Search

Abstract Background Titanium dioxide (TiO2) and carbon black (CB) nanoparticles (NPs) have biological effects that could aggravate pulmonary emphysema. The aim of this study was to evaluate whether pulmonary administration of TiO2 or CB NPs in rats could induce and/or aggravate elastase-induced emphysema, and to investigate the underlying molecular mechanisms. Methods On day 1, Sprague-Dawley rats were intratracheally instilled with 25 U kg−1 pancreatic porcine elastase or saline. On day 7, they received an intratracheal instillation of TiO2 or CB (at 100 and 500 μg) dispersed in bovine serum albumin or bovine serum albumin alone. Animals were sacrificed at days 8 or 21, and bronchoalveolar lavage (BAL) cellularity, histological analysis of inflammation and emphysema, and lung mRNA expression of heme oxygenase-1 (HO-1), interleukin-1β (IL-1β), macrophage inflammatory protein-2, monocyte chemotactic protein-1, and matrix metalloprotease (MMP)-1, and -12 were measured. In addition, pulmonary MMP-12 expression was also analyzed at the protein level by immunohistochemistry. Results TiO2 NPs per se did not modify the parameters investigated, but CB NPs increased perivascular/peribronchial infiltration, and macrophage MMP-12 expression, without inducing emphysema. Elastase administration increased BAL cellularity, histological inflammation, HO-1, IL-1β and macrophage MMP-12 expression and induced emphysema. Exposure to TiO2 NPs did not modify pulmonary responses to elastase, but exposure to CB NPs aggravated elastase-induced histological inflammation without aggravating emphysema. Conclusions TiO2 and CB NPs did not aggravate elastase-induced emphysema. However, CB NPs induced histological inflammation and MMP-12 mRNA and protein expression in macrophages.

Abstract Background The aim of this study was to assess the psychological consequences of HRCT scan screening in retired asbestos-exposed workers. Methods A HRCT-scan screening program for asbestos-related diseases was carried out in four regions of France. At baseline (T1), subjects filled in self-administered occupational questionnaires. In two of the regions, subjects also received a validated psychological scale, namely the psychological consequences questionnaire (PCQ). The physician was required to provide the subject with the results of the HRCT scan at a final visit. A second assessment of psychological consequences was performed 6 months after the HRCT-scan examination (T2). PCQ scores were compared quantitatively (t-test, general linear model) and qualitatively (chi²-test, logistic regression) to screening results. Multivariate analyses were adjusted for gender, age, smoking, asbestos exposure and counseling. Results Among the 832 subjects included in this psychological impact study, HRCT-scan screening was associated with a significant increase of the psychological score 6 months after the examination relative to baseline values (8.31 to 10.08, p < 0.0001, t-test). This increase concerned patients with an abnormal HRCT-scan result, regardless of the abnormalities, but also patients with normal HRCT-scans after adjustment for age, gender, smoking status, asbestos exposure and counseling visit. The greatest increase was observed for pleural plaques (+3.60; 95%CI [+2.15;+5.06]), which are benign lesions. Detection of isolated pulmonary nodules was also associated with a less marked but nevertheless significant increase of distress (+1.88; 95%CI [+0.34;+3.42]). However, analyses based on logistic regressions only showed a close to significant increase of the proportion of subjects with abnormal PCQ scores at T2 for patients with asbestosis (OR = 1.92; 95%CI [0.97-3.81]) or with two or more diseases (OR = 2.04; 95%CI [0.95-4.37]). Conclusion This study suggests that HRCT-scan screening may be associated with increased distress in asbestos-exposed subjects. If confirmed, these results may have consequences for HRCT-scan screening recommendations.

Pleural mesothelioma (PM) is a rare cancer defined by 3 main histologic subtypes: epithelioid (EM), biphasic (BM), and sarcomatoid (SM). All have a very aggressive course. It is usually diagnosed [...], Context.-Homozygous deletion (HD) of CDKN2A is one of the most frequent genetic abnormalities in pleural mesotheliomas. HD of CDKN2A by fluorescence in situ hybridization (FISH) is a reliable marker of malignancy in mesothelial proliferations; however, evaluation of CDKN2A deletion requires FISH. The 9p21 locus includes both CDKN2A and MTAP (methylthioadenosine phosphorylase); the latter is frequently codeleted with CDKN2A. Objective.-To examine the question of whether immunohistochemistry for MTAP and p16, the protein product of CDKN2A, can serve as a surrogate for CDKN2A HD by FISH. Design.-A random selection of 125 pleural mesothelioma cases was divided into 3 groups for evaluation of p16 and MTAP expression compared with FISH for CDKN2A deletion: 53 with HD, 39 with heterozygous deletion, and 33 without deletion. Results.-By itself, loss of p16 nuclear expression ( Conclusions.-MTAP immunohistochemical staining is a valid surrogate marker for CDKN2A HD by FISH; however, to obtain the same accuracy as the FISH assay, a combination of nuclear p16 and cytoplasmic MTAP staining is recommended. These findings correlate with prognosis. doi: 10.5858/arpa.2021-0331-OA

A large amount of crude palm oil production in South East Asia (SEA) is causing the production of a vast amount of agricultural waste from the palm oil industry. Oil palm empty fruit bunch (OPEFB) is one of the agricultural wastes with high lignocellulose content. Lignin is the lignocellulose component that has the potential to be used as fuel for energy production and as a filler in composite materials. This review provides information on the solvent extraction methods used such as alkaline treatment, organosolv treatment, and deep eutectic solvent treatment to extract the lignin from lignocellulose OPEFB. The extracted lignin from different solvent extraction methods also gave different properties of lignin. In conjunction with that, catalyst and enzyme have been used to overcome the limitations of solvent extraction methods.

Background: Ultrafine particles are present in ever greater quantities in the workplace and only one epidemiological study to date has found an association with the occurrence of lung cancer. Objective: To investigate the effect of occupational exposure to ultrafine particles on the risk of lung cancer. Methods: The ARDCO is a surveillance program involving retiree workers who had been exposed to asbestos during their working life. Exposure to ultrafine particles over the complete lifetime occupational history was assessed using the French job exposure matrix MATPUF. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CI). Results: There was no association between exposure to ultrafine particles and lung cancer after adjustment for smoking and exposure to asbestos and crystalline silica. Conclusion: The findings do not indicate increased risks of lung cancer for UFP after adjustment for level of exposure to asbestos, crystalline silica, and smoking status. Clinical trial number: Not applicable. [ABSTRACT FROM AUTHOR]

BackgroundPatients are increasingly turning to the Internet for health information. Numerous online symptom checkers and digital triage tools are currently available to the general public in an effort to meet this need, simultaneously acting as a demand management strategy to aid the overburdened health care system. The implementation of these services requires an evidence-based approach, warranting a review of the available literature on this rapidly evolving topic.ObjectiveThis scoping review aims to provide an overview of the current state of the art and identify research gaps through an analysis of the strengths and weaknesses of the presently available literature.MethodsA systematic search strategy was formed and applied to six databases: Cochrane library, NICE, DARE, NIHR, Pubmed, and Web of Science. Data extraction was performed by two researchers according to a pre-established data charting methodology allowing for a thematic analysis of the results.ResultsA total of 10,250 articles were identified, and 28 publications were found eligible for inclusion. Users of these tools are often younger, female, more highly educated and technologically literate, potentially impacting digital divide and health equity. Triage algorithms remain risk-averse, which causes challenges for their accuracy. Recent evolutions in algorithms have varying degrees of success. Results on impact are highly variable, with potential effects on demand, accessibility of care, health literacy and syndromic surveillance. Both patients and healthcare providers are generally positive about the technology and seem amenable to the advice given, but there are still improvements to be made toward a more patient-centered approach. The significant heterogeneity across studies and triage systems remains the primary challenge for the field, limiting transferability of findings.ConclusionCurrent evidence included in this review is characterized by significant variability in study design and outcomes, highlighting the significant challenges for future research.An evolution toward more homogeneous methodologies, studies tailored to the intended setting, regulation and standardization of evaluations, and a patient-centered approach could benefit the field.

Background Lung cancer screening programs concern smokers at risk for cardiovascular diseases (CVDs) and chronic obstructive pulmonary disease (COPD). The LUMASCAN (LUng Cancer Screening, MArkers and low-dose computed tomography SCANner) study aimed to evaluate the acceptability and feasibility of screening for these 3 diseases in a community population with centralized organization and to determine low-dose computed tomography (CT) markers associated with each disease. Methods This cohort enrolled participants meeting National Comprehensive Cancer Network criteria (v1.2014) in an organized lung cancer–screening program including low-dose CT scans; spirometry; evaluations of coronary artery calcifications (CACs); and a smoking cessation plan at inclusion, 1, and 2 years; then telephone follow-up. Outcomes were the participation rate and the proportion of participants affected by lung cancer, obstructive lung disease, or CVD events. Logistic-regression models were used to identify radiological factors associated with each disease. Results Between 2016 and 2019, a total of 302 participants were enrolled: 61% men; median age 58.8 years; 77% active smoker; 11% diabetes; 38% hypertension; and 27% taking lipid-lowering agents. Inclusion, 1-year, and 2-year participation rates were 99%, 81%, 79%, respectively. After a median follow-up of 5.81 years, screenings detected 12 (4%) lung cancer, 9 of 12 via low-dose CT (78% localized) and 3 of 12 during follow-up (all stage IV), 83 (27%) unknown obstructive lung disease, and 131 (43.4%) moderate to severe CACs warranting a cardiology consultation. Preexisting COPD and moderate to severe CACs were associated with major CVD events with odds ratios of 1.98 (95% confident interval [CI] = 1.00 to 3.88) and 3.27 (95% CI = 1.72 to 6.43), respectively. Conclusion The LUMASCAN study demonstrated the feasibility of combined screening for lung cancer, COPD, and CVD in a community population. Its centralized organization enabled high participation and coordination of healthcare practitioners. [ABSTRACT FROM AUTHOR]

Abstract Background The COVID-19 pandemic affects the processes of routine care for chronic patients. A better understanding helps to increase resilience of the health system and prepare adequately for next waves of the pandemic. Methods A qualitative study was conducted in 16 primary care practices: 6 solo working, 4 monodisciplinary and 7 multidisciplinary. Twenty-one people (doctors, nurses, dieticians) were interviewed, using semi-structured video interviews. A thematic analysis was done using the domains of the Chronic Care Model (CCM). Results Three themes emerged: changes in health care organization, risk stratification and self-management support. All participating practices reported drastic changes in organization with a collective shift towards COVID-19 care, and reduction of chronic care activities, less consultations, and staff responsible for self-management support put on hold. A transition to digital support did not occur. Few practitioners had a systematic approach to identify and contact high-risk patients for early follow-up. A practice with a pre-established structured team collaboration managed to continue most chronic care elements. Generally, practitioners expected no effects of the temporary disruption for patients, although they expressed concern about patients already poorly regulated. Conclusion Our findings show a disruption of the delivery of chronic care in the Belgium prim care context. In such contexts, the establishment of the CCM can facilitate continuity of care in crisis times. Short term actions should be directed to facilitate identifying high-risk patients and to develop a practice organization plan to organize chronic care and use digital channels for support, especially to vulnerable patients, during next waves of the epidemic.

Direct determination of the oxidative potential in exhaled air (OPEA) as a biological indicator of the redox balance status in airways requires an extremely sensitive sensing approach to counterbalance the high dilution of the exhaled air matrix. In opposite to standard colorimetric assays based on Beer-Lambert Law, the use of simple multiscattering-enhanced absorbance (MEA) strategy results in an improved photonic sensing system. Based on this strategy and using the ferrous-xylenol orange assay, analytical performances allowing the detection of 3 ​pmol of H2O2 could be obtained. The comparative analysis of photometric configurations – standard vs MEA – highlights the large absorbance gain obtained for tiny H2O2 amounts – from 0 to 30 ​pmol – whereas similar sensing trends are observed at higher concentration range. The automated introduction of exhaled air sample into the reaction compartment via needle-impinger coupled with the MEA-based photonic cell enables ultrasensitive determination of OPEA in short time (

Silicon dioxide (SiO2) is a mineral compound present in the Earth’s crust in two mineral forms: crystalline and amorphous. Based on epidemiological and/or biological evidence, the pulmonary effects of crystalline silica are considered well understood, with the development of silicosis, emphysema, chronic bronchitis, or chronic obstructive pulmonary disease. The structure and capacity to trigger oxidative stress are recognized as relevant determinants in crystalline silica’s toxicity. In contrast, natural amorphous silica was long considered nontoxic, and was often used as a negative control in experimental studies. However, as manufactured amorphous silica nanoparticles (or nanosilica or SiNP) are becoming widely used in industrial applications, these paradigms must now be reconsidered at the nanoscale (

Abstract This study was undertaken to determine the healthcare burden of malignant pleural mesothelioma (MPM) in France and to analyze its associations with socioeconomic deprivation, population density, and management outcomes. A national hospital database was used to extract incident MPM patients in years 2011 and 2012. Cox models were used to analyze 1‐ and 2‐year survival according to sex, age, co‐morbidities, management, population‐density index, and social deprivation index. The analysis included 1,890 patients (76% men; age: 73.6 ± 10.0 years; 84% with significant co‐morbidities; 57% living in urban zones; 53% in highly underprivileged areas). Only 1% underwent curative surgical procedure; 65% received at least one chemotherapy cycle, 72% of them with at least one pemetrexed and/or bevacizumab administration. One‐ and 2‐year survival rates were 64% and 48%, respectively. Median survival was 14.9 (95% CI: 13.7–15.7) months. The mean cost per patient was 27,624 ± 17,263 euros (31% representing pemetrexed and bevacizumab costs). Multivariate analyses retained men, age >70 years, chronic renal failure, chronic respiratory failure, and never receiving pemetrexed as factors of poor prognosis. After adjusting the analysis to age, sex, and co‐morbidities, living in rural/semi‐rural area was associated with better 2‐year survival (HR: 0.83 [95% CI: 0.73–0.94]; P