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Abstract: Urinary trans,trans-muconic acid (t,t-MA), a biomarker of benzene exposure, is usually determined by HPLC methods with detection by either UV or, more recently, electrospray tandem mass spectrometry. However, not all these methods have been fully validated for quantitative analysis. This paper presents an HPLC/MS/MS method for reliable quantitative determination of t,t-MA that uses a commercial deuterium-labeled isotope as internal standard; the matrix effect has been evaluated and LOD is 0.22μg/L. We used this method to test 200 urine samples, 175 of them collected at end-of-shift from workers in an oil refinery. [Copyright &y& Elsevier]

Persistent sciatic artery (PSA) is a rare vascular anomaly classified into five types according to the Pillet and Gauffre classification system. Although PSA may be detected as an incidental finding, symptomatic cases account for approximately 80% of all cases and have variable clinical presentations. Due to the frequent ischemic and aneurysmal complications, PSAs can lead to limb-threatening conditions requiring prompt identification and adequate treatment management. In this paper, we present a series of four cases of PSA with extremely different anatomical characteristics, patients' ages, medical histories and clinical presentations. All cases were diagnosed in our institution and managed after multidisciplinary discussions involving vascular surgeons and interventional radiologists. The series included three women and one man. In two cases, one of which included gluteal and back pain, pulsatile masses were found. Two patients had lower-limb chronic ischemia, one with rest pain and one with IIb claudication. Whereas selective angiography was performed only in endovascular approaches, computed tomography angiography (CTA) was performed on all patients as the decisive diagnostic modality. In our series, treatment strategies were selected on the basis of clinical and anatomical factors, and after the evaluation of the potential risks and benefits of each technique. Treatment was medical in two cases, endovascular in one case and hybrid in one case. [ABSTRACT FROM AUTHOR]

The article discusses a study related to measuring human exposure to benzene through environmental and biological monitoring by analyzing critical issues and optimal conditions of use. Topics discussed include using HPLC with tandem mass spectrometry, urinary benzene is used to assess exposure and benzene at low concentrations, and environmental monitoring depends on the choice of appropriate method of sampling and analysis.

Urban air contains benzene and polycyclic aromatic hydrocarbons (PAHs) which have carcinogenic properties. The objective of this paper is to study the correlation of exposure biomarkers with biomarkers of nucleic acid oxidation also considering smoking. In 322 subjects, seven urinary dose biomarkers were analyzed for benzene, pyrene, nitropyrene, benzo[a]pyrene, and naphthalene exposure, and four effect biomarkers for nucleic acid and protein oxidative stress. Chemometrics was applied in order to investigate the existence of a synergistic effect for the exposure to the mixture and the contribution of active smoking. There is a significant difference between nicotine, benzene and PAH exposure biomarker concentrations of smokers and non-smokers, but the difference is not statistically significant for oxidative stress biomarkers. The PAH biomarkers are those which best correlate with all the oxidative stress biomarkers. Results suggest that 8-Oxo-7,8-dihydroguanine and protein nitro-oxidation 3-nitrotyrosine are the most sensitive biomarkers for the exposure to the urban pollutant mixtures and that a synergic effect of the mixtures exists. All the oxidative stress biomarkers studied drive the increase in the oxidative stress biomarkers in the subjects having higher exposures. Chemometrics proved to be a powerful method for the interpretation of human biomonitoring data. [ABSTRACT FROM AUTHOR]

Aim: Chest computed tomography (CT) scan is useful to evaluate the type and extent of lung lesions in coronavirus disease 2019 (COVID‐19) pneumonia. This study explored the association between radiological parameters and various circulating serum‐derived markers, including microRNAs, in older patients with COVID‐19 pneumonia. Methods: A retrospective analysis was designed to study geriatric patients (≥75 years) with COVID‐19 pneumonia, who underwent chest CT scan on admission, and for whom clinical data and serum samples were obtained. To quantify the extent of lung involvement, CT‐score, the percentage of healthy lung (HL%), the percentage of ground glass opacity (GGO%), and the percentage of lung consolidation were assessed using computer‐aided tools. The association of these parameters with two circulating microRNAs, miR‐483‐5p and miR‐320b, previously identified as biomarkers of mortality risk in COVID‐19 geriatric patients, was tested. Results: A total of 73 patients with COVID‐19 pneumonia were evaluable (median age 85 years; interquartile range 82–90 years). Among chest CT‐derived parameters, the percentage of lung consolidation (HR 1.08, 95% CI 1.02–1.14), CT‐score (HR 1.14, 95% CI 1.03–1.25), and HL% (HR 0.97, 95% CI 0.95–0.99) emerged as significant predictors of mortality, whereas non‐significant trends toward increased mortality were observed in patients with higher GGO%. We also found a significant positive association between serum miR‐483‐5p and GGO% (correlation coefficient 0.28; P = 0.018) and a negative association with HL% (correlation coefficient −0.27; P = 0.023). Conclusions: Overall, the extent of lung consolidation can be confirmed as a prognostic parameter of COVID‐19 pneumonia in older patients. Among various serum‐derived markers, miR‐483‐5p can help in exploring the degree of lung involvement, due to its association with higher GGO% and lower HL%. Geriatr Gerontol Int 2024; 24: 962–972. [ABSTRACT FROM AUTHOR]

The use of radiomics and artificial intelligence applied for the diagnosis and monitoring of Alzheimer's disease has developed in recent years. However, this approach is not yet completely applicable in clinical practice. The aim of this paper is to provide a systematic analysis of the studies that have included the use of radiomics from different imaging techniques and artificial intelligence for the diagnosis and monitoring of Alzheimer's disease in order to improve the clinical outcomes and quality of life of older patients. A systematic review of the literature was conducted in February 2023, analyzing manuscripts and articles of the last 5 years from the PubMed, Scopus and Embase databases. All studies concerning discrimination among Alzheimer's disease, Mild Cognitive Impairment and healthy older people performing radiomics analysis through machine and deep learning were included. A total of 15 papers were included. The results showed a very good performance of this approach in the differentiating Alzheimer's disease patients—both at the dementia and pre-dementia phases of the disease—from healthy older people. In summary, radiomics and AI can be valuable tools for diagnosing and monitoring the progression of Alzheimer's disease, potentially leading to earlier and more accurate diagnosis and treatment. However, the results reported by this review should be read with great caution, keeping in mind that imaging alone is not enough to identify dementia due to Alzheimer's. [ABSTRACT FROM AUTHOR]

Using multiparametric magnetic resonance imaging, it is now possible to diagnose prostate cancer and categorize its risk. As it can accurately determine the extracapsular extension of the tumor, invasion of seminal vesicles, involvement of lymph nodes, and the potential presence of bone metastases, multiparametric magnetic resonance imaging plays a crucial role not only in the diagnosis but also in the local staging of prostate cancer. The patients with a history of negative biopsy/increasing prostatespecific antigen and the existence of further data supporting its use in biopsy-naive patients and active surveillance are the most blatant indications for multiparametric magnetic resonance imaging in guidelines. The traditional clinical examination, prostate-specific antigen tests, and systematic biopsy are all enhanced by multiparametric magnetic resonance imaging, which will miss certain cancers due to insufficient size or changes in tissue density. The use of multiparametric magnetic resonance imaging is expected to rise, and further advances in the method will be crucial for the secure adoption of targeted therapeutic ideas. Here, we give a succinct overview of multiparametric magnetic resonance imaging's application to the identification and risk classification of prostate cancer. [ABSTRACT FROM AUTHOR]

Fifty-eight workers exposed to styrene were monitored in four fibreglass reinforced plastic industries of Central Italy. The aim of the study was to explore the factors that can influence the levels of styrene exposure biomarkers of the workers and the aspects that might interfere with the exposure assessment measures, such as the co-exposure to acetone. Personal monitoring of professional exposure to airborne styrene and acetone was carried out by Radiello® samplers and GC/MS analysis. Biological monitoring was performed by the determination of urinary metabolites, mandelic (MA), and phenylglyoxylic (PGA) acids with HPLC/ MS/MS and unmetabolized styrene in saliva and venous blood by HS/GC/MS. The median values of the four sites ranged between 24.1 to 94.0 mg m-3 and 7.3 to 331.1 mg g-1 creatinine for airborne styrene and MA + PGA, respectively. A good linear correlation was found between styrene in air and its urinary metabolites (r = 0.854). The median value for airborne styrene was found to exceed the (Threshold Limit Value - Time Weighted Average) of 85 mg m−3 in one site for all the workers and in two if only moulders are considered. The multiple linear regression model showed that the determinants of urinary MA + PGA excretion were the type of process, workers' tasks, level of acetone co-exposure, and the use of respiratory protection devices. Data show that the simultaneous exposure to acetone modify the styrene metabolism with a reduction in the levels of (MA + PGA) excreted. A significant linear log-correlation was found between salivary levels of styrene and blood concentration (r = 0.746) sampled at the same tx time. [ABSTRACT FROM AUTHOR]

Highlights: [•] 1,3-Butadiene was classified as a human carcinogen. [•] Low levels of 1,3-butadiene in workplace air can be measured by Radiello® sampler. [•] The 1,3-butadiene ACGIH BEI (DHBMA) was found not correlated to personal exposure. [•] Urinary and environmental 1,3-butadiene were found to be correlated. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy of endovascular treatment for vascular renal injuries (VRIs) like bleeding, pseudoaneurysm and artero-venous fistula (AVF) and to compare patients with blunt trauma (T-VRIs) with those with iatrogenic damage (I-VRIs). Methods: We retrospectively assessed 49 renal artery embolizations performed to treat T-VRIs (26.5%) and I-VRIs (73.5%). Different embolic materials were used based on the type of lesion. Technical success was defined as the complete occlusion of target arteries with no further visualization of VRIs. Clinical success was defined if no recurrence was present and if renal function (difference between creatinine after and before treatment <0.5 mg/dl) was preserved after 1 month. Results: Angiography showed bleeding in 27 patients, pseudoaneurysm in 29 and an AVF in 6. Embolic agents used were coils in 39 procedures, coils with sponge in four and others in six. Technical success was 100% while clinical success was 85.7% due to seven patients with recurrence. The group I-VRIs showed a higher rate of clinical success than the group T-VRIs (94.4% vs 61.5%; p < 0.05). Moreover, the group I-VRIs had a higher incidence of pseudoaneurysms and AVFs compared with the group T-VRIs (69.4% vs 30.8% and 16.7% vs 0%; p < 0.05). Conclusion: Endovascular treatment for VRIs showed satisfactory results and no patient had a worsening of renal function. I-VRIs had better clinical success and more frequently appeared as pseudoaneurysms compared to T-VRIs: probably iatrogenic injury is localized and pseudoaneurysm is easily identifiable and treatable with endovascular treatment. [ABSTRACT FROM AUTHOR]

Abstract: The widespread use of phthalates results in human exposure: phthalates are rapidly metabolized to their respective monoesters and other oxidative products, which are glucuronidated and excreted through the urine and feces. Several in vivo studies showed that some phthalates, in particular diethyl-hexyl phthalate (DEHP), diethyl phthalate (DEP), di(n-butyl)phthalate (DnBP) and n-butylbenzylphthalate (BBzP), are able to interact with the human endocrine system, interfering with the reproduction ability. In this study, 56 couples were recruited from a centre of assisted reproduction. Spot urine samples were collected and five urinary metabolites of the above phthalates were determined using an HPLC/MS/MS analytical method with isotopic dilution. The results were compared with those of 56 couples of parents of one or more children and the statistical analysis revealed a significant difference between the two groups in terms of urinary concentrations of phthalates metabolites. A further step will be the correlation of these results with information on the life styles and working conditions collected through a specifically designed questionnaire. [Copyright &y& Elsevier]

Bone metastasis resulting from breast cancer in pregnancy is rare. In the literature there are few reports regarding osteolytic lesions in pregnancy and no data on the treatment of such femoral fractures. The present study reports a case of a 29-week primigravida presenting with severe lumbosciatica in the left side, refractory to medical therapy. During neurosurgical examination a spontaneous pathological fracture of the left femur occurred. Damage control orthopedic principals were applied and a biopsy specimen from the femoral lesion was obtained, providing a diagnosis of metastases from breast adenocarcinoma. Cesarean section was performed at 32 gestational weeks. Following delivery, an internal fixator was placed in the left femur for definitive treatment of the fracture and staging of cancer was conducted. Subsequently, adjuvant treatment comprising left mastectomy and percutaneous radiofrequency thermoablation of the sacroiliac lesion were performed. A follow-up one-year following percutaneous radiofrequency thermoablation of the sacroiliac lesion detected no metastatic bone pain, and identified a stable sacroiliac lesion. [ABSTRACT FROM AUTHOR]

Tubulocystic renal cell carcinoma is a rare subtype of renal tumor according to the 2016 World Health Organization, and less than 100 cases have been documented up to date in literature. The imaging features are not well known and to the best of our knowledge, there is not a radiology description of recurrence from tubulocystic renal cell carcinoma in the literature. We describe the case of a 70-year-old man with unusual cystic lesions in the left hypochondrium 11 years after a nephrectomy for tubulocystic renal cell carcinoma on the same side, and we report a review of the clinical characteristics of metastatic tubulocystic renal cell carcinoma. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the ototoxic effect of the exposure to different organic solvents and noise using distortion product otoacoustic emissions (DPOAEs). Design: The exposure to different solvents was evaluated by measuring, before and at the end of the work-shift, the urinary concentrations of solvent metabolites used as dose biomarkers. The urinary concentrations of DNA and RNA oxidation products were also measured as biomarkers of oxidative damage. The simultaneous exposure to noise was also evaluated. DPOAEs and pure tone audiometry (PTA) were used as outcome variables, and were correlated to the exposure variables using mixed effect linear regression models. Study sample: Seventeen industrial painters exposed to a solvent mixture in a naval industry. A sample size of 15 was estimated from previous studies as sufficient for discriminating small hearing level and DPOAE level differences (5 dB and 2 dB, respectively) at a 95% confidence level. Results: Statistically significant associations were found between the DPOAE level and the urinary dose biomarkers and the oxidative damage biomarkers. DPOAE level and the logarithm of the metabolite concentration showed a significant negative correlation. Conclusions: DPOAE are sensitive biomarkers of exposure to ototoxic substances and can be effectively used for the early detection of hearing dysfunction. [ABSTRACT FROM AUTHOR]

Highlights • Correlation between styrene exposure and urinary MA + PGA. • MN induction, reduction of NBs and increase of karyolitic cells by BMCyt assay. • Tail Length and Tail Moment reduction by Fpg comet assay. • Oxidative DNA damage on blood and increased oxidized DNA bases in urine. Abstract This study aimed to identify sensitive and not-invasive biomarkers of early genotoxic/oxidative effect for exposure to styrene in the fibreglass reinforced plastic manufacture. We studied 11 workers of a plastic manufacture using open molding process (A), 16 workers of a manufacture using closed process (B) and 12 controls. We evaluated geno/cytotoxic effects on buccal cells by Buccal Micronucleus Cytome (BMCyt) assay and genotoxic/oxidative effects on lymphocytes by Fpg-comet test. On A workers we also evaluated urinary 8oxoGua, 8oxodGuo and 8oxoGuo to investigate oxidative stress. Personal inhalation exposure to styrene was monitored by passive air sampling and GC/MS. Biological monitoring included urinary metabolites mandelic acid (MA) and phenylglyoxylic acid (PGA). The findings show higher styrene exposure, urinary MA + PGA levels and micronucleus frequency in manufacture A. Higher buccal karyolytic cell frequency vs controls were found in both exposed populations. We found in exposed workers, no induction of direct DNA damage but oxidative DNA damage. Fpg-comet assay and urinary oxidized guanine seem to be sensitive biomarkers of oxidative stress and BMCyt assay a good-not invasive biomarker of cyto-genotoxicity at target organ. The study, although limited by the small number of studied subjects, shows the usefulness of used biomarkers in risk assessment of styrene-exposed workers. [ABSTRACT FROM AUTHOR]

Context:Several urinary PAHs metabolites can be detected by HPLC-MS/MS for individual exposure assessment. Objective:Quantitation of urinary metabolites of four PAHs, selected on the basis of their significance, with reduced costs and high sensitivity. Materials and methods:HPLC-MS/MS was used and pure standards and isotope-labeled internal analogs of the analytes. Two hundred samples were tested after enzymatic hydrolysis. Results:Accuracy was higher than 90% and variability lower than 19%; LODs permit to measure 1-hydroxypyrene, 1 and 2-hydroxynaphthalene in all subjects, 6-hydroxynitropyrene in the 65% and 3-hydroxybenzo[a]pyrene in the 70%. Discussion and conclusion:The method is suitable both for occupational and for environmental studies. This is the first paper reporting urinary levels of 6-hydroxynitropyrene in European subjects, nonoccupationally exposed to nitro-PAHs. [ABSTRACT FROM PUBLISHER]

Styrene exposure is still present in different occupational settings including manufacture of synthetic rubber, resins, polyesters and plastic. The aim of this work was to investigate the effects of polymorphic genes CYP2E1, EPHX1, GSTT1, and GSTM1 on the urinary concentrations of the styrene metabolites mandelic acid (MA), phenylglyoxylic acid (PGA) and on the concentration ratios between (MA + PGA) and urinary styrene (U-Sty) and airborne styrene (A-Sty), in 30 workers from two fiberglass-reinforced plastic manufacturing plants and 26 unexposed controls. Personal air sampling and biological monitoring results revealed that sometimes exposure levels exceeded both the threshold limit value (TLV) and the biological exposure index (BEI) suggested by the American Conference of Governmental Industrial Hygienists. A significantly reduced excretion of styrene metabolites (MA + PGA) in individuals carrying the CYP2E1*5B and CYP2E1*6 heterozygote alleles, with respect to the homozygote wild type, was observed only in the exposed group. A reduction was also detected, in the same group, in subjects carrying the slow allele EPHX1 (codon 113), through the lowering of (MA + PGA)/urinary styrene concentration ratio. In addition, the ratio between MA + PGA and the personal airborne styrene concentration appeared to be modulated by the predicted mEH activity, in the exposed group, as evidenced by univariate linear regression analysis. Our results confirm some previous hypotheses about the role of the polymorphism of genes coding for enzymes involved in the styrene detoxification pathway: this may significantly reduce the levels of excreted metabolites and therefore it must be taken into account in the interpretation of the biological monitoring results for occupational exposure. [ABSTRACT FROM AUTHOR]

Purpose: To assess predictors of clinically significant (cs) prostate cancer (PCa) in men who had a non-malignant Multiparametric magnetic resonance imaging (mpMRI)-targeted biopsy and persistent Prostate Imaging-Reporting Data System (PI-RADS) 3 to 5 lesions in subsequent mpMRI.Materials and Methods: We retrospectively analyzed MRI-targeted biopsy database in three centers.Inclusion Criteria: persistence of at least one PI-RADS ≥3 lesion found negative for cancer in a previous MRI-targeted plus systemic biopsy (baseline biopsy).Exclusion Criteria: downgrading to PI-RADS 1-2. A logistic regression analysis was performed to estimate the predictors of csPCa.Results: Fifty-seven patients were included. Median interval between biopsies was 12.9(2.43) months. Median age was 68.0(12) years. Median PSA was 7.0(5.45) ng/ml. At follow-up, 24.6%, 54.4%, and 21% of patients had a PI-RADS score 3, 4, and 5 index lesion (IL), respectively. At re-biopsy, 28/57(49.1%) men were found to harbor PCa. Among these, 22(78.6%) had csPCa. csPCa was found outside the IL in only 2 patients. Eleven, 13, and 5 patients with PI-RADS 3, 4, and 5, respectively, had no cancer. Three patients with a PI-RADS 3 lesion had cancer (2 with Gleason score 3+3, 1 with Gleason score 3+4). 14/43 men with a PI-RADS 4/5 lesion harbored Gleason score ≥3+4 PCa. Logistic regression analysis found that PSA (HR 1.281, 95% CI: 1.013-1.619, P = 0.039) and IL size (HR 1.146, 95% CI: 1.018-1.268, P = 0.041) were the predictors of csPCa at re-biopsy.Conclusions: Patients with non-malignant pathology from PI-RADS ≥3 lesions targeted biopsy should be follow-up with mpMRI, and those with persistent PI-RADS 4 to 5 lesions should repeat MRI-targeted and systematic biopsy. [ABSTRACT FROM AUTHOR]

Purpose: To develop a nomogram incorporating clinical and multiparametric magnetic resonance imaging (mpMRI) parameters for the detection of clinically significant prostate cancer (csCaP) at radical prostatectomy (RP).Materials and Methods: We retrospectively analyzed all consecutive patients who underwent robotic RP between 2016 and 2020. All patients underwent a 1.5-T mp-MRI according to the PI-RADS-v2 scoring system. RP specimens were examined with the whole-mount technique. csCaP definition: any tumor with a volume larger than 0.5 cm3 or with a Gleason score ≥7. Univariable logistic regression models explored the association between clinical and imaging data and the risk of csCaP. Significant variables (P < 0.05) were selected into multivariable regression models to identify independent predictors. A nomogram was designed to select the significant relevant predictors. The nomogram was internally validated in terms of discrimination and calibration. Receiver operating characteristics of the area under the curve was used to assess the discrimination ability of the nomogram. To assess the predictive performance of mpMRI, the accuracy of the mpMRI-based nomogram was compared with that excluding either PI-RADS score or mpMRI IL size.Results: The analysis involved 393 patients. The median age was 65(9) years. The median prostate specific antigen was 5.81(3.76) ng/ml. 363 had csCaP. PI-RADS v2 score of 4-5, prostate specific antigen density of 0.15 or more, and mpMRI index lesion (IL) size were significantly associated with csCaP in the multivariable regression analyses. Based on these variables, a diagnostic model was developed. The full model yielded an area under the curve of 0.77 (95%CI:0.75-0.80) which was significantly better than those excluding mpMRI findings (P = 0.02) Decision curve analysis showed a slight but significant net benefit associated with the use of the mp-MRI based nomograms compared with those excluding either PI-RADS score (Delta net benefit 0.0278) or mpMRI maximum IL size (Delta net benefit 0.0111).Conclusions: The nomogram constructed in this study can assist urologists in assessing an individual's risk of csCaP at RP. [ABSTRACT FROM AUTHOR]

This study investigated the effect of polymorphic genes GSTT1, GSTM1, GSTA1, EHPX1, NQO1, CYP2E1, CYP1A and MPO on the urinary concentrations and ratio ( R ) of the benzene metabolites trans , trans -muconic acid ( t , t -MA) and S -phenyl mercapturic acid ( S -PMA) in 301 oil refinery workers. The metabolites’ concentrations are lower and R is higher (100.66) in non-smokers ( n = 184) than in smokers ( n = 117, R = 36.54). Non-smokers have lower S -PMA and a higher R in GSTT1 null genotypes than in positive, and a higher S -PMA and a lower R in GSTA1 wild type genotypes. In smokers the GSTT1 null genotype effect on both S -PMA and R is confirmed, and is also shown in GSTM1 null, but not in GSTA1 wild type genotypes. GSTT1 null polymorphism reduces the conjugation rate of benzene epoxide with GSH, and to a lesser extent also GSTTA1 mutant, GSTM1 null and NQO1 mutant genotypes. The activity of one GST is compensated by another in GSTM1 and GSTA1 defective subjects, but not in GSTT1 null genotypes, whose average S -PMA excretion is about 50% with respect to the positive ones, for the same benzene exposure. R showed to be a more sensitive marker for these effects than the metabolite levels. [ABSTRACT FROM AUTHOR]

Highlights: [•] β-Hydroxy dodecanoic and tetradecanoic acids are LPS markers in GN strains. [•] A new method is validated to quantify β-hydroxy-fatty acids in bacterial suspensions. [•] Results of HPLC-MS/MS and LAL-test on 4 bacterial strains are linearly correlated. [•] Results are not affected by β-glucans, nor by repeated sample freezing and thawing. [•] It is useful for the assessment of the occupational exposure to airborne endotoxins. [ABSTRACT FROM AUTHOR]

Abstract: The main objective of this study was to determine the average concentrations for the metabolites of the four more common phthalates, industrial chemicals widely used in commercial products and potential endocrine disruptors, in the urine of a control population living in Central Italy. The study population consisted of 157 healthy subjects, not occupationally exposed to phthalates (74 males and 83 females). Urinary levels of the analytes were determined by liquid chromatography tandem mass spectrometry (LC–MS/MS) with isotopic dilution. The reference values (geometric mean) for males and females were estimated for each metabolite:. Females: for MEP was 72.94μg/g creatinine (CI 95% 3.63–149.51), for MEHP was 3.37μg/g creatinine (CI 95% 1.85–4.89), for MEHHP was 12.74μg/g creatinine (CI 95% 9.45–22.19), for MnBP was 20.26μg/g creatinine (CI 95% 8.17–28.43) and for MBzP was 14.74 (CI 95% 2.94–17.68). Males: for MEP was 56.35μg/g creatinine (CI 95% 2.32–110.39), for MEHP was 2.80μg/g creatinine (CI 95% 1.08–4.52), for MEHHP was 10.77μg/g creatinine (CI 95% 6.18–16.95), for MnBP was 17.59μg/g creatinine (CI 95% 5.72–29.45) and for MBzP was 16.44 (CI 95% 7.90–29.45). To obtain reference values for these chemicals is without doubt an important topic for evaluate the exposure of population and their possible health effects. Information from different geographical areas are important to understand the real different background concentrations. [Copyright &y& Elsevier]

Abstract: The identification of reliable biomarkers is critical for the assessment of occupational exposure of benzene: S-phenylmercapturic acid (SPMA) and trans,trans-muconic acid (t,t-MA) are the most currently used. t,t-MA is an open-ring metabolite, but it is also a metabolite of the food preservative sorbic acid, while SPMA is formed by conjugation with glutathione, and several studies suggested that the genetic polymorphism of glutathione S-transferases modulates its production. This study compared the ability of these metabolites to assess the benzene exposure in a big group of petrochemical workers. Furthermore, investigated how genetic polymorphism of glutathione S-transferase theta 1 (GSTT1), glutathione S-transferase mu 1 (GSTM1), glutathione S-transferase pi 1 (GSTP1) and smoking habits, may influence their excretion. Results showed that occupational exposure to benzene was negligible compared to that from smoking and confirmed the modulating effect of the genetic polymorphism of GSTT1 on the urinary excretion of SPMA, but not of t, t-MA, even at very low levels of benzene exposure. The same effect was found for GSTM1, but only for smokers. The t,t-MA/SPMA ratio was not a constant value and resulted to be higher than the corresponding Biological Exposure Index (BEI) ratio, which is currently equal to 20. Higher values of metabolite have been associated with the GSTT1 or GSTM1 null genotype and these are responsible for increase health risk. We suggest that this ratio could be used as a marker of individual susceptibility for subjects with benzene exposure. [Copyright &y& Elsevier]

Abstract: The present study compared three methods for the determination of S-phenylmercapturic acid (S-PMA), a metabolite of benzene, in human urine: a HPLC/MS/MS technique with two different sample treatments (strong and partial hydrolysis) and a commercial assay based on anti-S-PMA monoclonal antibodies with chemiluminescence detection. Biological monitoring was done on 126 volunteers and the results were compared for the three methods and also with benzene exposure levels (range <3.0–592.5μg/m3). The correlation between environmental monitoring data and S-PMA levels in non-smokers (n =73) was highly significant (p <0.0001, Student''s t-test) for both HPLC/MS/MS methods (r =0.65 both for strong acidic hydrolysis of the urine and hydrolysis at pH 2) but not for the immunoassay, which overestimated the S-PMA levels by about 8μg/g creatinine (creat.). Therefore the immunoassay is only useful as a semiquantitative screening test, but quantitative results need to be confirmed by a more accurate method like HPLC/MS/MS. The HPLC/MS/MS procedure with strong acid hydrolysis led to a recovery of S-PMA about double that using pH 2 hydrolysis, giving more accurate results. The difference between the results with the two methods makes it difficult to compare the strong acidic hydrolysis data with the ACGIH BEI value of 25μg/g creat. since the BEI® documentation is based on data collected in pH conditions that were not always controlled, which may underestimate the true S-PMA concentration. Besides, as levels of benzene exposure were high, smoking was not considered a confounding factor. The BEI for S-PMA in end of shift urine samples could be reconsidered when sufficient data are available from studies where the analyses are carried out in comparable conditions of hydrolysis and monitoring only non-smoking subjects. [Copyright &y& Elsevier]

Abstract: The present work was aimed to study in petrochemical industry operators the correlation, if any, between environmental exposure to low levels of benzene and two biological exposure indexes in end-shift urine, i.e. trans, trans-muconic acid (t,t-MA) and S-phenylmercapturic acid (SPMA). Exposure to benzene was assessed in 133 male subjects employed in outdoor operations in a petrochemical plant, using personal passive-diffusive air samplers worn at the breathing zone; adsorbed benzene was determined by GC-FID analysis. S-PMA was determined by a new HPLCMS/MS method, after (quantitative) acidic hydrolysis of the cysteine conjugate precursor. t,t-MA was measured by an HPLC-UV method. Smoking habits were assessed by means of a self-administered questionnaire. Both environmental and biological monitoring data showed that benzene exposure of petrochemical industry operators was low (mean values were 0.014ppm, 101μg/g creat, and 2.8μg/g creat, for benzene, t,t-MA, and S-PMA, respectively) if compared with the ACGIH limits. Cigarette smoking was confirmed to be a strong confounding factor for the urinary excretion of both metabolites: statistically significant increases of t,t-MA and S-PMA levels were recorded in smokers when compared to non-smokers (p <0.0001). The best correlation found was that between exposure to benzene and S-PMA levels, particularly in non-smokers. This was partly due to the hydrolysis of the S-PMA precursor N-acetyl-S-(1,2-dihydro-2-hydroxyphenyl)-l-cysteine, a crucial step of the new analytical method used, which indeed reduced the variability of the results by means of an improved standardization of this critical preanalytical factor. A weaker correlation was found between exposure to benzene and t,t-MA, possibly explained by the fact that the latter is also a metabolite of sorbic acid, a common diet component. In summary, even at such low levels of exposure, urinary metabolites proved to be a useful tool for assessing individual occupational exposure to benzene, S-PMA appearing to be a more specific biomarker than t,t-MA, particularly in non-smokers. [Copyright &y& Elsevier]

Abstract: 1,3-Butadiene is used in the production of synthetic rubber and is also a widespread environmental pollutant, produced by car exhaust, heating and cigarette smoke. According to IARC it is probably carcinogenic to humans. A method was developed and validated for the quantification in human urine of 1,2-dihydroxybutyl mercapturic acid, a butadiene metabolite for which the American Conference of Governmental Hygienists suggests a biological exposure index of 2500μg/L. Solid phase extraction was used for analyte extraction and HPLC–MS/MS for detection. The calibration range from 20 to 2500μg/L required the use of polynomial calibration curves, and the performance of the analytical method was tested according to an international validation guideline. Accuracy was never less than 85%, precision always higher than 15% and the LOD 3.6μg/L. The method was applied to 33 non-smokers, non-occupationally exposed to butadiene, and gave urinary concentrations between 16 and 599μg/L. [Copyright &y& Elsevier]

Osteoid osteoma (OO) is one of the most common benign bone tumors with specific clinical and radiological characteristics. Analgesic therapy and surgical treatment have been considered the only therapy for a long time. Recently, safe and effective new therapeutic options have been introduced, among which percutaneous thermal ablation techniques. This review aims to describe the recent updates in the field of percutaneous thermal ablation techniques in the treatment of OO, assessing the outcomes in terms of efficacy, complications, and recurrence rate. [ABSTRACT FROM AUTHOR]

Abstract: The aim of this study was to assess gasoline filling-station attendants’ exposure to benzene and to determine which biological exposure index (BEI), trans,trans-muconic acid (t,t-MA) or S-phenylmercapturic acid (S-PMA), shows better correlation with environmental exposure. Exposure to benzene was measured using passive samplers (Radiello) attached to the collar of the overalls of subjects (n =33) just before the work-shift (approximately 8h); analysis was performed by GC-FID. S-PMA and t,t-MA were determined, respectively, by an immunochemiluminescent assay based on specific monoclonal antibodies and by HPLC–UV at 264nm. Both methods of biological monitoring were performed on beginning and end-shift urine samples, and expected t,t-MA and S-PMA values were calculated. Smoking habits and life-style were ascertained by means of a questionnaire. Both environmental and biological monitoring data showed that benzene exposure for gasoline filling-station attendants was low when compared with the respective ACGIH limit values (means—benzene: 0.044mg/m3; t,t-MA: 171μg/g creatinine; S-PMA: 2.7μg/g creatinine). No significant correlation was found between exposure to benzene and t,t-MA or S-PMA excretion data. The use of expected values was also experimented for S-PMA and t,t-MA. This consists of calculating, on the basis of the known half-life of the benzene metabolite, the concentration of that metabolite that a worker should present at the end of the work-shift, the difference between this value and the value actually found is a measure of benzene exposure during work. The use of expected values in biological monitoring did not improve correlations. At these low benzene levels, environmental monitoring seems to be the best method of evaluating individual exposure. However, biological monitoring remains useful, as a mean of assessing group exposure. [Copyright &y& Elsevier]

Background. The purpose of this study was to evaluate the prognostic impact of chest X-ray (CXR) score, frailty, and clinical and laboratory data on in-hospital mortality of hospitalized older patients with COVID-19. Methods. This retrospective study included 122 patients 65 years or older with positive reverse transcription polymerase chain reaction for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and with availability to CXRs on admission. The primary outcome of the study was in-hospital mortality. Statistical analysis was conducted using Cox regression. The predictive ability of the CXR score was compared with the Clinical Frailty Scale (CFS) and fever data using Area Under the Curve (AUC) and net reclassification improvement (NRI) statistics. Results. Of 122 patients, 67 died during hospital stay (54.9%). The CXR score (HR: 1.16, 95% CI, 1.04–1.28), CFS (HR: 1.27; 95% CI, 1.09–1.47), and presence of fever (HR: 1.75; 95% CI, 1.03–2.97) were significant predictors of in-hospital mortality. The addition of both the CFS and presence of fever to the CXR score significantly improved the prediction of in-hospital mortality (NRI, 0.460; 95% CI, 0.102 to 0.888; AUC difference: 0.117; 95% CI, 0.041 to 0.192, p = 0.003). Conclusions. CXR score, CFS, and presence of fever were the main predictors of in-hospital mortality in our cohort of hospitalized older patients with COVID-19. Adding frailty and presence of fever to the CXR score statistically improved predictive accuracy compared to single risk factors. [ABSTRACT FROM AUTHOR]