The industrialization of the agricultural sector has increased the chemical burden on natural ecosystems. Pesticides are agrochemicals used in agricultural lands, public health programs, and urban green areas in order to protect plants and humans from various diseases. However, due to their known ability to cause a large number of negative health and environmental effects, their side effects can be an important environmental health risk factor. The urgent need for a more sustainable and ecological approach has produced many innovative ideas, among them agriculture reforms and food production implementing sustainable practice evolving to food sovereignty. It is more obvious than ever that the society needs the implementation of a new agricultural concept regarding food production, which is safer for man and the environment, and to this end, steps such as the declaration of Nyéléni have been taken.
Background: Chronic hypocalcemia may cause electrocardiographic (ECG) changes and mimic acute myocardial infarction. It has also been associated with reversible cardiac dysfunction. On the other hand cardiomyopathy and heart failure have been reported in patients with idiopathic hypoparathyroidism or celiac disease. Clinical Case: A 39-year-old male was admitted to the emergency room with acute retrosternal pain and dyspnea. He exhibited severe hypocalcemia and acute renal failure. High creatine kinase (CK) levels did not correlate with biomarkers of myocardial necrosis (negative troponin test, heart type creatine kinase isoenzyme (CK-MB) <1% of CK value). The ECG showed an extremely long QT interval (0.6 sec) and T-wave inversions on V 4 through V 6 . The left ventricular ejection fraction (LVEF) was as low as 25%, while coronary angiography was normal. Investigation of the hypocalcemia revealed primary hypoparathyroidism (Parathyroid hormone (PTH) <3 pg/ml) and concomitant celiac disease with positive antigliadin and endomysial antibodies. The cardiovascular episodes and the dilated heart failure were attributed to the chronic hypocalcemia since no other cause was found. The correction of hypocalcemia has not been sufficient to reverse the end-stage heart failure after more than 6 months of treatment, even though ECG abnormalities have receded, implying permanent cardiac impairment. Conclusion: This case demonstrates an unusual clinical condition where 2 calcium homeostasis disorders led to severe hypocalcemia with clinical manifestations of end-stage heart failure. The severe cardiac failure appeared to be nonreversible after calcium repletion suggesting permanent cardiac muscle dysfunction due to associated cardiomyopathy.
IntroductionSevere chronic hypocalcemia may predominantly be presented with paresthesias, neuromuscular irritability, and tetany, but can sometimes manifest cardiovascular complications like hypotension, myocardial dysfunction, prolongation of the QT interval, and triggered dysrhythmias like torsades de pointes, decreased myocardial performance, and even heart failure.1 Hypocalcemia induced heart failure (or hypocalcemic heart failure) has been associated with various clinical entities like idiopathic or postsurgical hypoparathyroidism, vitamin D deficiency, and celiac disease. 2,3,4 The symptoms are often misleading and, consequently, endocrine causes of heart failure are sometimes overlooked.The case of a 39-year-old man, who upon evaluation for clinical acute myocardial syndrome and end-stage heart failure was diagnosed with primary hypoparathyroidismand celiac disease, is presented and the role of these diseases in heart function is discussed.
Coastline change and human activities in shoreline zones are two factors indicating the vulnerability and the quality of a coastal environment. In this article, coastline evolution and spatiotemporal differences on coastal touristic infrastructure are presented as two case studies. Both case studies have increasing interest among scientists monitoring sensitive coastal areas, and for stakeholders evolved in the tourist industry. The study is twofold: monitors the shoreline evolution and examines how the shoreline behavior affects the seasonal anthropogenic touristic infrastructure. Shoreline detection methodology integrates unmanned aerial systems (UAS) or high-resolution satellite images for data acquisition, and geographic object-based image analysis (GEOBIA) for the shoreline recognition and the infrastructure change detection. The methodology used produced robust results in the aspect of mapping and detecting coastline changes, coastal erosion and the human pressure due to specific activities.
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