“Il Corpo Ritrovato”: Dermocosmetological Skin Care Project for the Oncologic Patient

Neoplastic disease and its therapeutic options have a huge impact on the patient's quality of life from both the emotional and the working point of view. The project “Il Corpo Ritrovato” aims at creating an interdisciplinary network of physicians to improve the quality of life of the oncologic patient, focusing on such important aspects as dermocosmetological skin care but also on the evaluation of new therapeutic and diagnostic algorithms in order to make further progress in the field of prevention

Methodology for Gender Analysis in Transport: Factors with Influence in Women’s Inclusion as Professionals and Users of Transport Infrastructures

This work analyzes gendered processes by a methodology based on clustering factors with influence in the decision-making process of women as users or employees of the transport system. Considering gender as a social construction which changes over time and space, this study is based on the concept of a woman as a person who adopts this role in society. This paper performs a deep analysis of those factors women consider as needs and barriers to use or work in the transport system in four scenarios: railway public transport infrastructures, automated vehicles, bicycle sharing, and jobholders. A literature review and focus group discussions were performed under the consideration that the definition of woman includes the addition of several personal characteristics (age, sexual orientation, family responsibilities, and culture). The data analysis allowed the identification of fairness characteristics (FCs) that affect the interaction of women with the transport system for each scenario. A methodology for clustering the fairness characteristics identified the main areas of action to improve the inclusion of women within each use case. Further studies will be focused on the quantification and prioritization of the FCs through mathematical methods and the suggestion of inclusive measures by an interdisciplinary panel

How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Occupational Risk Assessment of Engineered Nanomaterials: Limits, Challenges and Opportunities

Background: The widespread application of nanotechnology in the last decades, the increasing likelihood of human exposure to nano-sized materials, together with the still limited knowledge concerning their toxicological profile, require a careful risk assessment, particularly in occupational settings. However, a specific “risk assessment paradigm” for these peculiar xenobiotics has not yet been defined. Objective: The aim of this review was to address those critical aspects that currently prevent the achievement of a suitable risk evaluation in order to point out priorities of research helpful to develop and implement an effective guidance for nano-risk assessment. Method: Literature search concerning NM physico-chemical characterization, toxicological behavior and exposure assessment strategies was analyzed to extrapolate opportunities, challenges and criticisms in the application of the general chemical risk assessment steps to the nano-sized toxicological field. Results: Uncertainties on the role of the physico-chemical properties in nanomaterial toxicity, the complexity in extrapolating dose-response relationships, and practical difficulties in measuring nanomaterial exposure emerged as challenging issues for the application of a traditional risk assessment approach to nano-sized exposures. Conclusion: Future investigations on these topics appear necessary to define an effective, nanofocused risk evaluation strategy that should be dynamically improved and verified as more substantial information become available. Such a suitable risk assessment process should provide adequate estimates of nanomaterial risks to guide the adoption of appropriate risk communication and management strategies for the protection and the safety of the workers

Biomonitoring of toxic metals in incinerator workers: A systematic review

Exposure to chemicals released during urban waste disposal and treatment is increasingly regarded as a potential occupational health issue. Indeed, several toxic metals emitted by an incinerator, including As, Be, Cd, Cr, Pb, Mn, Hg, Ni and V, have potentially toxic properties and their exposure, therefore, may be of concern for the health of the workers involved. The levels of exposure should therefore be carefully measured. Environmental monitoring, however, may be unable, alone, to assess true exposure, due to its intrinsic limitations mainly concerning its inability to assess oral and dermal absorption. In these cases biological monitoring may represent a fundamental supplementary tool for the definition of the workers' true occupational exposure and for the prevention of the related health effects. There is, therefore, an increasing interest in developing and using, in these workers, sensitive and specific biomarkers for health risk assessment, particularly at low or even very low levels of exposure. Despite the large number of original and review articles present in the literature on the biomonitoring of workers exposed to metals, the data on subjects employed in waste treatment activities are scattered and results are sometimes inconsistent. This is the first systematic review, performed according to PRISMA methodology, of the major studies investigating the levels of different toxic metals measured in the main biological matrices (blood, urine, hair) of incinerator workers. The results show that the levels of metals measured in incinerators' workers are generally low, with some notable exceptions for Cd and Pb. These results, though, can be affected by several confounders related either to non-occupational exposure, including diet, area of residence and others, and/or by a number of methodological limitations, as we found in the reported studies. Future work should focus on an integrated approach, using ideally both biological and environmental monitoring. A particular emphasis should be given to the measurement of the different granulometric fractions of the dust containing metals, i.e. inhalable, thoracic, respirable and ultrafine fractions. Moreover, an accurate description of the work tasks and the characteristics and levels of non-occupational exposure should always be provided

Epidemiology of Skin Cancer: Role of Some Environmental Factors

The incidence rate of melanoma and non-melanoma skin cancer entities is dramatically increasing worldwide. Exposure to UVB radiation is known to induce basal and squamous cell skin cancer in a dose-dependent way and the depletion of stratospheric ozone has implications for increases in biologically damaging solar UVB radiation reaching the earth’s surface. In humans, arsenic is known to cause cancer of the skin, as well as cancer of the lung, bladder, liver, and kidney. Exposure to high levels of arsenic in drinking water has been recognized in some regions of the world. SCC and BCC (squamous and basal cell carcinoma) have been reported to be associated with ingestion of arsenic alone or in combination with other risk factors. The impact of changes in ambient temperature will influence people’s behavior and the time they spend outdoors. Higher temperatures accompanying climate change may lead, among many other effects, to increasing incidence of skin cancer

Chronic Obstructive Pulmonary Disease in Farmers: A Systematic Review

Objective: Chronic obstructive pulmonary disease (COPD) is a significant public health problem but it is unclear whether agricultural work causes an increased risk of disease. The aim of this review was to study COPD risk among farmers and analyze occupational exposures in agricultural workplaces. Methods: A systematic literature search was conducted to identify epidemiological studies investigating COPD prevalence in farmers. Results: In the 14 studies reviewed, COPD prevalence ranged from 3% to 68% due to different characteristics of study population, working activities, case definition/diagnosis. Livestock farmers were at higher risk and significant associations were observed for exposure to organic dusts, endotoxins, mites, ammonia, and hydrogen sulfide. Conclusions: Farming work was associated with greater risk of developing COPD. However, considering the several variables that may influence the disease prevalence in farmers, we suggest the adoption of a standardized research strategy

Postoperative regression of retroperitoneal fibrosis in patients with inflammatory abdominal aortic aneurysms: Evaluation with spiral computed tomography

Partial or total regression of aortic and retroperitonel fibrosis after surgery has been reported in combination with inflammatory abdominal aortic aneurysm (AAA). In this report, we consider the most recent 21 patients with inflammatory AAA consecutively operated on at our institution. The group was composed of 19 men and 2 women, with a mean age of 66 years. In addition to preoperative CT angiographic study, abdominal ultrasound and aortoiliac angiography were also performed. There were no perioperative deaths. The perioperative morbidity rate was 9.5%. In 20 cases (95.2%), the aortic wall was subjected to histological examination with calculation of an inflammatory index. Each patient was reexamined with spiral CT angiography after surgery; postoperative results were assessed in terms of changes in maximal fibrotic-mantle thickness observed on follow-up spiral CT angiograms, expressed both in millimeters and percentage of change. Regression was analyzed for possible correlation with preoperative severity of fibrotic reaction, time of the postoperative exam, inflammatory index, and changes in the fibrotic process involving the adjacent structures. The results show that postoperative improvement was significantly more marked in cases characterized by higher preoperative inflammatory indices in the aneurysmal wall; the time course of regression was highly variable; but on the whole, improvement was more substantial during the early months after surgery, with significant slowing after the second or third year