A survey on lifestyle and level of biomarkers of environmental exposure in residents in Civitavecchia (Italy)

Background. The assessment of individual exposure to toxicants in industrially contaminated areas is difficult when multiple productions are active close to residential areas. Two thermoelectric power plants and a large harbor have been operating since the ’60s in the area of Civitavecchia (North of Rome). Methods. The ABC (Ambiente e Biomonitoraggio nell’area di Civitavecchia, Environment and Biomonitoring in Civitavecchia) program involved, in the period 2013-2014, residents in Civitavecchia and in the nearby municipalities (Santa Marinella, Allumiere, Tolfa and Tarquinia). They were randomly selected from the Municipal Register’s data and their residence addresses were geocoded using GIS techniques. Biomonitoring of the following urinary metals, Sb, Be, Mo, Cd, Sn, W, Ir, Pt, Hg, Tl, V, Cr, Mn, Co, Ni, Cu, Zn, Rh, Pd, As were performed. Glucose and lipid metabolism, liver, renal, and endocrine function were evaluated through blood laboratory tests. Tests of lung function were also carried out as well as saturometry (oxygen rate in the blood with an illuminated sensor placed on the fingertip), anthropometric and blood pressure measurements. Information on individual characteristics, histories of exposure, such as the consumption of local food, occupational history, lifestyle and medical history were collected through a validated questionnaire. Samples of nails and hair were also collected. The biological material (blood, urine, nails and hair) was stored in a biobank for future analysis related to the possible mechanisms of biological damage. The study protocol received the approval of the local ethics committee. Results. A total of 1177 residents were enrolled (58% female, 60% with a secondary or graduate school degree). No particular differences in metal concentrations based on the municipality of residence were observed. For arsenic, mercury, lead, and tungsten some differences between the two geographical areas were observed, probably due to different diet, lifestyle (e.g., alcohol consumption, smoking, use of jewelry and piercings, tattoos, physical activity, hormonal and mineral supplements, and drugs), and occupational exposure. Conclusions. The undergoing study on the association between biomarkers concentration and pollutants concentrations − estimated using a dispersion modeling approach, and adjusting for personal characteristics and concomitant other environmental exposure − could clarify the individual exposure of the residents in this industrial area

Direct Versus Indirect Corneal Neurotization for the Treatment of Neurotrophic Keratopahty: a Multicenter Prospective Comparative Study

PURPOSE: To analyze the comparative safety and efficacy of two techniques of corneal neurotization (CN) (direct corneal neurotization [DCN] vs indirect corneal neurotization [ICN] for the treatment of neurotrophic keratopathy (NK).DESIGN: Multicenter Interventional Prospective Comparative Case Series.METHODS: Setting: ASST Santi Paolo e Carlo University Hospital, Milan; S.Orsola-Malpighi University Hospital, Bologna; Santa Maria alle Scotte University Hospital, Siena.STUDY POPULATION: Consecutive patients with NK undergoing CN between November 2014 and October 2019; Intervention Procedures: DCN was performed by transferring contralateral supraorbital and supratrochlear nerves; ICN was performed using sural nerve graft.MAIN OUTCOME MEASURES: NK healing; corneal sensitivity; corneal nerve fiber length (CNFL) measured by in vivo confocal microscopy (IVCM); complication rate.RESULTS: 26 eyes of 25 patients were included: 16 were treated with DCN and 10 with ICN. After surgery, NK healed in all patients after a mean period of 3.9 months without differences between DCN and ICN. Mean corneal sensitivity improved significantly 1 year after surgery (from 3.07 to 22.11 mm; p<0.001) without differences between the two groups. Corneal sub-basal nerve plexus that was absent before surgery in all patients except 4 become detectable in all cases (mean CNFL 14.67±7.92 mm/mm2 1 year postoperatively). No major complications were recorded in both groups.CONCLUSIONS: CN allowed the healing of NK in all patients as well as the improvement of corneal sensitivity in the majority of them thanks to nerve regeneration documented by IVCM. One year postoperatively, DCN and ICN showed comparable outcomes