Hepatic morphopathologic findings of lead poisoning in a drug addict: A case report

We describe the case of a 40-year old Iranian man who was admitted to our hospital with severe abdominal pain, abnormal liver function tests and normocytic anemia. Suffering from multiple sclerosis, he was a regular user of opium for pain relief. Basophilic stippling of erythrocytes pointed towards the diagnosis of lead intoxication, the most likely source being contaminated Iranian opium. Serum lead and zinc protoporphyrin levels were strongly elevated. To assess the hepatotoxic effects of lead poisoning a liver biopsy was performed. Pathomorphologic fi ndings of hepatotoxicity, rarely reported in humans, included active hepatitis together with extensive microvesicular and macrovesicular steatosis, hemosiderosis and cholestasis, and a lymphocytic cholangitis. Whilst treated with chelating therapy, liver enzymes returned to normal, suggesting reversibility of the histological findings

Exploring cardiovascular health: the Healthy Life in Suriname (HELISUR) study. A protocol of a cross-sectional study

Obesity, hypertension and diabetes are on a dramatic rise in low-income and middle-income countries, and this foretells an overwhelming increase in chronic disease burden from cardiovascular disease. Therefore, rapid action should be taken through preventive population-based programmes. However, in these regions, data on the population distribution of cardiovascular risk factors, and of intermediate and final end points for cardiovascular disease are scarce. The Healthy Life in Suriname (HELISUR) study is a cardiovascular population study in Suriname, which is part of the Caribbean Community. The HELISUR study is dedicated to provide data on risk factors and prevalent cardiovascular disease in the multiethnic population, which is mainly of African and Asian descent. In a cross-sectional, observational population-based setting, a random representative sample of 1800 citizens aged between 18 and 70 years will be selected using a cluster household sampling method. Self-reported demographic, socioeconomic and (cardiovascular) health-related data will be collected. Physical examination will include the assessment of cardiovascular risk factors and prevalent cardiovascular disease. In addition, we will study cardiovascular haemodynamics non-invasively, as a novel intermediate outcome. Finally, fasting blood and overnight urine samples will be collected to monitor cardiometabolic risk factors. The main outcome will be descriptive in reporting the prevalence of risk factors and measures of (sub) clinical end organ damage, stratified for ethnicity and sex-age groups. Ethical approval has been obtained from the State Secretary of Health. Data analysis and manuscript submission are scheduled for 2016. Findings will be disseminated in peer-reviewed journals, and at national, regional and international scientific meetings. Importantly, data will be presented to Surinamese policymakers and healthcare workers, to develop preventive strategies to combat the rapid rise of cardiovascular diseas

Assessing the feasibility of the Healthy Life in Suriname Study: using advanced hemodynamics to evaluate cardiovascular risk

Objectives. To determine the feasibility of assessing population cardiovascular risk with advanced hemodynamics in the Healthy Life in Suriname (HELISUR) study. Methods. This was a preliminary study conducted in May - June 2012 using the Technical-Economic-Legal-Operational-Scheduling (TELOS) method to assess the feasibility of the HELISUR-a large-scale, cross-sectional population study of cardiovascular risk factors and disease in Suriname. Suriname, a middle-income country in South America with a population of mostly African and Asian ethnicity, has a high risk of cardiovascular disease. A total of 135 volunteers 18 - 70 years of age participated. A health questionnaire was tested in a primary health care center, and non-invasive cardiovascular evaluations were performed in an academic health center. The cardiovascular evaluation included sitting, supine, and standing blood pressure, and intermediate endpoints, such as cardiac output, peripheral vascular resistance, pulse wave velocity, and augmentation index. Results. The TELOS testing found that communicating by cellular phone was most effective for appointment adherence, and that completion of the questionnaire often required assistance from a trained interviewer; modifications to improve the clarity of the questions are recommended. Regarding the extended cardiovascular assessments of peripheral and central hemodynamics, the findings showed these to be technically and operationally feasible and well tolerated by participants, in terms of burden and duration. Conclusions. Findings of this feasibility assessment indicate that large-scale, detailed evaluations of cardiovascular risk, including a questionnaire and advanced central and peripheral hemodynamics, are feasible in a high-risk population in a middle-income settin

Prevalence of self-reported stroke in association with ethnic background within a multi-ethnic population in Paramaribo, Suriname: Results from the HeliSur study.

Background: Suriname is a middle-income country with a multi-ethnic population. Urbanization and ethnicity may be associated with incidence of cerebrovascular disease, but so far this has not been documented for Suriname. The objective of this study was to examine the prevalence of stroke in the capital of Suriname, and its association with ethnicity. Methods: Using the self-reported data from the ‘Healthy life in Suriname’ (HeliSur) study, we determined the prevalence of stroke in 1,478 subjects. The odds for having suffered from stroke in Javanese, Maroons and Creoles were separately compared to the odds in Hindustani. Odds ratios were adjusted for traditional risk factors including age, sex, diabetes, hypertension, dyslipidemia, and smoking, by use of multiple logistic regression analysis. Results:The overall prevalence of stroke in urban Surinameis 3.2% (95% CI 2.3 to 4.0%). Hindustani reported the highest prevalence of stroke (4.1%, 95% CI 2.4 to 5.8%) compared to the Javanese (2.0%, 95% CI 0 to 4.0%), Creoles (3.6%, 95% CI 2.7 to 4.5%) and Maroons (1.8%, 95% CI 0.5 to 3.1%). Adjusted odds ratios showed no significant association between ethnic background and stroke. Conclusions: Stroke prevalence is high in urban Suriname, and there seems to be ethnic difference in its prevalence. However, with and without adjustments for traditional risk factors, no significant association between stroke and ethnicity could be shown.</p

Prevalence of self-reported stroke in association with ethnic background within a multi-ethnic population in Paramaribo, Suriname: Results from the helisur study

Background: Suriname is a middle-income country with a multi-ethnic population. Urbanization and ethnicity may be associated with incidence of cerebrovascular disease, but so far this has not been documented for Suriname. The objective of this study was to examine the prevalence of stroke in the capital of Suriname, and its association with ethnicity. Methods: Using the self-reported data from the ‘Healthy life in Suriname’ (HeliSur) study, we determined the prevalence of stroke in 1,478 subjects. The odds for having suffered from stroke in Javanese, Maroons and Creoles were separately compared to the odds in Hindustani. Odds ratios were adjusted for traditional risk factors including age, sex, diabetes, hypertension, dyslipidemia, and smoking, by use of multiple logistic regression analysis. Results:The overall prevalence of stroke in urban Surinameis 3.2% (95% CI 2.3 to 4.0%). Hindustani reported the highest prevalence of stroke (4.1%, 95% CI 2.4 to 5.8%) compared to the Javanese (2.0%, 95% CI 0 to 4.0%), Creoles (3.6%, 95% CI 2.7 to 4.5%) and Maroons (1.8%, 95% CI 0.5 to 3.1%). Adjusted odds ratios showed no significant association between ethnic background and stroke. Conclusions: Stroke prevalence is high in urban Suriname, and there seems to be ethnic difference in its prevalence. However, with and without adjustments for traditional risk factors, no significant association between stroke and ethnicity could be shown.Biomechanical EngineeringBiomechatronics & Human-Machine Contro