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Diagnosis And Treatment Of Lead Poisoning In Children And Adults [diagnóstico E Tratamento Da Intoxicação Por Chumbo Em Crianças E Adultos]
No full textDiagnosis of lead intoxication must be based basically on signs and symptoms produced by the main affected target organs: brain, hemopoietic system, kidneys, and periphery nervous system. The critical organ is the brain, promoting signs and symptoms of encephalopathy more or less pronounced according to the dose and duration of exposure. Such a symptoms are: headache, memory loss, concentration and attention problems, humor changes, irritability, depression, insomnia, somnolence, stupor, convulsions and coma. Diagnosis can be confirmed by blood and urine lead measurement, or by dosage of any parameter of lead effect on hemoglobin formation, like delta aminulevulinic acid in blood or urine and blood erythrocyte protoporphirin. Treatment is performed using chelating agents. Considering costs and commercial availability Brazilian experience regarding chelating agents for lead intoxications is limited to the use of dimecaprol (BAL), calcium versenate (EDTACaNa2) and D-penicilamine. However, the most efficacious drugs are intravenous EDTACaNa2, and oral dimercapto succinic acid (DMSA). BAL can be used together with EDTACaNa2 in adults when encephalopathic signs are present, or in children using EDTACaNa2 even without CNS signs and symptoms because BAL can pass blood-brain barrier chelating lead in the brain and protecting children against lead mobilization from other tissues to the brain provoked by EDTACaNa2.423309319Paoliello MMB, De Capitani EM. Chumbo. In: Azevedo AA, M. CAA, eds. Metais - Gerenciamento da Toxicidade São Paulo: Atheneu-Intertox2003:353-98Dal Molin, F., Paoliello, M.M.B., De Capitani, E.M., A zincoprotoporfirina como indicador biológico na exposição ao chumbo: Uma revisão. (2006) Rev Bras Toxicol, 19, pp. 71-80Nadig, R.J., Treatment of lead poisoning (1990) Jama, 263, pp. 2181-2182de Madureira, P.R., De Capitani, E.M., Vieira, R.J., Lead poisoning after gunshot wound (2000) Sao Paulo Med J, 118, pp. 78-80Somervaille, L., Chettle, D., Scott, M., In vivo tibia lead measurement as an index of cumulative exposure in occupationally exposed subjects (1988) Br J Ind Med, 45, pp. 174-181Somervaille, L.J., Nilsson, U., Chettle, D.R., In vivo measurements of bone lead - a comparison of two x-ray fluorescence techniques used at three different bone sites (1989) Phys Med Biol, 34, pp. 1833-1845Ahlgren, L., Liden, K., Mattsson, S., Tejning, S., X-ray fluorescence analysis of lead in human skeleton in vivo (1976) Scand J Work Environ Health, 2, pp. 82-86Ahlgren, L., Haeger-Aronsen, B., Mattsson, S., Schutz, A., In-vivo determination of lead in the skeleton after occupational exposure to lead (1980) Br J Ind Med, 37, pp. 109-113Schutz A, Skerfving S, Christoffersson JO, Ahlgren L, Mattson S. Lead in vertebral bone biopsies from active and retired lead workers. Arch Environ Health. 1987;42:340-6CDC. Preventing lead poisoning in young children - a statement by the Centers for Disease Control - Oct 1991: USDHHS-PHS-CDCP1991CDC. Screening young children for lead poisoning: guidance for state and local public helath officials. In: Program. U-C-CIPP, ed. Atlanta1997Needleman, H.L., Gunnoe, C., Leviton, A., Deficits in psychologic and classroom performance of children with elevated dentine lead levels (1979) N Engl J Med, 300, pp. 689-695Needleman, H.L., Schell, A., Bellinger, D., Leviton, A., Allred, E.N., The long-term effects of exposure to low doses of lead in childhood. An 11-year follow-up report (1990) N Engl J Med, 322, pp. 83-88Rogan, W.J., Dietrich, K.N., Ware, J.H., The effect of chelation therapy with succimer on neuropsychological development in children exposed to lead (2001) N Engl J Med, 344, pp. 1421-1426Tong, S., Baghurst, P.A., Sawyer, M.G., Burns, J., McMichael, A.J., Declining blood lead levels and changes in cognitive function during childhood: The Port Pirie Cohort Study (1998) Jama, 280, pp. 1915-1919Stokes, L., Letz, R., Gerr, F., Neurotoxicity in young adults 20 years after childhood exposure to lead: The Bunker Hill experience (1998) Occup Environ Med, 55, pp. 507-516Porru, S., Alessio, L., The use of chelating agents in occupational lead poisoning (1996) Occup Med, 46, pp. 41-48. , LondMarkowitz, M.E., Rosen, J.F., Need for the lead mobilization test in children with lead poisoning (1991) J Pediatr, 119, pp. 305-310Lee, B.K., Schwartz, B.S., Stewart, W., Ahn, K.D., Provocative chelation with DMSA and EDTA: Evidence for differential access to lead storage sites (1995) Occup Environ Med, 52, pp. 13-19Markowitz, M.E., Rosen, J.F., Assessment of lead stores in children: Validation of an 8-hour CaNa2EDTA provocative test (1984) Pediatrics, 104, pp. 337-341Apostoli, P., Porru, S., Duca, P., Ferioli, A., Alessio, L., Significance and validity of a shortened lead chelation test (1990) J Occup Med, 32, pp. 1124-1129De Capitani EM, Paoliello MMB. Diagnóstico e Tratamento das Intoxicações. In: Azevedo AA, M. CAA, eds. Metais - Gerenciamento da Toxicidade. São Paulo: Atheneu-Intertox2003:415-50Klaassen, C.D., Heavy metals and heavy-metal antagonists (1996) Goodman & Gilman's The Pharmacological Basis of Therapeutis, p. 1905. , Hardman JG, Limbird LE, eds, 9th ed. New York: McGraw-Hill;Cardani, A., Farina, G., Profilassi del saturnismo mediante somministrazione di versene per via intramoscolare. (1970) Med Lav, 61, pp. 220-226Sachs, H.K., Blanksma, L.A., Murray, E.F., O'Connell, M.J., Ambulatory treatment of lead poisoning: Report of 1,155 cases (1970) Pediatrics, 46, pp. 389-396De Capitani, E.M., de Madureira, P.R., Moreira Filho, D.C., Estudo comparativo de tratamento quelante de pacientes intoxicados por chumbo inorgânico com EDTACaNa2 por duas vias de administraçã o. (2004) Rev Bras Med Trab, 2, pp. 185-190Cory-Slechta, D.A., Weiss, B., Cox, C., Mobilization and redistribution of lead over the course of calcium disodium ethylenediamine tetraacetate chelation therapy (1987) J Pharmacol Exp Ther, 243, pp. 804-813Graziano, J.H., 2,3-dimercaptosuccinic acid (DMSA, Succimer) (1994) Goldfrank's Toxicologic Emergencies, pp. 1045-1047. , Goldfrank LR, ed, 5th ed. Norwalk: Appleton & Lange;Jorgensen, F.M., Succimer: The first approved oral lead chelator (1993) Am Fam Physician, 48, pp. 1496-1502Chisolm Jr., J.J., Safety and efficacy of meso-2,3-dimercaptosuccinic acid (DMSA) in children with elevated blood lead concentrations (2000) J Toxicol Clin Toxicol, 38, pp. 365-375Friedheim, E., Graziano, J.H., Popovac, D., Dragovic, D., Kaul, B., Treatment of lead poisoning by 2,3-dimercaptosuccinic acid (1978) Lancet, 2, pp. 1234-1236Grandjean, P., Jacobsen, I.A., Jorgensen, P.J., Chronic lead poisoning treated with dimercaptosuccinic acid (1991) Pharmacol Toxicol, 68, pp. 266-269Thomas, D.J., Chisolm Jr, J., Lead, zinc and copper decorporation during calcium disodium ethylenediamine tetraacetate treatment of lead-poisoned children (1986) J Pharmacol Exp Ther, 239, pp. 829-835Graziano, J.H., Lolacono, N.J., Meyer, P., Dose-response study of oral 2,3-dimercaptosuccinic acid in children with elevated blood lead concentrations (1988) J Pediatr, 113, pp. 751-757Graziano, J., Siris, E., Lolacono, N., Silverberg, S., Turgeon, L., 2,3-Dimercaptosuccinic acid as an antidote for lead intoxication (1985) Clin Pharmacol Ther, 37, pp. 431-43
Lead Sources Of Human Exposure In Brazil [fontes De Exposição Humana Ao Chumbo No Brasil]
No full textAs result of increased environmental contamination, the interest on the accumulation of heavy metals in the human body and its harmful effects has increased. Some metals, such as lead, are non-essential elements and exert toxic effects on biological system. Despite the control measures established by law, acute and chronic intoxication by lead still happen in Brazil. Some sources of lead exposure are well known, such as industrial activities like mining and factories for batteries recycling. However, other sources, although common, are completely unknown by population. This article aims to present a review of past and current literature on the various lead sources of human exposure in Brazil.423301308Grandjean, P., Bach, E., Indirect exposures: The significance of bystanders at work and at home (1986) Am Ind Hyg Assoc J, 47, pp. 819-824Paoliello, M.M., De Capitani, E.M., Occupational and environmental human lead exposure in Brazil (2007) Environ Res, 103, pp. 288-297Franco-Netto, G., Alonzo, H.G., Cancio, J., Jost, M., de Souza-Oliveira, S., Human health risk reduction due to lead exposure in Brazil (2003) Salud Pública Mex, 45 (SUPPL. 2), pp. S255-S258Brasil. Balanço mineral brasileiro. Chumbo. In: DNPM, editor: DNPM-MME, 2001Thornton, I., Culbard, E.B., Moorcroft, S., Watt, J.M., Wheatley, M., Thompson, M., Metals in urban dusts and soils (1985) Environ Technol, 6, pp. 137-144Toxicologic Profile for Lead - Update Statement (1999) Registry, p. 587. , ATSDR, USDoHHS-PHS-AfTSaD, editor. AtlantaQuitério, S.L., Silva, C.R.S., Vaitsman, D.S., Martinhon, P.T., Moreira, M.F.R., Araujo, U.C., Use of dust and air as indicators of environmental pollution in areas adjacent to a source of stationary lead emission (2001) Cad Saúde Publica, 17, pp. 501-508De Capitani, E.M., Ensweiler, J.M.S.A., Paoliello, M.M.B., (2009) Dados não publicadosMeyer, I., Heinrich, J., Trepka, M.J., Krause, C., Schulz, C., Meyer, E., The effect of lead in tap water on blood lead in children in a smelter town (1998) Sci Total Environ, 209, pp. 255-271Trepka, M.J., Heinrich, J., Krause, C., Schulz, C., Lippold, U., Meyer, E., The internal burden of lead among children in a smelter town - a small area analysis (1997) Environ Res, 72, pp. 118-130Lanphear, B.P., Matte, T.D., Rogers, J., Clickner, R.P., Dietz, B., Bornschein, R.L., The contribution of lead-contaminated house dust and residential soil to children's blood lead levels. A pooled analysis of 12 epidemiologic studies (1998) Environ Res, 79, pp. 51-68Lima, M., Pimentel, M., Brayner, F., Abreu, C., Lead released by handmade glazed ceramic food wares (2002) Rev Bras Toxicol, 15, pp. 19-23Paoliello, M.M., De Capitani, E.M., Environmental contamination and human exposure to lead in Brazil (2005) Rev Environ Contam Toxicol, 184, pp. 59-96Romano, J., Godinho, R., Alonso, C., Martins, M., Ethanol induced changes in the atmospheric lead in São Paulo Metropolitan Area, Brazil (1992) 9th Word Air Clean CongressFreitas, C.U., (2004) Vigilância de população exposta a chumbo no município de Bauru, São Paulo: Investigação de fatores de risco de exposição e avaliação da dinâmica institucional, , Universidade de São PauloPaoliello, M.M., De Capitani, E.M., da Cunha, F.G., Matsuo, T., Carvalho Mde, F., Sakuma, A., Exposure of children to lead and cadmium from a mining area of Brazil (2002) Environ Res, 88, pp. 120-128Silvany-Neto AM, Carvalho FM, Tavares TM, Guimaraes GC, Amorim CJ, Peres MF, et al. Lead poisoning among children of Santo Amaro, Bahia, Brazil in 1980, 1985, and 1992. Bull Pan Am Health Organ. 1996;30:51-62Jordão, C.P., Distribution of heavy metals in environmental samples near smelters and mining areas in Brazil (1999) Environ Technol, 20, pp. 489-498Cunha, F.G., (2003) Contaminação humana e ambiental por chumbo no Vale do Ribeira, nos Estados de São Paulo e Paraná, , Brasil. Universidade Estadual de CampinasMaio, F., Okada, I., Carvalho, M., Kira, C., Duran, M., Zenebon, O., Evaluation of the labelling, the minerals and inorganic contaminants in domestic and imported mineral water (2002) Rev Inst Adolfo Lutz, 61, pp. 227-232(1989) Assessing human health risks from chemically contaminated fish and shellfish: A guidance manual, , USEPA, Washington DCOkada, I.A., Sakuma, A.M., Maio, F.D., Dovidauskas, S., Zenebon, O., Evaluation of lead and cadmium levels in milk in environmental contamination in the Vale do Paraiba Region, southeastern Brazil] (1997) Rev Saude Publica, 31, pp. 140-143Machado, I., Maio, F., Kira, C., Carvalho, M., Pb, C., Hg, Cu and Zn in mangrove oyster Crassostrea brasiliana Cananéia estuary, São Paulo, Brazil (2002) Rev Inst Adolfo Lutz, 61, pp. 13-18Pereira, O., Henriques, M., Zenebon, O., Sakuma, A., Kira, C., (2002) Determination of Pb, Cd, Hg, Cu and Zn levels in molluscus (Crassostrea brasiliana, Perna perna and Mytella falcate) Rev Inst Adolfo Lutz, 61, pp. 19-25Sakuma, A., Scorsafava, M., Zenebon, O., Tiglea, P., Fukumoto, C., Hortaliças comercializadas em São Paulo: Aspectos da contaminação por chumbo, cádmio e zinco. (1989) Rev Inst Adolfo Lutz, 49, pp. 81-84Garrido, N.S., Pregnolatto, N.P., Murata, L.T.F., Silva, M.R., Nunes, M.C.D., Antunes, J.L.F., Avaliação dos níveis de arsênio, chumbo e cádmio em corantes e pigmentos utilizados em embalagens para alimentos no período de 1982 a 1989. (1991) Rev Inst Adolfo Lutz, 51, pp. 63-68Garrido, N.S., Pregnolato, N.P., Murata, L.T.F., Silva, M.R., Nunes, M.C.D., Engler, V.M., Determinação de chumbo e cádmio em artigos escolares. (1990) Rev Inst Adolfo Lutz, 50, pp. 291-296Stewart, D.D., Notes on some obscure cases on poisoning by lead chromate manifested chiefly by encephalopathy (1887) Med News, pp. 676-681. , 1Glenn, W., Chrome yellow considered as a poison (1889) Science, 13, pp. 347-349Ajab, H., Yasmeen, S., Yaqub, A., Ajab, Z., Junaid, M., Siddique, M., Evaluation of trace metals in tobacco of local and imported cigarette brands used in Pakistan by spectrophotometer through microwave digestion (2008) J Toxicol Sci, 33, pp. 415-420Brasil, Ministério da Saúde. Secretaria Nacional de Assistência à Saúde. Instituto Nacional do Câncer. Coordenação Nacional de Controle de Tabagismo e Prevenção Primária de Câncer (Contapp). Falando sobre Tabagismo. Ministério da Saúde. Rio de Janeiro: 3 o ed. 1998Elevated blood lead levels among internationally adopted children - United States, 1998 (2000) MMWR Morb Mortal Wkly Rep, 49, pp. 97-100Kaul, B., Lead exposure and iron deficiency among Jammu and New Delhi children (1999) Indian J Pediatr, 66, pp. 27-35Gogte, S.T., Basu, N., Sinclair, S., Ghai, O.P., Bhide, N.K., Blood lead levels of children with pica and surma use (1991) Indian J Pediatr, 58, pp. 513-519Dunbabin, D.W., Tallis, G.A., Popplewell, P.Y., Lee, R.A., Lead poisoning from Indian herbal medicine (Ayurveda) (1992) Med J Aust, 157, pp. 835-836Hayes, E.B., The hazard of lead in children (1995) Environmental Medicine, pp. 383-397. , Brooks SM, editor, St Louis: MosbyAl-Ashban, R.M., Aslam, M., Shah, A.H., Kohl (surma): A toxic traditional eye cosmetic study in Saudi Arabia (2004) Public Health, 118, pp. 292-298Al-Saleh, I., Nester, M., DeVol, E., Shinwari, N., Al-Shahria, S., Determinants of blood lead levels in Saudi Arabian schoolgirls (1999) Int J Occup Environ Health, 5, pp. 107-114Busse, F., Omidi, L., Timper, K., Leichtle, A., Windgassen, M., Kluge, E., Lead poisoning due to adulterated marijuana (2008) N Engl J Med, 358, pp. 1641-164
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Lead Poisoning Due To Gunshot Bullet In Contact With Cerebrospinal Fluid: Case Report
No full textContext: Lead poisoning due to retained gunshot bullets is a well-known clinical problem that is fairly frequently described in the literature. The risk factors for this occurrence relate mainly to whether the lead bullet is in contact with the joint fluid or cerebrospinal fluid (CSF). The treatment for these cases entails chelation therapy while symptoms are shown and definitive surgical removal of the bullet as a potential source of lead. The aim of this paper is to describe a clinical case of lead poisoning due to a retained gunshot bullet in contact with CSF. Case Report: A 42-year-old male was hit by gunshot bullets during a holdup, and one of them was retained in the spinal cord. Six years later, he developed intense low back pain and underwent laminectomy. Nine years later, he then underwent arthrodesis on L5-S1, but he developed intense abdominal pain after the surgical procedure. For five years, he was treated with calcium versenate in five-day cycles, with a good response. The chelation therapy cycles showed great efficacy during symptomatic periods, thus reducing the symptoms and signs of poisoning and promoting great amounts of lead excretion, thereby reducing the total lead burden responsible for the symptoms. Fortunately, over the last four years, the symptoms have improved and the urine levels of aminolevulinic acid (ALA) have declined, to reach complete normalization. This shows that a healing process is probably taking place on the spinal wound, thereby isolating the bullet fragments from CSF contact.12715254Scuderi, G.J., Vaccaro, A.R., Fitzhenry, L.N., Greenberg, S., Eismont, F., Long-term clinical manifestations of retained bullet fragments within the intervertebral disk space (2004) J Spinal Disord Tech, 17 (2), pp. 108-111de Madureira, P.R., De Capitani, E.M., Vieira, R.J., Lead poisoning after gunshot wound (2000) Sao Paulo Med J, 118 (3), pp. 78-80Janzen DL, Tirman PF, Rabassa AE, Kumar S. Lead bursogram and focal synovitis secondary to a retained intrarticular bullet fragment. Skeletal Radiol. 1995;24(2):142-4De Capitani, E.M., Diagnóstico e tratamento de intoxicações (2003) Metais: Gerenciamento da toxicidade, pp. 415-450. , Azevedo FA, Chasin AAM, editors, São Paulo: Atheneu;Grogan, D.P., Bucholz, R.W., Acute lead intoxication from a bullet in an intervertebral disc space. A case report (1981) J Bone Joint Surg Am, 63 (7), pp. 1180-118
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
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