146 research outputs found
La gestione del paziente con vertigine acuta di recente insorgenza
No full textSimposio sulla gestione del paziente con vertigine acuta di recente insorgenza
Chemical risk to workers involved in the remediation of contaminated sites: conceptual model, fate and transport factors for risk evaluation
No full textIn Italy, the management of contaminated sites relies on a risk-based approach, where the actual pollution of the site is evaluated depending on the effective risk posed to the human health or environment. The main steps required for the application of risk assessment to contaminated sites are described in various technical documents such as those provided by the Italian environmental agency. The procedure outlined in these documents is based on the information collected during the contaminated site characterization, which are used to evaluate the potential effects on the health of exposed receptors and on the environment, allowing to assess whether a particular site requires remedial action and eventually the specific risk-based remediation goals. Namely, the risk is defined by using site-specific data concerning receptors, exposure potential, site hydrogeology and the type, amount, and toxicity of the chemicals of concern. Nevertheless, until recently, these directives and guidelines were lacking regarding the assessment of the potential exposure to contaminants for the workers involved in the site remediation activities. For this reason, in 2013 a team of experts in the fields of site remediation and of safety and health risks in workplaces, including the Authors of this work, issued a national guideline dealing with the operative instructions for the assessment and management of the chemical risk to workers involved in site remediation. This document addresses the main aspects related to the protection of workers exposed to contaminants considering both the toxic and the carcinogenic effects of chemicals . In this work, two issues addressed in the guideline are discussed: the construction of the conceptual site model (CSM), that includes the definition of the contamination source, the contaminants migration (migration pathways and fate and transport factors), the receptors (workers) and the exposure (e.g. ingestion, dermal contact, inhalation), and the equations used to estimate the risk for human health. The CSM typically used in the risk assessment of contaminated sites was properly modified adding the worker involved in clean-up activities. Differently to other human receptors, living or working in contaminated sites, the clean-up workers may be also exposed to higher concentration of contaminants due to soil excavation activities and to fugitive dust emissions that can be generated by construction vehicle traffic on temporary unpaved roads. Consequently, two new fate and transport factors were introduced for predicting the concentration of contaminants in air of volatile compounds resulting from soil resuspension and transport in the atmosphere occurring during the cleanup activities
Description and validation of Vehicular Emissions from Road Traffic (VERT) 1.0, an R-based framework for estimating road transport emissions from traffic flows
No full textVERT (Vehicular Emissions from Road Traffic) is an R package developed to estimate traffic emissions of a wide range of pollutants and greenhouse gases based on traffic estimates and vehicle fleet composition data, following the EMEP/EEA methodology. Compared to other tools available in the literature, VERT is characterised by its ease of use and rapid configuration, while it maintains great flexibility in user input. It is capable of estimating exhaust, non-exhaust, resuspension, and evaporative emissions and is designed to accommodate future updates of available emission factors. In this paper, case studies conducted at both urban and regional scales demonstrate VERT's ability to accurately assess transport emissions. In an urban setting, VERT is integrated with the Lagrangian dispersion model GRAMM–GRAL and provides NOx concentrations in line with observed trends at monitoring stations, especially near traffic hotspots. On a regional scale, VERT simulations provide emission estimates that are highly consistent with the reference inventories for the Emilia-Romagna region (Italy). These findings make VERT a valuable tool for air quality management and traffic emission scenario assessment
Fixed combination of cinnarizine and dimenhydrinate in the prophylactic therapy of vestibular migraine: an observational study
No full textVestibular migraine (VM) is one of the most frequent causes of episodic vertigo, with a lifetime prevalence of 0.98 %. Prophylactic therapy includes calcium channel blockers, beta-blockers, antiepileptic drugs and antidepressants. We studied the association of cinnarizine 20 mg and dimenhydrinate 40 mg (Arlevertan©) in a group of 22 patients affected by definite VM. Proposed therapy included one tablet twice a day for 1 month, which was repeated three times with 1 month of interval between drug intake; results were compared with those of a control group of 11 VM patients who asked to observe only lifestyle measures for migraine. The main outcome was the number of vertigo and headache crises in the 6 months before therapy and in the 6 months of follow-up. Subjects performing Arlevertan© presented during the 6 months of therapy a decrease of vertigo attacks from 5.3 to 2.1 and of headaches from 4.3 to 1.7 (p < 0.0001); 68 % of these subjects reported a decrease of at least 50 % of vertigo attacks, while 63 % of headaches. Conversely, vertigo attacks decreased from 3.5 to 2.2 and headaches from 2.6 to 2 in patients observing only lifestyle; 18 % of these subjects reported a decrease of at least 50 % of vertigo crises and 27 % of headaches. Our data do not differ from those of previous works assessing efficacy of different prophylactic therapies for VM and reporting consistent reduction of vertigo spells in a rate of patients ranging from 60 and 80 %
Vestibular function in HIV patients: Preliminary report
No full textScopo del lavoro è valutare in quale percentuale di pazienti HIVpositivi esistano segni strumentali di danno vestibolare perifericoed eventuale interessamento delle vie vestibolari centrali; aquesto scopo 30 pazienti sieropositivi (23 uomini e 7 donne), dietà compresa tra 26 e 68 anni, in Categoria A, B e C di infezionesecondo la classificazione CDC sono stati sottoposti ad esameElettronistagmografico con stimolazione termica secondoFreyss (125 cc. di acqua a 30 °C e 44 °C in 30 secondi). È statavalutata la VAFL (velocità angolare della fase lenta) come parametrodi funzionalità labirintica. Il 35,7% dei pazienti in classeA presentava segni di sofferenza vestibolare periferica; nelleclassi B e C tale percentuale resta costante ma aumentano i segniclinici di sofferenza vestibolare centrale. L’equilibrio è statovalutato utilizzando il Dynamic gait index (DGI) test. Il punteggiodel test è correlabile allo stadio dell’infezione; l’85,7Þi pazienti in classe A hanno ottenuto punteggi superiori a 21,mentre il 40% in classe C inferiori a 19Main purpose of this study was to evaluate vestibular function,focusing attention on percentage of peripheral damagein 30 HIV positive patients (23 male, 7 female), age range26-68 years, belonging to Categories A-C of CDC classificationof infection, underwent electronystagmographywith bithermic stimulation according to Freyss (125 cc ofwater at 30 °C and 44 °C in 30 sec). The angular velocityof slow phase was considered as the main value oflabirinthine functionality. Peripheral vestibular damage hasbeen found in 35.7% of Class A patients; a similarpercentage of peripheral signs was found in Classes B andC, where, on the contrary, increased central vestibular signswere observed. In order to evaluate equilibrium in thesepatients, a Dynamic Gait Index (DGI) test was performed.Scores were > 21 points in 85.7% of Class A patients anddecreased in Classes B and C
Cytokine gene expression in peripheral blood mononuclear cells (PBMC) from patients with pharmacologically treated cystic echinococcosis
No full textResidual dizziness after successful repositioning maneuvers for idiopathic benign paroxysmal positional vertigo.
No full textTo establish a possible causal factor for residual dizziness (RD) after successful repositioning maneuvers in patients with benign paroxysmal positional vertigo (BPPV).Ninety consecutive patients with idiopathic BPPV were treated with repositioning maneuvers, and the rate of RD was assessed as well as clinical data. Posturography and assessment of anxiety levels were performed on patients reporting RD. Results were compared with a control group of BPPV patients of the sample after repositioning maneuvers and without RD.Twenty-eight subjects (31.1\%) reported RD on the second day after successful repositioning maneuvers. The mean duration of RD was 11.6 ± 3.9 days. Patients with RD presented a higher duration of BPPV (14.1 vs. 10.9 days, p = 0.01). A correlation was demonstrated between the duration of BPPV and duration of RD (p < 0.01). Subjects with RD presented increased body sways, above all in eyes-closed conditions.RD is mainly correlated with duration of vertigo in BPPV patients. Anxiety was demonstrated to play a role in increased body sways
Residual dizziness after successful repositioning maneuvers for idiopathic benign paroxysmal positional vertigo
No full textPostural control in patients after a recent vestibular neuritis with hyperhomocysteinemia
No full textTo assess the possible role of hyperhomocysteinemia(HyHcy) in delaying recovery after acute vestibularneuritis. In our retrospective study, 90 subjects wereevaluated within 7 days from the beginning of an acutevertigo. All subjects had high plasma levels of homocysteine(Hcy). 46 patients were treated with homocysteinelowering therapy and betahistine for 1 month, while 44subjects received only betahistine. Subjective symptomswere evaluated with the Dizziness Handicap Inventory(DHI) questionnaire, administered 7 days after the beginningof vertigo and again after 1 month. Moreover, posturalcontrol performed at 1 month’ control was studiedwith static stabilometry in a subgroup of 21 non-treated and20 treated patients. DHI total score decreased significantlymore in the subgroup of subjects treated with homocysteinelowering therapy. Moreover, posturographic data weresignificantly increased in non-treated compared with treatedsubjects. Our data support the possibility of a role ofHyHcy in preventing recovery after a recent vestibularneuritis. A microvascular disorder or the neurotoxic effectof HyHcy have been considered as possible causal factors.Although not conclusive, our data are not inconsistent withthe hypothesis of a poorer adaptation in patients withuntreated HyHcy
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