scholarly journals The Effects of Succimer and Penicillamine on Acute Lead Poisoning Patients

2021 ◽  
Vol 11 (3) ◽  
pp. 33474-33474
Author(s):  
Gholamali Dorooshi ◽  
◽  
Negar Molavi ◽  
Rokhsareh Meamar ◽  
Akbar Hasanzadeh ◽  
...  
Keyword(s):  
Lead Poisoning ◽  
Clinical Symptoms ◽  
Blood Lead ◽  
Study Groups ◽  
Easy Access ◽  
Laboratory Findings ◽  
Treatment Groups ◽  
Significant Difference ◽  
Lead Levels ◽  
The Mean

Background: Lead poisoning was on the rise in recent years. There exists a lack of easy access to some of the main chelator drugs in developing countries. Thus, this study aimed to explore the comparative effects of Succimer and D-Penicillamine on acute lead poisoning patients from 2013 to 2018. Methods: This descriptive study was conducted in the Clinical Toxicology Department of Khorshid Hospital in Isfahan City, Iran. Adult patients with acute lead poisoning were included in the study. Patients in the 3 treatment groups of D-Penicillamine, D-Penicillamine with succimer, and succimer were compared concerning demographic characteristics as well as clinical and laboratory findings at admission time and two weeks later. Results: In total, 163 patients were evaluated in this research. There was no significant difference between the treatment groups respecting improvement in clinical symptoms. The mean blood lead levels during hospitalization and two weeks after the treatment did not significantly differ between the three groups; however, there was a significant reduction in all study groups after two weeks of treatment (P<0.05). The mean white blood cell count was significantly lower only in the D-Penicillamine group two weeks after hospitalization (P<0.05). In the D-Penicillamine group, the mean platelet, hematocrit, and hemoglobin levels were significantly lower two weeks after hospitalization, although within the healthy range. Conclusion: D-Penicillamine may be an acceptable chelator drug for treating patients with acute lead poisoning, especially in communities without access to drugs, like succimer.

Lead Levels in Cord Blood

PEDIATRICS ◽  
1972 ◽  
Vol 49 (4) ◽  
pp. 606-608
Author(s):  
Paul Harris ◽  
Marshall R. Holley
Keyword(s):  
Cord Blood ◽  
Lead Poisoning ◽  
Whole Blood ◽  
Blood Lead ◽  
Mean Value ◽  
Diagnosis And Treatment ◽  
Normal Blood ◽  
Blood Lead Levels ◽  
Lead Levels ◽  
The Mean

Blood lead levels were determined on 24 mothers during labor and on the blood of their newborn offspring. The mean value for the mother's blood lead was 13.2 µg/100 gm (range 10 to 20) and for the cord blood 12.3 (range 10 to 20) µg/100 gm whole blood. These levels are lower than "normal" blood lead standards usually accepted in the diagnosis and treatment of childhood lead poisoning.

Screening to Prevent Lead Poisoning

PEDIATRICS ◽  
1974 ◽  
Vol 54 (5) ◽  
pp. 626-628
Author(s):  
Richard W. Moriarty
Keyword(s):  
Natural History ◽  
Lead Poisoning ◽  
Diagnostic Tests ◽  
Chelating Agents ◽  
Clinical Evidence ◽  
Clinical Symptoms ◽  
Blood Lead ◽  
Blood Lead Levels ◽  
Lead Levels ◽  
Lead Encephalopathy

The absence of fully effective treatment for lead encephalopathy, and the suggestive evidence that lead poisoning may cause brain damage even in the absence of overt encephalopathy, have led to massive efforts to prevent such damage. These preventive efforts have been directed toward screening to identify children who have absorbed an undue amount of lead from their environment, reducing their further exposure to lead, and removing already absorbed lead from those most in danger of developing ill effects. This approach has been codified in the Surgeon General's Report of 19701 which makes the following recommendations: 1. All young children who live in or visit old dilapidated buildings should have periodic blood lead determinations. 2. Any child with repeated blood lead levels over 40µg/100 ml whole blood should be considered to be at risk of lead poisoning, h ave current sources of exposure to lead investigated and corrected, and be followed closely to ensure that he does not develop higher blood lead levels or clinical symptoms. 3. All children with blood lead levels between 50 and 79µg/100 ml should have diagnostic tests for metabolic and clinical evidence of lead poisoning and be treated immediately if such evidence is present. 4. All children with blood lead levels over 80µg/100 ml should be hospitalized immediately and treated with chelating agents. Many aspects of this approach are subjects of current controversey, and the last word will not be written until much better knowledge of the natural history and ecology of lead poisoning is available.

scholarly journals Monitoring of Lead in Topsoil, Forage, Blood, Liver, and Kidneys in Cows in a Lead-Polluted Area in Slovenia (1975–2002) and a Case of Lead Poisoning (1993)

2010 ◽  
Vol 2010 ◽  
pp. 1-9 ◽  
Author(s):  
T. Zadnik
Keyword(s):  
Lead Poisoning ◽  
Reference Values ◽  
Blood Lead ◽  
Polluted Area ◽  
Blood Lead Levels ◽  
Normal Reference ◽  
Liver And Kidney ◽  
Lead Levels ◽  
The Mean

The paper presents the results of a prolonged research in a lead-polluted area. Extensive systematic studies of lead concentrations in topsoil, forage, blood, liver, and kidney in cows on farms within 1–10 km around the lead mine and smelter were carried out. After installation of a filter in 1978, lead concentrations began to decrease. However, when toxic levels of lead were within normal reference values, the authorities stopped to finance the project. In 2002, the research was concluded. A review of studies showed that the protective filter was effective; during the period 1975–2002 mean lead in forage dropped from 584.0 ± 324.0 to 5.5 ± 2.9 mg/kg, and the mean blood lead levels dropped from 1.251 ± 0.580 to 0.069 ± 0.041 mg/kg. Three years after the filter was installed the amount of lead in the liver and kidneys had normalized. Closely related to our research was also a case of cow lead poisoning.

Relationship of Diet to Lead Poisoning in Children

PEDIATRICS ◽  
1975 ◽  
Vol 55 (5) ◽  
pp. 636-639
Author(s):  
Joyce Mooty ◽  
Charles F. Ferrand ◽  
Paul Harris
Keyword(s):  
Dietary Intake ◽  
Lead Poisoning ◽  
Low Income ◽  
Demographic Data ◽  
Daily Intake ◽  
Blood Lead ◽  
Blood Lead Levels ◽  
Control Group ◽  
Significant Difference ◽  
Lead Levels

Forty-six children, aged 24 to 47 months (25 controls and 21 subjects) chosen according to low and high blood lead levels respectively, were studied to ascertain the presence or absence of a relationship between dietary intake and the occurrence of plumbism (in children of low-income families). Through single-blind interviews by a nutritionist, dietary intakes were gathered, and the average daily intake of calories, protein, and iron was calculated. Hemoglobins, hematocrits, heights, weights, blood lead levels, and social and demographic data had been gathered during the routine check for lead poisoning and at registration at the clinic. The mean caloric and protein intake as percent of recommended dietary allowances were equal and adequate for both controls and subjects. There was no statistically significant difference between the controls and subjects with respect to iron intake which was low in both groups. Mean hemoglobin and hematocrit levels were in the anemic range for both groups. The subjects were shorter and weighed less than the control group. Pica was more prevalent among children with plumbism. The findings of this study suggest that some factors other than dietary intake must account for the occurrence of lead poisoning in the subjects and that Blacks have a higher prevalence of plumbism in our area.

scholarly journals The correlation between uremic pruritus and blood lead levels in prevalent hemodialysis patients and its relation to the severity of pruritus using visual analog score

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Sahar Mahmoud Shawky ◽  
Reeham Abdel Aziz Abdel Hamid ◽  
Lina Essam Khedr
Keyword(s):  
Blood Lead ◽  
Cross Sectional Study ◽  
Hemodialysis Patients ◽  
Visual Analog Score ◽  
Blood Lead Levels ◽  
Cross Sectional ◽  
Uremic Pruritus ◽  
Significant Difference ◽  
Lead Levels ◽  
Group 2

Abstract Background Pruritus is a common and often distressing symptom in patients with chronic kidney disease. Though the pathogenesis of uremic pruritus remains poorly understood, systemic inflammation has presented itself as one of the possible explanations. High blood lead levels (BLLs) have been noted to be associated with inflammation and poor nutritional status in hemodialysis patients. Our aim is to study the relation between blood lead levels and uremic pruritus. This is a cross-sectional study that enrolled 50 patients; all were on regular hemodialysis 3 times per week for at least 6 months. Patients were divided into 2 groups, group 1 (n =10) with no pruritus and group 2 (n=40) with varying degrees of pruritus. Group 2 was further divided according to intensity of pruritus by visual analog score (VAS) into mild (n=10), moderate (n=20), and severe pruritus (n=10). Results There was a significant difference in serum lead levels and ferritin levels between groups 1 and 2 (p value < 0.01 and < 0.05, respectively). There was a statistically significant difference in serum lead levels in the groups with varying intensity of pruritus, having higher serum lead levels in patients who exhibited severe pruritus (p value < 0.005) Moreover, a statistically significant relation between elevated blood lead levels and the duration of dialysis was observed in this study. Conclusion Uremic pruritus is a multi-factorial phenomenon, and our study showed that blood lead levels in hemodialysis patients might be associated with increased intensity of pruritus.

Blood lead levels and risk factors for lead poisoning among children in Jakarta, Indonesia

2003 ◽  
Vol 301 (1-3) ◽  
pp. 75-85 ◽  
Author(s):  
Rachel Albalak ◽  
Gary Noonan ◽  
Sharunda Buchanan ◽  
W.Dana Flanders ◽  
Carol Gotway-Crawford ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lead Poisoning ◽  
Blood Lead ◽  
Blood Lead Levels ◽  
Lead Levels

RAPID PROTOPORPHYRIN QUANTITATION FOR DETECTION OF LEAD POISONING

PEDIATRICS ◽  
1972 ◽  
Vol 50 (4) ◽  
pp. 625-631
Author(s):  
Larry P. Kammholz ◽  
L. Gilbert Thatcher ◽  
Frederic M. Blodgett ◽  
Thomas A. Good
Keyword(s):  
Lead Poisoning ◽  
Glacial Acetic Acid ◽  
Blood Lead ◽  
Deficiency Anemia ◽  
Blood Lead Levels ◽  
X Ray ◽  
Fluorescent Method ◽  
Lead Levels ◽  
Fluorescence Test

A rapid fluorescent method for estimation of free erythrocyte protoporphyrin (FEP) is described. Simple ethyl acetate-glacial acetic acid extractions are performed, fluorescence quantitated in a fluorimeter and expressed numerically by comparison with known coproporphyrin standards. Fifty-six children were studied and the extent of lead poisoning was evaluated initially and at different follow-up intervals. A clear relationship was shown between FEP fluorescence and blood lead levels. A correlation was also seen for the intensity of fluorescence and evidence for increased absorption of lead, as estimated by x-ray evidence of ingested lead and deposits in bone. Children with iron deficiency anemia also showed elevations of FEP fluorescence. This FEP fluorescence test allows for a rapid, numerical determination which appears to be useful as a screening test for lead intoxication. It can quickly select patients that may have markedly increased lead absorption and need prompt therapy or select those that at least require further studies for possible lead exposure or the presence of anemia.

Question Regarding Need for Treatment

PEDIATRICS ◽  
1975 ◽  
Vol 56 (4) ◽  
pp. 621-622
Author(s):  
Arthur W. Kaemmer ◽  
Byron R. Johnson
Keyword(s):  
Mass Screening ◽  
Lead Poisoning ◽  
Blood Lead ◽  
Blood Lead Levels ◽  
Elevated Blood ◽  
Screening Programs ◽  
Environmental Lead ◽  
Need For Treatment ◽  
Lead Levels ◽  
Elevated Blood Lead Levels

Dr. Greensher and his colleagues are to be congratulated for bringing to the readers' attention a most unusual source of lead poisoning. Inasmuch as many localities are initiating city-wide lead screening programs, it is obvious that pediatricians in this country will be seeing many children with abnormally elevated blood lead levels, and in many cases diligent efforts such as this will have to be undertaken to determine the exact source of the environmental lead. biggest problems with mass screening programs for lead poisoning are well outlined by Moriarty's article.2

scholarly journals Efficacy of intrathecal midazolam on enhancing analgesic effect of fentanyl in patients undergoing lower limb surgery

2018 ◽  
Vol 5 (10) ◽  
pp. 2726-2732
Author(s):  
Masoum Khoshfetrat ◽  
Sima Davarpanah ◽  
Aliakbar Keykha
Keyword(s):  
Nerve Block ◽  
Lower Limb ◽  
Analgesic Effect ◽  
Synergistic Effects ◽  
Sensory Nerve ◽  
Study Groups ◽  
The Third ◽  
Significant Difference ◽  
Lower Limb Surgery ◽  
The Mean

Background: Co-administration of drugs with synergistic effects is considered as one of the methods to increase the effectiveness of intrathecal anesthesia and to reduce the need for injectable analgesics. The purpose of this study was to investigate the efficacy of intrathecal midazolam on enhancing the analgesic effect of fentanyl in patients undergoing lower limb surgery. Materials: The present double-blinded clinical trial was conducted on 90 candidate patients undergoing lower limb orthopedic surgery in 2017 at Khatam-Al-Anbiya Hospital in the city of Zahedan, Iran. To this end, the patients were selected via convenience sampling method and then randomly divided into three groups. Afterwards, 3 cc of 0.5% hyperbaric Marcaine was injected intrathecally in the first group, 3 cc of Marcaine + 25 ug of fentanyl was administered to the second group, and 3 cc of Marcaine + 25 ug of fentanyl + 1 mg of midazolam was administered to the third group (the final volume of all three syringes was brought up to 3.7 cc with normal saline). The duration of sensory nerve block and those of motor block and analgesia, as well as changes in vital signs, were then measured in these groups. Moreover, the data were analyzed using SPSS Statistics (Version 22.0) through Chi-square test and one-way analysis of variance (ANOVA). Results: The mean age and gender distribution of the patients in the three study groups did not differ significantly. The mean duration of sensory nerve block was equal to 98.6+/-11.1 min in the first group, 142.2+/-12.4 min in the second group, and 174.3+/-10.9 min in the third group; all showed a statistically significant difference (P=0.0001, P=0.001, P=0.000).The mean duration of analgesia was also reported to be 204.43+/-0.3 min in the first group, 323.62+/-7.4 min in the second group, and 526.22+/-0.9 min in the third group, indicating a statistically significant difference between the three study groups (P=0.0001, P=0.000, P=000). Conclusion: The results of this study demonstrated that adding midazolam to intrathecal fentanyl could significantly increase the duration of sensory nerve block and that of post-operative analgesia.  

scholarly journals Topiramate Versus Propranolol in the Prophylaxis of Migraine in Bangladeshi Population

2020 ◽  
Vol 18 (2) ◽  
pp. 12-17
Author(s):  
Muhammad Tayeb ◽  
Md Hasanuzzaman ◽  
Abul Mansur Md Rezaul Karim ◽  
Mohammad Sanaullah ◽  
Md Ashraful Islam
Keyword(s):  
Migraine Attack ◽  
Divided Dose ◽  
Low Dose ◽  
Primary Headache ◽  
Headache Disorder ◽  
Treatment Groups ◽  
Primary Headache Disorder ◽  
Significant Difference ◽  
The Mean ◽  
Bangladeshi Population

Background : Migraine is primary headache disorder characterized by recurring attacks of pain and associated symptoms. The management modality is still unsatisfactory due to poor understanding of its cause and pathogenesis. To assess the efficacy and safety of low dose Topiramate vs Propranolol in migraine prophylaxis. Materials and methods : A randomized clinical trial including 130 patients with frequent migraine headache >5 attacks per month was performed in the out patients Department of Medicine and Neurology, CMCH for a period of 12 weeks. The patients were randomly divided into two treatment groups – treated by Topiramate 50mg/day and Propranolol 80mg/day respectively. Topiramate started with 25mg/day for 7 days then increased up to 50mg/day in two divided dose. Propranolol started with 40mg/day for 7 days then increased up to 80mg/day in two divided dose. The patients were assessed at 0, 8 and 12 weeks of the study. Results: The Topiramate group showed a reduction in the mean (±SD) of frequency of migraine attack from 6.95(±2.88) to 1.75(±1.08) episode per month, headache days per month from 7.62(±4.14) to 1.83(±1.10), intensity of headache per attack from 8.98(±1.05) to 6.10(±2.50) based on VAS scale, duration of headache per episode from 11.56(±9.16) to 5.40(±2.97) per hour and MIDAS score from 16.19(±3.91) to 8.14(±3.93). In patient treated with Propranolol, the mean (±SD) of monthly frequency of migraine attack declined from 7.09(±2.87) to 1.92(±0.98) episode per month, headache days per month from 8.17(±4.52) to 1.86(±o.83), intensity of headache per attack from 8.47(±1.10) to 6.03(±2.05) based on VAS scale, duration of headache per episode from 11.16(±8.08) to 5.97(±3.45), MIDAS score from 15.48(±3.55) to7.77(±3.49). Pre- and post-treatment values were significantly different for individual groups but no significant difference observed between groups. Conclusion: This study demonstrated that both low dose Topiramate and propranolol could significantly reduce migraine frequency, intensity and duration. Chatt Maa Shi Hosp Med Coll J; Vol.18 (2); July 2019; Page 12-17

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