The presence of metals in the environment is a matter of concern, since human activities are the major cause of pollution and metals can enter the food chain and bioaccumulate in hard and soft tissues/organs, which results in a long half-life of the metal in the body. Metal intoxication has a negative impact on human health and can alter different systems depending on metal type and concentration and duration of metal exposure. The present review focuses on the most common metals found in contaminated areas (cadmium, zinc, copper, nickel, mercury, chromium, lead, aluminum, titanium, and iron, as well as metalloid arsenic) and their effects on bone tissue. Both the lack and excess of these metals in the body can alter bone dynamics. Long term exposure and short exposure to high concentrations induce an imbalance in the bone remodeling process, altering both formation and resorption and leading to the development of different bone pathologies.

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and 31/03/2010, were identified through examination of electronic patient records. Exclusion criteria included patients with atrial flutter (AFl), or an ICD10 code indicating prior inpatient attendance for AF since 1995. Patient notes were reviewed manually and an anonymised data collection template completed by the clinician for analysis. RESULTS: Of the 126 patients meeting the inclusion criteria, the notes of 7 patients were unobtainable and 8 with a diagnosis of AFl were excluded. The majority of patients were symptomatic at presentation (56%) and less than half were male (41%). Within the study population, the frequency of patients with AF increased with age, peaking at 80-89 years (45% of the study sample). Method of admission was primarily through A&E or GP referral (48% each); with 50% of A&E admissions being for symptomatic AF, compared with 60% of those referred via a GP. Almost half the study population were recorded with "first detected AF" (47%); 67% of whom were symptomatic, compared to 47% being symptomatic in patients recorded as "not first detected AF". The majority of patients were reported to have 1 or 2 of the pre-defined co-morbidities of interest (29% each); one fifth had no co-morbidities. The most common co-morbidities were hypertension (51%), ischaemic heart disease (20%), heart failure (18%), diabetes (16%) and pulmonary disease (15%). CONCLUSIONS: Results from this study demonstrate the majority of patients presenting to secondary care with AF have multiple associated co-morbidities, which are known to influence the management and treatment strategy, and long-term complications. Further up-to-date epidemiological studies, which describe the history, management and prognosis of patients with AF, are required. OBJECTIVES:To analyze the add-on and switch patterns for patients who dispensed platelet aggregation inhibitors, excluding heparin (acetylsalicylic acid, clopidogrel, and dipyridamole) in the South-West region of Sweden. METHODS:This was a retrospective database study of medication utilization amongst patients from the South-West region of Sweden (1.5 million inhabitants). All patients who dispensed platelet aggregation inhibitors (B01AC), excluding heparin, from 2006 to 2009 were included in the study. A dispatch was classified as new, switch, add-on, or continuation. All dispatches were annotated, at the ATC level, as either new (no other anticoagulant within 105 days), add-on (another anticoagulant dispatched both before and after), switch (another anticoagulant dispatched before, but not after), or continuation (dispatched same ATC-code within 105 days). RESULTS: 163 330 patients had at least one B01AC filled prescription. The total number of dispatches for these patients were 3 327 499. 96% of all patients had been dispatched acetylsalicylic acid (ASA), 11% clopidogrel and 6% dipyridamole. ASA was dispatched as a new prescription in 17% of all dispatches, in Ͻ0.5% as add-on, Ͻ0.5% as switch, and in 83% as continuation. For clopidogrel the distribution was 17% (new), 4% (add-on)...

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