The actual health risk and associated diseases induced by the presence of pesticides and other organic pollutants in most environmental media worldwide are largely underestimatedbecause current ...analytical methods measure only the extractable fraction of the pollutant, whereas there is now ample evidence that a large part of pollutants are trapped as bound residues in complex organo-mineral matrixes, and are thus unanalyzable by current tools. Once trapped, pollutants can be stored for long periods, then released in the biosphere upon suitable conditions such as soil erosion and climate change. This ‘resurrection’ and underlying mechanisms of trapping, storage and release are poorly known. Here we discuss the limit of knowledge on bound pollutants and their later release, with examples of organochlorines in glaciers, vineyards and banana plantations. Unexpectedly, soil application of a modern pesticide such as glyphosate, can lead to the resurrection of ancient, actually banned pesticides such as chlordecone and dichlorodiphenyltrichloroethane (DDT) (Fig. 1).
The widespread use of pesticides in agriculture during the last several decades has contaminated soils and different Critical Zone (CZ) compartments, defined as the area extended from the top of the ...vegetation canopy to the groundwater table, and it integrates interactions of the atmosphere, lithosphere, biosphere, and hydrosphere. However, the long-term fate, storage, and transfer dynamics of persistent pesticides in CZ in a changing world remain poorly understood. In the French West Indies, chlordecone (CLD), a toxic organochlorine insecticide, was extensively applied to banana fields to control banana weevil from 1972 to 1993 after which it was banned. Here, to understand CZ trajectories we apply a retrospective observation based on marine sediment core analyses to monitor long-term CLD transfer, fate, and consequences in Guadeloupe and Martinique islands. Both CLD profiles show synchronous chronologies. We hypothesized that the use of glyphosate, a postemergence herbicide, from the late 1990s onward induced CZ modification with an increase in soil erosion and led to the release of the stable CLD stored in the soils of polluted fields. CLD fluxes drastically increased when glyphosate use began, leading to widespread ecosystem contamination. As glyphosate is used globally, ecotoxicological risk management strategies should consider how its application affects persistent pesticide storage in soils, transfer dynamics, and widespread contamination.
To analyze the clinical outcomes and the safety of preoperative high-dose-rate (HDR) image-guided adaptive brachytherapy (IGABT) followed by minimally invasive surgery (MIS) in the multidisciplinary ...management of early-stage cervical cancer.
Medical records of all consecutive patients with early-stage cervical cancer treated at our institution between 2012 and 2018 with preoperative IGABT in a multidisciplinary approach were reviewed. Treatment schedule was pelvic node dissection, preoperative IGABT followed 6–8 week later by MIS hysterectomy.
Seventy patients with cervical cancer FIGO stages (IB1 18.6%, IB2 75.7% and IIA1 5.7%) were treated by preoperative HDR brachytherapy. With a median follow-up of 37.4 months 95% confidence interval, 32.1-39.7 months isolated vaginal vault recurrence was not observed, 3 pelvic relapses were reported (4.3%). None of patients received postoperative radiotherapy (EBRT) or radiochemotherapy. The estimated 3-year local and pelvis relapse free survival for the entire population were respectively 98% 95% confidence interval, 89%–100% and 90% 80%–96%. The estimated 3-year disease-free survival (DFS) for the entire population was 88% 77–94%. The 3-year overall survival (OS) rate was 97% 88%–99%. Microscopic vaginal resection margin (R1) was observed in one patient (1.4%). Lymph-vascular space invasion (LVSI) was found found in 6 (8.6%) patients. Forty-eight late complications in 36 patients (51.4%) were observed. Five (7.1%) grade 3 vaginal wound dehiscence toxicities were observed. Urinary and gastrointestinal toxicities were grade 1–2. No grade 4–5 complications were observed.
Preoperative image-guided adaptive brachytherapy followed by minimally invasive surgery allows high local control, reduces positive surgical margins and rates of lymph-vascular space invasion avoiding adjuvants treatments. Surgical approaches must be discussed with patients including preoperative brachytherapy as a down-staging treatment.
•Modern preoperative brachytherapy allows down-staging and less invasive surgery.•Brachytherapy followed by hysterectomy decrease the rates of positive surgical margins and the presence of lymph-vascular space invasion.•Image-guided adaptive brachytherapy in early-stage cervical cancer improves oncologic outcomes without additional adjuvant therapy.
Introduction To investigate the feasibility and early clinical outcomes of combined intra-cavitary (IC) and interstitial (IS) image-guided adaptive brachytherapy (IGABT) as curative and definitive ...treatment of patients treated with chemoradiotherapy (CCRT) for locally advanced cervical cancer (LACC). Material and methods Data from medical records of all consecutive patients with histologically proven cervical cancer (FIGO 2018 stage IB-IV), treated by brachytherapy after CCRT at our institution between 2017 and 2020 were reviewed. Results One hundred and forty-two patients with LACC FIGO 2018 stages (IB: 20.4%, II: 31.7%, III: 45.8%, IV: 2.1%) underwent brachytherapy at our institution, out of which 53.5% underwent combined brachytherapy technique (IC/IS). Median number of implanted catheters was 3 (range, 1-6 catheters). None of the 142 patients required invasive hemorrhage management. With a median follow-up of 21.6 (95% CI confidence interval: 19.1-23.5%) months, local relapse was observed in nine patients (6.3%), with four showing persistent and progressive disease. The estimated 2-year local and pelvic relapse-free survival were 92% (95% CI: 84-96%) and 90% (95% CI: 83-94%), respectively. The estimated 2-year disease-free survival for the entire population was 80% (95% CI: 71-87%). The 2-year overall survival (OS) rate for the entire population was 92% (95% CI: 84-96%). Acute toxicity G3 was reported in two (1.4%) patients. High-grade late toxicity (grade 3) was reported in 9 (6.3%) patients. Conclusions Combined IC/IS brachytherapy for LACC allows for recommended doses to achieve local control even in large tumors after CCRT improving target volume coverage, with low rates of acute morbidity. Hybrid brachytherapy technique (IC/IS) is essential to have a favorable scenario at the time of brachytherapy to correctly treat locally advanced cervical cancer patients.
Abstract Mesoblastic nephroma is by far the most frequent intrarenal fetal tumor. To the best of our knowledge, we report the first case of a newborn with an intrarenal neuroblastoma that was ...discovered prenatally. An intrarenal echogenic and homogenous mass was observed on routine prenatal ultasonography, corroborated by magnetic resonance imaging, in a 30-week gestation fetus. A male weighing 3280 g was born with elevated blood pressure and cardiac failure. Postnatal ultrasound confirmed a left intrarenal tumor with microcalcifications and perirenal adenopathy. An open total left nephrectomy by laparotomy was performed. The pathologic study reported that the mass was an intrarenal neuroblastoma with local and regional invasion. Immediate postoperative urine analysis revealed a high level of vanillylmandelic acid, and blood samples showed high levels of normetanephrine. The purpose of this report is to demonstrate that prenatal intrarenal neuroblastoma can clinically and radiologically mimick a mesoblastic nephroma. High blood pressure, calcifications, and lymphadenopathy on ultrasound should raise the index of suspicion for a possible malignant process. Preoperative measurement of urinary vanillylmandelic acid (VMA) and metanephrines should be performed if the diagnosis is in doubt.
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