Risk factors for equine fractures in Thoroughbred flat racing in North America.

The aim of this paper is to identify risk factors associated with equine fractures in flat horse racing of Thoroughbreds in North America. Equine fractures were defined as any fracture sustained by a horse during a race. This was a cohort study that made use of all starts from the racecourses reporting injuries. The analysis was based on 2,201,152 racing starts that represent 91% of all official racing starts in the USA and Canada from 1st January 2009-31st December 2014. Approximately 3,990,000 workout starts made by the 171,523 Thoroughbreds that raced during that period were also included in the analysis. During this period the incidence of equine fractures was 2 per 1000 starts. The final multivariable logistic regression models identified risk factors significantly associated (p<0.05) with equine fracture. For example, horses were found to have a 32% higher chance of sustaining a fracture when racing on a dirt surface compared to a synthetic surface; a 35% higher chance if they had sustained a previous injury during racing and a 47% higher chance was also found for stallions compared to mares and geldings. Furthermore, logistic regression models based on data available only from the period 2009-2013 were used to predict the probability of a Thoroughbred sustaining a fracture for 2014. The 5% of starts that had the highest score in our predictive models for 2014 were found to have 2.4 times (95% CI: 1.9-2.9) higher fracture prevalence than the mean fracture prevalence of 2014. The results of this study can be used to identify horses at higher risk on entering a race and could help inform the design and implementation of preventive measures aimed at minimising the number of Thoroughbreds sustaining fractures during racing in North America.

Chemical Pesticides and Human Health: The Urgent Need for a New Concept in Agriculture.

The industrialization of the agricultural sector has increased the chemical burden on natural ecosystems. Pesticides are agrochemicals used in agricultural lands, public health programs, and urban green areas in order to protect plants and humans from various diseases. However, due to their known ability to cause a large number of negative health and environmental effects, their side effects can be an important environmental health risk factor. The urgent need for a more sustainable and ecological approach has produced many innovative ideas, among them agriculture reforms and food production implementing sustainable practice evolving to food sovereignty. It is more obvious than ever that the society needs the implementation of a new agricultural concept regarding food production, which is safer for man and the environment, and to this end, steps such as the declaration of Nyéléni have been taken.

Children exposure to trace levels of heavy metals at the north zone of Kifissos River.

This study evaluates the exposure level of primary school children at three different towns in northern Attica, near the banks of the Kifissos River, defining referential values of toxic heavy metals. Concentrations of five toxic metals (arsenic, cadmium, mercury, lead and nickel) were analyzed in water samples from the Kifissos River as well as in the scalp hair of children aged 11 to 12 years old living in the study area. Chronic low-level toxicity of lead and cadmium came into view in recent years as a problem of our civilization. Exposure to concentrations of arsenic (As), cadmium (Cd), mercury (Hg) and lead (Pb) poses a potential threat to humans and can cause effects on children's renal and dopaminergic systems without clear evidence of a threshold, a fact that reinforces the need to control all the potential heavy metal emissions into the environment in order to protect children's health. The results were analyzed with the IBM SPSS Statistics 20 for Windows. The possible influence of sex and area was examined. Statistical differences were observed by t-test between the log-transformed hair concentrations of lead (p=0.021), arsenic (p=0.016) and nickel (p=0.038) in children's scalp hair from the municipalities of Kifisia and Kryoneri. ANOVA one-way test confirmed the difference of Pb concentration in hair between girls and boys from the municipality of Kifisia (p=0.038). The t-test confirms the difference of heavy metal concentrations in river samples between the municipalities Kifisia and Philadelphia in comparison with the samples from Kryoneri. The observations suggest that children living at the municipality of Kifisia are exposed to higher concentrations of heavy metals than the others. Despite all the confounding factors, hair can be used as a biomarker in order to determine the exposure to heavy metals, according to standardized protocols.

Irreversible end-stage heart failure in a young patient due to severe chronic hypocalcemia associated with primary hypoparathyroidism and celiac disease.

BACKGROUND: Chronic hypocalcemia may cause electrocardiographic (ECG) changes and mimic acute myocardial infarction. It has also been associated with reversible cardiac dysfunction. On the other hand cardiomyopathy and heart failure have been reported in patients with idiopathic hypoparathyroidism or celiac disease. CLINICAL CASE: A 39-year-old male was admitted to the emergency room with acute retrosternal pain and dyspnea. He exhibited severe hypocalcemia and acute renal failure. High creatine kinase (CK) levels did not correlate with biomarkers of myocardial necrosis (negative troponin test, heart type creatine kinase isoenzyme (CK-MB) < 1% of CK value). The ECG showed an extremely long QT interval (0.6 sec) and T-wave inversions on V(4) through V(6). The left ventricular ejection fraction (LVEF) was as low as 25%, while coronary angiography was normal. Investigation of the hypocalcemia revealed primary hypoparathyroidism (Parathyroid hormone (PTH) < 3 pg/ml) and concomitant celiac disease with positive antigliadin and endomysial antibodies. The cardiovascular episodes and the dilated heart failure were attributed to the chronic hypocalcemia since no other cause was found. The correction of hypocalcemia has not been sufficient to reverse the end-stage heart failure after more than 6 months of treatment, even though ECG abnormalities have receded, implying permanent cardiac impairment. CONCLUSION: This case demonstrates an unusual clinical condition where 2 calcium homeostasis disorders led to severe hypocalcemia with clinical manifestations of end-stage heart failure. The severe cardiac failure appeared to be nonreversible after calcium repletion suggesting permanent cardiac muscle dysfunction due to associated cardiomyopathy.