Ecologic constituent of risk of reproductive complications

Technogenic pressure contributes to the constant emission of significant amounts of chemical pollutants in the environment, thus increasing the risk of ecologically conditioned pathology in the population of urbanized areas. Of the variety of environmental factors that have a detrimental effect on the body of a future mother, cadmium plays a particularly important role as a risk factor for complications in the course of pregnancy. Therefore, the purpose of the research was to determine the influence of external exposures of cadmium on the level of internal contamination of the body of pregnant women and the frequency of manifestation of nephropathy among residents of Dnipropetrovsk region in the complex impact of different levels of environmental pollution. The research program included an assessment of the cadmium content in life-saving environmental facilities and biological substrates of 89 healthy pregnant women, as well as a retrospective analysis of data of the primary statistical documentation on the complication of pregnancy. It is established that cadmium has a constant presence in environmental objects, in concentrations that do not exceed the normative meanings. The level of cadmium in the blood and urine of women in industrial districts is significantly higher in comparison with the control (

Second asymptomatic carotid surgery trial (ACST-2): a randomised comparison of carotid artery stenting versus carotid endarterectomy

Background: Among asymptomatic patients with severe carotid artery stenosis but no recent stroke or transient cerebral ischaemia, either carotid artery stenting (CAS) or carotid endarterectomy (CEA) can restore patency and reduce long-term stroke risks. However, from recent national registry data, each option causes about 1% procedural risk of disabling stroke or death. Comparison of their long-term protective effects requires large-scale randomised evidence. Methods: ACST-2 is an international multicentre randomised trial of CAS versus CEA among asymptomatic patients with severe stenosis thought to require intervention, interpreted with all other relevant trials. Patients were eligible if they had severe unilateral or bilateral carotid artery stenosis and both doctor and patient agreed that a carotid procedure should be undertaken, but they were substantially uncertain which one to choose. Patients were randomly allocated to CAS or CEA and followed up at 1 month and then annually, for a mean 5 years. Procedural events were those within 30 days of the intervention. Intention-to-treat analyses are provided. Analyses including procedural hazards use tabular methods. Analyses and meta-analyses of non-procedural strokes use Kaplan-Meier and log-rank methods. The trial is registered with the ISRCTN registry, ISRCTN21144362. Findings: Between Jan 15, 2008, and Dec 31, 2020, 3625 patients in 130 centres were randomly allocated, 1811 to CAS and 1814 to CEA, with good compliance, good medical therapy and a mean 5 years of follow-up. Overall, 1% had disabling stroke or death procedurally (15 allocated to CAS and 18 to CEA) and 2% had non-disabling procedural stroke (48 allocated to CAS and 29 to CEA). Kaplan-Meier estimates of 5-year non-procedural stroke were 2·5% in each group for fatal or disabling stroke, and 5·3% with CAS versus 4·5% with CEA for any stroke (rate ratio [RR] 1·16, 95% CI 0·86–1·57; p=0·33). Combining RRs for any non-procedural stroke in all CAS versus CEA trials, the RR was similar in symptomatic and asymptomatic patients (overall RR 1·11, 95% CI 0·91–1·32; p=0·21). Interpretation: Serious complications are similarly uncommon after competent CAS and CEA, and the long-term effects of these two carotid artery procedures on fatal or disabling stroke are comparable. Funding: UK Medical Research Council and Health Technology Assessment Programme

Ecotoxicological aspects of the influence of cadmium on the human organism

<p>Golovkova T. A. Ecotoxicological aspects of the influence of cadmium on the human organism. Актуальні проблеми транспортної медицини / Actual problems of transport medicine / 2018;1(51):146-149. ISSN 1818-9385</p> <p>DOI http://dx.doi.org/10.5281/zenodo.1239459</p> <p>http://aptm.org.ua</p> <p> </p> <p> </p> <p>UDК: 612.66-055.2:546.48</p> <p> </p> <p>ECOTOXICOLOGICAL ASPECTS OF THE INFLUENCE OF CADMIUM</p> <p>ON THE HUMAN ORGANISM</p> <p> </p> <p>Golovkova T. A.</p> <p> </p> <p>State establishment "Dnipropetrovsk Medical Academy of Health Ministry of Ukraine"</p> <p>Department of General Hygiene, Dnipro, Ukraine</p> <p> </p> <p>Summary</p> <p>Technogenic pressure contributes to the constant emission of significant amounts of chemical pollutants in the environment, thus increasing the risk of ecologically conditioned pathology in the population of urbanized areas. Of the variety of environmental factors that have a detrimental effect on the body of a future mother, cadmium plays a particularly important role as a risk factor for complications in the course of pregnancy. Therefore, the purpose of the research was to determine the influence of external exposures of cadmium on the level of internal contamination of the body of pregnant women and the frequency of manifestation of nephropathy among residents of Dnipropetrovsk region in the complex impact of different levels of environmental pollution. The research program included an assessment of the cadmium content in life-saving environmental facilities and biological substrates of 89 healthy pregnant women, as well as a retrospective analysis of data of the primary statistical documentation on the complication of pregnancy. It is established that cadmium has a constant presence in environmental objects, in concentrations that do not exceed the normative meanings. The level of cadmium in the blood and urine of women in industrial districts is significantly higher in comparison with the control (p <0.01), up to 36-50% of Dnipro citizens have an increased cadmium content in urine relative to norm, and its concentrations have a direct correlation dependence with the frequency of manifestations of nephropathy of pregnant women in apparently women. The established enhanced renal excretion of cadmium reflects the stresses of adaptation processes in the body of the pregnant woman, which is possibly due to an increase in the toxic effect of xenobiotics in this vulnerable to the physiological state period.</p> <p>Key words: pregnant women, cadmium, blood, urine, nephropathy of pregnant women.</p