Search

Background: Despite improvement in lung function, most lung transplant (LTx) recipients show an unexpectedly reduced exercise capacity that could be explained by persisting peripheral muscle dysfunction of multifactorial origin. We analyzed the course of symptoms, including dyspnea, muscle effort and muscle pain and its relation with cardiac and pulmonary function parameters during an incremental exercise testing., Methods: Twenty-four bilateral LTx recipients were evaluated in an observational cross-sectional study. Recruited patients underwent incremental cardio-pulmonary exercise testing (CPET). Arterial blood gases at rest and peak exercise were measured. Dyspnea, muscle effort and muscle pain were scored according to the Borg modified scale. Potential associations between the severity of symptoms and exercise testing parameters were analyzed using a Forest-Tree Machine Learning approach, which accomplishes for a ratio between number of observations and number of screened variables less than unit., Results: Dyspnea score was significantly associated with maximum power output (WR, watts), and minute ventilation (VE, L/min) at peak exercise. In a controlled subgroup analysis, dyspnea score was a limiting symptom only in LTx recipients who reached the higher levels of WR (≥ 101 watts) and V E (≥ 53 L/min). Muscle effort score was significantly associated with breathing reserve as percent of maximal voluntary ventilation (BR%MVV). The lower the BR%MVV at peak exercise (< 32) the higher the muscle effort perception. Muscle pain score was significantly associated with VO 2 peak, arterial [HCO 3 - ] at rest, and V E /VCO 2 slope. In a subgroup analysis, muscle pain was the limiting symptom in LTx recipients with a lower VO 2 peak (< 15 mL/Kg/min) and a higher V E /VCO 2 slope (≥ 32)., Conclusions: The majority of our LTx recipients reported peripheral limitation as the prevalent reason for exercise termination. Muscle pain at peak exercise was strictly associated with basal and exercise-induced metabolic altered pathways. The onset of dyspnea (breathing effort) was associated with the intensity of ventilatory response to meet metabolic demands for increasing WR. Our study suggests that only an accurate assessment of symptoms combined with cardio-pulmonary parameters allows a correct interpretation of exercise limitation and a tailored exercise prescription. The role and mechanisms of muscle pain during exercise in LTx recipients requires further investigations.

Background: Although blood eosinophils are currently recognized as the main clinical marker of TH2-type inflammation, their relevance in identifying asthma severity remains a matter of debate., Methods: Our retrospective real-life study on severe asthmatics included in the NEONet Italian database aimed to investigate the relevance of blood eosinophil count and fractional exhaled nitric oxide (FeNO) in the clinical assessment of severe asthma and their role as potential predictors of responsiveness to anti-IgE therapy. The cut-off values chosen were 300 eosinophils/mm3 and FeNO of 30 ppm., Results: We evaluated 132 adult patients. No significant differences were observed between the groups (high and low baseline eosinophil counts) in terms of demographic data, total IgE, lung function, patient-reported outcomes, or nasal comorbidities. The Asthma Control Test score and Asthma Quality of Life Questionnaire scores were poorer in patients with FeNO ≥30 ppb than in patients with FeNO <30 ppb. In the high FeNO subgroup, more frequent hospital admissions and a higher number of working days lost in the previous year were registered. A combined score including both eosinophils and FeNO did not improve the accuracy of the individual parameters. In the high-eosinophil subgroup, the proportion of responders to omalizumab was greater and increased at each follow-up time point., Conclusions: Our findings show that blood eosinophil count is not an unequivocal marker of asthma severity, whereas a higher FeNO level is associated with more frequent hospital admissions and more working days lost. Blood eosinophils seem to act as a predictor of response to omalizumab.

Indoor dust is considered an important human exposure route to flame retardants (FRs), which has arised concern due the toxic properties of some of these substances. In this study, ten organophosphorus flame retardants (OPFRs), eight polybrominated diphenyl ethers (PBDEs) and four new brominated flame retardants (NBFRs) were determined in indoor dust from different places in Araraquara-SP (Brazil). The sampled places included houses, apartments, offices, primary schools and cars. The analysis of the sample extracts was performed by gas chromatography coupled to mass spectrometry and two ionization techniques were used (electron ionization - EI; electron capture negative ionization - ECNI). OPFRs were the most abundant compounds and tris(2-butoxyethyl) phosphate (TBOEP), tris(phenyl) phosphate (TPHP), tris(1,3-dichloroisopropyl) phosphate (TDCIPP) and tris(2-chloroisopropyl) phosphate (TCIPP) were present at the highest concentrations. Among the brominated FRs, the most ubiquitous compounds were BDE-209, bis(2-ethylhexyl) tetrabromophthalate (BEH-TEBP) and decabromodiphenyl ethane (DBDPE). Statistical analysis revealed that there were differences among dust typologies for TBOEP, TDCIPP, ethylhexyl diphenyl phosphate (EHDPHP), BDE-209, 2-ethylhexyl 2,3,4,5-tetrabromobenzoate (EH-TBB), BEH-TEBP and DBDPE, which were attributed to different construction materials in each particular environment and to the age of the buildings. The highest levels of brominated FRs were observed in offices, TBOEP was at high concentration in primary schools, and TDCIPP was at high concentration in cars. A preliminary risk assessment revealed that toddlers were exposed to TBOEP levels higher than the reference dose when considering the worst case scenario. The results obtained in this study showed for the first time that although Brazil does not regulate the use of FRs, these substances are present in indoor dust at levels similar to the observed in countries that have strict fire safety standards, and that humans are exposed to complex mixtures of these contaminants via indoor dust., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

The presence of estrogenic mycotoxins, such as zearalenone (ZEN), in surface waters is an emerging environmental issue. Little is known about its phototransformation behavior, which may influence its environmental fate. In this context, the phototransformation of ZEN was investigated in pure water, river water and estuarine water using simulated sunlight irradiation. Kinetic studies revealed that two concomitant processes contribute to the fate of ZEN under solar irradiation: photoisomerization and photodegradation. This phototransformation followed a pseudo-first order kinetics. ZEN degrades quickly in natural waters and slowly in deionized water, with half-lives (t 1/2 ) of 28 ± 4 min (estuarine water), 136 ± 21 min (river water) and 1777 ± 412 min (deionized water). The effects of different water constituents on the phototransformation of ZEN in aqueous solution have been assessed (NaCl, Ca 2+ , Mg 2+ , Fe 3+ , NO 3 - and oxalate ions, synthetic seawater, Fe(III)-oxalate and Mg(II)-oxalate complexes, humic acids, fulvic acids and XAD-4 fraction). In the presence of synthetic seawater salt (t 1/2  = 18 ± 5 min) and Fe(III)-oxalate complexes (t 1/2  = 61 ± 9 min), the transformation rate increased considerably in relation to other water constituents tested. The solution pH also had a considerable effect in the kinetics with maximum transformation rates occurring around pH 8.5. These results allow us to conclude that phototransformation by solar radiation can be an important degradation pathway of ZEN in natural waters., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Background: Asthma mortality has declined since the 1980s. Nevertheless the World Health Organization (WHO) identified asthma as responsible for 225.000 deaths worldwide in 2005, and 430.000 fatal cases are expected by 2030. Some unexpected and concentrated fatal asthma events all occurred between 2013 and 2015 in Veneto, a North Eastern region of Italy, which prompted a more in-depth investigation of characteristics and risk factors., Methods: A web search including key words related to fatal asthma in Italy between 2013 and 2015 has been performed. Concerning the cases that occurred in Veneto, subjects' clinical records have been evaluated and details about concomitant weather conditions, pollutants and pollen count have been collected., Results: Twenty-three cases of asthma deaths were found in Italy; 16 of them (69%) occurred in the Veneto Region. A prevalence of male and young age was observed. Most of patients were atopic, died in the night-time hours and during the weekends. The possible risk factors identified were the sensitization to alternaria , previous near fatal asthma attacks and the incorrect treatment of the disease. Weather condition did not appear to be related to the fatal exacerbations, whereas among the pollutants only ozone was detected over the accepted limits. Smoking habits, possible drug abuse and concomitant complementary therapies might be regarded as further risk factors., Discussion: Although not free from potential biases, our web search and further investigations highlight an increasing asthma mortality trend, similarly to what other observatories report. The analysis of available clinical data suggests that the lack of treatment more than a severe asthma phenotype characterizes the fatal events., Conclusions: Asthma mortality still represents a critical issue in the management of the disease, particularly in youngsters. Once more the inadequate treatment and the lack of adherence seem to be not only related to the uncontrolled asthma but also to asthma mortality.

Objective: To analyze ovarian and uterine morphologic changes resulting from intrauterine and postnatal exposure to diesel exhaust., Design: Crossover study. Experimental groups: intrauterine and postnatal clean air exposure; intrauterine exposure to diesel only; postnatal exposure to diesel only; and intrauterine and postnatal exposure to diesel., Setting: Laboratory of Experimental Air Pollution., Animal(s): Swiss mice., Intervention(s): Mice exposed to diesel exhaust with doses that correspond to the daily average PM₂.₅ levels (fine particles in the ambient air 2.5 μm or less in size) reported by the World Health Organization., Main Outcome Measure(s): Morphometric analyses of the ovaries and uterus were performed to define the relative area occupied by follicles, corpus luteum, and stroma and the proportionate area of glands, epithelial layer, and stroma within the uterine endometrium., Result(s): A significant reduction in the proportion of primordial follicles was observed in intrauterine-exposed animals, those exposed during the postnatal period, and in animals exposed during both phases. Primary follicle proportion was reduced in animals exposed during pregnancy. No significant changes were detected in uterine morphology., Conclusion(s): Intrauterine exposure to acceptable levels of diesel exhaust compromises the reproductive potential of female mice, diminishing ovarian reserve when sexual maturity is achieved. This effect could increase the risk of premature menopause. The findings raise concern about current environmental guidelines for diesel exposure, warranting more careful examination of this issue in humans by regulatory authorities., (Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)

This work presents the influence of sugarcane burning on PAH levels and their profiles at a residence located in Araraquara (SP, Brazil), a city surrounded by sugarcane plantations. The average concentrations of total PAHs (ΣPAHs) associated with atmospheric particulate matter were higher during the burning period (ΣPAHs 22.9 ng m(-3)) than in the non-burning period (ΣPAH 2.35 ng m(-3)). A comparison of our results with previous studies regarding PAH levels and their profiles in Araraquara outdoor air indicated that sugarcane burning was the main PAH air source in the indoor harvesting season samples. The benzo[a]pyrene equivalent (BaP(eq)) was used for cancer risk assessment, and higher average values were obtained in the harvesting season air samples (1.7 ng m(-3)) than in the non-harvesting air samples (0.07 ng m(-3)). These findings suggest that sugarcane burning during the harvesting season can represent a public health risk in affected cities., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

The designation of biodiesel as an environmental-friendly alternative to diesel oil has improved its commercialization and use. However, most biodiesel environmental safety studies refer to air pollution and so far there have been very few literature data about its impacts upon other biotic systems, e.g. water, and exposed organisms. Spill simulations in water were carried out with neat diesel and biodiesel and their blends aiming at assessing their genotoxic potentials should there be contaminations of water systems. The water soluble fractions (WSF) from the spill simulations were submitted to solid phase extraction with C-18 cartridge and the extracts obtained were evaluated carrying out genotoxic and mutagenic bioassays [the Salmonella assay and the in vitro MicroFlow® kit (Litron) assay]. Mutagenic and genotoxic effects were observed, respectively, in the Salmonella/microsome preincubation assay and the in vitro MN test carried out with the biodiesel WSF. This interesting result may be related to the presence of pollutants in biodiesel derived from the raw material source used in its production chain. The data showed that care while using biodiesel should be taken to avoid harmful effects on living organisms in cases of water pollution., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

The designation of biodiesel as a green fuel has increased its commercialization and use, making its fate in the environment a matter of concern. Fuel spills constitute a major source of aquatic pollution and, like diesel spills, biodiesel can produce adverse effects on aquatic environments, animals and humans. The present study assessed cytotoxic effects of water systems contaminated with neat biodiesel and its diesel blends by means of different procedures on human T cell leukemia (Jurkat) and human hepatocellular carcinoma (HepG2) cells [detection of changes in mitochondrial membrane potential (ΔΨ(m)) using tetramethylrhodamine ethyl ester (TMRE), apoptosis recognition by Annexin V and impedance real-time cell analyzer (xCELLigence™ system)]. The data obtained showed concordance across the different bioassays, with cytotoxic effects observed as a dose-dependent response only for waters contaminated with pure diesel (D100) and B5 blend, which is characterized by a mixture of 95% diesel and 5% biodiesel. The data can also lead us to hypothesize that diesel accounts for the harmful effects observed, and that biodiesel does not worsen the impacts caused by diesel pollution., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Brazil contains 25% of the total land planted with sugarcane in the world and is thus one of the major producers. The annual burning of sugarcane fields prior to harvesting emits huge amounts of pyrogenic particles. Biomass burning is an important primary and secondary source of aerosol particles. The presence of carbonaceous particles in the inhalable size range makes it important to study this fraction in view of the possible effects on human health and the climate. In this study, the mutagenic activity associated with inhalable airborne particulate matter (PM(10)) collected on air filters in a sugarcane-growing area near the city of Araraquara (SE Brazil) was determined. The extracts were dissolved in dimethylsulfoxide and tested for mutagenicity by the Ames plate incorporation test with Salmonella typhimurium YG1024 in the presence and absence of the S9 mixture. To assess the association between mutagenicity and PM(10), samples were collected in sugarcane harvesting and non-harvesting periods of the year. Significant mutagenicity was detected in organic solvent extracts of all samples, with differences between the two periods. The highest values of mutagenic potency (13.45 and 5.72 revertants/m(3) of air in the absence and presence of the S9 mixture, respectively) were observed during the harvest. In this period, a Teflon™-coated glass-fiber air filter trapped 67.0 μg of particulate matter per m(3) of air. In the non-harvest period, on the same type of filter, only 20.9 μg of particulate matter was found per m(3). The mutagenic potencies at this time were 1.30 and 1.04 revertants/m(3) of air, in the absence and presence of the S9 mixture, respectively. Period, concentration of PM(10) and mutagenicity were associated with each other. For routine monitoring of mutagenicity in the atmosphere, the use of YG1024 tester strain without metabolic activation (S9) is recommended., (Copyright © 2011 Elsevier Inc. All rights reserved.)

A rapid, robust and economical method for the analysis of persistent halogenated organic compounds in small volumes of human serum and umbilical cord blood is described. The pollutants studied cover a broad range of molecules of contemporary epidemiological and legislative concern, including polychlorobiphenyls (PCBs), polychlorobenzenes (CBs), hexachlorocyclohexanes (HCHs), DDTs, polychlorostyrenes (PCSs) and polybromodiphenyl ethers (PBDEs). Extraction and clean-up with n-hexane and concentrated sulphuric acid was followed with analysis by gas chromatography coupled to electron capture (GC-ECD) and GC coupled to negative ion chemical ionisation mass spectrometry (GC-NICI-MS). The advantages of this method rest in the broad range of analytes and its simplicity and robustness, while the use of concentrated sulphuric acid extraction/clean-up destroys viruses that may be present in the samples. Small volumes of reference serum between 50 and 1000 microL were extracted and the limits of detection/quantification and repeatability were determined. Recoveries of spiked compounds for the extraction of small volumes (> or = 300 microL) of the spiked reference serum were between 90% and 120%. The coefficients of variation of repeatability ranged from 0.1-14%, depending on the compound. Samples of 4-year-old serum and umbilical cord blood (n = 73 and 40, respectively) from a population inhabiting a village near a chloro-alkali plant were screened for the above-mentioned halogenated pollutants using this method and the results are briefly described.