BACKGROUND: Perfluoralkylated substances (PFASs) are persistent and bioaccumulative environmental contaminants. They are included on the list of emergent compounds monitored in the frame of HBM4EU project. OBJECTIVES: To analyze PFASs levels in human milk samples collected in the period 2006 through 2017, to follow their time trends, to assess the PFASs exposure in breastfed infants, to calculate the daily intake of PFASs and to compare it with the tolerable daily/weekly) intakes and to quantify risk from exposure using the hazard quotient and hazard index approach. MATERIAL AND METHODS: A broad spectrum of PFASs were analyzed by means of UHPLC-MS/MS in primipara human milk samples collected in four consecutive time periods 2006, 2010/11, 2014, and 2017; N = 46, 183, 164 and 232, respectively. Mothers living in urban and suburban residences were recruited after their delivery at maternity hospitals, and milk samples were taken within 2 and 8 weeks after delivery. The questionnaire was focused on possible sources of exposure, dietary habits and lifestyle. RESULTS: Only perfluorooctane sulfonate (PFOS) and perfluorooctanoid acid PFOA (in 2017, also perfluorononanoic acid (PFNA)) were quantified in more than 90% of analyzed human milk samples. In all sampling periods, the levels of PFOA were higher than those of PFOS (p < 0.05). A significant downward temporal trend (p < 0.001) was observed for both PFOA and PFOS levels. The median concentrations in sampling years 2006, 2010/11, 2014, and 2017 were 0.075, 0.059, 0.035, and 0.023 ng/mL for PFOA and 0.045, 0.031, 0.029, and 0.020 ng/mL for PFOS, respectively. In 2017, PFNA was also quantified in 99% of samples with the median concentration of 0.007 ng/mL. The levels of PFASs correlated with maternal sea fish consumption. No maternal age-related relationship was observed. Using the tolerably daily intake (TDI) values for PFOS and PFOA set by the European Food Safety Authority (EFSA) in 2008, the calculated daily intakes from breastfeeding were clearly below these limits. Using the new, more conservative EFSA Provisional Tolerably Weekly Intake (PTWI) values set in 2018, we demonstrated a considerable exceedance of PTWI, with a hazard index above 1. CONCLUSION: Significant time-related decreasing trends in the PFOS and PFOA levels in human milk were observed. Nevertheless, the body burden of infants from breastfeeding might pose an enhanced health risk to infants when the current PTWI values are applied. These findings strongly support the present EU efforts to phase out PFOA, its salts and PFOA related compounds. Since PFOS exposure there has still been widely detected despite PFOS usage reduction measures, the major exposure routes should be further monitored and, if possible, eliminated.
- MeSH
- Biological Monitoring MeSH
- Fluorocarbons * analysis MeSH
- Caprylates analysis MeSH
- Infant MeSH
- Alkanesulfonic Acids * analysis MeSH
- Environmental Pollutants * analysis MeSH
- Humans MeSH
- Milk, Human chemistry MeSH
- Tandem Mass Spectrometry MeSH
- Pregnancy MeSH
- Animals MeSH
- Check Tag
- Infant MeSH
- Humans MeSH
- Pregnancy MeSH
- Female MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Czech Republic MeSH
BACKGROUND: Perfluoroalkyl substances (PFASs) are man-made fluorinated compounds with endocrine-disrupting properties, detected in 99% of serum samples worldwide and associated with adverse childhood health outcomes. The aim of this study was to describe determinants of prenatal exposure to PFASs in Slovakia. METHODS: This study was based on Slovak multicentric prospective mother-child cohort PRENATAL (N = 796). Cord blood samples were collected within 2010-2012 and PFASs were analyzed in a subpopulation of 322 newborns. Concentrations of perfluorooctane sulfonic acid (PFOS), perfluorohexane sulfonic acid (PFHxS), perfluorooctanoic acid (PFOA) and perfluorononanoic acid (PFNA) were measured in the samples of cord blood using an ultrahigh-performance liquid chromatography- mass spectrometry (U-HPLC-MS) method. From questionnaires, we obtained information on medical history of mother, socio-demographic factors, nutrition and environmental factors. Association between maternal characteristics and PFASs exposure was analyzed using multivariable linear regression models. RESULTS: The highest cord blood concentration (geometric mean ± SD) was observed for PFOA (0.79 ± 2.21 ng/ml) followed by PFOS (0.36 ± 2.56 ng/ml), PFNA (0.20 ± 2.44 ng/ml) and PFHxS (0.07 ± 2.36 ng/ml). Primiparity was associated with higher levels of all four PFAS: PFOS (exp. β = 1.25; 95%CI[1.03; 1.53]), PFOA (exp. β = 1.49; 95%CI[1.18; 1.89]), PFNA (exp. β = 1.30; 95%CI[1.05; 1.60]) and PFHxS (exp. β = 1.49; 95%CI [1.20; 1.86]). In addition, maternal age category 29 years and more was associated with higher PFNA and PFHxS levels (exp. β = 1.27; 95%CI[1.04; 1.55] and exp. β = 1.30; 95%CI[1.06; 1.60], respectively) and higher educational level of mother was associated with higher PFNA levels (exp. β = 1.32; 95%CI[1.04; 1.68]). Higher fish consumption was associated with lower PFNA levels (exp. β = 0.49; 95%CI[0.26; 0.92]). CONCLUSIONS: We observed that PFASs cord blood concentrations were comparable or lower than those measured in western or northern European countries. We identified parity as the main determinant of PFASs exposure in our population and maternal age and education as factors that might be associated with exposure to certain PFASs.
- MeSH
- Adult MeSH
- Endocrine Disruptors blood MeSH
- Fetal Blood chemistry MeSH
- Fluorocarbons blood MeSH
- Environmental Pollutants blood MeSH
- Humans MeSH
- Maternal Exposure * MeSH
- Young Adult MeSH
- Infant, Newborn MeSH
- Prospective Studies MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Young Adult MeSH
- Infant, Newborn MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Slovakia MeSH
The extensive use and bioaccumulation of Perfluoroalkyl Substances (PFAS) over time raise concerns about their impact on health, including mental issues such as depression. This study aims to evaluate the association between PFAS and depression. In addition, considering the importance of PFAS as an endocrine disruptor and in adipogenesis, the analyses will also be stratified by body fat status. A cross-sectional study with 479 subjects (56.4% women, 25-89 years) was conducted. Four PFAS were measured: perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), and perfluorooctane sulfonate (PFOS). The Poisson regression model was applied using robust error variances. The fully adjusted model included age, sex, educational level, income, smoking, physical activity, body fat percentage, and the questionnaire to assess depression. The prevalence of depression and high body fat was 7.9% and 41.1%, respectively. Only PFOA was significantly associated with depression in the entire sample (prevalence rate (PR): 1.91; confidence interval (CI95%): 1.01-3.65). However, in the group with normal adiposity, PFOA (3.20, CI95%: 1.46-7.01), PFNA (2.54, CI95%: 1.29-5.00), and PFDA (2.09, CI95%: 1.09-4.00) were also significant. Future research should investigate the role of obesity as well as the biological plausibility and possible mechanisms increasing the limited number of evidences between PFAS and depression.
- Publication type
- Journal Article MeSH
Even though there is evidence of decreasing trends of per- and polyfluoroalkyl substances (PFAS) in Czechia, there are still major sources of PFAS pollution. Regarding the still-inconsistent results of the relationship between cardiometabolic health and PFAS, the present study sought to determine the association between PFAS levels and the presence of cardiometabolic biomarkers, including blood pressure and dysglycemia drivers in the Czech population. A cross-sectional study with 479 subjects (56.4% women, median: 53 years, range: 25-89) was conducted. Four PFAS were measured in serum: perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), and perfluorooctane sulfonate (PFOS). The associations between natural log (ln)-transformed PFAS and cardiometabolic biomarkers were assessed through generalized additive models using linear regression and smoothing thin plate splines, adjusted for potential confounders. There were positive and significant (p < 0.05) associations between the ln-transformed PFOA and glucose (β = 0.01), systolic (β = 0.76) and diastolic blood pressure (β = 0.65); total cholesterol (β = 0.07) and LDL-c (β = 0.04); and PFOS with glucose (β = 0.03), BMI (β = 2.26), waist circumference (β = 7.89), systolic blood pressure (β = 1.18), total cholesterol (β = 0.13), and HDL-c (β = 0.04). When significant, the correlations of PFNA and PFDA were negative. Of the four PFAS, only PFOA and PFOS showed a positive association, even in serum levels not as high as the values from the literature.
- MeSH
- Biomarkers MeSH
- Cholesterol MeSH
- Adult MeSH
- Fluorocarbons * MeSH
- Glucose MeSH
- Cardiovascular Diseases * epidemiology MeSH
- Alkanesulfonic Acids * MeSH
- Environmental Pollutants * MeSH
- Humans MeSH
- Cross-Sectional Studies MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
PURPOSE OF THE STUDY Surgical treatment of trochanteric fractures with intramedullary nailing still remains controversial as to which nail design is the best with no postoperative complications. The purpose of this study was to provide a comparative evaluation of complications in the treatment of trochanteric fractures using 2-screw proximal femoral nail versus proximal femoral anti-rotational blade nail. MATERIAL AND METHODS A retrospective review was conducted between March 2013 and March 2019. The study included 519 patients (358 females and 161 males) treated surgically for trochanteric fractures. The mean age was 79.8±12.0 (24-100) years. A1.2 type of fracture occurred in 153 (29.5%) cases, A1.3 type in 155 (29.9%), A 2.2 type in 90 (17.4%), A2.3 type in 95 (18.3%), A3.1 type in 11 (2.1%), A3.2 type in 7 (1.3%) and A3.3 type in 8 (1.5%) cases. Patients were treated either by 2-screw nail PFN (393 patients (75.7%) or by anti-rotational blade nail PFNA (126 patients (24.3%). RESULTS Our primary objective was to evaluate the implant related complications (e.g. cut-out, back-out, irritation, peri-implant fractures). Other complications (infection) and revision surgeries were also recorded. Complications were observed in 38 (9.7%) patients with PFN nail and 7 (5.6 %) patients with PFNA blade nail (p = 0.15). Screw back-out (n = 11) and cut-out (n = 11) were the most frequent complications in patients treated by 2-screw PFN nail and occurred in 5.6%. In the PFNA group, cutout occurred in 1.6% (n = 2) of cases while no cases of back-out were reported. Infection (n=3) was the most common complication in the latter group and represented 2.4%. In the PFN group the infection rate was 2.3% (n = 9). There were no statistically significant differences between both the groups considering implant-related complications (p = 0.14) and infections (p = 1.0). Revision surgery was performed in 33 patients (66.7%). DISCUSSION Biomechanical studies of intramedullary nails suggest good results with minimal complications if a two-screw implant is used. When antirotational blade is used, compression of spongiosis around blade is observed, which increases stability, especially in an osteoporotic bone. In our study, complications in these two types of nails were retrospectively compared. Considered as the limitation of our study is the retrospective nature of evaluation, which made it impossible the create two study groups with equal or similar number of patients, to follow up the patients postoperatively for a long period of time and to evaluate fracture union and limb function. CONCLUSIONS In our study no statistically significant difference in postoperative mechanical and infectious complications was confirmed between the 2-screw proximal femoral nail and the proximal femoral nail with antirotational blade. We have arrived at the conclusion that both types of nails are equivalent in treating trochanteric fractures. Key words: intramedullary nail, screw, blade, trochanteric fracture, complication.
- MeSH
- Hip Fractures * surgery MeSH
- Fracture Fixation, Intramedullary * adverse effects MeSH
- Bone Nails MeSH
- Bone Screws MeSH
- Humans MeSH
- Retrospective Studies MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
While the immunomodulation effects of per- and polyfluoroalkyl substances (PFASs) are described on the level of clinical signs in epidemiological studies (e.g., suppressed antibody response after vaccination), the underlying mechanism has still not been fully elucidated. To reveal mechanisms of PFAS exposure on immunity, we investigated the genome-wide transcriptomic changes of peripheral blood mononuclear cells (PBMCs) responding to PFAS exposure (specifically, exposure to PFPA, PFOA, PFNA, PFDA, PFUnDA, PFHxS, and PFOS). Blood samples and the chemical load in the blood were analyzed under the cross-sectional CELSPAC: Young Adults study. The overall aim of the study was to identify sensitive gene sets and cellular pathways conserved for multiple PFAS chemicals. Transcriptome networks related to adaptive immunity were perturbed by multiple PFAS exposure (i.e., blood levels of at least four PFASs). Specifically, processes tightly connected with late B cell development, such as B cell receptor signaling, germinal center reactions, and plasma cell development, were shown to be affected. Our comprehensive transcriptome analysis identified the disruption of B cell development, specifically the impact on the maturation of antibody-secreting cells, as a potential mechanism underlying PFAS immunotoxicity.
- MeSH
- Fluorocarbons * toxicity MeSH
- Alkanesulfonic Acids * MeSH
- Environmental Pollutants * MeSH
- Leukocytes, Mononuclear MeSH
- Humans MeSH
- Young Adult MeSH
- Cross-Sectional Studies MeSH
- Transcriptome MeSH
- Check Tag
- Humans MeSH
- Young Adult MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
Persistent organic pollutants, such as perfluorinated alkylated substances (PFASs) and brominated flame retardants (BFRs) are widespread in the environment and most of them are bioaccumulated in wildlife and humans. The present study is the first investigation to reveal the PFAS and BFR levels of serum samples in the adult population of the Czech Republic. Altogether, 300 serum samples from blood donors in four cities were examined. In all samples 19 PFASs and 33 BFRs, including some of their metabolites, were targeted. The analyses were performed using ultra high performance liquid chromatography coupled with tandem mass spectrometry or gas chromatography with mass spectrometry (according to the type of analyte). PFASs, with the carbon chain length C6 and higher, dominated in all samples. Perfluorooctanesulfonate (PFOS; median: 2.43ng/mL), perfluorooctanoic acid (PFOA; median: 0.756ng/mL), perfluorodecanoic acid (PFDA; median: 0.145ng/mL) and perfluorohexanesulfonate (PFHxS; median: 0.184ng/mL) were detected in 100% of samples. Perfluorononanoic acid (PFNA; median: 0.325ng/mL) and perfluoroundecanoic acid (PFUdA; median: 0.058ng/mL) in 99.7% and 96.0% of samples, respectively. We observed statistically significant associations (p<0.05) between selected PFAS concentrations and the locality, gender, age of donors and education level. None of the BFRs was detected above the LOQ in more than 9% of the samples. The most frequently detected representatives of this group were congeners of polybrominated diphenyl ethers, namely BDE-47 (in 8.7%; range: 0.496-5.44ng/g lipid weight (l.w.)), BDE-99 (in 6.0%; range: 0.706-9.46ng/g l.w.), BDE-153 (in 7.3%; range: 0.736-6.44ng/g l.w.) and BDE-209 (in 7.0%; range: 13.7-2693ng/g l.w.).
- MeSH
- Adult MeSH
- Fluorocarbons blood MeSH
- Halogenated Diphenyl Ethers blood MeSH
- Alkanesulfonic Acids blood MeSH
- Carboxylic Acids blood MeSH
- Environmental Pollutants blood MeSH
- Middle Aged MeSH
- Humans MeSH
- Urban Population MeSH
- Adolescent MeSH
- Young Adult MeSH
- Environmental Monitoring MeSH
- Polybrominated Biphenyls blood MeSH
- Flame Retardants analysis MeSH
- Aged MeSH
- Cities MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Czech Republic MeSH
- Cities MeSH
In the present study, a novel analytical approach for the simultaneous determination of 18 perfluoroalkyl substances (PFASs) and 11 brominated flame retardants (BFRs) including their hydroxylated metabolites and brominated phenols has been developed and validated for breast milk and infant formula. The sample preparation procedure based on extraction using acetonitrile and subsequent purification by dispersive solid-phase extraction (d-SPE) employing C18 sorbent is rapid, simple and high-throughput. Ultra-high performance liquid chromatography (UHPLC) interfaced with a tandem mass spectrometry (MS/MS) was employed for the identification/quantification of these compounds. The method recoveries of target compounds for both matrices ranged from 80% to 117% with relative standard deviations lower than 28% and quantification limits in the range of 3-200 pg/mL for milk and 5-450 pg/g for infant formula. Within the pilot study, the new method was used for the analysis of PFASs and BFRs in 50 human breast milks and six infant formulas. In the breast milk samples the total contents of PFASs and BFRs were in the range of 38-279 and 45-16,200 pg/mL, respectively. The most abundant PFASs detected in all tested breast milk samples were perfluorooctanoic acid (PFOA) and perfluorooctanesulfonate (PFOS), the latter contaminant was present not only as a linear form but also as a branched isomers. The incidence of BFRs was lower, the only representatives of this group, tetrabromobiphenol A (TBBPA) and α-hexabromocyclododecane (α-HBCD), were detected in less than 30% of breast milk samples. None of the infant formulas contained BFRs, traces of either PFOS, PFOA or PFNA were found in three samples.
- MeSH
- Acetonitriles chemistry MeSH
- Hydrocarbons, Brominated analysis MeSH
- Solid Phase Extraction MeSH
- Fluorocarbons analysis MeSH
- Caprylates analysis MeSH
- Infant MeSH
- Alkanesulfonic Acids analysis MeSH
- Humans MeSH
- Limit of Detection MeSH
- Milk, Human chemistry MeSH
- Infant Formula chemistry MeSH
- Polybrominated Biphenyls analysis MeSH
- Flame Retardants analysis MeSH
- Tandem Mass Spectrometry MeSH
- Chromatography, High Pressure Liquid MeSH
- Check Tag
- Infant MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
PURPOSE OF THE STUDY The objective of this study was to establish relative fixation strengths of proximal femoral nail (PFN), dynamic hip screw (DHS), monolateral external fixator (EF), and cannulated screw (CS) in basicervical hip fracture model. MATERIAL AND METHODS The study involved four groups of implanted composite proximal femoral synthetic bones of eight specimens per group; nailing with PFN, DHS, fixation with three cannulated screws, and EF. 70˚ osteotomy was performed to simulate a Pauwels Type 3 basicervical fracture. Minimum preload of 100 N was applied before loading to failure. The constructs were subjected to cyclic loading with 16˚ to midline from 100 N to 1,000 N for 10,000 cycles at 3Hz. Axial loading was applied at 10 mm/min until failure. Failure load, failure mode, and displacement were documented. RESULTS Mean failure load was 2182.5 ± 377.9 N in PFN group, 2008.75 ± 278.4 N in DHS group, 1941.25 ± 171.6 N in EF group, and 1551.6 ± 236.2 N in CS group. Average displacement was 15.6 ± 4.5 mm, 15.5 ± 6.7 mm, 11.7 ± 1.9 mm, and 15 ± 1.7 mm, respectively. No significant difference was noted among groups for fixation strength except CS group. All CS constructs failed during cyclic loading. CONCLUSION Our findings suggest that PFN, DHS and EF achieved higher fixation strengths than CS in basicervical fracture. PFN has higher failure loads and possesses biomechanical benefits for fixation of unstable basicervical fractures compared with DHS and EF. Key words: basicervical fracture, internal fixation, biomechanics.
OBJECTIVES: Per- and polyfluoroalkyl substances (PFASs) are a large group of persistent synthetic chemicals widely used commercially. They accumulate increasingly in all environmental components and enter the organisms, including humans. Some of them are associated with the risk of harm to health, among others with metabolic disorders. To test the associations between blood serum levels of PFASs and blood lipid profile as well as metabolic syndrome, we linked human biomonitoring with the Czech Health Examination Survey (CZ-EHES) conducted in 2019. METHODS: A total of 168 participants of the CZ-EHES survey aged 25-64 years were examined including anthropometrical data and analyses for serum PFAS and blood lipid levels. Extended model approach in multiple linear regression models was used for identification of the associations between serum levels of 11 PFASs and lipid profile components. The relation between PFAS serum levels and metabolic syndrome prevalence was tested using a logistic regression model. RESULTS: Six PFASs were detected over the limit of quantification in at least 40% cases and were examined in subsequent analyses: perfluorodecanoic acid (PFDA), perfluorohexane sulfonic acid (PFHxS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorooctane sulfonic acid (PFOS), perfluoroundecanoic acid (PFUdA). The most dominant was PFOS with the mean value amounting to 4.81 ng/ml. After adjusting for potential confounders, we found a significant positive association between serum PFHxS and blood total cholesterol (p = 0.005) as well as LDL-cholesterol (p = 0.008). Significant positive association was also found between PFDA and HDL-cholesterol levels (p = 0.010). No significant associations were detected between PFASs and triglycerides, and between PFASs and metabolic syndrome. CONCLUSIONS: We found some evidence of a significant association between blood serum PFAS levels and blood cholesterol levels. Our results did not confirm an association between serum PFASs and the metabolic syndrome prevalence.
- MeSH
- Cholesterol MeSH
- Adult MeSH
- Fluorocarbons * MeSH
- Alkanesulfonic Acids * MeSH
- Decanoic Acids * MeSH
- Sulfonic Acids * MeSH
- Environmental Pollutants * MeSH
- Humans MeSH
- Lipids MeSH
- Metabolic Syndrome * epidemiology MeSH
- Serum MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
