Depressed serum erythropoietin in pregnant women with elevated blood lead.

During the course of a prospective study of lead exposure and pregnancy outcome in 1,502 women, we tested the hypothesis that environmental lead exposure is associated with depressed serum erythropoietin concentration. At mid-pregnancy and at delivery, blood samples were stratified by hemoglobin concentration; within each hemoglobin stratum, sera of women with the lowest and highest whole blood lead concentrations were selected for serum erythropoietin analysis. Analysis of variance revealed that women with higher blood lead levels had inappropriately low serum erythropoietin at both mid-pregnancy and at delivery. Thus, depressed serum erythropoietin appears to indicate lead nephrotoxicity, and it may also be responsible for the anemia associated with lead poisoning.

Serum levels of the extracellular domain of the epidermal growth factor receptor in individuals exposed to arsenic in drinking water in Bangladesh.

Epidermal growth factor receptor-dependent mechanisms have been implicated in growth signal transduction pathways that contribute to cancer development, including dermal carcinogenesis. Detection of the extracellular domain of the epidermal growth factor receptor (EGFR ECD) in serum has been suggested as a potential biomarker for monitoring this effect in vivo. Arsenic is a known human carcinogen, producing skin and other malignancies in populations exposed through their drinking water. One such exposed population, which we have been studying for a number of years, is in Bangladesh. The purpose of this study was to examine the EGFR ECD as a potential biomarker of arsenic exposure and/or effect in this population. Levels of the EGFR ECD were determined by enzyme-linked immunosorbent assay in the serum samples from 574 individuals with a range of arsenic exposures from drinking water in the Araihazar area of Bangladesh. In multiple regression analysis, serum EGFR ECD was found to be positively associated with three different measures of arsenic exposure (well water arsenic, urinary arsenic and a cumulative arsenic index) at statistically significant levels (p

Effects of nifedipine on diffusing capacity and pulmonary capillary blood volume in chronic obstructive pulmonary disease. A controlled study.

The acute dose-dependent effects of nifedipine on the pulmonary diffusing capacity for CO and other lung function indices were investigated in patients with chronic obstructive pulmonary disease (COPD) in a randomized double-blind, cross-over, placebo-controlled trial. Seventeen successive, clinically stable, moderate COPD patients with pulmonary hypertension and 15 control subjects were included in the study. The diffusing capacity of the lungs for carbon monoxide (DLCO) was measured with the single-breath method. Nifedipine (10 and 20 mg) and placebo were administered sublingually at room air. Nifedipine (10 and 20 mg) increased DLCO and DLCO/alveolar volume; however, a larger effect was observed with 10 mg. In addition, nifedipine increased the pulmonary capillary blood volume dose-dependently while arterial oxygenation was improved only with 10 mg nifedipine. Venous shunt was significantly increased with 20 mg nifedipine whereas spirometric parameters were unaffected. The percent DLCO change with 10 or 20 mg nifedipine was inversely correlated with baseline DLCO, but not with the severity of obstruction. Nifedipine did not have any effect in the control group, except for mild hypotension and a reflex increase in the heart rate. It is concluded that 10 mg nifedipine probably has an effect on the pulmonary circulation in moderate COPD patients with pulmonary hypertension.

Erythropoietin level and macrocytosis in patients with chronic pulmonary insufficiency.

In 30 patients with respiratory insufficiency due to chronic obstructive pulmonary disease and with normal red blood cell counts, the effect of hypoxia on erythropoiesis was studied. Pronounced hypoxaemia was ascertained in all the patients by measuring PaO2. The calculated HbO2 saturation was less than 85% in group I and greater than 85% in group II, each consisting of 15 patients. Although the RBC counts and Hb concentration were within the limits of normal values, the packed RBC volume was higher than 45% in all the patients tested. The calculated MCV was increased and the erythropoietin level in plasma, indirectly measured in polycythaemic mouse bioassay, was higher than normal. Macrocytosis was shown to be PaO2-dependent and should be, according to Stohlman's data, the result of erythropoietin excess and the subsequent cessation of nucleic acid synthesis with skipped terminal division of erythroblasts in the bone marrow. The absence of erythrocytosis in these patients could be explained by a shortened survival time of macrocytes and/or other causes.

[The effect of knowledge regarding the importance of oral health in pregnancy]. / Uticaj obavestenosti o znacaju zdrave usne duplje u trudnoci.

INTRODUCTION: Although in modern dental medicine a pregnant woman and her foetus are completely safe during all dental procedures, the prevention is still the most effective measure for the preservation of oral health in pregnancy. However, pregnant women often visit a stomatologist only when there are already serious disturbances, regardless of the fact that they are referred to a stomatologist even at their first visit to a gynaecologist. The aim of the study was to investigate (possible) changes in pregnant women's attitudes toward oral health during pregnancy according to our educational programme. METHODS: One hundred and sixty pregnant patients were randomly selected for the educational programme and were enrolled in the study. In direct contact (groups of 4 to 14 pregnant patients) they received basic information about the condition for attaining and maintaining their and foetal good health [1]. In order to establish the results, three anonymous questionnaires were conducted. Two of them made the questionnaire A because of identical results obtained before and after the education, and the third questionnaire B was different, and was conducted at the end. The questionnaire B concerned the personal point of view of pregnant women about the obtained information [2]. RESULTS: The results of the first two questionnaires (questionnaire A) are shown in Graph with a quantity of correct answers expressed in percents. The results of the questionnaire B are formulated according to answers to a question with "YES" and "NO", and they are expressed in percentage. The following results were obtained for questionnaire B: A hundred percent of pregnant women stated that they had learned something new about oral health, 67 percent had immediately changed their nutrition for healthy food, 100 percent of them understood well the significant role of fluor prophylaxis, 16 percent did not accept it for unknown reasons, but 100 percent thought that it was very useful to hear lectures about oral health [3]. DISCUSSION: A great interest existed for all preventive stomatologic measures and dental procedures during pregnancy, which formerly, as a rule, were avoided because of ignorance [4]. It is necessary to carry out a proper prevention, and adequately inform and motivate pregnant women, so that we could have a satisfied mother and carefree child in the future.