Effect of chronic lead intoxication on the distribution and elimination of amoxicillin in goats

A study of amoxicillin pharmacokinetics was conducted in healthy goats and goats with chronic lead intoxication. The intoxicated goats had increased serum concentrations of liver enzymes (alanine aminotransferase and gamma-glutamyl transferase), blood urea nitrogen, and reactivated delta-aminolevulinic acid dehydratase compared to the controls. Following intravenous amoxicillin (10 mg/kg bw) in control and lead-intoxicated goats, elimination half-lives were 4.14 and 1.26 h, respectively. The volumes of distribution based on the terminal phase were 1.19 and 0.38 L/kg, respectively, and those at steady-state were 0.54 and 0.18 L/kg, respectively. After intramuscular (IM) amoxicillin (10 mg/kg bw) in lead-intoxicated goats and control animals, the absorption, distribution, and elimination of the drug were more rapid in lead-intoxicated goats than the controls. Peak serum concentrations of 21.89 and 12.19 microg/mL were achieved at 1 h and 2 h, respectively, in lead-intoxicated and control goats. Amoxicillin bioavailability in the lead-intoxicated goats decreased 20% compared to the controls. After amoxicillin, more of the drug was excreted in the urine from lead-intoxicated goats than the controls. Our results suggested that lead intoxication in goats increases the rate of amoxicillin absorption after IM administration and distribution and elimination. Thus, lead intoxication may impair the therapeutic effectiveness of amoxicillin.

Hipertensión endocraneana benigna en un niño intoxicado por plomo / Benign endocraneal hypertension in a lead intoxicated child

Se expone el caso clínico de un escolar de 5 años de edad, que un mes antes de su ingreso presentaba alteraciones neuroconductuales, cefalea y síntomas generales, además de ser tratado ambulatoriamente a causa de anemia carencial. Ingresó en la Unidad de Cuidados Intensivos Pediátricos del Hospital Infantil Sur Docente de Santiago de Cuba con hipertensión endocraneana benigna y evolutivamente se le diagnosticó una intoxicación plúmbica, al manipularse sustancias que contenían plomo en su medio familiar, el cual penetró en su organismo por vías oral e inhalatoria. Ese hallazgo constituyó el punto de partida para la confirmación de otros afectados por el citado metal en su entorno comunitario.

The case report of a 5 year-old school child who a month before beginning school had neurobehavioral alterations, migraine and general symptoms is presented. He had been treated in the out-patient department due to lacking anemia. He was admitted to the Intensive Care Pediatric Unit from the Southern Teaching Children Hospital in Santiago de Cuba with benign endocraneal hypertension and during the clinical course he was diagnosed a lead intoxication,when substances that contained lead were manipulated in his house , which penetrated his organism through oral and inhalatory routes. This finding constituted the starting point for the confirmation of other members of his community affected by the mentioned metal.

Prevalência de anemia em trabalhadores expostos ocupacionalmente ao chumbo / Prevalence of anemia in workers with work-related exposure to lead

O chumbo é um dos elementos mais abundantes da natureza. Atualmente o chumbo é muito utilizado na manufatura de baterias, latão e bronze, radiadores, soldas, cabos, tintas, corantes, cerâmicas, munição, entre outros. A intoxicação do chumbo é chamada de saturnismo e está na maioria das vezes relacionada à atividade profissional. O chumbo pode causar alterações neurológicas, hematológicas, renais, cardíacas e reprodutivas. O objetivo deste trabalho foi comparar os níveis sanguíneos de 53 trabalhadores expostos ocupacionalmente ao chumbo, com grupo controle não exposto a agentes químicos ou físicos, avaliando dosagem de chumbo sérico, contagem de eritrócitos, hematócrito, dosagem de hemoglobina e idade. Com relação ao chumbo sérico, dentre o grupo exposto ocupacionalmente ao metal, 20,8 por cento dos trabalhadores apresentavam valores até 40 µg/dL, 35,8 por cento obtiveram resultados entre 40 µg/dL e 60 µg/dL, e 43,4 por cento apresentaram valores de chumbo sérico acima de 60 µg/dL. Já no grupo controle, todas as amostras apresentaram valores abaixo de 40 µg/dL de chumbo sérico. Com relação à hemoglobina, 7,5 por cento dos trabalhadores do grupo controle e 34,0 por cento dos expostos apresentaram valores abaixo de 13 g/dL, com diferença estatisticamente significativa. Os resultados indicam que níveis elevados de chumbo estão relacionados com valores de hemoglobina abaixo dos índices de referência.

Lead is one of the most abundant elements in nature. Currently, it is widely used in the manufacture of batteries, brass and bronze, radiators, solders, cables, paints and dyes, ceramics, and ammunition, among other things. Lead intoxication is called saturnism and is most often related to professional activities. Lead can cause neurological, hematological, renal, cardiac and reproductive disorders. The aim of this study was to compare blood parameters of 53 workers with work-related exposure to lead with a control group of individuals not exposed to chemical or physical agents. Serum lead levels, red blood cell count, hematocrit and hemoglobin levels and age were evaluated. In respect to serum lead levels, of the group with work-related exposure to the metal, 20.8 percent of the workers had values of up to 40 µg/dL, 35.8 percent presented with values between 40 µg/dL and 60 µg/dL and 43.4 percent above 60 µg/dL. In the control group, all samples presented values below 40 µg/dL. A statistically significant difference was observed between the groups, as 7.5 percent of workers in the control group and 34.0 percent of workers with occupational exposure presented with hemoglobin levels lower than 13 g/dL. These results indicate that high levels of lead are related to hemoglobin values below the normal range.

Plumbemia em trabalhadores da indústria de reciclagem de baterias automotivas da Grande Porto Alegre, RS / Blood lead levels in the battery recycling industry of the metropolitan region of Porto Alegre, RS

A reciclagem de baterias pode contaminar o ar, o solo e a água, não só no lugar de processamento, mas também nas regiões circunvizinhas, sendo que os resíduos permanecem no local mesmo após o término da atividade. No presente artigo descrevemos os resultados da avaliação da plumbemia em 53 operários que trabalhavam com reciclagem de baterias automotivas e em 53 indivíduos sem história de exposição. Os dados obtidos foram comparados e discutidos em relação às normas do Ministério do Trabalho (MT) e da Occupational Safety and Health Administration (OSHA). A plumbemia no sangue do grupo controle foi de 2,44±1,15 µg/dl e, no grupo exposto, de 59,43±28,34 µg/dl, sendo que 79,2 por cento dos indivíduos mostraram níveis acima do valor de referência (até 40 µg/dl). Estudos recentes recomendam estratégias para prevenir a intoxicação com chumbo: identificação, eliminação ou controle da fonte, monitoração da exposição e respectivos danos e um programa de recompra de baterias usadas das por parte da indústria de origem.

Battery recycling may contaminate soil, air and water not only at the processing site but also in the neighboring areas, inasmuch as the residues remain at the site even after the end of the activity. In the present article, we describe the results of plumbism evaluation in 53 individuals that work with car battery recycling and 53 individuals without history of lead exposure. The obtained data were compared and discussed according to the regulations of Brazilian Ministry of Labor and OSHA (Occupational Safety and Health Administration). Blood lead levels in the control group were 2.44 ± 1.15 µg/dl and 59.43 ± 28.34 µg/dl in the exposed group. 79.2 percent of the individuals presented levels above the reference value (40 µg/dl). Recent studies recommend strategies to prevent lead intoxication: source identification, control or elimination, monitoring of environmental exposure and hazards and a buy-back program of used batteries by the industry of origin.

Modifications of the sympathetic skin response in workers chronically exposed to lead

The long-term effects of low-level lead intoxication are not known. The sympathetic skin response (SSR) was evaluated in a group of 60 former workers of a primary lead smelter, located in Santo Amaro, BA, Brazil. The individuals participating in the study were submitted to a clinical-epidemiological evaluation including questions related to potential risk factors for intoxication, complaints related to peripheral nervous system (PNS) involvement, neurological clinical examination, and also to electromyography and nerve conduction studies and SSR evaluation. The sample consisted of 57 men and 3 women aged 34 to 69 years (mean ± SD: 46.8 ± 6.9). The neurophysiologic evaluation showed the presence of lumbosacral radiculopathy in one of the individuals (1.7 percent), axonal sensorimotor polyneuropathy in 2 (3.3 percent), and carpal tunnel syndrome in 6 (10 percent). SSR was abnormal or absent in 12 cases, representing 20 percent of the sample. More than half of the subjects (53.3 percent) reported a history of acute abdominal pain requiring hospitalization during the period of work at the plant. A history of acute palsy of radial and peroneal nerves was reported by about 16.7 and 8.3 percent of the individuals, respectively. Mean SSR amplitude did not differ significantly between patients presenting or not the various characteristics in the current neurological situation, except for diaphoresis. The results suggest that chronic lead intoxication induces PNS damage, particularly affecting unmyelinated small fibers. Further systematic study is needed to more precisely define the role of lead in inducing PNS injury.