Procjena ometanja funkcije mišića pronatora u sindromu profesionalnog oštećenja karpalnog tunela s pomoću elektromiografije i ultrazvuka

Normal flexion of the fingers involves an involuntary contraction of the pronator and lumbrical muscle. In individuals whose profession involves constant flexing of the fingers those muscles become hypertrophied, impinging on the carpal tunnel. The narrowing of the carpal tunnel yields well to ultrasonography. The objective of this investigation was to find an ultrasonographic index of occupational carpal tunnel syndrome. Thus »Index M« denotes the variation obtained in the »M Space« before and after flexion-extension of the fingers. The study included 45 subjects performing tasks which involved the risk of cumulative trauma disorders. The subjects were tested using the electromyography and ultrasonography. The method was based on relation between the decrease in conduction of the median nerve measured by electromyography and the ultrasonographically measured variation of »M Space« in terms of sensitivity and specificity. The sensitivity of ultrasonography was 85%, as it confirmed the pathologic findings determined by electromyography (»M Index« positive) in twenty-two out of 26 hands, but the specificity was not statistically significant. Ultrasonography seems to have found very important application as a screening technique in occupational medicine. It is non-invasive, sensitive, easily repeated, and costs little.Normalna fleksija prstiju uključuje i nekontroliranu kontrakciju pronatora i lumbrikalnog mišića. U osoba čija profesija uključuje opetovano stiskanje prstiju ovi mišići hipertrofiraju i blokiraju karpalni tunel. Sužavanje karpalnog tunela može se utvrditi ultrazvukom. Svrha je ovog rada bila utvrditi objektivni indeks sindroma karpalnog tunela s pomoću ultra zvuka. Tako »Indeks M« označuje varijacije u ultra zvučno-anatomskom »M prostoru« prije i nakon fleksije i ekstenzije prstiju. U istraživanje je uključeno 45 ispitanika koji su obavljali rizični posao što može dovesti do kumulativnih traumatskih poremećenja. Ispitanici su testirani elektromiografski i ultrazvučno. Metoda se zasniva na odnosu između smanjenja brzine provođenja impulsa nervusa medianusa elektromiografski. Ultrazvučno je mjerena varijacija »M-prostora« u smislu utvrđivanja osjetljivosti i specifičnosti. Od 26 patoloških elektromiografskih nalaza ultrazvučno je patološki nalaz potvrđen u 22 ruke. Čini se stoga da ultrazvuk ima vrlo važno mjesto u izdvajanju mogućih bolesnika u rizičnim skupinama, posebice stoga jer je neinvazivna, osjetljiva, ponovljiva i jeftina tehnika

Screening for Tuberculosis in Health Care Workers. Experience in an Italian Teaching Hospital

Health care workers (HCW) are particularly at risk of acquiring tuberculosis (TB), even in countries with low TB incidence. Therefore, TB screening in HCW is a useful prevention strategy in countries with both low and high TB incidence. Tuberculin skin test (TST) is widely used although it suffers of low specificity; on the contrary, the in vitro enzyme immunoassay tests (IGRA) show superior specificity and sensitivity but are more expensive. The present study reports the results of a three-year TB surveillance among HCW in a large teaching hospital in Rome, using TST (by standard Mantoux technique) and IGRA (by QuantiFERON-TB) as first- and second-level screening tests, respectively. Out of 2290 HCW enrolled, 141 (6.1%) had a positive TST; among them, 99 (70.2%) underwent the IGRA and 16 tested positive (16.1%). The frequency of HCW tested positive for TB seems not far from other experiences in low incidence countries. Our results confirm the higher specificity of IGRA, but, due to its higher cost, TST can be considered a good first level screening test, whose positive results should be further confirmed by IGRA before the patients undergo X-ray diagnosis and/or chemotherapy

Uporaba ultrazvuka u procjeni rizika od profesionalnog oboljenja donjeg dijela kralježnice

The aim of the study was to evaluate ultrasound tehnique in preemployment medical assessment of the risk for low-back pain. Volunteers for the study were recruited among agricultural workers employed in the »Agraria Department« of the University of Bologna, Italy. The group consisted of 90 subjects, 52 male and 38 female, aged 25 to 58 years. The subjects filled in a questionnaire on medical history of low-back pain and were examined using an ultrasonograph equipped with a high linear frequency probe (3.5 MHz). The oblique parasagittal diameter of the lumbar spinal canal was measured by transabdominal ultrasonic imaging in the lumbar (L4–L5) and lumbosacral (L5–S1) region. Individuals with significantly narrower canals (<14 mm) had an increased risk of low-back pain. The paper concludes that ultrasound imaging could become a valuable screening tool in industry, permitting selective job placement for workers at high risk for disorders of the back.Cilj je ovoga istraživanja bio ocijeniti vrijednost ultrazvuka kao sredstva za ocjenjivanje rizika od oboljenja donjeg dijela kralježnice prilikom pregleda za zaposlenje. Ispitano je 90 dobrovoljaca s Agrarnog odjela Sveučilišta u Bologni, od kojih 52 žene i 38 muškaraca u dobi između 25 i 58 godina. Ispitanici su popunili upitnik o anamnezi oboljenja donjeg dijela kralježnice te su pregledani s pomoću ultrazvuka s visokofrekventnom linearnom sondom (3,5 MHz). Promjer kanala leđne moždine mjeren je s pomoću transabdominalne primjene ultrazvuka u lumbalnom (L4–L5) i lumbosakralnom (L5–S1) području. Osobe sa značajnim suženjem kanala leđne moždine (<14 mm) pokazivale su povećani rizik od oboljenja donjeg dijela kralježnice. Autori zaključuju da ultrazvučna dijagnostika može biti vrlo korisna za provjeru radne sposobnosti u proizvodnji, omogućujući selektivan pristup raspoređivanju radne snage s visokim rizikom od smetnji u leđima

Healthcare Associated Infections. educational intervention by "Adult Learning" in an Italian teaching hospital

An educational intervention for HAI prevention based on a combination of training, motivation and subsequent application in the current clinical practice in an Italian teaching hospital

Taxonomic Analysis of Oral Microbiome during Orthodontic Treatment

Background: Orthodontic appliances induce significant changes in the oral microbiome, but this shift in microbial composition has not been well established by the available evidence yet. Objectives: To perform a systematic review of existing literature in order to assess the taxonomic microbial changes in orthodontic patients during Fixed Appliance Treatment (FAT) and Clear Aligner Treatment (CAT), using next-generation sequencing (NGS) technique of the bacterial 16S rRNA gene. Search Methods and Selection Criteria. The search for articles was carried out in PubMed, including articles published in English until May 2021. They included every human study report potentially relevant to the review. Data Collection and Analysis. After duplicate study selection and data extraction procedures according to the PICOS scheme, the methodological quality of the included papers was assessed by the Swedish Council on Technology Assessment in Health Care Criteria for Grading Assessed Studies (SBU) method. Results: The initial search identified 393 articles, 74 of which were selected by title and abstract. After full-text reading, six articles were selected according to inclusion criteria. The evidence quality for all the studies was moderate. Conclusions: Orthodontic treatment seems to transiently affect the composition of subgingival microbiome, although not salivary, maintaining a stable microbial diversity. Different results were found in the shift of microbiome between plaque and saliva, depending on the type of orthodontic treatment. This review should be interpreted with some caution because of the number, quality, and heterogeneity of the included studies

A Grapevine TTG2-Like WRKY Transcription Factor Is Involved in Regulating Vacuolar Transport and Flavonoid Biosynthesis

open7noA small set of TTG2-like homolog proteins from different species belonging to the WRKY family of transcription factors were shown to share a similar mechanism of action and to control partially conserved biochemical/developmental processes in their native species. In particular, by activating P-ATPases residing on the tonoplast, PH3 from Petunia hybrida promotes vacuolar acidification in petal epidermal cells whereas TTG2 from Arabidopsis thaliana enables the accumulation of proanthocyanidins in the seed coat. In this work we functionally characterized VvWRKY26 identified as the closest grapevine homolog of PhPH3 and AtTTG2. When constitutively expressed in petunia ph3 mutant, VvWRKY26 can fulfill the PH3 function in the regulation of vacuolar pH and restores the wild type pigmentation phenotype. By a global correlation analysis of gene expression and by transient over-expression in Vitis vinifera, we showed transcriptomic relationships of VvWRKY26 with many genes related to vacuolar acidification and transport in grapevine. Moreover, our results indicate an involvement in flavonoid pathway possibly restricted to the control of proanthocyanidin biosynthesis that is consistent with its expression pattern in grape berry tissues. Overall, the results show that, in addition to regulative mechanisms and biological roles shared with TTG2-like orthologs, VvWRKY26 can play roles in fleshy fruit development that have not been previously reported in studies from dry fruit species. This study paves the way toward the comprehension of the regulatory network controlling vacuolar acidification and flavonoid accumulation mechanisms that contribute to the final berry quality traits in grapevine.openAmato, Alessandra; Cavallini, Erika; Zenoni, Sara; Finezzo, Laura; Begheldo, Maura; Ruperti, Benedetto; Tornielli, Giovanni BattistaAmato, Alessandra; Cavallini, Erika; Zenoni, Sara; Finezzo, Laura; Begheldo, Maura; Ruperti, Benedetto; Tornielli, Giovanni Battist

Bipolar disorder in late life: clinical characteristics in a sample of older adults admitted for manic episode

BACKGROUND: Although manic episodes in older adults are not rare, little published data exist on late-life manic episodes. Resistance to treatment and concomitant neurological lesions are frequent correlates of elderly mania. The aim of this study was to investigate the prevalence of hospitalizations due to mania in patients older than 64 years through a period of 5 years in an Italian public psychiatric ward. Moreover, we aimed at describing clinical presentation of elderly manic episodes. METHODS: A retrospective chart review was conducted in order to describe clinical presentation of 20 elderly patients hospitalized for manic episode; moreover, we compared age at onset, the presence of family history for mood disorders, psychosis and irritability between the elderly group and a matched group of 20 younger manic inpatients. RESULTS: Seven percent of the whole inpatient elderly people suffered from mania. Half of those patients had a mood disorder age at onset after 50 years and 5 patients were at their first manic episode. Geriatric- and adulthood mania showed similar clinical presentation but younger people had more frequently a mood disorders family history. CONCLUSION: Half of our older manic inpatients consisted of "classic" bipolar patients with an extension of clinical manifestations into later life; the other half of our sample was heterogeneous, even though it was not possible to identify clearly which patients may have had vascular lesions related to the onset of mania

Edwards INSPIRIS RESILIA Valve for Aortic Valve Replacement Achieves Acute Reverse Remodelling of the Left Ventricle and Maintains Excellent Hemodynamic Profile after 1 Year in Young Adults

Objective: Mechanical aortic valve replacement (AVR) is still the recommended valve substitute in young adults, although cultural reasons have popularized bioprostheses also in these patients. Inde..