Higher Urinary Concentrations Research Articles

Daily intake of bisphenol A and triclosan and their association with anthropometric data, thyroid hormones and weight loss in overweight and obese individuals

Bisphenol A (BPA) and triclosan (TCS) were determined in urine of Belgian overweight and obese (n=151) and lean (n=43) individuals. After the first urine collection (0M), obese patients started a diet program or have undergone bariatric surgery. Hereafter, three additional urine samples from obese patients were collected after 3 (3M), 6 (6M) and 12 (12M) months. Both compounds were detected in >99% of the samples. BPA had median concentrations of 1.7 and 1.2ng/mL in obese and lean groups, respectively, while TCS had median concentrations of 1.5 and 0.9ng/mL in the obese and lean groups, respectively. The obese group had higher urinary concentrations (ng/mL) of BPA (p<0.5), while no significant differences were found for TCS between the obese and lean groups. No time trends between the different collection moments were observed. The BPA concentrations in the obese group were negatively associated with age, while no gender difference or relationship with body mass index was observed. For TCS, no relationships with gender, BMI, or age were found. The temporal variability of BPA and TCS was assessed with calculation of the intraclass correlation coefficient, Spearman rank correlation coefficients, and surrogate category analysis. We observed evidence that single spot urine samples might be predictive of exposure over a longer period of time. Dietary intakes of BPA and TCS did not differ significantly among the time points considered after obese individuals started losing weight (6 and 12months). Multiple linear regression analyses after adjusting for age and weight loss revealed negative associations between urinary TCS and serum FT4 in the 0M and 3M female obese individuals and positive associations between urinary BPA and serum TSH in the lean group.

Acute Inhaled Xylene Poisoning Confirmed by Methylhippuric Acid Urine Test

Xylene is a commonly used toxic volatile organic solvent. Diagnosis of acute xylene poisoning is limited by the lack of a readily available analytic assay. Methylhippuric acid, a metabolite of xylene excreted in the urine, is used for biomonitoring occupational exposures to xylene. We report two cases of acute occupational poisoning from xylene inhalation suggested by determination of high urinary methylhippuric acid. Two 21 and 23 years old healthy male adults collapsed after inhaling an unknown paint thinner during painting. On admission to the emergency department, they were confused and agitated, without hemodynamic or respiratory impairment. Admission urinary methylhippuric acid determined by HPLC with UV detector were 2.57 and 2.68 g/g creatinine (Biologic Exposure Index, BEI, 1.5 g/g creatinine). Urinary hippuric acid was below the previously used BEI for toluene. Mild increases in alanine aminotransferase (80 U/L) and aspartate aminotransferase (71 U/L) were found 12 hours after exposure, returning to normal after 24 hours. The patients gradually regained full consciousness within 24 hours and discharged after 48 hours' observation without any sequelae. High urinary methylhippuric acid concentrations suggested the diagnosis of acute xylene poisoning following its inhalation. Diagnosis in previous reports of acute xylene poisonings relied on history and clinical manifestations. Urinary methylhippuric acid assay is specific and available in special laboratories. It is suggested to determine urinary methylhippuric acid together with metabolites of other widely available organic solvents (e.g., hippuric acid, trichloroacetic acid) whenever unintentional exposure or abuse of volatile organic compounds is suspected.

Dehydration, hemodynamics and fluid volume optimization after induction of general anesthesia

OBJECTIVES:Fluid volume optimization guided by stroke volume measurements reduces complications of colorectal and high-risk surgeries. We studied whether dehydration or a strong hemodynamic response to general anesthesia increases the probability of fluid responsiveness before surgery begins.METHODS:Cardiac output, stroke volume, central venous pressure and arterial pressures were measured in 111 patients before general anesthesia (baseline), after induction and stepwise after three bolus infusions of 3 ml/kg of 6% hydroxyethyl starch 130/0.4 (n = 86) or Ringer's lactate (n = 25). A subgroup of 30 patients who received starch were preloaded with 500 ml of Ringer's lactate. Blood volume changes were estimated from the hemoglobin concentration and dehydration was estimated from evidence of renal water conservation in urine samples.RESULTS:Induction of anesthesia decreased the stroke volume to 62% of baseline (mean); administration of fluids restored this value to 84% (starch) and 68% (Ringer's). The optimized stroke volume index was clustered around 35-40 ml/m2/beat. Additional fluid boluses increased the stroke volume by ≥10% (a sign of fluid responsiveness) in patients with dehydration, as suggested by a low cardiac index and central venous pressure at baseline and by high urinary osmolality, creatinine concentration and specific gravity. Preloading and the hemodynamic response to induction did not correlate with fluid responsiveness. The blood volume expanded 2.3 (starch) and 1.8 (Ringer's) times over the infused volume.CONCLUSIONS:Fluid volume optimization did not induce a hyperkinetic state but ameliorated the decrease in stroke volume caused by anesthesia. Dehydration, but not the hemodynamic response to the induction, was correlated with fluid responsiveness.

Aetiology and antibiotic resistance issues regarding urological procedures

There are specific indications in urological procedures [transurethral resection of the prostate (TURP), transurethral resection of the bladder (TURB), endoscopic procedures, and all interventions classified as contaminated or dirty] requiring antibiotic prophylaxis. Most postoperative infections are caused by enterococci of the Gram-positive strains and Enterobacteriaceae of the Gram-negative ones. As reported by the European Center for Disease Prevention and Control (ECDC), there are increasing numbers of antibiotic-resistant pathogens. Most Enterococcus faecium strains are ampicillin-resistant and the Enterobacteriaceae have a high prevalence of extended-spectrum beta-lactamase (ESBL) producers, for which the cephalosporins and penicillins are not drugs of choice. In recent years, there are also increasing numbers of Gram-negative strains that are able to produce carbapenemases and for which the only therapeutic options are gentamicin, tigecycline and colistin. An alternative to these drugs, from a prophylactic point of view, is fosfomycin, an old antibiotic that maintains bactericidal activity against both enterococci and multidrug-resistant Enterobacteriaceae. Available in an oral formulation as trometamol salt, fosfomycin reaches high plasma and urine concentrations, and is therefore a possible alternative to other drugs both for therapy and urological prophylaxis.

Impact on bulk 15N natural isotopic abundance in hair of kidney function in type 2 diabetic nephropathy

summary Background and aims: Nephropathy is a serious long-term complication in type 2 diabetic patients. Few data are available about nitrogen metabolism in diabetic nephropathy. Bulk 15 N natural isotopic abundance (NIA) in hair has been shown modified in different pathologies with altered protein metabolism. We have compared bulk 15 N NIA in hair proteins in type 2 diabetic patients to look for differences between groups with or without nephropathy. Methods: Case patients were type 2 diabetic patients with high urinary albumin concentrations (� 20 mg/L or 30 mg/24 h on two of three urine collections) and/or an estimated glomerular filtration rate (eGFR) below 60 mL min � 1 1.73 m � 2 , according to the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. Control subjects were type 2 diabetic patients of the same geographical origin with long-term diabetes, normo-albuminuria and eGFR above 60 mL min � 1 1.73 m � 2 . The bulk 15 NN IA values for hair were measured by isotope ratio measurement mass spectrometry coupled with an elemental analyzer. Results: Thirty-three patients in the nephropathy group and 31 in the control group were included. The mean age of the participants was 69 ± 8 years, and the mean duration of diabetes was 22 ± 8 years. Bulk hair 15 N NIA were 8.9 ± 0.7‰ in the nephropathy group and 9.0 ± 0.5‰ in the control group (p ¼ 0.41). Positive correlations were found between bulk hair 15 N NIA with eGFR (p < 0.01) and with urinary urea concentration (p < 0.01), and a negative correlation with the urinary albumin-to-creatinine ratio (p < 0.001). Conclusions: Bulk hair

Cardiometabolic Risk Factors Are Associated with High Urinary Enterolactone Concentration, Independent of Urinary Enterodiol Concentration and Dietary Fiber Intake in Adults

The study objective was to evaluate independent and interactive associations of dietary fiber intake and high urinary enterolignans with cardiometabolic risk factors. The analysis included 2260 adults (≥20 y of age) from the 2003–2010 NHANES. Logistic regression models were used to evaluate obesity and clinically defined cardiometabolic risk factors in relation to dietary fiber intake and urinary enterolignan concentrations. Three sets of models were created: 1) independent associations, 2) mutually adjusted associations, and 3) interactions. Models were adjusted for age, gender, race/ethnicity, education, smoking status, and energy intake. High concentrations were considered to be above the 90th percentile of urinary enterolignan concentrations. Increasing dietary fiber intake was associated with high blood pressure (P = 0.02) and low serum HDL cholesterol (P-trend = 0.03). High urinary enterodiol concentration was not associated with obesity or cardiometabolic risk factors. High urinary enterolactone concentration was inversely associated with obesity (OR: 0.44; 95% CI: 0.29, 0.66), abdominal obesity (OR: 0.58; 95% CI: 0.39, 0.87), high serum C-reactive protein (CRP; OR: 0.52; 95% CI: 0.37, 0.74), high serum triglycerides (OR: 0.39; 95% CI: 0.23, 0.61), low serum HDL cholesterol (OR: 0.37; 95% CI: 0.23, 0.61), and metabolic syndrome (OR: 0.47; 95% CI: 0.30, 0.74). In mutually adjusted models, enterolactone associations observed in independent models remained similar, but associations for dietary fiber intake were attenuated, with the exception of blood pressure. In interaction models, there were 2 significant interactions: between high urinary enterodiol concentration and dietary fiber intake for high serum CRP (P = 0.04) and high plasma glucose (P = 0.04). Overall, being in the highest 10% of urinary enterolactone concentration was associated with cardiometabolic risk factors, independent of dietary fiber intake and enterodiol concentration. Future studies are warranted to evaluate physiologic actions of enterolactone or aspects of the gut microbial profile responsible for lignan metabolism to enterolactone.

Urinary bispenol a and breast cancer: nhanes 2005-2010

Bisphenol-A (BPA) is an environmentally ubiquitous estrogen-like endocrine- disrupting compound. Exposure to BPA in utero has been linked to female reproductive disorders, including breast cancer. In rodents, BPA exposure has been shown to cause malformation of the mammary gland leading to carcinoma. We hypothesize that high urinary BPA concentrations would be positively associated with breast cancer.

The human biomonitoring of occupational exposure to phthalates

Phthalates like endocrine disrupting compounds are ubiquitous environmental contaminants. Long term exposure to these chemicals at the work place has adverse effect on human health and usually leads to diseased conditions. The aim of our study was to assess, by biological monitoring, occupational exposure to di-(2-ethylhexyl) phthalate (DEHP), di-n-butyl phthalate (DnBP), diethyl phthalate (DEP) and diisononyl phthalate (DiNP) of occupationally exposed group i.e. workers from plastic manufactory with division of films and composites and injection moulding (n=37; average age 45.6±9.4) in comparison with general population i.e. students and workers from Constantine the Philosopher University in Nitra (n=144; average age 28±13.12) in Nitra region of Slovakia. In response to determine human exposure to phthalates, we used high performance liquid chromatography and tandem mass spectrometry analysis (HPLC-MS/MS) to estimate trace levels of 4 phthalate metabolites mono-(2-ethylhexyl) phthalate (MEHP), monoisononyl phthalate (MiNP), mono-n-butyl phthalate (MnBP) and monoethyl phthalate (MEP) in human urine. Median concentrations of the urinary metabolites in the exposed group were 35.48 µg/l for MEHP, 13.65 µg/l for MiNP, 93.79 µg/l for MEP, 108.62 µg/l for MBP and in general population were 21.62 µg/l for MEHP, 13.26 µg/l for MiNP, 84.36 for µg/l MEP and 88.99 µg/l for MBP. We observed, significantly higher urinary concentration (p≤0.001) of MEHP and on the border of the statistical significance urinary concentration of MiNP (p=0.07) in occupationally exposed group. Despite the fact that phthalates are ubiquitous environmental contaminants, there is evidence of occupational exposure of workers from plastic manufactory by DEHP a DiNP. This study was supported by project VEGA (V1/0042/12). DOI: 10.5901/mjss.2014.v5n19p101

Energy efficient reconcentration of diluted human urine using ion exchange membranes in bioelectrochemical systems

Nutrients can be recovered from source separated human urine; however, nutrient reconcentration (i.e., volume reduction of collected urine) requires energy-intensive treatment processes, making it practically difficult to utilize human urine. In this study, energy-efficient nutrient reconcentration was demonstrated using ion exchange membranes (IEMs) in a microbial electrolysis cell (MEC) where substrate oxidation at the MEC anode provides energy for the separation of nutrient ions (e.g., NH4+, HPO42−). The rate of nutrient separation was magnified with increasing number of IEM pairs and electric voltage application (Eap). Ammonia and phosphate were reconcentrated from diluted human urine by a factor of up to 4.5 and 3.0, respectively (Eap = 1.2 V; 3-IEM pairs). The concentrating factor increased with increasing degrees of volume reduction, but it remained stationary when the volume ratio between the diluate (urine solution that is diluted in the IEM stack) and concentrate (urine solution that is reconcentrated) was 6 or greater. The energy requirement normalized by the mass of nutrient reconcentrated was 6.48 MJ/kg-N (1.80 kWh/kg-N) and 117.6 MJ/kg-P (32.7 kWh/kg-P). In addition to nutrient separation, the examined MEC reactor with three IEM pairs showed 54% removal of COD (chemical oxygen demand) in 47-hr batch operation. The high sulfate concentration in human urine resulted in substantial growth of both of acetate-oxidizing and H2-oxidizing sulfate reducing bacteria, greatly diminishing the energy recovery and Coulombic efficiency. However, the high microbial activity of sulfate reducing bacteria hardly affected the rate of nutrient reconcentration. With the capability to reconcentrate nutrients at a minimal energy consumption and simultaneous COD removal, the examined bioelectrochemical treatment method with an IEM application has a potential for practical nutrient recovery and sustainable treatment of source-separated human urine.

공단지역주민의 요중 비소농도와 혈압과의 관련성에 관한 연구

Objectives: The study examines the relation between urinary arsenic concentration and blood pressure, which is a risk factor of cardiovascular disease. Materials: In this study, the urinary arsenic concentration, history of diagnosed disease, and blood pressure of 782 local residents in Gwangyang, Yeosu, and Hadong regions from May 2007 to July 2007. Results: The urinary arsenic concentration of total participants was <TEX>$9.06{\mu}g/g-ct$</TEX>. The logistic regression analysis of medical diagnosed history and urinary arsenic concentration, showed statistically significance (p<0.05) of high urinary arsenic concentration in participants with diagnosed hypertension. In addition, diagnosed hypertension it was observed that the high blood pressure was related with the pulse pressure. Conclusions: The arsenic concentration level was low in this study, but the exposure to low levels of arsenic has an effect on hypertension. Also, hypertension is related to pulse pressure and mean arterial blood pressure as well as being risk factor of cardiovascular disease. Therefore, close supervision of low -level arsenic exposure is needed.

Chemical communication in tilapia: A comparison of Oreochromis mossambicus with O. niloticus

In allopatric speciation species differentiation generally results from different selective pressures in different environments, and identifying the traits responsible helps to understand the isolation mechanism(s) involved. Male Mozambique tilapia (Oreochromis mossambicus) use urine to signal dominance; furthermore, 5β-pregnane-3α,17,20β-triol-3α-glucuronide (and its α-epimer, 5β-pregnane-3α,17,20α-triol-3α-glucuronide), in their urine is a potent pheromone, the concentration of which is correlated with social status. The Nile tilapia (Oreochromisniloticus) is a close relative; species divergence probably resulted from geographical separation around 6 million years ago. This raises the question of whether the two species use similar urinary chemical cues during reproduction. The olfactory potency of urine, and crude extracts, from either species was assessed by the electro-olfactogram and the presence of the steroid glucuronides in urine from the Nile tilapia by liquid-chromatography/mass-spectrometry. Both species showed similar olfactory sensitivity to urine and respective extracts from either species, and similar sensitivity to the steroid glucuronides. 5β-Pregnan-3α,17α,20β-triol-3α-glucuronide was present at high concentrations (approaching 0.5mM) in urine from Nile tilapia, with 5β-pregnan-3α,17α,20α-triol-3α-glucuronide present at lower concentrations, similar to the Mozambique tilapia. Both species also had similar olfactory sensitivity to estradiol-3-glucuronide, a putative urinary cue from females. Together, these results support the idea that reproductive chemical cues have not been subjected to differing selective pressure. Whether these chemical cues have the same physiological and behavioural roles in O. niloticus as O. mossambicus remains to be investigated.

The balance of cortisol–cortisone interconversion is shifted towards cortisol in neonates with congenital adrenal hyperplasia due to 21-hydroxylase deficiency

BackgroundPatients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency (21OHD) have an impaired cortisol synthesis, but it is unknown whether the metabolism of glucocorticoids differs between neonates and infants with and without 21OHD. ObjectiveThe objective of this study was to compare the glucocorticoid metabolism between neonates and infants with and without 21OHD. MethodsWe analyzed 14 urinary glucocorticoid metabolites, 7 metabolites each of cortisol and cortisone, by gas chromatography–mass spectrometry of 89 untreated 21OHD neonates and infants and 161 neonates and infants without 21OHD. ResultsNeonates with 21OHD exhibit elevated relative amounts of cortisol metabolites in total glucocorticoid metabolism and an increased ratio of cortisol to cortisone metabolites (p<0.0001). This reflects a shift toward cortisol in the relative balance of the interconversion between cortisol and cortisone. The ratio of cortisol to cortisone metabolites correlated significantly with low urinary glucocorticoid concentrations (p<0.03), with low 21-hydroxylase activity (p<0.001) and high urinary sodium and chloride concentrations (p<0.05) in neonates with 21OHD. ConclusionsOur results demonstrate substantial changes in the relative cortisone to cortisol interconversion in neonates with 21OHD. The shift of glucocorticoid metabolism toward active cortisol in neonates with 21OHD seems to be related to the severity of 21OHD and adrenal dysfunction. Our data provide new insights into the regulation of glucocorticoid homeostasis in 21OHD.

Reduced Activity of 11β-Hydroxylase Accounts for Elevated 17α-Hydroxyprogesterone in Preterms

To characterize the urinary steroid metabolome of neonates and infants born either at term or preterm. We retrospectively analyzed urinary steroid hormone metabolites determined by gas chromatography-mass spectrometry of 78 neonates and infants born at term and 83 neonates and infants born preterm (median 34 weeks of gestational age). The subjects' 11β-hydroxylase and 21-hydroxylase activities were assessed on the basis of urinary metabolite substrate-to-product ratios. Preterm neonates and infants had elevated urinary concentrations of 17α-hydroxyprogesterone (17OHP) metabolites (P<.001) but lower urinary concentrations of the 21-deoxycortisol metabolite pregnanetriolone (PTO) (P<.01). One reason was lower 11β-hydroxylase activity in preterms. We could demonstrate a correlation between low 11β-hydroxylase activity and high urinary concentrations of 17OHP metabolites (r=0.51, P<.001) but low urinary concentrations of the 21-deoxycortisol metabolite PTO (r=-0.24, P=.03) in preterms. Low 11β-hydroxylase activity may explain increased 17OHP but decreased 21-deoxycortisol metabolite excretion in preterms. Our analysis clarifies, first, why preterms have higher 17OHP levels and thus higher rates of false-positive screening results for congenital adrenal hyperplasia than do term infants, and, second, why 21-deoxycortisol or its urinary metabolite PTO is more specific than 17OHP for the diagnosis of 21-hydroxylase deficiency.

Metabolic Fate of Ellagitannins: Implications for Health, and Research Perspectives for Innovative Functional Foods

Consumption of dietary ellagitannins (ETs) has been associated with different health benefits. Nonetheless, ETs are not bioavailable as such and are metabolized in vivo. They are partially converted into ellagic acid (EA) in the upper gastrointestinal (GI) tract, but this first metabolite is also poorly bioavailable. In the lower GI tract, EA and residual ETs are metabolized by gut microbiota to produce urolithins, which, together with their conjugate relatives, persist at relatively high concentrations in plasma and urine for days after ingestion of dietary ETs. Thus, ETs and EA may exert local health benefits on the GI tract but systemic health benefits are more likely to result from urolithins. Cellular models suggest that, at physiological concentration, urolithins are active against chronic degenerative diseases. Health benefits have been proven in animal models and during clinical studies. Even so, the crucial involvement of gut microbiota in ET bioconversion induces important variability of physiological response among humans, giving rise to the concept of high and low urolithin producers. This variability among consumers in obtaining potential health benefits from dietary ETs raises new challenges for the functional food industry. Different research perspectives are discussed to tackle this significant issue for nutritionists, food technologists, and consumers.

Food sources of arsenic in pregnant Mediterranean women with high urine concentrations of this metalloid

Seafood consumption provides a significant amount of arsenic, although in its organic, nontoxic forms. Mediterranean populations may incorporate high levels of this metalloid as a consequence of seafood consumption. In the present study, the significance of this input among pregnant women from a Mediterranean city (Sabadell, Catalonia, Spain) is assessed. Total urinary arsenic was analyzed in 489 pairs of urine samples, corresponding to the 12th and 32 th weeks of pregnancy. Association of arsenic content with seafood and other dietary items were studied. Geometric mean concentrations were 34 and 37 μg/g creatinine during the first and third trimesters, respectively. The observed concentrations were similar to those reported in studies from other Mediterranean countries. The differences between both periods were not statistically significant. The only dietary factor significantly and positively associated with total urinary arsenic in both series of samples was seafood, particularly lean fish. Moreover, lean fish consumption during both periods was found to be the main determinant for differences in levels of arsenic between the first and third trimesters, which confirms the association between high levels of total urinary arsenic and seafood consumption.

Application of mycotoxin adsorbent to cattle feed contaminated with zearalenone: urinary zearalenone excretion and association with anti-Müllerian hormone

This study investigated (1) protective effects of a commercially available mycotoxin adsorbent (MA) and (2) endocrine effects ofin vivo exposure to zearalenone (ZEA) in cattle. The sample included a Japanese Black female cattle herd (MYT herd) that displayed persistently high urinary ZEA concentrations. A second herd (NM herd) was used as a control. Three groups from each herd were assessed: MX (n=6; MA mixed with concentrate), TD (n=6; MA applied as topdressing with the concentrate), and a positive control (n=6; no MA application). Urine and blood samples were collected at the start of MA supplementation (day 0), on the final day of supplementation (day 16), and on the final day of the sampling period (day 58 for MYT herd and day 50 for NM herd). Urinary ZEA concentrations (pg/mg of creatinine) were measured by ELISA and liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS). Haematological and serum biochemical analyses were performed to monitor hepatic, renal, nutritional, and mineral intake statuses. Ovulation status was assessed by progesterone (P4) and antral follicle population by anti-Müllerian hormone (AMH) levels. The urinary concentrations of ZEA and its metabolites in the MX and TD groups were significantly lower (P&lt;0.05) at day 16 compared with the control group, as measured by LC-MS/MS. The valid ratio of AMH-positive (≯0.08 ng/ml) cattle was significantly higher in the NM herd than in the MYT herd without affecting the P4-positive (≯3 ng/ml) ratio, suggesting different populations of antral follicles. Significant differences were also observed between the MX and the control in aspartate aminotransferase and γ-glutamyltransferase at day 58, suggesting preventive effects of MA supplementation. Our field trial indicated that MA supplementation of a ZEA-contaminated diet has beneficial effects in reducing ZEA absorption from the intestine of cattle, maintaining endocrine homeostasis and reversing hepatic effects.

Paraben Levels in an Urban Community of Western Canada

With effective antibacterial and antifungal properties, commercially used parabens are synthetic compounds widely utilized as preservatives in cosmetics, personal care products, pharmaceuticals, and as an additive in some foodstuffs. While long regarded as relatively safe and nontoxic, recent research has demonstrated xenoestrogenic properties of anthropogenic parabens with early evidence that paraben exposure may be linked to breast cancer, thyroid dysfunction, allergy, and obesity. In an attempt to determine the prevalence of paraben exposure in a Canadian urban community, a sample of convenience was done by measuring urinary levels of methyl, ethyl, propyl, butyl, and isobutyl parabens (MP, EP, PP, BP, and IP) in 39 consecutive patients in an Alberta primary care clinic. In 28 female patients including 9 pregnant women, the median urinary levels (in μg/L) were 25.45 for MP, 10.17 for EP, 2.80 for PP, 0.30 for BP, and 0.24 for IP. In 11 male patients, the median urinary levels (in μg/L) were 25.95 for MP, 10.37 for EP, 3.09 for PP, 0.35 for BP, and 0.22 for IP. Especially high urinary paraben levels were reported in a few patients, with the highest urinary concentrations (in μg/L) reported as 966.46 for MP, 220.6 as EP, and 612.73 for PP. It is evident that exposure to assorted parabens is a routine event for many if not most individuals, including pregnant women, in urban Alberta, Canada.

High Urinary Tungsten Concentration Is Associated with Stroke in the National Health and Nutrition Examination Survey 1999–2010

BackgroundIn recent years there has been an exponential increase in tungsten demand, potentially increasing human exposure to the metal. Currently, the toxicology of tungsten is poorly understood, but mounting evidence suggests that both the elemental metal and its alloys have cytotoxic effects. Here, we investigate the association between tungsten and cardiovascular disease (CVD) or stroke using six waves of the National Health and Nutrition Examination Survey (NHANES).MethodsWe investigated associations using crude and adjusted logistic regression models in a cohort of 8614 adults (18–74 years) with 193 reported stroke diagnoses and 428 reported diagnoses of CVD. We also stratified our data to characterize associations in a subset of younger individuals (18–50 years).ResultsElevated tungsten concentrations were strongly associated with an increase in the prevalence of stroke, independent of typical risk factors (Odds Ratio (OR): 1.66, 95% Confidence Interval (95% CI): 1.17, 2.34). The association between tungsten and stroke in the young age category was still evident (OR: 2.17, 95% CI: 1.33, 3.53).ConclusionThis study represents the most comprehensive analysis of the human health effects of tungsten to date. Individuals with higher urinary tungsten concentrations have double the odds of reported stroke. We hypothesize that the pathological pathway resulting from tungsten exposure may involve oxidative stress.

Fosfomycin Trometamol: A Review of Its Use as a Single-Dose Oral Treatment for Patients with Acute Lower Urinary Tract Infections and Pregnant Women with Asymptomatic Bacteriuria

Fosfomycin trometamol (fosfomycin tromethamine) [Monuril(®), Monurol(®), Monural(®)] is approved in numerous countries worldwide, mainly for the treatment of uncomplicated urinary tract infections (UTIs). Fosfomycin has good in vitro activity against common uropathogens, such as Escherichia coli (including extended-spectrum β-lactamase-producing E. coli), Proteus mirabilis, Klebsiella pneumoniae and Staphylococcus saprophyticus, and the susceptibility of uropathogens to fosfomycin has remained relatively stable over time. A single oral dose of fosfomycin trometamol 3g (the approved dosage) achieves high concentrations in urine. Results of recent randomized trials indicate that single-dose fosfomycin trometamol had similar clinical and/or bacteriological efficacy to 3- to 7-day regimens of ciprofloxacin, norfloxacin, cotrimoxazole or nitrofurantoin in women with uncomplicated lower UTIs. In addition, single-dose fosfomycin trometamol had similar bacteriological efficacy to a 5-day course of cefuroxime axetil or a 7-day course of amoxicillin/clavulanic acid in pregnant women with asymptomatic bacteriuria, and similar clinical and/or bacteriological efficacy to a 5-day course of cefuroxime axetil or amoxicillin/clavulanic acid or a 3-day course of ceftibuten in pregnant women with a lower UTI. Single-dose fosfomycin trometamol was generally well tolerated, with gastrointestinal adverse events (e.g. diarrhoea, nausea) reported most commonly. In conclusion, single-dose fosfomycin trometamol is an important option for the first-line empirical treatment of uncomplicated lower UTIs.

The Soluble Receptor for Vitamin B12 Uptake (sCD320) Increases during Pregnancy and Occurs in Higher Concentration in Urine than in Serum

BackgroundCellular uptake of vitamin B12 (B12) demands binding of the vitamin to transcobalamin (TC) and recognition of TC-B12 (holoTC) by the receptor CD320, a receptor expressed in high quantities on human placenta. We have identified a soluble form of CD320 (sCD320) in serum and here we present data on the occurrence of this soluble receptor in both serum and urine during pregnancy.MethodsWe examined serum from twenty-seven pregnant women (cohort 1) at gestational weeks 13, 24 and 36 and serum and urine samples from forty pregnant women (cohort 2) tested up to 8 times during gestational weeks 17-41. sCD320, holoTC, total TC and complex formation between holoTC and sCD320 were measured by in-house ELISA methods, while creatinine was measured on the automatic platform Cobas 6000. Size exclusion chromatography was performed on a Superdex 200 column.ResultsMedian (range) of serum sCD320 increased from 125 (87-839) pmol/L (week 15) to reach a peak value of 199 (72-672) pmol/L (week 35) then dropped back to its baseline level just before birth (week 40). Around one third of sCD320 was precipitated with holoTC at all-time points studied. The urinary concentration of sCD320 was around two fold higher than in serum. Urinary sCD320/creatinine ratio correlated with serum sCD320 and reached a peak median level of 53 (30–101) pmol/mmol creatinine (week 35). sCD320 present in serum and urine showed the same elution pattern upon size exclusion chromatography.ConclusionWe report for the first time that sCD320 is present in urine and in a higher concentration than in serum and that serum and urine sCD320 increase during pregnancy. The high urinary concentration and the strong correlation between urinary and serum sCD320 suggests that sCD320 is filtered in the kidney.