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Concept: Talc

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Multiple studies of ovarian cancer and genital talc use have led only to consensus about possible carcinogenicity. Seeking greater clarity, we examined this association in 2041 cases with epithelial ovarian cancer and 2100 age-and-residence-matched controls.

Concepts: Metastasis, Hereditary nonpolyposis colorectal cancer, Oncology, Talc, BRCA2, Epidemiology, Case-control study, Ovarian cancer

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Genital powder use has been associated with risk of epithelial ovarian cancer in some, but not all, epidemiologic investigations, possibly reflecting the carcinogenic effects of talc particles found in most of these products. Whether risk increases with number of genital-powder applications and for all histologic types of ovarian cancer also remains uncertain. Therefore, we estimated the association between self-reported genital powder use and epithelial ovarian cancer risk in eight population-based case-control studies. Individual data from each study was collected and harmonized. Lifetime number of genital-powder applications was estimated from duration and frequency of use. Pooled odds ratios were calculated using conditional logistic regression matched on study and age and adjusted for potential confounders. Subtype-specific risks were estimated according to tumor behavior and histology. 8,525 cases and 9,859 controls were included in the analyses. Genital powder use was associated with a modest increased risk of epithelial ovarian cancer (odds ratio 1.24, 95% confidence interval 1.15-1.33) relative to women who never used powder. Risk was elevated for invasive serous (1.20, 1.09-1.32), endometrioid (1.22, 1.04-1.43), and clear cell (1.24, 1.01-1.52) tumors, and for borderline serous tumors (1.46, 1.24-1.72). Among genital powder users, we observed no significant trend (p=0.17) in risk with increasing number of lifetime applications (assessed in quartiles). We noted no increase in risk among women who only reported non-genital powder use. In summary, genital powder use is a modifiable exposure associated with small-to-moderate increases in risk of most histologic subtypes of epithelial ovarian cancer.

Concepts: Statistical terminology, Oncology, Ovarian cancer, Odds ratio, Talc, Logit, Epidemiology, Cancer

16

Douching was recently reported to be associated with elevated levels of urinary metabolites of endocrine disrupting phthalates, but there is no literature on douching in relation to ovarian cancer. Numerous case-control studies of genital talc use have reported an increased risk of ovarian cancer, but prospective cohort studies have not uniformly confirmed this association. Behavioral correlation between talc use and douching could produce confounding.

Concepts: Talc, BRCA2, Ovarian cancer, Confounding, Case-control study, Study design, Epidemiology, Experimental design

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The Von Damm Vent Field (VDVF) is located on the flanks of the Mid-Cayman Spreading Centre, 13 km west of the axial rift, within a gabbro and peridotite basement. Unlike any other active vent field, hydrothermal precipitates at the VDVF comprise 85-90% by volume of the magnesium silicate mineral, talc. Hydrothermal fluids vent from a 3-m high, 1-m diameter chimney and other orifices at up to 215 °C with low metal concentrations, intermediate pH (5.8) and high concentrations (667 mmol kg(-1)) of chloride relative to seawater. Here we show that the VDVF vent fluid is generated by interaction of seawater with a mafic and ultramafic basement which precipitates talc on mixing with seawater. The heat flux at the VDVF is measured at 487±101 MW, comparable to the most powerful magma-driven hydrothermal systems known, and may represent a significant mode of off-axis oceanic crustal cooling not previously recognized or accounted for in global models.

Concepts: Silicate minerals, Asbestos, Olivine, Talc, Chlorite group, Hydrothermal vent, Magnesium, Mineral

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Background: Cosmetic talcum powder products have been used for decades. The inhalation of talc may cause lung fibrosis in the form of granulomatose nodules called talcosis. Exposure to talc has also been suggested as a causative factor in the development of ovarian carcinomas, gynecological tumors, and mesothelioma. Purpose: To investigate one historic brand of cosmetic talcum powder associated with mesothelioma in women. Methods: Transmission electron microscope (TEM) formvar-coated grids were prepared with concentrations of one brand of talcum powder directly, on filters, from air collections on filters in glovebox and simulated bathroom exposures and human fiber burden analyses. The grids were analyzed on an analytic TEM using energy-dispersive spectrometer (EDS) and selected-area electron diffraction (SAED) to determine asbestos fiber number and type. Results: This brand of talcum powder contained asbestos and the application of talcum powder released inhalable asbestos fibers. Lung and lymph node tissues removed at autopsy revealed pleural mesothelioma. Digestions of the tissues were found to contain anthophyllite and tremolite asbestos. Discussion: Through many applications of this particular brand of talcum powder, the deceased inhaled asbestos fibers, which then accumulated in her lungs and likely caused or contributed to her mesothelioma as well as other women with the same scenario.

Concepts: Ovarian cancer, Lung cancer, Transmission electron microscopy, Electron, Fibers, Talc, Cancer, Asbestos

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Malignant pleural mesothelioma incidence continues to rise, with few available evidence-based therapeutic options. Results of previous non-randomised studies suggested that video-assisted thoracoscopic partial pleurectomy (VAT-PP) might improve symptom control and survival. We aimed to compare efficacy in terms of overall survival, and cost, of VAT-PP and talc pleurodesis in patients with malignant pleural mesothelioma.

Concepts: Pleural cavity, Control, Medical terms, Talc, Mesothelioma, Pleurodesis, Randomized controlled trial

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This study’s objective is to assess the risk of asbestos-related disease being contracted by past users of cosmetic talcum powder.  To our knowledge, no risk assessment studies using exposure data from historical exposures or chamber simulations have been published. We conducted activity-based sampling with cosmetic talcum powder samples from five opened and previously used containers that are believed to have been first manufactured and sold in the 1960s and 1970s.  These samples had been subject to conflicting claims of asbestos content; samples with the highest claimed asbestos content were tested.  The tests were conducted in simulated-bathroom controlled chambers with volunteers who were talc users.  Air sampling filters were prepared by direct preparation techniques and analyzed by phase contrast microscopy (PCM), transmission electron microscopy (TEM) with energy-dispersive x-ray (EDX) spectra, and selective area diffraction (SAED).  TEM analysis for asbestos resulted in no confirmed asbestos fibers and only a single fiber classified as “ambiguous."  Hypothetical treatment of this fiber as if it were asbestos yields a risk of 9.6 × 10(-7) (under one in one million) for a lifetime user of this cosmetic talcum powder.  The exposure levels associated with these results range from zero to levels far below those identified in the epidemiology literature as posing a risk for asbestos-related disease, and substantially below published historical environmental background levels.  The approaches used for this study have potential application to exposure evaluations of other talc or asbestos-containing materials and consumer products.

Concepts: Microscopy, Phase-contrast imaging, Electron, Transmission electron microscopy, Evaluation, Microscope, Asbestos, Talc

1

Malignant pleural effusion causes disabling dyspnea in patients with a short life expectancy. Palliation is achieved by fluid drainage, but the most effective first-line method has not been determined.

Concepts: Clinical trial, Efficacy, Effectiveness, Talc, Randomized controlled trial, Pneumothorax, Pleurodesis, Pleural effusion

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The goal of dipping the umbilical cord after birth in calves is to promote healing of the umbilical stump, prevent infection, and encourage the umbilical tissue to detach from the body. Treatment applied to the umbilical area is an important management step for preventing morbidity and mortality in calves. The objective of this study was to compare the effect of 4 umbilical dips on the healing rate, incidence of infection, and age at umbilical cord detachment using newborn Holstein heifer calves (n = 73). Calves were alternately assigned by birth order to 4 treatment groups: 7% iodine, a dry dip formulated using an antibacterial peptide (nisin) mixed with talc (3.105 g of nisin per 100 g of talcum powder on a weight per weight basis), liquid nisin (64 µg/mL), and 4% chlorhexidine mixed with alcohol in a 50:50 solution. Umbilical cords were dipped 30 min after birth. Before initial dipping, umbilical cord diameter (as an indicator of the rate of cord drying and healing rate) was determined using a digital caliper. The caliper measurements were repeated at 24 ± 1, 48 ± 1, and 72 ± 1 h (±standard deviation) of age and were continued daily until the umbilical cord healed and detached from the animal’s body. Diagnosed umbilical infections were documented by veterinary staff based on a combination of clinical symptoms (redness, swelling, purulent discharge, painful response (flinch or kicking) to palpation of the umbilical stump) in addition to a lack of appetite and fever. Data were analyzed using MIXED model procedures with fixed effect of umbilical treatment. No treatment differences were noted between dips on the umbilical cord drying rate or days for umbilical cord to detach. Treatment effects were observed on incidence of umbilical infection (incidence of infection for calves across all treatments was 9.0%).

Concepts: Dual in-line package, DIP, Fetus, Infection, Talc, Navel, Antiseptic, Umbilical cord

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Widespread use of talc pleurodesis remains controversial for many providers concerned by adverse events such as respiratory failure, which are sometimes fatal. Particle talc size has been implicated in these adverse effects, mainly on the basis of animal studies utilizing large amounts of talc or in observational studies performed on different continents with different talc preparations and doses. Our aim was to determine the particle size and distribution of only the commercially available US-talc preparations and whether the fluid content can affect this distribution.

Concepts: Pulmonology, At-large, U.S. state, North America, Pleurodesis, Talc, United States