Heavy Metals Testing

Posted on Sunday, August 15, 2010 | 1 comments

‘All substances are poisons … dose differentiates a poison.'

---Paracelsus (1493-1541)

HEAVY METALS

Toxic heavy metals can cause the following health problems:

CADMIUM

· Renal dysfunction

· Obstructive lung diseases and has been linked to lung cancer.

· Bone defects in humans and animals.

CHROMIUM

· Ulceration

· Kidney and liver damage

· Damage to circulatory and nerve tissues.

COPPER

· Anemia, liver and kidney damage, and stomach and intestinal irritation

LEAD

· Problem in the synthesis of hemoglobin

· Damage to the kidneys, gastrointestinal tract, joints, reproductive system and the nervous system

MERCURY

· Tremors, gingivitis and/or minor psychological changes

· Damage to the brain and the central nervous system

· Congenital malformation

NICKEL

· Decreased body weight, heart and liver damage

· Skin irritation

ARSENIC

· Kidney and liver damage

· Death

ALUMINUM

· Bone disorders including fractures, osteopenia and osteomalacia

HEAVY METALS TESTING

ZINC PROTOPORPHYRIN (ZPP) TEST

· This is usually done to test for chronic lead exposure.

· The test result will increase if positive for lead exposure since lead interferes with RBCs ability to make hemoglobin.

· ZPP reflects an average of lead exposure but not recent exposure.

· The result is normal until the lead concentration is greater than 25 micrograms per deciliter.

· ZPP is not sensitive enough because values do not rise until lead concentrations exceed the acceptable range.

ATOMIC ABSORPTION SPECTROMETRY (AAS)

· It is the most widely used instrument for clinical trace element analysis in biological samples.

GRAPHITE FURNACE AAS (GFAAS)

· It has improved the limit of quantitation (LOQ) to parts per billion (ppb, μg/L) and permits the simultaneous measurement of multiple elements.

· Zeeman Effect background correction improves the element signal measurement when testing in complex specimens such as serum, plasma or blood, and other specimen-handling enhancements have further improved sensitivity and precision.

FLAME AAS (FAAS) has a LOQ of parts per million (ppm, mg/L).

ATOMIC EMISSION SPECTROMETRY (AES)

· Consists of flame AES and plasma source emission spectrometry, which measures photon output rather than photon absorption as in AAS. The emission line(s) of the excited electrons are measured. The LOQ is ppm (mg/L). The sample in neutron activation analysis (NAA) is irradiated with low-energy neutrons for the production of radioactive nuclides. In NAA there is excitation of the atomic nucleus, so that the trace element is determined independently of its physical or chemical state. The newly formed radionuclide emits X- or γ-rays. The LOQ is ppb (μg/L) to parts per trillion (ppt, ng/L) with multi-element detection, but with a limited dynamic range. This technique is especially suited for in vitro trace element determination in biologic matrices. In instrumental neutron activation analysis (INAA) there is direct measurement of the emitted X or γ radiation. Inductively coupled plasma–mass spectroscopy (ICP-MS) is a highly sensitive and specific method for the measurement of multiple trace elements in a single run over an especially broad dynamic range with low background interference and LOQs of ppb (μg/L) to ppt (ng/L). An internal standard is used for enhanced precision ( Milne, 1994 ; Chan, 1998a ).

SPECIMEN

· The first morning void urine is less affected by recent dietary intake.

· May be obtained from accessible tissues (hair, nails) and body fluids (serum, urine), or the activity of a trace element-dependent enzyme. Hair, fingernail or toenail analyses provide a retrospective window or an assessment of chronic exposure for the period of hair or nail growth ( Gibson, 2002 ).

Table 26-5 -- Properties of Essential Trace Mineral Elements

Element

Tissue distribution

Body content

Transport (Reference value)

Excretion

Chromium

Spleen, heart

4–6 mg Cr (III)

Transferrin-P 0.15 μg/mL Cr (0.12–2.1 μg/L)

Urine 100–200 ng/day

Cobalt

Muscle, liver, fat

1.1 mg

Albumin (0.11–0.45 μg/L)

Urine 80%

Copper

Muscle and liver

Liver 30–50 μg/g dry; 50–70% of body Cu

50–80 mg (1.2–2.5 μg/g fat-free tissue)

Ceruloplasmin 60–95%, albumin, transcuperin (Cu-S: 70–140 μg/dL AAS)

Feces includes bile and unabsorbed dietary Cu

Iodine

Thyroid: 70–80% of total body I in thyroxin bound to thyroglobulin

15–20 mg (11–15 mg in thyroid)

Thyroxine-binding protein, 80% thyroxine-binding prealbumin (transthyretin)

Urine 100–150 μg/day

Iron

RBC Hb 400–600 mg/L, liver, spleen, bone marrow 25%, myoglobin

4–5 g (3/4 in Hb)

50 mg/kg

2.5 g in RBCs

Transferrin-P (2–2.5 g/L)

Ferritin-S 1 μg/L = 10 mg tissue iron stores

Hemosiderin 1 g iron (Mn-blood: 200 nmol/L)

Bile 84 μg/kg, blood loss, menses, GI mucosal cells

Manganese

Liver, bone, pancreas

12–20 mg

Bile and intestinal secretions

Molybdenum

Liver, kidney, bone, adrenal

Blood 30–700 nmol/L

RBC protein, α1-macroglobulin (S: 8–34 μg/L)

Urine 90%, bile 10%

Selenium

Liver, kidney, muscle

15 mg

Protein [Se-P: 7–30 μg/dL]

Urine 60%, feces 40%

Zinc

Muscle 60%, bone 30%, liver, prostate, semen

1.2–2.3 g

Albumin 60–70%, α2-macroglobulin (Zn-P: 11–22 μmol/L)

Feces, gut secretions, GI mucosal cells

Data from: Fausto da Silva, 1991 ; Milne, 1994 ; O'Dell, 1997 ; Kohlmeier 2003 .

P = plasma; S = serum; AAS = atomic absorption spectrometry.

Source: Henry’s Clinical Diagnosis and Management by Laboratory Methods 21st Edition, Edited By Richard A. McPherson, Matthew R. Pincus, 2007

COMPULSARY DRUG TESTING FOR STUDENTS???

Posted on Wednesday, August 4, 2010 | 0 comments
COMPULSARY DRUG TESTING FOR STUDENTS???

Well, I certainly agree with this. There are a lot of students who are psychologically dependent on certain drugs that are not beneficial to them. If schools would implement the compulsory drug testing requirement before admitting students for enrolment, surely less trouble would be observed throughout the school year. This would also help the school to monitor their student’s medical record. If this step will be implemented, there are definitely some drawbacks and some will not agree with this policy. But let us just look at the positive side of this project; this is one step ahead towards achieving a drug free generation! J

TOXIC-ology

Posted on Wednesday, July 14, 2010 | 0 comments
“TOXIC”

I always hear this word from students having a hard time in their studies. Most of them are Medical Technology students. It is also a very common word; even our department lanyard has the word “toxic” in it! But, setting aside all these, do you really know what does “TOXIC” means?

Toxic comes from the
Greek word “toxicos” which means poisonous.


Toxicos + Logos = Toxicology


…adding the word “logos”, we form TOXICOLOGY, which is the study of the origin, nature, properties, and adverse effects of poisons on living organisms. It also includes the study of symptoms, mechanisms, treatments and detection of poisoning,most especially poisons which can cause harm to humans.
How about toxicity?
I simply define Toxicity as drugs which were metabolized to toxic products.

Applying this with my own experience, I can share to you what happened to me when I always experience migraine. Whenever I’m in pain, I immediately take in Paracetamol. This will somehow lessen the hurt in my head. But as time goes by, it seemed that taking 1 tablet of 500mg paracetamol everytime my head aches was not as effective as before. That is why I started taking 2 tablets whenever I have headache. Later on, I’ve experience, fatigue, nausea, vomiting, euphoria and mood swings, not knowing that these are some of the symptoms of Paracetamol overdose.

Excessive use or overdose of Paracetamol can lead to Paracetamol toxicity which can cause liver injury. Paracetamol toxicity is one of the most common causes of poisoning worldwide. There are no symptoms during the first 24 hours following overdose. Some may have nonspecific complaints such as vague abdominal pain and nausea. But when the disease progresses, signs of liver failure may develop which includes low blood sugar, low blood pH, easy bleeding, and hepatic encephalopathy.


Some may be treated, but cases which are untreated may result in death.
Another experience I had was an overdose of Augmentin, a drug prescribed by my dentist 3 days before the surgical removal of my impacted tooth. Since I’m really suffering from the pain caused by my tooth, I didn’t follow the prescribed 375 mg Augmentin, instead I bought 625 mg of the said drug. I continued to take this in twice a day for almost 3 days. I then experienced diarrhea, nausea and vomiting which are the common adverse effects of the drug.

Probably now that I know the risks of taking in drugs that are beyond the prescription of a dentist or taking in more than the prescribed dosage, I surely will follow the doctor’s advice for they know better than I do.

Urinary Estrogens Test

Posted on Tuesday, June 8, 2010 | 1 comments

There are many sacrifices involved in being a woman. There are certain standards in the society that people expect us to meet, as well as criticisms in any act we do. But what really is the essence of being a woman? A very familiar question, huh? But there is this one woman who certainly gave a very meaningful answer. She said that the very essence of being a woman is to carry a very precious gift from heaven inside her womb, a child. And I agree with her…

I can relate this to my blog assignment Urinary Estrogen Determination, which is done primarily to help in monitoring the development of the unborn child during pregnancy. Increase in the 24 hour urine output of estrogen is seen as the pregnancy progress. This rise observed over 9 months of pregnancy is due to increase in estriol formation. There are several methods used in the determination of urinary estrogen, these includes Kober reaction, Preedy and Aitkin (fluorometric), Brown and Ittrich. But only Kober reaction will be discussed in this post.

SPECIMEN:

A 24-hour urine specimen

PROCEDURE:

KOBER REACTION (Colorimetric Method)

Preceding estrogen analysis, the sample is checked first for glucose concentration because high levels of any compound forming acetaldehyde will produce false negative results by reacting with hydroquinone. Then procedure involves heating a urine sample in a strong aqueous sulfuric acid solution containing hydroquinone. After cooling and dilution, the absorbance of the resulting reddish-brown color is measured and total estrogen concentration determined.

Hydrolysis of estrogen conjugates is accomplished with HCl and heat or enzymatically. Extraction into ethyl acetate separates the steroids from other materials. After drying to remove the organic solvent, a mixture of hydroquinone and sulfuric acid is added to the tube containing the estrogens. The tubes are heated to produce the color. Absorbance is determined at 472, 512, and 556 nm, followed by an Allen correction to calculate the estrogen concentration using standard solutions for calibration.

The KOBER REACTION colorimetric assay has sensitivity enough to quantitate total urine estrogens during pregnancy. Slight alteration of the procedure allows fluorometric assays with good sensitivity and accuracy for specimens from nonpregnant women.

Meprobamate, L-dopa, and phenolphthalein all give reactions with the Kober reagent, falsely increasing the results for urine total estrogen output.

NORMAL VALUE:

· Total estrogens excretion in the urine range from 4 to 100 ug /day

(This depends on the phase of menstrual cycle)

· During pregnancy estrogen production rates rise markedly, reaching levels grater than 40 mg/24 hours at term, close to a 500-folds increase over non-pregnant rates.

(This increased synthesis in cause by joint participation of mother and child in the biochemical production of estrogens.)

Note: Significant decrease in urine estrogen output occurs in patients taking ampicillin or neomycin. These antibiotics reduce bacterial levels in the intestine, causing a diminished hydrolysis of estriol conjugates. The re-uptake of estriol into the circulation becomes impaired, as is the urine excretion of estrogens. Hydrochlorothiazide produces falsely lowered results due to its destruction of estrogens during the acid

CLINICAL SIGNIFICANCE:

Below are conditions where one might see an increase or decrease of estrogen levels.

Increased levels of estrogens are seen in:

Decreased levels of estrogen are seen in:


Reference: Clinical Chemistry: A Fundamental Text Book by Donald Calbreath

OUTLINE OF ENDOCRINE GLANDS

Posted on Tuesday, May 25, 2010 | 1 comments
(where they are found in the body and the hormones they produce)

----This is the topic assigned to me in our second blog assignment. I’m really not a blogger, I don’t have a very imaginative mind and I’m not good in composing grammar-free sentences, but I’m trying to give my all in every post I make. Surely, it would take time to be a very fantastic writer/blogger, but I believe that there are always rooms for improvement if one person is willing to learn. (And I am very willing!)

Before I discuss the location of the glands in our body, let us first take a look at the list of the Major Endocrine Glands...

THE MAJOR ENDOCRINE ORGANS
•Hypothalamus
•Pituitary gland
•Thyroid gland
•Parathyroid gland
•Pancreas
•Adrenal gland
•Pineal gland
•Testes
•Ovary

Not exclusively classified as endocrine gland but contains cells that secrete hormones.
•Gastrointestinal tract
•Placenta
•Kidneys
•Heart
•Adipose tissue


please do read my other posts regarding this topic. =)

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