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Cardiovascular diseases (CVDs) are among the most common causes of access to the Emergency Department and among the leading causes of death worldwide. Accurate diagnostic algorithms are mandatory to ensure a rapid life-saving treatment. However, non-specific clinical presentation and unnecessary referrals to other subspecialties may lead to misinterpretation of the diagnosis and delays. In recent years, the development of imaging technologies has allowed Computed Tomography (CT) to play a prominent role in the concepts of CVD rule-in and rule-out. An optimization strategy for CT protocols is needed to reduce variability and improve image quality. A correct diagnostic suspicion is crucial, as different districts (i.e., heart, aorta and pulmonary circulation) may require different investigation techniques. Additionally, the CVD pre-test probability assessment is highly correlated with CT accuracy. The purpose of this narrative review is to analyze the current role of CT in the approach to the CVDs in the ED, and to analyze the main strategies of CT optimization.

In December 2019, a disease caused by a novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was identified in Wuhan, Hubei Province, China. In March 2020, the World Health Organization declared the pandemic due to SARS-CoV-2. At the end of May 2020, SARS-CoV-2 confirmed cases and deaths due to novel Coronavirus disease (COVID-19) were about 6.5 million and 380,000, worldwide. In this commentary the authors argue on the impact of SARS-CoV-2 pandemic in different epidemiological settings within the Mediterranean area, discussing any possible association with higher or lower virus spread according to climatic factors, pollutants, characteristics of general population, and organization of health care services.

In the context of the global COVID-19 pandemic, companies and institutions all over the world are trying to find the best ways to reorganize their activity, minimizing the contagion risk among their employees, so as to protect their health and prevent internal SARS-COV-2 outbreaks. The recent development of new communication technologies, such as smartphones and tablets, has paved the way for the development and implementation of different applications. Starting with the above issues, in this study, we wanted to investigate the efficacy of iAudiometry application developed by our research team for the detection of deficits in the auditory system. Furthermore, we analyzed the precision in detecting ambient Sound Pressure Levels between 3 different types of headphones. To this aim we divided the study and development process into four main phases: the feasibility study; the development of a signal generation algorithm, calibration and evaluation of the ambient Sound Pressure Level (SPL) on different types of headphones, and; a comparative study between conventional audiometry and an app with related headphones. Finally, this study allowed us to differentiate the headphones tested into 3 different types: headphones suitable for professional screening; Bluetooth headphones suitable for professional screening, and; headphones with slight but statistically significant differences, not suitable for professional screening. Our App is able to easily reproduce a reliable audiometric screening, limiting the contact between patient and examiner.

Agonistic sport represents a physically stressful situation associated with the release of catecholamine and cortisol that in turn influence the immune system. This study aimed to investigate the influence, in a team of water polo players, of the emotional processes characterizing the phase of waiting for the race on endocrine changes at the end of an official match. Thirteen professional water polo players participated in this study. Each player provided two saliva samples before and after three different time phases: (1) rest time, (2) workout and (3) competition. The results of the present study showed a significant increase in salivary cortisol levels before and after the competition and after workout sections. Our research confirms that the changes observed in athletes after the official competition depend both on the effects of the psycho-physical stress of the race and on other behavioral factors present before the athletic competition.

L'articolo presenta il confronto dei risultati ottenuti su un edificio in muratura da analisi statiche nonlineari utilizzando diversi software, disponibili anche a livello professionale, che operano nell'ambito di vari approcci di modellazione. La struttura esaminata è ispirata ad un edificio reale, la scuola "P. Capuzi" di Visso (MC), gravemente danneggiata a seguito degli eventi sismici che hanno interessato il Centro Italia nel 2016/2017. L'attività descritta si inquadra in un più ampio programma di ricerca svolto in sinergia da varie unità coinvolte nel progetto ReLUIS 2017/2108 - Linea Strutture in Muratura e avente come oggetto l'analisi di strutture benchmark per la valutazione dell'affidabilità di codici di calcolo. Obiettivi più generali dell'attività sono quelli di sensibilizzare i professionisti ad un uso più consapevole dei software e fornire loro strumenti utili ad analizzare criticamente qualità e correttezza delle soluzioni ottenute. I dati di input e alcune scelte di modellazione sono stati condivisi al fine di limitare la potenziale dispersione dei risultati e renderne meno problematico il confronto. Quest'ultima finalità è guidata dalla volontà di ottimizzare la fase di controllo dei risultati, per la quale sono state individuate precise modalità operative. Il confronto delle analisi è stato svolto in relazione a parametri: globali (inerenti le proprietà dinamiche, le curve di capacità globale e le relative curve bilineari equivalenti), sintetici della sicurezza strutturale (quale, ad esempio, l'accelerazione massima compatibile con lo stato limite di salvaguardia della vita) e interpretativi della risposta complessiva (relativi al quadro di danno simulato). I risultati presentati consentono di eseguire delle riflessioni sull'utilizzo dei software, sulla dispersione dei risultati ottenibili e sulle potenziali ricadute in ambito professionale.

The effects of alcohol have been widely studied during the past century as alcohol abuse is a major health problem in Western society. In the last years, a growing body of evidence indicates that acetaldehyde, the first oxidation product of ethanol, is one of the mediators of peripheral and central effects of ethanol. Indeed, acetaldehyde has been recently taken into account as the mediator of the rewarding properties of alcohol. The role of acetaldehyde in ethanol-related properties has been proved by enzymatic manipulation studies in which the inactivation of acetaldehyde potentially synthesized in the brain produces the same results as blocking the formation of acetaldehyde by inhibiting brain catalase activity. Moreover, electrophysiological and pharmacological analyses showed that acetaldehyde is able to stimulate dopamine release in the nucleus accumbens through enhancement of firing rate, spikes/burst, and burst firing of ventral tegmental neurons. Thus, the aim of this review is to summarize latest results on the role of acetaldehyde as the mediator of ethanol-central effects.

Le cardiopatie da esposizione a sostanze chimiche hanno in passato suscitato un interesse secondario in confronto ad altre patologie più specificatamente correlate a noxae lavorative e caratterizzate da quadri clinici e fisiopatologici patognomonici per tecnopatia. Proprio la specificità di tali forme le ha rese di difficile diagnosi quando sganciate dal contesto eziologico lavorativo. Inoltre negli ambienti di lavoro a rischio chimico si verificano spesso situazioni di esposizione a molteplici sostanze, i cui effetti sulla salute a lungo termine sono di difficile interpretazione, visto il miglioramento complessivo delle condizioni di lavoro nei paesi occidentali e l’osservanza dei valori limite di esposizione imposti dalla normativa vigente in materia. si aggiunga poi l’effetto non trascurabile dei cosiddetti fattori di confondimento, come le abitudini voluttuarie (fumo, alcol) o l’ipercolesterolelmia o l’obesità o l’impiego di farmaci singolarmente ed in associazione, o la presenza di cardiopatie preesistenti. Da quanto sopra detto, ne consegue l’importanza della sorveglianza sanitaria nei lavoratori esposti a rischio chimico, come strumento indispensabile nella prevenzione delle malattie professionali. A tal proposito il nostro studio si è rivolto in particolare alla individuazione di eventuali effetti cardiolesivi precoci e tardivi attraverso un protocollo clinico e di esami di laboratorio specifici

Nei lavoratori esposti a rischio chimico, la sorveglianza sanitaria risulta strumento indispensabile nella prevenzione delle malattie professionali. A tal proposito il nostro studio si è rivolto in particolare alla individuazione di eventuali effetti nefrolesivi precoci attraverso un protocollo clinico e di esami di laboratorio specifici.

Nei lavoratori esposti a rischio da vibrazioni mano-braccio è indispensabile un’efficace sorveglianza sanitaria in linea con la recente normativa in materia, a garanzia della salute e della sicurezza nei luoghi di lavoro. In particolare abbiamo esaminato un gruppo di soggetti addetti alla manutenzione di aree verdi applicando le linee guida più recenti e la vigente normativa in tema di prevenzione(1,3) . As concerns those workers exposed to a risk of hand-arm vibration, an efficacious sanitary monitoring is necessary, according to recent norms, in order to assure health and secu - rity in workplaces. We have examined a group of people assigned to the maintenance of green spaces, applying the most recent guideli - nes and norms related to prevention policies.

This chapter presents a critical analysis of the case law of the European Court of Justice and of the General Court relating to the application of the international law of treaties. It covers the some forty cases in which the Courts have referred explicitly to the Vienna Convention on the Law of Treaties 1969, and a few more where this happened implicitly, during the period 1998–2010. Inevitably the emphasis falls on the application of the rules of treaty interpretation to the international agreements concluded by the European Union (EU), but also to the founding treaties of the EU itself. The Courts have been confronted with great regularity with questions relating to the law of treaties and thus have become increasingly sophisticated in their use of it. The recent accusation that the Court is adverse to international law seems to be based on a few dramatic cases, not on the steady stream of smaller cases in which the law of treaties plays a role.

Lately, the Court of Justice has been harshly criticised for having unduly restricted the effects of international law within the European legal order. Cases such as Van Parys, Kadi, Mox Plant, Intertanko, and Commune de Mesquer have led scholars to argue that the Court of Justice is becoming less international law friendly. This brings interesting questions to the fore: has the case-law changed? And if there is a change, is this change due to a different attitude of the Court of Justice towards international law? What factors could have influenced the recent decisions of the Court of Justice? This working paper addresses these questions. It analyses the Court’s recent decisions concerning international law, contrasts them with earlier rulings and places them in the broader context of the Court’s understanding of the European legal order. The analysis leads to a more nuanced conclusion. The Court’s attitude towards international law cannot easily be placed on a one dimensional scale of ‘international law friendliness’. Finally, four observations are made on what might have influenced the Court’s rulings in recent years.