Metal Exposure in Arica, Chile: Examining Toxic Elements / Análisis de exposición a metales en Arica, Chile: niveles de elementos tóxicos

BACKGROUND: Bioaccumulation of toxic metals in the population is associated with adverse health effects. Although some elements are essential for humans, high levels of exposure can be dangerous. OBJECTIVE: To describe the levels of Inorganic Arsenic (AsIn), Cadmium (Cd), Chromium (Cr), and Mercury (Hg) in urine, and Lead (Pb) in blood in the population of Arica, Chile. METHODOLOGY: Descriptive study. Beneficiaries of the Health Surveillance Program of Law 20.590 in sites of higher risk of exposure in the commune of Arica were considered eligible. The results of biological samples to measure their concentrations of AsIn, Cd, Cr, Hg in urine, and Pb in blood between August 2016 and May 2021 are described. RESULTS: 9520 samples from a population with a mean age of 40.5 years were studied. 4.21% of the adult population and 6.57% of the children had AsIn values above 35 μg/L, while at least 95 % of the total samples had levels below 33 μg/L. At least 90 % of the samples had Cd levels below 1.1 μg/L, and 8.44 % had Cd levels above 2 μg/L, higher in males (11.67%). There were no values above the reference in children. 99.77% and 99.33% had Cr and Pb values below the reference limit, respectively (using the lowest reference range established by Chile Ministry of Health (MINSAL) < 5 μg/L). Children did not present risk values for Cr, and 0.16% presented Pb concentrations between 5-10 μg/dL. All samples presented Hg concentrations below risk levels (< 10 μg/L). CONCLUSIONS: The results of this study suggest that a small percentage of the samples analyzed in the beneficiary population of Arica register metal concentration levels above national reference levels established by MINSAL, mainly AsIn, Cd, and Pb. It is essential to continue biomonitoring to reduce and prevent exposure to these metals, which can have harmful effects on human health.

ANTECEDENTES: La bioacumulación de metales en la población está asociada a efectos adversos y pueden ser peligrosos. OBJETIVO: Describir los niveles de Arsénico Inorgánico (AsIn), Cadmio (Cd), Cromo (Cr), Mercurio (Hg) y Plomo (Pb) en la población de Arica, Chile. MATERIALES Y MÉTODOS: Estudio descriptivo. Se incluyeron todas las personas beneficiarias del Programa de Vigilancia de Salud de la Ley 20.590 en sitios de riesgo de mayor exposición en la comuna de Arica entre agosto 2016 y mayo 2021. RESULTADOS: Se estudiaron 9.520 muestras provenientes de una población con una edad media de 40.5 años. 4.21% de la población adulta y el 6.57% de los niños presentaron valores de AsIn superiores a 35 μg/L y al menos el 95% de las muestras totales tenía niveles inferiores a 33 μg/L. Más del 90 % de las muestras tuvieron niveles de Cd menores a 1.1 μg/L y un 8.44% registró niveles de Cd superiores 2 μg/L. El 99.77% y 99.33% exhibieron valores normales de Cr y Pb, respectivamente. Todas las muestras presentaron concentraciones de Hg por debajo de los niveles de riesgo (< 10 μg/L). CONCLUSIONES: Los resultados sugieren que un porcentaje pequeño de la población de Arica registra niveles de concentración de metales por sobre niveles de referencia nacional establecidos por el Ministerio de Salud de Chile, principalmente de AsIn, Cd y Pb. Es importante continuar con la vigilancia para reducir y prevenir la exposición a estos metales, que pueden generar efectos nocivos en la salud humana.

UNCEMENTED ARTHROPLASTY AFTER HIP METASTATIC DISEASE AND MULTIPLE MYELOMA

ABSTRACT Objective: To describe a case series using a combination of narrative, graphical exploratory analysis and Bayesian Network modeling. Methods: Case series with 34 patients undergoing uncemented and hybrid arthroplasty procedures secondary to hip pain or fracture secondary to metastatic disease or multiple myeloma. Results: The most common tumors included gastrointestinal, multiple myeloma and breast cancer. Most devices were total arthroplasty (n = 16, 84.2%) rather than partial and uncemented arthroplasty (n = 12, 63.2%) rather than hybrid. The average time between surgery and deambulation was 20 days, the average length of hospital stay was 13 days, and the average patient survival was 589 days. Only one infection was reported. Uncemented and hybrid arthroplasty devices did not differ regarding time to walk, as well as the length of hospital stay in this sample. Conclusion: Our model may be used as a prior for the addition of subsequent patient samples, personalizing, thus, its recommendations to other patient populations. Level of Evidence IV, Case series.

Gct: what happened after 10 years of curettage and cement? Retrospective study of 46 cases

Comparar o resultado funcional de pacientes tratados portumor de células gigantes (TCG) que evoluíram com e sem artrose, edeterminar se o desenvolvimento da artrose está relacionado à distânciaentre o tumor e o osso subcondral. Métodos: 46 pacientes tratadospor TCG entre 1975 e 1999 preencheram os critérios de inclusão. OTCG foi diagnosticado por biópsia percutânea e confirmado após aressecção em todos os casos. As classificações de Campanacci eKellgren, a distância do cimento para o osso subcondral e o escorede MSTS foram obtidos para todos os casos. Resultados: A distânciado cimento para o osso subcondral está associada ao maior risco dedesenvolver artrose, mas não houve diferença nos escores funcionaisde MSTS entre os pacientes com e sem artrose. Conclusão: A distânciaentre o cimento e o osso subcondral tem valor prognóstico comrelação ao aparecimento de artrose, mas isso não acarreta impactono resultado funcional. Nível de Evidência IV, Estudo Terapêutico...

To compare the functional outcome of patients with andwithout arthrosis, and to determine whether the development of arthrosisis related to the distance of the tumor from the subchondralbone. Methods: Forty six patients treated for Giant-cell tumor (GCT)between 1975 and 1999 met inclusion criteria. GCT was diagnosedby percutaneous biopsy and confirmed after resection, in allcases. Campanacci’s and Kellgren’s classification, the distance ofthe cement to the articular surface and MSTS score were obtainedthroughout the sample. Results: The distance of the cement to thesubchondral bone was associated with greater risk of developingarthrosis, but there was no difference in MSTS scores betweenpatients with or without arthrosis. Conclusion: We found that thedistance from the cement to the subchondral bone has a prognosticvalue regarding future arthrosis, but it does not impact on thefunctional outcome. Level of Evidence IV, Therapeutic Study...

Comparacao da resistência à tracao da âncora metálica rosqueada inserida no osso cortical e no osso esponjoso / Comparison of the tensile strength of threaded metal anchors inserted on cortical and spongy bones

A rotura do manguito rotador é uma afeccao freqüente com repercussao na vida diária do paciente causando incapacidade funcional e dor. Um número considerável de pacientes necessita de reparacao tendínea. A tendência atual na cirurgia do ombro é a utilizacao de técnicas minimamente invasivas com menor morbidade operatória e reabilitacao mais precoce. A partir dos anos 90 houve um grande desenvolvimento da artroscopia do ombro e na utilizacao de âncoras para fixacao das suturas tendíneas. Essa evolucao técnica tem permitido resultados da cirurgia artroscópica comparáveis aos da cirurgia aberta. Um dos possíveis problemas do uso de âncoras nas cirurgias artroscópicas do ombro é sua soltura da superfície óssea. O presente estudo tem o objetivo de comparar a resistência à tracao das âncoras metálicas rosqueadas inseridas no osso cortical e no osso esponjoso.