ASBESTO SIGUE MATANDO

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EPIDEMIOLOGY OR STATISTICS?

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Waxy casts in the urinary sediment of patients with different types of glomerular diseases: Results of a prospective study

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Development and Preliminary Validation of an Electromyography-Scoring Protocol for the Assessment and Grading of Muscle Involvement in Patients With Juvenile Idiopathic Inflammatory Myopathies.

Abstract Introduction We performed a pilot study in order to investigate the feasibility of an electromyography (EMG)-scoring protocol for the assessment of disease activity in juvenile idiopathic inflammatory myopathies (JIIM). Methods Children with JIIM followed up in a tertiary-level care center underwent standardized clinical, laboratory, and EMG assessment. An EMG-scoring protocol was devised by a consensus panel including a pediatric neurophysiologist and two pediatric rheumatologists, based on a combined score obtained as the sum of (1) the presence of denervation signs (fibrillation potentials) and (2) motor unit remodeling (mixed pattern of short- and long-duration motor unit action potentials). The EMG-scoring protocol was then validated following the Outcome Measures in Rheumatoid Arthritis Clinical Trials filter for outcome measures in rheumatology and the consensus-based standards for the selection of health measurement instruments methodology. Results Thirteen children (77% females) were included in the study, with a median age of 10 years (interquartile range: 7-17 years) and median disease duration of 11.8 months (interquartile range: 2.1-44.5). A total of 39 EMG examinations were evaluated. A strong positive association between a standardized tool for muscle strength assessment and the combined score was observed. No significant associations were found with both creatine kinase and erythrocyte sedimentation rate levels. Discussion Our EMG-scoring protocol is the first standardized and reproducible tool for the neurophysiologic evaluation and grading of muscle involvement in patients with JIIM and could provide relevant additional information in the assessment and follow-up of these rare conditions

Câncer de pulmão e exposição ocupacional: estudo caso-controle de base hospitalar

Objetivo: Analisar a relação entre ocupação e câncer de pulmão em pacientes de um hospital de referência nacional para atendimento oncológico no Sul do Brasil.Método: Estudo caso-controle de base hospitalar realizado entre fevereiro e outubro de 2019. Os históricos ocupacionais foram codificados de acordo com classificações internacionais e traduzidos em ocupações associadas ao câncer de pulmão (Lista A e B). As odds ratios foram ajustadas para tabagismo, com intervalo de confiança de 95%, calculadas por regressão logística condicional.Resultados: Foram incluídos 99 casos e 227 controles. Entre os homens a ocupação de pintores (lista A) estava associada ao câncer de pulmão (OR= 14,3; IC 95%: 1,8-116,5), não houve ocupações da lista B associadas ao câncer de pulmão. Nas mulheres não foram encontrados riscos aumentados.Conclusões: Evidenciou-se que a exposição aos carcinógenos ocupacionais entre pintores de reparo e da construção civil aumentam o risco de câncer de pulmão. Palavras-chave: Neoplasias pulmonares. Estudos de casos e controles. Exposição ocupacional. Substâncias, produtos e materiais carcinogênicos. Saúde do trabalhador

Impact of an asbestos cement factory on mesothelioma incidence in a community in Italy

Abstract Background Broni is a small town (9000 inhabitants) in the province of Pavia, Lombardy, north-west Italy, where the second largest Italian asbestos cement factory (Fibronit) was in operation between 1932 and 1993. Based on Lombardy Mesothelioma Registry (RML) data (2000–2011), we previously showed a high impact of asbestos exposure on malignant mesothelioma (MM) incidence among Fibronit workers, their families, and people living in Broni and in the nearby town of Stradella (11,000 residents). Given the great concern of the community, we have recently updated the data regarding 5 more years (2012–2016). Methods From the RML database we extracted subjects who ever worked in Fibronit, their family members, ever residents in Broni, and subjects living in Stradella and nearby towns at the time of diagnosis. For each type of exposure we calculated standardized incidence ratios (SIR = observed/expected cases). Results In the period 2000–2016 we registered 56 cases (2.52 expected, SIR = 22.2), 49 men (41 pleural, 8 peritoneal MM), 7 women (5 pleural, 2 peritoneal MM) with past occupational exposure in Fibronit. Among subjects never occupationally exposed and never exposed to extra-occupational sources unrelated to Fibronit, we counted 39 cases (4.24 expected, SIR = 9.2), 10 men (all pleural MM), 29 women (28 pleural, 1 peritoneal MM) in Fibronit workers' families, 91 pleural mesothelioma cases (7.43 expected, SIR = 12.2, 31 men, 60 women), ever residents in Broni, and 25 pleural mesothelioma cases (3.05 expected, SIR = 8.2, 6 men, 19 women) living in Stradella at the time of diagnosis. The overall number of excess cases was about 194 (211 against 17.24 expected). In the remaining adjacent (No. 8) and surrounding (No. 17) municipalities (32,000 people) there were 7 cases (1 men, 6 women, 8.85 expected). Conclusion The mesothelioma burden related to the asbestos cement factory is still high on factory workers, their families, and residents in Broni and Stradella towns

Cone-Beam Computed Tomographic Assessment of the Mandibular Condylar Volume in Different Skeletal Patterns: A Retrospective Study in Adult Patients

The aim of this study was to assess the condylar volume in adult patients with different skeletal classes and vertical patterns using cone‐beam computed tomography (CBCT). CBCT scans of 146 condyles from 73 patients (mean age 30   12 years old; 49 female, 24 male) were selected from the archive of the Department of Dentistry and Maxillofacial Surgery of Fondazione IRCCS Ca’ Granda, Milan, Italy, and retrospectively analyzed. The following inclusion criteria were used: adult patients; CBCT performed with the same protocol (0.4 mm slice thickness, 16   22 cm field of view, 20 s scan time); no systemic diseases; and no previous orthodontic treatments. Three‐dimensional cephalometric tracings were performed for each patient, the mandibular condyles were segmented and the relevant volumes calculated using Mimics Materialize 20.0  software (Materialise, Leuven, Belgium). Right and left variables were analyzed together using random‐intercept linear regression models. No significant association between condylar volumes and skeletal class was found. On the other hand, in relation to vertical patterns, the mean values of the mandibular condyle volumes in hyperdivergent subjects (688 mm3) with a post‐rotation growth pattern (625 mm3) were smaller than in hypodivergent patients (812 mm3) with a horizontal growth pattern (900 mm3). Patients with an increased divergence angle had smaller condylar volumes than subjects with normal or decreased mandibular plane divergence. This relationship may help the clinician when planning orthodontic treatment

Geostatistical integration and uncertainty in pollutant concentration surface under preferential sampling

In this paper the focus is on environmental statistics, with the aim of estimating the concentration surface and related uncertainty of an air pollutant. We used air quality data recorded by a network of monitoring stations within a Bayesian framework to overcome difficulties in accounting for prediction uncertainty and to integrate information provided by deterministic models based on emissions meteorology and chemico-physical characteristics of the atmosphere. Several authors have proposed such integration, but all the proposed approaches rely on representativeness and completeness of existing air pollution monitoring networks. We considered the situation in which the spatial process of interest and the sampling locations are not independent. This is known in the literature as the preferential sampling problem, which if ignored in the analysis, can bias geostatistical inferences. We developed a Bayesian geostatistical model to account for preferential sampling with the main interest in statistical integration and uncertainty. We used PM10 data arising from the air quality network of the Environmental Protection Agency of Lombardy Region (Italy) and numerical outputs from the deterministic model. We specified an inhomogeneous Poisson process for the sampling locations intensities and a shared spatial random component model for the dependence between the spatial location of monitors and the pollution surface. We found greater predicted standard deviation differences in areas not properly covered by the air quality network. In conclusion, in this context inferences on prediction uncertainty may be misleading when geostatistical modelling does not take into account preferential sampling