Systematic Review of Potential Health Risks Posed by Pharmaceutical, Occupational and Consumer Exposures to Metallic and Nanoscale Aluminum, Aluminum Oxides, Aluminum Hydroxide and Its Soluble Salts

Aluminum (Al) is a ubiquitous substance encountered both naturally (as the third most abundant element) and intentionally (used in water, foods, pharmaceuticals, and vaccines); it is also present in ambient and occupational airborne particulates. Existing data underscore the importance of Al physical and chemical forms in relation to its uptake, accumulation, and systemic bioavailability. The present review represents a systematic examination of the peer-reviewed literature on the adverse health effects of Al materials published since a previous critical evaluation compiled by Krewski et al. (2007). Challenges encountered in carrying out the present review reflected the experimental use of different physical and chemical Al forms, different routes of administration, and different target organs in relation to the magnitude, frequency, and duration of exposure. Wide variations in diet can result in Al intakes that are often higher than the World Health Organization provisional tolerable weekly intake (PTWI), which is based on studies with Al citrate. Comparing daily dietary Al exposures on the basis of “total Al”assumes that gastrointestinal bioavailability for all dietary Al forms is equivalent to that for Al citrate, an approach that requires validation. Current occupational exposure limits (OELs) for identical Al substances vary as much as 15-fold. The toxicity of different Al forms depends in large measure on their physical behavior and relative solubility in water. The toxicity of soluble Al forms depends upon the delivered dose of Al+ 3 to target tissues. Trivalent Al reacts with water to produce bidentate superoxide coordination spheres [Al(O2)(H2O4)+ 2 and Al(H2O)6 + 3] that after complexation with O2•−, generate Al superoxides [Al(O2•)](H2O5)]+ 2. Semireduced AlO2• radicals deplete mitochondrial Fe and promote generation of H2O2, O2 • − and OH•. Thus, it is the Al+ 3-induced formation of oxygen radicals that accounts for the oxidative damage that leads to intrinsic apoptosis. In contrast, the toxicity of the insoluble Al oxides depends primarily on their behavior as particulates. Aluminum has been held responsible for human morbidity and mortality, but there is no consistent and convincing evidence to associate the Al found in food and drinking water at the doses and chemical forms presently consumed by people living in North America and Western Europe with increased risk for Alzheimer\u27s disease (AD). Neither is there clear evidence to show use of Al-containing underarm antiperspirants or cosmetics increases the risk of AD or breast cancer. Metallic Al, its oxides, and common Al salts have not been shown to be either genotoxic or carcinogenic. Aluminum exposures during neonatal and pediatric parenteral nutrition (PN) can impair bone mineralization and delay neurological development. Adverse effects to vaccines with Al adjuvants have occurred; however, recent controlled trials found that the immunologic response to certain vaccines with Al adjuvants was no greater, and in some cases less than, that after identical vaccination without Al adjuvants. The scientific literature on the adverse health effects of Al is extensive. Health risk assessments for Al must take into account individual co-factors (e.g., age, renal function, diet, gastric pH). Conclusions from the current review point to the need for refinement of the PTWI, reduction of Al contamination in PN solutions, justification for routine addition of Al to vaccines, and harmonization of OELs for Al substances

First tephrostratigraphic results of the DEEP site record from Lake Ohrid (Macedonia and Albania)

A tephrostratigraphic record covering the Marine Isotope Stages (MIS) 1–15 was established for the DEEP site record of Lake Ohrid (Macedonia and Albania). Major element analyses (energy dispersive spectroscopy (EDS) and wavelength-dispersive spectroscopy (WDS)) were carried out on juvenile fragments extracted from 12 tephra layers (OH-DP-0115 to OH-DP-2060). The geochemical analyses of the glass shards of all of these layers suggest an origin in the Italian volcanic provinces. They include the Y-3 (OH-DP-0115, 26.68–29.42 ka cal BP), the Campanian Ignimbrite–Y-5 (OH-DP-0169, 39.6 ± 0.1 ka), and the X-6 (OH-DP-0404, 109 ± 2 ka) from the Campanian volcanoes, the P-11 of Pantelleria (OH-DP-0499, 133.5 ± 2 ka), the Vico B (OH-DP-0617, 162 ± 6 ka) from the Vico volcano, the Pozzolane Rosse (OH-DP-1817, 457 ± 2 ka) and the Tufo di Bagni Albule (OH-DP-2060, 527 ± 2 ka) from the Colli Albani volcanic district, and the Fall A (OH-DP-2010, 496 ± 3 ka) from the Sabatini volcanic field. Furthermore, a comparison of the Ohrid record with tephrostratigraphic records of mid-distal archives related to the Mediterranean area allowed the recognition of the equivalents of other less known tephra layers, such as the TM24a–POP2 (OH-DP-0404, 102 ± 2 ka) recognized in the Lago Grande di Monticchio and the Sulmona Basin, the CF-V5–PRAD3225 (OH-DP-0624, ca. 163 ± 22 ka) identified in the Campo Felice Basin and the Adriatic Sea, the SC5 (OH-DP-1955, 493.1 ± 10.9 ka) recognized in the Mercure Basin, and the A11/12 (OH-DP-2017, 511 ± 6 ka) sampled at the Acerno Basin, whose specific volcanic sources are still poorly constrained. Additionally, one cryptotephra (OH-DP-0027) was identified by correlation of the potassium X-ray flourescence (XRF) intensities from the DEEP site with those from a short core of a previous study from Lake Ohrid. In these cores, a maximum in potassium is caused by glass shards, which were correlated with the Mercato tephra (8.43–8.63 ka cal BP) from Somma–Vesuvius. The tephrostratigraphic work presented here allows, for the first time, the extension of a consistent part of the Middle Pleistocene tephrostratigraphy of Italian volcanoes as far as the Balkans. The establishment of the tephrostratigraphic framework for the Lake Ohrid record provides important, independent tie points for the age–depth model of the DEEP site sequence, which is a prerequisite for palaeoclimatic and palaeoenvironmental reconstructions. Furthermore, this age–depth model will help to improve and re-evaluate the chronology of other, both undated and dated tephra layers from other records. Thus, the Lake Ohrid record may potentially become the template for the central Mediterranean tephrostratigraphy, especially for the hitherto poorly known and explored lower Middle Pleistocene period

Evaluación del Diklason® ampollas en el dolor agudo

Antecedentes: El dolor agudo es definido como dolor de reciente comienzo y probablemente de duración limitada que se relaciona de manera causal y temporal con un daño o enfermedad.Los antiinflamatorios no esteroideos modulan el dolor periférico por reducción de la producción de prostaglandinas y de los neuropéptidos. Ejemplos típicos de dolor agudo son: el dolor post-operatorio, lumbago, dolor por injuria de partes blandas o hueso y cólico nefrítico. Este tipo de dolor es incrementado por la ansiedad, el catastrofismo, neuroticismo y la depresión. El diclofenac potásico ha demostrado ser un fármaco seguro y efectivo en el manejo del dolor agudo.Material y Método: Se realizó un estudio abierto, prospectivo y multicéntrico en 220 pacientes con diagnóstico de dolor agudo, de intensidad severa y moderada a los cuales se les suministró una dosis IM o IV de diclofenac potásico (Diklason®) de 75 mg y se midió la intensidad del dolor mediante las siguientes escalas: VAS 0-100, PID, SPID, Pain Relief y TOTPAR, medicación de rescate y escala clínica de cambio.La inocuidad se evaluó por interrogatorio directo de efectos adversos.Las evaluaciones se realizaron al inicio, a las 0.5, 1, 2, 4, 6, 8 y 12 h de la administración de la dosis.Resultados: Se produjo un descenso importante en los niveles de VAS desde los 30 min. de tratamiento y este descenso fue significativo entre los períodos de evaluación hasta las 8 horas, el efecto persistió hasta las 12 horas. El 90,45% de los pacientes comenzaron a sentir alivio del dolor a los 30 min. Todas las escalas evaluadas mostraron cambios significativos en los períodos evaluados desde los primeros 30 min. hasta las 8 horas (SPID), 12 h (SPID, PR, y TOTPAR).En el 92,72% de los pacientes los resultados fueron adecuados: excelentes (56,3%) y buenos (36,36%). Se presentaron 6 efectos adversos leves.Conclusiones: El diclofenac potásico (Diklason®) resulta rápido, efectivo y duradero en el manejo del dolor agudo de diferentes etiologías.Background: Acute pain is defined as a pain of recent onset and probably limited duration which is associated with a causal and temporal damage or disease.NSAIDs modulate peripheral pain by reducing prostaglandin and neuropeptides production. Typical examples of acute pain include post operatory, lumbago, bone or soft tissue injuries and, renal colic. This type of pain is increased by anxiety, catastropic events, neuroticism and depression. Diclofenac potassium is proved to be safe and effective in management acute pain.Materials and methods: We conducted a multicenter; prospective, open study in 220 patients with acute pain (moderate to severe intensity) which supply with IM or IV dose of diclofenac potassium (Diklason®) 75 mg, the pain intensity was measured by the following scales: VAS 0-100, PID, SPID, Pain Relief and TOTPAR, rescue medication and clinical scale changes.The safety was assessed by direct questioning side effects.Evaluations were performed at baseline at 30 minutes, 1, 2, 4, 6, 8, and 12 hours after dosage.Results: There was a significant decrease in VAS levels from 30 minutes of treatment and this decrease was significant between the evaluation periods up to 8 hours, the effect persisted for 12 hours. In 90.45% of patients began to feel pain relief within 30 minutes. All scales evaluated showed significant changes in the periods evaluated from the first 30 minutes up to 8 hours (SPID), 12 h (SPID, PR, and TOTPAR).In 92.72% of results were suitable: excellent (56.3%) and good (36.36%). We found 6 mild adverse effects.Conclusions: Diclofenac potassium (Diklason®) is quick, effective and durable in the management of acute pain of various etiologies