Annali dell'Istituto Superiore di Sanità
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Gender differences in cardiac hypertrophic remodeling
Get PDFCardiac remodeling is a complex process that occurs in response to different types of cardiac injury such as ischemia and hypertension, and that involves cardiomyocytes, fibroblasts, vascular smooth muscle cells, vascular endothelial cells, and inflammatory cells. The end result is cardiomyocyte hypertrophy, fibrosis, inflammation, vascular, and electrophysiological remodeling. This paper reviews a large number of studies on the influence of gender on pathological cardiac remodeling and shows how sex differences result in different clinical outcomes and therapeutic responses, with males which generally develop greater cardiac remodeling responses than females. Although estrogens appear to have an important role in attenuating adverse cardiac remodeling, the mechanisms through which gender modulates myocardial remodeling remain to be identified
Gender differences in pain and its relief
Get PDFThere is much evidence to suggest that gender is an important factor in the modulation of pain. Literature data strongly suggest that men and women differ in their responses to pain: they are more variable in women than men, with increased pain sensitivity and many more painful diseases commonly reported among women. Gender differences in pharmacological therapy and non-pharmacological pain interventions have also been reported, but these effects appear to depend on the treatment type and characteristics. It is becoming very evident that gender differences in pain and its relief arise from an interaction of genetic, anatomical, physiological, neuronal, hormonal, psychological and social factors which modulate pain differently in the sexes. Experimental data indicate that both a different modulation of the endogenous opioid system and sex hormones are factors influencing pain sensitivity in males and females. This brief review will examine the literature on sex differences in experimental and clinical pain, focusing on several biological mechanisms implicated in the observed gender-related differences.
Sex-related biomarkers in cardiovascular and neurodegenerative disorders
Get PDFDespite considerable advances in the treatment of human inflammatory diseases, such as cardiovascular and neurological disorders, they remain the leading cause of death in developed countries. From a clinical perspective, an active area of investigation focuses on the identification of diagnostic and prognostic biomarkers, because preventing events in those at risk of chronic inflammatory disease is likely to have a substantial impact on the overall public-health burden. The sex difference has not been considered previously as important in the evaluation of biomarkers of human diseases, twithstanding it is now ascertained that the severity of these disorders is correlated with sex hormones which modulate the inflammatory response. The aim of the present brief review is to report and comment the state of art regarding the sex-related biomarkers in cardiovascular and neurodegenerative disorders, focusing on those compounds showing potential prognosticand diagnostic values, and/or acting as indicators of the therapeutic treatment efficacy
Monitoring and managing mental health in the wake of Ebola
Get PDFInfectious disease continues to have dramatic effects on morbidity and mortality around the world. Few events could cause such loss of life and damage to livelihoods. As witnessed with the recent West African Ebola outbreak, raising alerts and identifying the outbreak in the community took too long. As a consequence local health systems were quickly overwhelmed. In addition, response at the international level proved slow and poorly coordinated. Rapid diagnostics, effective therapeutics, protective equipment, and a vaccine were all lacking. The crisis was however ultimately halted, thanks to a massive deployment of international resources in combination with the bravery and compassion of the medical staff, scientists, healthcare and aid workers on the ground. Despite this triumph, the lingering psychological sequalae of Ebola remain a significant public health challenge. The importance of mental health service delivery and policy implementation in addition to public health funding resources will prove integral in tackling this issue in the long run. With this in mind, adopting a political ecology approach towards health and disease will be crucial in order to depathologize the clinically significant mental distress related to Ebola
Global and Mediterranean climate change: a short summary
No full textObserved changes at the global scale. An increase of the annual mean global temperature and changes of other climate parameters have been observed in the last century. The global temperature and the atmospheric concentration of greenhouse gases are changing at a very fast pace compared to those found in palaeoclimate records. Changes in the Mediterranean. Variations of some climate change indicators can be much larger at the local than at the global scale, and the Mediterranean has been indicated among the regions most sensitive to climate change, also due to the increasing anthropogenic pressure. Model projections for the Mediterranean foresee further warming, droughts, and long-lasting modifications. Impacts. Regional climate changes impact health and ecosystems, creating new risks, determined not only by weather events, but also by changing exposures and vulnerabilities. These issues, and in particular those regarding occupational safety, have not been sufficiently addressed to date
Climate change, vector-borne diseases and working population
Get PDFIntroduction. Risks associated with climate change are increasing worldwide and the global effects include altered weather and precipitation patterns, rising temperatures and others; human health can be affected directly and indirectly. This paper is an overview of literature regarding climate changes, their interaction with vector-borne diseases and impact on working population. Materials and methods. Articles regarding climate changes as drivers of vector-borne diseases and evidences of occupational cases have been picked up by public databank. Technical documents were also included in the study. Results. Evidences regarding the impact of climate changes on vector-borne diseases in Europe, provided by the analysis of the literature, are presented. Discussion. Climate-sensitive vector-borne diseases are likely to be emerging due to climate modifications, with impacts on public and occupational health. However, other environmental and anthropogenic drivers such as increasing travelling and trade, deforestation and reforestation, altered land use and urbanization can influence their spread. Further studies are necessary to better understand the phenomenon and implementation of adaptation strategies to protect human health should be accelerated and strengthened
Climate change: the potential impact on occupational exposure to pesticides
Get PDFObjective. This study investigates the possible influence of global climate change (GCC) on exposure to plant protection products (PPP) in the workplace. Methods. The paper has evaluated the main potential relationships between GCC and occupational exposure to pesticides, by highlighting how global warming might affect their future use and by reviewing its possible consequence on workers’ exposure. Results. Global warming, influencing the spatial and temporal distribution and proliferation of weeds, the impact of already present insect pests and pathogens and the introduction of new infesting species, could cause a changed use of pesticides in terms of higher amounts, doses and types of products applied, so influencing the human exposure to them during agricultural activities. GCC, in particular heat waves, may also potentially have impact on workers’ susceptibility to pesticides absorption. Conclusions. Prevention policies of health in the workplace must be ready to address new risks from occupational exposure to pesticide, presumably different from current risks, since an increased use may be expected
Mild cognitive impairment, from theory to practical intervention: “Camminando e leggendo … ricordo” (Walking and reading... I remember), an action plan. The Treviso Dementia (TREDEM) Registry
Get PDFDementia is one of the most disabling health conditions in older people. Increasing attention is paid to the preclinical phase of dementia and to the prevention programs to reduce the number of patients in the future. Aims of the current study are: a) to elucidate the relationships between the concepts of Mild Cognitive Impairment (MCI), and Cognitive Frailty (CF), in the light of the more recent literature and b) to present a model, called "Camminando e leggendo…ricordo" (CLR), as a practical experience of secondary prevention aimed at MCI older people.The CLR model is composed of a program of physical and reading activities in group to promote healthy lifestyles. Here we present a protocol to evaluate the effectiveness of our intervention model. A multidimensional geriatric assessment will be carried out. A questionnaire for the detection of frailty, disability and for the adherence to the Mediterranean diet will be administered. The Psychological General Well-Being Index (PGWBI) will be used to assess the quality of life.CLR is an intervention model for secondary prevention in MCI subjects. It is the description of a practical proposal aimed at improving lifestyles and reducing the risk of dementia.
Job stress models for predicting burnout syndrome: a review
Get PDFIn Europe, the Council Directive 89/391 for improvement of workers’ safety and health has emphasized the importance of addressing all occupational risk factors, and hence also psychosocial and organizational risk factors. Nevertheless, the construct of “work-related stress” elaborated from Eu-OSHA is not totally corresponding with the “psychosocial” risk, that is a broader category of risk, comprising various and different psychosocial risk factors. The term “Burnout”, without any binding definition, tries to integrate symptoms as well as cause of the burnout process. In Europe, the most important methods developed for the work related stress risk assessment are based on the Cox’s transactional model of job stress. Nevertheless, there are more specific models for predicting burnout syndrome. This literature review provides an overview of job burnout, highlighting the most important models of job burnout, such as the “Job Strain”, the “Effort/Reward Imbalance” and the “Job Demands-Resources” models. The difference between these models and the Cox’s model of job stress is explored.
Humanisation and soft qualities in emergency rooms
Get PDFScenario. Currently, there are few evaluation methods that analyse social aspects in healthcare issues, especially humanisation and well-being, as perceived by users in emergency departments which are places in which patients’ psycho-physical well-being is decisive. For this reason, research was conducted to create a tool to improve the quality of these areas. Methodology. In order to conduct the research, the work was structured in three phases: the first, based on the analysis of State-of-the-Art and the current studies on the interactions established between the physical and emotional conditions of the structure and the users; the second, through the definition of a questionnaire which explores humanisation and comfort aspects; the third, through the application of the instrument. Results. The paper presents and analyses data collected from the application on a case study in Milan, analysing the responses and proposing design suggestions for increasing the quality of emergency environments. Conclusions. In anticipation of future works, the application of such a tool can provide the opportunity to improve and enhance quality and staff efficiency in emergency departmentspaces