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Background There is limited knowledge on outcome of transvenous lead extraction (TLE) of leads being 20 and 30 years old. Methods Retrospective single center large database analysis containing 3673 TLE procedures performed from 20...
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Background There is limited knowledge on outcome of transvenous lead extraction (TLE) of leads being 20 and 30 years old. Methods Retrospective single center large database analysis containing 3673 TLE procedures performed from 2006 to 2020 was analysed. We aimed to compare procedure complexity and the incidence of the TLE major complications (MC) in groups where extracted leads were under 10 years, 10–20 years, 20–30 years (old) and over 30 years (very old). Results Rate of removal of old and very old leads almost doubles with successive five-year periods (3–6-10%). In patients with old and very old leads there is an accumulation of risk factors for major complications of TLE (young age, female, multiple and/or abandoned leads, multiple previous procedures). The removal of old and very old leads was more labour-consuming, more difficult, and much more often required second-line (advanced) tools and complex techniques. Incidence of all MC grew parallel to age of removed leads from 0.6 to 18.2%; haemopericardium—from 0.3 to 12.1%, severe tricuspid valve damage—from 0.2 to 2.1%, need for rescue cardiac surgery—from 0.4 to 9.1%. Notably, there was no procedure-related death when old or very old lead was extracted. The percentages of clinical and procedural success decreased with increasing age of the removed leads from 99.2 and 97.8% to 90.9 and 81.8%. The risk of MC during extraction of leads aged 10–20 years increases 6.7 times, aged 20–30 years—14.3 times (amounting to 8.4%), and aged 30 and more years—20.4 times, amounting to 18.2%. Removal of ventricular leads is associated with a greater complexity of the procedure but not with more frequent MC. Removal of the atrial leads is associated with a higher incidence of MC, especially haemopericardium, regardless of the age of the leads, although the tendency becomes less pronounced with the oldest leads. Conclusions 1. Extraction of old and very old leads is a rising challenge, since the rate of removal of leads aged 20-and-more years almost doubles with successive five-year periods. 2. Procedure difficulty, complexity and the risk of major complications increases along with the age of extracted lead. TLE is more time-consuming, difficult and much more often requires advanced tools and complex techniques. 3. TLE of old (≥20 years) or very old (≥30 years) leads can be performed with satisfactory success rate and safety profile when conducted at high-volume centre by an experienced operator under optimal safety conditions.
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Lead in homes is a well-known source of childhood lead exposure, which is still of concern due to the health effects of low lead doses.This study aims to describe lead contamination in the homes of children aged 6 months to 6 year...
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Lead in homes is a well-known source of childhood lead exposure, which is still of concern due to the health effects of low lead doses.This study aims to describe lead contamination in the homes of children aged 6 months to 6 years in France (without overseas). Between October 2008 and August 2009,484 housing units were investigated. Lead in tap water and total and leachable lead levels from floor dust, outdoor soils and paint chips were measured. X-ray fluorescence measurements were carried out on non-metallic and metallic substrates. Nationwide results are provided.The indoor floor dust lead (PbD) geometric mean (GM) was 8.8 ng/m~2 (0.8 ug/ft~2) and 6.8 ug/m~2 (0.6 |ig/ft2) for total and leachable lead respectively; 0.21% of homes had an indoor PbD loading above 430.5 u.g/m2 (40 u,g/ft2). The outdoor play area concentration GM was 33.5 mg/kg and 21.7 mg/kg in total and leachable lead respectively; 1.4% of concentrations were higher than or equal to 400 mg/kg. Outdoor floor PbD GM was 44.4 μg/m~2 (4.1 ug/ft~2) that was approximately 3.2 times higher than the GM of indoor PbD. Lead-based paint (LBP) was present in 25% of dwellings, LBP on only non-metallic substrates was present in 19% of homes and on metallic substrates in 10% of dwellings. The GM of lead concentrations in tap water was below 1 μg/L; 58% of concentrations were lower than 1 ug/L and 2.9% were higher than or equal to 10 μg/L The age cut-off for homes with lead would be 1974 for paint and 1993 for indoor floor dust. This study provides, for the first time, a look at the state of lead contamination to which children are exposed in French housing. Moreover, it provides policy makers an estimate of the number of French dwellings sheltering children where abatement should be conducted.
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Childhood uptake of lead from exposure to atmospheric leaded gasoline in the United States has been studied using mainly blood lead levels. Since reliable blood lead techniques were used only after the peak use of leaded gasoline,...
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Childhood uptake of lead from exposure to atmospheric leaded gasoline in the United States has been studied using mainly blood lead levels. Since reliable blood lead techniques were used only after the peak use of leaded gasoline, the prior exposure history is unclear. The well-documented decline in blood lead levels after the mid-1970s could represent the continuation of a historic steady decline in exposure from many sources. Alternatively, the post-1970s decline might represent the declining phase of a unimodal rise and fall corresponding closely to usage of leaded gasoline. To assess these possibilities, lead concentration and 207Pb/206Pb isotope ratios were measured in the enamel of permanent molar teeth formed between 1936 and 1993 in mainly African-American donors who grew up in the Cleveland area. Tooth enamel preserves the lead concentration and isotope ratio that prevails during tooth formation. Historical trends in enamel lead concentration were significantly correlated with surrogates of atmospheric lead exposure: lead in sediments of two dated Lake Erie cores, and lead consumed in gasoline. About two-thirds of the total lead uptake into enamel in this period was attributable to leaded gasoline, and the remainder to other sources (e.g. paint). Enamel 207Pb/206Pb isotope ratios were similar to those of one lake sediment. Multivariate analysis revealed significant correlation in neighborhoods with higher levels of traffic, and including lake sediment data, accounted for 53% of the variation in enamel lead levels. Enamel lead concentration was highly correlated with reported African-American childhood blood levels. The extrapolated peak level of 48 ng/dL (range 40 to 63) is associated with clinical and behavioral impairments, which may have implications for adults who were children during the peak gasoline lead exposure. In sum, leaded gasoline emission was the predominant source of lead exposure of African-American Cleveland children during the latter two-thirds of the 20th century.
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摘要 :AbstractLead battery recycling is a growing hazardous industry throughout Africa. We investigated potential soil contamination inside and outside formal sector recycling plants in seven countries. We collected 118 soil samples at ...
展开AbstractLead battery recycling is a growing hazardous industry throughout Africa. We investigated potential soil contamination inside and outside formal sector recycling plants in seven countries. We collected 118 soil samples at 15 recycling plants and one battery manufacturing site and analyzed them for total lead. Lead levels in soils ranged from < 40–140,000mg/kg. Overall mean lead concentrations were ~23,200mg/kg but, average lead levels were 22-fold greater for soil samples from inside plant sites than from those collected outside these facilities. Arithmetic mean lead concentrations in soil samples from communities surrounding these plants were ~2600mg/kg. As the lead battery industry in Africa continues to expand, it is expected that the number and size of lead battery recycling plants will grow to meet the forecasted demand. There is an immediate need to address ongoing exposures in surrounding communities, emissions from this industry and to regulate site closure financing procedures to ensure that we do not leave behind a legacy of lead contamination that will impact millions in communities throughout Africa.Highlights•Soil lead contamination was found at lead battery recycling facilities in Africa.•Mean lead concentrations were 2600mg/kg in soil on the outside of plants.•Lead pollution at these sites poses significant health risks to the public.•Lead contamination at these plants suggest that extensive remediation is warranted.收起
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Background: Despite significant progress made in recent decades in preventing childhood lead poisoning in the United States through the control or elimination of lead sources in the environment, it continues to be an issue in many...
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Background: Despite significant progress made in recent decades in preventing childhood lead poisoning in the United States through the control or elimination of lead sources in the environment, it continues to be an issue in many communities, primarily in low-income communities with a large percentage of deteriorating housing built before the elimination of lead in residential paint. The purpose of this study is to determine whether state laws aimed at preventing childhood lead poisoning are also effective in preventing recurring lead poisoning among children previously poisoned.
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Samples from 75 paint products made by 21 domestic and foreign manufacturers were purchased from retail stores in five major cities in Nepal and tested for lead content. Information provided on product labels were noted. Samples w...
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Samples from 75 paint products made by 21 domestic and foreign manufacturers were purchased from retail stores in five major cities in Nepal and tested for lead content. Information provided on product labels were noted. Samples were selected to be representative of the large number of brands and colors available in retail shops. Although a majority of the products purchased were manufactured in Nepal, paints from four additional countries were tested. Out of a total of 75 samples, 57 (76%) of the tested paints contained lead at concentrations greater than 90 ppm (ppm). Ninety-three percent of the paints that exceeded 90 ppm had levels in excess of 600 ppm. Lead concentrations in the tested paints ranged up to 200,000 ppm (20%) lead by weight and the median concentration was 5100 ppm. These results indicate that lead paint is commonly being sold for residential and other consumer applications in Nepal without any consumer warnings. Regulations are needed to specify the maximum concentration of lead allowed in paint products manufactured, imported, or distributed in the country to protect public health. Efforts must be made to get lead-containing paint products recalled from stores so that they are not used in homes, schools, and other child-occupied facilities.
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BACKGROUND Small-diameter implantable cardioverter-defibrillator (ICD) Sprint Fidelis and Riata leads have been recalled owing to an increased risk of lead failure, thus arousing the suspicion that lead size might be a critical is...
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BACKGROUND Small-diameter implantable cardioverter-defibrillator (ICD) Sprint Fidelis and Riata leads have been recalled owing to an increased risk of lead failure, thus arousing the suspicion that lead size might be a critical issue.OBJECTIVE To compare the incidence of failure of small-diameter (<8 F) and standard-diameter (>8 F) ICD leads implanted in a single center.METHODS From January 2003 to December 2010, 190 Sprint Fidelis, 182 Riata/Riata ST, 99 Optim (Riata Optim/Durata), and 419 standard-diameter leads were implanted in our center.RESULTS During a median follow-up of 33 months, the overall failure rate was 6.3%. Follow-up duration was similar for Sprint Fidelis, Riata, and standard-diameter leads but shorter for the Optim group. The failure rate was significantly higher in Sprint Fidelis leads than in both standard-diameter (4.8%/year vs 0.8%/ year; P < .001) and Riata/Riata ST (4.8%/year vs 2.6%/year; P = .03) leads. The incidence of lead failure in Riata/Riata ST leads proved significantly higher than in standard-diameter leads (2.6%/year vs 0.8%/year; P = .001). No cases of lead failure were recorded in the Optim group. On multivariable analyses, small-diameter (hazard ratio [HR] 5.03, 2.53-10.01, P < .001), Sprint Fidelis (HR 6.3, 3.1-13.3, P < .001), or Riata/Riata ST (HR 4.5,1.9-10.5, P = .001) leads and age < 60 years (HR 2.3, 1.3-4.3, P = .005) were found to independently increase the risk of lead failure.CONCLUSIONS Compared with standard-diameter Leads, both Sprint Fidelis and Riata/Riata ST small-diameter ICD leads are at an increased risk of failure, although the incidence of events is significantly lower in the Riata than in the Sprint Fidelis group.
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the electrochemical behavior of the lead electrode has been studied by cyclic voltammetry (CV) in sulfuric acid solutions, with concentrations ranged from 0.05 to 5 M. Also, the effect of a sweep rate, the range of potential polar...
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the electrochemical behavior of the lead electrode has been studied by cyclic voltammetry (CV) in sulfuric acid solutions, with concentrations ranged from 0.05 to 5 M. Also, the effect of a sweep rate, the range of potential polarisation and temperature has been examined. Special attention has been paid to unusual anodic processes, i.e., "anodic excursion" peaks that accompany the main reduction peak.
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Structural equation modeling is a statistical method for partitioning the variance in a set of interrelated multivariate outcomes into that which is due to direct, indirect, and covariate (exogenous) effects. Despite this model's ...
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Structural equation modeling is a statistical method for partitioning the variance in a set of interrelated multivariate outcomes into that which is due to direct, indirect, and covariate (exogenous) effects. Despite this model's flexibility to handle different experimental designs, postulation of a causal chain among the endogenous variables and the points of influence of the covariates is required. This has motivated the researchers at the University of Cincinnati Department of Environmental Health to be guided by a theoretical model for movement of lead from distal sources (exterior soil or dust and paint lead) to proximal sources (interior dust lead) and then finally to biologic outcomes (handwipe and blood lead).
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