Gram Of Creatinine Research Articles

Hepatorenal syndrome: Updates.

Hepatorenal syndrome: Updates.

The association between dietary micronutrient patterns and odds of diabetic nephropathy: A case-control study.

Uncontrolled diabetes can lead to diabetic nephropathy (DN). The aim of the study was to investigate the relationship between different dietary micronutrient patterns and risk of DN in women. This was a case-control study. One hundred and five patients had DN (defined as urinary mg of albumin per gram of creatinine ≥30 mg/g) were chosen as the case and 105 women without DN were chosen as control. Dietary intakes were assessed by a semi-quantitative food frequency questionnaire. Principal component analysis with varimax rotation was used to derive the micronutrient patterns. Patterns were divided into two groups of lower and higher than median. Logistic regression was used to discern and find the odds ratio (ORs) of DN, and its 95% confidence interval (CI) based on the micronutrient patterns in crude and adjusted model. Three patterns which were included, (1) mineral patterns such as chromium, manganese, biotin, vitamin B6, phosphorus, magnesium, selenium, copper, zinc, potassium, and iron, (2) water-soluble vitamin patterns such as vitamin B5, B2, folate, B1, B3, B12, sodium and C, and (3) fat-soluble vitamin patterns such as calcium, vitamin K, beta carotene, alpha tocopherol, alpha carotene, vitamin E, and vitamin A, were extracted. An inverse relationship was found between risk of DN and following mineral patterns and fat-soluble vitamin patterns in adjusted model (ORs=0.51 [95% CI 0.28-0.95], p=.03) and (ORs=0.53 [95% CI 0.29-0.98], p=.04), respectively. No relationship was seen between water-soluble vitamin patterns and risk of DN in crude and adjusted model but the significance was decreased in adjusted model. The risk of DN was 47% decreased after high adherence of fat-soluble vitamin patterns. In addition, we saw a 49% decrease of risk of DN in high adherence group of mineral patterns. The findings confirm that renal-protective dietary patterns can reduce risk of DN.

Smoking effect on the cadmium and zinc concentration in smokers and nonsmokers

Studies have shown that cigarette smoking affects the accumulation of some heavy metals in certain tissues and metabolism of essential elements. The aim of the study was to determine the differences in the concentrations of cadmium in the blood and urine and zinc in the urine of smokers and ex-smokers in relation to non-smokers, and to determine the possible influence of cadmium concentration on zinc excretion as an essential element. The study included 106 subjects. Subjects were regular smokers (n=51), ex-smokers (n=38) and non-smokers (n=17). Atomic absorption spectrophotometry (AAS) with an electrothermal atomizer was used to determine cadmium. Zinc was determined by AAS with a flame atomizer. There was a significant difference in the values of cadmium in the blood between the groups: smokers and non-smokers (p<0.001), smokers and ex-smokers (p <0.001), and between ex-smokers and non-smokers (p = 0.045). There is a significant positive and strong correlation in the level of zinc and cadmium in urine per gram of creatinine, and as the level of cadmium increases, the level of zinc also increases (rho=0.781; p=0.001). The data indicate that cigarette smoking has been shown to be a factor that can increase cadmium levels to an extent that will significantly increase zinc excretion, or its increased loss.

Estimating urine volume from the urine creatinine concentration.

Spot determinations of the urine creatinine concentration are widely used as a substitute for 24-h urine collections. Expressed as the amount excreted per gram of creatinine, urine concentrations in a single-voided sample are often used to estimate 24-h excretion rates of protein, sodium, potassium, calcium, magnesium, urea and uric acid. These estimates are predicated on the assumption that daily creatinine excretion equals 1 g (and that a urine creatinine concentration of 100mg/dL reflects a 1 L 24-h urine volume). Such estimates are invalid if the serum creatinine concentration is rising or falling. In addition, because creatinine excretion is determined by muscle mass, the assumption that 24-h urine creatinine excretion equals 1 g yields a misleading estimate at the extremes of age and body size. In this review, we evaluate seven equations for the accuracy of their estimates of urine volume based on urine creatinine concentrations in actual and idealized patients. None of the equations works well in patients who are morbidly obese or in patients with markedly decreased muscle mass. In other patients, estimates based on a reformulation of the Cockroft-Gault equation are reasonably accurate. A recent study based on this relationship found a high strength of correlation between estimated and measured urine output with chronic kidney disease (CKD) studied in the African American Study of Kidney Disease (AASK) trial and for the patients studied in the CKD Optimal Management with Binders and NictomidE (COMBINE) trial. However, the equation systematically underestimated urine output in the AASK trial. Hence, an intercept was added to account for the bias in the estimated output. A more rigorous equation derived from an ambulatory Swiss population, which includes body mass index and models the non-linear accelerated decline in creatinine excretion with age, could potentially be more accurate in overweight and elderly patients. In addition to extremes of body weight and muscle mass, decreased dietary intake or reduced hepatic synthesis of creatine, a precursor of creatinine or ingestion of creatine supplements will also result in inaccurate estimates. These limitations must be appreciated to rationally use predictive equations to estimate urine volume. If the baseline urine creatinine concentration is determined in a sample of known volume, subsequent urine creatinine concentrations will reveal actual urine output as well as the change in urine output. Given the constraints of the various estimating equations, a single baseline timed collection may be a more useful strategy for monitoring urine volume than entering anthropomorphic data into a calculator.

Sustainable health-based soil standards for arsenic using epidemiological data and toxicokinetic/probabilistic modelling.

This study presents an alternative method to the traditional reference dose approach for the determination of health risk-based soil standards for arsenic. The model combines multimedia equations for air, soil and dietary exposure, a toxicokinetic component, a probabilistic output, a reference distribution for urine arsenic in the general population and exposure parameters values traceable in US-EPA or EFSA reference studies. The model calculates a mean inorganic As urine concentration AsU (sum of inorganic arsenic Asi and its metabolites) from environmental data and exposure parameters, which is attributed to the central value of a lognormal distribution. Risk is assessed by comparing a high percentile of the modelled distribution to the target AsU attributed to the reference value of 10µg/gCREA (microgram As per gram of creatinine), the upper confidence interval of the 95th percentile from the AsU distribution in the French population. A soil standard value of 40mg/kg is determined as being the arsenic concentration in soil not giving rise to more than 5% probability of having a AsU concentration above the target value of 10µg/gCREA. Once soil As concentrations above 40mg/kg are measured, further environmental investigations should be carried, involving an assessment of As bioaccessibility to address health risks and decide of regulatory measures in residential setting.

Podocyturia in Fabry disease: a 10-year follow-up.

BackgroundFabry disease (FD) is a rare X-linked disorder of sphingolipid metabolism that results in chronic proteinuric nephropathy. Podocytes are one of the most affected renal cells and play an important role in the development and progression of kidney disease. Detached podocytes found in urine (podocyturia) are considered as a non-invasive early marker of kidney injury; however, the dynamics of podocyte loss remains unknown.MethodsIn this 10-year follow-up study, podocyturia and other renal clinical data were evaluated in 39 patients with FD. From 2009 to 2019, podocyturia was assessed in 566 fresh urine samples from 13 male and 26 female FD patients using immunocytochemical detection of podocalyxin.ResultsPodocyturia (number of podocytes per 100 mL of urine) was found in 311/566 (54.9%) of the samples, more frequently (68.9 ± 21.9% versus 50.6 ± 25.9%; P = 0.035) and with higher values (364 ± 286 versus 182 ± 180 number of podocytes per gram of creatinine (Cr) in urine; P = 0.020) in males compared with females. The mean number of assessed samples for each patient was 14.5 (range 3–40) and the frequency of samples with podocyturia ranged from 0% to 100% (median 57%). Podocyturia was already present in 42.9% of patients <20 years of age and in 89.5% of normoalbuminuric patients. Podocyturia correlated with albuminuria (urine albumin:Cr ratio) (r = 0.20, P < 0.001) and a higher incidence and values of podocyturia were observed in patients with lower estimated glomerular filtration rate.ConclusionsOur data demonstrated that podocyturia is an early clinical event in the development of nephropathy. In addition, we found podocyturia to be a discontinuous event with wide variability.

Combining and converting groups when extracting data for meta-analysis

It is important that as much evidence as possible is included in the pooled analyses of systematic reviews. Therefore, systematic reviewers may want to analyse outcomes that are not completely...

Relationship between microalbuminuria and metabolic parameters in a normotensive population with obesity

Aim: Today, the second-most common cause of preventable death after smoking is obesity. Microalbuminuria is defined as an albumin to creatinine ratio (ACR) of more than 30 mg per gram of creatinine. Obesity increases microalbuminuria by affecting the kidneys.Methods: This study was carried out by retrospectively examining the files of obese [Body mass index (BMI) ≥30 kg/m2)] individuals between the ages of 18 and 65 with spot microalbuminuria test in urine who admitted to the obesity outpatient clinic of a tertiary hospital between January 2013 and June 2015. Four hundred ninety subjects were included in the study. The physical parameters, blood and urine tests of the subjects included in the study at the time of first admission to the obesity clinic were examined.Results: Microalbuminuria was positive in 5.7 % of the participants. The glycated hemoglobin (HbA1c) and uric acid levels for subjects in the microalbuminuria-positive group were higher than in the levels of subjects in the microalbuminuria-negative group [5.6 (5.8-5.5) vs 5.5 (5.7-5.2); P=0.012 and 5.2 (6-4.5) vs 4.7 (5.5-4.2); P=0.038, respectively]. In microalbuminuria-negative group, 25-hydroxyvitamin D3 (25-OH D3) levels were higher than in the microalbuminuria-positive group [12 (18-7.1) vs 8.4 (12.9-6.9); P=0.032]. Urine albumin to creatinine ratio was positively associated with BMI, fasting insulin (FI), Homeostatic model assessment for insulin resistance (HOMA-IR), triglycerides (TG) and c-reactive protein (CRP).Conclusion: Obesity increases microalbuminuria by affecting the kidneys. Microalbuminuria is associated with insulin resistance, dyslipidemia and low 25-OH D3. Microalbuminuria must be checked in obese individuals. The prevalence of obesity should be reduced for a healthier life.

Erythrocyte and reticulocyte parameters during biological monitoring of lead exposure to the body

Introduction. The most susceptible to lead is the hematopoietic system of hematopoietic organs due to lead inhibition of heme and globin synthesis and cytotoxic effect on the membrane of Mature red blood cells. The aim of study was to evaluate the informative value of the study of erythrocyte and reticulocyte parameters determined on modern hematological analyzers in patients working in contact with lead during medical and biological monitoring. Materials and methods. 45 employees of the lead battery processing plant and 30 persons of control group were examined. The level of lead in the blood was determined by atomic absorption spectrometry, δ-ALA in the urine-by the reaction of pyrol formation with acetylacetone in terms of gram of creatinine, the study of hematological parameters was performed on a Sysmex HT-2000i analyzer. Statistical processing of the results was performed using the program STATISTICA 10.0. Results. Significant changes in erythrocytic (RDW) and reticulocytic (RET, IRF, LFR, MFR, HFR, RET-He) parameters, erythropoietin in workers in contact with lead compared to the control group, changes in MCV, MCH, RDW, RET indicators in the group working in dynamics after 2 years were revealed. Associations of hematological parameters with biomarkers of exposure and effect (lead level in blood and ALA in urine) were revealed. Conclusions. Assessment of erythrocyte (MCV, MCH, RDW) and reticulocyte parameters (RET% and their distribution by maturity) in dynamics during periodic medical examinations of workers in contact with lead allows us to detect the development of hematological disorders at early stages.

Searching for a better formulation to enhance muscle bioenergetics: A randomized controlled trial of creatine nitrate plus creatinine vs. creatine nitrate vs. creatine monohydrate in healthy men.

A novel creatine blend (creatine nitrate mixed with creatinine, CN‐CRN) has been anecdotally suggested to be superior to traditional creatine formulations for bioavailability and performance. However, does CN‐CRN supremely affects creatine levels in the blood and skeletal muscle of healthy humans remain currently unknown. This randomized, controlled, double‐blind, crossover trial evaluated the acute effects of single‐dose CN‐CRN on serum creatine levels, and 5‐days intervention with CN‐CRN on skeletal muscle creatine and safety biomarkers in healthy men. Ten healthy young men (23.6 ± 2.9 years) were allocated to receive either CN‐CRN (3 grams of creatine nitrate mixed with 3 grams of creatinine), pure creatine nitrate (3 grams, CN), or regular creatine monohydrate (3 grams, CRM) by oral administration. We found that CN‐CRN resulted in a more powerful rise in serum creatine levels comparing to either CN or CRM after a single‐dose intervention, as evaluated with the area under the concentration–time curve calculation (701.1 ± 62.1 (µmol/L) × min versus 622.7 ± 62.9 (µmol/L) × min versus 466.3 ± 47.9 (µmol/L) × min; p < .001). The peak serum creatine levels at 60‐min sampling interval were significantly higher in CN‐CRN group (183.7 ± 15.5 µmol/L), as compared to CN group (163.8 ± 12.9 µmol/L) and CRM group (118.6 ± 12.9 µmol/L) (p < .001). This was accompanied by a significantly superior increase in muscle creatine levels after CN‐CRN administration at 5‐days follow‐up, as compared to CN and CRM, respectively (9.6% versus 8.0% versus 2.1%; p = .01). While 2 out of 10 participants were found to be nonresponsive to CN intervention (20.0%) (e.g., no amplification in muscle creatine levels found at 5‐days follow‐up), and 3 participants out of 10 were nonresponsive in CRM trial (30%), no nonresponders were found after CN‐CRN administration, with individual upswing in total muscle creatine varied in this group from 2.0% (lowest increment) to 16.8% (highest increment). Supplemental CN‐CRN significantly decreased estimated glomerular filtration rate (eGFR) at 5‐days follow‐up, as compared to other interventions (p = .004), with the average reduction was 14.8 ± 7.7% (95% confidence interval; from 9.3 to 20.3). Nevertheless, no single participant experienced a clinically relevant reduction in eGFR (< 60 ml/min/1.73 m2) throughout the course of the trial. Liver enzymes remained in reference ranges throughout the study, with no participant experienced high liver blood tests (e.g., AST > 40 units per L or ALT >56 units per L). Besides, no participant reported any major side effects during the trial, while the odors of CN‐CRN and CN formulations were considered somewhat unpleasant in 8 out of 10 participants (80.0%). Our results suggest that CN‐CRN is a preferred and relatively safe alternative to traditional creatine formulations for improved creatine bioavailability in the blood and skeletal muscle after single‐dose and 5‐days interventions.

Determination of medication cutoff values in a pain patient population

Clinical laboratories are required to establish reference intervals for all the analytes tested, and these are provided along with the test results. In contrast, laboratories testing for pain medications use cutoffs established by the manufacturers of immunoassay reagents. These cutoffs may be inappropriate for monitoring patients being treated for chronic pain with opioid therapy because the cutoffs are set too high. To use quantitative urine drug excretion data determined by liquid chromatography-tandem mass spectrometry analysis to calculate cutoffs needed to best determine patient compliance with prescribed medications. Two methods of calculation were used to estimate cutoffs. First, all positive results for each drug or drug metabolite were ranked from highest to lowest. The lowest value was one-half of the lower limit of quantitation. A nonparametric 2.5 percent estimator was used to establish each cutoff Second, positive results were normalized using creatinine values, resulting in the excretion being expressed as nanograms of excreted drug per gram of creatinine. A nonparametric 2.5 percent estimator was used to establish the cutoff. Cutoffs established using these calculations included at least 97.5 percent of the data for the drugs: 7-aminoclonazepam, alpha-hydroxalprazolam, buprenorphine, carisoprodol, hydrocodone, hydromorphone, meperidine, meprobamate, methadone, morphine, oxycodone, oxymorphone, propoxyphene, and tramadol gave cutoffs near the lower limit of quantitation. One exception was with the drug codeine, where the lower limit could not be identified. These cutoffs were significantly lower than those suggested by many immunoassay manufacturers and better identify patient compliance in a representative population of pain patients. The limitation of the study is that only values one-half of our lowest calibrator were used. By using population values, laboratories can establish appropriate cutoffs for best monitoring pain patient medication compliance.

Exposure to organophosphate flame retardant chemicals in the U.S. general population: Data from the 2013–2014 National Health and Nutrition Examination Survey

BackgroundUse of organophosphate flame retardants (OPFRs) including tris(1,3-dichloro-2-propyl) phosphate, triphenyl phosphate, tris(1-chloro-2-propyl) phosphate, and tris-2-chloroethyl phosphate, in consumer products is on the rise because of the recent phase out of polybrominated diphenyl ether (PBDE) flame retardants. Some of these chemicals are also used as plasticizers or lubricants in many consumer products. ObjectivesTo assess human exposure to these chlorinated and non-chlorinated organophosphates, and non-PBDE brominated chemicals in a representative sample of the U.S. general population 6years and older from the 2013–2014 National Health and Nutrition Examination Survey (NHANES). MethodsWe used solid-phase extraction coupled to isotope dilution high-performance liquid chromatography-tandem mass spectrometry after enzymatic hydrolysis of conjugates to analyze 2666 NHANES urine samples for nine biomarkers: diphenyl phosphate (DPHP), bis(1,3-dichloro-2-propyl) phosphate (BDCIPP), bis-(1-chloro-2-propyl) phosphate (BCIPP), bis-2-chloroethyl phosphate (BCEP), di-n-butyl phosphate (DNBP), di-p-cresylphosphate (DpCP), di-o-cresylphosphate (DoCP), dibenzyl phosphate (DBzP), and 2,3,4,5-tetrabromobenzoic acid (TBBA). We calculated the geometric mean (GM) and distribution percentiles for the urinary concentrations (both in micrograms per liter [μg/L] and in micrograms per gram of creatinine). We only calculated GMs for analytes with an overall weighted frequency of detection >60%. For those analytes, we also a) determined weighted Pearson correlations among the log10-transformed concentrations, and b) used regression models to evaluate associations of various demographic parameters with urinary concentrations of these biomarkers. ResultsWe detected BDCIPP and DPHP in approximately 92% of study participants, BCEP in 89%, DNBP in 81%, and BCIPP in 61%. By contrast, we detected the other biomarkers much less frequently: DpCP (13%), DoCP (0.1%), TBBA (5%), and did not detect DBzP in any of the participants. Concentration ranges were highest for DPHP (<0.16–193μg/L), BDCIPP (<0.11–169μg/L), and BCEP (<0.08–110μg/L). Regardless of race/ethnicity, 6–11year old children had significantly higher BCEP adjusted GMs than other age groups. Females had significantly higher DPHP and BDCIPP adjusted GM than males, and were more likely than males to have DPHP concentrations above the 95th percentile (odds ratio=3.61; 95% confidence interval, 2.01–6.48). ConclusionsOur results confirm findings from previous studies suggesting human exposure to OPFRs, and demonstrate, for the first time, widespread exposure to several OPFRs among a representative sample of the U.S. general population 6years of age and older. The observed differences in concentrations of certain OPFRs biomarkers by race/ethnicity, in children compared to other age groups, and in females compared to males may reflect differences in lifestyle and exposure patterns. These NHANES data can be used to stablish a nationally representative baseline of exposures to OPFRs and when combined with future 2-year survey data, to evaluate exposure trends.

The Health Effects of Aluminum Exposure.

Aluminum is regularly taken up with the daily diet. It is also used in antiperspirants, as an adjuvant for vaccination, and in desensitization procedures. In this review, we present the scientifically documented harmful effects of aluminum on health and the threshold values associated with them. This review is based on publications retrieved by a selective search of the PubMed and SCOPUS databases on the topic of aluminum in connection with neurotoxicity, Alzheimer's disease, and breast cancer, as well as on the authors' personal experience in occupational and environmental medicine. The reference values for the internal aluminum load (<15 μg/L in urine, <5 μg/L in serum) are especially likely to be exceeded in persons with occupational exposure. The biological tolerance value for occupational exposure is 50 μg of aluminum per gram of creatinine in the urine. For aluminum welders and workers in the aluminum industry, declining performance in neuropsychological tests (attention, learning, memory) has been found only with aluminum concentrations exceeding 100 μg/g creatinine in the urine; manifest encephalopathy with dementia was not found. Elevated aluminum content has been found in the brains of persons with Alzheimer's disease. It remains unclear whether this is a cause or an effect of the disease. There is conflicting evidence on carcinogenicity. The contention that the use of aluminum-containing antiperspirants promotes breast cancer is not supported by consistent scientific data. The internal aluminum load is measured in terms of the concentration of aluminum in urine and blood. Keeping these concentrations below the tolerance values prevents the development of manifest and subclinical signs of aluminum toxicity. Large-scale epidemiologic studies of the relationship between aluminum-containing antiperspirants and the risk of breast cancer would be desirable.

O45 Validation study of a food frequency questionnaire for the measurement of food consumption in polyphenols: Use of a urinary biomarker. Preliminary results

The purpose of our study was to assess the validity of the food frequency questionnaire (FFQ) used in the NESCaV study (Nutrition, Environment and Cardiovascular Health) for the measurement of food polyphenols intake. 53 volunteer adults, aged between 20 and 60, were included in the Stroxybio study*. The nutritional intake of total polyphenols estimated from the FFQ was compared with the results obtained from a 3-day dietary recording (EA) as well as the total polyphenol urine concentrations determined by the Folin–Ciocalteu method. The polyphenol feed composition was estimated using the Phenol-Explorer database. The median intakes of polyphenols estimated from FFQ and EA were 2270.92 mg per day and 1203.63 mg per day, respectively. The results show that there is a strong association between the results of the two dietary questionnaires, FFQ and EA ( r = 0.633, P r = 0.30, P = 0.0319). The median urinary concentrations of polyphenols was 10678.57 μg of gallic acid equivalent per gram of creatinine. In conclusion, this study shows the importance of combining both food survey and nutritional biomarker data to estimate exposure to polyphenols in a given population. Acknowledgements *supported by Region Wallonne grant Cwality 117637.

P 066 - Validation study of a food frequency questionnaire for the measurement of food consumption in polyphenols : use of a urinary bioamarker. Preliminary results

The purpose of our study was to assess the validity of the food frequency questionnaire (FFQ) used in the NESCaV study (Nutrition, Environment and Cardiovascular Health) for the measurement of food polyphenols intake. 53 volunteer adults, aged between 20 and 60, were included in the Stroxybio study*. The nutritional intake of total polyphenols estimated from the FFQ was compared with the results obtained from a 3-day dietary recording (EA) as well as the total polyphenol urine concentrations determined by the Folin-Ciocalteu method. The polyphenol feed composition was estimated using the Phenol-Explorer database. The median intakes of polyphenols estimated from FFQ and EA were 2270.92 mg per day and 1203.63 mg per day, respectively. The median urinary concentrations of polyphenols are 10678.57 μg of gallic acid equivalent per gram of creatinine. The results show that there was a strong association between the results of the two dietary questionnaires, FFQ and EA (r=0.633, p In conclusion, this study shows all the interest to combine both food survey and nutritional biomarker data to estimate exposure to polyphenols in a given population.

High Urinary Polycyclic Aromatic Hydrocarbon Concentrations in Bomet County, Kenya, a Region With a High Incidence of Esophageal Squamous Cell Carcinoma

Abstract 43 Background: Polycyclic aromatic hydrocarbons (PAHs) are a group of more than 100 compounds that are formed during incomplete combustion of organic materials, many of which have been classified as known carcinogens. Exposure to PAHs has been suggested as an important risk factor for developing esophageal squamous cell carcinoma (ESCC) in several high-incidence areas, such as China and Iran, but corresponding PAH assessments have not been conducted in East Africa, another ESCC hot spot. To assess the internal uptake of PAH as a result of external exposures, body fluids and tissues can be monitored for PAHs or their metabolites. The primary aim of this study was to quantify the concentration of seven PAH urine metabolites in a cross-section of participants from Bomet, Kenya, an endemic area for ESCC. An additional aim was to assess demographic and lifestyle factors that may be associated with PAH metabolites. Methods: A community-based sample of 294 asymptomatic adults were recruited. Participants collected spot urine specimens and completed a questionnaire. Urine specimens were analyzed at the National Center for Environmental Health at the Centers for Disease Control—the same lab has performed similar analyses on urine samples from the US National Health and Nutrition Examination Survey (NHANES). The seven PAH analytes were hydroxylated metabolites of naphthalene, fluorene, phenanthrene, and pyrene. Median creatinine-adjusted PAH metabolite concentrations (nanogram per gram of creatinine) were compared by all relevant questionnaire items. Results: All seven measured PAH metabolites in the study population were markedly elevated compared with the US population. For example, the median value for 1-hydroxypyrene in Bomet was 1,190 ng/g in males versus 106 ng/g in NHANES, and 2,840 ng/g in females versus 133 ng/g in NHANES. Age (&lt; 50 years), sex (female), and performing indoor cooking were significantly ( P &lt; .01) associated with higher PAH concentrations for all measured metabolites. Regular tobacco use was not reported by many participants (19%) and was not associated with PAH concentrations. Conclusion: PAH metabolite concentrations in Bomet were high compared with the US population. Elevated PAH concentrations were associated with age, sex, and indoor cooking. Additional studies are needed to define the association between high PAH exposure and the risk of developing ESCC as well as to determine the sources of PAH exposure in this high-risk population. Funding: The African Organization for Research and Training in Cancer’s Beginning Investigator Grant for Catalytic Research (BIG Cat) Program, in collaboration with the US National Institutes of Health’s National Cancer Institute, Office of International Affairs. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the authors.

Significance of dermatologic findings in a cohort of depleted uranium-exposed veterans of Iraqi conflicts.

Depleted uranium (DU)-containing weapons have been used in military operations since 1991. There is interest in following veterans who were occupationally exposed to DU by either inhalation or retention of fragments. A cohort of DU-exposed Gulf War I veterans has been followed longitudinally at the Baltimore Veterans Administration Medical Center since 1993. The aim was to monitor chronic dermatological findings associated with occupational DU exposure in the 2013 cohort. Thirty-five veterans were evaluated. This study was reviewed and approved by the institutional review board and the Baltimore Veterans Administration Medical Center research service. Depleted uranium exposure was measured using creatinine-adjusted urine uranium concentrations (micrograms of uranium per gram of creatinine [μgU/gCrea]). Detailed medical histories, physical examinations, and exposure histories were performed. Using a cutoff level of 0.1 μgU/gCrea, 11 veterans were placed in the high-uranium exposure group, whereas 23 veterans were placed in the low-uranium exposure group. Retained fragments were documented in 91% of the high-exposure group versus that in 13% of the low-exposure group (P < 0.001), and fragment-related scarring was significantly increased in the high-exposure group (P = 0.002). Other dermatological findings such as dermatitis were also assessed. Fragment retainment and related scarring was significantly increased in veterans exposed to high levels of DU. Continuous monitoring of this cohort will yield interesting dermatological findings related to DU exposure.

Microalbuminuria as a Predictor of Pregnancy Induced Hypertension

Aims: This study was done to find out predictive value of microalbuminuria between 24-34 weeks of gestation in the development of pregnancy-induced hypertension, maternal and fetal complications. Methods: Urinary microalbuminuria was measured by turbidometry in 200 normo-tensive women between 24-34 weeks of gestation. Microalbuminuria was defined as a value of ≥ 20 mg albumin per gram of creatinine in a spot sample of urine. The women were divided into two groups as microalbuminuria positive and microalbuminuria negative. They were followed up to delivery and were evaluated for the development of pregnancy-induced hypertension, maternal and fetal complications. Results: Out of 200 women microalbuminuria was positive in 32 (16%) patients. Sixteen (50%) in the microalbuminuria group developed hypertension as compared to seven (4.1%) in the microalbuminuria negative group (p&lt;0.0001). Also 13 (40%) in the microalbuminuria positive group developed a maternal complication as compared to 11 (6.5%) in the microalbuminuria negative group (p&lt;0.0001). Nineteen women (59%) in the microalbuminuria group had a fetal complication as compared to 10 women (5.9%) in the microalbuminuria negative group (p&lt;0.0001). Conclusions: Presence of urinary microalbuminuria between 24-34 weeks of gestation can predict development of pregnancy-induced hypertension, maternal and fetal complications. DOI: http://dx.doi.org/10.3126/njog.v9i2.11761

Exposure assessment approach through mycotoxin/creatinine ratio evaluation in urine by GC–MS/MS

In this pilot survey human urine samples were analyzed for presence of 15 mycotoxins and some of their metabolites using a novel urinary multi-mycotoxin GC–MS/MS method following salting-out liquid–liquid extraction. Fifty-four urine samples from children and adults residents in Valencia were analyzed for presence of urinary mycotoxin and expressed in gram of creatinine. Three out of 15 mycotoxins were detected namely, HT-2 toxin, nivalenol and deoxynivalenol (DON). 37 samples showed quantifiable values of mycotoxins. Co-occurrence of these contaminants was also observed in 20.4% of assayed samples. DON was the most frequently detected mycotoxin (68.5%) with mean levels of 23.3μg/g creatinine (range: 2.8–69.1μg/g creatinine). The levels of urinary DON were used to carry out an exposure assessment approach. 8.1% of total subjects were estimated to exceed the DON provisional maximum tolerable daily intake (PMTDI) (1μg/kgb.w.). Two out of 9 exposed children exceeded the DON PMTDI thus, making them the most exposed based on the urinary results.

Effects of Freeze-Thaw Cycle on Urine Values from Bottlenose Dolphins (Tursiops truncatus)

Urinalysis is a valuable tool for assessing the renal health of marine mammals. While retrospective and population renal health studies often use frozen urine samples, it has not been determined if the freeze-thaw process alters urine values from bottlenose dolphins (Tursiops truncatus). The primary objective of our study was to compare the values of 38 fresh and frozen paired urine samples collected from 20 bottlenose dolphins at the U.S. Navy Marine Mammal Program. Paired t-tests and chi-squared tests were conducted to assess the effects of storage at -80° C for 2 to 301 d, and a subsequent thaw on urine specific gravity; pH; creatinine; protein:creatinine ratio; quantitative protein; uric acid; uric acid:creatinine ratio; and categorical characterizations of color, clarity, glucose, ketones, occult blood, protein levels, and crystals. The freeze-thaw cycle decreased urinary pH and increased urinary uric acid (p = 0.04 and 0.02, respectively). There were no other significant changes in urine variable values, including urinary uric acid concentration by grams of creatinine, when comparing fresh and frozen-thawed urine samples. Urinary uric acid concentration by grams of creatinine is the most accurate uric acid measurement when frozen-thawed samples are used. Urinary pH should be measured in fresh samples to avoid falsely decreased pH.