Endobronchial metastasis: an epidemiologic and clinicopathologic study of 174 consecutive cases

PURPOSE: Endobronchial metastases from extrapulmonary solid tumors are a rare event and currently available epidemiological and clinico-pathological data mainly derive from anecdotal case reports. METHODS: A series of 174 consecutive cases of endobronchial metastases from extrathoracic solid tumors were collected over a period of 18 years. Immunohistochemistry was performed in 115 cases. Complete imaging features were available in 81 patients, and analysis of the latency period between primitive tumor diagnosis and occurrence of endobronchial metastasis was obtained. RESULTS: Among all bronchoscopic examinations performed in the same period for malignancy, a mean of 5.6 cases per year consisted of endobronchial metastases (range 2-17 cases), with a statistically significant increase when comparing the periods 1992-2000 (65 cases, 37%) and 2001-2009 (109 cases, 63%) (p = 0.05). Overall, 4% of endobronchial biopsies for suspected malignancy disclosed an endobronchial metastasis from extrapulmonary tumor. Breast (52 cases, 30%), colorectal (42 cases, 24%), renal (14%), gastric (6%) and prostate (4.5%) cancers and melanoma (4.5%) were the most common metastatic neoplasms presenting as endobronchial mass. One-hundred fifty-four cases were identified after the primitive tumor diagnosis (metachronous cases, 89%), 11 cases were simultaneously evidenced in extrapulmonary and endobronchial sites (synchronous cases, 6%), while 9 occult metastatic cases (5%) first presented as endobronchial mass (anachronous cases). Overall, mean latency from extrapulmonary tumor diagnosis and endobronchial metastasis was 136 months (range, 1-300 months). The most frequent symptoms were dyspnea (23%), cough (15%) and haemoptysis (12%), while 26% of patients were totally asymptomatic. At radiology, 53% presented as multiple pulmonary nodules, while other cases presented as hilar and mediastinal mass, single peripheral nodule, atelectasis or pleural effusion. CONCLUSIONS: Endobronchial metastases from extrapulmonary tumors account for about 4% of all bronchoscopic biopsies performed for suspected malignancy and in 5% of the cases the metastasis is the first manifestation of the neoplasm

Veg*ns’ and omnivores’ reciprocal attitudes and dehumanization: The role of social dominance orientation, ingroup identification, and anticipated reproach

Two studies compared omnivores’ and veg*ns’ attitudes and dehumanization tendencies toward each other and identified the social psychological factors explaining them. Study 1 (N = 208, Italians) showed that veg*ns’ hold less positive attitudes toward omnivores than the reverse, and attributed to them less human uniqueness and nature; these differences were explained by veg*ns’ stronger identification with the ingroup and higher perceptions of reproach from the outgroup, even if omnivores’ higher levels of social dominance orientation worsened their attitude toward veg*ns. Study 2 (preregistered, N = 200, mostly from UK) overall replicated Study 1 findings at the explicit level. Interestingly, omnivores’ and veg*ns’ implicit attitudes were equally positive (but less positive than self-reported attitudes) and not predicted by the same mediators associated with the explicit measures. This work suggests that neither veg*ns nor omnivores hold negative attitudes toward each other: they were both positive or neutral toward the outgroup, even if at the explicit level this positivity is greater for omnivores

Optimization of a rapid QuEChERS sample treatment method for HILIC-MS2 analysis of paralytic shellfish poisoning (PSP) toxins in mussels

A rapid and simple QuEChERS sample treatment was proposed for the development of a selective hydrophilic interaction liquid chromatography-ESI-MS2-based method for the determination of saxitoxins (STXs) in mussel samples. Among different sorbents, ABS Elut-NEXUS phase, composed of polystyrene cross-linked with 50 % divinyl benzene and poly(methyl methacrylate), provided the best results. The effects of experimental parameters, including sorbent amount, vortexing time and centrifugation time were investigated and optimized by experimental design. In particular, regression models and desirability functions were applied to find the experimental conditions providing the highest global extraction response. The method was validated under the optimized conditions; detection and quantification limits in the 3-159 μg/kg and 7-436 μg/kg ranges respectively were obtained, except for C2 for which highest values were calculated due to its low ESI ionization efficiency. Finally, the analysis of twenty-eight mussel samples permitted to detect and quantify some of the investigated STXs, proving the applicability of the devised method

Biosafety in surgical pathology in the era of SARS-Cov2 pandemia. A statement of the Italian Society of Surgical Pathology and Cytology

Surgical pathology units face chemical and biological risks. While chemical risks have been intensely evaluated since the formalin ban, less attention has been drown to biological risks. The actual epidemiologic situation due to the SARS-CoV-2 pandemia has raised a series of questions, which need to be addressed as soon as possible. We have to pursue two lines of action: on one hand we must immediately adopt urgent measures to reduce the risk of SARS-CoV-2 infection of laboratory personnel, and on the other hand, we must address crucial technical and organizational aspects of biological risk reduction, preserving as much as possible the quality of tissue and cell samples. The evaluation of biological risk is an analytical process which involves different steps: a) characterization of the hazard (also known as risk assessment) and b) definition of a risk reduction strategy (also known as risk mitigation) 1. Risk assessment implies a) the identification of the intrinsic biologic characteristics of the infectious agent, and b) the identification of the laboratory procedures related to the agent. The intrinsic biologic characteristics of infectious agents are classified in 4 risk groups (RG) by the laboratory biosafety manual of the WHO 2. The RG range from level 1 (RG1) which includes microorganisms that are unlikely to cause human or animal disease, to level 4 (RG4) which includes pathogens which cause serious diseases, that can be readily transmitted from one individual to another, and for which effective treatment and preventive measures are not usually available. Risk mitigation includes the definition of the appropriate a) level of biosafety of the laboratory, b) type of personal protection equipment (PPE), c) type of infrastructure and equipment, and d) education of involved personnel. Laboratory biosafety is graded in 4 levels (BSL-1 to BSL-4) as exhaustively described in the laboratory biosafety manual of the WHO 2, and these levels are usually also defined by law (in Italy by the D. Lgs. 81/2008). BSL are a series of protections, which include individual safeguards designed to protect laboratory personnel, as well as the surrounding environment and community. The biosafety level required in laboratories derives from the characterization of the risk, and is not automatically derived from the risk group to which the pathogenic agent belongs. It is obvious that the biosafety level for a laboratory which cultivates a RG3 agent, will be higher than the level needed for a laboratory which performs diagnostic tests on inactivated biomaterials on the same agent. Specific checklists, derived from the WHO laboratory biosafety manual, which in Italy are also defined by the National Institute of Labor Safety Insurance (Istituto Nazionale Assicurazione Infortuni sul Lavoro) in its 6th Fascicle published in 2010 3 are necessary to verify the compliance of a given laboratory with the required biosafety level

Cibo da maschi e da femmine: stereotipi di genere associati agli alimenti in età prescolare

Numerosi studi mostrano l’esistenza di stereotipi di genere riguardo al cibo (Vartanian, Herman, Polivy, 2007). La carne rossa è considerata il tipico cibo maschile e consumarla in pubblico rappresenta per gli uomini una strategia per affermare la propria virilità (Vartanian, 2015). Frutta, verdura, latticini, pesce e dolci sono considerati cibi tipicamente femminili e consumarli rappresenta per le donne un modo per comunicare la propria femminilità (Vartanian et al., 2007). Sono poche le ricerche in questo ambito che coinvolgono bambini, ma sapere se e quando i bambini scelgono o evitano determinati alimenti (e.g., verdure) sulla base di questi stereotipi di genere (e.g., sono cibo da femmine) potrebbe avere importanti implicazioni per i programmi di educazione alimentare. Abbiamo condotto uno studio per esplorare se i bambini in età prescolare (4-6) possiedano stereotipi di genere legati al cibo a livello esplicito e implicito e abbiamo verificato il ruolo delle madri nell’influenzarne lo sviluppo. 137 bambini hanno partecipato insieme alle madri. I bambini hanno completato uno IAT che misurava l'associazione tra carne e verdure con volti maschili e femminili e assegnato immagini di cibi diversi a uomini, donne, bambini e bambine. Le madri, invece, hanno risposto a un questionario per valutare gli stereotipi di genere riguardo al cibo e le abitudini alimentari. I risultati mostrano che a livello implicito i bambini, soprattutto i maschi, tendono già ad associare la carne agli uomini e le verdure alle donne. Inoltre, gli stereotipi e i comportamenti alimentari delle madri influenzano, almeno in parte, l’associazione esplicita cibo-genere