Lead is a persistent toxic metal and associated with impairment of various body functions in occupational workers. The main objective was to determine the lead-induced oxidative stress and adverse health effects by biochemical markers in industrial workers. One hundred and forty-eight males consisting of 87 lead-exposed industrial workers and 61 controls were included. Blood lead level (BLL) was determined on a 3010B ESA lead analyzer. Blood complete counts were done on a hematology analyzer. Biochemical markers including serum uric acid, urea, creatinine, phosphate, alanine aminotransferase (ALT), and gamma glutamyltransferase (GGT) were measured on a Selectra E auto analyzer. Serum malondialdehyde (MDA) was measured spectrophotometrically and C-reactive protein (CRP) on Immulite-1000. Results revealed that lead-exposed workers had significantly high BLLs, median (range), 29.1 (9.0-61.1) microg/dL compared with controls, 8.3 (1.0-21.7) microg/dL. Oxidative stress (MDA, GGT) and inflammatory markers (high-sensitivity CRP) were significantly increased (P < or = 0.05). Blood pressure was raised, whereas hemoglobin was decreased in exposed group (P < or = 0.002). Serum urea, uric acid, phosphate, and ALT were significantly raised in lead-exposed workers (P < or = 0.001). Serum albumin, total proteins, and glomerular filtration rate (GFR) were decreased. Blood lead showed a significant positive correlation with serum GGT (r = 0.63), MDA (r = 0.71), CRP (r = 0.75), urea (r = 0.34), creatinine (r = 0.51), and uric acid (r = 0.29) (P < or = 0.01). It is concluded that lead exposure increases oxidative stress that correlates with adverse changes in hematological, renal, and hepatic function in the occupational workers. Elevated blood lead has positive correlation with oxidative stress, inflammatory and biochemical markers that might be used to detect impairment in the body function in lead exposed workers.

Quercetin (3,3ʹ,4ʹ,5,7-pentahydroxyl- flavone) is a flavonol, and it belongs to a class of plant secondary metabolites known as flavonoids. It is present in man's daily diet and is known for biological activities such as antioxidant, antiviral, anticancer, antimicrobial, anti-inflammatory and many more. Quercetin has been reported for its antioxidant and antiviral applications, hence, it is not only used as such but also its various derivatized forms have potentials for development into drugs for the treatment of diseases caused by oxidative stress and lethal viruses.

In hyperthyroidism, erythrocytes show decreased Na+,K+-ATPase activity, decreased [3H]ouabain binding capacity (an index of the number of sodium pumps) and decreased active sodium and potassium flux rates, with a high intracellular sodium concentration. As erythrocytes are non-nucleated and atypical cells, we have studied electrolyte status in thyroid disease using mixed leucocytes as well; the results obtained differed from those in erythrocytes. When compared with findings in healthy subjects, leucocyte Na+,K+-ATPase activity, [3H]-ouabain binding capacity, total and active rubidium (used instead of potassium) influx were all significantly increased in untreated hyperthyroidism and decreased in untreated hypothyroidism. In hyperthyroidism, there was also a decrease in plasma potassium, an increase in sodium efflux rate and efflux rate constant, but no significant changes in cell sodium and potassium concentrations. All these changes returned to normal in successfully treated patients. There was a significant correlation between these abnormalities of electrolyte status and thyroid disease status (as serum thyroid stimulating hormone and free thyroxine).

The effect of age on the haemodynamic response to tracheal intubation was studied. Ninety ASA 1 or 2 patients were divided into three groups of 30 each based on age; i.e., young (18-25 years), middle-aged (40-50 years) and elderly (65-80 years). The haemodynamic response after tracheal intubation was observed as percentage change in heart rate and blood pressure compared to the baseline. Inter-group comparison was also done at different time points. The greatest percentage change in the systolic arterial pressure after tracheal tube insertion was seen in the elderly group (15%). The increase in systolic arterial pressure was significantly less in the young group compared with the two older groups at one, two, three and four minutes post-intubation. The greatest percentage increase in the diastolic blood pressure compared to the baseline was seen in the middle aged group (24%). The elderly and young patients showed a significant difference in the diastolic blood pressure response only at one minute post-intubation. The heart rate response was greatest in the middle-aged patients (40%) and least in the elderly (16%). These differences may have clinical significance and should be considered in assessing and performing research into the haemodynamic response to intubation.

SummaryEighty patients undergoing lower third molar surgery under general anaesthesia were assigned to one of two groups to receive local anaesthetic blockade either 10 min prior to surgery or after surgery just before leaving the operating theatre. Patients in both groups received the local anaesthetic block whilst unconscious. Pain was assessed using visual analogue scales at 6 h and 1, 3 and 6 days after surgery. A McGill Pain Questionnaire was also completed on the morning following surgery. At no time was it possible to detect any significant difference in pain between the two groups. The administration of local anaesthesia prior to starting surgery does not appear to have any advantage over its postoperative administration in patients undergoing this type of surgery. The local anaesthetic, however, does provide excellent analgesia during the first few hours following surgery. The treatment of postoperative pain by intermittent doses of analgesic, on an 'as-required' basis, is often ineffective [1, 2]. A renewed interest in improving postoperative analgesia has taken place since the publication of a document by the Working Party on Pain After Surgery, highlighting the inadequacy of postoperative analgesia [1] and the possibility of improving this situation by providing analgesia prior to tissue injury [2]. The latter hypothesis was proposed in an editorial by Wall and was based on research which showed that blocking nociceptive stimuli from reaching the central nervous system (CNS) prevented hyperexcitability within the spinal cord [3][4][5].Animal and clinical work has illustrated the benefit of treating surgical pain by blocking nociception prior to surgery -pre-emptive analgesia [3, 6 ,7]. In theory, central sensitisation could be prevented if nociceptive information was prevented from arriving at the CNS by neuronal blockade or by the use of drugs like opioids to minimise this sensitisation [6]. We chose to study the former method, since it should result in the prevention of nociceptive information reaching the CNS during surgery and thus prevent the initiation of central sensitisation. MethodsEighty ASA grade 1 and 2 patients, who were to undergo lower third molar extraction under general anaesthesia, were enrolled into the study. The study had been granted Ethics Research Committee approval by the Queen's University of Belfast and written informed consent was obtained from each patient. Prior to surgery, each patient was given a pain questionnaire and advised on how to complete it during the week following surgery. Pain assessment was carried out using 100-mm vertical visual analogue scales for pain (VAS; 0 ¼ no pain; 100 ¼ worst pain possible) at 6 h or just after the local anaesthetic ceased to act. Assessments using VAS were also carried out on the morning following surgery, as well as on the mornings of the third and sixth days. A long form McGill Pain Questionnaire was also completed on the morning following surgery. ᮊ 1997 Blackwell Science LtdThe patients were randomly assigned to one of two ...

The study objective was to measure the change in pulse pressure associated with laryngoscopy and tracheal intubation and to relate these changes to trends in systolic, diastolic and mean blood pressure. The rationale was that the rise in systolic and diastolic blood pressure may be disproportionate and may result in either increase or decrease in pulse pressure. We also looked at the influence of age on this response. This prospective observational study measured the changes in pulse pressure secondary to laryngoscopy and tracheal intubation in eighty adult surgical patients. Two groups of forty patients each were included, young (group A) 18-25 years and middle-aged (group B) 45-55 years. The patients were ASA Class 1 or 2, of either gender, and non-hypertensive. Systolic, diastolic, and mean blood pressure, and heart rate were measured preinduction and 1, 2 and 3 minutes after induction. Thereafter they were measured every minute for five minutes after intubation. Pulse pressure was obtained by subtracting the diastolic from the systolic blood pressure. No pulse pressure change occurred in the young group despite of a significant increase in both systolic and diastolic blood pressures. The middle aged group showed an average rise of +18 mm of Hg in pulse pressure (taken at 1 minute post-intubation) compared to the baseline measurement (P<0.0001). These changes in pulse pressure during anaesthesia may indicate an additional pulsatile stress in vulnerable patients in addition to the changes associated with resistance alone and need to be studied further.

believe that printed issues, or at least tolls in the form of subscriptions and site licences, will continue indefinitely. ESA began selling immediate free web access in January 2000. During the first two months of the service, authors bought it for 13% of articles, rising steadily to 59% during March and April 2001. The price for the service is currently 75% of the price of 100 paper reprints, for example $90 for a 7-page article. This price provides a greater profit margin than for paper reprints, which are expensive to produce and deliver. Immediate free web access requires only that the PDF file of the article is made freely accessible on ESA's web server. If immediate free access is a profitmaking service that many authors want and will pay for, why is ESA apparently the only publisher that sells it? For scientific societies, the answer is probably that their institutional inertia is great and their members have yet to lobby for it-as ESA members did. Commercial publishers may fear that selling immediate free access to those who want it may lead to all authors buying it, in which case revenues from subscriptions and site licences might cease. On the other hand, societies have supplemented modest incomes from lower-priced library subscriptions with member dues and page charges. Without journal subscriptions, societies and commercial publishers will collect page charges to pay for refereeing, editing and composing. Publishers will pay nothing to make the articles freely web accessible, because research libraries and PubMed Central will post them without charge. Authors should encourage publishers to provide immediate free access at a fair price. Other things being equal, many will prefer to publish in journals that provide it, especially as electronic literature indexes begin linking directly to the e-versions of articles. Most authors would like nothing better than for their articles to be available in full text, without tolls, via links in widely used literature indexes.

BackgroundIdiopathic pulmonary fibrosis (IPF) is a progressive fibrotic lung disease with variable disease trajectory. Blood biomarkers reflecting disease severity that can accurately predict outcomes are urgently needed. Through systematic review and meta-analysis, we evaluate the prognostic potential of matrix-metalloproteinase-7 (MMP-7) and other frequently studied blood biomarkers in patients with IPF.MethodsElectronic databases were searched on 12th November 2020 to identify prospective studies reporting outcomes in patients with untreated IPF, stratified according to at least one pre-specified biomarker, measured at either baseline or change over three months. Individual participant data (IPD) was sought for studies investigating MMP-7 as a prognostic factor. The primary outcome was overall mortality, with secondary outcomes including disease progression, defined as >10% relative FVC decline or death.Results29 studies reporting outcomes from 3950 IPF participants were included, investigating a total of 16 biomarkers. IPD from MMP-7 studies was available for eleven cohorts. Baseline MMP-7 levels were associated with increased mortality (adjusted HR1.23 per SD increase, 95%CI 1.03;1.48, I2=64.3%) and disease progression (adjusted OR1.27 per SD increase, 95%CI 1.11;1.46, I2=5.9%), but change in MMP-7 over three-months was not associated with any of the measured outcomes. There was insufficient data for quantitative analysis in non-MMP7 studies, and whilst many biomarkers showed an association with clinical outcomes, replication of effects across studies was weak.ConclusionBaseline MMP-7 levels were associated with an increased risk of overall mortality and disease progression in patients with untreated IPF. The evidence for other biomarkers is currently insufficient with further studies needed.