SARS-CoV-2 Infections, Re-Infections and Clinical Characteristics: A Two-Year Retrospective Study in a Large University Hospital Cohort of Vaccinated Healthcare Workers

At the University Hospital of Bari, during the first year after the start of the mandatory vaccination campaign with BNT162b2 mRNA COVID-19 vaccine, the preliminary results of an observational study showed a significant prevalence of SARS-CoV-2 breakthrough infections (BIs) among healthcare workers (HCWs), but no hospitalization or deaths. In the present study, we extended the observation period (January 2021-January 2023) with the aim of determining the incidence, characteristics and clinical course of SARS-CoV-2 BIs among 6213 HCWs. All HCWs were regularly monitored and screened. To allow return to work after BI, the protocol required one negative nasopharyngeal swab test followed by a medical examination certifying complete clinical recovery. We observed an overall incidence rate of SARS-CoV-2 BIs of 20.2%. Females were most affected, especially in the nurse group compared with doctors and other HCWs (p < 0.0001). Cardiovascular diseases were the most frequent comorbidity (n = 140; 11.4%). The source of infection was non-occupational in 52.4% of cases. Most cases (96.9%) showed minor symptoms and only two cases of hospitalization (one in intensive care unit), 13 cases of re-infection and no deaths were recorded. Our results confirm that SARS-CoV-2 infection can break vaccination protection but the clinical course is favorable.

Mesothelioma Risk Among Maritime Workers According to Job Title: Data From the Italian Mesothelioma Register (ReNaM)

The study describes the 466 cases of malignant mesotheliomas (MM) collected by the National Mesothelioma Register (ReNaM) in Italy in the period 1993-2018 relating to subjects with exclusive asbestos exposure in merchant or military navy. The cases among maritime workers represent 1.8% of the total cases with defined exposure registred in the ReNaM, of which 212 cases (45.4%) among merchant maritime workers and 254 cases (54.5%) among navy. The distribution by site of mesothelioma showed 453 (97.2%) MM cases of the pleura, 11 (2.3%) of the peritoneum and 2 (0.4%) of the tunica vaginalis of the testis. With regard to occupational exposure, it was classified as certain in 318 (68.2%) cases, probable in 69 (14.8%) cases and possible in 79 (16.9%) cases. Among the 23 classified jobs, the highest percentages of certain exposures are among naval engineers, motor mechanics, machine captains and sailors. Machine crew accounted for 49.3% of the cases, deck crew for 27.6%. All cases began exposure on board between 1926 and 1988. Seamen were exposed to asbestos while at sea by virtue of living onboard ships and from continual release of asbestos fibers due to the motion of a vessel. Epidemiological surveillance through the ReNaM has allowed us to verify among cases in the maritime, navy and merchant marine sectors, that in the past, subjects were exposed regardless of the ship's department where have provided service therefore all these cases must be considered as occupational diseases.

Indoor Radon Concentration Levels in Healthcare Settings: The Results of an Environmental Monitoring in a Large Italian University Hospital

The aim of the study is to determine the radon concentrations in the University Hospital of Bari, Apulia Region, Southern Italy. The monitoring took place from 2017 to 2018 for a total of 402 days and included 3492 premises. Radon environmental sampling was performed with passive dosimeters of the CR-39 type. The highest mean concentration was found in basement rooms (118.9 Bq/m³), followed by ground-floor rooms (88.2 Bq/m³), first-floor rooms (78.1 Bq/m³), second-floor rooms (66.7 Bq/m³), and third-floor rooms (68.9 Bq/m³). An average radon concentration lower than the WHO recommended level of 100 Bq/m³ was detected in 73.5% of monitored environments, while only 0.9% exceeded the reference level of 300 Bq/m³ set by the national law (Legislative Decree 101/2020). The frequency of environments in which radon concentrations exceed 300 Bq/m³ is significantly higher in the basement (p-value < 0.001). As for a previous preliminary investigation in the same hospital conducted on a much smaller number of premises (n = 401), most of the monitored environments had radon concentrations lower than the reference levels set by the new national law, and the risk to the healthcare workers' health derived from occupational exposure to radon could be considered acceptable.

[Tendinopathy of the patellar ligament secondary to transtendineal arthroscopy of the knee. Ultrasonographic evaluation]

During knee arthroscopy, the transtendinous approach best visualizes articular structures, even though it may cause patellar tendinitis, following the surgical procedures. Thirty patients (22 men and 8 women) who had undergone transtendinous arthroscopy of the knee were submitted to clinical and US follow-up at 3, 6, 12 months. This monitoring was aimed at correlating clinical and instrumental findings of the above iatrogenic condition. Painful symptoms were present in 30% of the cases in group I, in 10% of group II and in no patient in group III. US demonstrated thickening of the patellar tendon in all the three groups of patients, with reduced echogenicity and blurred margins at the arthroscopic portal, plus decreasing gravity over time. The US pattern of arthroscopic surgical gap was observed in all patients in group I, in 10% of patients in group II and in none of the patients in group III. In conclusion because of its clinical course and of its US findings, in our experience patellar tendinopathy following transtendinous arthroscopy of the knee is not to be considered as a iatrogenic inflammatory or degenerative sequela, but as a physiological cicatricial evolution of the surgical transtendinous breach. The US follow-up of the latter allows the correct assessment of the recovering process.