Spatial distribution and contamination assessment of heavy metals in urban topsoils from Las Tunas City, Cuba.

Concentrations of Cr, Co, Ni, Cu, Zn, Pb and Fe in the topsoils (0-10 cm) from Las Tunas city were measured by X-ray fluorescence analysis. The mean Cr, Co, Ni, Cu, Zn and Pb contents in the urban topsoil samples (97 ± 30, 14 ± 2, 35 ± 36, 94 ± 26, 199 ± 87 and 42 ± 29 mg kg⁻¹ dry weight, respectively) were compared with mean concentrations for other cities around the world with similar population. Cr content in school grounds, parks and residential areas exceed in 20 % the average Cr background level. Highest content for Ni was determined in residential areas, for Zn in market gardens soils and as for Pb, the highest topsoil-background content ratios were observed for market gardens (2.7) and residential areas (2.3). Spatial distribution maps indicated the same behaviour for Cr-Co-Ni and Pb-Zn, respectively, whereas the spatial distribution of Cu differs from other heavy metals. On the other hand, the metal-to-iron normalisation, using (10-20 cm) bottom soil contents as background, showed that topsoils in Las Tunas city are severely enriched with lead and not enriched with the rest of the determined metals. The average values of integrated pollution index (IPI) indicated that soils are moderately contaminated by heavy metals (1.17 ≤ IPI(ave) ≤ 1.39), but enrichment index values shows that metal concentrations on the studied locations are not above the permissible levels for urban agriculture.

Acetabular fractures with marginal impaction: mid-term results.

Over a five-year period, adult patients with marginal impaction of acetabular fractures were identified from a registry of patients who underwent acetabular reconstruction in two tertiary referral centres. Fractures were classified according to the system of Judet and Letournel. A topographic classification to describe the extent of articular impaction was used, dividing the joint surface into superior, middle and inferior thirds. Demographic information, hospitalisation and surgery-related complications, functional (EuroQol 5-D) and radiological outcome according to Matta's criteria were recorded and analysed. In all, 60 patients (57 men, three women) with a mean age of 41 years (18 to 72) were available at a mean follow-up of 48 months (24 to 206). The quality of the reduction was 'anatomical' in 44 hips (73.3%) and 'imperfect' in 16 (26.7%). The originally achieved anatomical reduction was lost in12 patients (25.8%). Radiologically, 33 hips (55%) were graded as 'excellent', 11 (18.3%) as 'good', one (1.7%) as 'fair' and 15 (25%) as 'poor'. A total of 11 further operations were required in 11 cases, of which six were total hip replacements. Univariate linear regression analysis of the functional outcome showed that factors associated with worse pain were increasing age and an inferior location of the impaction. Elevation of the articular impaction leads to joint preservation with satisfactory overall medium-term functional results, but secondary collapse is likely to occur in some patients.

A discussion of airway and respiratory complications along with general considerations in obese patients.

Obesity is defined as the degree of excess weight associated with adverse health consequences. Within Great Britain, it is reported that a quarter of men and women are obese; these rates have trebled over the past 20 years. In 2001, it was estimated that obesity cost the National Health Service at least half a billion pounds, with a further two billion pounds lost on lower productivity and lost output. Obesity poses a significant risk factor for diseases, such as coronary heart disease, diabetes mellitus and certain forms of cancer, amongst others. Obese individuals pose significant problems to the clinician because of airway and respiratory complications. Sleep apnoea, obesity-hypoventilation syndrome, pulmonary atelectasis are associated with obesity and tracheostomy insertion is made all the more difficult in these patients. This article aims to discuss some of these issues relevant to the clinician and examine present strategies for dealing with them.