1H NMR-based metabolomics investigation on the biological effects of paralytic shellfish toxin in mussel Mytilus trossulus.

Paralytic shellfish poisoning is a global issue that would benefit from additional screening methods and rapid testing capacities. In this study, we applied 1H NMR spectroscopy-based metabolomics to identify biomarkers of Paralytic Shellfish Toxin (PST) exposure. We characterized the metabolic phenotypes of field-collected Alaskan mussels Mytilus trossulus across a wide range of bioaccumulated PST levels, from 0 to 1590 µg/100 g. A between-level grouping emerged for high (740-1590 µg/100 g) compared to low/non-detect (0-3.91 µg/100 g) PST levels. High levels of PST contamination in mussels were consistent with alterations to energy and amino acid metabolism, and disturbances in osmoregulation. This research demonstrates the effectiveness of 1H NMR-based metabolomics in elucidating the biological effects of paralytic shellfish toxin on the health of wild mussel populations, spatial variation, and identifies a metabolic signature indicative of PST contamination in Mytilus trossulus for potential use in a PSP biomarker panel.

Paralytic shellfish poisoning toxins in butter clams (Saxidomus gigantea) from the Kodiak Archipelago, Alaska.

Consumption of toxic butter clams (Saxidomus gigantea) is the most frequent cause of paralytic shellfish poisoning (PSP) in Alaskan coastal communities. This study examines seasonal variation in total paralytic shellfish toxin concentrations and congener distribution in tissues of butter clams collected in three communities in the Kodiak Islands, Alaska: the City of Kodiak, Ouzinkie and Old Harbor. In response to questions from local harvesters, the efficacy of removing particular clam tissues on total toxin levels was also assessed. Butter clam samples were collected ∼monthly during 2015-2020 in each community to monitor shellfish toxin levels. Results were combined with clam monitoring data collected previously (2013-2015) to document the seasonal distribution of saxitoxin (STX) and its congeners (neosaxitoxin, gonyautoxin) in clam tissues. Seasonally, paralytic shellfish toxin levels in butter clams were highest in summer, declined in winter, but often remained above regulatory limits throughout the year in the three Kodiak communities. Butter clams collected from Ouzinkie (2013-2020) averaged 165 ± 87 µg STX equivalents (Eq.) 100 g - 1, compared to Kodiak 73 ± 54 µg STX Eq. 100 g - 1 and Old Harbor 143 ± 103 µg STX Eq. 100 g - 1. STX accounted for 59-71% of the total toxin concentration in clams at Ouzinkie, Kodiak, and Old Harbor, while neosaxitoxin (neoSTX) accounted for 12-18%. Gonyautoxins (GTXs) represented 31-60% of the total toxin concentration during the seasonal Alexandrium catenella bloom in June-July, with lower percentages in other months. The fraction of total toxin varied among clam tissues: the siphon tip (2-29%), the neck (3-56%), the gut (3-65%) and the body (6-85%). Removal of the siphon tip reduced total toxin content substantially in some samples but had little effect in others. Saxitoxin congeners varied greatly and somewhat unpredictably among clam tissues, and the results indicate removal of specific tissues was not an effective strategy for reducing paralytic shellfish toxin levels in butter clams for safe consumption.

Home Cervical Traction to Reduce Neck Pain in Fighter Pilots.

INTRODUCTION: Most fighter pilots report cervical pain during their careers. Recommendations for remediation lack evidence. We sought to determine whether regular use of a home cervical traction device could decrease reported cervical pain in F-15C pilots. METHODS: An institutional review board-approved, Health Insurance Portability and Accountability Act-compliant, controlled crossover study was undertaken with 21 male F-15C fighter pilots between February and June 2015. Of the 21 subjects, 12 completed 6 wk each of traction and control, while logging morning, postflying, and post-traction pain. Pain was compared with paired t-tests between the periods, from initial pain scores to postflying, and postflying to post-traction. RESULTS: In the traction phase, initial pain levels increased postflight, from 1.2 (0.7) to 1.6 (1.0) Subsequent post-traction pain levels decreased to 1.3 (0.9), with a corresponding linear decrease in pain relative to pain reported postflight. The difference in pain levels after traction compared to initial levels was not significant, indicating that cervical traction was effective in alleviating flying-related pain. Control pain increased postflight from 1.4 (0.9) to 1.9 (1.3). Daily traction phase pain was lower than the control, but insignificant. DISCUSSION: To our knowledge, this is the first study of home cervical traction to address fighter pilots' cervical pain. We found a small but meaningful improvement in daily pain rating when using cervical traction after flying. These results help inform countermeasure development for pilots flying high-performance aircraft. Further study should clarify the optimal traction dose and timing in relation to flying.Chumbley EM, O'Hair N, Stolfi A, Lienesch C, McEachen JC, Wright BA. Home cervical traction to reduce neck pain in fighter pilots. Aerosp Med Hum Perform. 2016; 87(12):1010-1015.

Soft tissue amyloidoma of the extremities: report of a case and review of the literature.

Amyloidoma (tumoral amyloidosis) is defined as a solitary localized tumorlike deposit of amyloid, in the absence of systemic amyloidosis. Amyloidoma is the least common presentation of tissue amyloid deposition and may be of AL-type or AA-type. It has been reported in many anatomic sites including the respiratory, genitourinary, and gastrointestinal tracts, as well as internal viscera, the central nervous system, skin, breast, and soft tissues. Amyloidoma of soft tissues is extremely rare and occurs mainly in the mediastinum and abdomen. Soft tissue amyloidoma of the extremities is even more uncommon and, when strictly defined, only 11 such cases are reported in the English language to date. Most have been of AA-type and have occurred on the leg. Some have been associated with local trauma, surgery, infection, or peripheral vascular disease, and a few patients have been diabetic. We report the case of a soft tissue amyloidoma on the leg of an 85-year-old woman. Clinically, it was a subcutaneous nodule on the left shin, of approximately 4 years duration. Traumatic fat necrosis was suspected. On excision a firm gray/tan, lobulated, soft tissue mass, measuring 2.3 cm in greatest dimension, was observed. At the microscopic level, it was seen to consist mainly of amyloid, associated with a giant cell granulomatous reaction, a patchy lymphocytic infiltrate, and focal microcalcification. The features were those of a soft tissue amyloidoma of the extremity. Persistence of congophilia after pretreatment with permanganate in this case suggested the presence of AL amyloid.

Trends in the incidence of oral cancer in Nova Scotia from 1983 to 1997.

OBJECTIVE: The purpose of the study was to characterize the total burden of oral cancer in Nova Scotia over the 15-year period from 1983 to 1997 and to identify any trends in the number of cases or incidence rates at specific anatomic sites or within specific age or sex groups over this time period. STUDY DESIGN: All cases that had a diagnosis of invasive oral cancer (ICD-9 sites 140-146) during the study period were retrieved from the records of the Nova Scotia Cancer Registry, which theoretically includes all cancer cases in the province. Cases of in situ carcinoma, lymphoma, and leukemia were not included. All cases during the study period were categorized by tumor site and the age and sex of the patient. Tumors at ICD-9 sites 141 and 143-146 were analyzed separately as intraoral cancer. Trends were studied by grouping cases into three 5-year periods: period 1 (1983-1987), period 2 (1988-1992), and period 3 (1993-1997). Age-standardized incidence rates were calculated to the 1991 Canadian standard population. RESULTS: A total of 1,155 cases of oral cancer were registered in Nova Scotia for this 15-year study period, accounting for 2.0% of all cancer cases. There was an average of 57 cases in men and 20 cases in women per year. Overall, the most common site was the lip (26% of cases), followed by the tongue (20%), other mouth (16%), tonsil/oropharynx (12%), salivary gland (12%), floor of mouth (10%), and gum (4%). About 5% of cases occurred in patients 40 years and younger, and 53% occurred in patients 65 years and older. Lip cancer in men decreased by 38%, and the age-standardized incidence rate fell from 5.6 to 3.0 per 100,000 from period 1 to period 3. Intraoral cancers in men increased by 23% and the age-standardized incidence rate increased by 10% from period 1 to period 3. Both measures peaked in period 2. Intraoral cancer in women increased steadily by 84%, and the age-standardized incidence rate increased by 48% from period 1 to 3. The male-to-female ratio for intraoral cancer cases decreased from 2.9 to 2.5 to 1.9 over the 3 periods. CONCLUSION: Although there was a decreasing trend for lip cancer, the number of cases and the age-standardized incidence rate for intraoral cancer increased over the 15-year study period. Intraoral cancer increases in females were dramatic. Trends in the number of cases reflected changing risk and a growing, aging population. More oral cancers occurred each year than cancers of the uterine cervix, suggesting the need for more resource allocation in the areas of research, prevention, and early detection of oral cancer.