Arch replacement with collared elephant trunks: The Siena approach.

Objective: To illustrate our experience and results in patients with diffuse aneurysmal disease treated with arch replacement using the Siena collared graft, a device designed in 2002 to improve the elephant trunk technique. Results of the first step surgical implant and the subsequent treatment strategies, with extensive use of endovascular techniques, are reported.

Methods: All aortic arch-replacement procedures using the Siena graft between February 2002 and January 2020 were retrospectively analyzed for early and late clinical outcomes.

On the agreement between bibliometrics and peer review: Evidence from the Italian research assessment exercises.

This paper analyzes the concordance between bibliometrics and peer review. It draws evidence from the data of two experiments of the Italian governmental agency for research evaluation. The experiments were performed by the agency for validating the adoption in the Italian research assessment exercises of a dual system of evaluation, where some outputs were evaluated by bibliometrics and others by peer review.

Cytological analysis of bronchoalveolar lavage fluid in asbestos-exposed workers.

Background: Asbestos-related lung diseases are a group of heterogeneous disorders with different pathogenesis and prognosis. Very few studies investigated the BALF cell profile of asbestos exposed workers. The existence of a relationship between bronchoalveolar lavage fluid (BALF) cellular pattern and specific diagnosis and/or asbestos exposure biomarkers would allow the identification of effect biomarkers useful in the follow up of asbestos-exposed workers and in the diagnosis of asbestos-related diseases.

Polycyclic Aromatic Hydrocarbons Exposure Assessment in a Refractory Brick Production.

In a refractory brick manufacturing company a qualitative and quantitative determination of the sources of occupational exposure to polycyclic aromatic hydrocarbons (PAHs) was obtained in order to validate targeted hygiene measurements. The study included the assessment of PAHs contamination of work surfaces by wipe-sampling, cutaneous exposure by hand washing, contamination of personal protective equipments (gloves) by extraction in solvent, and airborne PAHs concentration in atmospheric samples. Biomonitoring was also carried out by measurement of urinary 1-hydroxypyrene (1-OHPU) in three groups of workers (packaging, production, and controls).

Newcomb-Benford law and the detection of frauds in international trade.

The contrast of fraud in international trade is a crucial task of modern economic regulations. We develop statistical tools for the detection of frauds in customs declarations that rely on the Newcomb-Benford law for significant digits. Our first contribution is to show the features, in the context of a European Union market, of the traders for which the law should hold in the absence of fraudulent data manipulation.

Asbestos exposure biomarkers in the follow-up of asbestos-exposed workers.

Health surveillance of asbestos exposed workers should be stratified according to the exposure level. Unfortunately there is a lack of information regarding asbestos exposure in many working places and markers of asbestos exposure are often needed. The aim of the study was to assess the reliability of different dose and effect biomarkers in the follow up of asbestos-exposed workers.

Skin photoaging in farmers occupationally exposed to ultraviolet radiation.

Background: Most personal exposures to UV radiations occur from outdoor activities and several studies detected a significant association between skin cancer and outdoor occupation.

Objective: The aim of the study was to ascertain the prevalence of photoaging signs in a population of Italian farmers and in a population of indoor workers taking account of confounding factors.

Methods: 169 farmers and 198 indoor workers were classified for skin phototype and for skin photoaging, moreover 13 variables were taken into account.

[Dose and effect biomarkers in the diagnosis of asbestos-related diseases and health surveillance of exposed workers].

The aim of the study was to assess the reliability of the indicators of dose and effect in the health monitoring of asbestos exposed workers. In 49 cases out of 158 studied workers (31%) asbestos-related diseases were diagnosed following ATS criteria (2004). Using nonparametric statistical methods (permutation tests) 6 variables were analyzed with respect to asbestos-related diseases and working sectors, demonstrating a difference in the concentration of amphiboles (p < 0.

Repeatability and agreement of 2 Scheimpflug analyzers in measuring the central corneal thickness and anterior chamber angle, volume, and depth.

Purpose: To evaluate the repeatability and agreement of 2 Scheimpflug tomographies (Pentacam HR, Oculus GmbH; Sirius, CSO Inc.) in measuring the central corneal thickness (CCT) and depth (ACD), volume (ACV), and angle (ACA) of the anterior chamber.

Methods: Three consecutive measurements were performed in one eye of each subject, with both instruments.

Erythropoiesis, erythropoietin and blood lead levels.

In a previous study EPO values were significantly lower in exposed subjects (PbB > or =30 mcg/dl) than in controls (PbB" 20 mcg/dl). The aim of the study was to verify if high PbB cause the reduction of EPO in connection with the serum concentration of this hormone expected considering the Hct and hemoglobin (Hb) levels. Both in Pb exposed workers and controls blood levels of EPO, PbB, Hb, Hct were measured.

Measurement of asbestos fibre concentrations in fluid of repeated bro-choalveolar lavages of exposed workers.

Objectives: The aim of this study was to assess the reliability of asbestos fibre concentration in bronchoalveolar lavage fluid (BALF) by carrying out the mineralogical analysis of BALF at different times in the same patient and comparing the results.

Methods: Twenty two patients underwent diagnostic fibreoptic bronchoscopy twice: the first was to assess the past asbestos exposure and the second for different clinical reasons. Mineralogical analysis of BALF was carried out.

Photorefractive keratectomy in high myopic defects with or without intraoperative mitomycin C: 1-year results.

Purpose: To study the results of the prophylactic use of mitomycin C (MMC) to reduce haze formation and refractive regression after excimer laser photorefractive keratectomy (PRK) for high myopic defects (>5 diopters).

Methods: Prospective, consecutive, observational study. A total of 124 eyes of 62 patients were divided into two groups of 31 patients, 62 eyes each (Groups A and B).

Limited role of aortic size in the genesis of acute type A aortic dissection.

Objective: Increased dimension of the aortic root and proximal aorta is considered a significant risk factor for catastrophic events that involve the ascending aorta. The objective of this study was to determine the possible correlation between pre-dissection aortic diameter and the occurrence of Stanford type A aortic dissection.

Methods: Samples of dissected ascending aortas were obtained from 220 patients at the time of their operation.

Cerebral autoregulation after hypothermic circulatory arrest in operations on the aortic arch.

Background: The purpose of this study was to determine whether patients who undergo thoracic aorta repairs with the aid of hypothermic circulatory arrest experience impairments in cerebral autoregulation, and to ascertain the influence of three different techniques of cerebral protection on autoregulatory function.

Methods: Sixty-seven patients undergoing elective aortic arch procedures with hypothermic circulatory arrest were tested for cerebral dynamic autoregulation using continuous transcranial Doppler velocity and blood pressure recordings. Twenty-three patients were treated using hypothermic circulatory arrest without adjuncts (group 1), 25 using antegrade cerebral perfusion (group 2), and 19 using retrograde cerebral perfusion (group 3).

Pulmonary embolism in very old patients.

Background And Aims: Diagnosis of pulmonary embolism (PE) in the elderly remains difficult and is often late, although its incidence increases steadily with age. Since few studies have reported the clinical picture of this disease in very old patients, the aim of our study was to focus on clinical, instrumental and laboratory aspects in patients 75 years of age and over with suspected PE.

Methods: Symptoms, signs, risk factors for venous thromboembolic diseases, 12-lead electrocardiograms, B-mode echocardiograms, chest X-rays, leg compression venous ultrasonography, latex-assay quantitative D-dimer, and arterial blood gas analyses were collected for 96 elderly patients of 75 years and over (mean age 81.

Ranked set sampling for replicated sampling designs.

In practical ecological sampling studies, a certain design (such as plot sampling or line-intercept sampling) is usually replicated more than once. For each replication, the Horvitz-Thompson estimation of the objective parameter is considered. Finally, an overall estimator is achieved by averaging the single Horvitz-Thompson estimators.

[In vitro study of transcutaneous inorganic mercury absorption from solid soil].

Objectives: Skin is such an important route of absorption of mercury compounds that the ACGIH has assigned them a skin notation. Soil has been recognised as a potential source of exposure to chemical contaminants. It therefore seems advisable to establish maximum daily exposure levels for mercury in soil.

[Evaluation of sources of mercury absorption through studying urinary mercury levels in the general population].

Objectives: The number of instances where mercury exposure is possible outside the workplace are numerous, with the main source being amalgam dental fillings and diet. It is also possible to envisage environmental exposure in subjects resident in areas where there is existing environmental contamination. This is probably what happened in Tuscany where past mining activity in the Monte Amiata area may have been the cause.

Extrathoracic cannulation of the left common carotid artery in thoracic aorta operations through a left thoracotomy: preliminary experience in 26 patients.

Background: In aortic operations performed through a left thoracotomy, which require total bypass and deep hypothermic circulatory arrest, femoral artery cannulation is commonly used for arterial perfusion. This route limits the time of safe circulatory arrest and is associated with the risks of retrograde embolization or, in the case of aortic dissection, malperfusion of the vital organs. To overcome these problems, we have used cannulation of the extrathoracic left common carotid artery to ensure a central a route of arterial perfusion in these operations.

Arterial blood gas analysis and alveolar-arterial oxygen gradient in diagnosis and prognosis of elderly patients with suspected pulmonary embolism.

Background: Arterial blood gas analysis (BGA) remains a first-step diagnostic approach in patients with suspected pulmonary embolism (PE). The aim of this study was to evaluate BGA parameters in elderly patients with suspected pulmonary embolism for diagnosis and 14-day prognosis.

Methods: We performed a retrospective cohort observational study of 6 years (1994-1999) in a 60-bed acute geriatric ward of University Hospital in Siena, Italy.

Length of hospitalization in elderly patients with community-acquired pneumonia.

Community-acquired pneumonia (CAP) is a serious social and medical problem in the elderly. Mortality, hospitalization and length of stay increase with age. The aim of this study was to determine the risk factors associated with prolonged hospital stay in elderly patients with CAP.