Source and impact of lead contamination on δ-aminolevulinic acid dehydratase activity in several marine bivalve species along the Gulf of Cadiz

Coastal areas and estuaries are particularly sensitive to metal contamination from anthropogenic sources and in the last few decades the study of space-time distribution and variation of metals has been extensively researched. The Gulf of Cadiz is no exception, with several rivers draining one of the largest concentrations of sulphide deposits in the world, the Iberian Pyrite Belt (IPB). Of these rivers, the Guadiana, one of the most important in the Iberian Peninsula, together with smaller rivers like the Tinto and Odiel, delivers a very high metal load to the adjacent coastal areas. The purpose of this work was to study the source and impact of lead (Pb) drained from historical or active mining areas in the IPB on the activity of a Pb inhibited enzyme (δ-aminolevulinic acid dehydratase, ALAD) in several bivalve species along the Gulf of Cadiz. Seven marine species (Chamelea gallina, Mactra corallina, Donax trunculus, Cerastoderma edule, Mytilus galloprovincialis, Scrobicularia plana and Crassostrea angulata) were collected at 12 sites from Mazagón, near the mouth of the rivers Tinto and Odiel (Spain), to Cacela Velha (Ria Formosa lagoon system, Portugal). Lead concentrations, ALAD activity and lead isotope ratios ((206)Pb/(204)Pb, (207)Pb/(204)Pb and (208)Pb/(204)Pb) were determined in the whole soft tissues. The highest Pb concentrations were determined in S. plana (3.50±1.09 μg g(-1) Pb d.w.) and D. trunculus (1.95±0.10 μg g(-1) Pb d.w.), while M. galloprovincialis and C. angulata showed the lowest Pb levels (<0.38 μg g(-1) Pb d.w.). In general, ALAD activity is negatively correlated with total Pb concentration. However this relationship is species dependent (e.g. linear for C. gallina ALAD=-0.36[Pb]+0.79; r=0.837; or exponential for M. galloprovincialis ALAD=2.48e(-8.3[Pb]); r=0.911). This indicates that ALAD activity has considerable potential as a biomarker of Pb and moreover, in marine bivalve species with different feeding habits. Lead isotope data showed significant seasonal and spatial changes in bivalve isotopic composition reflecting seasonal and geographic differences in bioaccumulation. Within the study area, Pb can be modelled as a mixing between geogenic Pb and mine-related, discharges of Pb from the IPB. For some sites at the mouth of the Guadiana River, the bivalves show contamination from other anthropogenic sources, such as leaded boat/aviation fuel and/or leaded paint. Finally, the study demonstrates convincingly the need to consider species-specific variation when using bivalve ALAD activity as a biomarker for Pb.

Biodynamic modelling of the accumulation of Ag, Cd and Zn by the deposit-feeding polychaete Nereis diversicolor: inter-population variability and a generalised predictive model

Biodynamic parameters of the ragworm Nereis diversicolor from southern Spain and south England were experimentally derived to assess the inter-population variability of physiological parameters of the bioaccumulation of Ag, Cd and Zn from water and sediment. Although there were some limited variations, these were not consistent with the local metal bioavailability nor with temperature changes. Incorporating the biodynamic parameters into a defined biodynamic model, confirmed that sediment is the predominant source of Cd and Zn accumulated by the worms, accounting in each case for 99% of the overall accumulated metals, whereas the contribution of dissolved Ag to the total accumulated by the worm increased from about 27 to about 53% with increasing dissolved Ag concentration. Standardised values of metal-specific parameters were chosen to generate a generalised model to be extended to N. diversicolor populations across a wide geographical range from western Europe to North Africa. According to the assumptions of this model, predicted steady state concentrations of Cd and Zn in N. diversicolor were overestimated, those of Ag underestimated, but still comparable to independent field measurements. We conclude that species-specific physiological metal bioaccumulation parameters are relatively constant over large geographical distances, and a single generalised biodynamic model does have potential to predict accumulated Ag, Cd and Zn concentrations in this polychaete from a single sediment metal concentration.

Sediment contamination, bioavailability and toxicity of sediments affected by an acute oil spill: Four years after the sinking of the tanker Prestige (2002)

Sediment contamination and three bioassays were used to determine the sediment quality four years after an oil spill (Prestige, 2002): the Microtox test, a 10-day bioassay using the amphipod Ampelisca brevicornis, and a polychaete 10-day toxicity test with the lugworm Arenicola marina. In addition, bioaccumulation of PAHs was examined in the polychaete after 10 days of exposure. The results obtained from the toxicity tests and bioaccumulation analyses were statistically compared to the sediment chemical data, in order to assess the bioavailability of the contaminants, their effects, and their relationship with the oil spill. The sediments studied were from two areas of the Galician Coast (NW Spain): the Bay of Corme-Laxe and the Cíes Island, located in the Atlantic Island National Park. The results point to a decrease in contamination with respect to previous studies and to the disappearance of the acute toxicity four years after the oil spill. However an important bioaccumulation of PAHs was detected in the organisms exposed to sediments from Corme-Laxe, suggesting that despite the recovery of the environmental quality of the area, effects in the biota might be occurring.

Comparing sediment quality in Spanish littoral areas affected by acute (Prestige, 2002) and chronic (Bay of Algeciras) oil spills

The quality of sediments collected from two areas of the Spanish coast affected by different sources of contaminants has been compared in this study. The areas studied are the coast of Galicia affected by the oil spill from the tanker Prestige (November 2002) and the Gulf of Cádiz which suffers continuous inputs of contaminants from industries located in the area and from oil spills. Contamination by several chemicals (metals, PCBs and PAHs) that bind to sediments was analyzed, and two toxicity tests (Microtox) and amphipod 10-day bioassay) were conducted. PAHs were identified as the compounds responsible for the toxic effects. Results show differences between an acute impact related to the sinking of the tanker Prestige and the chronic impact associated with continuous oil spills associated with the maritime and industrial activities in the Bay of Algeciras, this being the most polluted part of the two coastal areas studied in this work.

Apolipoprotein D in the aging brain and in Alzheimer's dementia

Apolipoprotein D (apoD) levels were examined in the temporal cortex as well as an assessment of the location of apoD positive cells within the brain by immunohistochemical and biochemical methods in young control (YC), aged control (AC), and Alzheimer's demented (AD) probands. Scattered apoD positive astrocytes and oligodendrocytes were found throughout the white matter by immunohistochemistry. ApoD immunoreactivity was also observed in the cerebellar oligodendrocytes of the YC group. There was faint positive apoD staining in scattered cortical astrocytes and a few neurons in the same group. In contrast, some of the AC and all of the AD probands had intense and frequent apoD immunostained cortical astrocytes and pyramidal neurons. The cortical senile plaques and neurofibrillary tangles were apoD immunonegative. No quantitative differences were found between the cortical apoD levels in the AC and AD groups, determined by immunoblotting. ApoD detected in the brain tissue was different in molecular weight (29 kDal) from that seen in CSF or in the serum (32 kDal). Our results indicate apoD is present in the human brain, especially in glial cells, and has increased abundance in the elderly and AD subjects.

Full and fractionated experimental designs for robustness testing in the high-performance liquid chromatographic analysis of codeine phosphate, pseudoephedrine hydrochloride and chlorpheniramine maleate in a pharmaceutical preparation

This paper describes the testing of a saturated factorial design using a full factorial design. Saturated factorial designs are often used to test the robustness of high-performance liquid chromatography (HPLC) methods, however they are based on several assumptions. A full factorial design relies on fewer assumptions and hence could be used to evaluate the effectiveness of the saturated design. Both designs were used to test a gradient HPLC method for the assay of codeine phosphate, pseudoephedrine hydrochloride and chlorpheniramine maleate. Six HPLC conditions, including wavelength, mobile phase pH and ion pairing reagent concentration were tested using the saturated design. Three of these factors were selected for full evaluation using a full factorial design. The results showed that the main effects calculated by each design were comparable. However, the saturated design showed higher standard errors, probably due to the effects of changing several more factors. One interaction effect was indicated as a confounding effect by the saturated design and this was confirmed by the calculation of the same interaction effect using the full design. Overall the method was shown to be robust under the variety of HPLC conditions tested.

Hemodynamic comparison of twice daily metoprolol tartrate with once daily metoprolol succinate in congestive heart failure

OBJECTIVES

To compare the hemodynamic effects of twice daily metoprolol tartrate (MT) and once daily metoprolol succinate (MS) in congestive heart failure patients.

BACKGROUND

Adverse hemodynamic effects with MT demonstrated during initiation persist with drug readministration during chronic therapy.

METHODS

Patients were randomly assigned to 6.25 mg MT or 25 mg MS orally and the dose was gradually increased to a target of 50 mg twice a day or 100 mg once a day, respectively. Hemodynamic measurements were obtained at baseline and after three months of therapy--both before and after drug readministration.

RESULTS

Long term metoprolol therapy produced significant functional, exercise and hemodynamic benefits with no difference in response between either metoprolol preparation in the 27 patients (MT [14], MS [13]). When full dose metoprolol was readministered during chronic therapy, there were parallel adverse hemodynamic effects in both drug groups. Cardiac index decreased by 0.6 liters/min/m2 (p < 0.0001) with MT and by 0.5 liters/min/m2 (p < 0.0001) with MS. Systematic vascular resistance increased by 253 dyne-sec-cm(-5) (p < 0.001) with MT and by 267 dyne-sec-cm(-5) (p < 0.0005) with MS. Stroke volume index decreased by 7.0 ml/m2 (p < 0.0005) with MT and by 6.5 ml/m2 (p < 0.0001) with MS, while SWI decreased by 6.2 g-m/m2 (p < 0.0005) with MT and by 6.0 g-m/m2 (p < 0.001) with MS.

CONCLUSION

Metoprolol tartrate and MS produce similar hemodynamic and clinical effects acutely and chronically despite the fourfold greater starting dose of MS used in this study. A more rapid initiation with readily available starting doses of MS may offer distinct advantages compared with MT in treating chronic heart failure patients with beta-adrenergic blocking agents.

Short-term and long-term hemodynamic and clinical effects of metoprolol alone and combined with amlodipine in patients with chronic heart failure

BACKGROUND

Initiation of beta-blocker therapy is often limited by worsening congestive heart failure, which may manifest as worsening hemodynamics. Deleterious hemodynamic effects might be mitigated with the vasodilation of combined calcium channel/beta-blocker therapy.

METHODS AND RESULTS

This prospective, randomized study assessed the safety and efficacy of metoprolol alone or combined with amlodipine on hemodynamic parameters at baseline, 2 hours after the first dose of study medication, and after 12 weeks of therapy in patients receiving background triple therapy for mild to severe heart failure. Functional, exercise, and hormonal status were assessed at baseline and end of study. Twenty-nine patients (mean age 50 +/- 12.1 years) were enrolled; 21 completed 12 weeks of treatment. Mean ejection fraction at baseline was 13.4% +/- 5.7%; 79% of patients had heart failure classified as New York Heart Association class III, and 66% had heart failure of idiopathic origin. Heart rate and blood pressure did not change with short-term therapy in either group. The first dose of both regimens produced significant increases in systemic vascular resistance and significant decreases in cardiac output and index and stroke volume and stroke work indexes; combination therapy acutely yielded small but statistically significant increases in pulmonary artery, pulmonary capillary wedge, and right atrial pressures. Long-term therapy with both regimens produced significant decreases in heart rate, systemic vascular resistance, and pulmonary capillary wedge pressure and significant increases in cardiac output and index and stroke volume and stroke work indexes. Combination therapy produced significant long-term decreases in blood pressure.

CONCLUSIONS

There was no further measurable benefit with the addition of amlodipine to metoprolol compared with the effects of metoprolol alone. Therapy with metoprolol alone and the combination of metoprolol and amlodipine was well tolerated in patients with mild to severe heart failure, as evidenced by a lack of adverse effects on hemodynamic parameters over the short term and clinical and hemodynamic improvement with long-term treatment.

Prospective, randomized comparison of effect of long-term treatment with metoprolol or carvedilol on symptoms, exercise, ejection fraction, and oxidative stress in heart failure

BACKGROUND

With beta-blocker use becoming more prevalent in treating chronic heart failure (CHF), the choice of drugs raises important theoretical and practical questions. Although the second-generation compound metoprolol is beta1-selective, the third-generation compound carvedilol is beta-nonselective, with ancillary pharmacological properties including alpha-blockade and antioxidant effects. A prospective comparison of these 2 agents can address the issue of optimal adrenergic blockade in selecting agents for therapy in CHF.

METHODS AND RESULTS

Sixty-seven patients with symptomatic stable heart failure were randomly assigned to receive either carvedilol or metoprolol in addition to standard therapy for CHF. Measured variables included symptoms, exercise, ejection fraction, and thiobarbituric acid-reactive substances (TBARS) as an indirect marker of free radical activity. Metoprolol and carvedilol were well tolerated, and both patient groups showed beneficial effects of beta-blocker therapy in each of the measured parameters, with no between-group differences. Ejection fraction increased over 6 months from 18+/-6.3% to 23+/-8.7% (P<0.005) with metoprolol and from 19+/-8.5% to 25+/-9.9% (P<0.0005) with carvedilol (P=NS between groups). With metoprolol, TBARS values decreased from 4.7+/-0.9 nmol/mL at baseline to 4.2+/-1.5 nmol/mL at month 4 to 3.9+/-1.0 nmol/mL at month 6 (P<0.0001). With carvedilol, there was a parallel decline from 4.7+/-1.4 to 4.2+/-1.3 to 4.1+/-1.2 nmol/mL over the same time frame (P<0.025), with no between-group difference in these changes.

CONCLUSIONS

Carvedilol and metoprolol showed parallel beneficial effects in the measured parameters over 6 months, with no relevant between-group differences in this heart failure population.

Doppler pulse waveform analysis of carotid and middle cerebral artery flow in a patient with an intra-aortic balloon pump

A 60-year-old man with intractable congestive heart failure (CHF) had an intra-aortic balloon pump placed to augment coronary artery perfusion. During the evaluation prior to heart transplant, carotid and transcranial Doppler ultrasonography (TCD) was performed. The authors report the findings of Doppler waveform analysis and the presence of balloon pump artifact which caused difficulty in distinguishing between internal and external carotid arteries. Higher blood flow velocity during diastole and diastolic runoff characteristically seen while insonating the internal carotid artery enabled that distinction.

Contrasting child and adolescent psychiatry services in Szeged, Hungary, and Glasgow, Scotland

International comparisons of child and adolescent psychiatry services are rarely reported in the literature. The present study arose out of a TEMPUS collaborative project between the University Departments of Child and Adolescent Psychiatry in Szeged, Hungary, and Glasgow, Scotland. Using the Glasgow Audit Questionnaire, a profile of each service was obtained, including basic demographic data, types of disorders referred, treatment modalities used, and a measure of outcome. The results of this descriptive study indicate that although the two centres were broadly similar, there were major differences in the treatment modalities used. Reasons for the findings are discussed, as are the limitations of the study.

Effect of race in the response to metoprolol in patients with congestive heart failure secondary to idiopathic dilated or ischemic cardiomyopathy

We sought to determine the effect of race in response to metoprolol in patients with dilated cardiomyopathy. We found no difference in exercise, hemodynamic, and neurohormonal responses to metoprolol based on race in patients with cardiomyopathy.

Beta blockade in congestive heart failure: persistent adverse haemodynamic effects during chronic treatment with subsequent doses

OBJECTIVE

To determine whether the acute adverse haemodynamic effects of beta blockade in patients with congestive heart failure persist during chronic treatment.

DESIGN

Sequential haemodynamic evaluation of heart failure patients at baseline and after three months of continuous treatment with the beta 1 selective antagonist metoprolol.

SETTING

Cardiac care unit in university hospital.

PATIENTS

26 patients with moderate to severe congestive heart failure (New York Heart Association grade II to IV) and background treatment with digoxin, diuretics, and angiotensin converting enzyme inhibitors, and with a left ventricular ejection fraction < 25%.

METHODS

Baseline variables included a six minute walk, maximum oxygen consumption, and right heart catheterisation. All patients received metoprolol 6.25 mg orally twice daily initially and the dose was gradually increased to a target of 50 mg twice daily. Haemodynamic measurements were repeated after three months of treatment, both before (trough) and after drug readministration.

RESULTS

Long term metoprolol had functional, exercise, and haemodynamic benefits. It produced decreases in heart rate, pulmonary capillary wedge pressure, and systemic vascular resistance, and increases in cardiac index, stroke volume index, and stroke work index. However, when full dose metoprolol was readministered during chronic treatment, there was a reduction in cardiac index (from 2.8 (SD 0.46) to 2.3 (0.38) l/min/m2, p << 0.001) and stroke work index (from 31.4 (11.1) to 26.6 (10.0) g.m/m2, p < 0.001) and an increase in systemic vascular resistance (from 943 (192) to 1160 (219) dyn.s.cm-5, p << 0.001).

CONCLUSIONS

Adverse haemodynamic effects of beta blockers in heart failure persist during chronic treatment, as shown by worsening haemodynamic indices with subsequent doses.

A placebo-controlled trial verifying the efficacy of milrinone in weaning high-risk patients from cardiopulmonary bypass

OBJECTIVE

To establish the efficacy of the phosphodiesterase inhibitor milrinone in facilitating weaning from cardiopulmonary bypass of high-risk patients with left ventricular dysfunction and/or pulmonary hypertension.

DESIGN

A double-blinded, placebo-controlled longitudinal study.

SETTING

A university teaching hospital.

PARTICIPANTS

Thirty-two patients with preoperative left ventricular ejection fraction < or = 35% and/or mean pulmonary artery pressure > or = 20 mmHg were studied after their written informed consent.

INTERVENTION

Patients were randomized to commence either intravenous milrinone, 50 micrograms/kg loading dose over 20 minutes followed by 0.5 microgram/kg/min infusion, or matching placebo 15 minutes before withdrawal of cardiopulmonary bypass.

MEASUREMENTS AND MAIN RESULTS

Two patients were withdrawn from the study and their results not analyzed: one because of early failure of hemodynamic monitoring and the other because of gross surgical bleeding. In the remaining 30 patients, who were well matched for clinical and baseline hemodynamic variables, bypass support was successfully withdrawn in all 15 patients randomized to receive milrinone but in only 5 of the 15 patients randomized to receive placebo. In the 10 patients who initially failed to wean from bypass while on placebo, bypass was reinstituted and open-label milrinone was administered in the dose outlined. After treatment with open-label milrinone, these patients could also be withdrawn from bypass support. During the period of hemodynamic monitoring, cardiac index increased in both milrinone- and placebo-treated patients, although this change was greater in those treated with milrinone. Perhaps related to routine clinical treatment, there were no significant differences between the two groups with mean pulmonary artery or pulmonary capillary wedge pressures, the other major hemodynamic endpoints. There were no significant adverse effects related to milrinone.

CONCLUSIONS

This placebo-controlled, double-blind study has conclusively demonstrated the benefits of milrinone in facilitating weaning of high-risk patients from cardiopulmonary bypass.