Association between exposure to organophosphate flame retardants and epidermal growth factor receptor expression in lung cancer patients.

BACKGROUND: Organophosphate flame retardants (OPFRs) are extensively distributed in our environment, prompting concerns about potential health hazards, including lung injuries resulting from OPFR exposure. METHODS: The present study recruited 125 lung cancer patients, assessing their exposure to 10 OPFR compounds through urine samples. The final analysis comprised 108 participants after excluding those lacking epidermal growth factor receptor (EGFR) status and those with chronic kidney disease. Demographic and clinical characteristics, as well as urinary OPFR concentrations, were compared based on OPFR detection. Spearman correlation was conducted to explore the relationship between OPFR compounds, while logistic regression was used to identify OPFR compounds associated with EGFR mutation. RESULTS: The study revealed widespread OPFR exposure among lung cancer patients, with an overall detection frequency of 99.07%. Tris(2-butoxyethyl) phosphate (TBEP) exhibited a strong correlation to its metabolite bis(2-butoxyethyl) phosphate (r = 0.88, p < 0.01). Patients with TBEP in their urine had higher percentage of wild-type EGFR and the detection of TBEP was associated with a reduced likelihood of mutant EGFR expression. CONCLUSIONS: OPFR exposure was prevalent in lung cancer patients, with TBEP detection identified as a factor with lower EGFR mutation expression. This study contributes to the understanding of OPFR exposure in lung cancer patients and underscores the significance of TBEP in evaluating EGFR mutation in this population.

Physiological changes and symptoms associated with short-term exposure to electromagnetic fields: a randomized crossover provocation study.

BACKGROUND: The biological association between electromagnetic fields (EMF) and idiopathic environmental intolerance attributed to EMF (IEI-EMF) has not been established. To assess the physiological changes and symptoms associated with exposure to EMF, we conducted a randomized crossover provocation study. METHODS: We recruited 58 individuals with IEI-EMF (IEI-EMF group) and 92 individuals without IEI-EMF (control group). In a controlled environment, all participants received EMF signals mimicking those from mobile phone base stations in a randomized sequence under the blinded condition. During the course, participants reported their symptoms and whether they perceived EMF, and we monitored their physiological parameters, including blood pressure (BP), heart rate (HR), and HR variability. RESULTS: The IEI-EMF and control groups reported similar frequencies of symptoms during both the provocation and sham sessions. No participant could accurately identify the provocation. In both groups, physiological parameters were similar between the two sessions. The control group, but not the IEI-EMF group, had elevated HR when they perceived EMF exposure. CONCLUSIONS: No symptoms or changes in physiological parameters were found to be associated with short-term exposure to EMF, and no participant could accurately detect the presence of EMF. Moreover, the participants in the control group, but not those in the IEI-EMF group, had elevated HR when they perceived EMF.

Relationship between Helicobacter pylori infection and bone mineral density: a retrospective cross-sectional study.

BACKGROUND: Helicobacter pylori (H. pylori) infection can induce individual inflammatory and immune reactions which associated with extra-digestive disorders. Our aim is to investigate the association between H. pylori infection and bone mineral density. METHODS: This retrospective cross-sectional study was performed by using the data from the health examination database in a medical center of southern Taiwan in 2013. We investigated the relationship between sex, age, body mass index (BMI), waist circumstance, lipid profile, H. pylori infection, the findings of upper gastrointestinal endoscopy and bone mineral density (BMD). Because of nonrandomized assignment and strong confounding effect of age on BMD, the 1:1 propensity score match was applied for age adjustment. The simple and multiple stepwise logistic regression analysis were performed to assess the risk factors of decreased BMD in these well-balanced pairs of participants. RESULTS: Of the 867 subjects in final analysis with the mean age of 55.9 ± 11.3 years, 381 (43.9%) subjects had H. pylori infection, and 556 (64.1%) subjects had decreased BMD. In decreased BMD group, the portion of woman was higher than a normal BMD group (37.2% versus 29.6%, P = 0.023), the age was significantly older (59.4 ± 9.8 versus 49.8 ± 11.3, p < 0.001) and BMI was significantly lower (24.7 ± 3.5 versus 25.4 ± 3.7, p = 0.006) than the normal BMD group. The prevalence of H. pylori infection was 39.9% and 46.2% in the normal BMD group and the decreased BMD group respectively (P = 0.071). The multivariate analysis which was used for these possible risk factors showed that only advanced age (OR 1.09, 95% CI 1.08-1.11, P < 0.001), and low BMI (OR 0.91, 95% CI 0.87-0.95, P < 0.001) were independently significantly associated with decreased BMD in this nonrandomized study. In the propensity score-matched participants, the multiple stepwise logistic regression analysis revealed H. pylori infection (OR 1.62, 95% CI 1.12-2.35, P = 0.011) and low BMI (OR 0.92, 95% CI 0.87-0.97, P = 0.001) were independently significantly associated with decreased BMD. CONCLUSIONS: H. pylori infection and low BMI were independently significantly associated with decreased BMD in selected propensity score-matched populations after age adjustment.

Hepatic angiosarcoma may have fair survival nowadays.

Hepatic angiosarcoma (HAS) is rare but often fatal. A review of literature in 1979 found that only 3% of the 70 patients lived for more than 2 years, but the survival might have been improved over the years. We conducted a retrospective study and reviewed the medical records of patients who visited a teaching hospital in Taiwan from January 2000 to August 2010 and had pathological proof of HAS. In addition, we conducted a review of literature and compared those who survived for 2 years or more to those who did not. Of the 3503 patients with primary liver cancer we identified, 9 had HAS, of whom 3 (33.3%) survived for 2 years or more. One survived for 24 months without surgical resection, and the other two received surgery with postoperative chemotherapy and were still alive 32 and 37 months later, respectively. Through reviewing literature, we identified 3 more patients in Taiwan who had survived for 2 years or more. One survived for 42 months without surgical resection, the other two received segmentectomy with postoperative chemotherapy or radiotherapy. We also identified 8 such cases outside Taiwan, including 1 who received chemotherapy without surgery and survived for 53 months. None of the differences in the clinical characteristics between those who had and had not survived for 2 years or more reached statistical significance. In conclusion, we believe the combination of surgery and adjuvant chemotherapy may be able to achieve long-term survival in some HAS patients nowadays, and it is even possible to achieve fair survival using chemotherapy alone.

Changing prevalence of anti-hepatitis A virus in adolescents in a rural township in Taiwan.

BACKGROUND: Hepatitis A virus (HAV) is transmitted through the oral-anal route. Areas of low prevalence of anti-HAV might have risks for a hepatitis A outbreak even under accidental infection as the source can spread easily. The prevalence of anti-HAV among children in Taipei is reported to be nearly 0%; however, the prevalence in rural areas remains undetermined. Our study aims to realize the prevalence change in a rural area. METHODS: We took blood samples for anti-HAV detection from the entire junior high school population in Taihsi Township of Yunlin County in Taiwan. Two cross-sectional studies were conducted in 1999 and 2006, with students born in the years 1984-1985 and 1993-1994 respectively. RESULTS: The prevalence of anti-HAV was 0.96% (2/209) among subjects born between 1984-1985, and 0.6% (1/168) in those born between 1993-1994. The HAV vaccine was not available for at the time of the earlier study, and it is suggested that this figure was caused by natural infection. The only anti- HAV-positive student in the later study had a history of HAV vaccination. CONCLUSIONS: The prevalence of anti-HAV has decreased to a very low level in recent years and is almost 0% in the generation born after 1984 in rural areas. Therefore, the possibility of an HAV outbreak should be noted. Furthermore, it is also necessary to offer correct information and suggestions concerning hepatitis A for tourists traveling abroad and reentering Taiwan.

Hepatitis delta virus and GBV-C infection in two neighboring hepatitis B virus and hepatitis C virus-endemic villages in Taiwan.

BACKGROUND: Previous reports in Taiwan have shown that the hepatitis B virus (HBV)- and hepatitis C virus (HCV)-endemic areas are also endemic for hepatitis D virus (HDV), GBV-C and TT virus. This study aimed to elucidate the epidemiology of HDV and GBV-C infection in two neighboring HBV- and HCV-endemic villages, to deduce the epidemiological characteristics of multiple viral infections in communities. METHODS: A total of 74 adult residents of Wukwai (W) village and 95 adults residents of Haipu (H) village were studied. Laboratory tests for all subjects included alanine transaminase (ALT), hepatitis B surface antigen (HBsAg), anti-HCV, HCV RNA, genotype of HCV, GBV-C RNA, and anti-GBV-C E2. Anti- HDV was checked only in HBsAg-positive subjects. RESULTS: Subjects from W village were older than those from H village (61.7 +/- 11.8 vs 56.6 +/- 16.4 years, p = 0.02). The prevalence of ALT elevation (37.8% vs 15.8%, p = 0.006), anti-HCV (67.6% vs 34.7%, p < 0.0001), and GBV-C infection (39.2% vs 24.2%, p = 0.054), and the distribution of HCV genotype 1b (37.8% vs 70.4%, p = 0.01) were different in W and H villages, respectively. Among anti-HCV-positive subjects, HCV RNA-positive rates were 75.9% (63/83), and were higher for men (88.2%) than women (67.3%). Only one HBsAg-positive subject was positive for anti-HDV, and one anti-HCVnegative subject was positive for HCV RNA. In multivariate analyses, GBVC infection correlated with HCV infection or HCV endemicity, and HCV RNA was the only determining factor in ALT elevation. CONCLUSION: In HBV and HCV-endemic areas, GBV-C was more prevalent in areas with a higher prevalence of anti-HCV. Positive HCV-RNA, but not GBV-C infection, was associated with ALT elevation.

Identifying hepatitis C virus: endemic areas and estimating the viral antibody prevalence based on the prevalence of ALT elevation.

To evaluate the validity of predicting the prevalence of antibodies to hepatitis C virus (anti-HCV) based on the prevalence of alanine transaminase (ALT) elevation (>40IU/l), we conducted a community-based study. In total, 56698 individuals underwent health examinations in 2004. Another 43738 subjects in 2005 were the validation set. It should be valid to predict the prevalence of anti-HCV in villages (>25 participants) by the prevalence of ALT elevation. The equation was anti-HCV (%)=(% of ALT elevation - 6%)/65% (n=487 villages, R(2)=0.58). Villages with prevalence of ALT elevation >13% had a high probability of being HCV-endemic (anti-HCV >10%). The sensitivity and specificity were 73.6 and 74.6%, respectively. By the validation set, the positive and negative predictive values were 52.0% and 79.4%, respectively. Clinical and epidemiological deductions of the equation were that baseline of ALT elevation was 6% and two-thirds of anti-HCV-positive subjects had elevated ALT.