Looking for an Objective Parameter to Identify Early Vocal Dysfunctions in Healthy Perceived Singers

The finding of minimal laryngeal dysfunctions in professional voice users is essential to prevent the onset of organic vocal pathologies. The purpose of this study is to identify an objective parameter that supports the phoniatric evaluation in detecting minimal laryngeal dysfunctions in singers. 54 professional and non-professional singers have been evaluated with laryngostroboscopy, Multi-Dimensional Voice Program (MDVP), Dysphonia Severity Index (DSI), maximum phonation time (TMF), minimum intensity of sound emission (I-min), maximum frequency (F-max), voice handicap index (VHI), singing voice handicap index (SVHI), manual phonogram and audiometric examination. The SVHI of all the "healthy" singers was on average 23.7 ± 22.5, while that of the "dysfunctional" 20.9 ± 18. No statistically significant difference was found between the SVHI scores of the total of healthy singers compared to the scores of the dysfunctional ones on the VSL (p = 0.6). The between-group comparison of the means of individual parameter values of DSI, TMF, F-max, Jitter, Shimmer, NHR, and SPI was not statistically significant (respectively p = 0.315, 0.2, 0.18, 0.09, 0.2, 0.08, 0.3). The only parameter analyzed that was statistically significant was the I-min (p < 0.05). SVHI is a valid instrument for the evaluation after a therapy but in our experience, it is not useful in distinguishing healthy from dysfunctional patients. The minimum intensity of sound emission measured with the sound level meter (I-low2) resulted a reliable parameter to identify minimal laryngeal dysfunctions and a useful tool in supporting the phoniatric diagnostic-therapeutic process in singers.

Women's wrist and elbow at work: analysis of acute injuries and cumulative trauma disorders to improve ergonomics in female-dominated activities

The aim of this study is to analyse women's wrist and elbow acute work injuries together with cumulative trauma disorders, such as carpal tunnel syndrome (CTS) and epicondylitis. Five years records (2015-2019) on women's wrist/elbow acute work injuries and CTS/epicondilytis, from Italian National Compensation Authority, were collected and pooled all together as 'dis-ac' (disorders + acute) events. A statistical analysis was performed in comparing the different female-dominated work sectors. Results showed that hairdressing/laundry sector was associated with the highest risk for wrist acute work injuries and cleaning for elbow while manufacturing for CTS and epicondylitis. Hairdressing/laundry and manufacturing were associated with the highest risk for dis-ac events (hairdressing: wrist dis-ac OR: 4.89; CI 95% 4.22-5.67; elbow dis-ac OR: 3.70; CI 95% 2.99-4.58; manufacturing: wrist dis-ac OR: 3.39; CI 95% 3.13-3.66; elbow dis-ac OR: 2.45; CI 95% 2.20-2.73). The relationship between acute injuries and cumulative trauma disorders is discussed to preserve women's safety and health in ergonomics.Practitioner Summary: Women's wrist and elbow acute work injuries and cumulative trauma disorders (carpal tunnel syndrome and epicondylitis) were analysed and studied all together (dis-ac events) in female-dominated activities. Hairdressing and manufacturing work sectors were associated with the highest risk, showing the need to safeguard the health and safety of female workers.

How direct measurements of worker eyes with a Scheimpflug camera can affect lensdose coefficients in interventional radiology

The 2013/59/Euratom Directive reduced the occupational exposure limits for the lens. Since it has become crucial to estimate the dose absorbed by the lens, we have studied the individual variability of exposed workers' ocular conformations with respect to the data estimated from their personal dosimetry. The anterior eye conformations of 45 exposed workers were acquired using Scheimpflug imaging and classified according to their sight conditions (emmetropia, myopia or hypermetropia). Three eye models were computed, with two lens reconstructions, and implemented in an interventional radiology scenario using Monte Carlo code. The models were dosimetrically analysed by simulating setup A, a theoretical monoenergetic and isotropic photon source (10-150 keV) and setup B, a more realistic interventional setting with an angiographic x-ray unit (50, 75, 100 kV peak). Scheimpflug imaging provided an average anterior chamber depth of (6.4 ± 0.5) mm and a lens depth of (3.9 ± 0.3) mm, together with a reconstructed equatorial lens length of (7.1-10.1) mm. Using these data for model reconstruction, dose coefficients (DCs) were simulated for all ocular structures. Regardless of the eye model used, the DCs showed a similar trend with radiation energy, which highlighted that for the same energy and setup, no significant dependence on ocular morphology and workers' visual conditions was observed. The maximum difference obtained did not exceed 1% for all eye models or structures analysed. Therefore, the individual variabilities of worker ocular anatomy do not require any additional correction, compared to the personal dosimetry data measured with a dedicated lens dosimeter. To estimate the dose absorbed by the other eye structures, it is, instead, essential to know the spectrum of the source that has generated the irradiation, since there are differences between monoenergetic sources and more realistic angiographic units.

[Commuting accidents while walking: a women occupational risk]

BACKGROUND

there are few studies in occupational health literature addressing the issue of work injuries among women.

OBJECTIVES

the purpose of this study is to examine gender differences in the occurrence and causes of one type of work injuries which is more frequent among women: the commuting accident while walking.

DESIGN

this study is based on the data of recognized commuting while walking injuries in the industrial and service sectors recorded by the Italian National Institute for Insurance against Accidents at Work during the last five years (2014-2018).

SETTING AND PARTICIPANTS

Italy; all compensated workers for commuting while walking injuries.

MAIN OUTCOME MEASURES

number of injuries, rate incidence, incidence rate ratio, odds ratio.

RESULTS

commuting while walking injuries in the last five years were three times more frequent among women, with an increasing incidence over the years and by age (women: 1,31‰ vs men 0,40‰; IR 3,24; 95%CI 3,19-3,30). Women were more often injured going to work, in winter, on Mondays, in the North-Western areas of the country. Female mail-carriers, cleaners, care givers, public administrators were particularly vulnerable, especially the less young (>=50 years old). Females were at a higher risk for fractures particularly of wrist, elbow, and foot, while males had a higher risk for hand, knee, and chest injuries. Gender difference in incidence rate and type of commuting while walking injuries may be also due to a diverse work and home exposures together with fall dynamics.

CONCLUSIONS

commuting while walking work injuries show the higher incidence rate among women and the need to gender oriented prevention.

DNA damage in lens epithelial cells exposed to occupationally-relevant X-ray doses and role in cataract formation

The current framework of radiological protection of occupational exposed medical workers reduced the eye-lens equivalent dose limit from 150 to 20 mSv per year requiring an accurate dosimetric evaluation and an increase understanding of radiation induced effects on Lens cells considering the typical scenario of occupational exposed medical operators. Indeed, it is widely accepted that genomic damage of Lens epithelial cells (LEC) is a key mechanism of cataractogenesis. However, the relationship between apoptosis and cataractogenesis is still controversial. In this study biological and physical data are combined to improve the understanding of radiation induced effects on LEC. To characterize the occupational exposure of medical workers during angiographic procedures an INNOVA 4100 (General Electric Healthcare) equipment was used (scenario A). Additional experiments were conducted using a research tube (scenario B). For both scenarios, the frequencies of binucleated cells, micronuclei, p21-positive cells were assessed with different doses and dose rates. A Monte-Carlo study was conducted using a model for the photon generation with the X-ray tubes and with the Petri dishes considering the two different scenarios (A and B) to reproduce the experimental conditions and validate the irradiation setups to the cells. The simulation results have been tallied using the Monte Carlo code MCNP6. The spectral characteristics of the different X-ray beams have been estimated. All irradiated samples showed frequencies of micronuclei and p21-positive cells higher than the unirradiated controls. Differences in frequencies increased with the delivered dose measured with Gafchromic films XR-RV3. The spectrum incident on eye lens and Petri, as estimated with MCNP6, was in good agreement in the scenario A (confirming the experimental setup), while the mean energy spectrum was higher in the scenario B. Nevertheless, the response of LEC seemed mainly related to the measured absorbed dose. No effects on viability were detected. Our results support the hypothesis that apoptosis is not responsible for cataract induced by low doses of X-ray (i.e. 25 mGy) while the induction of transient p21 may interfere with the disassembly of the nuclear envelop in differentiating LEC, leading to cataract formation. Further studies are needed to better clarify the relationship we suggested between DNA damage, transient p21 induction and the inability of LEC enucleation.

Non-vehicle commuting in Italy: need for ergonomic action for women's lower limbs?

INTRODUCTION

The aim of this paper is to examine gender differences in the occurrence of accidents among workers while walking to or from their workplace (non-vehicle commuting accidents). We have previously found that the lower limb is more often injured at work among women, compared to men, so the paper concentrates on lower limb injuries.

METHODS

Using the records of the National Institute for Insurance against Injuries at Work (INAIL), we focused on the non-vehicle commuting accidents of women and men recognized as work-related for the period 2013-2017. In particular, we examined the gender difference by work sector and type of trauma suffered with particular attention to lower limb injuries.

RESULTS

The rate of non-vehicle commuting accidents (n. 60,936) among women was significantly higher than for men (1.29‰ vs 0.40‰ men, p < 0.001) for the period studied. Lower limb injuries (50.5% for women and 43.7% for men, p < 0.001) constituted the large majority of these injuries. In particular, dislocation of the ankle (78% for women vs 65.5% for men, p < 0.001), bruise of the knee (71.2% for women vs 54.9% for men, p < 0.001) and fracture of the foot (41% for women vs 33.6% for men, p < 0.001) were all significantly higher among women. The work sectors with higher injury rates were: Transport and Warehouse, Public Administration, Health and care services and Wholesale and retail trade. This result may be due to wear and tear from conditions at work. The women injured were on the average, a decade older than men (50-59 vs 40-49 years old).

CONCLUSIONS

Non-vehicle commuting represents an important, albeight neglected, preventable risk for women workers, causing lower limb trauma particularly at the ankle, the foot and the knee. These areas may be particularly injure-prone among women in specific sectors, due to the work environment. Effective prevention of these injuries requires gender-oriented ergonomic actions at work and in the commuting environment.

Risk of fall among the hospitalized over-49 population. A retrospective cohort study in a hospital

Background

Despite the copious efforts made to prevent the problem, inpatient falls remain one of the most common adverse events in hospitals, with high risks in term of morbidity and mortality rates, as well as high costs for the healthcare system. This study aims to evaluate the inpatient falls incidence rate in a hospital in Rome, Italy.

Methods

A retrospective cohort study has been set out based on data collected by a Risk Management Unit concerning the falls of patients over 49 years, which happened in the hospital between 1st July 2008 and 30th June 2013. Data collected from the incident report forms were inserted in a database and analyzed using the statistical program SPSS, 20.0 Illinois version.

Results

During the period observed, 516 falls were reported. Patients who fell had a mean age of 68.8 years (SD ± 16.2). The falls are distributed for these age groups: 109 (21.1%) in 50-64; 129 (25%) in 65-74; 181 (35.1%) in 75-84; 97 (18.8%) in &gt; 84. Fall incidence rate was calculated on the overall number of hospital admissions in the observed period (N = 35,812) (1.44 per 100 hospital admissions IC95% 1.32-1.56). Most of the patients were men (333; 64.5%) and older than 75 (53.9%). Inpatient falls were more frequent in the medicine wards (incidence rate 2.2 per 100 hospital admissions, IC95% 1.85-2.55,). The 51.6% of falls happened during the night shift. Severe outcome resulted in 13.6% of falls. Most of the falls (52.3%) happened within three days from the hospital admission. At multivariate analysis, a period of 2-3 days from hospital admission is the main risk factor to determine severe outcomes such as death or cranial trauma (p = 0.02; OR 2.87 IC95% 1.16-7.09).

Conclusions

The study contributes to measure the phenomenon in older adults and age group 50-64, identifying a specific indicator to properly measure inpatient falls incidence rate in the elderly. The study gives indications on the main risk factors related to this adverse event and on prevention strategies.

Key messages

Falls in hospital is an important adverse event not only in the elderly. The first period of three days from the hospital admission constitutes the main risk factor for the falls.

Ultrasound delivery of Surface Enhanced InfraRed Absorption active gold-nanoprobes into fibroblast cells: a biological study via Synchrotron-based InfraRed microanalysis at single cell level

Ultrasound (US) induced transient membrane permeabilisation has emerged as a hugely promising tool for the delivery of exogenous vectors through the cytoplasmic membrane, paving the way to the design of novel anticancer strategies by targeting functional nanomaterials to specific biological sites. An essential step towards this end is the detailed recognition of suitably marked nanoparticles in sonoporated cells and the investigation of the potential related biological effects. By taking advantage of Synchrotron Radiation Fourier Transform Infrared micro-spectroscopy (SR-microFTIR) in providing highly sensitive analysis at the single cell level, we studied the internalisation of a nanoprobe within fibroblasts (NIH-3T3) promoted by low-intensity US. To this aim we employed 20 nm gold nanoparticles conjugated with the IR marker 4-aminothiophenol. The significant Surface Enhanced Infrared Absorption provided by the nanoprobes, with an absorbance increase up to two orders of magnitude, allowed us to efficiently recognise their inclusion within cells. Notably, the selective and stable SR-microFTIR detection from single cells that have internalised the nanoprobe exhibited clear changes in both shape and intensity of the spectral profile, highlighting the occurrence of biological effects. Flow cytometry, immunofluorescence and murine cytokinesis-block micronucleus assays confirmed the presence of slight but significant cytotoxic and genotoxic events associated with the US-nanoprobe combined treatments. Our results can provide novel hints towards US and nanomedicine combined strategies for cell spectral imaging as well as drug delivery-based therapies.

In vitro effects of 1-MHz ultrasound on the mitotic spindle

The effects of ultrasound on the cytoskeleton, comprising microtubules, had been studied decades ago. Nonetheless, very little attention has been paid to the effects of ultrasound on the mitotic spindle, which is also formed by microtubules. In this study, we treated human fibroblasts and human cancer cells (HeLa and MCF-7) with 1-MHz ultrasound at low intensities (70, 140, and 300 mW/cm² ). In all cell lines, 5 min after the end of sonication, we found an intensity-dependent increase of mitotic abnormalities (including multipolar spindles). Two hours after sonication, these abnormalities were present, but at much lower frequencies. Twenty-four hours after sonication, mitotic abnormalities were at the same level of untreated samples, suggesting a transient effect due to ultrasound. Beside abnormalities of the mitotic spindle, we also observed an increase of metaphases with nonaligned chromosomes. The mitotic index of fibroblasts and HeLa cells, two hours after sonication, showed an intensity-dependent decrease; this was not observed in MCF-7 cells. In agreement with this last result, ultrasound-induced growth inhibition (which was also intensity-dependent) was more marked in fibroblasts and HeLa cells compared to MCF-7 cells. This work indicates that therapeutic ultrasound, even at intensities below the cavitation threshold, can affect genome integrity, showing the need to increase the knowledge of the potential risks of ultrasound to human health. Environ. Mol. Mutagen. 2019. © 2019 Wiley Periodicals, Inc.

Very low intensity ultrasounds as a new strategy to improve selective delivery of nanoparticles-complexes in cancer cells

Background

The possibility to combine Low Intensity UltraSound (LIUS) and Nanoparticles (NP) could represent a promising strategy for drugs delivery in tumors difficult to treat overcoming resistance to therapies. On one side the NP can carry drugs that specifically target the tumors on the other the LIUS can facilitate and direct the delivery to the tumor cells. In this study, we investigated whether Very Low Intensity UltraSound (VLIUS), at intensities lower than 120 mW/cm², might constitute a novel strategy to improve delivery to tumor cells. Thus, in order to verify the efficacy of this novel modality in terms of increase selective uptake in tumoral cells and translate speedily in clinical practice, we investigated VLIUS in three different in vitro experimental tumor models and normal cells adopting three different therapeutic strategies.

Methods

VLIUS at different intensities and exposure time were applied to tumor and normal cells to evaluate the efficiency in uptake of labeled human ferritin (HFt)-based NP, the delivery of NP complexed Firefly luciferase reported gene (lipoplex-LUC), and the tumor-killing of chemotherapeutic agent.

Results

Specifically, we found that specific VLIUS intensity (120 mW/cm²) increases tumor cell uptake of HFt-based NPs at specific concentration (0.5 mg/ml). Similarly, VLIUS treatments increase significantly tumor cells delivery of lipoplex-LUC cargos. Furthermore, of interest, VLIUS increases tumor killing of chemotherapy drug trabectedin in a time dependent fashion. Noteworthy, VLIUS treatments are well tolerated in normal cells with not significant effects on cell survival, NPs delivery and drug-induced toxicity, suggesting a tumor specific fashion.

Conclusions

Our data shed novel lights on the potential application of VLIUS for the design and development of novel therapeutic strategies aiming to efficiently deliver NP loaded cargos or anticancer drugs into more aggressive and unresponsive tumors niche.

Electronic supplementary material

The online version of this article (10.1186/s13046-018-1018-6) contains supplementary material, which is available to authorized users.

Genomic damage induced by 1-MHz ultrasound in vitro

Genotoxic effects of therapeutic ultrasound are poorly documented, when compared with the wide use of this physical agent. The aim of this work was to investigate the clastogenic and aneugenic potential of 1 MHz ultrasound, employing intensities (200 and 300 mW/cm² ) above the cavitational threshold, but in the range of those normally used in therapeutics. Both normal fibroblasts (AG01522) and tumoral cells (MCF-7) were sonicated. While no effects on viability were noted, significant increases of CREST-negative micronuclei (indicative of clastogenesis) and CREST-positive micronuclei (indicative of aneuploidy) were detected. Clastogenesis was confirmed by increases of γ-H2AX foci, while increases of spindle anomalies confirmed the induction of aneuploidy. Our results confirm previous works that showed ultrasound-induced DNA breakage. Moreover, our experiments show that the known effect of ultrasound-induced damage to microtubules is also able to damage the mitotic spindle and induce aneuploidy. On the overall, this work highlights the importance to further investigate the potential risks related to therapeutics US. Environ. Mol. Mutagen. 59:60-68, 2018. © 2017 Wiley Periodicals, Inc.

Differential effects on membrane permeability and viability of human keratinocyte cells undergoing very low intensity megasonic fields

Among different therapeutic applications of Ultrasound (US), transient membrane sonoporation (SP) - a temporary, non-lethal porosity, mechanically induced in cell membranes through US exposure - represents a compelling opportunity towards an efficient and safe drug delivery. Nevertheless, progresses in this field have been limited by an insufficient understanding of the potential cytotoxic effects of US related to the failure of the cellular repair and to the possible activation of inflammatory pathway. In this framework we studied the in vitro effects of very low-intensity US on a human keratinocyte cell line, which represents an ideal model system of skin protective barrier cells which are the first to be involved during medical US treatments. Bioeffects linked to US application at 1 MHz varying the exposure parameters were investigated by fluorescence microscopy and fluorescence activated cell sorting. Our results indicate that keratinocytes undergoing low US doses can uptake drug model molecules with size and efficiency which depend on exposure parameters. According to sub-cavitation SP models, we have identified the range of doses triggering transient membrane SP, actually with negligible biological damage. By increasing US doses we observed a reduced cells viability and an inflammatory gene overexpression enlightening novel healthy relevant strategies.

[Gender differences and commuting accidents in Italy: INAIL Data Base analysis on fatalities (2009-2013)]

BACKGROUND

Commuting accidents represent the leading cause of work-related fatalities among women in Italy. For working women, the journey from home to work is the most dangerous part of the day.

OBJECTIVES

Analysis of data on fatal commuting accidents in order to identify risk factors among women.

METHODS

INAIL Statistical Data (2009-2013) related to fatal commuting were analyzed by gender, age, immigration, activities, geographical area, working time, month and day of the week.

RESULTS

Italian and immigrant women die mainly from commuting accidents (207 cases out of 371; 56%), a significant number of immigrant women also die in commuting accidents involving no vehicles (4%); Italian and immigrant men die mainly from causes related to the work environment (48%), especially immigrants (54%), and not from commuting accidents (921 out of 3997; 23%). Prevalent age at commuting fatality is 35-49 years, and among immigrant women 18-34. Deaths among women occur mostly in Northeast Italy, and among women working in health and social services; among immigrant women accommodation and catering services are also relevant. The highest number of fatal accidents among men occurs in Northwest Italy, among men working in wholesale trade. All fatalities take place mainly going to work, between 5-10 a.m., among women from October to December, among men from July to September, among Italian women are significantly higher on Saturday, among immigrant women on Sunday. Deaths among men are significantly higher in the eighth hour of work, between 3- 8 p.m. and on Monday among Italian workers, on Wednesday among immigrant men.

CONCLUSIONS

Commuting fatalities among women, according to INAIL Statistical Data, show specific risk conditions by age, immigration, work activity, geographical area, working time, month and day of the week that require targeted preventive policies.

[Health issues and regulatory aspects of the use of ultrasound in physiotherapy]

The use of ultrasounds in medicine requires, like all physical agents potentially harmful to human health, an accurate assessment of the risks to the health of patients. The nature and extent of these risks depend on exposure levels which in turn are differentiated according to the specific diagnostic or therapeutic applications. Intermediate exposure levels are associated to physiotherapic applications. To analyze specific issues relating to the effectiveness and safety of physiotherapic treatments, a review of the scientific literature and technical standards was carried out. At present, the actual effectiveness of ultrasound physiotherapy is still far from being clearly assessed: further clinical and experimental studies are needed in order to optimize therapies, determining the benefits and risks of treatments and deepening the understanding of the action mechanisms of the physical agent, even on the basis of a better characterization of those physical quantities mostly significant for biological effects. The examination of technical standards defining the security requirements of the equipment allowed the identification of some critical issues; on these bases some proposals are suggested for the improvement of quality and safety of treatments.

Potential third-party radiation exposure from patients undergoing therapy with 131I for thyroid cancer or metastases

The purpose of this work is to evaluate the potential third-party radiation exposure from patients undergoing therapy with 131I for ablation of residual thyroid tumor or metastases, based in part on serial measurements of exposure rates. Exposure rate measurements were performed at 1 m and 5 cm from the surface of each treated patient until patient release. Dose estimates based on measured exposure rates were compared with those based on analytic point-source (PSM) and line-source (LSM) models. Effective doses D(∞) to travelers, co-workers and sleeping partners were estimated by using the standard gamma factor (Γ) and the physical half-life or the values derived from measured data. Seven hundred ten patients were studied until the exposure at 1 m was below the constraints of 0.010 mSv. The 131I activities administered ranged from 1.85 to 11.0 GBq (median: 3.7 GBq), according to the therapeutic requirements. Based on the PSM and an experimental Γ, the mean/maximum estimated D(∞) to sleeping partners, partners, travelers, and co-workers were 2.60/20.65, 0.32/2.53, 0.96/7.59, and 0.57/4.50 mSv, respectively. Using the LSM and an experimental Γ, the D(∞) values were 2.41/19.15, 0.32/2.50, 0.83/6.62, and 0.57/4.42 mSv, respectively, while they were almost double using the theoretical Γ. The results presented, based on measured data in a large cohort of 131I-treated thyroid cancer patients, will allow more accurate estimation of potential third-party D(∞) following patient release and thus may be used to better inform physicians and hospital staff on recommendations for patient release and post-release precautions following radioiodine therapies.

Ultrasound well below the intensity threshold of cavitation can promote efficient uptake of small drug model molecules in fibroblast cells

Ultrasound (US) induced enhancement of plasma membrane permeability is a hugely promising tool for delivering exogenous vectors at the specific biological site in a safe and efficient way. In this respect, here we report effects of membrane permeability alteration on fibroblast-like cells undergoing very low-intensity of US. The change in permeability was pointed out in terms of high uptake efficiency of the fluoroprobe calcein, thus resembling internalization of small cell-impermeable model drugs, as measured by fluorescence microscopy and flow cytometry. Fluorescence evidences moreover suggests that the higher the time of exposure, the larger will be the size of molecules can be internalized. The uptake events were related to the cell viability and also with structural changes occurring at membrane level as revealed by infrared spectroscopy and preliminary membrane fluidity and atomic force microscopy (AFM) investigation. Thus, the question of whether the uptake of cell-impermeable molecules is consistent with the presence of disruptions on the cell membrane (sonopore formation) has been addressed. In this framework, our findings may constitute experimental evidence in support of sub-cavitation sonoporation models recently proposed, and they may also provide some hints towards the actual working condition of medical US dealing with the optimum risk to benefit therapeutic ratio.

Structural and permeability sensitivity of cells to low intensity ultrasound: Infrared and fluorescence evidence in vitro

This work is focused on the in vitro study of the effects induced by medical ultrasound (US) in murine fibroblast cells (NIH-3T3) at a low-intensity of exposure (spatial peak temporal average intensity Ita<0.1Wcm(-2)). Conventional 1MHz and 3MHz US devices of therapeutic relevance were employed with varying intensity and exposure time parameters. In this framework, upon cells exposure to US, structural changes at the molecular level were evaluated by infrared spectroscopy; alterations in plasma membrane permeability were monitored in terms of uptake efficiency of small cell-impermeable model drug molecules, as measured by fluorescence microscopy and flow cytometry. The results were related to the cell viability and combined with the statistical PCA analysis, confirming that NIH-3T3 cells are sensitive to therapeutic US, mainly at 1MHz, with time-dependent increases in both efficiency of uptake, recovery of wild-type membrane permeability, and the size of molecules entering 3T3. On the contrary, the exposures from US equipment at 3MHz show uptakes comparable with untreated samples.

Dose evaluation for skin and organ in hepatocellular carcinoma during angiographic procedure

PURPOSE

The purpose of this study is to evaluate the radiation dose in patients undergoing liver angiographic procedure and verify the usefulness of different dose measurements to prevent deterministic effects. Gafchromic film, MicroMOSFET data and DIAMENTOR device of the X-ray system were used to characterize the examined interventional radiology (IR) procedure.

MATERIALS AND METHODS

A liver embolization procedure, the SIRT (Selective Internal Radiation Therapy), was investigated. The exposure parameters from the DIAMENTOR as well as patient and geometrical data were registered. Entrance skin dose map obtained using Gafchromic film (ESDGAF) in a standard phantom as well as in 12 patients were used to calculate the maximum skin dose (MSDGAF). MicroMOSFETs were used to assess ESD in relevant points/areas. Moreover, the maximum value of five MicroMOSFETs array, due to the extension of treated area and to the relative distance of 2-3 cm of two adjacent MicroMOSFETs, was useful to predict the MSD without interfering with the clinical practice. PCXMC vers.1.5 was used to calculate effective dose (E) and equivalent dose (H).

RESULTS

The mean dose-area product (DAPDIAMENTOR) for SIRT procedures was 166 Gycm2, although a wide range was observed. The mean MSDGAF for SIRT procedures was 1090 mGy, although a wide range was experienced. A correlation was found between the MSDGAF measured on a patient and the DAPDIAMENTOR value for liver embolizations. MOSFET and Gafchromic data were in agreement within 5% in homogeneous area and within 20% in high dose gradient regions. The mean equivalent dose in critical organs was 89.8 mSv for kidneys, 22.9 mSv for pancreas, 20.2 mSv for small intestine and 21.0 mSv for spleen. Whereas the mean E was 3.7 mSv (range: 0.5-13.7).

CONCLUSIONS

Gafchromic films result useful to study patient exposure and determine localization and amplitude of high dose skin areas to better predict the skin injuries. Then, DAPDIAMENTOR or MOSFET data could offer real-time methods, as on-line dose alert, to avoid any side effects during liver embolization with prolonged duration.

[Cell phones: health risks and prevention]

The paper describes first of all the electromagnetic radiation of cellular phones and presents the physical parameters used to measure and evaluate the absorption of emissions of radio stations and cellular phones. It then presents selected research results of the experimental studies in vivo and in vitro which examine the biological effects of the emissions of cellular phones. The review of the epidemiologic evidence focuses in particular the epidemiologic studies on the use of cell phones and brain tumours, identifying some of the reasons of the conflicting results obtained. Studies dealing with the health risks involved in the increasing use of cellular phones by adolescents and children, more sensitive to this exposure, are also presented showing the need for special caution. The problem of hypersensitivity observed in some individuals is also briefly discussed. Finally the paper presents a summary of the main prevention measures necessary in order to reduce the risks in the framework of the "precautionary principle" including prevention policies and exposure limits in various countries.

Ultrasound-mediated structural changes in cells revealed by FTIR spectroscopy: a contribution to the optimization of gene and drug delivery

Ultrasound effects on biological samples are gaining a growing interest concerning in particular, the intracellular delivery of drugs and genes in a safe and in a efficient way. Future progress in this field will require a better understanding of how ultrasound and acoustic cavitation affect the biological system properties. The morphological changes of cells due to ultrasound (US) exposure have been extensively studied, while little attention has been given to the cells structural changes. We have exposed two different cell lines to 1 MHz frequency ultrasound currently used in therapy, Jurkat T-lymphocytes and NIH-3T3 fibroblasts, both employed as models respectively in the apoptosis and in the gene therapy studies. The Fourier Transform Infrared (FTIR) Spectroscopy was used as probe to reveal the structural changes in particular molecular groups belonging to the main biological systems. The genotoxic damage of cells exposed to ultrasound was ascertained by the Cytokinesis-Block Micronucleus (CBMN) assay. The FTIR spectroscopy results, combined with multivariate statistical analysis, regarding all cellular components (lipids, proteins, nucleic acids) of the two cell lines, show that Jurkat cells are more sensitive to therapeutic ultrasound in the lipid and protein regions, whereas the NIH-3T3 cells are more sensitive in the nucleic acids region; a meaningful genotoxic effect is present in both cell lines only for long sonication times while in the Jurkat cells also a significant cytotoxic effect is revealed for long times of exposure to ultrasound.

Structural changes induced in proteins by therapeutic ultrasounds

The structural effect induced by therapeutic ultrasound on proteins in aqueous solution has been investigated with FTIR spectroscopy, UV-VIS spectroscopy, circular dichroism and light scattering. Six proteins (cytochrome, lysozyme, myoglobin, bovine serum albumin, trypsinogen, and alpha-chymotrypsinogen A) with different molecular weight and secondary structure have been studied. The experiment has been performed using an ultrasound source at resonant frequency of 1 MHz and sonication times of 10, 20, 30, 40, 50, and 60 min. A different behaviour of proteins under sonication depends on the dominant secondary structure type (alpha-helix or beta-sheets) and on the grade of the ordered structure. The results suggest that the free radicals, produced by water sonolysis, have an important role in the changes of structural order.

Monitoring of people and workers exposure to the electric, magnetic and electromagnetic fields in an Italian National Cancer Institute

Background

The paper reports the electric, magnetic and electromagnetic fields (emf) measurements carried out in the Regina Elena National Cancer Institute (NCI). Several devices, used in diagnostics and in medical cures, can represent sources of emf for the workers and for the public subjected to the treatments. The aim is to evaluate their exposition, in order to assess the compliance with the law.

Methods

The investigations have been carried out in the departments of: intensive care, physiotherapy, MR presstherapy and in the surgical rooms. The measurements have been performed using broad band probes in the frequency ranges 5 Hz÷30 kHz and 100 kHz-3 GHz.

Results

The variability of the magnetic induction (B(μT)) levels is between 0,05 μT and 80 μT. The statistical distribution shows that most of the measurements are in the range 0,05<B = 0,5 μT and the 89% of the B(μT) levels are within the 3 μT.

Conclusion

The measurement of the emf levels in the NCI is recommended because of the presence of the oncological patients; their long stay near the equipments and their day-long exposure represent additional risk factors for which a prudent avoidance strategy have to de adopted.

[Information and communication on the electromagnetic fields: analysis of the Italian Internet sites]

The aim of this study is to evaluate the presence of contents related to communication and information on the exposure to the electromagnetic fields (emf) in the first 100 Italian Internet sites, carried out using the search engine Google with the key words "emf" and "emf and health". Each Internet site has been evaluated using 10 selected indicators: (1) Definition of electric, magnetic and electromagnetic fields; (2) Description of the physical effects of the emf; (3) Description of biological and health effects of the emf; (4) Description of the environmental sources; (5) Description of the environmental levels produced by the different sources; (6) Main legislation; (7) Risk perception; (8) Frequently asked questions (FAQ); (9) Links; (10) Forum for discussion. The sites, obtained for each search, have been classified into 6 main categories: (1) Public Research Institutes; (2) Health and Environmental Authorities; (3) Local Authorities; (4) Associations; (5) Commercial sites; (6) Other. The results show lack of information and communication on the emf in the analysed Italian Internet sites. A need for a design of any scientific Internet information and communication on this topic is shown.

Electromagnetic radiation from VDT units: study of the effectiveness of an active shielding device

Measurements of extremely low frequency electromagnetic fields and low frequency magnetic fields emitted by a set of video display terminal (VDT) units are reported. The field values measured at the position normally occupied by the user are below the safety limits. This is because the field amplitudes decrease rapidly (following a 1/R3 law) with the distance from the source, as has been verified in this work. Measurements with a commercial shielding device consisting of small plastic balls filled with a water solution of rare earth elements were also performed. The only physical mechanism that could be hypothesized to produce an active suppression of the VDT field is that rare earth atoms, which probably were chosen due to their large magnetic moment, behave as oscillating magnetic dipoles capable of emitting a secondary magnetic field that, along some particular directions, has a phase that is opposite to that of the exciting field. Unfortunately, if one analyzes this mechanism quantitatively, it is easy to show that the secondary magnetic field is absolutely negligible, as was confirmed by experimental measurements performed in this study.