Observational Study on a Large Italian Population with Lipedema: Biochemical and Hormonal Profile, Anatomical and Clinical Evaluation, Self-Reported History.

We analyzed the medical condition of 360 women affected by lipedema of the lower limbs in stages 1, 2, and 3. The data were assessed for the whole population and compared between different clinical stages, distinguishing between obese and non-obese patients. The most frequent clinical signs were pain when pinching the skin, subcutaneous nodules, and patellar fat pads. The most frequently painful site of the lower limbs was the medial lower third of the thigh. The pain score obtained on lower limb points increased progressively with the clinical stage. In all points evaluated, the thickness of the subcutaneous tissue increased with the clinical stage. Analyzing the data on the lower medial third of the leg and considering only patients with type 3 lipedema, the difference between stages was statistically significant after correction for age and BMI. We found higher levels of C-reactive protein at more severe clinical stages, and the difference was significant after correction for age and BMI between the stages. Overall, the prevalence of alterations of glucose metabolism was 34%, with a progressive increase in prevalence with the clinical stage. The most frequent comorbidities were vitamin D insufficiency, chronic venous disease, allergies, dyslipidemia, headache, and depression of mood. Interestingly, in comparison with the general population, we found higher prevalence of chronic autoimmune thyroiditis and polycystic ovary syndrome. Finally, the clinical stage and the involvement of the upper limbs or obesity suggest a worse clinical, anthropometric, and endocrine-metabolic profile.

Potential toxic elements in groundwater and their health risk assessment in drinking water of Limpopo National Park, Gaza Province, Southern Mozambique.

Concentrations of trace elements in drinking water affect its safety and acceptability for use. Potentially toxic element (PTE) contaminations are considered extremely hazardous because of toxicity, persistence, and bioaccumulative behaviour. Many areas in the Southern African Development Community are data poor and have poor accessibility. The results of our previous research identified the presence of fossil waters in southern Limpopo National Park. Groundwater and river water are the only sources of drinking water for the villages in the study area. The current study focuses on the understanding of trace element distribution and health perspectives of PTEs (Hg, U, Sr, B, and Mn) in the groundwater and surface water samples (rivers and lakes) collected within the buffer zone of the Limpopo National Park, Southern Mozambique. Two sampling campaigns (October 2016-March 2017) were carried out during the end of the wet season and the end of the dry season to analyse the differences. The results improved our knowledge of the occurrence of trace elements in drinking water in an area where water resources play a fundamental role-because of their scarcity-and where the climate is harsh. ICP-MS results provided information on concentration ranges, highlighting the exceedance of the permissible maximum limit of mercury imposed by the World Health Organization on several groundwater samples. In the buffer zone of Limpopo Park, the highest levels of risk seem to be associated with the presence of Hg and U in drinking water. The use of risk assessment markers such as non-cancer risk value (hazard quotient [HQ]) revealed the exceedance of HQ values for Hg and U. The HQ values are higher in the wet season than the dry season, and most of the exceedance has been found in groundwater. HQ values are higher in exposed children than exposed adults. The water of Lake Massingir seems to be safer than any other source, but people do not currently use it because of the distance between the lake and their villages. Proactive control and research on alternative solutions for the water needs of the population and on creation of water distribution are recommended. In the current study, drinking water was the only route of exposure that was evaluated. Therefore, it would be appropriate to investigate the concentrations of PTEs in crops, livestock, and any other potential pathways.

Maternal transfer of per- and polyfluoroalkyl substances (PFAS) in wild birds: A systematic review and meta-analysis.

Per- and polyfluoroalkyl substances (PFAS) are synthetic chemicals widely used in consumer products. PFAS can accumulate in animal tissues, resulting in biomagnification and adverse effects on wildlife, such as reproductive impairment. In bird species, PFAS are transferred from mothers to eggs along with essential nutrients and may affect embryo development. However, the extent of maternal PFAS transfer across different species and compounds remains poorly understood. Here, we conducted a systematic review and meta-analysis to quantify maternal PFAS transfer in wild birds and investigate potential sources of variation. We tested the moderating effects of compounds' physicochemical properties and biological traits of studied birds. The dataset included 505 measurements of PFAS concentration and 371 effect sizes derived from 13 studies on 16 bird species and 25 compounds. Overall, across all studies and species, we found a 41% higher concentration of PFAS in offspring than in mothers. Specifically, contaminants were concentrated in the yolk, longer and heavier compounds showed preferential transfer, larger clutch size was associated with decreased PFAS transfer and a higher transfer rate was shown in species with piscivorous and opportunistic/diverse diets. A validation assessment showed good robustness of the overall meta-analytic result. Given the crucial role of birds in maintaining ecological balance, this research article has relevant implications for modelling the impacts of PFAS on wildlife, ecosystems, and human health.

A research synthesis of humans, animals, and environmental compartments exposed to PFAS: A systematic evidence map and bibliometric analysis of secondary literature.

BACKGROUND: Per- and polyfluoroalkyl substances (PFAS) are a class of widely used anthropogenic chemicals. Concerns regarding their persistence and potential adverse effects have led to multiple secondary research publications. Here, we aim to assess the resulting evidence base in the systematic secondary literature by examining research gaps, evaluating the quality of reviews, and exploring interdisciplinary connections. METHODS: This study employed a systematic evidence-mapping approach to assess the secondary literature on the biological, environmental, and medical aspects of exposure to 35 fluorinated compounds. The inclusion criteria encompassed systematic reviews published in peer-reviewed journals, pre-prints, and theses. Comprehensive searches across electronic databases and grey literature identified relevant reviews. Data extraction and synthesis involved mapping literature content and narrative descriptions. We employed a modified version of the AMSTAR2 checklist to evaluate the methodological rigour of the reviews. A bibliometric data analysis uncovered patterns and trends in the academic literature. A research protocol for this study was previously pre-registered (osf.io/2tpn8) and published (Vendl et al., Environment International 158 (2022) 106973). The database is freely accessible through the interactive and user-friendly web application of this systematic evidence map at https://hi-this-is-lorenzo.shinyapps.io/PFAS_SEM_Shiny_App/. RESULTS: Our map includes a total of 175 systematic reviews. Over the years, there has been a steady increase in the annual number of publications, with a notable surge in 2021. Most reviews focused on human exposure, whereas environmental and animal-related reviews were fewer and often lacked a rigorous systematic approach to literature search and screening. Review outcomes were predominantly associated with human health, particularly with reproductive and children's developmental health. Animal reviews primarily focused on studies conducted in controlled laboratory settings, and wildlife reviews were characterised by an over-representation of birds and fish species. Recent reviews increasingly incorporated quantitative synthesis methodologies. The methodological strengths of the reviews included detailed descriptions of study selection processes and disclosure of potential conflicts of interest. However, weaknesses were observed in the critical lack of detail in reporting methods. A bibliometric analysis revealed that the most productive authors collaborate within their own country, leading to limited and clustered international collaborations. CONCLUSIONS: In this overview of the available systematic secondary literature, we map literature content, assess reviews' methodological quality, highlight data gaps, and draw research network clusters. We aim to facilitate literature reviews, guide future research initiatives, and enhance opportunities for cross-country collaboration. Furthermore, we discuss how this systematic evidence map and its publicly available database benefit scientists, regulatory agencies, and other stakeholders by providing access to current systematic secondary literature on PFAS exposure.

Management of Lipedema with Ketogenic Diet: 22-Month Follow-Up.

Lipedema is a pathology of adipose tissue, still of unclear etiology and challenging to diagnose. For these reasons, a therapeutic approach is also complex and sometimes controversial. The inflammation state present in lipedema can be limited by controlling the glycemic peaks. Specifically, the ketogenic diet (KD) seems to have the right conditions to be effective. Herein, we reported a subject diagnosed with lipedema who, with only KD nutritional intervention, achieved a significant weight loss (-41 Kg), with a net decrease in body circumferences, and also reporting an improvement in pain, and therefore in the overall quality of life. She refused other types of intervention and kept KD for two years. This case could represent the first step to organize a KD nutritional protocol specifically applied to lipedema.

Assessment of groundwater quality in the buffer zone of Limpopo National Park, Gaza Province, Southern Mozambique.

Many areas in the Southern African Development Community are data-poor and poorly accessible. Water quality assessment in these areas therefore has to rely on the limited available data, coupled with restricted field sampling. This paper documents the first evaluation of the main geochemical processes and impact of anthropogenic and natural sources of contamination on the groundwater quality of the aquifer system used for domestic and agricultural purposes in Limpopo National Park, Gaza Province, Southern Mozambique. Twenty-five groundwater and surface water samples were collected during two field campaigns, one in October 2016 (the end of the arid period) and the other in March 2017 (the end of the wet period). In the field, the researchers analysed chemical-physical parameters such as temperature, pH and EC. In the laboratory, the major ions (boron, Na+, Ca2+, K+, Mg2+) and anions (Cl-, SO42-, NO3-, HCO3-, CO32-) were determined, and almost all groundwater samples fall into the brackish water category. The B/Cl ratio and δ11B concentrations were then measured to better understand the origin of these brackish waters. The direct relationship between boron and chlorine and δ11B concentrations above 40‰ suggests the presence of fossil water in the aquifer. The groundwater in this area was found to be above the limits stated as desirable by the Department of Water and Sanitation (DWS) and the World Health Organisation for domestic and irrigation purposes. The suitability of the groundwater for drinking purposes was also evaluated, with the results indicating that it is not suitable. The values of the sodium absorption ratio, sodium percentage and electrical conductivity show that most of the groundwater samples are also not suitable for agricultural purposes. However, the surface waters have higher quality for both domestic and irrigation purposes. The water of Massingir Lake turns out to be the most suitable resource for a possible rural development plan for the area.