Small-scale or artisanal mining, using gold-mercury amalgamation to extract gold from ore, is a significant source of exposure for the workers and nearby populations. Few studies on hair mercury (Hg) have been conducted in Africa despite the fact that Africa has several gold deposits. No studies have been conducted in Eritrea that is one of the emerging gold producing countries in Africa. The aim of the study was to assess the Hg concentration in hair samples (n = 120) of a population living in Asmara, capital of Eritrea, and to evaluate the influence of some factors on the Hg levels in hair. Information on age, height, weight, occupation, smoking and fish consumption of participants were collected via questionnaire. Hair Hg concentration was significantly higher among women compared to men (p < 0.001) and among women preparing spicy products in Medeber market compared to those who did other jobs (p = 0.010). These results highlight the need for routine biomonitoring surveys and for health promotion campaigns devoted to local decision makers and workers.

Background: Long COVID is defined as persistency of symptoms, such as exertional dyspnea, twelve weeks after recovery from SARS-CoV-2 infection. Objectives: To investigate ventilatory efficiency by the use of cardiopulmonary exercise testing (CPET) in patients with exertional dyspnea despite normal basal spirometry after 18 (T₁₈) and 36 months (T₃₆) from COVID-19 pneumonia. Methods: One hundred patients with moderate-critical COVID-19 were prospectively enrolled in our Long COVID program. Medical history, physical examination and lung high-resolution computed tomography (HRCT) were obtained at hospitalization (T₀), 3 (T₃) and 15 months (T₁₅). All HRCTs were revised using a semi-quantitative CT severity score (CSS). Pulmonary function tests were obtained at T₃ and T₁₅. CPET was performed in a subset of patients with residual dyspnea (mMRC ≥ 1), at T₁₈ and at T₃₆. Results: Remarkably, at CPET, ventilatory efficiency was reduced both at T₁₈ (V’_E/V’CO₂ slope = 31.4±3.9 SD) and T₃₆ (V’_E/V’CO₂ slope = 31.28±3.70 SD). Furthermore, we identified positive correlations between V’_E/V’CO₂ slope at T₁₈ and T₃₆ and both percentage of involvement and CSS at HRCT at T₀, T₃ and T₁₅. Also, negative linear correlations were found between V’_E/V’CO₂ slope at T₁₈ and T₃₆ and DL_CO at T₃ and T₁₅. Conclusions: At eighteen months from COVID-19 pneumonia, 20 % of subjects still complains of exertional dyspnea. At CPET this may be explained by persistently reduced ventilatory efficiency, possibly related to the degree of lung parenchymal involvement in the acute phase of infection, likely reflecting a damage in the pulmonary circulation.

Background: Contrast-enhanced ultrasound (CEUS) recently emerged as a valuable imaging modality for evaluating pleuropulmonary diseases. By combining morphological information from conventional B-mode ultrasound with real-time assessment of microvascular perfusion, CEUS can provide functional insights that improve diagnostic accuracy, guide interventions, and support patient surveillance. Methods: This review summarizes the current evidence on the use of CEUS in major pleuropulmonary disorders, including pneumonia, pleural effusion, pulmonary embolism, neoplasms, and COVID-19-related lung injury. The most relevant clinical studies and meta-analyses were analyzed, focusing on CEUS parameters, diagnostic performance, and integration with other imaging techniques. Results: CEUS enables the differentiation between inflammatory, ischemic, and malignant lesions through qualitative and quantitative analyses of enhancement patterns. Early and homogeneous enhancement is typical of inflammatory or infectious processes, whereas heterogeneous or delayed enhancement with early washout strongly suggests malignancy or ischemia. In pneumonia and pleural infections, CEUS identifies non-perfused or necrotic areas, guiding drainage and evaluating therapeutic responses. In pulmonary embolism, it reveals avascular consolidations corresponding to infarction, even when CT angiography is inconclusive. For peripheral lung tumors, CEUS assesses angiogenesis and vascular supply, correlating perfusion parameters with histopathology, and improving biopsy targeting. Furthermore, in COVID-19 pneumonia, CEUS can detect microvascular alterations related to thrombosis and fibrosis. Conclusions: CEUS is a safe, noninvasive, and radiation-free technique that provides unique real-time information on pulmonary perfusion. Its integration with conventional ultrasound enhances diagnostic precision, optimizes interventional guidance, and allows for dynamic monitoring of treatment response. Future developments in quantitative analysis, artificial intelligence, and targeted contrast agents are expected to further expand CEUS clinical applications in pleuropulmonary imaging.

Introduction and case report: Angiosarcomas, rare soft tissue malignancies originating from endothelial cells, represent only 1–2% of all soft tissue sarcomas. Primary pleural angiosarcoma (PPA) is exceptionally rare, with only 43 reported cases since 1943. There are many diagnostic and therapeutic challenges due to the rarity of these tumors. We present the case of a 72-year-old man presenting with back pain, dyspnea and anemia. Conventional imaging revealed bilateral pleural effusion and a thickened parietal pleura, while contrast chest MR was able to identify pleural sites of contrast enhancement. Left chest tube placement evidenced a hemothorax, and the cytology result was negative. A thoracoscopic approach was chosen, allowing us to perform different parietal pleural biopsies. Radiological and pathological features led to the diagnosis of epithelioid PPA. Despite pleural drainage and blood transfusions, the patient died only 4 days after diagnosis. Objectives: To present a literature review, evaluating the disease epidemiology and the clinical, diagnostic and therapeutic features of PPA. Methods: We reviewed cases of PPA in the literature (1954–2024) by searching the PubMed database for the terms “pleural angiosarcoma” and “pleura + angiosarcoma”. Results: We found a total of 47 cases that were described between 1987 and 2024 with sufficient data to be included in our review. PPA was found to be a challenging diagnosis, found mostly in older Caucasian males. The cytology is mostly indeterminant, and an endoscopic approach is usually needed. Radical surgery is the most common treatment option, and chemotherapy and radiation therapy are also often used. However, the prognosis is poor. Conclusions: PPA is very rare, and complex cases such as this one showcase the importance of innovative approaches like MRI and emphasize the significance of multidisciplinary collaboration for optimal patient management. Bilateral spontaneous hemothorax, as seen in this case, is uncommon and poses additional challenges in disease management. Further research to advance the diagnostic capabilities and treatment efficacy is needed.

Malignant pleural disease is a clinical condition of growing health importance, often presenting as pleural thickening and/or malignant pleural effusion. Rapid and accurate diagnosis is crucial to guide treatment decisions. In most cases, pleural biopsy is necessary: thoracoscopy, ultrasound‐ and CT‐guided biopsies all offer high accuracy and good safety. The use of ultrasound has revolutionised procedural approaches, increasing safety thanks to its good sensitivity and very high specificity, allowing direct and immediate visualisation of complications such as pneumothorax or haemorrhage. In this case report, we describe how intrapleural adrenaline instillation successfully controlled pleural haemorrhage, which was identified as a complication of ultrasound‐guided pleural biopsy thanks to real‐time ultrasound and colour Doppler monitoring of the procedure. Adrenaline was administered under ultrasound guidance directly into the vascular structure presumed to be the source of the bleeding. This technique can be considered an effective and minimally invasive approach for managing bleeding complications of ultrasound‐guided pleural biopsy, even though larger studies are needed to validate efficacy and safety of this approach.