Arsenic and mercury exposure in different insect trophic guilds from mercury mining areas in Mexico.

The exposure to arsenic and mercury in various insect trophic guilds from two mercury mining sites in Mexico was assessed. The two study sites were La Laja (LL) and La Soledad (LS) mines. Additionally, a reference site (LSR) was evaluated for LS. The terrestrial ecosystem was studied at LL, whereas both the terrestrial ecosystem and a stream called El Cedral (EC) were assessed at LS. The study sites are situated in the Biosphere Reserve Sierra Gorda (BRSG). Mercury vapor concentrations were measured with a portable analyzer, and concentrations of arsenic and mercury in environmental and biological samples were determined through atomic absorption spectrophotometry. Both pollutants were detected in all terrestrial ecosystem components (soil, air, leaves, flowers, and insects) from the two mines. The insect trophic guilds exposed included pollinivores, rhizophages, predators, coprophages, and necrophages. In LS, insects accumulated arsenic at levels 29 to 80 times higher than those found in specimens from LSR, and 10 to 46 times higher than those from LL. Similarly, mercury exposure in LS was 13 to 62 times higher than LSR, and 15 to 54 times higher than in LL. The analysis of insect exposure routes indicated potential exposure through air, soil, leaves, flowers, animal prey, carrion, and excrement. Water and sediment from EC exhibited high levels of arsenic and mercury compared to reference values, and predatory aquatic insects were exposed to both pollutants. In conclusion, insects from mercury mining sites in the BRSG are at risk.

Pilot Monitoring of Lead in Umbilical Cord Blood of Newborns Associated With the Use of Glazed Ceramics from Guanajuato, Mexico.

The use of lead-glazed pottery for cooking and storing food, a widespread practice in Mexico, represents a risk of exposure to lead from the human intrauterine stage. Therefore, a pilot study was carried out by means of the measurement of lead in umbilical cord blood by inductively coupled plasma mass spectrometry (ICP-MS) including 69 newborns from the Mexican state capital of Guanajuato, Guanajuato City, where the use of glazed clay is still widespread. Lifestyle and sociodemographic data were collected by interviewing the participating mothers. Hematological parameters and the anthropometry of the newborns and their mothers were analyzed; likewise, the G177C polymorphism in the ALAD gene was genotyped by PCR-RFLP as a marker of genetic vulnerability to lead. The geometric mean of lead in umbilical cord blood was 0.7 µg/dL (< limit of detection = 0.01-28.22). Boys presented higher values than girls (p = 0.03). Only 5.8% of these were above the safety value of the US Centers for Disease Control and Prevention (CDC) of 3.5 µg/dL. Correlations among lead concentrations, maternal age, weeks of gestation, newborn anthropometry, and hematological parameters were not found; however, the participating mothers who reported using glazed ceramics for cooking or storing food had the highest cord-blood lead concentrations (p = 0.04). Regarding genotyping, 97% had ALAD 1, while 3% had ALAD 1, 2; unfortunately, the sample size did not allow analysis of genetic vulnerability to lead. The preparation and conservation of food in handcrafted clay pottery increased the risk of having cord-blood lead values higher than those recommended by the CDC of 3.5 µg/dL (OR = 5; 95% CI:1.3-23; p = 0.01). Our preliminary results suggest that there continues to be intrauterine exposure to lead in Guanajuato.

Mercury entomotoxicology.

Mercury is an industrial pollutant of global concern. Currently entomofauna is disappearing and chemical pollution is one cause, however, it is unknown whether mercury is an additional threat. Therefore, it is necessary to know the entomotoxicology of mercury. The aim of the present work was to perform a comprehensive literature review on the entomotoxicology of mercury. The toxicokinetics and toxicity of mercury in insects, the participation of insects in the mercury cycle and the fact that this element is a threat to entomofauna are characterized. Insects can be exposed to mercury through ingestion, tracheal respiration, and gill respiration. Organic forms of mercury are better absorbed, bioaccumulated and distributed than inorganic forms. In addition, insects can biotransform mercury, for example, by methylating it. Metal elimination occurs through feces, eggs and exuvia. Toxicity molecular mechanisms include oxidative stress, enzymatic disruptions, alterations in the metabolism of neurotransmitters and proteins, genotoxicity, cell death and unbalances in the energetic state. Moreover, mercury affects lipid, germ, and gut cells, causes deformations, disturbs development, reproduction, behavior, and locomotion, besides to alters insect populations and communities. In terrestrial ecosystems, entomofauna participate in the mercury cycle by bioaccumulating mercury from soil and air, predating, being predated and decomposing organic matter. In aquatic ecosystems insects participate by accumulating mercury from water and sediment, predating, being predated and transporting it to terrestrial ecosystems when they emerge as winged adults. There are still information gaps that need to be addressed.

A preliminary study on health impacts of Mexican mercury mining workers in a context of precarious employment.

Mercury mining is one of the main sources of mercury (Hg) release into the environment, causing serious impacts on human health and the environment. Workers in these mines are employed informally and precariously and therefore lack labor rights such as social security. The objective of the study is to make visible the exposure to environmental contaminants and the health of workers in mercury mines. An environmental assessment was conducted to determine workers' exposure to contaminants; urine samples were obtained to measure exposure to mercury and arsenic, and blood samples were obtained for lead and cadmium. Clinical parameters were also evaluated. Concentrations of Hg, As and Pb were determined in soil, 279.4 mg/kg (24.4-788.5), 14.7 mg/kg (9.5-20.3) and 1.4 mg/kg (1-2.8), respectively. The exposure results for mercury were 551 µg/g creatinine, for arsenic 50 µg/L and for lead 4.7 µg/dL. Cd-B was not found. In addition, 17.6 % of the workers had diabetes and 17.6 % had renal disorders. Principal Component Regression was performed obtaining an r2 of 0.86 for glomerular filtration rate and 0.54 for albumin creatinine ratio using clinical, occupational, and metal exposure variables. Exposure to Hg in this type of mine is not exclusive, so there is a cumulative risk of chronic exposure to different environmental pollutants directly impacting the health of workers. It is necessary to implement health strategies and different work opportunities for these workers.

Assessment of biomarkers of early kidney damage and exposure to pollutants in artisanal mercury mining workers from Mexico.

Artisanal mercury mining (AMM) is an informal economic activity that employs low technology and limited protection, and poses a risk to workers and their families; due to the extraction process, these scenarios involve exposure to complex mixtures of pollutants that synergistically aggravate the health of miners and people living near the site. Although mercury is the predominant pollutant, there are others such as polycyclic aromatic hydrocarbons (PAHs), toluene, arsenic, and lead which have been classified as nephrotoxic pollutants. Therefore, the purpose of this research was to evaluate the association between exposure to a complex mixture of pollutants (mercury, lead, arsenic, PAHs, and toluene) and kidney damage in artisanal Hg mining workers through early kidney damage proteins (KIM-1, OPN, RBP-4, NGAL, and Cys-C). The results demonstrate the presence of OH-PAHs at concentrations of 9.21 (6.57-80.63) µg/L, hippuric acid as a biomarker of exposure to toluene, As and Pb (655. 1 (203.8-1231) mg/L, 24.05 (1.24-42.98) g/g creatinine, and 4.74 (2.71-8.14) g/dL, respectively), and urinary Hg (503.4 (177.9-878.7) g/g creatinine) in the study population. As well as biomarkers of kidney damage, NGAL and RPB-4 were found in 100% of the samples, KIM-1 and Cys-C in 44.1%, and OPN in 41% of the miners. Significant correlations were found between several of the evaluated pollutants and early kidney damage proteins. Our results demonstrate the application of the early kidney damage biomarkers for the assessment of damage caused by the exposure to mixtures of pollutants and, therefore, the urgent need for monitoring in AMM areas.

Presence of Arsenic in Potential Sources of Drinking Water Supply Located in a Mineralized and Mined Area of the Sierra Madre Oriental in Mexico.

Mine wastes from the La Aurora mine in the state of Guanajuato were generated by the flotation process and placed in four tailing dumps on the local stream while the plant operated. Given that these wastes contain toxic elements, it is important to establish their impact on the quality of several surrounding natural sources of water that are considered potential drinking water supplies. This study identified four water source types, in which the contents of arsenic (As), mercury (Hg), and thallium (Tl) were exceeded, according to international guideline values for drinking water quality. The first type of aqueous sample corresponded to leachates produced by rainwater infiltration in tailings and water-mineral waste interactions. The second type corresponded to surface water along the Xichú and La Laja Streams, and the third and fourth types involved two groundwater well samples and spring samples, respectively. The Chiquito Stream was used as a reference area that had not been impacted by the mine wastes. The isotopic signatures associated with δ34Ssulfate and δ18Osulfate compositions from the El Ojo de Agua spring are similar to those of the Santa María River and are different from those of the mine waste leachates. This study shows evidence of the presence of As in the El Ojo de Agua spring, which results from dissolution of secondary mineral phases that were produced by alteration of the mine wastes, which then migrated along the Xichú Stream system until reaching the spring. These As-bearing fine particles are prone to dissolution when in contact with this water source. Principal component analysis revealed that the observed As, Tl, and Hg can be attributed to weathering of the mine wastes. However, the results suggest that a natural contribution of these elements could be associated with rainwater-igneous rock interactions.

Holistic health risk assessment in an artisanal mercury mining region in Mexico.

Mexico is one of the world's leading mercury producers and exporters. However, mercury mining is carried out using artisanal procedures, which highly impact ecosystems. In the municipality of Pinal de Amoles, Queretaro, Mexico, artisanal mercury mining (AMM) is practiced in a region that has been categorized as a Biosphere Reserve. Therefore, a holistic health risk assessment for mercury was performed in the region, including environmental monitoring (air, water, and soil) and mercury exposure in both humans (children, women, and miners) and biota (plants, rodents, and worms). The atmospheric mercury determination was carried out using the JEROME® J405 analyzer, whereas total mercury in environmental and biological samples was determined by atomic absorption spectrophotometry/cold vapor. Results showed that mercury concentrations in the environmental and biological matrices exceeded their respective reference values. These results demonstrate the direct influence of AMM in the increasing levels of mercury in all the components of the studied ecosystem. Therefore, comprehensive intervention strategies must be implemented to reduce and prevent human health and ecological risks due to the presence of mercury. In this regard, the Minamata Convention for mercury control should include biomonitoring programs not only for humans but also for critical ecological receptors in polluted ecosystems.

Application of the Electronic Nose in Predicting Preeclampsia in High-risk Pregnancies. Pilot Study.

BACKGROUND: Preeclampsia is a syndrome that affects 2-8 % of pregnancies worldwide and is the leading cause of maternal death. Therefore, early detection is crucial to identify women who require clinical monitoring during pregnancy and to evaluate new preventive therapies before clinical symptoms occur. METHODS: The chemical fingerprints of the urine from three study groups pregnant with Preeclampsia, Healthy Pregnant (HP) and pregnant at High Risk of Preeclampsia (HRP) were evaluated using an electronic nose and the data obtained were subjected to principal component analysis (PCA), Canonical Analysis of Principal Coordinates (CAP), Partial Least Squares - Discriminant Analysis (PLS-DA) and ROC curves to determine the diagnostic power of the test. RESULTS: A separation was found between the patients with preeclampsia and HP explaining 99% of the variability of the data. Subsequently, a CAP was obtained with a correct classification of 100%, and the PLS-DA was obtained an accuracy of 88%. With the results of axis CAP1, a ROC curve was performed resulting in a sensitivity of 100% and a specificity of 95.5%. Based on the CAP model it was found that 36% (n=9) of the HRP patients would develop preeclampsia based on the metabolites found in urine. CONCLUSION: metabolomics can be used as a tool for early detection of preeclampsia in high-risk pregnant women, using portable olfactory technology.

Lead (Pb) exposure is associated with changes in the expression levels of circulating miRNAS (miR-155, miR-126) in Mexican women.

The environmental contamination with lead (Pb) is considered a critical issue worldwide. Therefore, this study aimed to evaluate the expression levels of circulating miRNAs (miR-155, miR-126, and miR-145) in Mexican women exposed to Pb. Blood lead levels (BLL) were assessed in enrolled women (n = 190) using an atomic absorption method. Also, serum miRNAs expression levels were quantified through a real-time PCR assay. A mean BLL of 10.5 ± 4.50 µg/dL was detected. Overexpression of miR-155 was detected in highly exposed women. Besides, a significant simple positive relationship (p < 0.05) was found between BLL and serum miR-155 expression levels. Additionally, a significant inverse correlation (p < 0.05) was determined between BLL and serum miR-126 expression levels, as downregulation of miR-126 expression levels was observed in highly exposed women. The findings in this study are the concern, as epigenetic changes detected may represent a connection between health illnesses and Pb exposure.

Effect of gene-environment interaction (arsenic exposure - PON1 Q192R polymorphism) on cardiovascular disease biomarkers in Mexican population.

Cardiovascular diseases (CVDs) are the primary cause of death worldwide. However, little is known about how the interaction between risk factors affects CVDs. Therefore, the aim of this study was to evaluate the effect of the gene-environment interaction (arsenic exposure x PON1 Q192R polymorphism) on serum levels of CVDs biomarkers in Mexican women. Urinary arsenic levels (UAs) ranged from 5.50-145 µg/g creatinine. The allele frequency was 0.38 and 0.62 for the Q and R alleles, respectively. Moreover, significant associations (p<0.05) were detected between UAs and CVDs biomarkers (ADMA, FABP4, and miR-155). Comparable data were found when CVDs biomarkers were evaluated through PON1 genotype, significant (p<0.05) higher serum concentrations of CVDs biomarkers were identified in R allele carriers compared to levels found in Q allele carriers. Besides, a gene-environment interaction was documented. The results of this study we believe should be of significant interest to regulatory authorities worldwide.

Circulating miRNA-126, -145 and -155 levels in Mexican women exposed to inorganic arsenic via drinking water.

The aim of this research was to investigate circulating expression levels of three miRNAs (miR-126, miR-155, and miR-145) proposed as predictive CVD biomarkers in Mexican women exposed to inorganic arsenic via drinking water. Mean UAs concentration of 19.5 ± 14.0 µg/g creatinine was found after urine samples were analyzed (n = 105). Significant associations between UAs levels and serum expression levels of miR-155 (p < 0.05) and miR-126 (p < 0.05) were observed after adjustment for assessed co-variables. Alterations in the serum expression levels of miR-155 and miR-126 may be associated with the onset and development of cardiovascular diseases, hence miRNAs could be proposed as prognostic CVD biomarkers. Data found in this study are of concern and risk reduction plans are necessary for the assessed communities to prevent cardiovascular events in this population of women.

Effectiveness of Two Targeted Temperature Management Methods After Pediatric Postcardiac Arrest: A Multicenter International Study.

OBJECTIVES: It is currently recommended that after return of spontaneous circulation following cardiac arrest, fever should be prevented using TTM through a servo-controlled system. This technology is not yet available in many global settings, where manual physical measures without servo-control is the only option. Our aim was to compare feasibility, safety and quality assurance of servo-controlled system versus no servo-controlled system cooling, TTM protocols for cooling, maintenance and rewarming following return of spontaneous circulation after cardiac arrest in children. DESIGN: Prospective, multicenter, nonrandomized, study. SETTING: PICUs of 20 hospitals in South America, Spain, and Italy, 2012-2014. PATIENTS: Under 18 years old with a cardiac arrest longer than 2 minutes, in coma and surviving to PICU admission requiring mechanical ventilation were included. METHODS: TTM to 32-34°C was performed by prospectively designed protocol across 20 centers, with either servo-controlled system or no servo-controlled system methods, depending on servo-controlled system availability. We analyzed clinical data, cardiac arrest, temperature, mechanical ventilation duration, length of hospitalization, complications, survival, and neurologic outcomes at 6 months. PRIMARY OUTCOME: feasibility, safety and quality assurance of the cooling technique and secondary outcome: survival and Pediatric Cerebral Performance Category at 6 months. MEASUREMENTS AND MAIN RESULTS: Seventy patients were recruited, 51 of 70 TTM (72.8%) with servo-controlled system. TTM induction, maintenance, and rewarming were feasible in both groups. Servo-controlled system was more effective than no servo-controlled system in maintaining TTM (69 vs 60%; p = 0.004). Servo-controlled system had fewer temperatures above 38.1°C during the 5 days of TTM (0.1% vs 2.9%; p < 0.001). No differences in mortality, complications, length of mechanical ventilation and of stay, or neurologic sequelae were found between the two groups. CONCLUSIONS: TTM protocol (for cooling, maintenance and rewarming) following return of spontaneous circulation after cardiac arrest in children was feasible and safe with both servo-controlled system and no servo-controlled system techniques. Achieving, maintaining, and rewarming within protocol targets were more effective with servo-controlled system versus no servo-controlled system techniques.

Impact of arsenic exposure on clinical biomarkers indicative of cardiovascular disease risk in Mexican women.

An appropriate and precise identification of high-risk individuals to develop cardiovascular diseases (CVD) is of high importance to reduce these kinds of diseases, a major health concern worldwide. Therefore, the aim of this research was to evaluate prognostic CVD biomarkers in Mexican women exposed to inorganic arsenic via drinking water. Then, a cross-sectional study including 190 women was achieved. Urinary arsenic (UAs) levels were analyzed as exposure biomarker to that metalloid. While, plasma asymmetric dimethylarginine (ADMA), adipocyte fatty acid-binding protein (FABP4), adiponectin, and chemerin levels, hypertriglyceridemic waist (HW) phenotype, atherogenic index of plasma (AIP), and Framingham risk score (FRS) were assessed as prognostic CVD biomarkers. Mean UAs level detected in the evaluated urinary samples was 45.0 ±â€¯40.0 µg/g creatinine. In addition, mean plasma ADMA, FABP4, chemerin and adiponectin levels were 0.68 µmol/L, 20.3 ng/mL, 12.5 µg/mL, and 255 ng/mL, correspondingly. Approximately, 54% of women participants displayed an HW phenotype. Regarding AIP and FRS values, 0.12 ±â€¯0.15 and 7.50 ±â€¯8.00 were found, respectively. Besides, strong and significant associations (p < 0.05) between UAs and AIP, ADMA, and FABP4 were distinguished. Also, after a multivariate analysis, the association between those variables persisted after adjustment for traditional risk factors of CVD. In conclusion, according to the results found in this research, the most sensible CVD biomarkers distinguished in this study were AIP, ADMA, and FABP4. Nevertheless, more studies are necessary to confirm the results found in this investigation.

[Effect of a four-week vitamin and mineral supplementation on the nutritional status and urinary excretion of arsenic in adolescents]. / Efecto de una suplementación de vitaminas y minerales de cuatro semanas sobre el estado nutricio y excreción urinaria de arsénico en adolescentes.

INTRODUCTION: adequate nutrition in adolescence is important for growth and development. There are environmental factors that cannot be avoided, such as exposure to heavy metals through natural sources such as water. Arsenic is a metalloid that can cause damage to health (alterations in nutritional status, diabetes, cancer) and it has been found in concentrations higher than those allowed in drinking water. OBJECTIVE: to measure the effect of vitamin and mineral supplementation on the nutritional status and urinary excretion of arsenic in adolescents exposed to this metal through drinking water. MATERIAL AND METHODS: an observational, follow-up study of a cohort was conducted to assess the efficacy of vitamin and mineral supplementation on supplementation in 45 adolescents exposed to arsenic in drinking water, who were given a daily multivitamin supplement for four weeks. Weekly nutritional status and arsenic levels in urine and drinking water were evaluated. RESULTS: the basal nutritional intake was low for proteins, fiber, folic acid, vitamin B2, B6, B12, E, C, selenium and iron, increasing their consumption through the supplement during the intervention and with an increase of approximately 1 g/dl of hemoglobin in all participants. At the end of the intervention, there was an increase in fat-free mass and a decrease in the percentage of body fat. In relation to the urinary excretion of arsenic, the biggest elimination of this metalloid was observed from the first week of intervention (35.91 µg/g Cr [IC 95% = 23.2-74.8 µg/g Cr]), which was statistically significant compared to basal levels of urinary arsenic (43.2 µg/g Cr [IC 95% = 30.8-117.6 µg/g Cr]) (p < 0.05), with an average water consumption with As of 96.2 ± 7.5 µg/l. CONCLUSION: four weeks of supplementation with vitamins and minerals in the adolescent population studied improved nutritional status and increased metalloid excretion significantly in the first and second week after intervention.

Introducción: la adecuada nutrición en la adolescencia es de importancia para el crecimiento y desarrollo. Existen factores ambientales que no pueden evitarse, como la exposición a metales pesados a través de fuentes naturales como el agua. El arsénico es un metaloide que puede causar un daño a la salud (alteraciones del estado nutricio, diabetes, cáncer) y ha sido encontrado en concentraciones superiores a las permitidas en el agua de consumo.Objetivo: medir el efecto de una suplementación de vitaminas y minerales sobre el estado nutricio y la excreción urinaria de arsénico en adolescentes expuestos a este metal a través de agua de consumo.Material y métodos: se realizó un estudio de intervención y longitudinal para la valorar la eficacia de la suplementación de vitaminas y minerales sobre la suplementación en 45 adolescentes, expuestos a arsénico en agua de consumo, a quienes se dio un suplemento multivitamínico diariamente durante cuatro semanas. De forma semanal se evaluaron el estado nutricio y los niveles de arsénico en orina y en agua de consumo.Resultados: en la población de estudio se observó que el consumo nutrimental basal fue bajo para proteínas, fibra, ácido fólico, vitamina B2, B6, B12, E, C, selenio y hierro, incrementando su consumo a través del suplemento durante la intervención y con un aumento de aproximadamente 1 g/dl de hemoglobina en todos los participantes. Al final de la intervención presentaron incremento de masa libre de grasa y disminución en el porcentaje de grasa corporal. Por otro lado, en cuanto a la excreción urinaria de arsénico, se observó mayor eliminación de este metal (35,91 µg/g Cr [IC 95% = 23,2-74,8 µg/g Cr]) desde la primera semana de intervención, la cual fue estadísticamente significativa en comparación con los niveles basales de arsénico urinario (43,2 µg/g Cr [IC 95% = 30,8-117,6 µg/g Cr]) (p < 0,05), con un consumo promedio de agua con As de 96,2 ± 7,5 µg/l.Conclusión: la suplementación con vitaminas y minerales de cuatro semanas en la población de adolescentes estudiada mejoró el estado nutricio y aumentó la excreción del metaloide de manera significativa en la primera y segunda semana postintervención.

Efecto de una suplementación de vitaminas y minerales de cuatro semanas sobre el estado nutricio y excreción urinaria de arsénico en adolescentes / Effect of a four-week vitamin and mineral supplementation on the nutritional status and urinary excretion of arsenic in adolescents

Introducción: la adecuada nutrición en la adolescencia es de importancia para el crecimiento y desarrollo. Existen factores ambientales que no pueden evitarse, como la exposición a metales pesados a través de fuentes naturales como el agua. El arsénico es un metaloide que puede causar un daño a la salud (alteraciones del estado nutricio, diabetes, cáncer) y ha sido encontrado en concentraciones superiores a las permitidas en el agua de consumo. Objetivo: medir el efecto de una suplementación de vitaminas y minerales sobre el estado nutricio y la excreción urinaria de arsénico en adolescentes expuestos a este metal a través de agua de consumo. Material y métodos: se realizó un estudio de intervención y longitudinal para la valorar la eficacia de la suplementación de vitaminas y minerales sobre la suplementación en 45 adolescentes, expuestos a arsénico en agua de consumo, a quienes se dio un suplemento multivitamínico diariamente durante cuatro semanas. De forma semanal se evaluaron el estado nutricio y los niveles de arsénico en orina y en agua de consumo. Resultados: en la población de estudio se observó que el consumo nutrimental basal fue bajo para proteínas, fibra, ácido fólico, vitamina B2, B6, B12, E, C, selenio y hierro, incrementando su consumo a través del suplemento durante la intervención y con un aumento de aproximadamente 1 g/dl de hemoglobina en todos los participantes. Al final de la intervención presentaron incremento de masa libre de grasa y disminución en el porcentaje de grasa corporal. Por otro lado, en cuanto a la excreción urinaria de arsénico, se observó mayor eliminación de este metal (35,91 μg/g Cr [IC 95% = 23,2-74,8 μg/g Cr]) desde la primera semana de intervención, la cual fue estadísticamente significativa en comparación con los niveles basales de arsénico urinario (43,2 μg/g Cr [IC 95% = 30,8-117,6 μg/g Cr]) (p < 0,05), con un consumo promedio de agua con As de 96,2 ± 7,5 μg/l. Conclusión: la suplementación con vitaminas y minerales de cuatro semanas en la población de adolescentes estudiada mejoró el estado nutricio y aumentó la excreción del metaloide de manera significativa en la primera y segunda semana postintervención

Introduction: adequate nutrition in adolescence is important for growth and development. There are environmental factors that cannot be avoided, such as exposure to heavy metals through natural sources such as water. Arsenic is a metalloid that can cause damage to health (alterations in nutritional status, diabetes, cancer) and it has been found in concentrations higher than those allowed in drinking water. Objective: to measure the effect of vitamin and mineral supplementation on the nutritional status and urinary excretion of arsenic in adolescents exposed to this metal through drinking water. Material and methods: an observational, follow-up study of a cohort was conducted to assess the efficacy of vitamin and mineral supplementation on supplementation in 45 adolescents exposed to arsenic in drinking water, who were given a daily multivitamin supplement for four weeks. Weekly nutritional status and arsenic levels in urine and drinking water were evaluated. Results: the basal nutritional intake was low for proteins, fiber, folic acid, vitamin B2, B6, B12, E, C, selenium and iron, increasing their consumption through the supplement during the intervention and with an increase of approximately 1 g/dl of hemoglobin in all participants. At the end of the intervention, there was an increase in fat-free mass and a decrease in the percentage of body fat. In relation to the urinary excretion of arsenic, the biggest elimination of this metalloid was observed from the first week of intervention (35.91 μg/g Cr [IC 95% = 23.2-74.8 μg/g Cr]), which was statistically significant compared to basal levels of urinary arsenic (43.2 μg/g Cr [IC 95% = 30.8-117.6 μg/g Cr]) (p < 0.05), with an average water consumption with As of 96.2 ± 7.5 μg/l. Conclusion: four weeks of supplementation with vitamins and minerals in the adolescent population studied improved nutritional status and increased metalloid excretion significantly in the first and second week after intervention

Serum Concentrations of New Predictive Cardiovascular Disease Biomarkers in Mexican Women Exposed to Lead.

The purpose of this study was to evaluate lead exposure and its relationship with serum levels of predictive CVD biomarkers [asymmetric dimethylarginine (ADMA), adipocyte fatty acid-binding protein (FABP4), adiponectin, and chemerin] in women living in San Luis Potosi, Mexico. A mean blood lead level (BLL) of 11.5 ± 9.00 µg/dL (mean ± standard deviation) was found after all blood samples were analyzed. Regarding serum predictive CVD biomarkers, mean serum level of 0.68 ± 0.38 µmol/L, 20.5 ± 16.5 ng/mL, 12.5 ± 3.30 µg/mL, and 255 ± 130 ng/mL were found for ADMA, FABP4, adiponectin, and chemerin, respectively. Simple significant associations (Pearson´s correlations) between BLL and ADMA (r = 0.17; p = 0.04) and FABP4 (r = 0.23; p = 0.03) were found. Furthermore, a multivariate linear regression model showed that BLL was a significant predictor of serum ADMA (ß = 0.06; p = 0.001) and FABP4 (ß = 1.75; p = 0.0004) concentrations after adjusting by confounders. For serum chemerin and adiponectin levels, no associations were found with BLL. In conclusion, high serum ADMA and FABP4 (predictive CVD biomarkers) levels were found in women exposed to lead. Consequently, this research can be used as a point of departure for the prevention of CVD events in populations living in sites environmentally impacted with lead.

Exposure to Mixtures of Pollutants in Mexican Children from Marginalized Urban Areas.

BACKGROUND: Exposure to contaminant mixtures in developing countries is an important public health issue. Children are identified as the most susceptible group to adverse health effects due to the exposure. OBJECTIVE: The aim of this study was to conduct a screening for mixture pollutants in Mexican children in urban marginalized communities. METHODS: We analyzed children (aged 6-12 years old) who resided in four urban marginalized communities in San Luis Potosi, Mexico: i) Bellas Lomas (BEL), a site with vehicular traffic; ii) Tercera Chica (TC), a site with brick kilns; Iii) Rincon de San Jose (SJR), a site with a hazardous waste landfill; and (iv) Morales (MOR) a metallurgical zone with copper-arsenic and electrolytic zinc smelters. Polycyclic Aromatic Hydrocarbons (1-hydroxypyrene (1-OHP)), benzene (trans, trans-muconic acid (t,t-MA), manganese, arsenic and fluoride were quantified in urine and lead in blood samples. FINDINGS: Our results indicate that median exposures to manganese were 4.4, 5.2, 5.8 and 6.3 µg/L for BEL, TC, SJR and MOR, respectively. For BEL, fluoride was present at a higher concentration with 2.3 mg/L followed by MOR, TC and SJR with 1.7, 1.5 and 1.2 mg/L respectively. The highest concentrations of arsenic that were found were 11 µg/L in MOR and lead concentration was reported between 4.2 and 6.8 µg/dL, in BEL, TC and MOR. 1-OHP and t,t-MA were higher in TC (0.23 µmol/mol creatinine (cr), 429.7 µg/g cr, respectively) followed by SJR (0.09 µmol/mol cr, 427.4 µg/g cr), MOR (0.03 µmol/mol cr, 258.6 µg/g cr) and BEL (0.06 µmol/mol cr, 220.6 µg/g cr). CONCLUSION: Considering the large number of people, especially children, exposed to multiple pollutants, it is important to design effective intervention programs that reduce exposure and the resultant risk in the numerous urban marginalized communities in Mexico.

[Primary immunodeficiencies in seriously ill children: Report of 3 clinical cases]. / Inmunodeficiencias primarias en niños gravemente enfermos: a propósito de 3 casos clínicos.

Primary immunodeficiency diseases (PID) are congenital disorders secondary to an impaired immune response. Infections, autoimmune disorders, atopy, and lymphoproliferative syndromes are commonly associated with this disorder. OBJECTIVE: To present and discuss 3 infants diagnosed with PID. CLINICAL CASES: The cases are presented of three patients with PID diagnosed during their first admission to a Paediatric Intensive Critical Care Unit. The first patient, a 4-month-old infant affected by a severe pneumonia, and was diagnosed as a Severe Combined Immunodeficiency Disease. The second patient was an 8-month-old infant with Candida lusitaniae mesenteric adenitis, and diagnosed with a Chronic Granulomatous Disease. The last patient, a 6-month-old infant presented with ecthyma gangrenosum and X-linked agammaglobulinaemia. CONCLUSION: PID should be suspected when an infectious disease does not responde to the appropriate therapy within the expected period. An update of each disease is presented.

Inmunodeficiencias primarias en niños gravemente enfermos: a propósito de 3 casos clínicos / Primary immunodeficiencies in seriously ill children: Report of 3 clinical cases

Las inmunodeficiencias primarias (IDP) son enfermedades congénitas causadas por alteraciones cuantitativas o funcionales de la respuesta inmunitaria. Se caracterizan por predisposición a infecciones, autoinmunidad, alergia y enfermedades linfoproliferativas. Objetivo: Reportar 3 casos de lactantes menores con IDP que se manifestaron como infecciones graves de curso inhabitual. Casos clínicos: Se presentan 3 pacientes diagnosticados como IDP en su estadía en la Unidad de Paciente Crítico Pediátrico. El primero corresponde a un lactante de 4 meses con neumonía multifocal extensa a quien se diagnosticó un síndrome de inmunodeficiencia combinada severa ligada a X; el segundo es un lactante de 8 meses que se manifestó como una adenitis mesentérica por Candida lusitaniae y que correspondió a enfermedad granulomatosa crónica, y el tercero se trata de un lactante de 6 meses que se presentó con un ectima por Pseudomona y se diagnosticó una agammaglobulinemia ligada a X. Conclusión: El diagnóstico de IDP debe sospecharse en presencia de una infección de evolución arrastrada que no responde a tratamiento habitual. Se discuten los casos y se presenta una puesta al día de las patologías diagnosticadas.

Primary immunodeficiency diseases (PID) are congenital disorders secondary to an impaired immune response. Infections, autoimmune disorders, atopy, and lymphoproliferative syndromes are commonly associated with this disorder. Objective: To present and discuss 3 infants diagnosed with PID. Clinical cases: The cases are presented of three patients with PID diagnosed during their first admission to a Paediatric Intensive Critical Care Unit. The first patient, a 4-month-old infant affected by a severe pneumonia, and was diagnosed as a Severe Combined Immunodeficiency Disease. The second patient was an 8-month-old infant with Candida lusitaniae mesenteric adenitis, and diagnosed with a Chronic Granulomatous Disease. The last patient, a 6-month-old infant presented with ecthyma gangrenosum and X-linked agammaglobulinaemia. Conclusion: PID should be suspected when an infectious disease does not responde to the appropriate therapy within the expected period. An update of each disease is presented.