Pineoblastoma in Adults: A Rare Case Successfully Treated with Multimodal Approach Including Craniospinal Irradiation Using Helical Tomotherapy

Pineoblastomas (PBs) are rare and aggressive malignancies of the pineal gland. They are more commonly diagnosed in children between 1-12 years old, and are very rarely diagnosed in adults. For this reason, evidence in literature for adults is scarce and mainly derives from the paediatric practice. For their clinical behaviour and embryonal histology, PBs are often grouped together with medulloblastomas in clinical trials. In this report, we describe an adult PB case who was treated at our institution. We reference the literature to explain the clinical reasoning behind our decision-making process. A 46-year-old male patient was referred to our institution in November 2015 with three months history of headache. Imaging confirmed localised disease of the pineal gland. He underwent surgery which was radical and clinically uncomplicated. Histology showed PB. He then received adjuvant craniospinal radiotherapy with a boost to the tumour bed followed by consolidation chemotherapy. After 36 months follow-up, he remains disease-free without significant toxicities. Surgery followed by craniospinal irradiation and consolidation chemotherapy can be a safe and effective treatment option in adult PBs

Varicella zoster virus reactivation antedating ipsilateral brainstem stroke

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Selenium in humans: which is the safe range of intake?

Selenium in humans: which is the safe range of intake

Selenium, zinc and copper content of foods consumed in an Italian community

This study aimed to determine the concentrations of selenium, zinc and copper in foods generally composing the diet of Northern Italy population in order to implement a database of the quantitative content for each of the three trace elements, according to food category intake. Food samples were collected from (small to large) distribution markets in triplicates and trace elements determination was performed with ICP-MS after sample mineralization. We found the highest levels of selenium in meat (202g/kg), fish and seafood (489), dry fruits (314) and legumes (220). The level of zinc was higher in cereal products (11.7 mg/kg), meat (28.4), dairy products (18.8), legumes (21.2) and dry fruits (37.8). Finally, the highest concentration of copper was found in dry fruits (14.9 mg/kg), legumes (6.2), sweets (4.1) and meat (3.7). Our findings will allow to estimate dietary trace elements exposure which could be useful for both toxicological and epidemiological studies

FOOD INTAKE OF ZINC AND CADMIUM IN NORTHERN ITALY POPULATION

Background: Some trace elements are essential for humans; their deficiency may cause abnormal biological functions, whereas excessive intakes may produce adverse health effects. The aim of this study was to estimate the daily intake through diet of zinc (Zn) and cadmium (Cd) in a Northern Italy population and verify the compliance with recommended levels of intake for Italian population recently updated by Italian Society of Human Nutrition (SINU). Methods: We investigated dietary intake of Zn, and Cd in 719 residents of five provinces of Emilia Romagna region in Northern Italy, using a validated semi-quantitative food frequency questionnaire designed to capture eating behaviors in Italy, specifically developed as part of the European Prospective Investigation into Cancer and Nutrition study, for the Northern Italy population. Results: We analyzed the diet of 319 men and 400 women, mean (±SD) aged 59.0 (± 14.0) and 52.3 (±14.1) respectively. The daily average (±SD) intake of Zn and Cd was 11.99 (±4.31) mg/day and 15.06 (±8.41) μg/day in men and 10.83 (±4.06) mg/day and 13.23 (±7.23) μg/day in women. Dietary intake levels of Zn were above the recommended values and well below the upper safe levels set by SINU for healthy adults. Cd intake did not exceed the safety limits established by European Food Safety Authority (EFSA). Conclusions: Our analysis suggested that dietary intake of the above-mentioned essential and toxic trace elements characterizing this Northern Italy population is within the range defined as safe by SINU and EFSA

Assessing multiple sources of cadmium exposure in an Italian population.

Assessing multiple sources of cadmium exposure in an Italian population

Dietary determinants of serum selenium species in Italian populations

We investigated the correlation between dietary habits with serum levels of selenium (Se) species collected from an Italian community. Consumption of food items was assessed using a food frequency questionnaire. Cereal intake showed a positive relation with total and organic Se, but null/negative with inorganic Se. Fish and seafood positively correlated with inorganic Se and negatively with organic Se. Correlations were generally negative/null in vegetables (only Se-Cys was positively correlated), while in fruits they were positive with organic species, mainly Se-Cys. Legumes showed inverse relation with overall organic Se, but positive with Se-Cys, Se-TrXr and inorganic Se. Correlation of potatoes intake was negative with Se forms, except a positive one with Se-Cys and selenate. Our results show highly specific associations between intake of selected foods and circulating Se species levels

Residential proximity to petrol stations and risk of childhood leukemia

Petrol stations emit benzene and other contaminants that have been associated with an increased risk of childhood leukemia. We carried out a population-based case-control study in two provinces in Northern Italy. We enrolled 182 cases of childhood leukemia diagnosed during 1998-2019 and 726 age- and sex-matched population controls. We geocoded the addresses of child residences and 790 petrol stations located in the study area. We estimated leukemia risk according to distance from petrol stations within a 1000 m buffer and amount of supplied fuel within a buffer of 250 m from the child's residence. We used conditional logistic regression models to approximate risk ratios (RRs) and 95% confidence intervals (CIs) for associations of interest, adjusted for potential confounders. We also modeled non-linear associations using restricted cubic splines. In secondary analyses, we restricted to acute lymphoblastic leukemia (ALL) cases and stratifed by age (<5 and >= 5 years). Compared with children who lived >= 1000 m from a petrol station, the RR was 2.2 (95% CI 0.5-9.4) for children living<50 m from nearest petrol station. Associations were stronger for the ALL subtype (RR=2.9, 95% CI 0.6-13.4) and among older children (age >= 5 years: RR=4.4, 95% CI 0.6-34.1; age<5 years: RR=1.6, 95% CI 0.1-19.4). Risk of leukemia was also greater (RR=1.6, 95% CI 0.7-3.3) among the most exposed participants when assigning exposure categories based on petrol stations located within 250 m of the child's residence and total amount of gasoline delivered by the stations. Overall, residence within close proximity to a petrol station, especially one with more intense refueling activity, was associated with an increased risk of childhood leukemia, though associations were imprecise

Joint Effect of Maternal Tobacco Smoking and Pregestational Diabetes on Preterm Births and Congenital Anomalies: A Population-Based Study in Northern Italy

Smoking and pregestational diabetes (PGD) are recognized risk factors for adverse pregnancy outcomes, but to date, no population-based study has investigated their joint effects. Using hospital discharges, we identified all women with PGD delivering in Emilia-Romagna region during 2007-2010 matched 1: 5 with parturients without diabetes. Our study endpoints were preterm births and congenital anomalies. We measured interaction between PGD and maternal smoking, by calculating excess prevalence and prevalence ratio due to interaction, relative excess risk due to interaction (RERI), attributable proportion (AP), and the synergy index (S). Analyses were performed in the overall study population and in the subgroup whose PGD was validated through diabetes registers. The study included 992 women with PGD (10.5% smokers) and 4788 comparison women (11.9% smokers). The effects of PGD and maternal tobacco smoking were greater than additive for both preterm birth (excess prevalence due to interaction = 11.7%, excess ratio due to interaction = 1.5, RERI = 2.39, AP = 0.51, S = 2.82) and congenital anomalies (excess prevalence due to interaction = 2.2%, excess ratio due to interaction = 1.3, RERI = 1.33, AP = 0.49, S = 5.03). Joint effect on both endpoints was confirmed in the subgroup whose PGD status was validated. In conclusion, we found that maternal tobacco smoking and PGD intensify each other's effect on preterm birth and congenital anomalies