Urine Mercury Excretion Following meso-Dimercaptosuccinic Acid Challenge in Fish Eaters

2009 ◽  
Vol 133 (1) ◽  
pp. 87-92
Author(s):  
Anne-Michelle Ruha ◽  
Steven C. Curry ◽  
Richard D. Gerkin ◽  
Kathleen L. Caldwell ◽  
John D. Osterloh ◽  
...  
Keyword(s):  
Public Awareness ◽  
Dimercaptosuccinic Acid ◽  
Mercury Poisoning ◽  
Oral Ingestion ◽  
Metal Chelator ◽  
Urinary Mercury ◽  
Before And After ◽  
Blood Mercury ◽  
Urine Mercury ◽  
Diagnostic Indicator

Abstract Context.—Public awareness of methylmercury in fish has caused patients to seek testing for mercury poisoning. In some patients, the diagnosis of mercury poisoning has been made based on urine mercury excretions following oral dosing of meso-dimercaptosuccinic acid (DMSA), a metal chelator. However, studies comparing urine mercury excretion following DMSA in healthy non–fish eaters with healthy fish eaters could not be located. Objectives.—To describe urinary mercury excretion before and after DMSA in healthy fish eaters and non–fish eaters, and to determine whether urine mercury excretion after DMSA would rise above baseline levels to a greater extent in fish eaters. Design.—A total of 24 healthy physicians were assigned to 1 of 3 groups based on fish consumption: non–fish eaters; 1 to 2 fish servings per week; and 3 or more servings per week. Blood mercury concentrations and 12-hour urine mercury and creatinine excretions were measured before and after oral ingestion of 30 mg of DMSA per kilogram of body weight. Results.—A total of 24 subjects completed the study, and 2 subsequently were excluded. No difference in baseline urinary mercury excretion was detected between groups. All groups demonstrated an increase in urinary mercury excretion following DMSA, which was higher in fish eaters (P = .04). Multiple linear regression found that the best predictor of a rise in urine mercury excretion following DMSA challenge was the prechelation blood mercury concentration. Conclusions.—In this study of healthy physicians, oral DMSA produced a rise in urine mercury excretion both in non–fish eaters and fish eaters. The increase in chelated mercury excretion was higher in fish eaters. A simple rise in chelated mercury excretion over baseline excretion is not a reliable diagnostic indicator of mercury poisoning.

Establishment of a multidisciplinary concussion program: impact of standardization on patient care and resource utilization

2014 ◽  
Vol 13 (1) ◽  
pp. 82-89 ◽  
Author(s):  
Sara Anne Wilkins ◽  
Chevis N. Shannon ◽  
Steven T. Brown ◽  
E. Haley Vance ◽  
Drew Ferguson ◽  
...  
Keyword(s):  
Emergency Department ◽  
Retrospective Study ◽  
Resource Utilization ◽  
Media Coverage ◽  
Public Awareness ◽  
Return To Play ◽  
Management Protocol ◽  
Before And After ◽  
Multiple Variables ◽  
The Impact

Object Recent legislation and media coverage have heightened awareness of concussion in youth sports. Previous work by the authors' group defined significant variation of care in management of children with concussion. To address this variation, a multidisciplinary concussion program was established based on a uniform management protocol, with emphasis on community outreach via traditional media sources and the Internet. This retrospective study evaluates the impact of standardization of concussion care and resource utilization before and after standardization in a large regional pediatric hospital center. Methods This retrospective study included all patients younger than 18 years of age evaluated for sports-related concussion between January 1, 2007, and December 31, 2011. Emergency department, sports medicine, and neurosurgery records were reviewed. Data collected included demographics, injury details, clinical course, Sports Concussion Assessment Tool-2 (SCAT2) scores, imaging, discharge instructions, and referral for specialty care. The cohort was analyzed comparing patients evaluated before and after standardization of care. Results Five hundred eighty-nine patients were identified, including 270 before standardization (2007–2011) and 319 after standardization (2011–2012). Statistically significant differences (p < 0.0001) were observed between the 2 groups for multiple variables: there were more girls, more first-time concussions, fewer initial presentations to the emergency department, more consistent administration of the SCAT2, and more consistent supervision of return to play and return to think after adoption of the protocol. Conclusions A combination of increased public awareness and legislation has led to a 5-fold increase in the number of youth athletes presenting for concussion evaluation at the authors' center. Establishment of a multidisciplinary clinic with a standardized protocol resulted in significantly decreased institutional resource utilization and more consistent concussion care for this growing patient population.

Comparison of rates of referral and diagnosis of axial spondyloarthritis before and after an ankylosing spondylitis public awareness campaign

2014 ◽  
Vol 33 (7) ◽  
pp. 963-968 ◽  
Author(s):  
Andrew A. Harrison ◽  
Christoffel Badenhorst ◽  
Sandra Kirby ◽  
Douglas White ◽  
Josie Athens ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Axial Spondyloarthritis ◽  
Public Awareness ◽  
Awareness Campaign ◽  
Public Awareness Campaign ◽  
Before And After

Optimal emergency personnel allocation after a natural disaster

2012 ◽  
Vol 7 (1) ◽  
pp. 31-36 ◽  
Author(s):  
James S. Davis, MD ◽  
Bassan J. Allan, MD, MBA ◽  
Amy M. Pearlman, BS ◽  
Daniel P. Carvajal, BBA, PMP ◽  
Carl I. Schulman, MD, PhD, MSPH
Keyword(s):  
Natural Disasters ◽  
Public Awareness ◽  
Public Health Education ◽  
South Florida ◽  
Emergency Personnel ◽  
Phone Calls ◽  
Network Utilization ◽  
Before And After ◽  
The Mean ◽  
Personnel Allocation

Objective: Little work has been devoted to the links between natural disasters, subsequent Emergency Medical Services (EMS) network utilization, triage, and public awareness. The aim of this study was to investigate the types and distribution of emergency calls recorded after each South Florida hurricane during the 2005 season, identifying target areas for public health education, and emergency personnel use and training.Design: Retrospective database review.Setting: Miami-Dade Fire Rescue (MDFR) emergency dispatch headquarters.Patients, participants: All persons making 911 phone calls to the MDFR emergency dispatch headquarters in the 3 days before and after category 3 or higher hurricanes during 2005.Interventions: None.Results: There were 192,363 emergencies reported in 2005. The mean number of 911 emergencies reported per day for the 3 days before and after Katrina was 503 ± 26 and 819 ± 105, respectively (p = 0.007). The mean number for Wilma was 533 ± 42 before and 800 ± 63 after (p = 0.004). However, Rita had no impact on the number of 911 emergencies reported. Katrina resulted in a statistically significant increase in 911 calls for breathing (p = 0.03), convulsions and seizures (p = 0.02), and hazardous situations (p = 0.04). Rita led to an increase in convulsions and seizures (p = 0.03). Lastly,Wilma caused a rise in breathing emergencies (p = 0.02) and hazardous situations (p = 0.02).Conclusions: This study suggests that 911 calls regarding respiratory complaints, convulsions, seizures, and hazardous situations can be expected to significantly increase after a hurricane. Educational initiatives,EMS resource allocation, and modified triage systems designed to target these areas may limit EMS system-wide strain and improve health outcomes following natural disasters.

scholarly journals Penerapan PHBS dengan peningkatan pengetahuan dan sikap melalui pendekatan keluarga di Desa Gaji Kabupaten Demak

2019 ◽  
Vol 1 (2) ◽  
pp. 126
Author(s):  
Siti Thomas Zulaikhah ◽  
Ratnawati Ratnawati ◽  
Joko Wahyu Wibowo ◽  
Muhammad Ulil Fuad ◽  
Elly Noerhidayati ◽  
...  
Keyword(s):  
Random Sampling ◽  
Public Awareness ◽  
Development Program ◽  
Average Score ◽  
Attitude Score ◽  
Healthy Behavior ◽  
Knowledge And Attitudes ◽  
Before And After ◽  
The Difference ◽  
Cluster Random Sampling

AbstrakDerajat kesehatan merupakan salah satu unsur penting dalam upaya peningkatan Indeks Pembangunan Manusia (IPM) bangsa Indonesia. Sementara itu, derajat kesehatan tidak hanya ditentukan oleh pelayanan kesehatan, tetapi yang lebih dominan justru adalah kondisi lingkungan dan perilaku masyarakat. Upaya untuk meningkatkan perilaku masyarakat agar mendukung peningkatan derajat kesehatan dilakukan melalui program pembinaan Perilaku Hidup Bersih dan Sehat (PHBS).�Perilaku Hidup Bersih dan Sehat (PHBS) merupakan upaya untuk memberdayakan anggota keluarga agar tahu, mau dan mampu melaksanakan PHBS serta berperan aktif dalam gerakan kesehatan di masyarakat. Kesadaran masyarakat akan kesehatan dan pola hidup bersih sehat, khususnya masyarakat desa masih sangat rendah.� Peningkatan pengetahuan dan sikap terkait Perilaku Hidup bersih sehat� diharapkan dapat menjadi upaya menyadarkan masyarakat akan pentingnya melakukan upaya perilaku hidup bersih dan sehat dalam kehidupan sehari-hari sekaligus memberikan gambaran bagaimana cara merealisasikannya sehingga bisa terwujud masyarakat yang peduli terhadap kesehatan.Target yang ingin dicapai adalah terwujudnya peningkatan pengetahuan dan sikap terhadap PHBS sehingga masyarakat� mempunyai kemampuan� mempraktekkan pola hidup bersih dan sehat secara mandiri. Metode yang digunakan adalah dengan memberikan penyuluhan, pemeriksaan kesehatan, praktek cuci tangan yang benar dan talkshow. Peserta adalah� masyarakat di desa Gaji yang diwakili oleh ibu/istri dari setiap KK�yang merupakan Pasangan Usia Subur (PUS),� berjumlah 60 orang yang diambil secara cluster random sampling. Peserta diberikan pretes pada awal kegiatan dan postes pada akhir kegiatan sebagai evaluasi terhadap kegiatan yang dilaksanakan. Hasil kegiatan terjadi peningkatan pengetahuan dan sikap� tentang PHBS, terlihat skor sesudah kegiatan lebih tinggi dibandingkan dengan sebelumnya (perbedaan rerata skor pengetahun sebelum dan sesudah kegiatan 24,16; sedang perbedaan rerata skor sikap sebelum dan sesudah kegiatan 23, 9. Peserta juga mampu mempraktekkan cuci tangan� dengan 6 langkah secara benar.�Kata kunci:�PHBS; pengetahuan; sikap; keluargaAbstractHealth degree is one of the important elements in efforts to increase the Indonesian Human Development Index (HDI). Meanwhile, the degree of health is not only determined by health services, but what is more dominant is the environmental conditions and people's behavior. Efforts to improve community behavior to support the improvement of health status are carried out through the Clean and Healthy Behavior (PHBS) development program. Clean and Healthy Behavior (PHBS) is an effort to empower family members to know, be willing and able to carry out PHBS and play an active role in the health movement in the community. Public awareness of health and a healthy clean lifestyle, especially rural communities, is still very low. Increased knowledge and attitudes related to healthy hygiene behavior is expected to be an effort to make the public aware of the importance of making clean and healthy life behavior efforts in daily life while providing an overview of how to realize it so that people who care about health can be realized. The target to be achieved is the realization increasing knowledge and attitudes towards PHBS so that the community has the ability to practice clean and healthy lifestyles independently. The method used is to provide counseling, health checks, proper hand washing practices and talk shows. Participants are people in the village of Salary, represented by mothers / wives of each KK who are Fertile Age Couples (PUS), totaling 60 people taken by cluster random sampling. Participants are given a pretest at the beginning of the activity and posttest at the end of the activity as an evaluation of the activities carried out. The results of the activity increased knowledge and attitudes about PHBS, seen after the activity score was higher compared to before (the difference in the average score of knowledge before and after the activity 24,16; while the difference in the average attitude score before and after the activity 23, 9. Participants were also able to practice washing hands with 6 steps correctly.�Keywords:�PHBS; knowledge; attitude; family

scholarly journals Pendidikan Kesehatan Mobilisasi Dini Pasca Bersalin

2020 ◽  
Vol 1 (2) ◽  
pp. 60-63
Author(s):  
Isnaeni Rofiqoch ◽  
Purwati Purwati ◽  
Wulan Margiana
Keyword(s):  
Health Education ◽  
Post Partum ◽  
Public Awareness ◽  
Healing Process ◽  
Early Mobilization ◽  
Learning By Doing ◽  
Transfer Of Knowledge ◽  
Counseling Training ◽  
Early Postpartum ◽  
Before And After

Health education is a process of providing knowledge and a process in public awareness of the importance of health. Health education on early mobilization for postpartum mothers can provide more knowledge about health to mothers or their families in order to overcome problems and accelerate the postpartum healing process. This is because the postpartum stage is one of the stages that is susceptible to bleeding and infection in the mother, and a cause of death in the mother. The method in implementing IbM is carried out by the method of learning by doing (learning by doing) with the transfer of knowledge through counseling, training and skill practice. In the implementation of providing health education about early mobilization after childbirth there is an increase in knowledge before and after providing health education about early mobilization after childbirth. Providing health education about early postpartum mobilization is carried out as early as possible, with the hope that post-partum mothers can immediately practice and help heal uterine wounds and postpartum birth canals.

scholarly journals Diagnostic Value of Urine Mercury Measurements

1977 ◽  
Vol 14 (1-6) ◽  
pp. 297-300 ◽  
Author(s):  
Andrew Taylor ◽  
Vincent Marks
Keyword(s):  
Heavy Metals ◽  
Case Reports ◽  
Diagnostic Value ◽  
Mercury Toxicity ◽  
Mercury Poisoning ◽  
Urine Mercury

A review of referrals to a regional heavy metals centre for possible mercury poisoning was made. Samples were received either from subjects who were well but were known to have some contact with mercury or from patients with an illness under investigation but undiagnosed. The problems associated with diagnosis of mercury toxicity in the absence of known exposure are illustrated by two case reports.

scholarly journals Impact of a theory-informed and user-centered stroke information campaign on the public’s behaviors, attitudes, and knowledge when facing acute stroke: a controlled before-and-after study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Julie Haesebaert ◽  
Caroline Laude ◽  
Anne Termoz ◽  
Estelle Bravant ◽  
Nathalie Perreton ◽  
...  
Keyword(s):  
Public Awareness ◽  
Warning Signs ◽  
Trial Registration ◽  
Information Campaign ◽  
Link Type ◽  
Significant Difference ◽  
Before And After ◽  
Attitudes And Knowledge ◽  
Before And After Study ◽  
User Centered

Abstract Background Public awareness of stroke symptoms is a key factor to ensure access to reperfusion strategies in due time. We designed and launched a regional theory-informed and user-centered information campaign and assessed its impact on emergency medical services (EMS) calls for stroke suspicion, time-to-call, and public attitudes and awareness concerning stroke. Methods A controlled before-and-after study was conducted during 3 sequential time-periods in 2 separate counties. Key messages of the campaign were underpinned by stroke representations and the theory of planned behavior, and focused on recognition of stroke warning signs and the need to call EMS urgently. The campaign included posters, leaflets, adverts and films displayed in bus and subway stations, internet, social networks, and local radio. Outcome measures on behavior, attitudes, and knowledge were assessed before the launch of the campaign, at 3 months, and 12 months. Results The number of EMS calls for stroke suspicion increased by 21% at 12 months in the intervention county and this change was significantly different to that observed in the control county (p = 0.02). No significant changes were observed regarding self-reported attitudes in case of stroke. An 8% significant increase in recognizing at least 2 stroke warning signs was observed in the intervention county (p = 0.04) at 3 months, while it did not change significantly in the control county (p = 0.6). However, there was no significant difference in warning sign recognition between both counties (p = 0.16). Conclusion The campaign significantly improved public’s behavior of calling EMS, although stroke knowledge was not improved as much as expected. Repeating these campaigns over time might further help improve timeliness and access to reperfusion strategies. Trial registration Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT02846363.

Technetium-99m pentavalent dimercaptosuccinic acid imaging in patients with pituitary adenomas

1995 ◽  
Vol 133 (1) ◽  
pp. 38-47 ◽  
Author(s):  
Secondo Lastoria ◽  
Annamaria Colao ◽  
Emilia Vergara ◽  
Diego Ferone ◽  
Paola Varrella ◽  
...  
Keyword(s):  
Pituitary Adenomas ◽  
Addison’S Disease ◽  
Primary Hypothyroidism ◽  
Dimercaptosuccinic Acid ◽  
Addison's Disease ◽  
Klinefelter’S Syndrome ◽  
Klinefelter's Syndrome ◽  
Technetium 99M ◽  
Before And After ◽  
Acth Secreting

Lastoria S, Colao A, Vergara E, Ferone D, Varrella P, Merola B, Lombardi G, Salvatore M. Technetium-99m pentavalent dimercaptosuccinic acid imaging in patients with pituitary adenomas. Eur J Endocrinol 1995;133:38–47. ISSN 0804–4643 We studied the tumor-seeking agent technetium-99m-labeled pentavalent dimercaptosuccinic acid ([99mTc](V)DMSA) to visualize 21 growth hormone (GH)-, nine prolactin (PRL)-, two mixed GH/PRL-, six adrenocorticotropin (ACTH)-secreting and 15 clinically non-functioning pituitary adenomas, three craniopharyngiomas and one dysgerminoma of the sella. All non-adenomas and 31 out of 53 adenomas were studied before treatment: 22 after surgery and/or radiotherapy. Eight cases of acromegaly were studied before and after chronic treatment with octreotide, whereas three cases of acromegaly, one of prolactinoma and two of non-functioning adenoma were imaged before and after adenomectomy. As a control group, 27 patients without any clinical evidence of pituitary adenoma were studied: 10 of them were operated on previously and treated with iodine-131 for metastatic thyroid carcinoma, 10 had brain tumors and the remaining seven patients had functional pituitary hypersecretion (four Klinefelter's syndrome, two primary hypothyroidism and one Addison's disease). The scintigraphy was repeated after testosterone in Klinefelter's syndrome, l-thyroxine in primary hypothyroidism and cortisone administration in Addison's disease. Seventeen GH-secreting (81%), seven PRL-secreting (78%), three ACTH-secreting (50%), 15 non-functioning (100%) and one (50%) mixed adenoma significantly concentrated [99mTc](V)DMSA, showing elevated tumor-to-background (T/B) ratios. The T/B ratios were similar in untreated and surgically treated adenomas (11.2 ± 5.6 vs 11.8 ± 6.2). Radiotherapy significantly lowered the [99mTc](V)DMSA uptake to 5.1 ± 2.8 (p < 0.1 vs untreated patients). Non-adenomatous lesions of the sella turcica did not concentrate [99mTc](V)DMSA in the pituitary as well as brain tumors and 8 out of 10 metastatic thyroid cancers. The treatment with octreotide normalized GH and insulin-like growth factor I levels and reduced [99mTc](V)DMSA from 15.7 ± 4.8 to 13.5 ± 3.9 (p < 0.05). Conversely, adequate substitutive therapy completely inhibited the uptake of the radiotracer in Klinefelter's syndrome, in primary hypothyroidism and in Addison's disease. The [99mTc](V)DMSA scintigraphy showed an overall sensitivity of 81% (43/53) in detecting pituitary adenomas, which was increased to 95% for lesions greater than 10 mm in size. High-quality images with minimal total body radiation were obtained, enabling a good in vivo characterization of viable adenomatous tissue as well as an accurate monitoring of the effects of different therapeutic regimens. Secondo Lastoria, Department of Nuclear Medicine, National Cancer Institute, Fondazione G Pascale, via M Semmola, 80131 Napoli, Italy

Urinary mercury levels before and after amalgam restoration

1996 ◽  
Vol 188 (1) ◽  
pp. 39-47 ◽  
Author(s):  
Y CHIEN ◽  
C FELDMAN ◽  
H ZOHN ◽  
C WEISEL
Keyword(s):  
Urinary Mercury ◽  
Amalgam Restoration ◽  
Before And After
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