Correction to: Impact of smoking habit on adult-onset Still’s disease prognosis,findings from a multicentre observational study

Clinical Rheumatology -     

The reference values in the interpretation of toxicological data

The worldwide gradual expansion of industrialization has led to a dramatic increase in the production and use of chemical substances. This has resulted in a greater dispersion of these elements in the environment and in an increased exposure of the general population and workers. In this scenario, a thorough knowledge of exposure levels is needed in order to assess chemical risks in environmental and occupational settings. Biological monitoring is among the most useful tools for assessing exposure. However, in order to provide really effective guidance in the application/implementation of risk management measures, biomonitoring results need to be compared with appropriate references. Reference values (RVs) are an excellent resource since useful information for a correct interpretation of toxicological data can be obtained by comparing them with biomonitoring results. In the field of public health, this may enable us to identify potential sources of exposure, define the principal and most frequently exploited routes of exposure, and outline chemical absorption. Similarly, in occupational medicine, RVs can be used to give meaning to biomonitoring findings, especially when a biological limit value is not available for the chemical in question. Furthermore, these values are a valid tool for assessing exposure to chemical carcinogens. Therefore, by integrating reference values in an appropriate and complete system of guide values that also includes action levels and biological limit values, we could obtain both an adequate assessment of exposure and a better understanding of toxicological data.Key words: Biological limit values, biological monitoring, chemical risk, exposure assessment, reference values     

Cardiac Surgery in Patients With Liver Cirrhosis (CASTER) Study: Early and Long-Term Outcomes

1. Download : Download high-res image (165KB)
2. Download : Download full-size image

     

Metastasis-directed Therapy (SBRT) Guided by PET-CT 18F-CHOLINE Versus PET-CT 68Ga-PSMA in Castration-sensitive Oligorecurrent Prostate Cancer: A Comparative Analysis of Effectiveness

BackgroundThe present analysis aims to compare the impact of 18F-fluorocholine (¹⁸F-choline) and gallium-68 prostate-specific membrane antigen (⁶⁸Ga-PSMA) positron emission tomography (PET)-computed tomography (CT)–guided metastases-directed therapies (MDTs) in patients with castration-sensitive oligorecurrent prostate cancer (PC).Materials and MethodsInclusion criteria were: (1) histologically proven prostate adenocarcinoma; (2) evidence of biochemical relapse after primary tumor treatment; (3) ≤ 3 hypermetabolic oligorecurrent lesions detected by ¹⁸F-choline or ⁶⁸Ga-PSMA PET-CT; (4) PET-CT imaging performed in a single nuclear medicine department; (5) patients treated with upfront stereotactic body radiotherapy (SBRT) without hormone therapy; and (6) SBRT delivered with a dose per fraction ≥ 5 Gy. In the case of oligoprogression (≤ 3 lesions outside the previous RT field) after MTD, a further course of SBRT was proposed; otherwise, androgen deprivation therapy (ADT) was administered.ResultsA total of 118 lesions in 88 patients were analyzed. Forty-four (50%) patients underwent ⁶⁸Ga-PSMA PET-guided SBRT, and the remaining underwent choline PET-based SBRT. The median follow-up was 25 months (range, 5-87 months) for the entire cohort. Overall survival and local control were both 100%. Distant progression occurred in 48 (54.5%) patients, for a median distant progression-free survival of 22.8 months (range, 14.4-28.8 months). The median pre-SBRT prostate-specific antigen was 2.04 ng/mL in the choline PET cohort and 0.58 ng/mL in the PSMA-PET arm. Disease-free survival rates were 63.6% and 34%, respectively, in the ⁶⁸Ga-PSMA and choline PET group (P = .06). The ADT administration rate was higher after choline-PET–guided SBRT (P = .00) owing to the higher incidence of polymetastatic disease after first-course SBRT compared with ⁶⁸Ga-PSMA-based SBRT.ConclusionIn the setting of oligorecurrent castration-sensitive PC, PSMA-PET-guided SBRT produced a higher rate of ADT-free patients when compared with the ¹⁸F-choline-PET cohort. Randomized trials are advocated.