Lung burdens of deposited particles from fumes generated by arc-welding were established in rats by single inhalation exposures, repeated intermittent exposure or by intratracheal injection. Fumes from manual metal arc-welding using flux-coated mild-steel rods (MMA-MS) were compared with those from metal inert-gas welding with stainless steel wire (MIG-SS). After initial rapid clearance of deposited material from the lungs, persistent residual deposits remained. Such residues resulting from single inhalation were small and confined mainly to peribronchial accumulations in macrophage clusters. Deposits remaining after repeated inhalation were larger and more widespread. Intratracheal administration (50 mg) established massive residual deposits, giving nodular accumulations in peribronchial, subpleural and perivascular sites, with substantial alveolar parenchymal involvement. Deposits from both types of fumes contained predominantly iron. Particles from stainless steel also contained chromium, but concentrations of this element were low in deposits from MMA-MS fumes. MMA-MS deposits contained silica, probably amorphous. Long-term studies (up to 450 days) attempted to detect evidence of fibrosis resulting from particle burdens. Low-grade collagen fibre layers developed at margins of MMA-MS nodules. Diffuse reticulin fibre networks occurred within MIG-SS aggregates. Tissue hydroxyproline levels were increased (doubled) in lungs with intratracheal burdens of MMA-MS particles, but no significant increases resulted from MIG-SS. The major lesions were nodular aggregates of particle-laden macrophages with giant-cell formation, and alveolar epithelial thickening with atelectasis.
Osteoarthritis is the most prevalent arthritic disease and a leading cause of disability. The pathogenesis of osteoarthritis involves multiple etiologies, including variable degree of synovial inflammation. Metformin and pioglitazone could potentially reduce the levels and activity of inflammatory mediators. This may consider as a new therapeutic approach added to the current used drugs in an attempt to decrease the pain, inflammation, and improve daily activity and quality of life in patients with knee osteoarthritis. This study designed to evaluate the clinical utility of using metformin or pioglitazone as anti-inflammatory agents in combination with non-steroidal anti-inflammatory drugs (NSAID) of selective type of cyclooxygenase-2 (COX-2) inhibitor, meloxicam, in the treatment of knee osteoarthritis (OA). Randomized, double blinded clinical study was performed on 98 patients who have symptomatic and radiologic evidence of painful OA of the knee (57 patients only completed the study). Patients were allocated into three groups, group (A); 20 patients treated with meloxicam (15mg/day) alone, group (B); 20 patients treated with metformin (1000mg/day) + meloxicam (15mg/day) and group (C); 17 patients treated with pioglitazone (15mg/day) + meloxicam (15mg/day). The treatment was followed for 12 weeks through measurement of the clinical effects of drugs each 7 days, using the Knee Injury and Osteoarthritis Outcome Score (KOOS) system. The results showed that metformin or pioglitazone, when used in combination with NSAID resulted in significant improvement in the components of KOOS, higher than that produced by meloxicam when used alone. In conclusion, administration of metformin or pioglitazone as adjuvant therapy to NSAID, meloxicam, in OA patients produced very well characterized analgesic and anti-inflammatory activities, and improves the therapeutic profile of meloxicam. Keywords: Metformin, Pioglitazone, Osteoarthritis, Knee injury, KOOS.
Rats were exposed to single periods of inhalation of fumes generated by arc welding. Two processes were compared: either manual metal arc (MMA) using flux-coated mild steel (MS) electrodes or metal inert-gas (MIG) welding with stainless steel (SS). Widespread but small deposits of fume particles were cleared effectively from alveoli and airways. Peribronchial and subpleural aggregates of particle-laden macrophages remained. More massive and persistent lung-burdens were established by intratracheal administration of suspensions of fume-particles (10 mg and 50 mg, single doses). Initial pneumonitis was attributed to irritant gases or soluble toxic components of particles. MIG-SS particle deposits were more persistent and lesions more severe, inhibition of phagocytosis or clearance and damage to epithelial cells being associated with possible toxic effects in macrophages. Both types of particle caused alveolar epithelial thickening, with proliferation of granular pneumocytes and exudation of lamellar material. Foam cells appeared in alveoli. Long-term effects (80-300 days) involved formation of nodular aggregates of particle-laden macrophages. Giant cells were formed. Nodules containing MIG-SS material were irregular and surrounded by collapsed and thickened epithelium. Soluble chromium or nickel constituents are cited as probable active agents producing effects resembling those of cytotoxic non-fibrogenic dusts, e.g., soluble silicas . MMA-MS particles produced low-grade fibrotic ( collagenised ) changes.
Hypothyroidism has been associated with disorders of glucose and insulin metabolism..The present study was designed to evaluate the possible change in some hormones (free testosterone, estradiol, prolactin, insulin), glucose and homeostasis model assessment of insulin resistance (HOMA-IR) in women with primary hypothyroidism under thyroid hormone replacement therapy .This cross-sectional study was carried on 62 hypothyroid patients׳ women and 22 healthy women as control group at the specialized center for endocrinology and diabetes, AL-Rasafa Directorate of Health Baghdad, with age range(15-60 years), diagnosed as having primary hypothyroidism on thyroxine replacement therapy with duration not less than four months. Each of the selected patients women and the healthy control were distributed into two groups, normal cyclic and postmenopausal. Blood samples were collected to measure thyroid stimulating hormone(TSH), total thyroxine (TT4) , total triiodothyronine (TT3), free thyroxine(fT4), free testosterone (FT), estradiol(E2) ,prolactin(PRL), insulin , fasting blood glucose( FBG), homeostasis model assessment-insulin resistance(HOMA-IR). The results showed that the majority of hypothyroid women (older than 40 years and obese) had high levels of TSH in normal cyclic and postmenopausal patients women. A significant increase in f T4 and TT4 in postmenopausal patients women when compared with postmenopausal control group f T4 and TT4. A significant increase in free testosterone and FBG and significant decrease in TT3 and E2 levels in normal cyclic patients women when compared with normal cycle control group. High prolactin levels were found in the normal cyclic patients women in comparism with control group. Higher levels of insulin were found in normal cyclic and postmenopausal patients women as compared with control groups, however insulin was not statistically different. Significant increase in HOMA-IR of normal cyclic patients women compared with control group. In conclusion, elevation of TSH levels in postmenopausal patients women were less than in normal cyclic patients women this explain the increase levels of thyroxine hormone(T4)in this group of patients as compared with both control group and normal cyclic patients women. Some hormonal changes were found in normal cyclic hypothyroid patients women as compared with control group.The alteration of these hormones disappear when euthyroid state restored, so adjustment of thyroxine therapy is required in these patients. Key words: Hypothyroidism , Thyrid replacement therapy.
Hypertension is a major health problem throughout the world because of its high prevalence and its association with increased risk of cardiovascular diseases. It is defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. The aim of this study was to compare the efficacy, safety and cardiovascular disease risk lowering ability, of three antihypertensive drug regimens. A retrospective study was carried out on 66 hypertensive patients, divided in to three groups based on their antihypertensive drug regimens (ACE inhibitors, β-blockers treated and combination antihypertensive therapy, the combination therapy consist of two or more of the following antihypertensive drugs ACE inhibitor diuretic, CCBs β-blockers), the study also included 22 healthy individuals. Duration of treatment was 2-10 years. Blood pressure and pulse rate were measured and blood sample was collected, and the serum processed for the measurement of lipid profiles, fasting blood glucose, liver function test, kidney function test, electrolytes, and C-reactive protein. Cardiovascular disease risk lowering ability have been assessed by cardiovascular risk assessor computer program. The results shows that systolic and diastolic blood pressure in the three antihypertensive drug regimens treated group, were significantly higher than systolic and diastolic blood pressure in control healthy individuals indicating that these antihypertensive drug regimens were unable to reach hypertension treatment target, although ACE inhibitors and combination antihypertensive drugs reach minimal hypertension treatment target. ACE inhibitors regimen did not show any significant adverse effects on lipid profiles and blood glucose, while β-blockers regimen adversely affected it. Most predominant adverse effects that appear, in ACE inhibitors treated group were dry cough and taste disturbances, in β-blockers treated group were bradycardia and sleep disturbances while in combination therapy treated group were according to the combination used. In combination containing thiazide diuretics, disturbed lipid profiles and hyperurecemia were predominant and in combination containing calcium channel blockers constipation and peripheral edema were predominant. Coronary heart disease and stroke risk percentage in all three antihypertensive drug regimens were significantly higher compared to control healthy individuals group, and all three antihypertensive drugs regimens have the same cardiovascular risk lowering ability. In conclusion the results indicated that all three antihypertensive drug regimens used were not efficient enough to reach hypertension treatment target, the combination therapy and ACE inhibitors regimens were only capable to reach minimal hypertension treatment target which is ≤150/90 mm Hg. Key words: ACE inhibitors, B blockers, Hypertension.
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