Experiência da Rede Brasileira de Teleodontologia

Este artigo descreve a experiência da Rede Brasileira de Teleodontologia como parte das estratégias em eHealth. Várias instituições de todo o país participam ou vêm recebendo treinamento e suporte para a implantação de seus próprios núcleos de Telessaúde e Teleodontologia. Diversas iniciativas estão sendo tomadas de modo articulado, a fim de facilitar a criação e a consolidação de uma rede colaborativa de trabalho em Telessaúde e Teleodontologi

SINDROME DEL BAP1 IN FAMILIARI DI UN LAVORATORE AFFETTO DA MESOTELIOMA DI ORIGINE PROFESSIONALE

I mesoteliomi sono rari tumori maligni che originano dal le cellule mesoteliali di membrane seriose quali la pleura (93, 2%), il peritoneo (6,3%), i l pericardio (0,2%) e la tunica vaginale del testicolo (0,3%), strettamente correlati all’esposizione ad amianto. Peculiare è il lungo periodo di latenza, ossia il tempo che intercorre tra l'esposizione all'amianto e la comparsa del mesotelioma (circa 40 - 50 anni)

Response to the "Letter to the Editor" by Gabor Mezei et al., Comments on Vimercati et al., 2019, "Asbestos exposure and malignant mesothelioma of the tunica vaginalis testis: a systematic review and the experience of the Apulia (Southern Italy) mesothelioma register"

Dear Sir, Thank you for the opportunity to respond to the Letter to the Editor you have received from Gabor Mezei et al., on our study titled “Asbestos exposure and malignant mesothelioma of the tunica vaginalis testis: a systematic review and the experience of the Apulia (southern Italy) mesothelioma register

Asbestos exposure and malignant mesothelioma of the tunica vaginalis testis: a systematic review and the experience of the Apulia (southern Italy) mesothelioma register

Malignant mesothelioma of the tunica vaginalis testis (MMTVT) is a rare disease with a poor prognosis. The diagnosis and management of these lesions are often difficult for pathologists, surgeons, oncologists and occupational physicians. A preoperative diagnosis of malignancy is rarely made, and there is no established effective therapy except orchidectomy

Silicosis in a paint‐production worker: Study of a lung histological specimen with scanning electron microscopy—Energy dispersive X‐ray spectrometer

The occupational risks in silica-exposed workers have been greatly reduced over the last decades; however, only few studies investigated uncommon forms of exposure to crystalline silica as shown by this case of silicosis in a paint-production worker

Asbestos Air Pollution: Description of a Mesothelioma Cluster Due to Residential Exposure from an Asbestos Cement Factory

The study describes a cluster of 71 malignant mesothelioma cases among Bari residents without asbestos exposure other than residential exposure. This small cohort, as expected, was composed of a majority of females (56.34%) with a M/F ratio of 0.8, ages ≤ 65 years old (52.11%) and the epithelioid morphological type (78.87%). Sixty-four subjects (90.14%) lived between 10 m and 1000 m from the asbestos cement factory (Fibronit), and the latency length was longer than 55 years for 25 subjects (35.21%). The adjusted risk (adjusted OR) of observing the epithelial form of mesothelioma among subjects living at small distances from Fibronit was high (OR = 1.870 (0.353-9.905)) for people living 550-1000 m from the site and for those living less than 550 m from the site (OR = 1.470 (0.262-8.248)). Additionally, the subjects with a high length of exposure showed a relevant risk of epithelioid mesothelioma both for 21-40 years of exposure (OR = 2.027 (0.521-7.890)) and more than 40 years of exposure (OR = 2.879 (0.651-12.736)). All of the estimates were high but not significant because this transitional study has a typically low power. The adjustment for latency showed the same trend. Using detailed information collected by the regional mesothelioma registry, this study provided evidence of a continuing health impact of the Fibronit asbestos cement factory in Bari on the resident population

Occupational Exposure to Noise and Age-related Hearing Loss in an Elderly Population of Southern Italy

Background: Age-Related Hearing Loss (ARHL) is a gradual and irreversible age-dependent decline in auditory function. There is still no consensus on the long-term functional effects of noise exposure on ARHL. Objective: This study aimed to compare the prevalence of ARHL in an elderly population occupationally exposed to noise in a non-exposed population. Methods: The population was divided into two groups: a group of 482 subjects professionally exposed to noise for over 10 years and a group of 1129 nonexposed subjects. Among the exposed subjects, a subgroup of 298 who worked for over 10 years in the glassware industry was selected. All the participants underwent a thorough otorhinolaryngological examination. Results: The presence of ARHL was found in 81% of exposed subjects and in 4% of non-exposed subjects. In the sub-group of glassware workers, the prevalence was 88%. The statistical analysis showed a significant association between previous occupational exposure to noise and ARHL (OR = 1.09; 95% CI = 1.067-1.124; p = 0.0012) and between exposure to the glassware industry and ARHL (OR = 1.89; 95% CI = 1.78-1.96; p = 0.006). Conclusion: Consistent with recent studies, we found a significantly higher prevalence of ARHL among workers exposed to noise; however, further studies are needed to support these findings

Relationships among Indoor Radon, Earthquake Magnitude Data and Lung Cancer Risks in a Residential Building of an Apulian Town (Southern Italy)

(1) Background: The association of radon-222 with lung cancer is well studied. The aim of the study was to validate a model of indoor radon measurements, to apply radon software to estimate lung cancer cases that are attributable to radon and to study the relationship between radon and earthquakes. (2) Methods: Different data detectors were used to obtain radon measurements in different places. Continuous data collection and predictions of indoor radon concentrations were carried out. Software was used to assess radon-attributable lung cancer cases, and data related to earthquake magnitudes were downloaded from Italian Vulcanology Institute. (3) Results: As expected, the highest radon concentrations were observed on the ground floor (232 ± 232 Bq/m3), with higher values measured during winter than in other seasons. The comparison of the detectors showed the overlapping of the two detectors-measured data sets. The cases of lung cancer that were attributable to radon in Locorotondo were studied (3.66/10,000). From the multivariate analysis of the relationship between high radon concentrations and high earthquake magnitude values, they show statistically significant ORs of just over 1. (4) Conclusions: Although the measured values are, on average, within the reference level, prevention measures must be implemented, as the measured radon values allow us to estimate an expected value of 3.66 cases of lung cancer per 10,000 people in the resident population

A Single Liver Metastasis from Pleural Biphasic Mesothelioma

Virtually any malignancy can metastasize to the liver. Large solitary metastases are rare and can be difficult to distinguish from primary tumors. Malignant mesothelioma is often considered as a locally invasive cancer but tumor dissemination to extra-thoracic sites is possible, and the liver can be involved. Herein, we present a rare case of pleural mesothelioma with a solitary large liver metastasis diagnosed postmortem in a ninety-two-year-old man with 35 years of exposure to asbestos. Results of immunohistochemical staining of the pleural and liver tumor were similar, both positive for low-molecular weight keratins, calretinin, vimentin, and podoplanin, and negative for Claudin-4, TTF1, CEA, BerEP4, CK7, CK19, CK20, BAP1, Hep Par1, p40, and WT1. Fluorescent in-situ hybridization (FISH) for p16/CDKN2A was also performed and a homozygous deletion was detected in both tumors, supporting the diagnosis of mesothelioma. Reporting this case, we would like to point out that extra-thoracic dissemination from pleural mesothelioma, even if exceptional, can occur. In cases where differential diagnoses are challenging, the value of ancillary techniques and a practical approach to diagnostic work-up is of primary importance

COVID-19 hospital outbreaks: Protecting healthcare workers to protect frail patients. An Italian observational cohort study

OBJECTIVES: to determine the prevalence of SARS-CoV-2 infection among exposed HCWs after preventive protocol implementation. METHODS: 5750 HCWs. Those in contact with COVID-19 patients were allocated into a highrisk or a low-risk group based on contact type (PPE- or non-PPE-protected); high risk workers underwent nasopharyngeal swab tests, while for low-risk workers swab tests were carried out only for symptomatic workers (active surveillance). The prevalence was determined by real-time reverse transcriptase–polymerase chain reaction on nasopharyngeal samples. RESULTS: 3570 HCWs had contact with 1065 COVID-19 patients. Among them, 3494 were subjected to active surveillance (low-risk group); 2886 (82.60%) were subjected to a swab test and 15 were positive (0.52%). 76 HCWs (2.13% of exposed) were included in the high-risk group, and a swab test was mandatory for each participant. Overall, 66 (86.84% of high-risk) were negative, and 10 positive (13.16%), resulting in a higher risk of infection than in the low-risk group [OR= 29.00; 95% CI:12.56-66.94; p<0.0001]. CONCLUSION: To date, the SARS-CoV-2 infection prevalence is 0.70% among exposed HCWs and 0.435% among all HCWs working at the examined university hospital. The correct use of PPE and the early identification of symptomatic workers are essential factors to avoiding nosocomial clusters