Road traffic pollution and childhood leukemia: a nationwide case-control study in Italy

Background The association of childhood leukemia with traffic pollution was considered in a number of studies from 1989 onwards, with results not entirely consistent and little information regarding subtypes. Aim of the study We used the data of the Italian SETIL case-control on childhood leukemia to explore the risk by leukemia subtypes associated to exposure to vehicular traffic. Methods We included in the analyses 648 cases of childhood leukemia (565 Acute lymphoblastic–ALL and 80 Acute non lymphoblastic-AnLL) and 980 controls. Information on traffic exposure was collected from questionnaire interviews and from the geocoding of house addresses, for all periods of life of the children. Results We observed an increase in risk for AnLL, and at a lower extent for ALL, with indicators of exposure to traffic pollutants. In particular, the risk was associated to the report of closeness of the house to traffic lights and to the passage of trucks (OR: 1.76; 95% CI 1.03–3.01 for ALL and 6.35; 95% CI 2.59–15.6 for AnLL). The association was shown also in the analyses limited to AML and in the stratified analyses and in respect to the house in different period of life. Conclusions Results from the SETIL study provide some support to the association of traffic related exposure and risk for AnLL, but at a lesser extent for ALL. Our conclusion highlights the need for leukemia type specific analyses in future studies. Results support the need of controlling exposure from traffic pollution, even if knowledge is not complete

Wachstumshemmende Wirkung von Jodid und Natrium-Jodid-Symporter-Expression in Schilddrüsenknoten mit gesteigerter oder verminderter Jodidspeicherung

Die Arbeit untersuchte die Expression des NIS Gens in benigne Schilddrüsenknoten: warme Knoten enthielten im Schnitt 3,8 mal mehr NIS mRNA als kalte Knoten. Zusätzlich wurden Wachstumsexperimente durchgeführt, um die Wirkung von pharmakologischen Jodiddosen zu untersuchen. Die stärkste Reaktion auf die Zugabe von NaI zeigten Primärzellen aus warmen Knoten. Schon nach 24 Stunden war die Zellzahl signifikant abgesunken, eine noch stärkere Wirkung trat nach 72 Stunden auf (75,1% der Kontrolle). Bei Thyreozyten aus kalten Knoten trat im Durchschnitt erst nach 72 Stunden eine geringere, aber auch signifikante Veränderung der Zellzahl auf. Insgesamt zeigte sich eine große Heterogenität, sowohl in der Expression des NIS, als auch bei dem wachstumshemmenden Effekt von Jodid bei jeweils beiden Knotenarten. Diese Ergebnisse zeigen, daß der hemmende Effekt von Jodid auf das Wachstum von Schilddrüsenknoten, zumindest teilweise von der Expression des NIS abhängig ist

The role of dynamic magnetic resonance imaging in exclusion of inguinal hernia in patients suffering from indefinitive groin pain

Rationale and objectives: The objective of this study was to analyze the role of dynamic magnetic resonance imaging (MRI) in patients who suffered from groin pain and whose physical examination and ultrasound returned inconclusive/indefinite results, as well as in patients receiving an ongoing assessment for a previous herniotomy. Material and methods: For this study, 25 patients 14 women and 11 men were selected with a mean age of 41.6 years, including clinical complaints, such as groin pain and or a previous herniotomies. These patients underwent dynamic MRI. Reports were created by a radiology resident and a radiology consultant. Clinical and ultrasound documentation were compared to with imaging results from the MRI. Results: The results of the dynamic MRI were negative for 23 patients (92%) and positive for two patients (8%). One patient suffered from an indirect hernia and one from a femoral hernia. A repeated hernia was an excluding for the preoperated patients with pain and ongoing assessment. Conclusions: Dynamic MRI shows substantially higher diagnostic performance in exclusion of inguinal hernia, when compared to a physical examination and ultrasound. The examination can also be used in assessments to analyze the operation’s results

Circulating hypoxia marker carbonic anhydrase IX (CA9) in patients with hepatocellular carcinoma and patients with cirrhosis

Background and aims: Expression of carbonic anhydrase IX (CA9), an enzyme expressed in response to hypoxia, acidosis and oncogenic alterations, is reported to be a prognostic factor in HCC patients. Here we evaluated serum CA9 levels in HCC and cirrhosis patients. Methods: HCC and cirrhosis patients were prospectively recruited and CA9 levels were determined. CA9 levels were compared to stages of cirrhosis and HCC stages. The association of the CA9 levels and overall survival (OS) was assessed. Furthermore, immunohistochemical CA9 expression in HCC and cirrhosis was evaluated. Results: 215 patients with HCC were included. The median serum CA9 concentration in patients with HCC was 370 pg/ml and significantly higher than in a healthy cohort. Patients with advanced cancer stages (BCLC and ALBI score) had hid significant higher levels of CA9 in the serum. HCC patients with high serum CA9 concentrations (>400 pg/ml) had an increased mortality risk (hazard ratio (HR) 1.690, 95% confidence interval (CI) 1.017–2.809, P = 0.043). Serum CA9 concentration in cirrhotic patients did not differ significantly from HCC patients. Higher CA9 levels in cirrhotic patients correlated with portal hypertension and esophageal varices. Patients with ethanol induced cirrhosis had the highest CA9 levels in both cohorts. Levels of CA9 did not correlate with immunohistochemical expression. Conclusions: We conclude that a high CA9 level is a possible prognostic indicator for a poor outcome in HCC patients. The high CA9 levels are probably mainly associated with portal hypertension. Ductular reactions might be a possible source of serum CA9

Circulating hypoxia marker carbonic anhydrase IX (CA9) in patients with hepatocellular carcinoma and patients with cirrhosis.

BACKGROUND AND AIMS:Expression of carbonic anhydrase IX (CA9), an enzyme expressed in response to hypoxia, acidosis and oncogenic alterations, is reported to be a prognostic factor in HCC patients. Here we evaluated serum CA9 levels in HCC and cirrhosis patients. METHODS:HCC and cirrhosis patients were prospectively recruited and CA9 levels were determined. CA9 levels were compared to stages of cirrhosis and HCC stages. The association of the CA9 levels and overall survival (OS) was assessed. Furthermore, immunohistochemical CA9 expression in HCC and cirrhosis was evaluated. RESULTS:215 patients with HCC were included. The median serum CA9 concentration in patients with HCC was 370 pg/ml and significantly higher than in a healthy cohort. Patients with advanced cancer stages (BCLC and ALBI score) had hid significant higher levels of CA9 in the serum. HCC patients with high serum CA9 concentrations (>400 pg/ml) had an increased mortality risk (hazard ratio (HR) 1.690, 95% confidence interval (CI) 1.017-2.809, P = 0.043). Serum CA9 concentration in cirrhotic patients did not differ significantly from HCC patients. Higher CA9 levels in cirrhotic patients correlated with portal hypertension and esophageal varices. Patients with ethanol induced cirrhosis had the highest CA9 levels in both cohorts. Levels of CA9 did not correlate with immunohistochemical expression. CONCLUSIONS:We conclude that a high CA9 level is a possible prognostic indicator for a poor outcome in HCC patients. The high CA9 levels are probably mainly associated with portal hypertension. Ductular reactions might be a possible source of serum CA9

Patient characteristics.

<p>Patient characteristics.</p

Patient characteristics and tumor stage of CA9 immunohistochemistry in HCC specimen.

<p>Patient characteristics and tumor stage of CA9 immunohistochemistry in HCC specimen.</p

CA9 levels in HCC patients.

<p><b>A</b> CA9 levels in healthy patients, patients with cirrhosis only and patients with hepatocellular carcinoma. <b>B</b> CA9 levels in different stages of Child Pugh in HCC patients. <b>C</b> CA9 levels in different stages of HCC according to BCLC. <b>D</b> CA9 levels in different stages of HCC according to ALBI score. (*, P<0.01). Vertical lines indicate the range, the horizontal boundaries of the boxes represent the first and third quartile.</p

Survival in patients stratified for CA9 levels.

<p><b>A</b> Mortality according to CA9 levels in patients with HCC. Patients with high serum CA9 concentrations had an increased mortality risk (hazard ratio (HR) 1.690, 95% confidence interval (CI) 1.017–2.809, <i>p</i> = 0.043). <b>B</b> Mortality according to CA9 levels in patients with cirrhosis. Patients with high serum CA9 concentrations had an increased mortality risk in this cohort (hazard ratio (HR) 2.458, 95% confidence interval (CI) 1.010–6.114, p = 0.048).</p