injuries in the period 2007-2011. The indicators of lifestyles used were the smoking status, alcohol consumption and drugs, body mass index (BMI), physical activity.

[Survey on alcohol and construction workers]. / Indagine conoscitiva su alcool e lavoro in edilizia.

On the basis of the data drawn by national and international literature and the introduction of legislation concerning "alcohol and alcohol-related problems" authors studied alcohol consumption in a group of 512 building workers during the periodic health surveillance examination (years 2011-2012). Another group of 209 construction workers were examined for alcohol concentration in expired air and during work on building sites. In the first group, 62.1% of workers refers to drink alcoholic beverages; we found GGT and CTD alterations in about 1/3 of workers who reported high alcohol consumption. Alcohol tests in building sites demonstrated that alcohol consumption during pauses in work is still common.

[Prevalence of contact dermatitis as occupational diseases in a group of construction workers followed up by the 'Territorial Joint Committee of Bergamo' between 2003-2011]. / Prevalenza delle dermatiti da contatto occupazionali in una coorte di lavoratori edili seguiti presso il Comitato Paritetico Territoriale di Bergamo nel periodo 2003-2011.

UNLABELLED: Occupational contact dermatitis is the most represented skin disease within the broad spectrum of occupational dermatoses, that also include skin cancers, skin infections and "scleroderma like disease." The scientific literature has long noted an increase in dermatological disease in the construction industry. MATERIALS AND METHODS: retrospective evaluation (2003-2011), in a group of construction workers followed by the 'Territorial Joint Committee of Bergamo', of the prevalence of allergic and irritant contact dermatitis. DISCUSSION AND CONCLUSIONS: The following report confirms the literature data and reaffirms the need for a careful medical surveillance, as a result of a strict cooperation between the different professionals involved (company physicians, dermatologists/allergists, family physicians).

Morphological and molecular characterization of healthy human ascending aorta.

Knowledge of the characteristics of the normal human aorta has been constrained by lack of data on fresh aortic tissue, especially from healthy individuals. In this study, the gene expression and morphological characteristics of the thoracic ascending aorta (AA) of healthy organ donors have been evaluated, with the aim of providing reference data for the analysis of pathological AAs. We analysed by RT-PCR the differential expression of mRNAs coding for myocardin, smoothelin, alpha-smooth muscle actin (alpha-SMA) and the ED-A isoform of fibronectin (ED-A FN) in AA specimens from donors, integrating the results with immunohistochemical analysis of the same targets. Morphological and morphometric characteristics of the AAs were also evaluated. In order to account for possible regional variations in wall structure, the convexity of the aortic profile was compared to the concavity. No differences in gene expression occurred for any of the target genes between the concavity and the convexity of AAs. Immunohistochemistry revealed a different distribution of total FN and of its ED-A isoform in the media and in the intima. Smoothelin is expressed by the majority of cells in the media, with some positive cells also in the intima. Alpha-SMA is expressed in all the tunicae. Immunohistochemistry also revealed in the convexity of 50% of AAs the presence of discrete areas in the subadventital media with altered structure and cell morphology and with altered gene expression, resulting positive for ED-A FN and alpha-SMA, but not for smoothelin, indicating the occurrence of early lesions also in macroscopically healthy AAs.

[The Bergamo experience of health surveillance in the bakery sector]. / L'esperienza bergamasca di Sorveglianza Sanitaria nel settore della panificazione.

The purpose of this study is to analyse the various risk factors present in the artisan and semi industrial bread making technological cycle as well as verify the kind of illnesses and ailments encountered amongst the workforce. The objective being to identify a preventive action programme together with the necessary Health support measures. Our case study, drew upon a sample of 428 workers (252 bread makers and 176 sales staff). Each of them was asked to complete a questionnaire about the production process, the kind of exposure to wheat flour particles, smoking habits, present or past common allergy pathologies, the symptoms connected to the work, both in the allergic and osteomuscular field. Those positive respondents were subjected to various medical tests so as to ascertain a definitive diagnosis of their ailments. As was easy to predict, the most common pathology (ailment), found amongst bread makers, related to the respiratory system--16.7% of the population. In particular, 7.5% was affected by eye rhinitis, 2.8% by allergic bronchial asthma, 3.2% indicated a mix between rhinitis and bronchial asthma and 3.2% by BPCO. Skin ailments affected 2% of workers and WMSDs more than 2.8%.

[Carpal tunnel syndrome in handicraft planning]. / La sindrome del tunnel carpale nella panificazione artigianale.

The purpose of this study is to assess the prevalence of carpal tunnel syndrome (CTS) in a group of bakers and to evaluate the presence of a biomechanical risk for upper limbs in the technological cycle. Health assessment (history, clinical examination, upper limbs electromyography) and risk evaluation through Check List OCRA (Occupational Repetitive Actions - Colombini / Occhipinti) have confirmed the initial hypothesis, placing this profession between those at risk for carpal tunnel syndrome.

[Differences in the prevalence of work related disorders among construction workers between the end of 90s and 2006]. / Differenze nella prevalenza di malattie professionali in edilizia tra la fine degli anni '90 ed il 2006.

The aim of this work is to analyse the prevalence of occupational diseases in construction industry, comparing the results of the first years of health surveillance (1996-2000) and today's situation. We compare the prevalence of occupational diseases observed in 1348 workers during the period 1996-2000 (mean age 36,4 years, DS 11,8; mean experience in construction industry 16,9 years, DS 12,3) and the one observed in 795 different workers during 2006 (mean age 38,8 years, DS 11,1; mean experience in construction industry 18 years, DS 16,6). The prevalence of occupational diseases is respectively 12.09% and 12.83%. But analysing the single pathology it's possible to observe important differences between the two groups. In the workers observed in 2006 there is a significant reduction in prevalence of hearing loss caused by chronic exposure to noise and in prevalence of vascular disease caused by hand-arm vibrations: respectively from 94,9 to 79,2 cases/1000 workers and from 6,7 to 2.6 cases/1000 workers. Musculoskeletal diseases instead are increased from 11,1 to 37,7 cases/1000 workers, showing more attention to the problem, better diagnostics ability and more recognition by public insurance agency for occupational diseases.

[Efficacy of periodic health surveillance of construction workers visited at the CPT of Bergamo]. / Considerazioni sull'efficacia della sorveglianza sanitaria periodica di lavoratori edili visitati presso il CPT di Bergamo.

The aim of this work is to expose the results obtained with the application of a model about efficacy in occupational medicine proposed by ALMLII. In particular we discuss the validity of some indicators of efficacy used in a large group of construction workers during health surveillance, in order to verify effectiveness and appropriateness of an occupational medicine service, as a part of the whole prevention and safety system.

Evaluation of IFNalpha bioavailability by MxA mRNA in HCV patients.

Previously, we have reported the development of a new quantitative-competitive polymerase chain reaction (qc-PCR) method to evaluate interferon-beta (IFNbeta) bioavailability in multiple sclerosis (MS) patients, by measuring mRNA of mixovirus resistance protein A (MxA). Here we show that our assay is also able to assess IFNalpha bioavailability in hepatitis C virus (HCV) patients treated with different IFNalpha regimens. Indeed, our method was able to detect a slight constitutive expression of MxA mRNA in untreated HCV patients (median=70 fgMxA/pgGAPDH) and a significant induction 12 h after the first IFNalpha administration (median=750 fgMxA/pgGAPDH).