Cholinesterase Levels Research Articles

Neuropathy caused by pesticide exposure on farmers in Ngablak District, Magelang, Central Java, Indonesia: An electroneuromyography study

Uncontrolled and unsafe use of pesticides can lead to acute and chronic toxicity in farmers, with neuropathy being one of the most common symptoms of chronic toxicity. However, the effects of this toxicity on farmers' electroneuromyography (ENMG) are still unclear. To address this, we conducted a cross-sectional study from July to October 2017 in Ngablak District, Magelang, Central Java, Indonesia. Eligible farmers who were exposed to pesticides underwent electrophysiology examinations, as well as additional tests such as physical examination and laboratory testing. We collected general information such as age and work history by interview. In total, 64 farmers were included in this study. Out of these, 44 farmers were found to have polyneuropathy, with 41 of them having motor polyneuropathy and 19 of them having sensory polyneuropathy. Our findings showed that low blood cholinesterase was associated with distal latency prolongation (p-value: 0.014). The group exposed to organophosphate/carbamate pesticides was also significantly associated with prolonged distal latency (p-value: 0.012). However, motor polyneuropathy was significantly associated with chronic exposure to organophosphate/carbamate pesticides (p-value: 0.009) and not with low blood cholinesterase levels (p-value: 0.454). The study concludes that chronic exposure to organophosphate or carbamate pesticides could result in polyneuropathy disease, particularly in the motor system.

Serum Cholinesterase, C-reactive Protein, Interleukin 6, and Procalcitonin Levels as Predictors of Mortality in Patients in the Intensive Care Unit.

The prognostic utility of inflammatory markers in survival has been suggested in patients with cancer; however, evidence on their prognostic value in severely ill patients is very limited. We aimed to explore the prognostic value of cholinesterase (ChE), C-reactive protein (CRP), interleukin-6 (IL-6), and procalcitonin (PCT) in predicting mortality in patients from the intensive care unit (ICU). Serum levels of ChE, CRP, IL-6 and PCT were measured in ICU patients from December 13th, 2019 to June 28th, 2022. We assessed the predictive power of ChE, CRP, IL-6, and PCT using the receiver operating characteristic (ROC) curves. Furthermore, we evaluated their diagnostic accuracy by comparing the areas under the ROC curve (AUCs) along with their corresponding 95% confidence intervals (CIs). The cut-off values were determined to dichotomise these biomarkers, which were then included in multivariable logistic regression models to examine their relationship with ICU mortality. Among 253 ICU patients included in the study, 66 (26%) died during the ICU stay. The AUCs to predict ICU mortality were 0.643 (95% CI, 0.566-0.719), 0.648 (95% CI, 0.633-0.735), 0.643 (95% CI, 0.563-0.723) and 0.735 (95% CI, 0.664-0.807) for ChE, CRP, IL-6 and PCT, respectively. After adjusting for age, sex and disease severity, lower ChE level (<3.668 × 103 U L-1) and higher levels of CRP (>10.546 mg dL-1), IL-6 (>986.245 pg mL-1) and PCT (>0.505 μg L-1) were associated with higher mortality risk, with odd ratios of 2.70 (95% CI, 1.32-5.54), 4.99 (95% CI, 2.41-10.38), 3.24 (95% CI, 1.54-6.78) and 3.67 (95% CI, 1.45-9.95), respectively. ChE, CRP, IL-6 and PCT were independent ICU mortality risk factors in severely ill patients. Elevated PCT levels exhibited better predictive value than the other three biomarkers that were evaluated.

The Influence of Exposure to Pesticides on Plasma Cholinesterase Levels and Hepatic, and Renal Functions among Farmers in Khan Yunis Governorate, Palestine

Background: An increase in acute intoxication signs/symptoms indicates a serious public health problem among farmers who use organophosphate (OP) pesticides. This study aimed to assess the health effects of OP pesticides on farm workers who deal with pesticides in Khan Yunis Governorate, Palestine. Methods: A comparative cross-sectional study started in March and finished in September 2021 on a total of 120 randomly selected farmers, out of them 60 subjects that used pesticides (cases group) for six months or more. The other 60 were not exposed to pesticides (controls group), aged between 20-50 years old. Sociodemographic data, health-related data, and working-related data habits of the study population were taken by interview questionnaire. Biochemical evaluations were carried out. Collected data were analyzed using SPSS 22. Results: The prevalence of abnormal plasma cholinesterase (PChE) activity among the cases group due to chemical poisoning was significantly higher as compared to those in the control group (p ≤ 0.05). The case group has higher levels of serum liver enzymes (AST, ALT, &amp; ALP) when compared with the control group (p ≤ 0.05 for all). The kidney function indicators (creatinine and urea) were significantly higher among the cases group as compared to the control group (p ≤ 0.05 for all). The occurrence of headaches is associated with abnormal PCHE activity among farmers who on pesticides. Conclusion: The decrease in PCHE activity and increase in serum AST, ALT, ALP, urea &amp; creatinine that were observed among farmers who were on pesticides-using in the current study indicate the adverse and toxic effects of pesticides on the liver and kidney functions among them, so these observations should be of interest to health and environmental policymakers in Palestine.

Decreased cholinesterase level combined with renal dysfunction and sympathetic denervation associated with increased cardiac mortality in systolic heart failure.

Cardiac mortality in patients with heart failure (HF) is likely to be aggravated by malnutrition, assessed by serum cholinesterase (ChE) level, as well as by kidney dysfunction or impairment of cardiac sympathetic denervation. Their prognostic interactions, however, have not been determined. A total of 991 systolic HF patients were enrolled in our HF database following clinical evaluation including evaluation of the nutrition state and assessment of standardized heart-to-mediastinum ratio (sHMR) of iodine-123-labeled meta-iodobenzylguanidine activity. Patients were followed up for an average of 43 months with the primary endpoint of fatal cardiac events (CEs). The CE patient group had a lower level of ChE, lower estimated glomerular filtration rate (eGFR) and lower late sHMR than those in the non-CE patient group. A five-parameter model with the addition of serum ChE selected in the multivariate logistic analysis (model 2) significantly increased the AUC predicting risk of cardiac events compared with a four-parameter model without serum ChE (model 1), and net reclassification analysis also suggested that the model with the addition of serum cholinesterase significantly improved cardiac event prediction. Moreover, in overall multivariate Cox hazard analysis, serum ChE, eGFR and late sHMR were identified to be significant prognostic determinants. HF patients with two or all of the prognostic variables of serum ChE < 230 U/L, eGFR < 48.8 ml/min/1.73 m2 and late sHMR < 1.90 had significantly and incrementally increased CE rates compared to those in HF patients with none or only one of the prognostic variables. Decreases in cholinesterase level and kidney function further increase cardiac mortality risk in HF patients with impairment of cardiac sympathetic innervation.

Predicting outcome in organophosphorus poisoning using RBC cholinesterase and serum cholinesterase values: A hospital-based longitudinal study

Objectives: Organophosphorus (OP) poisoning is a leading cause of mortality due to self-harm in Asian countries, including India. Red blood cell cholinesterase (RBC-ChE) and serum cholinesterase (serum-ChE) levels are used for predicting outcomes. There is a paucity of literature studying the RBC-ChE levels in OP poisoning and comparing it with the serum-ChE levels. Materials and Methods: This is a longitudinal study assessing the outcome in OP poisoning patients using the RBC-ChE and serum-ChE levels. Both enzyme levels are compared and correlated for adult patients presenting within 24 hours of consumption of the OP compound. Sensitivity and specificity are measured. Statistical Analysis: Data were analyzed using SPSS v21. Results of descriptive statistics were expressed as mean T standard deviation (SD) for normally distributed data or median (interquartile range [IQR]) for skewed data for continuous variables and frequency (percentage) for categorical variables. Results: Of the 99 OP poisoning patients included, 20 patients did not survive, and 23 patients required ventilatory support. At admission, RBC-ChE (median, interquartile range [IQR]) was significantly different between survivors (45.2 [30.5–60] U/g Hb) and nonsurvivors (6.3 [4.2–13.4] U/g Hb), while serum-ChE (median, IQR) was not statistically different (p ¼ 0.061) between survivors (350 [247–670]) and nonsurvivors (290 [182–415.8]). Similarly, RBC-ChE was significantly different between patients requiring a ventilator and those not requiring a ventilator (6.8 vs. 44.2 U/g Hb), whereas the serum-ChE values measured on admission were not significantly different for patients requiring a ventilator versus those not requiring a ventilator (290 vs. 348 U/L; p ¼ 0.119). At the cutoff of 20 U/g Hb, RBC-ChE had 90.5% sensitivity and 91% specificity in predicting mortality. Kaplan–Meier survival showed the probability of survival decreased to nearly 50% if the time to reach the hospital was ≤4 hours. Conclusion: RBC-ChE was superior in predicting outcomes in OP poisoning patients compared with serum-ChE measured on the day of admission.

Comparing Longitudinal Measures of Cholinesterase as Biomarkers for Insecticide Exposure Among Latinx Children in Rural Farmworker and Urban Nonfarmworker Communities in North Carolina.

In a 2-group prospective design, this study compared seasonal cholinesterase levels of Latinx children in rural farmworker families and comparable urban children to assess the impact of environmental exposure to cholinesterase-inhibiting insecticides. Quarterly blood samples and passive dosimeter wristbands were collected over 2 years in 8-year-old children (74 rural, 62 urban). Laboratory analysis assessed total cholinesterase, acetylcholinesterase, and butyrylcholinesterase from blood samples, and insecticides from wristbands. In spring and summer, total cholinesterase and acetylcholinesterase levels were depressed in rural children compared with winter and fall. Butyrylcholinesterase was depressed in rural children in fall compared with spring and summer. Adjustment for insecticide exposure did not affect these associations. Environmental exposures to cholinesterase-inhibiting insecticides have measurable biochemical effects on blood cholinesterases in rural children from farmworker families.

Small ruminant lentivirus-infected dairy goats’ metabolic blood profile in different stages of lactation

Abstract The study aims to determine the differences in metabolic parameters in blood serum between asymptomatic animals with small ruminant lentivirus (SRLV) and uninfected goats. Pearson correlations were also estimated between biochemical parameters. The study included 26 goats which were divided into SRLV-infected and SRLV-free groups. Blood samples were taken at four points of lactation (days 14, 45, 85, and 240, reflecting perinatal period, early lactation, the peak of lactation, the end of lactation). Hepatic, kidney, bone, cardiac, pancreatic, lipid profiles and CRP concentrations were analyzed. Choline esterase (CHE), calcium (Ca*), creatine kinase (CK), and triglyceride (TRI) levels differed between groups, on day 240 (p≤0.05). Some parameters varied during lactation, with similar patterns observed in both groups. Mainly positive correlations between biochemical parameters were observed in the SRLV-free and SRLV-infected groups both within organ profiles and between them. CRP was not correlated with any biochemical parameters in the SRLV-free group but was negatively correlated with parameters of the liver, kidney, cardiac, and lipid profiles in the SRLV-infected group. The correlations suggest that SRLV may affect the kidneys, liver and heart, even in asymptomatic animals. Some differences were found between asymptomatic SRLV-infected and SRLV-free goats in the last stage of lactation; however, the nature of these changes requires further detailed studies.

Low levels of endogenous cholinesterases support the choice of cows, sheep and goats for the transgenic expression of human butyrylcholinesterase in milk

Butyrylcholinesterase purified from human plasma (Hu BChE) as well as recombinant (r) Hu BChE are candidate enzymes that can protect humans from toxicity of organophosphorus compounds (OPs). Domestic animals such as cows, pigs, sheep, and goats have been used for the transgenic expression of a variety of valuable therapeutic proteins. Indeed, rHu BChE was successfully expressed in the milk of transgenic goats, but the presence of any endogenous cholinesterases (ChE) in milk would interfere with the isolation of expressed rHu BChE. The aim of this study was to determine the presence of endogenous ChEs in bovine, ovine, caprine, and porcine milk to determine the suitability of these species for the production of rHu BChE. Using acetyl- and butyryl- thiocholine as substrates, ChE activity (2–4 U/mL) was detected in pig milk only. ChE activities in milk from other animals were <0.01 U/mL and could only be detected following enrichment on procainamide-Sepharose gel. Two different methods based on measuring activity in the presence of acetylcholinesterase (AChE)- or BChE- specific inhibitors were used to estimate the proportions of AChE and BChE activities in enriched milk. Monoclonal antibodies (MAbs), against fetal bovine serum AChE that recognize AChEs from ruminants only, were also used to confirm the identity of AChEs. While bovine and ovine milk contain both AChE and BChE activities, caprine and porcine milk contain predominantly BChE activity. The presence of very low ChE activity supports the choice of cows, sheep, and goats for the transgenic expression of rHu BChE in milk.

Serum Pseudocholinesterase as a Biomarker in the Differentiation between Gastric Cancer and Benign Gastric Diseases

Background: Worldwide gastric cancer is the fifth most common cancer with poor prognosis. In early stages, it is hard to distinguish gastric cancer from benign gastric diseases, resulting in delayed diagnosis. There is a need to develop a biomarker for differentiating between gastric cancer and benign gastric diseases. Serum cholinesterase is synthesized in liver and released into plasma, and it has an important role in oncogenesis. Objectives: To determine the correlation between serum cholinesterase activity and gastric cancer, in comparison to benign gastric diseases. Subjects and Methods: A case control study carried out at Medical City Directorate\ Gastroenterology, Hepatology Hospital, and at Oncology Teaching Hospital from April 2022 to September 2022. It involved 25 patients with gastric cancer and age matched 25 patients with benign gastric diseases. Serum cholinesterase activity was determined by a colorimetric method.. Results: There was a significant difference in the mean level of serum cholinesterase between gastric cancer group (5339.28 U/L±1816) and benign gastric diseases group (7516.92 U/L±2351) with (P value&lt;0.001). Significant association between low levels of serum cholinesterase and early cancer stages and grades (P value&lt;0.001). Serum cholinesterase showed 60% sensitivity and 80% specificity in differentiating between gastric cancer and benign gastric diseases with optimal cutoff value of 5568U\L. Conclusions: Serum cholinesterase can be considered as a potential rapid and non-invasive biomarker for differentiating between gastric cancer and benign gastric diseases.

Effects of branched-chain amino acids supplementation on patients undergoing hepatic intervention: a meta-analysis of randomised controlled trials.

The benefits of branched-chain amino acid (BCAA) administration after hepatic intervention in patients with liver diseases remain unclear. We conducted a systematic review and meta-analysis to evaluate the effects of BCAA on patients undergoing hepatectomy, trans-arterial embolisation and radiofrequency ablation. Relevant randomised controlled trials (RCT) were obtained from PubMed, EMBASE and Cochrane Library databases. A meta-analysis was performed to calculate the pooled effect size by using random-effects models. The primary outcomes were survival and tumour recurrence. The secondary outcomes were hospital stay, nutrition status, biochemistry profile, complication rate of liver treatment and adverse effect of BCAA supplementation. In total, eleven RCT involving 750 patients were included. Our meta-analysis showed no significant difference in the rates of tumour recurrence and overall survival between the BCAA and control groups. However, the pooled estimate showed that BCAA supplementation in patients undergoing hepatic intervention significantly increased serum albumin (mean difference (MD): 0·11 g/dl, 95 % CI: 0·02, 0·20; 5 RCT) at 6 months and cholinesterase level (MD: 50·00 U/L, 95 % CI: 21·08, 78·92; 1 RCT) at 12 months and reduced ascites incidence (risk ratio: 0·39, 95 % CI: 0·21, 0·71; 4 RCT) at 12 months compared with the control group. Additionally, BCAA administration significantly increased body weight at 6 months and 12 months and increased arm circumference at 12 months. In conclusion, BCAA supplementation significantly improved the liver function, reduced the incidence of ascites and increased body weight and arm circumference. Thus, BCAA supplementation may beneficial for selected patients undergoing liver intervention.

Serum Cholinesterase Level in Patients with Cirrhosis of Liver and Its Correlation with the Severity of the Disease

Background: Serum cholinesterase mainly comes from the liver, a sensitive indicator of the synthetic capacity of the liver. It can be used as a prognostic marker for cirrhosis.&#x0D; Objectives: To measure the serum cholinesterase level in cirrhotic patients and to correlate its level with the severity of the disease as per the Child-Pugh score.&#x0D; Methodology: This cross-sectional study was conducted in the Department of Gastroenterology, Sir Salimullah Medical College Mitford Hospital, Dhaka, Bangladesh, from January 2018 to December 2018. Fifty adult patients with cirrhosis of the liver were enrolled. Fifty healthy individuals were also taken to compare serum cholinesterase levels. Cirrhotic patients were grouped strictly into A, B, and C classes, as per the Child-Pugh score. Serum cholinesterase level was measured in all participants. The correlation between cholinesterase level and the severity of the disease was analyzed.&#x0D; Result: Mean age of the patients was 47.42 ± 12.40 years and 47.22 ± 11.99 years in cirrhotic patients and healthy group, respectively. The number of patients in the Child-Pugh A, B, and C subgroups was 12 (24%), 20 (40%), and 18 (36%), respectively. The mean serum cholinesterase level was 2938 ± 1561 U/L in cirrhotic patients and 9036 ± 2024 U/L in the healthy group. Serum cholinesterase level in different Child-Pugh class was 4740 ± 1046 U/l (Child A), 3157 ± 1161 U/l (Child B), and 1493 ± 500 U/l (Child C). Serum Cholinesterase was positively correlated with serum albumin and negatively correlated with bilirubin, prothrombin time, and INR. A negative correlation was found between serum Cholinesterase level and the severity of the disease.&#x0D; Conclusion: Serum cholinesterase level was low in cirrhotic patients, and its level was inversely correlated with the severity of the disease. Thus it can be used as a prognostic marker of cirrhosis. However, further study with a large sample size could explain this more precisely.&#x0D; TAJ 2022; 36: No-1: 33-40

An Evaluation of a Pesticide Training Program to Reduce Pesticide Exposure and Enhance Safety among Female Farmworkers in Nan, Thailand.

Although exposure to chemical pesticides is known to cause negative effects on human health, farmers in Ban Luang, Nan, Thailand, continue to use them regularly to protect crops. This study focused on mothers who were engaged in farm tasks and had children between the ages of 0 to 72 months, with the objective of reducing pesticide exposure. This study was conducted from May 2020 to October 2020 in the Ban Fa and Ban Phi sub-districts in Ban Luang due to the high use of pesticides in these areas. A systematic random sampling technique was used to recruit 78 mothers exposed to pesticides. Thirty-nine mothers from Ban Fa district were randomly assigned to the intervention group and 39 from Ban Phi to the control group over a 3-month period. This study applied a pesticide behavioral change training program for the intervention group. To assess the effectiveness of the program, the study compared the results of a questionnaire regarding knowledge, attitude, and practice (KAP) and health beliefs related to pesticide exposure as well as the levels of acetylcholinesterase (AChE) and butyryl cholinesterase (BChE) enzymes, biomarkers of exposure to pesticides, before and after the intervention using ANCOVA statistical test. Furthermore, to evaluate the effectiveness of the intervention program, a paired t-test was used to investigate the in-home pesticide safety assessment. After the intervention, we observed no significant change in AChE; however, a significant improvement in BChE (p < 0.05), a marker of short-term recovery, was observed. Pesticides can cause a reduction in AChE and BChE, however, after eliminating pesticides, BChE takes a shorter time (about 30-50 days) to recover than AChE (around 90-120 days). Therefore, increases in the measured concentrations of AChE and/or BChE suggest the presence of less chemicals from pesticides in the human body. The study also found a significant improvement in KAP and beliefs about chemical pesticide exposure after the intervention (p < 0.05). Furthermore, using a paired t-test, we found a significant increase in pesticide safety practices (p < 0.05) in the intervention group and a borderline significant increase regarding in-home safety (p = 0.051) in the control group. Based on the results, the constructs of the intervention program were effective and could be applied in other agricultural areas in less developed countries. However, due to time limitations during the COVID-19 pandemic, further studies should be conducted to enable data collection over a longer time, with a larger number of subjects providing the ChE levels for the non-agricultural season.

Significance of Serum Butyrylcholinesterase in Evaluating the Liver Reserve in Chronic Hepatitis (C) Cirrhotic Patients

Abstract Background Hepatitis C virus can cause both acute and chronic hepatitis. The acute process is self-limited, rarely causes hepatic failure and usually leads to chronic infection. Chronic HCV infection often follows a progressive course over many years and can ultimately result in cirrhosis, HCC and the need for liver transplantation. Liver cirrhosis is one of the major leading causes of morbidity and mortality worldwide including Egypt. Cirrhotic patients evaluated for the presence of complications by using Child-Pugh score. However; the cirrhotic patients particularly those with Child grades B and C with ascites or hemorrhagic tendency are usually treated with albumin or blood transfusion which may affect the numerical value for calculating the Child- Pugh score. Objective To evaluate serum cholinesterase level as a biomarker for detecting liver damage in patients with chronic hepatitis C. Subjects and Methods The aim of this study is to evaluate serum cholinesterase level as a biomarker for detecting liver injury in patients with CHC. For this propose 40 patients with liver cirrhosis due to HCV infection and 10 healthy adults were selected and divided into 3 groups: Group 1: 20 Patients having compensated liver cirrhosis due to HCV infection. Group 2: 20 Patients having decompensated liver cirrhosis due to HCV infection. Group 3: 10 Healthy subjects matched for age and sex as a control. Results Sensitivity of cholinesterase is 100%, its specificity is 100% and its accuracy is 100%, in predicting liver injury in patients with chronic hepatitis C. Cholinesterase is positively correlated with Hb, platelets and albumin. Cholinesterase is negatively correlated with ALT, AST and ALP, total, direct bilirubin, PT, INR, urea, creatinine and AFP. Conclusion Serum cholinesterase is an excellent biomarker of the synthetic function of liver in CLD with hepatitis C. Cholinesterase levels should be routinely checked to assess liver function. It can be effectively used to follow the staging of liver disease in hepatitis C.

Clinical Significance of Serum Cholinesterase in the Diagnosis and Assessment of Clinical Activity in Patients with IBD

Abstract Background Inflammatory bowel diseases (IBD), including Crohn’s disease and Ulcerative colitis, witnessed dramatic rise in incidence in the past few decades. Fecal calprotectin has been widely established as laboratory marker in assessment, diagnosis and severity of IBD. It showed low specificity and high number of false positive results. Cholinesterase (ChE) enzymatic glycoprotein used in hydrolosis of acetylcholine, showed significant correlation with IBD activity, it showed also potential role in diagnosis and assessing clinical severity in IBD patients. We will evaluate the role of serum cholinesterase in diagnosis and assessment of severity in IBD patients. Aim of the Work The aim of this study is to evaluate the role of serum cholinesterase (ChE) in diagnosis and assessment of activity in IBD patients Patients and Methods A Case control study in outpatients and inpatients in departments of Internal Medicine, Ain Shams University Hospital for Six months since beginning of data collection (till fulfilling the sample size) on 70 subjects divided into 3 groups: Group A: 25 patients with Crohn’s disease evidenced by colonoscopy and tissue biopsy, group B: 25 patients with Ulcerative Colitis disease evidenced by colonoscopy and tissue biopsy, group C: 20 age-matched, sex-matched healthy controls Results Our results confirmed that, compared with healthy controls, serum ChE levels were decreased in patients with IBD, and the decline in serum ChE levels was more pronounced as clinical activity in IBD increased. We also found that the serum ChE levels of patients with CD and those with UC were significantly different. It needs to be further clarified the relationship between serum ChE and endoscopic activity in the future. Conclusion Serum ChE levels can be used as a simple, economical method to help diagnose and distinguish the different stages of IBD. With the increasing biomedical research on the cholinergic anti-inflammatory pathway and ChE, serum ChE is expected to become a new immunotherapy target for IBD.

The Impact of Nutritional Markers and Dietary Habits on the Bioimpedance Phase Angle in Older Individuals.

Low phase angle (PhA), as determined via bioelectrical impedance analysis, reflects unhealthy aging and mortality. In this study, we assessed whether nutritional status, including serum nutritional markers and dietary habits, is related to PhA in older individuals. We recruited 212 participants (aged ≥ 65 years) who underwent medical health checkups. PhA was measured using a multi-frequency impedance body composition analyzer. Habitual food and nutrient intake was evaluated using a brief, self-administered diet history questionnaire. Low PhA values were defined as ≤4.95 in males and ≤4.35 in females. Males with low PhA had poor exercise habits (p = 0.0429) and a lower body mass index (p = 0.0024). PhA was significantly correlated with serum cholinesterase levels, a nutritional status marker (r = 0.3313, p = 0.0004 in males; r = 0.3221, p = 0.0070 in females). The low-PhA group had significantly lower total energy and carbohydrate intake per ideal body weight (IBW) than the high-PhA group in males (total energy intake:30.2 ± 9.8 and 34.5 ± 9.3 kcal/kg/day, p = 0.0307; carbohydrate intake:15.2 ± 4.9 and 18.0 ± 5.8 kcal/kg/day, p = 0.0157). Total energy intake per IBW (adjusted odds ratio [95% confidence interval], 0.94 [0.89-1.00] per 1 kcal/kg/day increase) was independently associated with a low PhA in males. Our study revealed that lower total energy intake independently impacted low PhA in older males.

Comparative Study of Two Pesticide-Associated Health Risk Assessment Methods: Questionnaire and Blood Cholinesterase Level Examination

Comparative Study of Two Pesticide-Associated Health Risk Assessment Methods: Questionnaire and Blood Cholinesterase Level Examination

Differences in the Time Course of Recovery from Brain and Liver Dysfunction in Conventional Long-Term Treatment of Wilson Disease.

The aim of this study was to demonstrate that both neurological and hepatic symptoms respond to copper chelation therapy in Wilson disease (WD). However, the time course of their recovery is different. Eighteen patients with neurological WD from a single specialized center who had been listed for liver transplantation during the last ten years and two newly diagnosed homozygous twins were recruited for this retrospective study. The mean duration of conventional treatment was 7.3 years (range: 0.25 to 36.2 years). A custom Wilson disease score with seven motor items, three non-motor items, and 33 biochemical parameters of the blood and urine, as well as the MELD score, was determined at various checkup visits during treatment. These data were extracted from the charts of the patients. Treatment was initiated with severity-dependent doses (≥900 mg) of D-penicillamine (DPA) or triethylene-tetramin-dihydrochloride (TRIEN). The motor score improved in 10 and remained constant in 8 patients. Worsening of neurological symptoms was observed only in two patients who developed comorbidities (myasthenia gravis or hemispheric stroke). The neurological symptoms continuously improved over the years until the majority of patients became only mildly affected. In contrast to this slow recovery of the neurological symptoms, the MELD score and liver enzymes had already started to improve after 1 month and rapidly improved over the next 6 months in 19 patients. The cholinesterase levels continued to increase significantly (p < 0.0074) even further. One patient whose MELD score indicated further progression of liver disease received an orthotopic liver transplantation 3 months after the diagnosis of WD and the onset of DPA treatment. Neurological and hepatic symptoms both respond to copper chelation therapy. For patients with acute liver failure, the first 4 months are critical. This is the time span in which patients have to wait either for a donor organ or until significant improvement has occurred under conventional therapy. For patients with severe neurological symptoms, it is important that they are treated with fairly high doses over several years.

A Bio-Indicator Pilot Study Screening Selected Heavy Metals in Female Hair, Nails, and Serum from Lifestyle Cosmetic, Canned Food, and Manufactured Drink Choices.

Lifestyles, genetic predispositions, environmental factors, and geographical regions are considered key factors of heavy metals initiatives related to health issues. Heavy metals enter the body via the environment, daily lifestyle, foods, beverages, cosmetics, and other products. The accumulation of heavy metals in the human body leads to neurological issues, carcinogenesis, failure of multiple organs in the body, and a reduction in sensitivity to treatment. We screened for Cr, Al, Pb, and Cd in selected foods, beverages, and cosmetics products depending on questionnaire outcomes from female volunteers. We also screened for Cr, Al, Pb, and Cd on hair, nails, and serum samples using inductively coupled plasma mass spectrometry (ICP-MS) from the same volunteers, and we analyzed the serum cholinesterase and complete blood picture (CBC). We performed an AutoDock study on Cr, Al, Pb, and Cd as potential ligands. Our results indicate that the most elevated heavy metal in the cosmetic sample was Al. In addition, in the food and beverages samples, it was Pb and Al, respectively. The results of the questionnaire showed that 71 percent of the female volunteers used the studied cosmetics, food, and beverages, which were contaminated with Cr, Al, Pb, and Cd, reflecting the high concentration of Cr, Al, Cd, and Pb in the three different types of biological samples of sera, nails, and hair of the same females, with 29 percent of the female volunteers not using the products in the studied samples. Our results also show an elevated level of cholinesterase in the serum of group 1 that was greater than group 2, and this result was confirmed by AutoDock. Moreover, the negative variation in the CBC result was compared with the reference ranges. Future studies should concentrate on the actions of these heavy metal contaminations and their potential health consequences for various human organs individually.

Nutritional state of orthognathic surgery patients: A systematic review and meta-analysis

PurposeIs to systematically review the available evidence of the patient's nutritional state before and after orthognathic surgery MethodsThe protocol to the International Prospective Register of Systematic Reviews (PROSPERO; registration No. CRD42020177156). ResultsThe search strategy yielded a total of 43 articles from all databases. Of the 43 articles, 13 were excluded after an examination of the titles and abstracts, and full-text articles of the remaining 30 studies were reviewed independently for eligibility. Of these 30 studies, 23 were excluded because they did not meet the inclusion criteria. Finally, a total of 7 studies met the inclusion criteria and were processed for critical review ConclusionPatient's body weight and body mass index (BMI) decreases after orthognathic surgery. No significant changes in body fat percentage were observed. The estimated blood loss and the need for blood transfusion increased. No significant changes were observed in hemoglobin levels, lymphocyte counts, total cholesterol levels, and cholinesterase levels between the pre-operative and postoperative periods. Increments in serum albumin levels and total protein counts were observed after orthognathic surgery.

A STUDY ON BIOCHEMICAL PARAMETERS IN ASSESSING THE SEVERITY OF ACUTE ORGANOPHOSPHORUS POISONING

Objectives: Organophosphorus (OP) poisoning is an important global health issue with increasing mortality rate for every year particularly in developing countries since its overuse in agricultural activity. The present study was performed to analyze the clinical profile and biochemical parameters such as serum cholinesterase, serum creatinine phosphokinase (CPK), liver enzymes, serum amylase, lipase, serum k+, troponin, serum urea, and creatinine on day 1 for correlation with clinical severity of poisoning. Methods: A observational study was performed on 100 cases with OP poisoning at a tertiary care center. Peradeniya OP Poisoning Scale was applied to all cases at the time of admission and the severity was designated as mild, moderate, and severe taking into account 5 vital parameters such as miosis, fasciculations, respiration rate, bradycardia, and level of consciousness and data were statistically analyzed by SPSS. Results: Rise in clinical severity of poisoning and substantial reduction in the level of serum cholinesterase was observed. The mean serum CPK, troponin T (Trop T), amylase, lipase, bilirubin, aspartate aminotransferase, and alanine aminotransferase showed marked elevation according to the severity of OP poisoning. In addition, serum potassium levels showed decreased level as per the severity level. Conclusion: Initial serum cholinesterase and serum Trop T are strong predictors of the clinical severity of OP poisoning.