Serum Metal Concentrations Research Articles

Development of a diagnostic algorithm to ascertain malignant pleural effusion utilizing clinical indicators and serum metal concentrations

Development of a diagnostic algorithm to ascertain malignant pleural effusion utilizing clinical indicators and serum metal concentrations

Comparative mathematical modeling of causal association between metal exposure and development of chronic kidney disease.

Previous studies have identified several genetic and environmental risk factors for chronic kidney disease (CKD). However, little is known about the relationship between serum metals and CKD risk. We investigated associations between serum metals levels and CKD risk among 100 medical examiners and 443 CKD patients in the medical center of the First Hospital Affiliated to China Medical University. Serum metal concentrations were measured using inductively coupled plasma mass spectrometry (ICP-MS). We analyzed factors influencing CKD, including abnormalities in Creatine and Cystatin C, using univariate and multiple analysis such as Lasso and Logistic regression. Metal levels among CKD patients at different stages were also explored. The study utilized machine learning and Bayesian Kernel Machine Regression (BKMR) to assess associations and predict CKD risk based on serum metals. A chained mediation model was applied to investigate how interventions with different heavy metals influence renal function indicators (creatinine and cystatin C) and their impact on diagnosing and treating renal impairment. Serum potassium (K), sodium (Na), and calcium (Ca) showed positive trends with CKD, while selenium (Se) and molybdenum (Mo) showed negative trends. Metal mixtures had a significant negative effect on CKD when concentrations were all from 30th to 45th percentiles compared to the median, but the opposite was observed for the 55th to 60th percentiles. For example, a change in serum K concentration from the 25th to the 75th percentile was associated with a significant increase in CKD risk of 5.15(1.77,8.53), 13.62(8.91,18.33) and 31.81(14.03,49.58) when other metals were fixed at the 25th, 50th and 75th percentiles, respectively. Cumulative metal exposures, especially double-exposure to serum K and Se may impact CKD risk. Machine learning methods validated the external relevance of the metal factors. Our study highlights the importance of employing diverse methodologies to evaluate health effects of metal mixtures.

Elemental Profiling of different Cancer Patients by ICP-MS from River Indus Region Sindh, Pakistan

Background: The relationship between exposure to heavy metals and the development of cancer has been a subject of extensive research. Trace elements, both essential and non-essential, play significant roles in various biological processes, with imbalances potentially contributing to carcinogenesis. This study aims to investigate serum concentrations of selected metals in cancer patients and compare these levels with those of a healthy control group, highlighting the potential link between metal exposure and cancer risk. Objective: To quantify and compare the serum concentrations of sodium (Na), calcium (Ca), iron (Fe), cadmium (Cd), and arsenic (As) in cancer patients and a control group, thereby assessing the potential association between elevated levels of specific metals and cancer incidence. Methods: This cross-sectional study analyzed blood samples from cancer patients (n=30) and a matched control group (n=30) from the Jamshoro and Hyderabad areas. Inductively Coupled Plasma Mass Spectrometry (ICP-MS) was utilized to measure serum concentrations of Na, Ca, Fe, Cd, and As. Participants' demographic data, including age, gender, place of residence, degree of education, cancer type, and water sources, were collected through questionnaires. Statistical analyses were conducted to compare metal concentrations between groups, with P-values <0.05 considered significant. Results: The average ages of cancer patients and controls were 55.3 ± 15.7 and 52.13 ± 23.7 years, respectively. Significantly higher serum Na levels were observed in cancer patients compared to controls (P > 0.05), with an average concentration exceeding 32.04 µg/L. Cd levels were also higher in the cancer group (0.0046 ppm) compared to controls (0.0000 ppm), contrary to expectations. Conversely, no significant difference was found in As levels between groups. Serum Fe concentrations were substantially higher in cancer patients (P > 0.4949), with Ca levels in cancer patients also elevated (3.302 ppm). Conclusion: The study found significant discrepancies in serum metal concentrations between cancer patients and healthy controls, suggesting an association between elevated levels of certain metals and increased cancer risk. These findings emphasize the need for further investigation into the role of metal exposure in carcinogenesis and the potential for incorporating metal concentration assessments into cancer risk evaluation protocols.

High risk of elevated metal concentrations with 9/10-mm stem trunnions and highly cross-linked polyethylene grafted with poly(2-methacryloyloxyethyl phosphorylcholine) in total hip arthroplasty

BackgroundThe risks of metal release due to fretting and corrosion at the head–neck junction and consequent adverse local tissue reaction (ALTR) have concerns in metal-on-polyethylene (MoP) total hip arthroplasty (THA). Although trunnions have become thinner in diameter to increase the range of motion, it has remained unclear whether this change affects metal release and ALTR in vivo. This study aimed to investigate serum metal concentrations and the prevalence of ALTR in MoP THA with a 9/10-mm stem trunnion.Patients and methodsA consecutive series of 37 hips that underwent THA using MoP grafted with poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC) with a 9/10-mm trunnion stem were retrospectively reviewed. Serum metal levels were assessed and compared with those in MoP THA with a 10/12-mm trunnion stem. ALTR was diagnosed with serum metal levels and cross-sectional images. The factors associated with serum metal levels were also assessed.ResultsThe median serum cobalt and chromium levels were 1.5 μg/L and 1.0 μg/L in the 9/10-mm group and 0.2 μg/L and 0.4 μg/L in the 10/12-mm group, respectively. ALTR was found in 5 hips of 3 patients. Revision surgery was performed in 4 hips, and all stem trunnions and femoral heads showed severe corrosion. Postoperative walking ability was associated with serum metal levels.ConclusionIt was found that a 9/10-mm stem trunnion with MoP grafted with PMPC had high risks of metal release in primary THA. Careful follow-up and cross-sectional imaging are needed to detect ALTR for early revision.

Metal exposure and oxidative stress biomarkers in a Brazilian agricultural community

We examined the association between exposure to metals, metalloids, and oxidative stress biomarkers among rural community residents in Brazil. Multiple linear regression was used to evaluate associations between serum metal and metalloid concentrations and blood oxidative stress biomarkers, adjusting for sex, age, education, smoking, and alcohol use. After adjustment for covariates, glutathione peroxidase activity (GPx) was inversely and significantly associated with an increase in serum arsenic (As) levels. Positive and significant associations were seen between elevated glutathione reductase (GR) activity and serum cadmium (Cd), barium (Ba), and lead (Pb) concentrations. In addition, we observed a significant increase in malondialdehyde (MDA) levels in association with an increase in Ba levels. These findings suggest that toxic metals and metalloids such as As, Ba, Cd, and Pb alter antioxidant enzyme activities. In addition, Ba seems to promote lipid peroxidation.

Incidence of Pseudotumors in a Dual Modular Stem Construct With and Without Metal-on-Metal Bearing Surface.

The purpose of this study was to compare the incidence of pseudotumors in metal-on-metal (MoM) titanium modular neck hip arthroplasties to non-MoM modular neck hip arthroplasties. A secondary goal was to determine whether a correlation exists between elevated metal concentrations and pseudotumor incidence. The data were collected and evaluated from 49 MoM joints and 26 non-MoM joints between the years 2012 and 2017. Hip ultrasonography was done after a minimum of 5 years postimplantation. Whole serum metal (titanium, cobalt, and chromium) concentrations were measured at the hip ultrasonography study. The average time elapsed between surgery and ultrasonography visit was 7.6 years. In the 49 patients with MoM joints, 22.4% (n = 11) had a pseudotumor. In the 26 patients with non-MoM joints, 9.1% of metal-on-polyethylene hips (n = 1) and 0% of ceramic-on-ceramic/polyethylene hips developed a pseudotumor. No significant statistical correlation was observed between serum metal concentrations and pseudotumor formation (P > 0.05). A significant correlation was observed of serum titanium concentration to pseudotumor size (P = 0.024). The incidence of pseudotumor formation in MoM total hip arthroplasties was more than five times the incidence associated with non-MoM bearings. The correlation between serum titanium concentration and pseudotumor size suggests that titanium levels may be a useful indicator for pseudotumor formation in patients with this particular titanium modular neck femoral implant. No notable correlation was observed between serum cobalt and chromium concentration and pseudotumor formation or size.

Associations of prenatal exposure to multiple metals with testicular volume and anogenital distance in infant boys: A longitudinal cohort study

BackgroundHuman are widely exposed to multiple metals, some of which have suspected reproductive toxicity, but no human studies have investigated the developmental effects of prenatal metal exposure. ObjectivesWe aimed to evaluate the associations between prenatal multiple metal exposure and reproductive development in boys at 2–3 years using multi-pollutant approach. MethodsThis prospective study used data of 564 mother–child pairs recruited from the Guangxi Birth Cohort Study. Twenty serum metal concentrations were measured. Least absolute shrinkage and selection operator (LASSO) penalized regression was used to identify independent associations between prenatal multiple metal exposure and testicular volume (TV), and anogenital distance (AGD). Adjusted estimates were then obtained using multiple linear regression analysis, and the regression tree method was used to explore the interactions. ResultsBoys in the highest quartile of prenatal lead exposure had a 0.064 mL (95% CI: −0.124, −0.004) smaller ln-transformed TV, 0.060 cm (95% CI: −0.110, −0.011) shorter ln-transformed anopenile distance (AGDap), and 0.115 cm (95% CI: −0.190, −0.039) shorter ln-transformed anoscrotal distance (AGDas) than boys in the lowest quartile (all Ptrend < 0.05). Chromium was inversely with ln-transformed AGDap (β = −0.078, 95% CI: −0.127, −0.030) and ln-transformed AGDas (β = −0.113, 95% CI: −0.188, −0.038), while stibium was positivity associated with ln-transformed AGDap (β = 0.091, 95% CI: 0.046, 0.136) and strontium was positivity associated with ln-transformed AGDas (β = 0.120, 95% CI: 0.051, 0.189) (all Ptrend < 0.05). And the critical window of vulnerability may be the late pregnancy (the second and third trimester). Moreover, we detected interaction effects between lead, chromium and stibium on AGDap; lead, chromium and strontium on AGDas. ConclusionsThe results suggest that prenatal exposure to lead, chromium, stibium and strontium may affect TV and/or AGD in infant boys. Potential mechanisms for the complex metal interactive effects during vulnerable periods are worthy of further investigation.

Echocardiographic Changes in the Context of Metal-on-Metal Versus Nonmetal-on-Metal Total Hip Arthroplasty

BackgroundThe purpose of this study is to determine if there is a difference in echocardiographic results between patients with metal-on-metal (MoM) vs non-MoM total hip arthroplasty (THA) and to determine if a correlation exists between serum metal levels and echocardiographic outcomes. MethodsSeventy-five patients with the same modular THA enrolled in this prospective cohort study, and 49 had MoM bearings. All patients had serum cobalt, chromium, and titanium levels drawn at 2 study visits with a transthoracic echocardiogram at the second visit. Serum metal concentrations and echocardiographic parameters were compared with 2-way t-tests. Multiple linear regression analyses identified any significant predictors of echocardiographic outcomes. ResultsMean serum cobalt and chromium levels were significantly greater in the MoM group at both time-points (P < .001 and P < .05, respectively). Titanium levels were similar between groups (P > .05). MoM patients had significantly lower global longitudinal strain compared with the non-MoM group (18.4% vs 20.2%; P = .026). Serum cobalt concentration was found to be an independent predictor of tricuspid annular plane systolic excursion (P = .02). ConclusionMoM THA bearings are associated with increased serum cobalt and chromium levels. Patients with MoM THAs had decreased global longitudinal strain, a measure of left ventricular function, but both groups remained within normal range. The clinical impact of the positive association between serum cobalt concentration and tricuspid annular plane systolic excursion, a marker of right ventricular function, deserves further study. These findings can reassure physicians and patients that metal-induced cardiomyopathy is not typical in the setting of MoM THA. Level of EvidenceLevel II, Prospective Cohort Study.

Characterization of trace elements exposure in pregnant women in the United States, NHANES 1999–2016.

ObjectiveThe objective of the current study is to report on urine, blood and serum metal concentrations to characterize exposures to trace elements and micronutrient levels in both pregnant women and women of child-bearing age in the U.S. National Health and Nutrition Examination Survey (NHANES) years 1999–2016. MethodsUrine and blood samples taken from NHANES participants were analyzed for thirteen urine metals, three blood metals, three serum metals, speciated mercury in blood and speciated arsenic in urine. Adjusted and unadjusted least squares geometric means and 95% confidence intervals were calculated for all participants among women aged 15–44 years. Changes in exposure levels over time were also examined. Serum cotinine levels were used to adjust for smoke exposure, as smoking is a source of metal exposure. ResultsDetection rates for four urine metals from the ATSDR Substance Priority List: arsenic, lead, mercury and cadmium were ~83–99% for both pregnant and non-pregnant women of child bearing age. A majority of metal concentrations were higher in pregnant women compared to non-pregnant women. Pregnant women had higher mean urine total arsenic, urine mercury, and urine lead; however, blood lead and mercury were higher in non-pregnant women. Blood lead, cadmium, mercury, as well as urine antimony, cadmium and lead in women of childbearing age decreased over time, while urine cobalt increased over time. ConclusionsPregnant women in the US have been exposed to several trace metals, with observed concentrations for some trace elements decreasing since 1999.

Hip resurfacing arthroplasty for osteonecrosis of the femoral head: Implant-specific outcomes and risk factors for failure

BackgroundHip resurfacing arthroplasty (HRA) may be a suitable option for treating osteonecrosis of the femoral head (ONFH). However, concerns regarding the extent of osteonecrosis, amount of defect under the prosthesis, and implant-related complications remain. This study aimed to report implant-specific outcomes and risk factors for failure of HRA in ONFH. MethodsA total of 202 HRAs (166 patients) performed by a single surgeon were investigated. The stage, size, and location of ONFH were evaluated using preoperative radiographs and magnetic resonance images. Clinical, radiographic results, and serum metal concentrations of articular surface replacement (ASR) and non-ASR devices were compared. Logistic regression analysis was performed to identify the contributors of failures. The mean follow-up duration was 10.6 years. ResultsTwenty-six hips (12.9%) were operated with Birmingham Hip Resurfacing (BHR), 99 (49.0%) with ASR, and 77 (38.1%) with Conserve Plus. The mean Harris Hip Score improved from 52.1 to 93.2 at the final follow-up (P < 0.001). Revision-free survivorships of non-ASR and ASR implants were 99.0% and 82.4%, respectively (P < 0.001). In multivariate analysis, the use of ASR prosthesis, greater combined necrotic angle, and smaller head size were associated with revision surgery. A large combined necrotic angle was the only independent risk factor for mechanical failure at the femoral side (P = 0.029). ConclusionHRA for ONFH using BHR and Conserve Plus implants demonstrated favourable clinical outcomes with high revision-free survival rates at 10 years. However, care should be taken for large necrotic lesions that can lead to femoral neck fracture or aseptic femoral loosening. The translational potential of this articleThis study suggests HRA performed for appropriately selected patients with ONFH can show excellent long-term clinical results. Therefore, HRA should remain as one of the treatment options for ONFH, and further development of HRA implants should be continued.

Associations between maternal serum and urinary metal concentrations and birthweight

Subjective measures of success after urethroplasty have become increasingly valuable in postoperative monitoring. We examined patient reported satisfaction following anterior urethroplasty using objective measures as a proxy for success.Men 18 years old or older with urethral strictures undergoing urethroplasty were prospectively enrolled in a longitudinal, multi-institutional urethroplasty outcomes database. Preoperative and postoperative assessment included questionnaires to assess lower urinary tract symptoms, pain, satisfaction and sexual health. Analyses controlling for stricture recurrence (defined as the inability to traverse the reconstructed urethra with a flexible cystoscope) were performed to determine independent predictors of dissatisfaction.At a mean followup of 14 months we found a high 89.4% rate of overall postoperative satisfaction in 433 patients and a high 82.8% rate in those who would have chosen the operation again. Men with cystoscopic recurrence were more likely to report dissatisfaction (OR 4.96, 95% CI 2.07–11.90) and men reporting dissatisfaction had significantly worse uroflowmetry measures (each p <0.02). When controlling for recurrence, multivariate analysis revealed that urethra and bladder pain (OR 1.71, 95% CI 1.05–2.77 and OR 2.74, 95% CI 1.12–6.69, respectively), a postoperative decrease in sexual activity (OR 4.36, 95% CI 2.07–11.90) and persistent lower urinary tract symptoms (eg straining to urinate OR 3.23, 1.74-6.01) were independent predictors of dissatisfaction.Overall satisfaction after anterior urethroplasty is high and traditional measures of surgical success strongly correlate with satisfaction. However, independently of the anatomical appearance of the reconstructed urethra, postoperative pain, sexual dysfunction and persistent lower urinary tract symptoms were predictors of patient dissatisfaction.

Association between serum heavy metals and prostate cancer risk – A multiple metal analysis

BackgroundProstate cancer is one of the most prevalent cancers in men. Exposure to heavy metals and their association with prostate cancer risk has been studied extensively, but combined effects remain largely inconclusive. ObjectivesTo elucidate the association between serum concentrations of heavy metals and prostate cancer risk. MethodsInductively coupled plasma mass spectrometry (ICP-MS) was used to determine the concentrations of a panel of 10 heavy metals (Mn, Cu, Zn, As, Se, Sb, Co, Cu, Cd and Pb) in serum samples of 141 cases and 114 controls in the Singapore Prostate Cancer Study. Linear probit regression models were used to estimate risk differences (RDs) and 95% confidence intervals (CIs) for the associations between log-centered serum metal concentrations and prostate cancer risk with adjustment for potential confounders. Bayesian kernel machine regression (BKMR) models were used to account for nonlinear, interactive, and joint metal effects. ResultsUsing probit regression, four heavy metals (As, Zn, Mn, Sb) were significantly and positively associated with prostate cancer risk in the unadjusted models. Using BKMR analysis, both As and Zn had positive risk differences on prostate cancer risk when all other metals were held fixed at the 25th and 50th percentiles (RD, 25th percentile: As: 0.15, Zn: 0.19, RD, 50th percentile: As: 0.45, Zn: 0.37). In addition, the overall mixture risk difference was positive and the 95% credible intervals did not include 0 when all metals in the mixture were jointly above their 55th percentile, as compared to when all metals were below their median values. ConclusionsIn summary, we found positive associations between the serum levels of As and Zn and prostate cancer risk on the risk difference scale using BKMR models. The overall mixture effect was also associated with increased prostate cancer risk. Future studies are warranted to validate these findings in prospective studies.

A comparative study of the typical toxic metals in serum by patients of schizophrenia and healthy controls in China

Toxic metals are ubiquitous environmental pollutants, and their potential risks associated with the development of schizophrenia remain a subject of debate. In this study, we investigated the associations between six typical toxic metals (mercury, lead, chromium, silver, antimony, and uranium) in serum with the risk of schizophrenia using a case-control study design. In total, 109 patients with schizophrenia (cases) and 106 normal subjects (controls) from Shandong Province, China were recruited. Fasting blood samples were collected from all participants, as well as serum samples from the cases before and after medical treatment. The six metals were analyzed by inductively coupled plasma mass spectrometry. Only three metals (antimony, silver and uranium) had acceptable detection rates of >80%. The concentrations of antimony and uranium were significantly higher in the cases than in the controls, while no significant difference for silver. Moreover, the serum concentrations of antimony and uranium were significantly lower after medical treatment. Clear dose–response relationships between serum metal concentrations and the risk of schizophrenia were observed, even after adjusting for potential covariates. This suggests that higher levels of antimony and uranium may be one of the factors associated with an elevated risk of schizophrenia.

Trace metal status and the Impact of occupational exposure on the Serum metal content of the Laboratories staff

Exposure to trace metals through various sources is likely to be somewhat higher in the work place than in the external environment. Recently there has been growing interest in the problem of the health and occupational disease risks that associated with protecting workers from unsafe working conditions. However, the health risks of chemicals and exposure to the trace metals in Sulaimani city scientific laboratories has not received much attention from scientist. This study aimed to compare the trace metals (Pb, Cu, Ni, Fe, Zn, Cr, Mn) concentrations of the serum sample for the 25 exposed laboratory staff members of chemistry department, with 25 unexposed individuals consisted of healthy office employees and to assess the impact of occupational exposure on serum heavy and trace metal concentration. The serum samples were analyzed by Inductively Coupled Plasma spectroscopy (ICP-OES). The results revealed that all exposed participant had elevated level of some trace and heavy metals. The statistical analysis shows a significant difference between the mean of serum metal concentrations of exposed staff and non-exposed control. Serum lead, copper, Nickel, Iron and Zinc concentrations of exposed staff were significantly higher compared with unexposed controls (P &lt; 0.05), while chromium concentrations were significantly lower (P&lt; 0.05). Moreover, Manganese serum concentrations remained unaltered. Regression results of the Lead (Pb) concentration indicate that the elevation of (Pb) serum content according to other parameters show a statistically significant effect for exposing time and using PPE parameters.

Serum levels of lead, mercury and cadmium in relation to coronary artery disease in the elderly: A cross-sectional study

BackgroundThere is a continuing attempt to identify novel factors that can predict the risk of cardiovascular disease beyond the established coronary risk factors. It has been suggested that serum levels of lead, mercury and cadmium are associated with the risk of coronary artery disease (CAD). In the present study, we aimed to evaluate serum concentrations of lead (s-Pb), mercury (s-Hg) and cadmium (s-Cd) in patients with CAD in comparison with those of healthy individuals. The correlation between serum levels of these heavy metals and lipid profile parameters was also investigated. MethodsIn this case-control study, we included 65 patients (35 females) aged 50–70 years with angiographically-documented CAD and 65 healthy controls (43 female) matched for sex, age and place of residence. Serum concentrations of heavy metals were determined using graphite furnace atomic absorption (GFAA). Serum lipids were measured using routine enzymatic methods. ResultsIt was observed that the mean concentration of s-Pb (12.54 ± 8.41 vs. 5.89 ± 4.44 μg/L, p < 0.05) and s-Cd (0.938 ± 0.72 vs. 0.448 ± 0.30, p < 0.05; CI: 95%) and s-Hg (10.14 ± 5.06 vs. 6.11 ± 5.66, p < 0.05) were significantly higher in CAD patients compared with control subjects. The same result was also obtained after adjustment for cardiovascular risk factors including age, dyslipidemia, diabetes mellitus and hypertension (p < 0.05). The mean concentration of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and TC:HDL-C ratio were significantly higher in CAD patients (p < 0.05). There was no significant association between serum metal concentrations with TC, HDL-C and TC:HDL-C ratio (p > 0.05). ConclusionsThe present results showed that serum levels of heavy metals are associated with the presence of CAD. Long-term exposure to trace levels of Pb, Cd and Hg may play a role in the development of coronary atherosclerotic plaques.

Serum Metal Concentrations in Patients With Titanium Ceramic Composite Cervical Disc Replacements.

Prospective longitudinal study. The serum titanium (Ti) concentrations were examined in patients implanted with a PRESTIGE LP Cervical Disc System (Medtronic, Inc., Memphis, TN). The metal-on-metal disc with ball-in-trough articulation is made of titanium alloy/titanium carbide composite (Ti-6Al-4 V/TiC). Cervical disc arthroplasty provides a motion-preserving treatment alternative to anterior cervical discectomy and fusion for degenerative cervical disc disease. The articulating surfaces have a tendency to generate in vivo wear in the form of insoluble particulates (debris) and soluble metal ions. Not much information is available on the long-term metal concentrations observed in cervical disc arthroplasty and how these compare with the metal concentrations in Ti-based posterior fixation devices and other joint replacement implants. Thirty patients were enrolled after strict exclusion criteria that included no previous permanent metal implants and no professional exposure to metal particles. High-resolution inductively coupled plasma-mass spectrometry was used to assay blood serum titanium concentrations preoperatively and at 3, 6, 12, 24, 36, 60, and 84 months after surgery. The detection limit for Ti was 0.2 ng/mL. The Friedman test was used to make longitudinal statistical comparisons. The median serum Ti concentrations determined preoperatively, and at 3, 6, 12, 24, 36, 60, and 84 months were 0.10, 1.22, 1.15, 1.27, 1.21, 1.46, 1.34, and 1.42 ng/mL, respectively. The serum Ti concentrations at all postoperative time points were significantly higher than that at the preoperative time point (Friedman P < 0.01). The long-term postoperative serum Ti concentrations were significantly higher than the preoperative concentrations. The observed serum Ti concentrations in this study are lower than the reported concentrations in patients receiving posterior spinal instrumentation and metal or ceramic-on-polyethylene hip prostheses with Ti-alloy based stems and acetabular components. 3.

Wissenschaftliche Auswertung von 350 fehlgeschlagenen Metasul-LDH®-Hüftprothesen mit DUROM®-Azetabulumkomponente bei Verdacht auf Konusinsuffizienz, implantiert in einem einzelnen Zentrum 2003 bis 2008

Introduction: The revision rates were high for patients with Metasul-LDH® hip prosthesis (LDH = large-diameter head) with DUROM® acetabulum components implanted in a single centre between 2003 and 2008. This suggested that there was a system-related weakness in total hip replacements with large diameter heads. It was suspected that the tapered connection between head and stem was responsible for the implantation failure. This led to a scientific reappraisal of the unsuccessful hip prostheses, in order to clarify whether there was a tribological problem or a cone failure. Method: To this end, data on serum metal concentrations, types of prosthesis and stem alloys were collected and analysed for the 315 patients with 350 DUROM®-LDH-HTP. Results: There were significant differences between blood metal concentrations in patients with different types of stem. For patients with titanium stems, there were more serious affects on bone substance surrounding the affected joint, and significantly higher serum cobalt concentrations. Conclusion: It was concluded that the problem did not lie with the tribology of the sliding surfaces, but with the cone-stem connection.

Evaluation of serum metal profile in relation to biri smoking using ICP-MS

ABSTRACTThe metals intake through tobacco smoking is associated with adverse effects for human health. The present study was aimed to understand the effects of biri smoking on smoker’s serum metal profile. Seven metals, cadmium (Cd), nickel (Ni), lead (Pb), chromium (Cr), copper (Cu), iron (Fe) and zinc (Zn), were analysed in serum samples of 20 biri smokers and 20 non-smokers from North India. The Cd, Ni, Pb, Cr and Cu concentrations were higher while Fe and Zn concentrations were lower in smokers compared to non-smokers. The Fe concentrations, the highest among all metals, seemed to be unassociated with the smoking activity. This study indicated that biri smoking is a contributor to the body burden of Cd, Ni, Cu and Cr in the smoker’s body. The Cd, Ni, Cu and Fe concentrations are non-significantly associated with the age of smokers at p < 0.01 significance level, whereas Pb and Cr concentrations increase and Zn concentrations decrease with the increase in the age of smokers. Serum metal concentrations in the smoker subjects of North India are higher compared to the results of other similar studies. This could be linked to the poor quality of tobacco used in biri. We recommend conducting more detailed and controlled studies in this regard as a smoker is also subjected to other sources of exposure to metals.

Lipopolysaccharide Exposure Induces Maternal Hypozincemia, and Prenatal Zinc Treatment Prevents Autistic-Like Behaviors and Disturbances in the Striatal Dopaminergic and mTOR Systems of Offspring.

Autism is characterized by social deficits, repetitive behaviors, and cognitive inflexibility. The risk factors appear to include genetic and environmental conditions, such as prenatal infections and maternal dietary factors. Previous investigations by our group have demonstrated that prenatal exposure to lipopolysaccharide (LPS), which mimics infection by gram-negative bacteria, induces autistic-like behaviors. To understand the causes of autistic-like behaviors, we evaluated maternal serum metal concentrations, which are involved in intrauterine development and infection/inflammation. We identified reduced maternal levels of zinc, magnesium, selenium and manganese after LPS exposure. Because LPS induced maternal hypozincemia, we treated dams with zinc in an attempt to prevent or ease the impairments in the offspring. We evaluated the social and cognitive autistic-like behaviors and brain tissues of the offspring to identify the central mechanism that triggers the development of autism. Prenatal LPS exposure impaired play behaviors and T-maze spontaneous alternations, i.e., it induced autistic-like behaviors. Prenatal LPS also decreased tyrosine hydroxylase levels and increased the levels of mammalian target of rapamycin (mTOR) in the striatum. Thus, striatal dopaminergic impairments may be related to autism. Moreover, excessive signaling through the mTOR pathway has been considered a biomarker of autism, corroborating our rat model of autism. Prenatal zinc treatment prevented these autistic-like behaviors and striatal dopaminergic and mTOR disturbances in the offspring induced by LPS exposure. The present findings revealed a possible relation between maternal hypozincemia during gestation and the onset of autism. Furthermore, prenatal zinc administration appears to have a beneficial effect on the prevention of autism.

Endothelial function and serum concentration of toxic metals in frequent consumers of fish.

BackgroundEndothelial dysfunction is involved in the pathogenesis of atherosclerosis. Consumption of fish is associated with reduced cardiovascular risk, but there is paucity of data concerning its effect on endothelial function. Furthermore, investigation of the effects of fish consumption on health must take into account the ingestion of contaminants, including transition metals and some metalloids, which may have unfavorable effects on health, including those on the cardiovascular system. We investigated the association between fish consumption, endothelial function (flow mediated dilation of the brachial artery), and serum concentration of some toxic metals in apparently healthy people.MethodsTwenty-nine high fish consumers (at least 3 portions a week) were compared with 25 low fish consumers (less than 1 portion a week). All participants were free of diabetes, cardiovascular or other systemic diseases. Serum metal (antimonium, arsenic, mercury, lead, cobalt, copper, zinc, selenium, strontium) concentrations were measured in subgroups of 24 high fish consumers and 19 low fish consumers.ResultsBoth groups exhibited similar habitual dietary patterns, age and anthropometric characteristics. The high fish consumers had higher flow mediated dilation (9.7±1.8 vs. 7.3±1.9%; P<0.001), but also higher serum concentrations of mercury (5.87±2.69 vs. 1.65±1.10 mcg/L; P<0.001) and arsenic (6.04±3.25 vs. 2.30±1.58 mcg/L; P<0.001). The fasting plasma glucose concentrations were significantly correlated with both mercury (r = 0.39; P = 0.01) and arsenic concentrations (r = 0.55; P<0.001).ConclusionsHabitual consumption of high amounts of fish is associated with better endothelial function despite higher serum concentrations of mercury and arsenic.