Cadmium exposure and risk of breast cancer: A meta-analysis.

BACKGROUND: Cadmium is a heavy metal with carcinogenic properties, highly prevalent in industrialized areas worldwide. Prior reviews evaluating whether cadmium influences breast cancer have been inconclusive and not reflected several recent studies. OBJECTIVE: To evaluate the association between cadmium exposure and female breast cancer incidence, with an emphasis on separately estimating dietary vs. airborne vs. biomarker measures of cadmium and studies published until October 2022. METHODS: We evaluated risk of bias using set criteria and excluded one study judged to have high risk based on self-report of breast cancer and insufficient adjustment. We conducted a random effects meta-analysis of epidemiological studies, including subgroups by exposure route and by menopausal status. RESULTS: A total of 17 studies were eligible for our meta-analysis. Only 2 studies addressed airborne cadmium directly. Breast cancer risk was elevated in women exposed to higher levels of cadmium across all studies - pooled odds ratio: 1.13 (95% confidence interval: 1.00, 1.28), with notable heterogeneity between studies (I2 = 77%). When examining separately by exposure route, dietary cadmium was not linked with an elevated risk - (OR: 1.05; 95%CI: 0.91, 1.21; I2 = 69%), consistent with prior reviews, but biomarker-based studies showed an elevated but non-significant pooled measure (OR: 1.37; 95%CI: 0.96, 1.94; I2 = 84%). We did not observe any clear patterns of different risk by menopausal status. CONCLUSION: Findings from our meta-analysis suggest that exposure to higher cadmium increases the risk of breast cancer in women, but with remaining questions about whether non-dietary exposure may be more risky or whether residual confounding by constituents of tobacco smoke may be at play.

Biological removal of pharmaceutical compounds using white-rot fungi with concomitant FAME production of the residual biomass.

The efficiency of two white-rot fungi (WRF), Trametes versicolor and Ganoderma lucidum, to eliminate thirteen pharmaceutical pollutants with concomitant biodiesel production from the accumulating lipid content after treatment, was examined. The removal efficiency was studied using both individual and combined strains. The results of individual and combined strains showed a total removal (100%) of diclofenac (DCF), gemfibrozil (GFZ), ibuprofen (IBP), progesterone (PGT) and ranitidine (RNT). Lower removals were achieved for 4-acetamidoantipyrin (AAA), clofibric acid (ACF), atenolol (ATN), caffeine (CFN), carbamazepine (CZP), hydrochlorothiazide (HCT), sulfamethoxazole (SMX) and sulpiride (SPD), although the combination of both strains enhanced the system's efficiency, with removals ranging from 15 to 41%. This increase of the removal efficiency when combining both strains was attributed to the interactions developed between them (i.e., competition). Results from enzymatic and cytochrome P450 examination suggested that both extracellular (laccase, MnP, LiP) and intracellular oxidation mechanisms participate in the biological removal of pharmaceuticals. On the other hand, the "green" potential of the fungal sludge generated during the biological removal process was assessed for biodiesel production by means of one-step direct (in-situ) transformation. This process consists of the simultaneous extraction and conversion of lipids contained in the sludge by catalytic esterification/transesterification using a robust acid heterogeneous Zr-SBA-15 catalyst. This catalytic system provided conversions close to 80% of the saponifiable fraction (including free fatty acids and glycerides) in the presence of high amount of impurities. The overall weight FAME yield, based on the initial dried mass, was close to 30% for both strains.

Patterns and predictors of personal exposure to indoor air pollution from biomass combustion among women and children in rural China.

UNLABELLED: Indoor air pollution (IAP) from domestic biomass combustion is an important health risk factor, yet direct measurements of personal IAP exposure are scarce. We measured 24-h integrated gravimetric exposure to particles < 2.5 µm in aerodynamic diameter (particulate matter, PM2.5) in 280 adult women and 240 children in rural Yunnan, China. We also measured indoor PM2.5 concentrations in a random sample of 44 kitchens. The geometric mean winter PM2.5 exposure among adult women was twice that of summer exposure [117 µg/m³ (95% CI: 107, 128) vs. 55 µg/m³ (95% CI: 49, 62)]. Children's geometric mean exposure in summer was 53 µg/m³ (95% CI: 46, 61). Indoor PM2.5 concentrations were moderately correlated with women's personal exposure (r=0.58), but not for children. Ventilation during cooking, cookstove maintenance, and kitchen structure were significant predictors of personal PM2.5 exposure among women primarily cooking with biomass. These findings can be used to develop exposure assessment models for future epidemiologic research and inform interventions and policies aimed at reducing IAP exposure. PRACTICAL IMPLICATIONS: Our results suggest that reducing overall PM pollution exposure in this population may be best achieved by reducing winter exposure. Behavioral interventions such as increasing ventilation during cooking or encouraging stove cleaning and maintenance may help achieve these reductions.

Functionalization, self-assembly, and photoswitching quenching for azobenzene derivatives adsorbed on Au(111).

We have used scanning tunneling microscopy to investigate the structure and photoswitching behavior of azobenzene molecules functionalized with bulky spacer groups and adsorbed onto Au(111). We find that positioning tert-butyl "legs" in a canted arrangement on the azobenzene phenyl rings quenches photoisomerizability of the molecule on Au(111). Addition of cyano groups at the para positions changes the molecular self-assembly significantly, but does not alter the quenched photoisomerizability. This behavior likely arises from a combination of molecule-surface interactions, molecule-molecule interactions, and alteration of azobenzene electronic structure resulting from the position-specific addition of tert-butyl groups.

Interethnic differences in the accuracy of anthropometric indicators of obesity in screening for high risk of coronary heart disease.

BACKGROUND: Cut points for defining obesity have been derived from mortality data among Whites from Europe and the United States and their accuracy to screen for high risk of coronary heart disease (CHD) in other ethnic groups has been questioned. OBJECTIVE: To compare the accuracy and to define ethnic and gender-specific optimal cut points for body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) when they are used in screening for high risk of CHD in the Latin-American and the US populations. METHODS: We estimated the accuracy and optimal cut points for BMI, WC and WHR to screen for CHD risk in Latin Americans (n=18 976), non-Hispanic Whites (Whites; n=8956), non-Hispanic Blacks (Blacks; n=5205) and Hispanics (n=5803). High risk of CHD was defined as a 10-year risk > or =20% (Framingham equation). The area under the receiver operator characteristic curve (AUC) and the misclassification-cost term were used to assess accuracy and to identify optimal cut points. RESULTS: WHR had the highest AUC in all ethnic groups (from 0.75 to 0.82) and BMI had the lowest (from 0.50 to 0.59). Optimal cut point for BMI was similar across ethnic/gender groups (27 kg/m(2)). In women, cut points for WC (94 cm) and WHR (0.91) were consistent by ethnicity. In men, cut points for WC and WHR varied significantly with ethnicity: from 91 cm in Latin Americans to 102 cm in Whites, and from 0.94 in Latin Americans to 0.99 in Hispanics, respectively. CONCLUSION: WHR is the most accurate anthropometric indicator to screen for high risk of CHD, whereas BMI is almost uninformative. The same BMI cut point should be used in all men and women. Unique cut points for WC and WHR should be used in all women, but ethnic-specific cut points seem warranted among men.

Isolation and genetic identification of PAH degrading bacteria from a microbial consortium.

Polycyclic aromatic hydrocarbons (PAH; naphthalene, anthracene and phenanthrene) degrading microbial consortium C2PL05 was obtained from a sandy soil chronically exposed to petroleum products, collected from a petrochemical complex in Puertollano (Ciudad Real, Spain). The consortium C2PL05 was highly efficient degrading completely naphthalene, phenanthrene and anthracene in around 18 days of cultivation. The toxicity (Microtox method) generated by the PAH and by the intermediate metabolites was reduced to levels close to non-toxic in almost 40 days of cultivation. The identified bacteria from the contaminated soil belonged to gamma-proteobacteria and could be include in Enterobacter and Pseudomonas genus. DGGE analysis revealed uncultured Stenotrophomonas ribotypes as a possible PAH degrader in the microbial consortium. The present work shows the potential use of these microorganisms and the total consortium for the bioremediation of PAH polluted areas since the biodegradation of these chemicals takes place along with a significant decrease in toxicity.

The relationship between chronic stress, hair cortisol and hypertension.

Inconsistencies in studies of chronic psychosocial stress and hypertension may be explained by the use of stress markers greatly influenced by circadian rhythm and transient stressors. We assessed whether hair cortisol, a marker that captures systemic cortisol over months, was independently associated with hypertension. We measured hair cortisol and blood pressure in 75 consecutive participants in the Survey of the Health of Wisconsin, using an ELISA test. Individuals with values â€‹≥ â€‹median (78.1 â€‹pg/mg) were considered exposed. We used approximate Bayesian logistic regression, with a prior odds ratio of 1.0-4.0, to quantify the multivariate-adjusted hair cortisol-hypertension association. Participants' average age was 46.9 years; 37.3% were male; and 25.3% were hypertensive. Hypertension prevalence was 2.23 times higher in exposed (95% CI: 1.69-3.03). This finding was unlikely explained by differential measurement errors, since we conducted blinded measurements of exposure and outcome. Sensitivity analyses showed the association was unlikely explained by an unmeasured confounder, survival bias, or reverse causality bias. Findings suggest elevated hair cortisol is a risk factor for hypertension. Although feasible, the clinical value of hair cortisol as a tool for hypertension risk stratification or for monitoring the effect of chronic psychosocial stress management interventions is still uncertain.

Factors associated with false-positive self-reported adherence to antihypertensive drugs.

Self-reported medication adherence is known to overestimate true adherence. However, little is known about patient factors that may contribute to the upward bias in self-reported medication adherence. The objective of this study is to examine whether demographic, behavioral, medication and mood factors are associated with being a false-positive self-reported adherer (FPA) to antihypertensive drug treatment. We studied 175 patients (mean age: 50 years; 57% men) from primary-care clinics starting antihypertensive drug treatment. Self-reported adherence (SRA) was measured with the Medication Adherence Report Scale (MARS) and by the number of drug doses missed in the previous week/month, and compared with pill count adherence ratio (PCAR) as gold standard. Data on adherence, demographic, behavioral, medication and mood factors were collected at baseline and every 3 months up to 1 year. FPA was defined as being a non-adherer by PCAR and an adherer by self-report. Mixed effect logistic regression was used for the analysis. Twenty percent of participants were FPA. Anxiety increased (odds ratio (OR): 3.00; P=0.01), whereas smoking (OR: 0.40; P=0.03) and drug side effects (OR: 0.46, P=0.03) decreased the probability for FPA by MARS. Education below high-school completion increased the probability of being an FPA as measured by missing doses in the last month (OR: 1.66; P=0.04) and last week (OR: 1.88; P=0.02). The validity of SRA varies significantly according to drug side effects, behavioral factors and patient's mood. Careful consideration should be given to the use of self-reported measures of adherence among patients likely to be false-positive adherers.

Independent association between inflammatory markers (C-reactive protein, interleukin-6, and TNF-alpha) and essential hypertension.

High blood pressure (HBP) has been associated with elevated C-reactive protein (CRP), a marker of chronic mild inflammation. However, the association between HBP and other inflammatory markers, particularly interleukin 6 (IL-6) and tumour necrosis alpha (TNF-alpha), has not been evaluated in well-controlled studies. We examined the cross-sectional relationship between IL-6, TNF-alpha, and CRP and HBP in a random sample of 196 healthy subjects. All markers were measured in duplicate with high-sensitivity ELISA tests. Three blood pressure (BP) measurments were averaged for the analysis, and subjects with systolic BP >or=140 and/or diastolic BP >or=90 mmHg were considered hypertensive. Log binomial regression was used to estimate multivariate-adjusted prevalence ratios (PR) of HBP. Of the subjects, 40% (79) were hypertensive (mean age: 44 years; range 30-64). After adjustment for age, sex, body mass index, family history of HBP, and the level of the other inflammatory markers, subjects in the second (PR: 3.10, P=0.003), third (PR: 2.32; P=0.031), and fourth quartiles (PR: 2.30; P=0.036) of IL-6 were more than twice as likely to be hypertensive than those in the first quartile. Corresponding PR estimates for TNF-alpha levels were 1.41 (P=0.014) for the second; 1.59 (P=0.001) for the third; and 1.61 (P=0.025) for the fourth quartile. The CRP-HBP association was not statistically significant. Our results suggest that TNF-alpha and IL-6 could be independent risk factors for HBP in apparently healthy subjects. Nevertheless, the temporal relationship between elevated inflammation markers and HBP should be ascertained in prospective cohort studies.

Pronóstico perinatal y de la paciente embarazada con infección por COVID-19 / Pregnancy and perinatal outcome of a woman with COVID-19 infection

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Is C-reactive protein an independent risk factor for essential hypertension?

CONTEXT: C-reactive protein (CRP), predicts coronary heart disease incidence in healthy subjects and has been associated with decreased endothelium-dependent relaxation, a potential risk factor for hypertension. However, the relationship between CRP and hypertension has not been studied. OBJECTIVE: To assess whether circulating levels of CRP are independently related to essential hypertension. DESIGN: Cross-sectional population survey. We measured circulating levels of CRP, blood pressure and cardiovascular risk factors among participants. Binomial regression was used to calculate the adjusted effect of CRP on the prevalence of hypertension. SETTING: General community of Bucaramanga, Colombia. PARTICIPANTS: A random sample of 300 subjects > or = 30 years old. MAIN OUTCOME MEASURE: Arterial blood pressure. RESULTS: Overall hypertension prevalence was 46.0%. The unadjusted prevalence of hypertension was 58.7% in the highest quartile of CRP, but only 34.7% in the lowest quartile. After adjustment for age, sex, body mass index, family history of hypertension, fasting glycemia, sedentary behaviour, and alcohol consumption, the prevalence of hypertension was 1.14 [95% confidence interval (CI), 0.82, 1.58; P= 0.442], 1.36 (95% CI, 0.99, 1.87; P= 0.057) and 1.56 (95% CI, 1.14, 2.13; P = 0.005) times higher in subjects in the second, third and fourth quartiles of CRP, as compared to subjects in the first quartile. CONCLUSIONS: Our results suggest, for the first time, that CRP level may be an independent risk factor for the development of hypertension. However, because of the cross-sectional nature of our study, this finding should be confirmed in prospective cohort studies, aimed at elucidating the role of CRP in the prediction, diagnosis and management of hypertension.

Role of the Metal/Semiconductor interface in quantum size effects: Pb /Si(111)

Self-organized islands of uniform heights can form at low temperatures on metal/semiconductor systems as a result of quantum size effects, i.e., the occupation of discrete electron energy levels in the film. We compare the growth mode on two different substrates [Si(111)- (7x7) vs Si(111)- Pb(sqrt[3]xsqrt[3] )] with spot profile analysis low-energy electron diffraction. For the same growth conditions (of coverage and temperature) 7-step islands are the most stable islands on the (7x7) phase, while 5-step (but larger islands) are the most stable islands on the (sqrt[3]xsqrt[3] ). A theoretical calculation suggests that the height selection on the two interfaces can be attributed to the amount of charge transfer at the interface.

Colombian study to assess the use of noninvasive determination of endothelium-mediated vasodilatation (CANDEV). Normal values and factors associated.

The endothelium plays a critical role in vascular homeostasis. Recently, a noninvasive method has been developed to assess flow mediated vasodilatation of the brachial artery (FMD). This test is remarkably stable overtime but no clear set of normal values has been developed. The purposes of our study were to evaluate the accuracy and reproducibility and to identify a set of normal values of FMD. We included 253 normotensive healthy volunteers from three Colombian cities (mean age: 38.2 years; 33% were women). All subjects underwent ultrasound evaluation of endothelial and smooth muscle function. Flow mediated vessel diameter change was measured by two independent observers. The interobserver Lin's concordance correlation coefficient was 0.88% (95% CI: 0.82, 0.94) and there was no evidence of systematic difference between the two measurements (mean difference of -0.30% with limits of agreement of -4.48 to 3.87). Mean %FMD was 11.98% (95% CI: 11.36, 12.61), 13.32% (95% CI: 12.39, 14.25) in women and 11.32% (95% CI: 10.52, 12.13) in men. Subjects with no cardiovascular risk factors had a mean %FMD of 13.74% (95% CI: 13.14, 14.35), in contrast to a mean of only 7.40% (95% CI: 4.33, 9.91) in those with at least one risk factor. A %FMD cut point of 10.4 had a sensitivity of 71.2% and an specificity of 77.2% to identify subjects with at least one cardiovascular risk factor. Using this cut point, endothelial dysfunction was 3.13 times more frequent in subjects with than in subjects without cardiovascular risk factors (95% CI: 2.30, 4.25). In addition, obesity, smoking and hypercholesterolemia were the modifiable risk factors with largest independent significant reduction effects on %FMD. FMD measurements can be made with high accuracy and precision, and a cut point of 10.4% is useful to discriminate between subjects with and without cardiovascular risk factors, and can be recommended as a screening test for the detection of patients at risk of CVD.

Inflammation, endothelial dysfunction, and the risk of high blood pressure: epidemiologic and biological evidence.

In spite of its high impact on cardiovascular and renal disease, knowledge on risk factors for the development of high blood pressure (HBP) is limited. Mild chronic inflammation may play a significant role in the incidence of HBP. A persistent low-grade inflammation state could be associated with high but within the 'normal range' cytokine plasma concentration. By impairing the capacity of the endothelium to generate vasodilating factors, particularly nitric oxide (NO), elevated cytokines may lead to the development of endothelial dysfunction, chronic impaired vasodilation, and HBP. These alterations in the L-arginine : NO pathway may play a major role in the development of HBP in young subjects, with inflammation-related alterations in the production of cyclo-oxygenase-derived vasoconstrictors becoming more prominent with advanced age. Cross-sectional independent associations between HBP and plasma levels of C-reactive protein, interleukin-6, and tissue necrosis factor alpha have been reported, but no prospective evidence of these associations is currently available.

Use of a diffusion model for mono- and bicomponent anion-exchange of two isoenzymes of glucoamylase from Aspergillus niger in a fixed bed.

The adsorption of glucoamylases I and II (GA I and GA II, respectively) from Aspergillus niger on the anion exchanger DEAE-Toyopearl 650 was studied in fixed-bed experiments, and the effect of temperature, flowrate, inlet concentration, bed length, and particle size on the process was characterized. The anion exchanger showed a higher adsorption capacity for the more active isoenzyme GA I in all experimental conditions studied. A mathematical model accounting for external and pore diffusion and nonlinear equilibrium isotherm (for GA I) was used to fit the experimental breakthrough curves, showing very accurate fittings in all of the operating conditions. The values of the pore diffusion coefficient at 15, 20, and 25 degrees C were, respectively, 1.25 x 10(-)(11), 1.46 x 10(-)(11) and 1.83 x 10(-)(11) (for GA I) and 1.82 x 10(-)(11), 2.44 x 10(-)(11) and 2.73 x 10(-)(11) (for GA II) m(2)/s. Bicomponent adsorption experiments showed no significant interference effects between GA I and GA II, and so the mathematical model was again used to fit these experiments, yielding very satisfactory results.

Effects of palm oil and dietary cholesterol on plasma lipoproteins: results from a dietary crossover trial in free-living subjects.

OBJECTIVE: To study the effects of palm oil (PO) and egg consumption (E) on plasma lipoproteins. DESIGN: Randomized crossover trial. SETTING: Free-living subjects. SUBJECTS: Twenty-eight healthy male students aged 20-34 y. INTERVENTIONS: Four typical Colombian diets (10 878 kJ/day; 57% energy in carbohydrates, 12% energy in proteins and 31% energy in fats) were consumed for 4 weeks. The HPOLC diet was high in PO (8.8% energy as palmitic acid, PA) and low in eggs (181.2 mg/kJ of dietary cholesterol, DC); the HPOHC diet was high in PO and high in eggs (866.1 mg/kJ of DC); the MPOMC diet was moderate in PO (6.3% energy as PA) and moderate in eggs (581.6 mg/kJ of DC); and the LOPOMC diet had no PO and was moderate in eggs (543.9 mg/kJ of DC). MAIN OUTCOME: Total (TC), low density (LDL-c), and high density lipoprotein cholesterol (HDL-c), and triacylglycerols (TAG) were measured on a pool of three fasting blood samples collected in consecutive days the last week of each diet. RESULTS: Comparison of the HPOHC and HPOLC diets showed increases in TC and LDL-c of 0.21 (P=0.01), and 0.16 mmol/l (P=0.05). Comparison of LOPOMC and MPOMC diets showed increases in TC and LDL-c of 0.39 (P<0.001), and 0.38 mmol/l (P<0.001), respectively. No significant changes in HDL-c or TAG were observed. CONCLUSIONS: Our findings suggest that non-extreme short-term changes in PO and DC consumption lead to significant elevations in plasma TC and LDL-c. SPONSORSHIP: CENIPALMA, Fundación Cardiovascular del Oriente Colombiano, Universidad Industrial de Santander.

Influence of lactic starter inoculation, curd heating and ripening temperature on Staphylococcus aureus behaviour in Manchego cheese.

Growth and survival of Staphylococcus aureus were investigated in 52 lots of raw ewe's milk Manchego cheese manufactured and ripened under different conditions. A 5.8-fold reduction in S. aureus counts after 60 days of ripening was obtained by inoculating milk with 1% Streptococcus lactis culture, and a further 2.0-fold reduction could be achieved by adding 0.1% Lactobacillus plantarum culture. Curd heating temperature had a significant effect on S. aureus survival, with counts 4-5 times lower in cheese from 30 degrees C curd than in cheese from curd heated at 36-40 degrees C. Ripening temperature was the parameter with the greatest influence on S. aureus counts, which reached in cheese cured at 10 degrees C or 20 degrees C for 60 days levels 10 and 100 times lower, respectively, than in cheese held at 5 degrees C.

[Factors affecting the course of hospital detoxication of drug addicts]. / Factores que inciden en la evolución de la desintoxicación hospitalaria de drogodependientes.

BACKGROUND: Despite the long waiting list (2-3 months) for entering the Detoxication Unit of the Psychiatric Hospital in Madrid, some of the drug addicts (DA) voluntarily give up treatment. This study attempts to outline the differences between the DA who successfully complete the treatment and those who fail. METHODS: Anamnestic personal and family data and information concerning drug dependence collected from the clinical history of 1,313 DA admitted between October 1985 and March 1990 were analyzed. The sample was divided into 2 stages; the first being up to October 1988 in which adrenergic drugs (clonidine and guanfacine) were used and the second in which an opiacium agonist (methadone) was also taken. Two groups have been made according to the success and failure of the treatment. RESULTS: In the first stage, the number of failures was greatest among those subjects with prison records (42% vs 27%, p less than 0.0001), heroin and cocaine addicts (33% vs 15%, p less than 0.001) and those whose urine analysis proved positive for cocaine on the day of hospital admission (46% vs 21%, p less than 0.0001). No differences were found in the second stage. CONCLUSIONS: The possible usefulness of opiacium agonists vs adrenergic agonists in the detoxication of heroin and cocaine drug addicts are discussed in accordance with the knowledge obtained by other authors in preclinical studies.