Search Results (534)

Background: Mesothelioma of the tunica vaginalis testis (MTVT) is an exceedingly rare tumor. We performed a registry-based study on MTVT patient management and survival in Italy. Methods: Cases were extracted from the dataset of the Italian National Mesothelioma Registry. A descriptive analysis of patient characteristics, including asbestos exposure, clinical presentation, diagnostic work-up and therapeutic management, was performed. Overall survival was evaluated. We calculated hazard ratios (HR) and 95% confidence intervals (CI) for selected variables by fitting univariate and multivariable Cox models. Results: Overall, 104 patients with MTVT were included. Median age was 72 years (range 17–92). Epithelioid histotype was the most frequent. Previous asbestos exposure was identified in two thirds of cases. Data on diagnostic and therapeutic management were available for 74 patients (71%). The most frequent presentations were scrotal swelling/mass, hydrocele and inguinal pain. All patients underwent surgery, mostly with orchi-funicolectomy. Adjuvant therapy was administered to 15 patients (20%). Overall median survival was 26.2 months (95% CI 22.1–52.1); 3-, 5- and 10-year survival was 49%, 30% and 18%. Older age at diagnosis and presence of distant metastasis (HR 1.91, CI: 0.85–4.26) were negative prognostic factors. Adjuvant therapy was associated with higher mortality (HR 2.54, CI: 1.25–5.15), indicating a more advanced stage at diagnosis. Conclusions: Surgery remains the mainstay of treatment for MTVT; adjuvant therapy in our study did not improve outcome. Data from cancer registries are essential for rare cancers, but they should be integrated routinely with additional diagnostic and therapeutic information. Full article

Pleural Mesothelioma (PM) remains a challenging malignancy associated with asbestos exposure and characterized by poor prognosis. This review aims to consolidate recent findings on the efficacy of perioperative therapies encompassing chemotherapy, surgery, and emerging immunotherapy strategies. Current management strategies debate the role of surgery in early-stage patients, particularly due to the limited success of solitary treatment modalities and significant rates of postoperative complications. Retrospective studies indicate that multimodal treatment, incorporating surgical resection with perioperative chemotherapy, can enhance overall survival (OS), especially in favorable prognostic subsets. However, significant randomized trials, notably the MARS and MARS 2 trials, revealed that the addition of aggressive surgical strategies like extrapleural pneumonectomy (EPP) did not confer survival benefits and was accompanied by heightened morbidity. In light of persistent challenges, integrating perioperative chemotherapy—primarily with platinum-based regimens—has shown improved disease control outcomes. Neoadjuvant chemotherapy permits real-time assessment of tumor responsiveness, providing valuable clinical insights for surgical candidacy. The role of immunotherapy, particularly immune checkpoint inhibitors (ICIs), is also under active exploration, with preliminary results suggesting promising activity and manageable safety profiles. In conclusion, while current protocols primarily recommend surgery for a select group of patients, ongoing investigations into neoadjuvant approaches, adjuvant therapies, and novel immunotherapeutic strategies are crucial for developing effective, personalized treatment paradigms for PM. Future efforts should prioritize clinical trials that integrate these therapies within a structured multidisciplinary approach to optimize patient outcomes. Full article

Malignant pleural mesothelioma (MPM) is a rare and aggressive malignancy associated with occupational or environmental exposure to asbestos. Effective management of MPM remains challenging due to its prolonged latency period and the typically late onset of clinical symptoms. Accordingly, there is an increasing demand for the implementation of reliable, non-invasive, and data-driven diagnostic strategies within large-scale screening programs. In this context, the chemical profiling of volatile organic compounds (VOCs) in exhaled breath has recently gained recognition as a promising and non-invasive approach for the early detection of cancer, including MPM. Therefore, in this cross-sectional observational study, an overall number of 125 individuals, including 64 MPM patients and 61 healthy controls (HC), were enrolled. End-tidal breath fraction (EXP) was collected directly onto two-bed adsorbent cartridges by an automated sampling system and analyzed by thermal desorption–gas chromatography–mass spectrometry (TD-GC/MS). A machine learning approach based on a random forest (RF) algorithm and trained using a 10-fold cross-validation framework was applied to experimental data, yielding remarkable results (AUC = 86%). Fifteen VOCs reflecting key metabolic alterations characteristic of MPM pathophysiology were found to be able to discriminate between MPM and HC. Moreover, twenty breath samples from asymptomatic former asbestos-exposed (AEx) and eight MPM patients during follow-up (FUMPM) were exploratively analyzed, processed, and tested as blinded samples by the validated statistical method. Good agreement was found between model output and clinical information obtained by CT. These findings underscore the potential of breath VOC analysis as a non-invasive diagnostic approach for MPM and support its feasibility for longitudinal patient and at-risk subjects monitoring. Full article

Background/Objectives: Mesothelioma is a rare and aggressive form of cancer that primarily affects the lining of the lungs, abdomen, or heart. It typically arises from exposure to asbestos and is often diagnosed at advanced stages. Limited datasets and complex tissue structures contribute to delays in diagnosis. This study aims to develop a novel hybrid model to improve the accuracy and timeliness of mesothelioma diagnosis. Methods: The proposed approach integrates automatic image segmentation, transformer-based model training, class-based feature extraction, and image transformation techniques. Initially, CT images were processed using the segment anything model (SAM) for region-focused segmentation. These segmented images were then used to train transformer models (CaiT and PVT) to extract class/type-specific features. Each class-based feature set was transformed into an image using Decoder, GAN, and NeRV techniques. Discriminative score and class centroid analysis were then applied to select the most informative image representation for each input. Finally, classification was performed using a residual-based support vector machine (SVM). Results: The proposed hybrid method achieved a classification accuracy of 99.80% in diagnosing mesothelioma, demonstrating its effectiveness in handling limited data and complex tissue characteristics. Conclusions: The results indicate that the proposed model offers a highly accurate and efficient approach to mesothelioma diagnosis. By leveraging advanced segmentation, feature extraction, and representation techniques, it effectively addresses the major challenges associated with early and precise detection of mesothelioma. Full article

The awareness of the potential risks associated with the environmental exposition of asbestos is on the rise and has facilitated a new interest in in situ identification and assessment of the hazards of fibrous minerals. The mineralised metacarbonate rocks of the Guelb Moghrein deposit have not been studied regarding the identification and characterisation of fibrous minerals occurrences. Thus, the aim of this study was to collect samples from different lithotypes with visually identifiable fibrous minerals and to examine the geological–structural features pertaining to their mode of occurrence and formation. The mineral fibre components of the rock samples demonstrate that fibrous and asbestiform mineralisation occurred via several modes, including fracture fill, slip-fibre recrystallisation and replacement. The geological diversity of fibrous amphibole mineralisation points to the chemistry of the rocks in this area and open space being the major factors controlling the presence of NOA in this deposit. The variability of NOA due to different fibrous mineral intergrowths is investigated by determining the bulk mineralogical and geochemical properties of the fibrous mineral content of each sample. A novel observation was pointed out in this study, showing the coexistence of fibrous siderite and anthophyllite. The identification of the asbestiform features exhibited by siderite, anthophyllite and talc in the mineralised metacarbonate of the Guelb Moghrein deposit underlines the necessity for further mineralogical research to enhance our understanding of fibrous minerals and how we assess their potential hazards to health. Full article

Although asbestos use has been banned in many countries, including South Korea, the long latency period of asbestos-related diseases remains a serious public health concern. We conducted a nationwide, registry-based retrospective study to estimate the latency period of asbestosis and identify its determinants. We analyzed exposure history and demographics for 1110 asbestosis cases collected by the Ministry of Environment and the Environmental Health Center for Asbestos in Korea between 2009 and 2021. Mean latency was 45.3 years for asbestosis Grade 1 and 46.3 years for Grade 2. Patients with occupational exposure had shorter latency than those with environmental exposure: 44.4 vs. 46.0 years in Grade 1 (p = 0.010) and 45.0 vs. 47.0 years in Grade 2 (p < 0.001). Within occupations, production-type work showed the shortest latency; within environmental exposure, residence near asbestos-related industries showed the shortest latency, whereas residence near asbestos mines showed the longest. Longer exposure duration (occupational) was associated with shorter latency, and greater residential distance from the source (environmental) with longer latency. Priorities for further investigation include differences by asbestos fiber type and exposure intensity/modality, to inform strengthened occupational health monitoring and targeted surveillance for residents near industrial sources and legacy mines. Full article

Idiopathic pulmonary fibrosis (IPF) is currently defined as a progressive fibrosing interstitial lung disease (ILD) associated with a histopathologic and radiologic pattern of usual interstitial pneumonia (UIP). The relationship between IPF and particles is described, and a pathogenesis for the disease is proposed based on an association with these exposures. In clinical studies and epidemiological investigations, the majority of IPF diagnoses are associated with particle exposures. Cigarette smoking presents the greatest particle challenge in any society, and a relationship with IPF has repeatedly been demonstrated. Environmental exposures to particles other than cigarette smoking, including biomass fuel smoke and ambient air pollution, as well as numerous occupational particle exposures, have also been associated with IPF. The pathogenesis of the disease includes a complexation and sequestration of cell iron at the particle surface, which results in a functional cell deficiency of the requisite metal. In response to the insufficiency of metal in cells, there is the synthesis of biopolymers, including exopolysaccharides (e.g., hyaluronic acid), which accumulate in the extracellular matrix. These biopolymers complex iron and, following depolymerization, facilitate the delivery of the metal intracellularly via receptor-mediated uptake. This process reverses the functional iron deficiency introduced by the particle. Pulmonary fibrosis after particle exposure reflects a response to the modification of a functional intracellular iron deficiency in the lower respiratory tract. The temporal and spatial heterogeneity of IPF results from a dose–response with retained particles and reversibility of the fibrosis. Full article

Inhalation of multi-walled carbon nanotubes (MWCNTs) poses potential health risks due to their structural similarity to asbestos and their ability to induce chronic lung inflammation, fibrosis, and lung cancer in animal models. This study investigated the pulmonary inflammatory and transcriptomic responses of two distinct MWCNTs—NM-401 (long, rigid) and NM-403 (short, thin)—in rats and mice using intratracheal instillation at matched dose levels at two post-exposure time points. Both MWCNTs induced acute neutrophilic inflammation and dose-dependent transcriptomic alterations in both species, with NM-403 eliciting a stronger response. Transcriptomic profiling revealed a substantial overlap in differentially expressed genes across materials and species, particularly at the early time point. Fibrosis-associated genes were upregulated in both species, with more persistent expression observed in rats. Acute phase response genes, including Orosomucoid 1 and Lipocalin 2 were commonly induced, while Serum Amyloid A3 and Orosomucoid 2 were selectively upregulated in mice. Functional enrichment analyses showed conserved activation of immune and inflammatory pathways. Our findings show that even short, non-fiber-like MWCNTs can provoke potent and persistent pulmonary effects, challenging assumptions based solely on MWCNT properties. Despite differences in long-term responses, the overall inflammatory and transcriptional profiles showed strong interspecies concordance, suggesting that both rats and mice are relevant models for assessing MWCNT-induced pulmonary toxicity. Full article

This study investigates the presence of naturally occurring asbestos (NOA) in the Bajgora region of Mitrovica, Republic of Kosovo. Rock samples were collected and analyzed using X-ray powder diffraction (XRPD) and scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy (SEM/EDX). The analyses confirmed the presence of the chrysotile mineral, which is part of the asbestos mineral family, while the minerals of the serpentine group, lizardite and antigorite, were identified. Also, in the last sample, in the flyschite sandstone formations, quartz was identified. XRPD enabled the identification of mineral phases, while SEM/EDX provided detailed morphological and chemical characterization, essential for confirming asbestos structures. The detection of asbestos near residential areas raises serious public health concerns, as airborne fibers may be inhaled during routine daily activities. Exposure to these fibers is linked to severe diseases, including asbestosis and mesothelioma. These findings highlight the need for continued monitoring and comprehensive assessment of asbestos contamination in the Bajgora region. The findings point to the need for continuous monitoring and comprehensive assessment of the Bajgora region for asbestos contamination. Furthermore, the ecological risks to human health resulting from the dispersion of asbestos mineral fibers in the soil, where their presence may be found in surface waters and in the air, these fibers represent a significant environmental risk that requires urgent attention by establishing a monitoring system for the benefit of public health. Full article

This paper presents the potential use of calcined cement–asbestos waste as an additive in cement mortars. Due to its harmful asbestos content, cement–asbestos waste poses a significant environmental challenge. One method of disposal is high-temperature calcination, which degrades the structure of asbestos fibers and removes their carcinogenic properties. After appropriate thermal treatment, this material can be used as a mineral additive in cement mixtures. This study analyzed the physical and chemical properties of the calcined waste and its impact on the basic strength parameters of cement mortars. The results indicate that, with appropriate dosing, calcined cement–asbestos waste can serve as a useful additive or filler without significantly impairing—and in some cases even improving—the mechanical properties of the mortars. The developed solution aligns with the principles of the circular economy, enabling the safe and effective management of hazardous waste. Full article

Asbestos-related diseases (ARDs), including malignant mesothelioma, asbestos-related lung cancer, and asbestosis, are known for their long latency periods and poor prognoses. Although the physical effects of ARDs have been widely studied, limited research has examined the psychological burden faced by affected individuals. This study investigated depressive and anxiety symptoms among 275 patients officially recognized as asbestos victims in Korea. Mental health was assessed using the Korean version of the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and the Hospital Anxiety and Depression Scale (HADS). The analysis revealed that the mean ± standard deviation of depression and anxiety levels among patients with asbestos-related diseases were 8.06 ± 6.27 for PHQ-9, 6.02 ± 5.64 for GAD-7, 7.09 ± 5.44 for HADS-A, and 8.41 ± 5.47 for HADS-D. Patients with asbestosis had higher levels of depressive and anxiety symptoms than those with malignant mesothelioma or lung cancer, with symptom severity increasing alongside asbestosis grade. When compared with national data from the 2020–2021 Korea National Health and Nutrition Examination Survey (KNHANES), PHQ-9 and GAD-7 scores among ARD patients, particularly those with Grade 1 asbestosis, were higher than the scores reported for all major cancer types. These findings highlight the substantial psychological distress experienced by individuals with ARDs and emphasize the urgent need for targeted mental health interventions in this population. Full article

Background: BAP1 mutation carriers are predisposed to the development of mesothelioma. In mice, there is limited data and controversy about whether germline Bap1 heterozygous mutations alone cause mesothelioma. However, a marked increase in mesothelioma incidence is observed in Bap1-mutant mice upon even minimal asbestos exposures. Methods: To address this issue, we investigated spontaneous mesothelioma development over the lifetime of a large cohort of Bap1-mutant and wild-type (WT) mice across several genetic backgrounds. To determine if the incidence of mesotheliomas in Bap1-mutant mice is significantly increased compared to WT mice, we performed statistical analyses using frequentist and Bayesian frameworks. In the Bayesian framework, to model the probability of disease occurrence, a non-informative prior was used for Bap1-mutant mice, whereas an informative prior for the WT group was derived from historical data spanning the animals’ lifetimes. Multiple strategies were employed to incorporate historical data and infer the informative prior, including a meta-analysis, assuming a consistent probability of mesothelioma across historical datasets, and applying Bayesian meta-analytic predictive priors derived from historical data. Posterior distribution was used, and a comparison was made using odds ratio, risk difference, and risk ratio. Results: Spontaneous mesotheliomas were detected in 2/329 Bap1-mutant and 0/227 WT mice from various genetic backgrounds. Using four statistical approaches, the results did not detect a significant difference in the probabilities of mesothelioma occurrence between Bap1-mutant and WT mice.  Conclusions: Based on these analyses, we cannot conclude that germline Bap1-mutant mice have a significantly increased risk of mesothelioma in the absence of asbestos exposure. Full article

Among the existing challenges in the field of hyperspectral imaging, the need to optimize memory usage and computational capacity in material detection methods stands out, given the vast amount of data associated with the hundreds of reflectance bands. In line with this, this article proposes a comparative study on the effectiveness and efficiency of five computational methods for detecting composite material asbestos cement (AC) in hyperspectral images: correlation, spectral differential similarity (SDS), Fourier phase similarity (FPS), area under the curve (AUC), and decision trees (DT). The novelty lies in the comparison between the first four methods, which represent the spectral proximity method and a machine learning method, such as DT. Furthermore, SDS and FPS are novel methods proposed in the present document. Given the accuracy that detection methods based on supervised learning have demonstrated in material identification, the results obtained from the DT model were compared with the percentage of AC detected in a hyperspectral image of the Manga neighborhood in the city of Cartagena by the other four methods. Similarly, in terms of computational efficiency, a 20 × 20 pixel region with 380 bands was selected for the execution of multiple repetitions of each of the five computational methods considered, in order to obtain the average processing time of each method and the relative efficiency of the methods with respect to the method with the best effectiveness. The decision tree (DT) model achieved the highest classification accuracy at 99.4%, identifying 11.44% of asbestos cement (AC) pixels in the reference image. However, the correlation method, while detecting a lower percentage of AC pixels (9.72%), showed the most accurate visual performance and had no spectral overlap, with a 1.4% separation between AC and non-AC pixels. The SDS method was the most computationally efficient, running 23.85 times faster than the DT model. The proposed methods and results can be applied to other hyperspectral imaging tasks involving material identification in urban environments, especially when balancing accuracy and computational efficiency is essential. Full article

(1) Background: Occupational exposure to asbestos remains a significant public health concern due to its association with pleural cancer and other cancers. This cohort study examines the incidence of asbestos-related diseases among railway carriage maintenance workers exposed to asbestos between 1960 and 1979 in Bologna, Italy. (2) Methods: A cohort of 2197 male workers was followed from 1960 onwards, with data collected on asbestos exposure, smoking habits, and mortality outcomes. The association of asbestos exposure and smoking with the risk of pleural cancer and lung cancer was assessed using Cox proportional hazards regression models. (3) Results: This study identified a substantial burden of asbestos-related pleural cancer, with an exponential increase in risk over time since the beginning of exposure. Our results suggest the lack of a multiplicative effect of asbestos exposure and smoking on lung cancer risk. The Cox models showed a significant association between smoking and lung cancer risk, with a hazard ratio of 3.26 (95% CI: 1.10–9.64, p = 0.03), less significant for asbestos exposure, with a hazard ratio of 1.42 (95% CI: 0.66–3.06). (4) Conclusions: This study provides valuable insights into the long-term health effects of occupational asbestos exposure and underscores the complex interaction between asbestos exposure and smoking in the development of lung cancer. Full article

We report the first case of pleural mesothelioma (PM) occurring in a child affected by NF2-related schwannomatosis (NF2-SWN) and without any history of environmental exposure to asbestos. Mesothelioma is a rare secondary tumor in brain cancer patients and the association with NF2-SWN has been described only in a few anecdotal cases and never in the pediatric field. NF2-SWN is an autosomal dominant disease caused by inactivating germline mutations of the NF2 tumor suppressor gene, one of the most common mutations associated with human primary mesothelioma too. By MLPA assay, array-CGH analysis, and NGS on blood and tumor DNA, we determined the mutation profile of this rare NF2-driven PM and we identified several atypical chromosomal aberrations in tumor cells, suggesting a different genomic signature between pediatric and adult mesothelioma. Full article