Increasing of syncytial knot and fibrinoid deposit in high-Cd accumulated human placentas / Aumento del nodo sincicial y depósitos de fibrinoide en placenta humanas con alta acumulación de cadmio

A toxic metal, cadmium (Cd), can accumulate in human organs. Placenta is usually used as indicator organ for Cd exposure. Therefore, we aim to investigate the different of placental morphology between the low- and high-Cd accumulated placentas. The samples were collected from 14 pregnant women who resided in low-Cd contaminated (L-Cd group) and high-Cd contaminated (H-Cd group) areas. The concentrations of Cd in blood (B-Cd), urine (U-Cd) and placentas (P-Cd) were measured by ICP-MS and AAS. The morphological appearance of placentas was examined by using routine paraffin section and H & E staining. The results showed that levels of B-Cd, U-Cd and P-Cd were significantly higher in H-Cd group than in L-Cd group (p= 0.001). Moreover, the B-Cd was positively correlated with U-Cd (rs= 0.823, p= 0.000) and P-Cd concentrations (rs= 0.854, p= 0.000). The appearances of syncytial knot (STK) and fibrinoid deposit (Fd) were obviously greater in H-Cd group than in L-Cd group (p= 0.007, p= 0.026). The STK was positively correlated with both Fd (rs= 0.572, p= 0.032) and P-Cd concentration (rs= 0.766, p= 0.001). Although the chorioamnitis and decidual inflammation features were found in both groups but the appearance in H-Cd group seems to be more severe than in L-Cd group. From these results, we suggested that high Cd level in placenta may be involved in morphological changes, especially STK and Fd increasing and probably disturb the connection between maternal and fetal circulation.

Un metal tóxico, el cadmio (Cd), se puede acumular en órganos humanos. La placenta se utiliza, por lo general, como órgano indicador de la exposición a Cd. Nuestro objetivo fue investigar la diferente morfología placentaria entre las placentas con baja y alta acumulación de Cd. Las muestras fueron recolectadas de 14 mujeres embarazadas que residían áreas con alta (grupo H-Cd) y baja contaminación por Cd (grupo L-Cd). Las concentraciones de Cd en la sangre (B- Cd), orina (U-Cd) y placentas (P-Cd) se midieron por ICP-MS y AAS. La apariencia morfológica de las placentas fue examinada usando cortes histológicos teñidos con H-E. Los resultados mostraron que los niveles de B-Cd, U-Cd y P-Cd fueron significativamente mayores en el grupo H-Cd (p= 0,001). Por otra parte, el B-Cd se correlacionó positivamente con las concentraciones de U-Cd (rs= 0,854, p = 0,000 ) y P-Cd (rs= 0,823, p = 0,000). Las apariciones de nodos sinciciales (NS) y depósitos fibrinoides (Fd) fueron mayores en el grupo H-Cd (rs= 0,007, p= 0,026). Los ND se correlacionaron positivamente con los Fd (rs= 0,572, p= 0,032) y la concentración de P-Cd (rs= 0,766, p = 0,001). Aunque características de corioamnitis e inflamación de la decidua se encontraron en ambos grupos, su aparición en el grupo H-Cd pareció ser más grave que en el grupo L-Cd. A partir de estos resultados, sugerimos que el nivel alto de Cd en la placenta puede estar involucrado en los cambios morfológicos, especialmente el aumento de NS y Fd, los que probablemente alteran la relación entre la circulación materna y fetal.

An outbreak of cholera among migrants living in a Thai-Myanmar border area.

OBJECTIVE: To study epidemiologic characteristics of a cholera outbreak involving mainly Myanmar migrants living in overcrowded conditions with poor sanitation in a Thai-Myanmar border district, in 2007. MATERIAL AND METHOD: Both passive and active case surveillances were carried out in Mae Sot District, Tak Province since the beginning of the outbreak. Samples of various types of drinking and non-drinking water from the infected areas, communal waters, and some selected foods were analyzed for the presence of cholera contamination. A case-control study was conducted to determine the vehicle of cholera transmission among Myanmar migrants in one municipal community with a cluster of 72 cholera cases. Preventive and control measures were primarily carried out by trained migrant health volunteers and workers. RESULTS: Between May and October 2007, 477 cholera cases of biotype El Tor, serotype Inaba, were identified in the district. The majority of them (93.1%) were detected by active case surveillance in the communities. None died in this outbreak. Most (84.9%) were Myanmar migrants and the remainder were local Thai residents. The infection rates of cholera were significantly greater in communities with known passive cases than in those with no such cases. Three samples of seafood illegally imported from Myanmar were positive for cholera of the same biotype and serotype. Fifteen of 324 (4.6%) food handlers in the district were found to carry V. cholerae O1. A case-control study in one municipal community revealed a significant association between infection and frequently having food purchased from one infected food handler. CONCLUSION: Active case finding and implementation of control measures by the assistance of trained migrant health volunteers and workers might reduce the morbidity and mortality in this population.

Cadmium-exposed population in Mae Sot District, Tak Province: 1. Prevalence of high urinary cadmium levels in the adults.

BACKGROUND: In Mae Sot District, Tak Province, Thailand, the paddy fields receiving irrigation from the two creeks and crops grown in the areas were found to contain markedly elevated cadmium levels during the surveys in 2001-2004. OBJECTIVE: The present report carried out a survey in 2004 to determine urinary cadmium, a good index of excessive cadmium exposure and body burden, among the exposed residents aged 15 years and older in these contaminated areas. MATERIAL AND METHOD: Morning urine samples were collected from the subjects and then kept frozen until cadmium analysis. Urinary cadmium was determined using the atomic absorption spectrometry and urinary creatinine was determined using a method of reaction with picric acid at alkaline pH and colorimetry. RESULTS: Of the 7,697 persons surveyed, only 45.6% had urinary cadmium levels < 2 microg/g creatinine. About 4.9% were between 5 and 10 microg/g creatinine and 2.3% had cadmium concentrations > 10. The urinary cadmium level was greater among women than men and increased with increasing age. Smokers were more likely to have high urinary cadmium than non-smokers. Persons who mainly consumed rice grown locally in the contaminated areas had higher urinary cadmium than those who did not. CONCLUSION: Persons who had high urinary cadmium levels and might have cadmium-induced toxic effects should be screened for early detection of chronic cadmium toxicity. Smoking cessation programs should be one component of preventive action beneficial for the study population. The production of rice and other crops for human consumption should be prohibited to prevent further accumulation of cadmium in the body of the exposed population.