Steroid injection in chronic inflammatory vocal fold disorders, literature review

Os corticosteróides são potentes inibidores da inflamação e da cicatrização. Administração local de esteróides diretamente na laringe tem sido relatada em diversas patologias laríngeas. OBJETIVO: O objetivo desse estudo é realizar uma revisão da literatura sobre o uso de infiltração de corticosteróide em pregas vocais, em pacientes com patologias vocais benignas, inflamatórias e crônicas de laringe. METODOLOGIA: Realizou-se uma busca eletrônica na base de dados Medline, selecionando-se estudos clínicos que utilizavam corticosteróides em patologias benignas da laringe. RESULTADOS: Os corticosteróides são indicados nas seguintes situações: 1) doenças inflamatórias agudas, principalmente naquelas relacionadas a edema que comprometa a via aérea; 2) doenças auto-imunes com alterações laríngeas; 3) estenose laríngea; 4) em lesões benignas inflamatórias das pregas vocais, como nódulos, pólipos e edema de Reinke, para diminuir o processo inflamatório pré-cirúrgico ou na tentativa de se evitar uma intervenção cirúrgica; 5) em fonocirurgia, com o objetivo de reduzir a formação de cicatriz. Seu uso pode ser profilático, visando à prevenção da formação de cicatriz ou terapêutico em uma cicatriz já formada. CONCLUSÃO: Os corticosteróides podem ser considerados uma opção terapêutica importante no manejo de várias patologias, principalmente aquelas de origem inflamatória que causam alterações vocais.Steroids are potent inhibitors of inflammation and wound repair. Local administration of steroids directly into the larynx has been reported in many laryngeal diseases. AIM: The purpose of this study is to review related literature about the use of steroid injection in patients with benign, inflammatory and chronic vocal disease. METHODOLOGY: We performed an electronic survey in Medline database and selected clinical trials regarding steroid use in benign laryngeal diseases. RESULTS: Steroids are indicated in these situations: 1) acute inflammatory diseases, mainly when edema compromises the airways; 2) auto- immune disease with laryngeal involvement; 3) laryngeal stenosis; 4) benign lesions of the vocal folds, e.g., nodules, polyps and Reinke's edema, to reduce the inflammatory reactions before phonosurgery or in an attempt to avoid surgery; 5) In phonosurgery, aiming to reduce scarring. In this case, it could be used as a preventive measure in vocal fold scarring, or for scar treatment. CONCLUSION: Steroids may be considered an important therapeutic option in the management of many diseases, specially the inflammatory ones, associated with vocal changes

Monitor and sensors 2.0 for exposure assessment to airborne pollutants

In recent years, the issue of exposure assessment to airborne pollutants has become increasingly popular, both in the occupational and environmental fields. The increasingly stringent national and international air quality standards and exposure limit values both for indoor environments and occupational exposure limit values have been developed with the aim of protecting the health of the general population and workers. On the other hand, this requires a considerable and continuous development of the technologies used to monitor the concentrations of the pollutants to ensure the reliability of the exposure assessment studies. In this regard, one of the most interesting aspects is certainly the development of “new generation” instrumentation for monitoring airborne pollutants (“Next Generation Monitors and Sensors” – NGMS). The main purpose of this work is to analyze the state of the art regarding the afore-mentioned instrumentation, to be able to investigate any practical applications within exposure assessment studies. In this regard, a systematic review of the scientific literature was carried out using three different databases (Scopus, PubMed and Web of Knowledge) and the results were analyzed in terms of the objectives set out above. What emerged is the fact that the use of NGMSs is increasingly growing within the scientific community for exposure assessment studies applied to the occupational and environmental context. The investigated studies have emphasized that NGMSs cannot be considered, in terms of the reliability of the results, to be equal to the reference measurement tools and techniques (i.e., those defined in recognized methods used for regulatory purposes), but they can certainly be integrated into the internal exposure assessment studies to improve their spatial-temporal resolution. These tools have the potential to be easily adapted to different types of studies, are characterized by a small size, which allows them to be worn comfortably without affecting the normal activities of workers or citizens, and by a relatively low cost. Despite this, there is certainly a gap with respect to the reference instrumentation, regarding the measurement performance and quality of the data provided; the objective to be set, however, is not to replace the traditional instrumentation with NGMSs but to integrate and combine the two typologies of instruments to benefit from the strengths of both, therefore, the desirable future developments in this sense has been discussed in this work

Smart-working VS office work: how does personal exposure to different air pollutants change?

The COVID-19 pandemic is raging all over the world, with possible structural effects on the work: the smart-working (WFH -Working From Home) role is therefore emphasized by the fact that it could become a traditional way of working in many work sectors. Several scientific papers have recently analyzed the WFH phenomenon under different aspects, but scientific studies have not yet been conducted considering the differences between WFH and WFO (Working From Office), in terms of evaluation of personal exposure assessment to selected airborne pollutants. This study, therefore, aims to evaluate, using portable monitors, the differences in terms of personal exposure to selected airborne pollutants, during different working conditions (WFO vs WFH), over long periods of time (from days to weeks), extending the results to even longer periods (years), to adhere to the approach proposed by the concept of the exposome. The preliminary results of this study refer to three separate phases of the work (i) re-analyses of literature data via Monte Carlo simulation, and assessment of personal exposure to different air pollutants during different working conditions, during (ii) “long term” campaign and (iii) a “short term” monitoring campaign. During the two different measurement campaigns, portable instrumentation was used, because of the ability of these kinds of instruments to obtain data characterized by a high spatial and temperature resolution. The re-elaborations of the data obtained from the literature show how, under different conditions, the exposure concentrations to different PM fractions are statistically lower in WFH working conditions, compared to WFO conditions. These results are in contrast with the preliminary results obtained from exploratory monitoring (both for the “long term” and for the “short term” campaigns). The results obtained from these exploratory monitoring show that the WFH condition has a greater impact on the daily exposure of the monitored subjects, compared to the WFO condition

Epidemiological profile of laryngeal cancer in Hospital de Clínicas de Porto Alegre

OBJETIVO: O objetivo foi documentar a distribuição e o padrão de comportamento deste tumor entre os nossos pacientes. MATERIAIS E MÉTODOS: Foi realizado um estudo retrospectivo dos pacientes com diagnóstico de câncer de laringe atendidos no Hospital de Clínicas de Porto Alegre entre 1990 e 1996. RESULTADOS: Foram encontrados 242 casos, a maioria da raça branca (94,2%). A divisão por faixa etária mostrou um pico do ocorrência na sétima década de vida e a proporção de homens em relação à mulheres foi de 15:1. O tipo histológico mais comum foi carcinoma epidermóide (98,76%) e o sítio mais freqüentemente acometido foi a glote (44,7%), conseqüentemente, o sintoma mais comum na apresentação foi a disfonia (76,5%). Os pacientes com tumores na supraglote apresentaram, principalmente, disfagia e, aqueles com tumores transglóticos, dispnéia. Quanto ao estadiamento, 43,2% estavam no estágio IV no momento do diagnóstico. Os tumores localizados na supraglote estão relacionados com pior prognóstico, nesta amostra 38,3% dos pacientes com câncer na supraglote estavam no estágio IV, enquanto que a maioria dos tumores glóticos (74,2%) estavam no estágio I. A cirurgia total foi o tratamento mais realizado (50,7%). CONCLUSÃO: O diagnóstico do câncer de laringe no Hospital de Clínicas de Porto Alegre é feito, em sua maior parte, em estágio avançado, tornando o prognóstico desses pacientes bastante reservado.OBJECTIVES: The aim was to document the distribution and pattern of behavior of this tumor among our patients. MATERIALS AND METHODS: A retrospective study of patients with diagnosis of laryngeal cancer seen in the Hospital de Clínicas de Porto Alegre between 1990 to 1996 was carried out. RESULTS: There were 242 cases, the majority of whom were from the white race (94,2%). The peak incidence was in the seventh decade of life and male to female ratio was 15:1. The most common histological type was squamous cell carcinoma (98,76%) and by site, glottic involvement was the most frequent (44,7%), and so the most common symptom at presentation was hoarseness (76,5%). Supraglottic tumors presented, mainly, with dysphagia and the transglottics with dyspnea. As to staging, 43,3% were in IV stage at the diagnosis. The supraglottic tumors were, mainly, in the stage IV (38,3%), while the majority of glottic tumors (74,2%) were in the stage I, its reflect a worse prognosis for the supraglottic tumors. The total surgery was the most frequent treatment performed (50,7%). CONCLUSIONS: The laryngeal cancer diagnosis in the Hospital de Clínicas de Porto Alegre is done at a late stage, making the patient’s prognosis really reserved

An In-Field Assessment of the P.ALP Device in Four Different Real Working Conditions: A Performance Evaluation in Particulate Matter Monitoring

This study aimed to assess the performance, in terms of precision and accuracy, of a prototype (called “P.ALP”—Ph.D. Air Quality Low-cost Project) developed for monitoring PM2.5 concentration levels. Four prototypes were co-located with reference instrumentation in four different microenvironments simulating real-world and working conditions, namely (i) office, (ii) home, (iii) outdoor, and (iv) occupational environments. The devices were evaluated for a total of 20 monitoring days (approximately 168 h) under a wide range of PM2.5 concentrations. The performances of the prototypes (based on the light-scattering working principle) were tested through different statistical methods. After the data acquisition and data cleaning processes, a linear regression analysis was performed to assess the precision (by comparing all possible pairs of devices) and the accuracy (by comparing the prototypes against the reference instrumentation) of the P.ALP. Moreover, the United States Environmental Protection Agency (US EPA) criteria were applied to assess the possible usage of this instrumentation, and to evaluate the eventual error trends of the P.ALP in the data storage process, Bland–Altman plots were also adopted. The outcomes of this study underlined that the P.ALP performed differently depending on the microenvironment in which it was tested and, consequently, on the PM2.5 concentrations. The device can monitor PM2.5 variations with acceptable results, but the performance cannot be considered satisfactory at extremely low and remarkably high PM2.5 concentrations. Thanks to modular components and open-source software, the tested device has the potential to be customized and adapted to better fit specific study design needs, but it must be implemented with ad hoc calibration factors depending on the application before being used in field

Smart working in Italy: what aspects to consider in terms of health prevention and protection?

Agile (or remote) work has spread since the early 90s, but the adoption of this type of work hasn’t always been exploit ed to its full potential. Recently, this way of working has acquired greater importance: in response to the COVID-19 pandemic, to limit the number of infections, and consequent number of deaths and hospital admissions, many coun tries have adopted a wide spectrum of containment measures, such as encouraging (or oblige) people to work remote ly, whenever possible. Due to this containment measure, millions of workers around the world have been destined to work from home. Moreover, it would seem that this mode of working will stand out as a hybrid mode form, to ensure a better balance between office- and home-working. For this reason, the present work aims to highlight the main out comes from studies conducted in Italy, concerning the positive and negative effects of smart working, reporting the gaps relating to the assessments of the remote working environment. To achieve this goal, results (N: 9 scientific papers) obtained from a search query set for extraction of studies from a scientific literature database were analyzed. In addition to report the positive and negative effects of smart working, our research shows that the studies conducted in Italy regarding this way of working are still scarce and based only on the administration of a questionnaire (or on the conduction of an interview) to workers. No real assessments have been performed, in terms of workers’ safety and health, in the condition of working from home. An in depth analysis of the experience of employees involved in remote working conditions could be of particular interest in future studies, to maximize the positive aspects and reduce the risks of worsening the physical and psy chosocial well-being of employees. In fact, if smart working would become a common way of working as reported in the literature, it could have a significant impact on both organizations and employees and it should therefore be investigated in the best possible wa

The role of genetic factors in otitis media

É sabido que a otite média aguda pode ser causada por fatores ambientais, comofreqüentar creches, fumo passivo, curto período de amamentação e baixas condições sócio-eco-nômicas. A revisão das pesquisas recentes, contudo, sugere que fatores genéticos também contri-buem de forma significativa para a ocorrência da otite média aguda, recorrente e da otite médiacrônica, com efusão. Embora não existam estudos genéticos específicos, há consistentes evidên-cias em favor da transmissão genética de uma suscetibilidade para otite média. A história familiar,características raciais, a freqüência de antígenos HLA e de marcadores genéticos, entre outrosfatores, são algumas das evidências que serão apresentadas nesta revisão de literatura.It is well-known that otitis media can be caused by environmental factors, such asattending day care centers, passive smoking, early interruption of breast feeding, and unfavorablesocio-economic conditions. The review of current literature, however, suggests that genetic factorsalso contribute significantly to the occurrence of recurrent acute otitis media and otitis media witheffusion. Although there are no specific genetic studies, there is consistent evidence to support theidea of genetically transmitted susceptibility to otitis media. Family history, racial characteristics,HLA and genetic marker frequency are some of the topics discussed in the literature, which will bepresented in this review

Evolution and Applications of Recent Sensing Technology for Occupational Risk Assessment: A Rapid Review of the Literature

Over the last decade, technological advancements have been made available and applied in a wide range of applications in several work fields, ranging from personal to industrial enforcements. One of the emerging issues concerns occupational safety and health in the Fourth Industrial Revolution and, in more detail, it deals with how industrial hygienists could improve the risk-assessment process. A possible way to achieve these aims is the adoption of new exposure-monitoring tools. In this study, a systematic review of the up-to-date scientific literature has been performed to identify and discuss the most-used sensors that could be useful for occupational risk assessment, with the intent of highlighting their pros and cons. A total of 40 papers have been included in this manuscript. The results show that sensors able to investigate airborne pollutants (i.e., gaseous pollutants and particulate matter), environmental conditions, physical agents, and workers’ postures could be usefully adopted in the risk-assessment process, since they could report significant data without significantly interfering with the job activities of the investigated subjects. To date, there are only few “next-generation” monitors and sensors (NGMSs) that could be effectively used on the workplace to preserve human health. Due to this fact, the development and the validation of new NGMSs will be crucial in the upcoming years, to adopt these technologies in occupational-risk assessment

Epidemiological profile of laryngeal cancer in Hospital de Clínicas de Porto Alegre

OBJETIVO: O objetivo foi documentar a distribuição e o padrão de comportamento deste tumor entre os nossos pacientes. MATERIAIS E MÉTODOS: Foi realizado um estudo retrospectivo dos pacientes com diagnóstico de câncer de laringe atendidos no Hospital de Clínicas de Porto Alegre entre 1990 e 1996. RESULTADOS: Foram encontrados 242 casos, a maioria da raça branca (94,2%). A divisão por faixa etária mostrou um pico do ocorrência na sétima década de vida e a proporção de homens em relação à mulheres foi de 15:1. O tipo histológico mais comum foi carcinoma epidermóide (98,76%) e o sítio mais freqüentemente acometido foi a glote (44,7%), conseqüentemente, o sintoma mais comum na apresentação foi a disfonia (76,5%). Os pacientes com tumores na supraglote apresentaram, principalmente, disfagia e, aqueles com tumores transglóticos, dispnéia. Quanto ao estadiamento, 43,2% estavam no estágio IV no momento do diagnóstico. Os tumores localizados na supraglote estão relacionados com pior prognóstico, nesta amostra 38,3% dos pacientes com câncer na supraglote estavam no estágio IV, enquanto que a maioria dos tumores glóticos (74,2%) estavam no estágio I. A cirurgia total foi o tratamento mais realizado (50,7%). CONCLUSÃO: O diagnóstico do câncer de laringe no Hospital de Clínicas de Porto Alegre é feito, em sua maior parte, em estágio avançado, tornando o prognóstico desses pacientes bastante reservado.OBJECTIVES: The aim was to document the distribution and pattern of behavior of this tumor among our patients. MATERIALS AND METHODS: A retrospective study of patients with diagnosis of laryngeal cancer seen in the Hospital de Clínicas de Porto Alegre between 1990 to 1996 was carried out. RESULTS: There were 242 cases, the majority of whom were from the white race (94,2%). The peak incidence was in the seventh decade of life and male to female ratio was 15:1. The most common histological type was squamous cell carcinoma (98,76%) and by site, glottic involvement was the most frequent (44,7%), and so the most common symptom at presentation was hoarseness (76,5%). Supraglottic tumors presented, mainly, with dysphagia and the transglottics with dyspnea. As to staging, 43,3% were in IV stage at the diagnosis. The supraglottic tumors were, mainly, in the stage IV (38,3%), while the majority of glottic tumors (74,2%) were in the stage I, its reflect a worse prognosis for the supraglottic tumors. The total surgery was the most frequent treatment performed (50,7%). CONCLUSIONS: The laryngeal cancer diagnosis in the Hospital de Clínicas de Porto Alegre is done at a late stage, making the patient’s prognosis really reserved