Influence of age on the concentrations of perfluoroalkyl acids (PFAA) in the tissues of perch (Perca fluviatilis).

Globally, perfluoroalkyl acids (PFAA) are ubiquitous due to their almost unlimited applications in industry and households and are detected in a wide variety of matrices.Aquatic ecosystems are of particular importance due to the spread of PFAA via water fluxes. The majority of published studies describe PFAA concentrations in fish or aquatic mammals, but not the dependence of PFAA concentrations in tissues and organs in fish of different ages. Since this is very important for understanding the accumulation behavior of these substances our study systematically investigates the influence of age on the PFAA concentration in the tissues of 74 perches (Perca fluviatilis), a very popular edible fish. Fish are particularly suitable as indicators of PFAA contamination of water because of their uptake via water (gills and skin) and food (predominantly piscivorous diet). The mean total PFAA concentrations (as the sum of the individual concentrations of 11 compounds) were: 114 µg/kg (kidney), 112 µg/kg (heart), 79.9 µg/kg (liver), 78.4 µg/kg (spleen), 64.6 µg/kg (gills) and 21.7 µg/kg (muscle), with longer-chain compounds accounting for 90% of the substances. Perfluorooctanesulfoic acid (PFOS) accounted for the largest percentage of the total PFAA concentration in all tissues at 43-63%. With the exception of the heart and spleen, a significant increase in total concentrations was observed with increasing age of the perch. The strongest correlation was observed for the kidney, followed by the liver and gills. With regard to their consumption as human nutrition the tolerable weekly PFAA intake of 4.4 ng/kg bodyweight and week for the sum of the 4 EFSA PFAA in adults and children was exceeded many times over (860% and 1,600% respectively) with an average fish consumption per week. The maximum PFAA levels set in the E.U. since January, 2023 were exceeded five times.

Cancer and Female Sexual Function.

Sexual health is a concern that often goes unaddressed among female cancer survivors. Management of these issues depends upon the type of malignancy, stage and other tumor characteristics, treatment, and the history, concerns, and goals of the individual patient.

Chronic graft-versus-host disease. Part I: Epidemiology, pathogenesis, and clinical manifestations.

Chronic graft-versus-host disease is a major complication of allogeneic hematopoietic cell transplantation and a leading cause of long-term morbidity, nonrelapse mortality, and impaired health-related quality of life. The skin is commonly affected and presents heterogeneously, making the role of dermatologists critical in both diagnosis and treatment. In addition, new clinical classification and grading schemes inform treatment algorithms, which now include 3 U.S. Food and Drug Administration-approved therapies, and evolving transplant techniques are changing disease epidemiology. Part I reviews the epidemiology, pathogenesis, clinical manifestations, and diagnosis of chronic graft-versus-host disease. Part II discusses disease grading and therapeutic management.

Chronic graft-versus-host disease. Part II: Disease activity grading and therapeutic management.

Chronic graft-versus-host disease (cGVHD) is a major complication of allogeneic hematopoietic cell transplantation and a leading cause of long-term morbidity, nonrelapse mortality, and impaired health-related quality of life. The skin is commonly affected and presents heterogeneously, making the role of dermatologists critical in both diagnosis and treatment. In addition, new clinical classification and grading schemes inform treatment algorithms, which now include 3 Federal Drug Administration-approved therapies, and evolving transplant techniques are changing disease epidemiology. Part I reviews the epidemiology, pathogenesis, clinical manifestations, and diagnosis of cGVHD. Part II discusses disease grading and therapeutic management.

Sexual Health Issues in Cancer Survivors.

OBJECTIVE: To review the sexual health issues cancer survivors may experience, including incidence, association with treatment modalities, and approach to evaluation and treatment. DATA SOURCES: Peer-reviewed journal articles, medical society or government Web sites. CONCLUSION: Cancer diagnosis and treatment often impacts sexual function and addressing this is a key component of health-related quality of life. IMPLICATIONS FOR NURSING PRACTICE: Screening, evaluation, and treatment of sexual dysfunction should be incorporated into routine oncologic care.

Levels, accumulation patterns and retrospective trends of perfluoroalkyl acids (PFAAs) in terrestrial ecosystems over the last three decades.

As a result of their ubiquitous presence in the environment perfluoroalkyl acids (PFAAs) have been demonstrated in numerous organisms worldwide, in particular in those of higher trophic levels. The fact that PFAAs have been detected in various human matrices, together with the resultant potential human health risks, knowledge of possible paths of entry and distribution in various ecosystems, is of great importance. In this context pooled samples of terrestrial ecosystems - roe deer liver (n = 141), earthworms (n = 44) as well as leaves from beech and poplar trees (n = 70) - from the year 1989-2015 were obtained from the German Environmental Specimen Bank and examined for the presence of 11 PFAAs for the first time. In addition to determining individual and total PFAA concentrations, temporal trends have been deduced in order to determine the effectiveness of regulatory measures. The highest total mean concentration of PFAAs (sum of the concentrations of the 11 analytes) were 9.9 µg/kg in the roe deer liver samples, followed by earthworm samples with a mean PFAA concentration of 3.5 µg/kg and leaves with a mean total concentration of 2.5 µg/kg. In regard to temporal trends there was a significant reduction of concentrations for perfluorooctane sulfonate, perfluorooctanoic acid, perfluorononanoic acid and perfluorodecanoic acid in roe deer liver from 2003 to 2015, an indication of the effectiveness of regulatory measures. The same is true for the perfluorooctane sulfonate concentrations in earthworms and for perfluorooctanoic acid concentrations in the leaves. In contrast, an increase in perfluorobutanoic acid concentrations was observed from 2003 to 2015 in all three matrices. In summary it must be noted that in spite of the discernible effectiveness of minimization strategies, PFAAs are still detectable in terrestrial matrices and concentrations of other PFAAs as perfluorobutanoic acid appear to be increasing.

Determination of adsorbable organically bound fluorine (AOF) and adsorbable organically bound halogens as sum parameters in aqueous environmental samples using combustion ion chromatography (CIC).

Because of their toxicity and biomagnification potential individual perfluoroalkyl and polyfluoroalkyl substances (PFAS) are regularly examined in food and environmental matrices by LC-MS/MS. The combustion ion chromatography (CIC) can be used to determine adsorbable organic fluorine (AOF) in aqueous samples. This report describes the optimization and validation of an automated, robust, cost-efficient and rapid CIC method for the determination of AOF. The analysis of 25 fluorinated organic reference substances was performed with recoveries between 16% and 121%. Water from selected surface waters (n = 74), municipal (n = 116) and industrial wastewaters (n = 33) as well as ground water (n = 93) were analyzed by means of CIC. The AOF values of surface water varied between 2.3 and 24.5 µg/L. The concentrations of AOF in 85% of the wastewater discharges were between 2.0 and 8.5 µg/L, while 15% of the samples were below the limit of quantitation (LOQ = 2 µg/L AOF). In 56% of the ground water samples the values were below the LOQ. In 44% of the surface water samples (n = 41) the values were between 2.0 and 6.1 µg/L AOF. CIC analysis was performed in 22 samples from a chemical company wastewater treatment plant, and 14 individual PFAS were determined by LC-MS/MS. AOF values up to 555 µg/L were found in these samples while the total of the individual PFAS, calculated as fluorine, was 8.8 µg/L. This provides evidence, that CIC covers a huge range of fluoroorganic compounds that are presently not detected by LC-MS/MS. Furthermore, the CIC method allowed the determination of four halogens in 26 surface water samples. This demonstrated that the CIC technique can be used as a powerful screening test to support LC-MS/MS methods, and is also useful to detect organic chlorine, bromine and iodine compounds (AOCl, AOBr and AOI).

Concentrations and Distribution Patterns of Perfluoroalkyl Acids in Sewage Sludge and in Biowaste in Hesse, Germany.

A total of 201 sewage sludge and 45 biowaste samples were examined for 14 different perfluoroalkyl acids (PFAA). For perfluorooctanesulfonic acid, maximum concentrations of 698 µg/kg dry weight were measured in sewage sludge and for perfluorohexanesulfonic acid 29.0 µg/kg dry weight were found in biowaste. Looking at the fingerprints of both these matrixes it can be see that long-chain PFAA make up 85.9% of the total concentration in sewage sludge whereas short-chain PFAA only account for 14.1%. In contrast, the trend in biowaste is just the opposite, with 53.2% long-chain and 46.8% short-chain PFAA. These results lead to the conclusion that sewage sludge functions as a sink for long-chain PFAA, and the plants preferentially take up short-chain PFAA from the sludge/soil, as seen by the concentrations found in biowaste. It can be calculated that the total yearly amount of PFAA spread onto agricultural lands amount to 15.3 kg.

Migration of aluminum from food contact materials to food-a health risk for consumers? Part III of III: migration of aluminum to food from camping dishes and utensils made of aluminum.

BACKGROUND: When cooking on a barbecue grill, consumers often use aluminum grill pans. For one, the pan catches the fats and oils that would drip into the embers causing the formation of potentially noxious smoke, and the pan also protects the food from being burned by direct heat from the coals. In addition, new aluminum products for use in ovens and grills are becoming increasingly popular. Due to their light weight and excellent heat transfer camping, utensils made of aluminum are, for example, often used by fishermen and mountain climbers. Preparing food in aluminum utensils can, however, result in migration of the aluminum to the foodstuffs. RESULTS/CONCLUSIONS: In this study presented here, it was found that the transfer limit of 5.00 mg/L for aluminum is not exceeded using simulants for oil or for tap water; however, with an aqueous solution of 0.5% citric acid, the limit is clearly exceeded at 638 mg/L. This means that the Tolerable Weekly Intake (TWI) is exceeded by 298% for a child weighing 15 kg and for an adult weighing 70 kg it is equivalent to 63.8% of the TWI, assuming a daily uptake of 10 mL marinade containing lemon juice over a period of 1 week. Preparation of a fish dish with a marinade containing lemon juice in camping dishes would result in the TWI being exceeded by 871% for a child weighing 15 kg and by 187% for an adult weighing 70 kg assuming a daily uptake of 250 g over a period of 1 week.

Migration of aluminum from food contact materials to food-a health risk for consumers? Part II of III: migration of aluminum from drinking bottles and moka pots made of aluminum to beverages.

BACKGROUND: Drinking bottles and stove-top moka pots made of aluminum have become very popular. Storing drinks in bottles and preparing coffee in a moka pot may result in the migration of aluminum to the beverage. RESULTS/CONCLUSIONS: In a systematic study of aluminum drinking bottles, it has been shown that drinking a mixture of apple juice and mineral water in an aluminum bottle may reach 86.6% of the total weekly intake (TWI) for adults, and drinking tea from an aluminum bottle may exceed the TWI (145%) for a child weighing 15 kg. In contrast, preparing coffee in an aluminum moka pot results in a maximum of 4% to TWI, if an average of 3.17 L coffee is consumed per week, even if the pots are washed in the dishwasher, against the explicit instructions of the manufacturer.

Migration of aluminum from food contact materials to food-a health risk for consumers? Part I of III: exposure to aluminum, release of aluminum, tolerable weekly intake (TWI), toxicological effects of aluminum, study design, and methods.

BACKGROUND: In spite of the prevalence of aluminum in nature, no organism has been found to date which requires this element for its biological functions. The possible health risks to human beings resulting from uptake of aluminum include detrimental effects to the hemopoietic system, the nervous system and bones. Aluminum is used in many fields and occurs in numerous foodstuffs. Food contact materials containing aluminum represent an anthropogenic source of dietary aluminum. RESULTS: As a result of their frequent use in private households a study was undertaken to detect migration of this metal to foodstuffs from drink containers, coffee pots, grill pans, and camping cookware made of aluminum. CONCLUSIONS: An estimate of the health risk to consumers is calculated, based on the tolerable weekly intake (TWI) specified by the European Food Safety Authority of 1 mg/kg body weight for all groups of people. In some instances the TWI is significantly exceeded, dependent upon the food contact material and the food itself.

Vaginal Health During Breast Cancer Treatment.

There are increasing numbers of breast cancer survivors. Chemotherapy or endocrine therapy result in effects on vaginal health that may affect quality of life. These effects may impact sexual function, daily comfort, or the ability to perform a pelvic examination. Vulvovaginal atrophy, or genitourinary syndrome of menopause, may be treated with nonhormonal or hormonal measures. Breast cancer survivors who are menopausal and/or on endocrine therapy should be screened for issues with vaginal health and counseled about treatment options.

Perfluoroalkyl Acid Concentrations in Livers of Fox (Vulpes vulpes) and Chamois (Rupicapra rupicapra) from Germany and Austria.

The concentrations of 11 perfluorinated alkyl acids (PFAAs) were measured in the livers of foxes (Vulpes vulpes) from Germany, a primarily carnivorous species, and chamois (Rupicapra rupicapra) from Austria, an herbivorous species. Perfluorooctanesulfonate (PFOS) at concentrations [all results refer to wet weight (ww)] of 3.2-320 µg/kg were detected in all 40 fox livers tested, yielding an arithmetic mean of 46.6 µg/kg and a median of 29.8 µg/kg. Long-chain PFAAs were detected at concentrations of 1.7 µg/kg perfluorononanoic acid (PFNA) to 2.4 µg/kg perfluorodecanoic acid (PFDA) and perfluorododecanoic acid (PFDoDA). Of the short-chain PFAAs tested, only perfluorohexanoic acid (PFHxA) was found in 1 fox liver at a concentration of 1.4 µg/kg, and perfluorohexane sulfonate (PFHxS) was found in 2 fox livers at a concentration of 1 µg/kg each. PFOS and PFNA concentrations higher than limit of quantification (LOQ) were detected in 90.9 and 81.8 % of chamois livers, respectively. The arithmetic mean for PFOS concentrations was 2.2 µg/kg (median 2.4 µg/kg), a factor of 21 (median factor of 12) lower than in fox livers. The arithmetic mean for PFNA concentrations was 2.0 µg/kg (median 1.9 µg/kg). Perfluorobutanoic acid, PFHxA, perfluorooctanoic acid, perfluorobutanesulfonate, and PFHxS were not detected at concentrations higher than the LOQ in any of the samples. The various results are compared with one another and with the results of other studies of herbivorous, carnivorous, and omnivorous wild animals. The highest concentrations of PFAA, in particular PFOS, were found in omnivorous animals followed by carnivores. The lowest levels were present in herbivores.

Managing premature menopause and sexual dysfunction.

PURPOSE OF REVIEW: Young women (<45 years of age) diagnosed with breast cancer face increased risk of sexual dysfunction as a result of their cancer-directed treatment. We will review the recent literature examining this critical challenge and discuss current efforts to address sexual dysfunction. RECENT FINDINGS: In the period since 2013, the literature has focused on sexual issues that result from the premature onset of menopausal symptoms and changes in sexual health following breast surgery. The impact of premature menopause in young women with breast cancer is profound and can affect all aspects of the sexual experience, from desire to function, and quality of life. Furthermore, the surgical treatment of breast cancer also has significant implications with respect to sexual desire and body image. There is a paucity of sexual health intervention for this population, though recent efforts suggest that sexual health outcomes may be improved if women are offered the appropriate intervention opportunities. However, the sexual function of young breast cancer patients is an under-discussed and under-treated health issue that warrants greater research and clinical focus. SUMMARY: Further intervention trials must be completed in this population of young women for whom sexual function plays such a critical role in their personal and relationship well being.

Accumulation potentials of perfluoroalkyl carboxylic acids (PFCAs) and perfluoroalkyl sulfonic acids (PFSAs) in maize (Zea mays).

Uptake of perfluoroalkyl acids (PFAAs) by maize represents a potential source of exposure for humans, either directly or indirectly via feed for animals raised for human consumption. The aim of the following study was, therefore, to determine the accumulation potential of perfluoroalkyl carboxylic acids (PFCAs) and perfluoroalkyl sulfonic acids (PFSAs) in maize (Zea mays). Two different concentrations of PFAAs were applied as aqueous solution to the soil to attain target concentrations of 0.25 mg or 1.00 mg of PFAA per kg of soil. Maize was grown in pots, and after harvesting, PFAA concentrations were measured in the straw and kernels of maize. PFCA and PFSA concentrations of straw decreased significantly with increasing chain length. In maize kernels, only PFCAs with a chain length ≤ C8 as well as perfluorobutanesulfonic acid (PFBS) were detected. The highest soil-to-plant transfer for both straw and kernels was determined for short-chained PFCAs and PFSAs.

Tissue specific uptake and elimination of perfluoroalkyl acids (PFAAs) in adult rainbow trout (Oncorhynchus mykiss) after dietary exposure.

Tissue specific uptake and elimination of perfluoroalkyl acids (PFAAs) were studied in rainbow trout (Oncorhynchus mykiss). Adult trout were exposed to perfluorobutane sulfonic acid (PFBS), perfluorohexane sulfonic acid (PFHxS), perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA) and perfluorononanoic acid (PFNA) via food over a time period of 28d. In the following 28-d depuration period the fish were fed PFAA-free food. At defined sampling times four animals were removed from the experimental tank, euthanized and dissected. Muscle, liver, kidneys, gills, blood, skin and carcass were examined individually. At the end of the accumulation phase between 0.63% (PFOA) and 15.5% (PFOS) of the absolute, applied quantity of PFAAs was recovered in the whole fish. The main target organ was the liver with recovery rates between 0.11% (PFBS) and 4.01% (PFOS) of the total amount of ingested PFAAs. Perfluoroalkyl sulfonic acids were taken up more readily and had longer estimated elimination half-lives than perfluoroalkyl carboxylic acids of the same chain length. The longest estimated elimination half-lives were found to be for PFOS between 8.4d in muscle tissue and 20.4d in the liver and for PFNA between 8.2d in the blood and 11.6d in the liver.

Effects of chain length and pH on the uptake and distribution of perfluoroalkyl substances in maize (Zea mays).

Maize is the most important grain crop grown for human nutrition, animal fodder and biogas production worldwide. Nonetheless, no systematic studies have been undertaken on these plants to examine the uptake mechanisms for perfluoroalkyl substances (PFASs) dependent upon chain length and pH value. The aim of the present study was therefore to determine the influence of chain length (C4 to C10) and pH value (pH 5, pH 6, pH 7) on the uptake and distribution of seven perfluoroalkyl carboxylic acids (PFCAs) and three perfluoroalkane sulfonic acids (PFSAs) by maize in nutrient solution experiments under controlled conditions in a climate chamber. A pH-dependent uptake was observed for perfluorodecanoic acid (PFDA) with an uptake rate of 2.51 µg g(-1) at pH 5 compared to 1.52 µg g(-1) root dry weight (DW) per day (d) at pH 7. Perfluorobutanoic acid (PFBA) had the highest uptake rate within the group of PFCAs with an average of 2.46 µg g(-1) root DWd(-1) and perfluorooctane sulfonic acid (PFOS) had the highest uptake rate (3.63 µg g(-1) root DWd(-1)) within the group of PFSAs. The shoot:root ratio for shorter-chain PFCAs (≤ C7) and PFBS (C4) was >2.0, which indicates that shorter-chain PFASs are transferred predominantly and at higher concentrations to the shoot. In contrast, long-chain PFCAs such as perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA) and perfluorodecanoic acid (PFDA) as well as the PFASs perfluorohexane sulfonic acid (PFHxS) and perfluorooctane sulfonic acid (PFOS) accumulated at higher concentrations in the roots of maize plants with a shoot:root ratio of <1.0.

Sexual dysfunction in women with cancer.

Approximately 14 million people have a history of cancer in the United States alone, and the number is expected to increase with time. This has prompted an appreciation of the quality of life for survivors. Women treated for cancer identify gynecologic issues as a major concern for both general health and the negative impact on sexual function that follow the cancer diagnosis and subsequent treatment. Unfortunately, issues related to sexual health continue to be underappreciated. Although comprehensive cancer centers have adopted specialized centers for survivorship issues, including those involving sexual health, consultations are not widely available in most communities. We provide background information on female sexual health, examine the impact of cancer treatment on sexual function, and discuss some of the major sexual health issues of women who have received a cancer diagnosis and been subsequently treated.

Biomagnification and tissue distribution of perfluoroalkyl substances (PFASs) in market-size rainbow trout (Oncorhynchus mykiss).

The present study investigated the biomagnification potential as well as the substance and tissue-specific distribution of perfluoroalkyl substances (PFASs) in market-size rainbow trout (Oncorhynchus mykiss). Rainbow trout with an average body weight of 314 ± 21 g were exposed to perfluorobutane sulfonate (PFBS), perfluorohexane sulfonate (PFHxS), perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA), and perfluorononanoic acid (PFNA) in the diet for 28 d. The accumulation phase was followed by a 28-d depuration phase, in which the test animals were fed with nonspiked trout feed. On days 0, 7, 14, 28, 31, 35, 42, and 56 of the present study, fish were sampled from the test basin for PFAS analysis. Biomagnification factors (BMFs) for all test compounds were determined based on a kinetic approach. Distribution factors were calculated for each test compound to illustrate the disposition of PFASs in rainbow trout after 28 d of exposure. Dietary exposure of market-size rainbow trout to PFASs did not result in biomagnification; BMF values were calculated as 0.42 for PFOS, >0.23 for PFNA, >0.18 for PFHxS, >0.04 for PFOA, and >0.02 for PFBS, which are below the biomagnification threshold of 1. Liver, blood, kidney, and skin were identified as the main target tissues for PFASs in market-size rainbow trout. Evidence was shown that despite relative low PFAS contamination, the edible parts of the fish (the fillet and skin) can significantly contribute to the whole-body burden.