Chronic ingestion of a zinc-based penny

Pennies for Your Thoughts: A Case Series of Pancytopenia Due to Zinc-induced Copper Deficiency in the Same Patient

A 47-year-old schizophrenic male presented on three separate occasions with pancytopenia and sideroblastic anemia due to copper deficiency from massive zinc penny ingestion. The poisoning was treated differently on each visit: intravenous (IV) copper plus surgical decontamination and chelation with calcium disodium versenate (CaNa2EDTA); IV copper plus whole bowel irrigation; and IV copper with surgical decontamination only. Serum zinc half-lives were 80.0 hours, 233.2 hours, and 83.9 hours, respectively. Importantly, chelation with CaNa2EDTA did not significantly alter the elimination half-life. This is the first reported case of the same patient being treated on three different occasions with three different regimens for this condition.

Reduced zinc leaching from scrap tire during pavement applications

Large quantities of scrap tires have been generated and accumulated over the years. However, a significant amount of them are stocked due to the lack of environmentally-friendly methods for disposing of, or reusing them. Because tires contain approximately 1-2% zinc by weight, leaching of zinc from scrap tires could be an environmental concern. In this research, we investigated the leaching of zinc from tire particles that are used with asphalt for pavement applications. The effects of tire particle size and pH on zinc leaching were also examined. Our results indicated that asphalt treatment significantly reduced zinc leaching from tires, and that it was also reduced by increasing the tire particle size and pH. The leaching of zinc was quantified by using a speciation-based modeling approach. The model parameters, namely, the total leachable zinc mass and the adsorption constant, can be used to predict the leaching of zinc under different conditions. The reduction in zinc leaching from asphalt-treated tire particles was due to the physical blocking of the tire surface by the asphalt. Results also indicated that, while the leaching of zinc and other selected toxic elements from untreated tire particles using simulated acid rain was not significant compared to the drinking water regulations, asphalt treatment during the pavement application further improved the environmental performance of the tire particles.

Pica in end-stage chronic kidney disease: Literature review

Pica is an individual entity in the patient with chronic kidney disease (CKD), which phenomenon has not been widely studied despite the high reported prevalence. Moreover, pica complications (anemia, altered electrolytes, poor absorption of micro and macronutrients and malnutrition) could be exacerbated in CKD and limit the quality of renal replacement therapy. The intake of non-caloric and non-nutritional substances could be harmful and cause effects on satiety and metabolic / electrolyte imbalance and modify the biocompatibility of micronutrients, toxins and pathogens worsening health status. In daily practice, pica could be under-reported because patient's shame to recognize it, or fear that such behavior influences their treatment. Additionally, clinicians who not investigate the presence of pica or its complications contribute to the lack of information about the magnitude and relevance of this problem in CKD.

Minerals and Heavy Metals in the Whole Raw Milk of Dairy Cows from Different Management Systems and Countries of Origin: A Meta-Analytical Study

The objective of this meta-analytical study was to investigate selected macrominerals, microminerals, and toxic heavy metals in the bovine whole-raw-milk (WRM) samples of published data. An analytical data set was constructed from 72 different studies from 37 countries with two types of production systems: a conventional production system (CPS) and an organic production system (OPS) compared with commercially available or retail-store-available milk (COM). Results of the meta-analytical study showed differences in the concentrations of macrominerals. Concentrations of Ca, Mg, K, and P were greater in the CPS samples, whereas Na was greater in the COM samples ( P < 0.05). Data also demonstrated that concentrations of microminerals like Cu, I, Fe, Mn, Se, and Zn in the organic WRM were lower ( P < 0.05) compared with the milk from CPS. The highest concentration of Ni was reported for COM ( P < 0.05); however, this value was below the minimum-risk level (MRL). Concentrations of heavy metals like As and Ni were greater in CPS milk than those in organic milk ( P < 0.05). In addition, there were greater concentrations of Cd and Pb in the WRM from CPS versus that from the organic farms. Concentration of Al was lowest in the OPS milk versus Al in the CPS which was 6.5-fold greater than in organic milk. The amount of Hg was below the MRL of 0.01 μmol/L for all production systems. A high variability was observed in the published data regarding the country of origin. Raw milk originating from Europe and North America was characterized by concentrations of macro- and microminerals below the MRLs as compared with that from specific countries, which had some minerals above the MRLs. For example, concentrations of Pb were above the MRL in the milk samples from Brazil, Croatia, Egypt, Mexico, Nigeria, Palestine, Romania, Serbia, and Turkey. Moreover, data from this study indicate that organic dairy farms are characterized by lower concentrations of toxic heavy metals in the WRM compared with those from CPS dairy farms.

The risks of self-made diets: the case of an amateur bodybuilder

BACKGROUND

Following DIY (do it yourself) diets as well as consuming supplements exceeding by far the recommended daily intake levels, is common among athletes; these dietary habits often lead to an overconsumption of some macro and/or micronutrients, exposing athletes to potential health risks. The aim of this study is to document the development of possible adverse effects in a 33 year-old amateur bodybuilder who consumed for 16 years a DIY high protein diet associated to nutrient supplementation. Body composition, biochemical measures and anamnestic findings were evaluated. We present this case to put on alert about the possible risks of such behavior repeated over time, focusing on the adverse gastrointestinal effects. We discuss the energy and nutrient composition of his DIY diet as well as the use of supplements.

CONCLUSION

This study provides preliminary data of the potential risks of a long-term DIY dietary supplementation and a high protein diet. In this case, permanent abdominal discomfort was evidenced in an amateur body builder with an intake exceeding tolerable upper limit for vitamin A, selenium and zinc, according to our national and updated recommendations. As many amateur athletes usually adopt self-made diets and supplementation, it would be advisable for them to be supervised in order to prevent health risks due to a long-term DIY diet and over-supplementation.

Heavy metals in selected tissues and histopathological changes in liver and kidney of common moorhen (Gallinula chloropus) from Anzali Wetland, the south Caspian Sea, Iran

The present study aimed to measure the concentrations of Sn, Pb, Zn, Hg, Cu, Ni and Cd in the muscle and liver of 40 Common Moorhens (Gallinula chloropus) hunted from four stations in Anzali Wetland (Pirbazar, Ghalam-Koudeh, Selkeh and Abkenar). The histopathologic alteration index (HAI) of liver and kidney was also assessed in these birds. The highest concentrations of selected metals were measured in the liver of birds collected from Ghalam-Koudeh (Pb: 4.59±0.21, Sn: 6.663±0.282, Zn: 29.867±2.011, Cu: 24.07±1.84, Hg: 7.5±0.257, Ni: 6.85±0.52, Cd: 1.879±0.4mg kg(-1) dw). The lowest concentrations of metals were measured in the muscle of birds caught from Abkenar (Pb: 0.799±0.207, Sn: 1.873±0.066, Zn: 18.533±1.582, Hg: 0.86±0.08, Ni: 0.53±0.117, Cu: 6.63±1.114, Cd: 0.08±0.002mg kg(-1) dw). Also the highest and lowest concentrations of metals were recorded in sediment of Ghalam-Koudeh and Abkenar stations, respectively. These stations were located next to multi-industry Anzali Port. However, the concentration of Sn and Zn in sediment and tissues of Common Moorhens collected from different stations was lower than the permissible limit suggested by WHO and Canadian Council of Ministers of the Environment (CCME). But, Pb, Hg and Ni concentration in sediment and birds caught from all stations was higher than the permissible limit defined by WHO and CCME. Cu and Cd concentration in tissue samples and sediment of Ghalam-Koudeh and Pirbazar was also higher than the permissible limit defined by WHO and CCME. Hemorrhage, melanomacrophage aggregations, sinusoidal congestion and hepatocyte vacuolation were the most pathological changes found in the liver. Reduction of the Bowman space, melanomacrophage aggregations and hemorrhage also were observed in the kidney. The HAI means of G. chloropus collected from Ghalam-Koudeh and Pirbazar were significantly higher than other sites. Based on the HAI values and metal bioaccumulation in the tissues of G. chloropus, Ghalam-Koudeh and Pirbazar could be considered as having the worst environmental quality.

Biodegradable Magnesium Alloys: A Review of Material Development and Applications

Magnesium based alloys possess a natural ability to biodegrade due to corrosion when placed within aqueous substances, which is promising for cardiovascular and orthopedic medical device applications. These materials can serve as a temporary scaffold when placed in vivo, which is desirable for treatments when temporary supportive structures are required to assist in the wound healing process. The nature of these materials to degrade is attributed to the high oxidative corrosion rates of magnesium. In this review, a summary is presented for magnesium material development, biocorrosion characteristics, as well as a biological translation for these results.

Retrieval of a penny from the pediatric esophagus: a cost analysis

OBJECTIVE

As part of the oral phase of development, children commonly ingest foreign bodies. The most common lodged foreign body, requiring operative removal, in the United States is the penny. Valued at 1 cent, comprised of materials valued at less than 1 cent, costing 1.62 cents to manufacture, and being never removed from circulation, pennies are aplenty. But ingestion can lead to mucosal damage, the consequences of which can be esophageal perforation or stricture formation. We hypothesize that the monetary value of the penny is far less than the cost of its ingestion and removal. This quality assurance study examines the effect of the penny on the purse.

PATIENTS AND METHODS

This retrospective review identified 180 foreign bodies in children under the age of 18 over a five year period. Eighty-two were pennies. Operative notes revealed degree of injury. Hospital charge assessments revealed the "cost" of each visit.

RESULTS

There were no esophageal perforations, and cases were divided evenly among injury grades 0-III. The average total charge for all penny-related injuries was $7164.78.

CONCLUSIONS

The purpose was to examine the actual cost of a penny (more than its value in production) and the potential cost of its damage (thousands of dollars in measurable costs, untold immeasurable costs). The goal of this study is to draw healthcare professional and public attention to a potentially serious and yet highly preventable injury in young children.

Overview of health risk assessments for zinc

Zinc is an essential trace mineral nutrient required for growth and reproduction in man and other living organisms. Zinc deficiency has been identified as global public health issue that significantly impacts developing countries; as a result, zinc essentiality and the impacts of deficiency have been extensively studied. Zinc is also widely used in commercial products and is a high-production-volume industrial metal. This has provided opportunities for human exposure and prompted multiple assessments of adverse health impacts that might result from exposure excess. Zinc thus provides an illustrative case study of the methodological contrasts between nutritional and toxicological evaluations and highlights the need for risk assessment guidelines that may be tailored to accommodate the properties of essential trace elements.

Antacids in the initial management of metallic zinc ingestion in dogs

Zinc poisoning in dogs, following ingestion of post-1982 U.S. one cent coins is an increasingly common toxicological syndrome causing gastrointestinal abnormalities, hemolytic anemia, pancreatitis and renal failure. Thermodynamic laws predict that the rate of the chemical reaction between HCl and metallic zinc, which releases absorbable zinc anions, is dependent on pH. The significance of the relation between pH and dissolution is, however, apparently contradicted by the fact that recent veterinary toxicology texts are silent on the use of antacids in the early management of zinc ingestion in dogs. A series of experiments were conducted to test the hypotheses that the degree to which zinc dissolution is pH dependent is likely to be of clinical importance and that the use of antacids will be of benefit in preventing zinc poisoning in dogs that had ingested metallic zinc. Zinc dissolution was strongly dependent on pH in an exponential manner, indicating that clinically achievable upward adjustment of gastric pH using antacids is likely to have significant effects on the rate of zinc absorption in dogs. These data clearly support the use of antacids during the initial treatment of metallic zinc ingestion in dogs.

Comparison of major and trace element concentrations in 16 varieties of Cuban mango stem bark (Mangifera indica L.)

An aqueous decoction of mango (Mangifera indica L.) stem bark (MSB) has been developed in Cuba on an industrial scale to be used as a nutritional supplement, cosmetic, and phytomedicine, with antioxidant, anti-inflammatory, analgesic, and immunomodulatory properties. The concentration of major and trace elements was determined for 16 varieties of MSB belonging to two cultivars and grown in Cuba in the same soil (red ferralytic). Plants were classified into two groups, according to the tree age (12 and 26 year olds) and were analyzed for As, Ca, Cd, Cu, Fe, Hg, K, Mg, Pb, Se, and Zn content by means of ICP-AES technique. Experimental data were processed by ANOVA and principal component analysis in terms of elements, variety, and plant age, to choose the most adequate varieties for industrial purposes.

Case of the missing penny: thoracoscopic removal of a mediastinal coin

Complications of coin ingestion in children, although rare, include esophageal perforation, tracheoesophageal fistula, esophago-aortic fistula, and death. The authors describe thoracoscopic removal of a mediastinal coin that migrated extraluminally from the esophagus in a 23-month-old girl. Right-sided thoracoscopic exploration using a 3-trocar technique in a modified prone position was used. Coin location was assisted by manipulation of a transorally placed Foley catheter and intraoperative fluoroscopy. The coin was retrieved successfully with no intraoperative or postoperative complications and minimal postoperative pain. This is the first report of successful thoracoscopic removal of a mediastinal coin. Thoracoscopy may be a valuable approach for mediastinal foreign body removal in children.

Cecal retention of a swallowed penny mimicking appendicitis in a healthy 2 year old

Toddlers commonly ingest coins. Studies of the evaluation and management of such ingestions have focused on the risk of complications from impaction in the esophagus. It is commonly assumed that coins that have passed through the esophagus present little or no risk for distal complications. We present the first report of cecal retention of a penny in a previously healthy 2 year old, ultimately resulting in surgical intervention.