Blood Levels Of Cr Research Articles

Long-Term Outcome of Small Head Metal-On-Metal Total Hip Arthroplasty: A 15-to-22 Year Follow-Up

BackgroundThe Metasul articular interface was a second-generation metal-on-metal (MoM) total hip arthroplasty (THA) that was introduced as a promising interface with improved manufacturing technology, better clearances, and enhanced metal hardness. In December 2001, the manufacturer recalled these implants due to the failure of cup osseointegration. MethodsBetween 1997 and 2004, 168 consecutive primary Metasul THAs were performed in 144 patients. Most patients received a cementless femoral and porous-coated acetabular component with 28 mm head. A competing risk analysis was performed for determination separately for bearing surface-related, recalled bearing failure, and end point revision for any reason. For clinical patient evaluation, we used Harris hip score and University of California at Los Angeles scores. Cobalt and chromium ion level measurement and standard radiographic assessment was performed. ResultsOf the 168 THAs, 19 hips were revised at a mean period of 15 years as follows: 12 of them were due to recalled acetabular component, five hips had noninterface-related complication, and two true interface surface failure. The survival distribution function of all hips with revision for any reason was 88.4%, for bearing interface relation 98.8%, and 92.6% for recalled cups. The mean Harris hip score and University of California at Los Angeles scores were 85 and 6, respectively, and the median Co and Cr blood levels were 1.0 and 0.91 μg/L. ConclusionExcluding the recalled components, Metasul articular interface has performed extremely well at a minimum follow-up of 15 years in this relatively young population. There were two interface-related revisions in the entire cohort.

Karakteristik limbah dan dampaknya bagi kesehatan pembatik di Lendah, Kulon Progo

Synthetic batik coloring often uses heavy metals element such as lead (Pb), chromium (Cr),silica (Si), and hydrochloric acid (HCl). The exposure of heavy metals in long period results in health impair on the artisans and eventually harming the environment. The purpose of this research is to analyze the waste characteristics and health impact towards the artisans in the Lendah, Kulon Progo. Seventy-six batik artisan, consisting of 37 from SB, 20 from FA, and 19 from SA underwent 5 ml blood sampling. The samples were used to determine their hemoglobin (Hb) level, packed cell volume (PCV), blood sugar, and total cholesterol. Blood plasma and wastewater were examined for Pb and Cr using the inductively coupled plasma (ICP) method; Si using atomic absorption spectrophotometry (AAS); and Cl- using spectrophotometry. Respondents underwent health checks and were interviewed about the impact of waste and disease complaints experienced using a questionnaire. Cognitive disorders were examined using mini-mental state examination (MMSE) and peripheral neuropathy was assessed using diabetic neuropathy symptom (DNS) score. The results obtained were analyzed by analysis of variance and t-test. Correlation test was used to examine the relationship of Pb and Cr with cognitive disorders. Total cholesterol levels and blood sugar were analyzed descriptively. There is no difference in knowledge about waste in batik makers in SB, FA, and SA. The level of Pb, Cr, and Cl- within the three production centers showed no significant difference (p > 0,05), whilst Si level showed significant difference between centers (p < 0,05). There is no correlation between Pb and Cr blood levels with cognitive impairing according to MMSE and occurence of peripheral neuropathy according to DNS score (p > 0.05). Normal cholesterol levels (< 200mg/dL) andnormal blood glucose levels (< 200 mg/dL) were observed in 70.0-80.5% and 85.0-95.1% batik artisans, respectively. Si levels in all three production centers’ waste shows significant difference. The most frequent complaint was back pain and dizziness. There is no correlation caused by Pb and Cr levels toward cognitive impairing. Cholesterol level in batik artisans tended to be high.

Body burdens of heavy metals associated with epigenetic damage in children living in the vicinity of a municipal waste incinerator

To evaluate the body burdens of heavy metals correlated with health impact on school-age children living around a waste incinerator. A total of 81 children from the exposure area and 95 from the control area were recruited in our study. We measured the blood levels of chromium (Cr), cadmium (Cd) and lead (Pb) by an inductively coupled plasma mass spectrometer (ICP-MS), conducted comet assays, calculated the percentage of 5-methylcytosine (5 mC) and 5-hydroxymethylcytosine (5hmC) by MethylFlash methylated and a hydroxymethylated DNA quantification kit, and performed the flow cytometry to detect the expressions of surface antigens (including CD3+, CD19+, CD3+CD4+, CD3+CD8+, and CD3−CD16+ and/or CD56+) in peripheral lymphocytes. Besides, we measured hormonal levels, including triiodothyronine (T3), thyroxine (T4), free triiodothyronine (FT3), free thyroxine (FT4), and thyroid-stimulating hormone (TSH), and analyzed several regular hematological parameters. In addition, concentrations of heavy metals in environmental samples including rice, soils, vegetables, and drinking water were detected by ICP-MS. The mean blood levels of Cr, Cd, and Pb in the exposure group were all statistically higher than in the control group (2.57 vs. 0.79 μg/L; 1.83 vs. 1.81 μg/L; 44.00 vs. 32.31 μg/L, p < 0.01). The 5 mC and 5hmC levels in the exposure group were statistically lower (1.15% vs. 4.14%; 0.22% vs. 0.30%, p < 0.01), whereas the mean level of % tail DNA was statistically higher (10.10% vs. 8.62%, p < 0.01). Furthermore, the mean blood level of Cr and Pb was negatively correlated with the level of 5 mC (r = −0.279, r = −0.190, P < 0.05) in total population. In conclusion, children living in the vicinity of the municipal waste incinerator suffered increased body burdens of heavy metals (Cr, Cd, and Pb) associated with genotoxicity and epigenetic modifications.

Seasonal variation in oxidative stress markers of Murrah buffaloes in heavy metal exposed areas of Ludhiana

The parameters related to oxidative stress and heavy metal levels were assessed during summer and winter seasons in buffaloes from environmentally exposed areas (n=60) of Ludhiana district of Punjab (India) and control area (n=40). Buffaloes of heavy metal exposed areas exhibited significantly (p less than 0.05) increased blood levels of Cr, Ni, As and Pb along with significantly (p less than 0.05) higher erythrocytic malondialdehyde (MDA) levels; whereas significant (p less than 0.05) decrease was observed in superoxide dismutase activity and the levels of reduced glutathione (GSH), vitamins C and E as compared to buffaloes from control area. The level of oxidative stress was higher in all buffaloes during summer as compared to winter as indicated by significantly (p less than 0.05) higher MDA level, and lower concentrations of GSH, vitamins C and E irrespective of the area. Blood Cr, Ni, As and Pb levels showed highly significant positive correlation (p less than 0.01) with MDA level but negative correlation with SOD activity and the concentrations of GSH, vitamins C and E. Thus, it may be concluded that buffaloes exposed to heavy metals encounter significant oxidative stress and potential to quench free radicals is compromised during summer.

Exposure assessment of particulate matter and blood chromium levels in people living near a cement plant.

This study evaluates the effect of air pollution caused by cement plants on nearby residential areas and performs an exposure assessment of particulate matter (PM) and total Cr, Cr6+, Pb, and Al. Further, the blood Cr levels of residents exposed to PM released by cement plants are also assessed. Nine buildings (eight residential and one elementary school building) close to cement plants were selected for this study, which were located in Pyeongtaek port, in west of Gyeonggi Province, South Korea. A total of 51 suspended particulate samples were collected at a flow rate of 2.0L/min. Total Cr was more widely detected in residents' houses and elementary schools. PM levels were higher at distances of 4.1 and 4.8km than those at closer distances of 2.7km. This was due to the influence of wind direction. The estimated mean blood level of Cr for the study participants was 3.80μg/L, which is higher than levels estimated by other studies on Cr blood levels. Therefore, cement plants could cause an increase in total Cr and blood Cr levels in residential areas, and more continuous monitoring is necessary to better understand their impacts.

N-Acetyl-Cysteine as Effective and Safe Chelating Agent in Metal-on-Metal Hip-Implanted Patients: Two Cases.

Systemic toxicity associated with cobalt (Co) and chromium (Cr) containing metal hip alloy may result in neuropathy, cardiomyopathy, and hypothyroidism. However clinical management concerning chelating therapy is still debated in literature. Here are described two metal-on-metal hip-implanted patients in which N-acetyl-cysteine decreased elevated blood metal levels. A 67-year-old male who underwent Co/Cr hip implant in September 2009 referred to our Poison Control Centre for persisting elevated Co/Cr blood levels (from March 2012 to November 2014). After receiving oral high-dose N-acetyl-cysteine, Co/Cr blood concentrations dropped by 86% and 87% of the prechelation levels, respectively, and persisted at these latter concentrations during the following 6 months of follow-up. An 81-year-old female who underwent Co/Cr hip implant in January 2007 referred to our Centre for detection of high Co and Cr blood levels in June 2012. No hip revision was indicated. After a therapy with oral high-dose N-acetyl-cysteine Co/Cr blood concentrations decreased of 45% and 24% of the prechelation levels. Chelating agents reported in hip-implanted patients (EDTA, DMPS, and BAL) are described in few cases. N-acetyl-cysteine may provide chelating sites for metals and in our cases reduced Co and Cr blood levels and resulted well tolerable.

Association between blood arsenic levels and nasal polyposis disease risk in the Tunisian population.

Although the pathophysiology underlying nasal polyposis (NP) formation is not fully understood, systemic, local, and environmental factors appear to contribute to NP disease development. This study aimed to explore the relationship between metal blood levels and NP risk. To the best of our knowledge, the current research represents the first scientific contribution reporting levels of Cr and As in blood of NP patients. In this context, 90 NP patients and 171 controls were recruited and blood samples were analyzed to determine the concentrations of As and Cr. Metal blood levels of As in patients (2.1μg/L) were significantly higher than those of controls (1.2μg/L). However, no significant difference in blood Cr levels was found between cases and controls. Arsenic blood levels of cigarette smokers were significantly higher than those of non-smokers. Environmental exposure and shisha consumption presented the most significant association with NP disease (OR = 10.1 and 14.1, respectively). High levels of blood As were significantly associated with NP disease (OR = 2.1). Cr blood levels were found to be associated with the four stages of polyps in both nasal cavities. This study found a strong association between nasal polyposis disease and As blood levels. These findings merit further investigation.

Cognitive deficits and ALA-D-inhibition in children exposed to multiple metals

Children are especially vulnerable to adverse effects of multiple metals exposure. The aim of this study was to assess some metals concentrations such as lead (Pb), arsenic (As), chromium (Cr), manganese (Mn) and iron (Fe) in whole blood, serum, hair and drinking water samples using inductively coupled plasma-mass spectrometry (ICP-MS) in rural and urban children. In addition, evaluate the adverse effects of multiple metals exposure on cognitive function and δ-aminolevulinate dehydratase (ALA-D) activity. The cognitive ability assessment was performed by the Raven's Colored Progressive Matrices (RCPM) test. The ALA-D activity and ALA-D reactivation index (ALA-RE) activity with DTT and ZnCl2 also were determined. Forty-six rural children and 23 urban children were enrolled in this study. Rural children showed percentile IQ scores in the RCPM test significantly decreased in relation to urban children. According to multiple linear regression analysis, the Mn and Fe in hair may account for the cognitive deficits of children. Manganese and Fe in hair also were positively correlated with Mn and Fe in drinking water, respectively. These results suggest that drinking water is possibly a source of metals exposure in children. ALA-D activity was decreased and ALA-RE with DTT and ZnCl2 was increased in rural children in comparison to urban children. Moreover, ALA-D inhibition was correlated with Cr blood levels and ALA-RE/DDT and ALA-RE/ZnCl2 were correlated with levels of Cr and Hg in blood. Thus, our results indicated some adverse effects of children's exposure to multiple metals, such as cognitive deficits and ALA-D inhibition, mainly associated to Mn, Fe, Cr and Hg.

Blood nickel and chromium levels in association with smoking and occupational exposure among head and neck cancer patients in Tunisia

Chronic exposure to chromium (Cr) and nickel (Ni) has long been recognized as being capable to increase head and neck cancer (HNC) incidence among exposed human populations. This study represents the first biomonitoring of Cr and Ni exposure in Tunisia and focuses on a possible association with HNC risk. The aim of the present study was to evaluate the concentrations of Cr and Ni in the blood of HNC patients and controls. Metals blood levels of 169 HNC patients and 351 controls were determined using a Perkin-Elmer Analyst 800 Atomic Absorption Spectrometer. Mean blood levels of Cr and Ni in HNC cases (52.15 and 111.60 μg/L, respectively) were significantly higher than those of controls (37.04 and 30.50 μg/L, respectively). Cases' blood levels of Cr and Ni were significantly higher than those of controls after controlling for the other risk factors of HNC, including smoking, shisha consumption, occupational exposure, and nearby environment (P<0.05). Among these risk factors, smoking and occupational exposure presented the most significant association with HNC (odds ratio (OR)=6.54 and 7.66, respectively, P<0.001). Cr and Ni levels in blood sample of cases and controls that are smoker/occupationally exposed were higher than that of non-smoker/non-occupationally exposed (P<0.05). Smokers who are occupationally exposed present the most significant association with HNC (OR=25.08, P<0.0001). High levels of blood Cr (OR=2.09) and high levels of blood Ni (OR=8.87) were strongly associated with HNC after other potential confounders were controlled (P=0.004 and P<0.0001, respectively). This study suggested a potential role of Cr and Ni in the mechanism of HNC development.

Clinical application of on-line hemodiafiltration in the treatment of chronic renal failure

Objective To explore the clinical efficacy and safety of on-line hemodiafiltration (online-HDF) in treatment of chronic renal failure.Methods 82 patients with chronic renal failure who had been treated in our hospital were randomly assigned to HD group (38 patients) and HDF/HD group (44 patients).HD group underwent conventional hemodialysis,while HDF/HD group received hemodialysis twice and then hemodiafiltration.The changes in blood levels of Cr,BUN,and phosphorus and the complications were compared between the two groups after treatment.Results There were no statistical differences in levels of Cr and BUN in HDF/HD group after treatment; whereas serum phosphorus level differed significantly between HDF/HD group and HD group (P＜0.05).The incidence rate of complications was lower in HDF/HD group than in HD group.Conclusions On-line hemodiafiltration is safe and convenient and has remarkable efficacy in the treatment of chronic renal failure. Key words: Chronic renal failure; On-line hemodiafiltration; Hemodialysis

Continuous veno-venous hemodiafiltration on acute kidney injury in children

Objective To investigate the effect and outcome of critically illness with acute kidney injury (AKI) treated with continuous veno-venous hemodiafiltration (CVVHDF) in children.Methods Twenty-four cases of critically illness with AKI were treated with CVVHDF in our pediatric intensive care unit from Jan 2008 to Dec 2010.The levels of creatinine (Cr),blood urea nitrogen (BUN),K +,Na + and HCO3- were observed before CVVHDF and 6,12,24,48,72 h after CVVHDF.Results Catheter was successfully established for CVVHDF in 24 cases of AKI.The average duration of CVVHDF was 46 h ( 16 ～142 h).The blood levels of Cr and BUN were significantly decreased at 6 h after CVVHDF [ ( 196.3 ±112.4) μmol/L,( 13.3 ± 8.5 ) mmol/L] and 12 h after CVVHDF [ ( 106.1 ± 84.2) μ mol/L,( 10.2 ± 9.7 )mmol/L] as compared to those before treatment [ (340.6 ±298.2) μmol/L,(31.6 ± 11.3) mmol/L] (P ＜0.05,P ＜ 0.01 ).After 48 h of CVVHDF,the Cr,BUN returned to normal range.The imbalance of blood K +,Na +,and HCO3- improved at 6 h after CVVHDF and returned to nomal levels at 24 h.Total 28 d fatality rate was 29.2％ (7/24),and all death cases were complicated with multiple organ dysfunction syndrome.Conclusion CVVHDF therapy for AKI can quickly clear Cr,BUN and excess water,correct electrolyte disorders,improve kidney function in children. Key words: Continuous veno-venous hemodiafiltration; Acute kidney injury; Multiple organ dysfunction syndrome; Children

Chelation in metal intoxication XVI: Influence of chelating agents on chromate poisoned rats

The ability of selective polyaminocarboxylic acids and common drugs to reduce the body burden of chromium and restore Cr induced biochemical alterations in chromate intoxicated rats was investigated. 1,2 Cyclohexylene dinitrilotetraacetic acid (CDTA) and triethylenetetramine hexacetic acid (TTHA) were more effective than p-aminosalicylic acid (PAS) and isoniazid (INH) in enhancing urinary excretion of Cr, lowering hepatic and blood levels of Cr and restoring inhibited activity of hepatic aldolase. The chromate antidotal property of chelators seem to be related to the combination of nitrogen and oxygen as the electron donating centres.