Threshold distribution of equal states for quantitative amplitude fluctuations.

Objective. The distribution of equal states (DES) quantifies amplitude fluctuations in biomedical signals. However, under certain conditions, such as a high resolution of data collection or special signal processing techniques, equal states may be very rare, whereupon the DES fails to measure the amplitude fluctuations.Approach. To address this problem, we develop a novel threshold DES (tDES) that measures the distribution of differential states within a threshold. To evaluate the proposed tDES, we first analyze five sets of synthetic signals generated in different frequency bands. We then analyze sleep electroencephalography (EEG) datasets taken from the public PhysioNet.Main results. Synthetic signals and detrend-filtered sleep EEGs have no neighboring equal values; however, tDES can effectively measure the amplitude fluctuations within these data. The tDES of EEG data increases significantly as the sleep stage increases, even with datasets covering very short periods, indicating decreased amplitude fluctuations in sleep EEGs. Generally speaking, the presence of more low-frequency components in a physiological series reflects smaller amplitude fluctuations and larger DES.Significance. The tDES provides a reliable computing method for quantifying amplitude fluctuations, exhibiting the characteristics of conceptual simplicity and computational robustness. Our findings broaden the application of quantitative amplitude fluctuations and contribute to the classification of sleep stages based on EEG data.

Neuroanatomy of reduced distortion of body-centred spatial coding during body tilt in stroke patients.

Awareness of the direction of the body's (longitudinal) axis is fundamental for action and perception. The perceived body axis orientation is strongly biased during body tilt; however, the neural substrates underlying this phenomenon remain largely unknown. Here, we tackled this issue using a neuropsychological approach in patients with hemispheric stroke. Thirty-seven stroke patients and 20 age-matched healthy controls adjusted a visual line with the perceived body longitudinal axis when the body was upright or laterally tilted by 10 degrees. The bias of the perceived body axis caused by body tilt, termed tilt-dependent error (TDE), was compared between the groups. The TDE was significantly smaller (i.e., less affected performance by body tilt) in the stroke group (15.9 ± 15.9°) than in the control group (25.7 ± 17.1°). Lesion subtraction analysis and Bayesian lesion-symptom inference revealed that the abnormally reduced TDEs were associated with lesions in the right occipitotemporal cortex, such as the superior and middle temporal gyri. Our findings contribute to a better understanding of the neuroanatomy of body-centred spatial coding during whole-body tilt.

Alto porcentaje de ausencia de reflejo bulbocavernoso en pacientes neurológicamente sanos con disfunción vesical / High Percentage of Absence of Bulbocavernosus Reflex in Neurologically-Healthy Patients with Bladder Dysfunction

Introducción y Objetivo El reflejo bulbocavernoso (RBCV) se ha observado ausente incluso en pacientes neurológicamente sanos. Los trastornos funcionales del piso pélvico deben incluir su evaluación. Nuestro objetivo primario fue evaluar la prevalencia de ausencia de RBCV en pacientes sanos. El objetivo secundario fue observar la afectación del RBCV en presencia de otras comorbilidades cómo enfermedad neurológica y diabetes mellitus tipo 2. Métodos Estudio descriptivo y retrospectivo, en el que se revisaron mil expedientes clínicos de pacientes sometidos a estudio urodinámico a quienes se les realizó exploración mecánica del RBCV como parte de una exploración rutinaria. Se realizó estadística descriptiva para las variables cuantitativas y cualitativas utilizando la prueba tde Student y la de chi cuadrado, respectivamente. Se consideraron estadísticamente significativos valores de p < 0,05. Resultados La muestra tenía una media de edad de 59,84 años (desviación estándar [DE]: ± 14,13 años), y contenía 36,19% de mujeres y 21,13% de hombres sin enfermedad neurológica y RBCV ausente. Se observó mayor ausencia de RBCV en pacientes con presencia de enfermedad neurológica en comparación con pacientes neurológicamente sanos: 21,6% versus 10,6%, respectivamente (p < 0,0001); además, se observó una ausencia importante de RBCV en presencia de diabetes mellitus en comparación con pacientes no diabéticos: 30.8% versus 18.8%, respectivamente (p < 0,0001). No se observaron diferencias al comparar grupos con respecto a disfunción vesical. Conclusión La ausencia de RBCV no es exclusiva de una enfermedad neurológica con repercusión de síntomas del tracto urinario inferior, y la proporción de pacientes neurológicamente sanos con ausencia de RBCV no es despreciable. No se encontró una diferencia significativa en los grupos con ausencia de RBCV con respecto a disfunción vesical.

Introduction and Objective Absence of the bulbocavernosus reflex (BCVR) has been observed even in neurologically-healthy subjects. Functional disorders of the pelvic floor should include its assessment. The primary objective of the present study was to evaluate the absence of BCVR in healthy subjects. The secondary objective was to evaluate the BCVR with regards to the presence of other comorbidities, such as neurogenic bladder and type-2 diabetes mellitus. Methods A descriptive and retrospective study in which we reviewed the clinical files of one thousand subjects who underwent a urodynamic study and were submitted to a mechanical exploration of the BCVR as part of a routine evaluation. Descriptive statistics were performed for the quantitative and qualitative variables using the Student t and the Chi-squared tests accordingly. Values of p < 0.05 was considered statistically significant. Results The sample had a mean age of 59.84 years (standard deviation [SD] ± 14.13 years), and it contained 36.19% of women and 21.13% of men without neurological disease and absent BCVR. A higher proportion of BCVR absence was observed in patients with neurological disease compared to their healthy counterparts: 21.6% and 10.6% respectively (p ≤ 0.0001); furthermore, an important absence of the BCVR was observed in patients with type-2 diabetes mellitus compared to non-diabetic patients: 30.8% and 18.8% respectively (p ≤ 0.0001). No statistically significant differences were observed in the group comparison regarding bladder dysfunction. Conclusion The absence of the RBCV is not exclusive to a neurological disease with repercussions in terms of lower urinary tract symptoms, and the proportion of neurologically healthy subjects with absence of the BCVR is not negligible. No significant difference was found in groups with absence of the BCVR with regards to bladder dysfunction

Antibiotic use on acute respiratory tract infection nonpneumonia and nonspecific diarrhea in Primary Health Care Centre in Banjarbaru City, South Kalimantan, Indonesia.

OBJECTIVES: Acute respiratory tract infection (ARTI) nonpneumonia and nonspecific diarrhea are the most common cases in primary health care centre (PHCC) in Indonesia with the enormous use of antibiotics. The aims of this study were to analyze the antibiotic use and factors affected to the quality of antibiotic use in PHCC in Banjarbaru City, South Kalimantan, Indonesia. METHODS: The study was conducted in four PHCCs, two in urban and two in rural areas. All of the patients visited these PHCCs since March to April 2018 were recruited as samples after signing informed consent. Data were analyzed using SPSS version 18. RESULTS: There were no significant difference in antibiotic use between urban and rural PHCC, both on ARTI nonpneumonia and nonspecific diarrhea. The most prescribed antibiotics were amoxycillin and cephadroxil. Based on DDD/1,000 patients-day calculation, the quantity of antibiotics in urban PHCC was 3,544.4 and in rural PHCC was 3,478.6. Physicians with more than seven years of service, both in rural and urban PHCCs, were prescribe the antibiotics higher than who had been working for shorter period. There were no significant difference between physicians who had trained on rational drug use and had not trained yet in urban PHCC (p=0.874), while in rural PHCC there were a significant difference among them. CONCLUSIONS: The quantitative analysis showed that the antibiotics use in DDD in urban PHCC was 3,544.416 and in rural PHCC was 3,478.693. Factors affected to the quality of antibiotic use were physician's years of service and rational drug use training's.

A Case-control Study of Major Genetic Predisposition Risk Alleles in Developing DDD in the Northeast US Population: Effects of Gene-gene Interactions.

STUDY DESIGN: A case-control study of risk alleles for degenerative disc disease (DDD) using magnetic resonance (MR) imaging for phenotyping. OBJECTIVE: We aim to provide the first statistically adequately powered study of the relationship between the presence of common risk alleles and occurrence of DDD in Eastern US population. SUMMARY OF BACKGROUND DATA: Many genetic predisposing factors have been identified in elevating the risk of DDD, including common variants in VDR, COL1A1, AGC1, COL9A2/3 genes. METHODS: We utilized the Mass General Brigham (MGB) Biobank in which subjects' Medical Record is linked with genotyped data from single-nucleotide polymorphism (SNP) arrays. Subjects with lumbosacral spine MR imaging studies were used to construct the Cases cohort; the Biobank's Controls cohort was used as the Control cohort. Odds ratios (OR) and False-discovery-rate (FDR) q values from multiple-hypotheses-testing corrections were used to assess the likelihood of DDD given occurrence of the listed DDD risk alleles. RESULTS: Four-hundred-fourteen subjects (mean age = 64, range = 27 to 94) were Cases and 925 Controls (mean age = 46, range = 21-61). A systematic search has identified 25 SNPs in 18 genes in the SNP arrays. At univariate level, rs1544410 in VDR was significantly associated with DDD for male subjects (odds ratio [OR] = 0.594, P = 0.011). After adjustment for all significant variants and demographics, three predictor variables had a significant association with the outcome, age (OR = 1.130, q < 0.0001), rs143383 (OR = 1.951, q = 0.056), and rs3737821 (OR = 2.701, q = 0.069). A novel variant-to-variant correlation rs143383:rs763110 had a significant adjusted OR = 7.933, q = 0.070). CONCLUSION: In this large-scale study of common variants' correlation with the presence of DDD in the Northeast United States, we have found a novel and significant variant-to-variant interaction to be associated with the risk of developing DDD, corroborating and necessitating the inclusion of gene-gene interactions in predictive risk model development for DDD.Level of Evidence: 4.

Surgical treatment outcome of primary aldosteronism assessed using new modified diagnostic tests.

PURPOSE: Primary aldosteronism (PA) is the most frequent type of endocrine hypertension. In our previous studies, we introduced two modified diagnostic tests for PA, the post-dexamethasone saline infusion test (DSIT) and the overnight dexamethasone, captopril, and valsartan test (DCVT). In this study, we aimed to validate both tests in respect to the biochemical and clinical response of a cohort of hypertensive patients in pre- and post-surgical setting. METHODS: We retrospectively studied 41 hypertensive patients (16 males), with a median (IQR, range) age of 50 (16, 35-74) years and positive histology for adrenal adenoma. Preoperatively, all patients had a single adenoma on CT and a diagnosis of PA with either DSIT or DCVT. The defined daily dose (DDD) of hypertensive drugs was assessed pre- and postoperatively. DSIT or DCVT and basal ARR were reassessed postoperatively. RESULTS: Two of the 41 patients failed to suppress aldosterone post-surgery, leading to a post-adrenalectomy biochemical cure rate of 95%, while blood pressure was improved in 36 patients, leading to a clinical cure rate of 88% as assessed by the DDD methodology. CONCLUSIONS: The present study was a proof-of-concept process to validate two modified diagnostic tests for PA in clinical practice. These tests, used to diagnose a group of patients with PA, successfully assessed their biochemical cure post-adrenalectomy at rates similar to those reported in the literature.

High Density Supercritical Carbon Dioxide for the Extraction of Pesticide Residues in Onion with Multivariate Response Surface Methodology.

The excessive use of pesticides is a serious health problem due to their toxicity and bioaccumulation through the food chain. Due to the complexity of foods, the analysis of pesticides is challenging often giving large matrix effects and co-extracted compounds. To overcome this problem, a selective and "green" supercritical fluid extraction method was developed, using neat carbon dioxide as a solvent at pressures of up to 800 bars. A Box-Behnken response surface experimental design was used, with the independent variables of density (0.70-1.0 g mL-1), temperature (40-70 C), and volume (10-40 mL) of solvent, and the dependent variable of extracted amount of pesticides. The optimum extraction condition was found at the use of 29 mL of supercritical CO2 at 0.90 g mL-1 and 53C (corresponding to 372 bars of pressure). It was observed that increasing the density of CO2 significantly increased the extraction recovery of endrin and 2,4'-dichlorodiphenyldichloroethane. Matrix-matched calibration curves showed satisfactory linearity (R2 ≥ 0.994), and LODs ranged from 0.2 to 2.0 ng g-1. Precision was lower than 11% and recoveries between 80%-103%. Thus, the developed method could efficiently be used for trace analysis of pesticides in complex food matrices without the use of organic solvents.

Changes of various insecticides during in vitro human digestion.

This study was performed to determine the effects of in vitro human digestion on the concentrations of five insecticides, namely 1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane (DDT), 1,1-dichloro-2,2-bis(p-chlorophenyl)ethane (DDD), 2,2-bis(p-chlorophenyl)-1,1-dichloroethylene (DDE), bifenthrin, and fipronil. In vitro models included all the steps of human digestion, i.e., passage through the mouth, stomach, small intestine, and large intestine (with enteric bacteria). The concentrations of DDT and fipronil did not change (P > 0.05) until small intestinal digestion, whereas those of DDD, DDE, and bifenthrin decreased (P < 0.05) at each digestion step. The concentrations of all the insecticides decreased (P < 0.05) during the large intestinal digestion step with enteric bacteria, Lactobacillus sakei and Escherichia coli. In conclusion, the concentrations of all the tested insecticides decreased during all the steps of in vitro human digestion and were especially reduced by enteric bacteria during the large intestinal digestion step.

Evaluating the left ventricular hemodynamic phenomena of DDD septum pacemaker implants using vector flow mapping.

PURPOSE: We set out to undertake a preliminary assessment of the left ventricular hemodynamic status with right ventricular double-chamber pacing by energy loss (EL), wall shear stress (WSS), and circulation intensity (CIR) of vector flow mapping (VFM). We also planned to evaluate the value of VFM technology by measuring cardiac function after pacemaker implantation. METHOD: Data from 58 patients living with right ventricular double-chamber (right ventricular septal) pacemakers as well as 58 healthy volunteers matched in age and gender were collected. The EL, numbers of vortex cycles (n), area (A), CIR, and WSS of the left ventricle with different phases of the same cardiac cycle were obtained. RESULTS: The EL of the left ventricle was significantly higher in the pacemaker group than the control group at partial section of atrial contraction (AC), isovolumetric contraction (IVC), and rapid ejection (RE) (P < 0.05). The WSS of the left ventricle was significantly lower in the pacemaker group than the control group at part of the section in the rapid filling (RF), the AC, IVC, and RE phase (P < 0.05). DISCUSSION: EL in the left ventricular was significantly increased, while related WSS was significantly decreased in patients with right ventricular double-chamber pacing. Our exploration of the state of the flow field in the left ventricular cavity revealed that the implantation of the right ventricular double-chamber pacemaker led to an abnormal left ventricular hemodynamic state, reducing the left ventricular systolic efficiency.

Evaluating toxicity risk in sediments after remediation at a Superfund megasite using a Triad approach.

The Pine River downstream of the Velsicol Superfund site has been contaminated with various hydrophobic organic pollutants for more than 50 years. Remediation and sediment dredging near the site began in spring of 1999, and was completed in 2006. In 2011, the Michigan Department of Environmental Quality completed a baseline assessment report long-term monitoring plan for the Pine River. However, there has been limited assessment of the benthic community since this evaluation. The objective of this research was to evaluate the risk of Pine River sediment to aquatic macroinvertebrates downstream from the Superfund site after decades of degradation and dredging using the Triad approach. Three sites were selected downstream from the Superfund site, and an upstream reference site was used. At each site, macroinvertebrates surveys were conducted and sediments were collected for chemical analysis of DDT (1,1,1-trichloro-2,2-bis (4-chlorophenyl) ethane) and its degradation products and for laboratory toxicity testing for mortality and sublethal effects using Hyalella azteca and Chironomus dilutus. Sediment concentrations of DDT, DDD, and DDE were below levels expected to cause toxicity, and there was no observed toxicity in laboratory tests. Additionally, there were no statistically significant differences in richness, richness of Ephemeroptera, Plecoptera, and Trichoptera (EPT) species, total EPT abundance, percent EPT, or percent dominant taxa between the reference site and the downstream sites. There was an observed decrease in abundance of macroinvertebrate taxa at all downstream sites and a shift in macroinvertebrate structure when comparing the reference with most impaired sites. Although the sites downstream of the Superfund site remain different than the upstream control, there are improvements in species composition and abundance. However, more research is needed to evaluate the potential effects on ecosystem function.

Country-Owned, Country-Driven: Perspectives from the World Health Organization on Malaria Elimination.

Malaria has infected and killed humans since long before history began recording evidence of the parasite's pernicious influence. The extraordinary discoveries of the Plasmodium parasite by Charles Louis Alphonse Laveran in 1880, and the role of the Anopheles mosquito in transmission of the parasite to humans by Sir Ronald Ross in 1897, led to an understanding of the parasite life cycle and ultimately to the development of interventions that would interrupt disease transmission. Almost as soon as the insecticidal properties of dichlorodiphenyltrichloroethane (DDT) were discovered in 1939, the public health profession began battling to achieve a world free of malaria. That vision persists as the aim of all malariologists and, increasingly, the goal of all nations that remain endemic for malaria. This chapter recounts the history of malaria eradication and elimination efforts throughout the world and focuses on the current status of country-led and country-driven malaria elimination programs, along with the technical strategies recommended by the World Health Organization (WHO) for achievement of malaria elimination.

A case study on the application of an expert-driven read-across approach in support of quantitative risk assessment of p,p'-dichlorodiphenyldichloroethane.

Deriving human health risk estimates for environmental chemicals has traditionally relied on in vivo toxicity databases to characterize potential adverse health effects and associated dose-response relationships. In the absence of in vivo toxicity information, new approach methods (NAMs) such as read-across have the potential to fill the required data gaps. This case study applied an expert-driven read-across approach to identify and evaluate analogues to fill non-cancer oral toxicity data gaps for p,p'-dichlorodiphenyldichloroethane (p,p'-DDD), an organochlorine contaminant known to occur at contaminated sites in the U.S. The source analogue p,p'-dichlorodiphenyltrichloroethane (DDT) and its no-observed-adverse-effect level of 0.05 mg/kg-day were proposed for the derivation of screening-level health reference values for the target chemical, p,p'-DDD. Among the primary similarity contexts (structure, toxicokinetics, and toxicodynamics), toxicokinetic considerations were instrumental in separating p,p'-DDT as the best source analogue from other potential candidates (p,p'-DDE and methoxychlor). In vitro high-throughput screening (HTS) assays from ToxCast were used to evaluate similarity in bioactivity profiles and make inferences toward plausible mechanisms of toxicity to build confidence in the read-across approach. This work demonstrated the value of NAMs such as read-across and in vitro HTS in human health risk assessment of environmental contaminants with the potential to inform regulatory decision-making.

Evidence of non-DDD pathway in the anaerobic degradation of DDT in tropical soil.

DDT transformation to DDD in soil is the most commonly reported pathway under anaerobic conditions. A few instances of DDT conversion to products other than DDD/DDE have been reported under aerobic conditions and hardly any under anaerobic conditions. In particular, few reports exist on the anaerobic degradation of DDT in African tropical soils, despite DDT contamination arising from obsolete pesticide stockpiles in the continent as well as new contamination from DDT use for mosquito and tsetse fly control. Moreover, the development of possible remediation strategies for contaminated sites demands adequate understanding of different soil processes and their effect on DDT persistence, hence necessitating the study. The aim of this work was to study the effect of simulated anaerobic conditions and slow-release carbon sources (compost) on the dissipation of DDT in two tropical clay soils (paddy soil and field soil) amenable to periodic flooding. The results showed faster DDT dissipation in the field soil but higher metabolite formation in the paddy soil. To explain this paradox, the levels of dissolved organic carbon and carbon mineralization (CH4 and CO2) were correlated with p,p-DDT and p,p-DDD concentrations. It was concluded that DDT underwent reductive degradation (DDD pathway) in the paddy soil and both reductive (DDD pathway) and oxidative degradation (non-DDD pathway) in the field soil.

Formation and Fate of Point-Source Nonextractable DDT-Related Compounds on Their Environmental Aquatic-Terrestrial Pathway.

Nonextractable residues (NER) are pollutants incorporated into the matrix of natural solid matter via different binding mechanisms. They can become bioavailable or remobilize during physical-chemical changes of the surrounding conditions and should thus not be neglected in environmental risk assessment. Sediments, soils, and groundwater sludge contaminated with DDXs (DDT, dichlorodiphenyltrichloroethane; and its metabolites) were treated with solvent extraction, sequential chemical degradation, and thermochemolysis to study the fate of NER-DDX along different environmental aquatic-terrestrial pathways. The results showed that DDT and its first degradation products, DDD (dichlorodiphenyldichloroethane) and DDE (dichlorodiphenyldichloroethylene), were dominant in the free extractable fraction, whereas DDM (dichlorodiphenylmethane), DBP (dichlorobenzophenone), and DDA (dichlorodiphenylacetic acid) were observed primarily after chemical degradation. The detection of DDA, DDMUBr (bis( p-chlorophenyl)-bromoethylene), DDPU (bis( p-chlorophenyl)-propene) and DDPS (bis( p-chlorophenyl)-propane) after chemical treatments evidenced the covalent bindings between these DDXs and the organic matrix. The identified NER-DDXs were categorized into three groups according to the three-step degradation process of DDT. Their distribution along the different pathways demonstrated significant specificity. Based on the obtained results, a conceptual model of the fate of NER-DDXs on their different environmental aquatic-terrestrial pathways is proposed. This model provides basic knowledge for risk assessment and remediation of both extractable and nonextractable DDT-related contaminations.

Mercury and Organochlorines in the Terrestrial Environment of Schirmacher Hills, Antarctica.

We report the levels of mercury (Hg) and nine organochlorine pesticides [OCPs: α-hexachlorocyclohexane (HCH), ß-HCH, γ-HCH, δ-HCH, α-Endosulfan, ß-Endosulfan, Endosulfan sulfate, p,p'-dichlorodiphenyldichloroethylene (DDE) and p,p'-dichlorodiphenyldichloroethane (DDD)] in the terrestrial environment (moss and soil) and water (OCPs only) of Schirmacher Hills, Antarctica. This area has never been studied for mercury and not for OCPs since 1988. Mercury levels in moss, 66 ± 37 ng/g dry weight (dw), are comparable to other Antarctic locations. Levels of α-HCH, below detection to 4.48 ng/g dw, and p,p'-DDE, below detection to 31 ng/g dw, in mosses are lower or marginally higher than other Antarctic locations. No other OCPs were detected in moss. None of the OCPs were detected in soil. This suggests that Schirmacher Hills may be considered as a background site with respect to mercury and analyzed OCPs, despite the operation of two old research stations (Maitri, est. 1989, and Novolazarevskaya, est. 1961) in the region.

Pathology of C3 Glomerulopathy

C3 glomerulopathy is a renal disorder involving dysregulation of alternative pathway complement activation. In most instances, a membranoproliferative pattern of glomerular injury with a prevalence of C3 deposition is observed by immunofluorescence microscopy. Dense deposit disease (DDD) and C3 glomerulonephritis (C3GN) are subclasses of C3 glomerulopathy that are distinguishable by electron microscopy. Highly electron-dense transformation of glomerular basement membrane is characteristic of DDD. C3GN should be differentiated from post-infectious glomerulonephritis and other immune complex-mediated glomerulonephritides showing C3 deposits.

Foetal exposure to mitotane/Op'DDD: Post-natal study of four children.

OBJECTIVE: Mitotane/Op'DDD is used in the treatment of adrenocortical carcinoma and for other causes of hypercortisolism. Mitotane inhibits cortisol secretion and displays adrenolytic and antitumor actions. This compound is a metabolite of the pesticide and endocrine disruptor DDT (dichlorodiphenyltrichloroethane) and is classified among teratogenic compounds worldwide. However, little is known about its effects on human development. DESIGN: The outcome of four children exposed to mitotane during their intrauterine life was examined. PATIENTS: Patients having conceived while taking mitotane, or with detectable mitotane plasma levels, were retrospectively recruited via the French COMETE and FIRENDO networks. MEASUREMENTS: Mitotane in maternal plasma, adrenocortical hormones in children. RESULTS: Three women treated with mitotane gave birth to four children. During early pregnancy, all patients had detectable mitotane plasma levels (0.9, 2.4 and 6.7 mg/L, respectively). During pregnancy, no foetal malformations were detected. The four exposed newborns presented at birth with apparently normal adrenal function and genitalia. One twin female had a low birthweight. Evaluation at birth and after 3 months, 2 years and 7 years of follow-up showed no significant neurological abnormality. Evaluation of adrenocortical functions showed no cortisol deficiency. CONCLUSIONS: Unexpectedly, exposure of these four children to mitotane during foetal life seemed to have no clear teratogenic effect. However, considering the sub-therapeutic mitotane concentrations used here, the small number of cases, and because long-term follow-up is unknown, we strongly advise not to take mitotane during pregnancy and still recommend avoiding pregnancy, at least as long as mitotane plasma levels remain detectable.

Degradation of various insecticides in cooked eggs during in vitro human digestion.

The objective of this study was to determine the effects of cooking and in vitro human digestion on the changes of five insecticides-fipronil, bifenthrin, 1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane (DDT), 1,1-dichloro-2,2-bis(p-chlorophenyl)ethane (DDD), and 2,2-bis(p-chlorophenyl)-1,1-dichloroethylene (DDE)-in egg whites and yolks. Each insecticide was applied to egg whites and yolks at a concentration of 1000 µg/g. After cooking the egg whites and yolks, concentrations of bifenthrin, DDD, and DDE decreased (P < 0.05), whereas those of fipronil and DDT were unchanged (P > 0.05) in both egg whites and yolks. Next, an in vitro human digestion model that simulates all the steps of human digestion was employed. Until digestion in the small intestine, the concentrations of fipronil and DDT in the cooked egg whites and yolks were unchanged (P > 0.05), whereas those of bifenthrin, DDD, and DDE decreased (P < 0.05) at each digestion step. In the large intestinal digestion step with Escherichia coli and Lactobacillus sakei as enterobacteria, the concentrations of all the insecticides decreased (P < 0.05) in the cooked egg whites and yolks. Among the insecticides, bifenthrin showed the lowest concentration (P < 0.05). In conclusion, the use of bifenthrin as an insecticide would be comparatively less toxic than other insecticides in terms of environmental pollution and human health, because of its easy degradation.