Preface to “Physical Agents: Measurement Methods, Modelling and Mitigations”

Physical agents (noise, vibration, ionizing, and non-ionizing radiation) are playing an increasing role in environmental protection and health [...

[Risk of pneumonia during long term regular treatment of stable COPD with inhaled glucocorticoids: a systematic review.]

Inhaled glucocorticoids are anti-inflammatory drugs used in combination with long acting bronchodilators beta2-agonists for the treatment of stable chronic obstructive pulmonary disease (COPD), to improve lung function and symptoms and to reduce the future risk COPD exacerbations. However, has been also associated to an increased risk of pneumonia. The objective of this systematic review was therefore to analyze all randomized controlled trials to identify the risk of pneumonia during the regular treatment with long-term inhaled glucocorticosteroids compared to treatment with placebo in patients with stable COPD. From a literature search on PubMed, 19 randomized, placebo-controlled, long term (at least 52-week) studies have been identified. The inhaled glucocorticoids administered were: budesonide (6 studies), mometasone furoate (3 studies), beclomethasone dipropionate (1 study), triamcinolone acetonide (1 study), fluticasone propionate (7 studies) and fluticasone furoate (1 study). Only 7 of the 19 trials identified in our systematic review reported data on pneumonia and only one study required radiological evidence for diagnosis. The incidence of pneumonia was slightly increased in patients treated with glucocorticoid inhaled compared to placebo in most studies, regardless of the type of glucocorticoid inhalation used, suggesting a class effect. Older age, low body mass index, low FEV1, being a smoker are all factors variously associated with increased risk of pneumonia

CALIBRATION AND ERRORS IN THE DETECTION OF HEAVY METALS IN FRESH AND SEA WATER BY PIXE IN THE PPB-PPM RANGE

A methodology for the simultaneous detection of several heavy metals in water samples is described in detail. Targets were chemically prepared by preconcentration of the metals. Characteristics of the proton beam and X-ray detection are summarized. The concentration was obtained by using an internal standard in the range ppb-ppm. The method was tested by calibration with samples of known concentration. The subtraction of background and the data processing are discussed. The error in each concentration is evaluated

Concentrazione di SO2 nell'area urbana di Modena

E' in corso lo studio di una serie di dati relativi alla concentrazione di SO2 nell'area urbana di Modena. In questa fase preliminare si è cercato di verificare l'esistenza ed il tipo di correlazioni tra concentrazione dell'inquinante e parametri meteorologici per mezzo di un semplice modello matematico. Per la città di Modena i valori della concentrazione, anche se mediati su tempi lunghi (1 mese), risultano indipendenti dalla velocità media del vento, mentre mostrano, a parità di intensità di emissione (Q), una certa correlazione con la temperatura, almeno durante la stagione fredda

Absolute estimation of radon daughter concentrations in air by alfa-spectrometry

A method for the estimation of the concentration of radon daughter in air is given. The method is based on alfa spectrometric counting measurements performed either during or after the dust collection with an electrostatic precipitator. The relations between measured counts and concentrations in air of the collected nuclides (RaA, RaB and RaC) are obtained assuming a constant collection rate and a linear collection rate model. It turns out that the less sophisticated model gives more satisfactory estimations of the parameters

[Risk of diabetes mellitus during regular long-term inhaled glucocorticoid treatment in COPD patients: narrative review of the literature.]

Glucocorticoids are anti-inflammatory drugs used in combination with inhaled bronchodilators, such as β2-agonists and antimuscarinics, for the treatment of stable chronic obstructive pulmonary disease (COPD), to improve respiratory symptoms, such as exertional dyspnoea, and to decrease the risk of future COPD exacerbations. However, it remains controversial whether their regular long-term use increases the risk of developing diabetes mellitus. The objective of this narrative review is therefore to analyse all the randomized controlled trials performed in patients with stable COPD to identify the risk of new onset diabetes mellitus during a long-term (at least 52 weeks) regular treatment with inhaled glucocorticoids alone compared to placebo. From a literature search on PubMed, 19 studies fulfilling these criteria have been identified. The inhaled glucocorticoids administered were: fluticasone propionate (7 studies), budesonide (6 studies), mometasone furoate (3 studies), beclomethasone dipropionate (1 study), triamcinolone acetonide (1 study), and fluticasone furoate (1 study) respectively. Only 3 out of the 19 trials identified in our narrative review reported data on diabetes mellitus, and in these the incidence of diabetes mellitus was not significantly different in both treatment arms (inhaled glucocorticoids and placebo), regardless of the type of glucocorticoid used

Asthma under/misdiagnosis in primary care setting: An observational community-based study in Italy

BACKGROUND: Published data suggest that asthma is significantly under/misdiagnosed. The present community-based study performed in Italy aims at investigating the level of asthma under/misdiagnosis among patients referring to the General Practitioner (GP) for respiratory symptoms and undergoing Inhaled corticosteroids. METHODS: A sub-analysis of a previously published observational cross-sectional study has been provided. It included subjects registered in the GP databases with at least three prescriptions of inhaled or nebulised corticosteroids during the 12 months preceding the start of the study. All subjects, independently of the diagnosis, were invited to visit their GP's office for a standardised interview and to fill the European Community Respiratory Health Survey (ECRHS) questionnaire. RESULTS: The studies involved 540 GPs in most of the Italian regions and 2090 subjects (mean age 54.9 years, 54.1 % females) were enrolled. Among them 991 cases of physician-diagnosed asthma were observed while 1099 subjects received a diagnosis other than asthma (chronic obstructive pulmonary disease, chronic upper respiratory tract infections etc.). Among the lasts, the ECRHS questionnaire was suggestive for asthma diagnosis in 365 subjects (33.2 %). CONCLUSIONS: The data suggest that there is still a large under/misdiagnosis of asthma in the Italian primary care setting, despite the spread of GINA guidelines nearly 20 years before this study. A validated tool like the ECRHS questionnaire has detected a considerable proportion of potentially asthmatic patients who should be addressed to lung function assessment to confirm the diagnosis. Further educational efforts directed to the GPs are needed to improve their diagnosis of asthma (SAM104964)

The level of control of mild asthma in general practice: an observational community-based study

The aim of the present community-based study was to evaluate the level of asthma control in patients with mild asthma, regularly treated with inhaled steroids (ICS)

Asthma under/misdiagnosis in primary care setting: An observational community-based study in Italy

BACKGROUND: Published data suggest that asthma is significantly under/misdiagnosed. The present community-based study performed in Italy aims at investigating the level of asthma under/misdiagnosis among patients referring to the General Practitioner (GP) for respiratory symptoms and undergoing Inhaled corticosteroids. METHODS: A sub-analysis of a previously published observational cross-sectional study has been provided. It included subjects registered in the GP databases with at least three prescriptions of inhaled or nebulised corticosteroids during the 12 months preceding the start of the study. All subjects, independently of the diagnosis, were invited to visit their GP's office for a standardised interview and to fill the European Community Respiratory Health Survey (ECRHS) questionnaire. RESULTS: The studies involved 540 GPs in most of the Italian regions and 2090 subjects (mean age 54.9 years, 54.1 % females) were enrolled. Among them 991 cases of physician-diagnosed asthma were observed while 1099 subjects received a diagnosis other than asthma (chronic obstructive pulmonary disease, chronic upper respiratory tract infections etc.). Among the lasts, the ECRHS questionnaire was suggestive for asthma diagnosis in 365 subjects (33.2 %). CONCLUSIONS: The data suggest that there is still a large under/misdiagnosis of asthma in the Italian primary care setting, despite the spread of GINA guidelines nearly 20 years before this study. A validated tool like the ECRHS questionnaire has detected a considerable proportion of potentially asthmatic patients who should be addressed to lung function assessment to confirm the diagnosis. Further educational efforts directed to the GPs are needed to improve their diagnosis of asthma (SAM104964)