943 research outputs found
[A cohort study on mortality and morbidity in the area of Taranto, Southern Italy].
No full textIntroduction: the area of Taranto has been investigated in several environmental and epidemiological studies due to the presence of many industrial plants and shipyards. Results from many studies showed excesses of mortality and cancer incidence for the entire city of Taranto, but there are no studies for different geographical areas of the city that take into account the important confounding effect of socioeconomic position. Objective: to assess mortality and hospitalization rates of residents in Taranto, Statte and Massafra through a cohort study, with a particular focus on residents in the districts closest to the industrial complex, taking into account the socioeconomic position. Methods: a cohort of residents during the period 1998-2010 was enrolled. Individual follow-up for assessment of vital status at 31.01.2010 was performed using municipality data. The census-tract socioeconomic position level and the district of residence were assigned to each participant, on the basis of the geocoded addresses at the beginning of the follow-up. Standardized cause specific mortality/morbidity rates, adjusted for age, were calculated by gender and districts of residence. Mortality and morbidity Hazard Ratios (HR, CI95%) were calculated by districts and socioeconomic position using Cox models. All models were adjusted for age and calendar period, and were done separately for men and women. Results: 321.356 people were enrolled in the cohort (48.9% males). Mortality/morbidity risks for natural cause, cancers, cardiovascular and respiratory diseases were found to be higher in low socioeconomic position groups compared to high ones. The analyses by districts have shown several excess mortality/morbidity risks for residents in Tamburi (Tamburi, Isola, Porta Napoli and Lido Azzurro), Borgo, Paolo VI and the municipality of Statte. Conclusions: The results of this study showed a significant relationship between socioeconomic position and health status of people resident in Taranto. People living in the districts closest to the industrial zone have higher mortality/morbidity levels compared to the rest of the area also taking into account the socioeconomic position
Respiratory symptoms in children living near busy roads and their relationship to vehicular traffic: results of an Italian multicenter study (SIDRIA 2).
No full textBACKGROUND: Epidemiological studies have provided evidence that exposure to vehicular traffic increases the prevalence of respiratory symptoms and may exacerbate pre-existing asthma in children. Self-reported exposure to road traffic has been questioned as a reliable measurement of exposure to air pollutants. The aim of this study was to investigate whether there were specific effects of cars and trucks traffic on current asthma symptoms (i.e. wheezing) and cough or phlegm, and to examine the validity of self-reported traffic exposure. METHODS: The survey was conducted in 2002 in 12 centers in Northern, Center and Southern Italy, different in size, climate, latitude and level of urbanization. Standardized questionnaires filled in by parents were used to collect information on health outcomes and exposure to traffic among 33,632 6-7 and 13-14 years old children and adolescents. Three questions on traffic exposure were asked: the traffic in the zone of residence, the frequency of truck and of car traffic in the street of residence. The presence of a possible response bias for the self-reported traffic was evaluated using external validation (comparison with measurements of traffic flow in the city of Turin) and internal validations (matching by census block, in the cities of Turin, Milan and Rome). RESULTS: Overall traffic density was weakly associated with asthma symptoms but there was a stronger association with cough or phlegm (high traffic density OR = 1.24; 95% CI: 1.04, 1.49). Car and truck traffic were independently associated with cough or phlegm. The results of the external validation did not support the existence of a reporting bias for the observed associations, for all the self-reported traffic indicators examined. The internal validations showed that the observed association between traffic density in the zone of residence and respiratory symptoms did not appear to be explained by an over reporting of traffic by parents of symptomatic subjects. CONCLUSION: Children living in zones with intense traffic are at higher risk for respiratory effects. Since population characteristics are specific, the results of validation of studies on self-reported traffic exposure can not be generalized
Strong current response to slow modulation: A metabolic case-study
No full textWe study the current response to periodic driving of a crucial biochemical reaction network, namely, substrate inhibition. We focus on the conversion rate of substrate into product under time-varying metabolic conditions, modeled by a periodic modulation of the product concentration. We find that the system exhibits a strong nonlinear response to small driving frequencies both for the mean time-averaged current and for the fluctuations. For the first, we obtain an analytic formula by coarse-graining the original model to a solvable one. The result is nonperturbative in the modulation amplitude and frequency. We then refine the picture by studying the stochastic dynamics of the full system using a large deviation approach that allows us to show the resonant effect at the level of the time-averaged variance and signal-to-noise ratio. Finally, we discuss how this nonequilibrium effect may play a role in metabolic and synthetic networks
Short-term exposure to PM2.5 and risk of venous thromboembolism. A case-crossover study
No full textBackground: Short-term exposure to air pollution increases the risk of cardiovascular mortality and morbidity but little evidence is available on pollution effects on venous thromboembolism (VTE), a common vascular disease. Methods: We conducted a case-crossover analysis of all urgent hospitalizations for deep vein thrombosis (DVT) or pulmonary embolism (PE) among patients >35 years during the period 2006 to 2017 in Rome (Italy). We examined whether 1) short-term exposure to particulate matter with aerodynamic diameter <2.5 μg (PM2.5) increases the risk of hospitalization for DVT or PE, and 2) if the associations are modified by the period of the year (warm and cold seasons), sex, age and comorbidity. Results: We found that short-term exposure to PM2.5 was associated with an increase of PE hospitalization risk of during the warm season (April to September) of 19.6% (95% confidence intervals: 8.3, 31%) per 10 μg/m3, while no statistically significant effects were displayed during the cold season or the whole year or for DVT hospitalizations. The effect of PM2.5 remained significant (%change: 21.3; 95%CI: 5.4, 39.5) after adjustment for nitrogen dioxide (NO2) co-exposure (a marker of traffic sources) and when limiting to primary diagnosis of PE (%change: 19.1; 95%CI: 4.2, 36.1). Age, sex and comorbid conditions did not modify the association. Conclusions: Our results suggested a positive association between short-term exposure to PM2.5 and pulmonary embolism during the warm period of the year while no evidence emerged for deep vein thrombosis
Analgo-sedazione con sufentanil in terapia intensiva:esperienza di un gruppo di studio italiano
No full textA prospective, randomized, clinical trial on the effects of a valveless trocar on respiratory mechanics during robotic radical cystectomy: A pilot study
No full textBACKGROUND: Prolonged pneumoperitoneum and Trendelenburg positioning for robot-assisted radical cystectomy (RARC) are essential for optimizing visualization of the operative field, although they worsen hemodynamic and respiratory function. Our hypothesis is that the use of a valveless trocar (VT) may improve respiratory mechanics. METHODS: In this prospective, 2-arm parallel trial, patients ASA II to III undergoing RARC were randomly assigned into 2 groups: In the VT group, the capnoperitoneum was maintained with a VT; in the control group, the capnoperitoneum was maintained with a standard trocar (ST group). Inspiratory plateau pressure (Pplat), static compliance (Cstat), minute volume (MV), tidal volume (Vt), and carbon dioxide (CO 2) elimination rate were recorded at these times: 15 minutes after anesthesia induction (T0), 10 minutes (T1) and 60 minutes (T2) after first robot docking, 10 minutes before first undocking (T3), 10 minutes (T4) and 60 minutes (T5) after second docking, 10 minutes before second undocking (T6), and 10 minutes before extubation (T7). The primary end point of the study was the assessment of Pplat mean value from T1 to T6. RESULTS: A total of 56 patients were evaluated: 28 patients in the VT group and 28 in the ST group. VT group had lower Pplat (means and standard error, VT group 30 [0.66] versus ST group 34 [0.66] cm H 2 O, with estimated mean difference and 95% confidence interval, -4.1 [-5.9 to -2.2], P <.01), lower MV (means and standard error, VT group 8.2 [0.22] versus ST group 9.8 [0.21] L min -1, P <.01), lower CO 2 elimination rate (means and standard error, VT group 4.2 [0.25] versus ST group 5.4 [0.24] mL kg -1 min -1, P <.01), lower end-tidal CO 2 (etco 2) (means and standard error, VT group 28.8 [0.48] versus ST group 31.3 [0.46] mm Hg, P <.01), and higher Cstat (means and standard error, VT group 26 [0.9] versus ST group 22.1 [0.9] mL cm H 2 O -1, P <.01). Both groups had similar Vt (P =.24). CONCLUSIONS: During RARC, use of a VT was associated with a significantly lower Pplat and improvement in other respiratory parameters
Improved transmutation of elements in Pd-D systems processed by an UV laser
No full textG. C. Righini and M. A. Forastiere Eds
Assessing short-term impact of PM10 on mortality using a semiparametric generalized propensity score approach
No full textBackground: The shape of the exposure-response curve describing the effects of air pollution on population health has crucial regulatory implications, and it is important in assessing causal impacts of hypothetical policies of air pollution reduction.
Methods: After having reformulated the problem of assessing the short-term impact of air pollution on health within the potential outcome approach to causal inference, we developed a method based on the generalized propensity score (GPS) to estimate the average dose-response function (aDRF) and quantify attributable deaths under different counterfactual scenarios of air pollution reduction. We applied the proposed approach to assess the impact of airborne particles with a diameter less than or equal to 10 μm (PM10) on deaths from natural, cardiovascular and respiratory causes in the city of Milan, Italy (2003-2006).
Results: As opposed to what is commonly assumed, the estimated aDRFs were not linear, being steeper for low-moderate values of exposure. In the case of natural mortality, the curve became flatter for higher levels; this behavior was less pronounced for cause-specific mortality. The effect was larger in days characterized by higher temperature. According to the curves, we estimated that a hypothetical intervention able to set the daily exposure levels exceeding 40 μg/m3 to exactly 40 would have avoided 1157 deaths (90%CI: 689, 1645) in the whole study period, 312 of which for respiratory causes and 771 for cardiovascular causes. These impacts were higher than those obtained previously from regression-based methods.
Conclusion: This novel method based on the GPS allowed estimating the average dose-response function and calculating attributable deaths, without requiring strong assumptions about the shape of the relationship. Its potential as a tool for investigating effect modification by temperature and its use in other environmental epidemiology contexts deserve further investigation
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