Biomonitoring of metal in children living in a mine tailings zone in Southern Mexico: A pilot study

Accumulation of metals in soil represents a health risk for individuals living near mining areas, especially for children who have a higher susceptibility to metal related diseases. The Taxco mining district in Southern Mexico was one of the largest Mexican metal producers of silver and gold, among other metals. The aim of this pilot study was to evaluate metal exposure on children aged 6-11 years living in and around the Taxco mine tailings zone. Lead in blood (PbB) was measured by graphite furnace atomic absorption spectrophotometry (AAS). Urine arsenic (AsU) was measured by hydride generation AAS, urinary Hg (HgU) by flow injection cold vapor atomic absorption, and urinary concentration of other metals such as chromium (Cr), nickel (Ni), cadmium (Cd), barium (Ba), cobalt (Co), copper (Cu), zinc (Zn), manganese (Mn), molybdenum (Mo), strontium (Sr), and iron (Fe) were determined by inductively coupled plasma optical emission spectrometry. Fifty samples were analyzed for PbB, AsU, and HgU, and 35 samples for the other metals. The mean concentration +/- SD for each metal was: PbB, 9.4 +/- 3.3 mu g/d

Cerebellar Contributions to Hypokinetic Symptoms in an Acute Lesion Parkinsonism Model

Background: Parkinsonism, characterized by motor symptoms, is typically attributed to basal ganglia dysfunction. Recent evidence suggests that the cerebellum may also influence these symptoms. This study investigated Crus II, the dentate nucleus (DN), and the inferior olive (IO) in a rat model of parkinsonism induced by a bilateral ventrolateral striatal (VLS) lesion. Materials and Methods: Twenty-four male Wistar rats were divided into control (n = 12) and experimental (n = 12) groups. Monopolar electrodes were implanted in target structures. The experimental group received a bilateral VLS lesion. Animals underwent four weekly sessions of electrophysiological recordings and blind behavioral assessments (resting, grooming, locomotion, rearing, sniffing) via video tracking. Power spectral density (PSD) in the 300–500 Hz band was computed. Statistical analyses included Mann–Whitney U, Friedman with Wilcoxon post hoc, and Spearman correlation tests. Results: During weeks one and two, there were significant PSD increases in the experimental group compared to the control, particularly in Crus II—grooming (p = 0.005), locomotion (p = 0.007), and rearing (p = 0.026); in IO—sniffing (p = 0.0167); and in DN—grooming (p < 0.001) and locomotion (p = 0.0008). Additionally, intragroup analysis revealed significant PSD elevations relative to baseline in these structures. Significant correlations were observed only for grooming (negative correlations) and sniffing (positive correlations) across all cerebellar regions. Conclusions: These findings suggest compensatory cerebellar hyperactivity induced by VLS lesion, potentially modulating hypokinetic symptoms and highlighting dynamic network interactions. Interpretation warrants caution due to limitations inherent to the acute lesion model and experimental duration

Characterizing Secondary and Atypical Parkinsonisms: Defining Features and Clinical Variability

Parkinsonism is a clinical syndrome characterized by akinesia/bradykinesia, muscle rigidity, resting tremor, and postural instability. Within the group of parkinsonisms is Parkinson’s disease, also known as neurodegenerative parkinsonian syndrome. The group of atypical parkinsonisms was established due to the existence of sporadic parkinsonisms that do not share the exact etiology of Parkinson’s disease. Additionally, parkinsonisms that arise from causes other than neurodegeneration have been classified as secondary parkinsonisms. With this in mind, given the diversity of etiologies that can trigger parkinsonism, it is crucial to understand the symptomatology and its relationship with the basal ganglia (including damage to the nigrostriatal pathway, neuroinflammation, and neuronal damage). Only then will it be possible to propose appropriate treatments for each variant of parkinsonism

Electrocardiographic pattern in V1, aVL and I as predictor of events in heart failure following cardiac resincronization

Abstract Funding Acknowledgements Type of funding sources: None. Introduction following cardiac resincronization therapy (CRT), QRS duration is the most important prognostic factor in the 12-lead electrocardiogram (ECG). However, there is little evidence regarding if the electrocardiographic pattern following CRT has impact on morbidity and mortality. Purpose In this historical cohort study we analysed if a certain pattern in three leads of the ECG (Rs in V1, Qr in aVL or rS in I) is associated with lower incidence of adverse outcomes in a population of CRT patients within 1 year of implant. Other variables previously associated with success or failure of CRT were analysed. Methods patients with CRT devices with left ventricle lead in the coronary sinus were included from January 2012 to April 2019. The primary endpoint was a composite of death of any cause and heart failure hospitalization at 1 year. Survival analysis was performed using Kaplan-Meier test, comparing survival graphics through Log-Rank test. For multivariate analysis, Cox regression was performed. Results 111 patients were included. Sample was divided into 2 groups according to the presence of the pattern in any of the three ECG leads. Baseline characteristics are reported in Table 1. Presence of any of the three patterns was independently associated with a lower incidence of the primary endpoint (2.3% vs. 17.6%, hazard ratio 0.1, 95% confidence interval 0.013-0.774, p = 0.016). Previous atrial fibrillation was also independently associated with a higher incidence of the primary endpoint. QRS duration postimplantation did not showed prognostic value. Conclusion the presence of the patterns Rs in V1, Qr in aVL or rS in I is an independent predictor of good prognosis in patients with CRT. Baseline characteristicsPattern Rs-V1/Qr-aVL/rS-INo patternp-valueAge (years)69 ± 1767 ± 210.257Women8 (18.6)17 (25)0.432Atrial fibrillation18 (41.9)22 (32.4)0.309- Ischemic cardiomyopathy- Non ischemic cardiomyopathy18 (41.9)25 (58.1)26 (38.8)41 (61.2)0.75Indication- HFrEF + NYHA II-IV + wide QRS- rEF + indication of cardiac stimulation- LV dysfunction secondary to stimulation 35 (81.4)7 (16.3)1 (2.3) 58 (85.3)9 (13.2)1 (1.5) 0.5870.6560.741Preimplantation LVEF (%)28 ± 1328 ± 150.882Up-titrated treatment17 (39.5)26 (38.2)0.891- LBBB- RBBB36 (83.7)5 (11.6)61 (89.7)6 (8.8)0.3550.63QRS duration postimplantation (ms)144 ± 35142 ± 500.657HFrEFheart failure with reduced ejection fraction; NYHA: New York Heart Association; rEF: reduced ejection fraction; LV: left ventricle; LVEF: left ventricle ejection fraction; LBBB: left bundle branch block; RBBB: right bundle branch block.Abstract Figure. Kaplan Meier survival curves </jats:sec

Prognostic effect of the electrocardiographic pattern following cardiac resincronization

Abstract Introduction Following cardiac resincronization therapy (CRT), QRS duration is the most important prognostic factor in the 12-lead electrocardiogram (ECG). However, there is little evidence regarding if the electrocardiographic pattern following CRT has impact on morbidity and mortality. Purpose In this historical cohort study we analysed if a certain pattern in three leads of the ECG (Rs in V1, Qr in aVL or rS in I) is associated with lower incidence of adverse outcomes in a population of CRT patients within 1 year of implant. Other variables previously associated with success or failure of CRT were analysed. Methods Patients with CRT devices (pacemaker or defibrillator) with left ventricle lead in the coronary sinus were included from January 2012 to April 2019. One year clinical follow-up was performed. The primary endpoint was a composite of death of any cause and heart failure hospitalization. Differences in categorical data were reported as frequencies then compared using χ2 tests. Continuous variables were reported as means ± standard deviation with differences between groups tested using independent samples t-tests. Survival analysis was performed using Kaplan-Meier test, comparing survival graphics through Log-Rank test. For multivariate analysis, Cox regression was performed. Variables that showed significance in the univariate analysis were included. Results 111 patients were included. Sample was divided into 2 groups according to the presence of the pattern in any of the three ECG leads. Two patients (1.8%) presented Rs in V1 and Qr in aVL simultanously and two patients (1.8%) presented Rs in V1 and rS in I. None of the patients presented all three patterns simultaneously. Baseline characteristics are reported in Table 1. Presence of any of the three patterns was independently associated with a lower incidence of the primary endpoint (2.3% vs. 17.6%, hazard ratio 0.1, 95% confidence interval 0.013–0.774, p=0.016). Previous atrial fibrillation was also independently associated with a higher incidence of the primary endpoint. QRS duration postimplantation did not showed prognostic value. Conclusion The presence of the patterns Rs in V1, Qr in aVL or rS in I is an independent predictor of good prognosis in patients with CRT. Funding Acknowledgement Type of funding sources: None. Baseline characteristicsKaplan Meier survival curves </jats:sec