A review of the success and challenges in characterizing human dermal exposure to flame retardants.

Since organic flame retardants (FRs) have several industrial applications, they have been largely detected in environmental and biological samples, and humans have been highly exposed to them. Although the effects of oral and inhaled FRs have been well studied, dermal exposure to them has only recently been pointed out as a potential route of human exposure. Consequently, the effects of FRs on the skin and secondary target organs have been poorly investigated. This review article summarizes the main findings regarding dermal exposure to FRs, points the limitation of the published studies, and suggests future perspectives for better understanding of how dermal exposure to FRs impacts the human health. This review lists some gaps that must be filled in future studies, including characterization of the bioavailable fraction and assessment of exposure for new FRs, to establish their physiological significance and to improve the development of 3D dermal tissue for more reliable results to be obtained.

Evaluation of acute skin toxicity during radiotherapy for breast cancer in elderly patients.

BACKGROUND: For women with early stage breast cancer, the hypofractionation is the standard of care, whereas for women in other situations the standard dose is still recommended. Although the hypofractionation studies included elderly patients (>70 years), many studies excluded this population. The goals of this study are to demonstrate our results in terms of acute skin toxicity in elderly patients, and to show that they can receive the same treatment as young patients. METHODS: We conducted a retrospective study searching our database for patients at least 70 years old at the beginning of the treatment for breast cancer. The treatment planning and the medical records were reviewed to check not only the details of the treatment but also the skin reactions developed. The RTOG (Radiation Therapy Oncology Group) was used to take note of the skin toxicity. RESULTS: Two hundred and seventy-six patients treated from June 2015 to May 2019 were included in the final analysis. The vast majority of patients (72.99%) developed only a RTOG grade 1 reaction, the only two patients which presented with RTOG 4 had ulceration of skin, achieving full recovery. Regarding the volume of treatment, the percentages for RTOG 1 were similar for "Breast" and "Breast plus Drainage" (~75%). Patients receiving treatment aiming breast, drainage and boost had the higher percentage of RTOG 4 (6.2%). Patients that received the hypofractionation showed slightly better results than the standard fractionation, with no patient with RTOG 4 and lesser patients with RTOG 2 and 3, RTOG 1 was predominant for all sub-groups analyzed. Mild erythema and dry desquamation are common reactions that usually do not greatly affect the quality of life of the patients. The volume of treatment has an important effect on skin reactions with the number of events increasing considerably at larger volumes. Overall, there is a benefit in favor of hypofractionation in terms of acute skin toxicity. CONCLUSIONS: It can clearly be seen that elderly patients can tolerate the acute side effects of the radiotherapy and they should receive the same treatment as young patients. Larger volumes of treatment increased the toxicity, hence these patients should be more carefully evaluated during the treatment.

The effect and safety of dressing composed by nylon threads covered with metallic silver in wound treatment.

Silver is used worldwide in dressings for wound management. Silver has demonstrated great efficacy against a broad range of microorganisms, but there is very little data about the systemic absorption and toxicity of silver in vivo. In this study, the antimicrobial effect of the silver-coated dressing (SilverCoat(®)) was evaluated in vitro against the most common microorganisms found in wounds, including Pseudomonas aeruginosa, Candida albicans, Staphylococcus aureus, Methicillin-resistant Staphylococcus aureus and Klebsiella pneumoniae. We also performed an excisional skin lesion assay in mice to evaluate wound healing after 14 days of treatment with a silver-coated dressing, and we measured the amount of silver in the blood, the kidneys and the liver after treatment. Our data demonstrated that the nylon threads coated with metallic silver have a satisfactory antimicrobial effect in vitro, and the prolonged use of these threads did not lead to systemic silver absorption, did not induce toxicity in the kidneys and the liver and were not detrimental to the normal wound-healing process.