[Metabolomic profiles of exhaled breath condensate of 39 nickel exposed workers]. / Profili metabolomici del condensato espiratorio di 39 lavoratori esposti a nichel.

Nickel compounds have proven lung carcinogenic effects and their processing involve a large amount of population. The aim of this study was to investigate the metabolomic profiles of Exhaled Breath Condensate (EBC) of a group of nickel exposed workers. Nickel in blood, urine and EBC of 39 workers (electroplaters) and 50 controls was measured. The 10 most nickel exposed workers were chosen for the analysis of EBC metabolomic profiles, matched to controls by gender and smoke habits. All the samples were analyzed using the HPLC-MS/MS system (High-Performance Liquid Chromatography/Mass Spectrometry). The profiles of the spectra obtained by the mass spectrometer (Orbitrap) analysis were processed using the MZmine 2.4 software. Nickel concentrations in EBC of the exposed workers were significantly higher compared to controls (1.39 microg/L; 0.039 microg/L, p = 0.017). The observation of the metabolomic profiles pointed out a significantly different response pattern between the exposed and the controls. This result was further studied by a subsequent processing with the XCMS program: an overexpression of 3 hypothetical substances in controls compared to exposed was detected. Although these data must be considered as preliminary, it has been observed that the mass-to-charge ratio of one of these substances may respond to the Phenylacethylglutamine (PAG) one, whose role in the control of cellular cycle is controversial and uncertain. Even if further studies to confirm these results are necessary, the analysis of the metabolomic profiles in the biological matrices is supposed to provide useful information both in the clinical and in the prevention fields.

[Chemical risk management in health care settings]. / Gestione del rischio chimico in ospedale.

The aim of this review is pointing out the most relevant allergic and chemical risk factors in health care settings. Some tables summarize the main sensitizing agents, the most frequent allergic diseases and examples of alternative gloves and materials currently available. Some suggestions, to evaluate the allergic risk related to specific tasks in the different hospital departments, are given in order to underline possible failures and to plan focused preventive actions. The chemical hazard has been valued on the basis of the current exposure, which is significantly improved due to structural and technological changes adopted in almost all hospitals. However there are still some critical points due to the use of particularly toxic substances and new molecules, whose health effects should be carefully evaluated, and to a more extensive use of techniques and procedures previously limited to a few work realities.

Fetal Doppler mechanical PR interval: correlation with fetal heart rate, gestational age and fetal sex.

OBJECTIVES: To establish normal fetal values for the mechanical PR interval by pulsed-wave Doppler at 16-36 weeks of gestation, and to evaluate the influence of fetal heart rate (FHR), gestational age (GA) and fetal sex. METHODS: Fetal mechanical PR intervals were evaluated prospectively by obstetric ultrasound examination. Healthy mothers with sonographically normal fetuses from singleton pregnancies were included. Mechanical PR intervals were measured from simultaneous mitral and aortic Doppler waveforms, from the onset of left atrial contraction (mitral A-wave) to the onset of left ventricular ejection (aortic pulse wave). Simple and multiple linear regression analyses were performed to examine the correlation between PR interval and GA, FHR and fetal sex. RESULTS: We evaluated 336 fetuses at 16-36 weeks. The mean +/- SD FHR was 143.4 +/- 8.3 beats per min (bpm). The PR intervals had a typical Gaussian distribution with a mean +/- SD of 122.4 +/- 10.3 ms. Robust linear regression showed that the PR increased by about 0.40 ms (95% CI, 0.22-0.58) per gestational week (P < 0.001), and this relationship remained after adjustment for FHR and fetal sex. PR intervals diminished by 1.4 (95% CI, 0.75 to 2.0) ms for each 5 bpm increase in FHR (P < 0.001), independently of GA and fetal sex. No fetal sex differences were observed. CONCLUSIONS: We provide normal fetal values for the mechanical PR interval at 16-36 weeks of gestation. Mechanical PR intervals in normal fetuses are influenced by GA and FHR independently, and both variables should be taken into account when evaluating fetuses at risk for congenital heart block.

Three-dimensional analysis of pulmonary nodules by MSCT with Advanced Lung Analysis (ALA1) software.

PURPOSE: The purpose of this study was to test the reproducibility of the three-dimensional (3D) Advanced Lung Analysis software (3D-ALA, GE Healthcare) in the estimation of pulmonary nodule volume. MATERIALS AND METHODS: We retrospectively reviewed the unenhanced multislice CT scans (Lightspeed Pro 16 GE) of 77 patients with a solitary pulmonary nodule (n=71) or metastatic pulmonary disease (n=6). A total of 103 pulmonary nodules (19 well-circumscribed, 45 juxtavascular and 39 juxtapleural) were analysed grouped into five classes based on diameter: <5 mm, 10 nodules (9.7%); >or=5 to <10 mm, 25 nodules (24.2%); >or=10 mm to <15 mm, 41 nodules (39.8%); >or=5 to <18 mm, 14 nodules (13.6% ); >or=8 to <30 mm, 13 nodules (12.62%). The following acquisition parameters were used: slice thickness 0.625 mm, reconstruction interval 0.4 mm, pitch 0.562:1, 140 kV, 300 mAs, field of view 13 cm, bone kernel. For each of the 103 nodules three, 3D volume measurements were obtained by the 3D-ALA software. The reproducibility of nodule segmentation was evaluated according to a visual score (1=optimal, >or=95%; 2=fair, 90-95%; 3=poor, 0.05). CONCLUSIONS: Three-dimensional volume measurement with ALARiassunto 1 software is reproducible for all nodules as regards dimension and site. ALA-1 software provided a good and reproducible volume measurement in well-circumscribed and most juxtavascular nodules. Volumetric evaluation and reproducibility of volume estimation in juxtapleural pulmonary nodules, particularly those adjacent to diaphragmatic pleura, is inadequate, and software improvement is needed.

[Fever of unknown origin. A study of cases seen at the third level]. / Más allá de la fiebre de origen obscuro. Un estudio de casos atendidos en el tercer nivel.

Clinical records of 160 patients admitted with fever of unclear origin were reviewed. Of them, all cases with fever of obscure origin (FOO) were selected based on the following criteria: at least two weeks with fever, with an oral temperature of 37.5 degrees C or more during hospitalization and whose clinical history, physical examination, hemocytologic data, erithrosedimentation rate, urinalysis, febrile tests, glutamic-piruvic transaminase, chest and abdomen radiographies were not suggestive of any specific diagnosis. 32 cases of FOO were found, but only the 30 which had been studied previously in another hospital were considered for analysis. Of these 30 patients, 18 were men and 12 women, with a mean age of 36.3 (range 19-64). Infectious diseases caused 40 percent and neoplastic disease 27 percent of cases. The single most frequent cause was non-Hodgkin lymphoma in four cases, followed by tuberculosis and Hodgkin's disease in three patients each. In four cases the cause of fever was not identified. Eleven patients required exploratory laparotomy; in nine of them it was usefull for diagnosis. Our results show a high proportion of neoplastic diseases, probably related with patient's selection and with intrinsic diagnostic difficulty of these kind of diseases.