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Objective: The aim of this study was to verify the efficacy and applicability of the Ultracision Harmonic Scalpel (Ethicon Endo-Surgery, Cincinnati, OH) in pharyngolaryngectomy with radical neck dissection. Design: This work evaluated the use of the Harmonic Scalpel in otolaryngology as a new and alternative method to overcome some complications of traditional surgery. Setting: The study was conducted with 20 patients in the ENT Department of the University of Genoa (Italy) between January 1, 2005, and December 31, 2006. Methods: A prospective, randomized study was undertaken on 20 pharyngolaryngectomies with radical neck dissection performed using a Harmonic Scalpel (10 patients) or traditional surgery (10 patients). Main Outcome Measures: The evaluation included operation time, intraoperative blood loss, postoperative seroma formation, and pattern of wound healing. Results: In patients treated with Harmonic Scalpel, the mean operation time was significantly shorter, the blood loss was less, laryngeal and neck drainage on the first and second postoperative days was significantly smaller, and no postoperative complications were noted. Conclusions: The use of the Harmonic Scalpel during pharyngolaryngectomy and radical neck dissection led to diminished bleeding, shorter operative time, less seroma formation, and better wound healing in the postoperative period. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Personal exposure to airborne benzene is influenced by various outdoor and indoor sources. The first aim of this study was to assess the benzene exposure of a sample of urban inhabitants living in an inner-city neighborhood of Florence, Italy, excluding exposure from active smoking. The secondary objective was to differentiate the personal exposures according to personal usage patterns of the vehicles. Methods: A sample of 67 healthy non-smokers was monitored by passive samplers during two 4-weekday campaigns in winter and late spring. Simultaneously, benzene measurements were also taken for a subset of participants, inside and outside their houses. A 4-day time microenvironment activity diary was completed by each subject during each sampling period. Other relevant exposure data were collected by a questionnaire before the sampling. Additional data on urban ambient air benzene levels were also available from the public air quality network. The passive samplers, after automated thermal desorption, were analyzed by GC-FID. Results: Benzene personal exposure levels averaged 6.9 (SD=2.1) and 2.3 (SD=0.7) μg/m3 in winter and spring, respectively. Outdoor and indoor levels showed high correlation in winter and poor in spring. In winter the highest benzene personal exposure levels were for people traveling by more public transport, followed by users of only car and by users of only bus respectively. Conclusions: The time spent in-transport for work or leisure makes a major contribution to benzene exposure among Florentine non-smoking citizens. Indoor pollution and transportation means contribute significantly to individual exposure levels especially in winter season. [Copyright &y& Elsevier]

Objective.. This study assesses 2,5-hexanedione (2,5-HD) in the urine of subjects exposed to n-hexane solvent between 1991 and 1998, from details obtained from the Registry of Biological Monitoring (BM) at the Florence Local Health Unit, and its development over time. Methods.. The Registry contains 15,925 samples from 6,650 subjects occupationally exposed to n-hexane, especially in leather (9,099 samples; 3,607 subjects) and shoe (3,865 samples; 1,938 subjects) production. Results.. Over the time span studied there was a total reduction of 31.9% in urinary 2,5-HD level. The yearly decrease over the entire period was 5.4%. Dividing the 8 years into three periods: before the introduction of the new legislation for health protection in the workplace (1991–1993), during its transition (1994–1996) and after its complete enforcement (1997–1998), respectively, we observed a marked decrease in the last period. Women and young people (under 30 years) experienced significantly higher absorption levels (respectively, 7.1% and 24.4%). Conclusion.. The data suggest that monitoring was more frequent in subjects with higher starting values, and the greatest decrease was reported in this group. Reduction may be due to less n-hexane in the products used, better structural conditions in the factories, and the effectiveness of inspections carried out by the authority for hygiene and safety in the workplace. The results confirm the usefulness of the reporting of risk levels of exposure to industrial toxicants by routine biological monitoring. [ABSTRACT FROM AUTHOR]

Benign paroxysmal positional vertigo (BPPV) usually has a favorable course, although it is possible to observe BPPV with a high recurrence rate. Previous studies suggested that vitamin D deficiency might affect BPPV recurrences, and oxidative stress might play a complementary role in BPPV pathogenesis. This multicentric trial aimed to evaluate the effectiveness of oral nutritional supplementation with a compound of alpha-lipoic acid, Carnosine, and Zinc (LICA® (Difass International, Coriano (RN), Italy)), vitamins of group B and vitamin D in preventing BPPV recurrences. A total of 128 patients with high recurrence-BPPV were randomized in three arms: Arm 1 consisted of subjects with "insufficient" or "deficient" vitamin D blood levels, treated with daily oral supplementation of LICA®, vitamins of group B and vitamin D3 (800 UI), Arm 2 included BPPV subjects with "sufficient" vitamin D who did not receive any nutritional support, and Arm 3 included subjects with a "sufficient" serum concentration of vitamin D who received supplementation with a compound of LICA® and Curcumin. After six months of follow-up, a significant reduction of BPPV relapses compared to the baseline was found only in Arm 1 (−2.32, 95% CI: 3.41–1.62, p-value < 0.0001). Study results suggested that oral nutritional supplementation with vitamin D3 plus antioxidants can prevent relapses in patients suffering from high recurrence-BPPV. [ABSTRACT FROM AUTHOR]

Aim of the Study: in humans, spatial orientation consists of the ability to move around the environment through memorized and pre-programmed movements, according to the afferent sensory information of the body and environmental analysis of the Central Nervous System (CNS). The purpose of this study is to analyze the abilities of professional athletes, such as footballers, to use mental navigation systems, cognitive maps, and memorized motor patterns in order to obtain better physical performance and to obtain useful information for training both non-sports subjects and vestibular patients for rehabilitation purposes. Materials and Methods: all the motor performances of sportsmen, healthy non-sporting subjects, or vestibular patients are based on the acquisition of visual–spatial and training information. In this study, we analyzed the visual–spatial performance of 60 trained sportsmen (professional footballers), 60 healthy non-sports subjects, and 48 patients affected by chronic unilateral vestibular loss by means of the Navigation Ability Test 2.0. A score based on the number of targets correctly reached in the various tests quantifies the degree of performance of the subjects. Results: NAT 2.0 scores progressively improve from vestibular subjects to healthy non-sporting subjects to footballers. NAT 2.0 scores improve in all three subject groups as the number of tasks performed in all patient groups increases, regardless of gender and age. Conclusions: the analysis of performance data through NAT 2.0 in athletes (footballers) opens new perspectives for rehabilitation purposes, regardless of age, sex, and training conditions, both in healthy non-sporting subjects to improve their sporting potential and in patients affected by chronic vestibular dysfunction, in order to optimize their motor skills and prevent falls. [ABSTRACT FROM AUTHOR]

Abstract: A qualitative and quantitative method for the analysis of drugs of abuse (cocaine and benzoylecgonine, opiates) and some stimulants in human hair was developed and validated. Hair samples were incubated with phosphate buffer (pH 5.0), chosen as the extraction medium, extracted with Bond Elut Certify cartridges and analyzed by LC–MS–MS and LC–MS3 as confirmation for positive results. The method proved to be specific, accurate and precise across the calibration range (0.1–30ng/mg) where good linearity was observed. Total extraction recovery, intra-assay accuracy and precision, limits of detection and limits of quantitation were estimated. The method was successfully applied to the analysis of hair samples collected from drug abusers and it was suitable for routine analytical applications in the Antidoping Laboratory of Public Health Laboratory. [Copyright &y& Elsevier]

This paper presents the results of a polycentric study carried out in seven different areas, organized by the Italian Society of Reference Values (SIVR) for assessing reference values of lead in blood (B-Pb) at the current doses of the metal to general population. The estimated arithmetic mean for B-Pb in males was of 45.1 μg/l and 30.6 μg/l in females; the 95th centile was 100 and 60 for males and females, respectively. The main variables influencing B-Pb levels were gender, age, BMI, outside sport practice, alcohol consumption and smoking habits, while the geographic area and the urban residence did not affect the metal concentration in blood. [Copyright &y& Elsevier]

There is great interest in developing reliable biomarkers to support antemortem diagnosis of late-onset Alzheimer's disease (AD). Early prediction and diagnosis of AD might be improved by the detection of a proteolytic dysfunction in extracts from cultured AD fibroblasts, producing altered isoelectrophoretic forms of the enzyme transketolase (TK-alkaline bands). The TK profile and apolipoprotein E (APOE) genotype were examined in fibroblasts from 36 clinically diagnosed probable late-onset sporadic AD patients and 38 of their asymptomatic relatives, 29 elderly healthy individuals, 12 neurological non-AD patients, and 5 early-onset AD patients. TK alterations occurred in (i) several probable AD patients regardless of age-of-onset and severity of disease; (ii) all early-onset AD patients and APOE ε4/4 carriers; and (iii) nearly half of asymptomatic AD relatives. Normal subjects and non-AD patientswere all negative. Notably, culture conditions promoting TKalterationswere also effective in increasing active BACE1 levels. Overall, the TK assay might represent a low-cost laboratory tool useful for supporting AD differential diagnosis and identifying asymptomatic subjects who are at greater risk of AD and who should enter a follow-up study. Moreover, the cultured fibroblasts were confirmed as a useful in vitro model for further studies on the pathogenetic process of AD. [ABSTRACT FROM AUTHOR]

The purpose of this study is to define a new system for assessing the freshness of marine bony fish based on measurable parameters. 151 fish were analysed to determine the concentrations of total volatile basic nitrogen, trimethylamine N-oxide, trimethylamine and malondialdehyde. The results of the determinations were included in an algorithm to calculate the value of the Freshness Index (FI). the most appropriate threshold value of FI that can distinguish fresh from not fresh fish was 0.33 (sensitivity 95.6%, specificity 73.6%). The results demonstrate the possibility of using the index for the evaluation, at low-cost, of consignments of fresh or presumed fresh fish both in the phase of official control and in self-verification systems. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate changes in acoustic features of speech and voice after uvulopalatopharyngoplasty (UPPP) with the Harmonic Scalpel (HS), using the multidimensional voice program (MDVP) in conjunction with other tests. Before and 6 months after surgery, phonetically balanced sentences and sustained vowels a, e, i were carried out and digitalized with MDVP in all the patients, as an evaluation of nasal resonance (trough the Glatzel and the Gutzmann tests), speech articulation and voice handicap index (VHI). These parameters were estimated: average of fundamental frequency, Jitter, Shimmer, noise-to-harmonics ratio, voice turbulence index, soft phonation index, degree of voiceless, degree of voice breaks and peak amplitude variation. Six months after surgery, improvements in all the acoustic parameters, in nasalance and VHI were achieved. In our experiences UPPP, with the HS, improves speech and voice in patients affected by snoring and/or obstructive sleep apnea syndrome. [ABSTRACT FROM AUTHOR]

Intracellular cholesterol metabolism was reported to modulate amyloid-β (Aβ) generation in Alzheimer's disease (AD). Results presented herein demonstrated that, like brain cells, cultured skin fibroblasts from AD patients contained more cholesterol esters than fibroblasts from healthy subjects. Particularly, Oil Red-O, Nile Red, and filipin staining highlighted higher levels of neutral lipids which responded to inhibitors of acyl-coenzyme A:cholesterol acyl-transferase (ACAT-1), associated with an increase in free cholesterol. ACAT-1 mRNA levels increased significantly in AD fibroblasts, whereas those of sterol regulatory element binding protein-2, neutral cholesterol ester hydrolase, and ATP-binding cassette transporter member 1 were markedly down-regulated. Instead, mRNA levels of low-density lipoprotein receptor, hydroxy-methyl-glutaryl-coenzyme A reductase, caveolin-1, and amyloid-β protein precursor (AβPP) were virtually unchanged. Notably, mRNA levels of both β-site AβPP-cleaving enzyme 1 (BACE1) and neprilysin were significantly down-regulated. An increase in Aβ _{40}; and Aβ _{42}; immunostaining and a decrease in BACE1 active form were also found in AD versus control fibroblasts. Altogether, these findings support the hypothesis that the derangement of cholesterol homeostasis is a systemic alteration involving central but also peripheral cells of AD patients, and point to cholesterol ester levels in AD fibroblasts as an additional metabolic hallmark useful in the laboratory and clinical practice. [ABSTRACT FROM AUTHOR]

The objective of this study is to optimize the evaluation of the exposure to N, N-dimethylformamide (DMF) in synthetic leather factories by diffusive samplers. The DMF exposure was monitored in synthetic leather factories by two sampler types: active and diffusive. Air measurements were carried out using two different personal air samplers, a diffusive and an active one. The diffusive sampling method, TK200 with charcoal filters, was examined in comparison with pumping through NIOSH silica gel tubes workplace air as with the currently available “gold standard”. The evaluation was carried out, in two different years but in the same season, for all the duration of the shift, i. E. 8 h on workers employed in five different factories in the district of Florence and Prato (Italy). The statistical and graphical analysis of data show a good correlation between active and passive samplers ( r = 0. 96, P < 0. 001, n = 91), a good linear regression (DMFdiffusive = 0. 95 DMFactive + 0. 15, R 2 = 0. 92), a not statistically significant difference between data (tested by paired t test and non-parametric Wilcoxon test). Moreover, all these results are confirmed for data lower and higher than TLV-TWA, in particular we found a significant Pearson correlation ( r = 0. 92, P < 0. 001, n = 83; r = 0. 92, P < 0. 05, n = 8, respectively) and a significant linear regression (DMFdiffusive = 0. 88 DMFactive + 0. 73, R 2 = 0. 86; DMFdiffusive = 0. 90 DMFactive + 3. 76, R 2 = 0. 85). Besides, the analysis of graphical representations confirmed the previous evidences. Finally, we can not find a significant difference between different types of job. Due to the good agreement between the two groups of data, the TK200 samplers can be considered as a simpler approach than the pump for screening worker exposures to DMF. [ABSTRACT FROM AUTHOR]

Alzheimer''s disease (AD) is a progressive neurodegenerative illness and the most frequent cause of dementia in the elderly. The identification of activated microglia within neuritic plaques, coupled with the presence of numerous inflammatory proteins, suggests that inflammation is an integral part of the pathogenetic process in AD. In the present paper we have investigated the levels of circulating inflammatory mediators as potential AD biomarkers concentrating essentially on (a) soluble CD40 (sCD40), a member of the tumor necrosis factor receptor superfamily lacking the membrane-associated endodomain by alternative splicing, and (b) transforming growth factor (TGF)-β1, a cytokine deeply involved in AD and playing a protective role on CNS. Decrease of TGF-β1 in AD patients could enhance the effects of pro-inflammatory cytokines produced by activated microglia as well as the expression of factors, such as the CD40/CD40 ligand complex, by microglia and astrocytes.Total venous blood samples were obtained from 33 patients with clinical diagnosis of possible late-onset AD, 40 healthy age-matched and 11 healthy young individuals. A significant increase of sCD40 levels plasma of AD patients versus healthy controls was measured, concomitantly with a decrease in TGF-β1 concentration. These variations, however, showed no correlation with the expression of ApoE ε4 allele, which was determined in order to assess the different frequency of this risk factor between AD and control groups.Since no comparable modifications were detected in patients affected by Parkinson''s disease or non-AD-based dementia, we propose that sCD40 and TGF-β1 plasma levels might represent possible differential biomarkers of AD, and be useful pre-mortem to support the clinical diagnosis of late-onset AD. [Copyright &y& Elsevier]

Comprehensive geriatric assessment has become synonymous with geriatric practice. This includes evaluation of the older person’s physical and mental health, and the functional and social status. We propose a new way of representing a person’s condition, called the “polar diagram”. This shows the subject’s scores on the evaluation scales that are arranged in radial positions inside a circle. The outer part of the circle corresponds to the best condition. Gaps between the best condition and the actual scores are easily identified. The diagram can be employed to monitor the subject’s condition and to assess any changes in outcomes. [Copyright &y& Elsevier]

In this study, the authors evaluated exposure to airborne polycyclic aromatic hydrocarbons (PAHs) in workers exposed to exhaust gas from cars, and they assessed the efficiency of urinary 1-hydroxypyrene as an indicator of exposure to pyrene and PAHs. The authors selected 2 groups of police who worked in 2 areas in the city of Florence: 1 group was highly exposed to high-density traffic emissions during the winter and summer of 1997, and the 2nd group experienced low exposure to traffic emissions during the same period. Ambient monitoring was achieved with personal sampling of airborne PAHs during each workshift. Eight hydrocarbons were used as indicators of pollution caused by PAHs (e.g., pyrene, benzo[a]pyrene, benzo[a]anthracene, dibenzo[a,h]anthracene). Biological monitoring was performed through dosing of 1-hydroxypyrene (pyrene metabolite) in urine samples taken at the end of each workshift. The ambient monitoring revealed that PAH concentrations were influenced by both season of sampling and varying intensities of traffic in the different areas. The median concentration of benzo[a]pyrene in winter was twice as high in the high-density traffic area as in the low-density traffic area (i.e., 4.1 ng/m³ versus 1.8 ng/m³). [ABSTRACT FROM AUTHOR]

15 women with a positive patch test only to nickel (Ni) and without atopy and 10 control women were selected for the study. Blood and urine specimens were collected with a standard procedure either before (at 8 a.m.) or 4 and 24 h after the ingestion of 10 mg of Ni (as Ni sulfate). 7 of the Ni-sensitized patients showed a flare-up of eczema and/or urticaria during the test, while the other women were non-symptomatic. Serum and urine Ni of controls and Ni-sensitized women did not significantly differ. Serum and urine Ni levels determined before the oral Ni challenge were in the range of reference values recently reported by other authors (0.2-2.0 µg/l of serum or urine). Ni was greatly augmented in urine and serum 4 h after the challenge (25th-75th percentiles: 43-264 µg/l urine Ni and 15-52 µg/l serum Ni). 24 h after Ni ingestion, urine Ni was 41-153 µg/l and serum Ni 4-17 µg/l. Our study confirms a previous investigation showing similar levels of serum and urine Ni following ingestion of the metal in control and Ni-sensitized women without atopy. [ABSTRACT FROM AUTHOR]