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Toxic Metals Data

Life Flow One
The Solution For Heart Disease

by
Karl Loren

Lead & EDTA

Results for your query on March 15, 1999:

Search all fields for: lead And oral EDTA

Published in 1966 through 1999

Only select references with abstracts available

Show references published in English only

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Documents: 1 to 26 of 26

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NLM database Documents

Record 1 from database: MEDLINE
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Title

Chronic industrial exposure to lead in 63 subjects. II. Evaluation of chelation therapy.

Author

Strickland GT; Hwang YF; Chang NK; Blackwell RQ

Address

Source

Southeast Asian J Trop Med Public Health, 1976 Dec, 7:4, 569-74

Abstract

Efficacy of chelation therapy with intravenous calcium disodium edetate, oral Ca EDTA, and oral penicillamine was tested in 63 subjects with chronic minimal industrial exposure to lead. All three agents increased the urinary lead excretion. The effect was greatest with intravenous Ca EDTA, next with oral penicillamine and least with oral Ca EDTA. Symptoms, particularly colicky abdominal pain, improved during the period of chelation therapy. Anaemic subjects showed improvements in haematological parameters. It is recommended that subjects with chronic minimal industrial exposure to lead receive chelation therapy. The relative merits of the three agents are discussed.

Language of Publication

English

Unique Identifier

77174905

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MeSH Heading (Major)

Edetic Acid|AD/*TU; Lead Poisoning|*DT/UR

MeSH Heading

Adult; Chronic Disease; Clinical Trials; Comparative Study; Environmental Exposure; Human; Lead|UR; Male; Penicillamine|AD/TU

Publication Type

CLINICAL TRIAL; JOURNAL ARTICLE

ISSN

0038-3619

Country of Publication

THAILAND

Record 2 from database: MEDLINE
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Title

Chelation therapy in lead nephropathy.

Author

Morgan JM

Address

Source

South Med J, 1975 Aug, 68:8, 1001-6

Abstract

Although treatment has been well defined for childhood lead poisoning and for industrial lead exposure, the treatment of lead nephropathy has been poorly studied. The available chelating agents are reviewed and the results of treatment in 17 cases of lead nephropathy are shown. It is concluded that lead nephropathy should be recognized early and treated energetically, as this may stabilize or improve renal function. Since EDTA is excreted much like creatinine, the dosage must be reduced proportionately in response to elevated serum creatinine levels in the patient with renal failure.

Language of Publication

English

Unique Identifier

76013429

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MeSH Heading (Major)

Chelating Agents|*TU; Kidney Diseases|*PA; Lead Poisoning|*DT

MeSH Heading

Administration, Oral; Creatinine|BL; Dimercaprol|TU; Drug Eruptions|CI; Drug Therapy, Combination; Edetic Acid|AD/AE/TU; Human; Hypocalcemia|CI; Infusions, Parenteral; Injections, Intramuscular; Injections, Intravenous; Kidney Failure, Acute|CI; Lead|UR; Male; Penicillamine|TU; Thrombophlebitis|CI

Publication Type

JOURNAL ARTICLE

ISSN

0038-4348

Country of Publication

UNITED STATES

Record 3 from database: MEDLINE
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Title

Aggressive approach in the treatment of acute lead encephalopathy with an extraordinarily high concentration of lead.

Author

Gordon RA; Roberts G; Amin Z; Williams RH; Paloucek FP

Address

Department of Pharmacy Practice, College of Pharmacy, University of Illinois, Chicago 60612, USA.

Source

Arch Pediatr Adolesc Med, 1998 Nov, 152:11, 1100-4

Abstract

OBJECTIVE: To report a case of a 3-year-old child with an extraordinarily massive lead concentration, 26.4 micromol/L (550 microg/dL), following environmental exposure to lead paint in the home. LITERATURE REVIEW: The relevant literature concerning the treatment of lead encephalopathy was reviewed during the treatment of this child and preparation of the manuscript. To our knowledge, the landmark article written by Julian Chisolm in 1968 is the only recent article that reported similarly high levels of lead concentration. This case, however, is the first in which 3 chelating agents were used for the treatment of lead encephalopathy. We also reviewed the literature on the use of whole bowel irrigation in heavy metal intoxications. CONCLUSIONS: In this case, aggressive gut decontamination with whole bowel irrigation and triple chelation therapy with British anti-Lewisite, EDTA, and oral succimer was well tolerated and seemed effective for rapidly deleading the child. The extent to which her lead concentration increased while being treated with oral succimer alone necessitated further chelation with EDTA. Further evaluation is necessary to determine if triple chelation therapy is an appropriate method for severe lead intoxication, and if the use of whole bowel irrigation should be considered in heavy metal intoxication.

Language of Publication

English

Unique Identifier

99027427

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MeSH Heading (Major)

Brain Diseases|*ET/TH; Iron Chelating Agents|*TU; Lead|*BL; Lead Poisoning|BL/*TH

MeSH Heading

Case Report; Child, Preschool; Dimercaprol|TU; Edetic Acid|TU; Environmental Exposure; Female; Human; Irrigation; Paint|PO; Polyethylene Glycols|AD; Succimer|TU

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW OF REPORTED CASES

ISSN

1072-4710

Country of Publication

UNITED STATES

Record 4 from database: MEDLINE
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Title

The efficacy of chelation therapy and factors influencing mortality in lead intoxicated petrol sniffers.

Author

Burns CB; Currie B

Address

Clinical Unit, Menzies School of Health Research, Darwin, NT.

Source

Aust N Z J Med, 1995 Jun, 25:3, 197-203

Abstract

BACKGROUND: The use of chelating agents to treat patients with petrol sniffing encephalopathy has been controversial, since alkyllead additives in petrol are not chelatable. A high mortality has also been reported in hospitalised petrol sniffers. AIMS: (i) Evaluate the efficacy of chelating agents in mobilising lead for excretion and lowering blood lead; (ii) Review factors contributing to mortality in hospitalised petrol sniffers. METHODS: All males chelated between 1992-1993 were studied (n = 20). Blood and urinary lead were measured daily before and during chelation then twice weekly until discharge. Parenteral calcium disodium edetate (EDTA) and dimercaprol (BAL) were administered together, every six hours for five days, seven patients subsequently received oral D-penicillamine until discharge. Clinical details were reviewed for eight patients with petrol sniffing encephalopathy who died between 1990-1994. RESULTS: Urinary lead excretion substantially increased during parenteral chelation (median excretion = 113 microM/5 days, compared with pre-chelation excretion = 1.1 microM/day). Median blood lead concentration fell from 4.83 microM/L (pre-chelation) to 1.91 microM/L (post-chelation). D-Penicillamine did not appear to increase urinary lead excretion appreciably. All eight deaths followed sepsis; five from complications of aspiration pneumonia. CONCLUSIONS: Airway maintenance and management are crucial for survival in these patients. In the short-term, parenteral chelation was effective in mobilising lead for excretion and reducing blood lead in encephalopathic petrol sniffers and was comparable to cases of inorganic lead intoxication. However, as in the treatment of inorganic lead intoxication, the long-term efficacy of chelation for petrol sniffers remains controversial. Prevention strategies against petrol sniffing at a community level are recommended.

Language of Publication

English

Unique Identifier

96078344

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MeSH Heading (Major)

Chelating Agents|*TU; Chelation Therapy|*; Dimercaprol|*TU; Edetic Acid|*TU; Gasoline|*; Lead|*/UR; Lead Poisoning|*ET; Substance-Related Disorders|*CO

MeSH Heading

Human; Male; Support, Non-U.S. Gov't; Treatment Outcome

Publication Type

JOURNAL ARTICLE

ISSN

0004-8291

Country of Publication

AUSTRALIA

Record 5 from database: MEDLINE
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Title

Comparison of dimercaptosuccinic acid and calcium disodium ethylenediaminetetraacetic acid versus dimercaptopropanol and ethylenediaminetetraacetic acid in children with lead poisoning.

Author

Besunder JB; Super DM; Anderson RL

Address

Department of Pediatrics, MetroHealth Medical Center, Cleveland, OH 44109-1998, USA.

Source

J Pediatr, 1997 Jun, 130:6, 966-71

Abstract

OBJECTIVES: To compare the response to dimercaptopropanol (BAL) and calcium disodium ethylenediaminetetraacetic acid (EDTA) versus orally administered meso-2,3-dimercaptosuccinic acid (DMSA) and EDTA in children with lead poisoning. METHODS: Retrospective review of medical records of children admitted to MetroHealth Medical Center with a whole blood lead (BPb) concentration of 2.17 mumol/L (45 micrograms/dl) or more (or less than 2.17 mumol/L and not a candidate for outpatient oral chelation) and treated with BAL + EDTA or DMSA + EDTA. In each group, the mean BPb values at the end of therapy and at 14 and 33 days after chelation were compared with pretreatment BPb by the Wilcoxon signed-rank test, whereas the Mann-Whitney U test was used to compare percentage change from pretreatment at each follow-up day between the two groups. RESULTS: Twenty-three children received BAL + EDTA and 22 received DMSA + EDTA. The BPb values (mean +/- SD) at the end of therapy and at 14 and 33 days after chelation were significantly lower than pretreatment in both groups (BAL + EDTA: 17 +/- 10, 34 +/- 7, 36 +/- 11 vs 58 +/- 14 micrograms/dl, p < 0.02, 0.01, 0.001, respectively; DMSA + EDTA: 10 +/- 4, 30 +/- 10, 30 +/- 14 vs 50 +/- 10 micrograms/dl, p < 0.01, 0.001, 0.01, respectively). The percentage reduction (mean +/- SD) in BPb from pretreatment at the end of therapy and on days 14 and 33 after chelation did not differ between the groups (BAL + EDTA: -71.2% +/- 19.8%, -40.2% +/- 13.8%, -37.1% +/- 17%; DMSA + EDTA: -79.9% +/- 8.7%, -38.3% +/- 21.6%, -37% +/- 32%; p > 0.20). Elevation of alanine aminotransferase and vomiting during therapy were observed more frequently in the BAL + EDTA group compared with the DMSA + EDTA group. CONCLUSIONS: Treatment with DMSA or BAL combined with EDTA results in a comparable reduction in BPb.

Language of Publication

English

Unique Identifier

97346201

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MeSH Heading (Major)

Edetic Acid|AE/*TU; Lead Poisoning|BL/*DT; Succimer|AE/*TU

MeSH Heading

Alanine Transaminase|BL; Blood Urea Nitrogen; Child; Child, Preschool; Comparative Study; Creatinine|BL; Female; Hemoglobins; Human; Male; Retrospective Studies; Vomiting|ET

Publication Type

JOURNAL ARTICLE

ISSN

0022-3476

Country of Publication

UNITED STATES

Record 6 from database: MEDLINE
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Title

Provocative chelation with DMSA and EDTA: evidence for differential access to lead storage sites.

Author

Lee BK; Schwartz BS; Stewart W; Ahn KD

Address

Institute of Industrial Medicine, Soonchunhyang University, Chunan, Republic of Korea.

Source

Occup Environ Med, 1995 Jan, 52:1, 13-9

Abstract

OBJECTIVES--To validate a provocative chelation test with 2,3-dimercaptosuccinic acid (DMSA) by direct comparison with the standard ethylene diamine tetraacetic acid (EDTA) test in the same subjects; and to compare and contrast the predictors of lead excretion after DMSA with those after EDTA. A metal chelating agent given orally, DMSA may mobilise and enhance the excretion of lead from the storage sites in the body that are most directly relevant to the health effects of lead. A provocative chelation test with DMSA could thus have wide potential application in clinical care and epidemiological studies. METHODS--34 male lead workers in the Republic of Korea were given a single oral dose of 10 mg/kg DMSA, urine was collected over the next eight to 24 hours, and urine volume and urinary lead concentration determined at 0, 2, 4, 6, 8, and 24 hours. Either two weeks before or two weeks after the dose of DMSA 17 of these workers also received 1 g intravenous EDTA followed by an eight hour urine collection with fractionation at 0, 2, 4, 6, and 8 hours. RESULTS--Urinary lead concentration peaked at two hours after DMSA and four hours after EDTA. Lead excretion after DMSA was less than after EDTA, and cumulative excretion after DMSA plateaued at six to eight hours. The two hour and four hour cumulative lead excretions after DMSA were highly correlated with the eight hour total (r = 0.76 and 0.95). In multiple linear regression analyses, blood lead was found to be an important predictor of EDTA-chelatable lead, whereas urinary aminolevulinic acid (ALAU) was associated with DMSA-chelatable lead. Notably, lead excretion after DMSA was greatly increased if EDTA was given first. An earlier dose of EDTA also modified the relation between ALAU and DMSA-chelatable lead in that workers who received EDTA before DMSA showed a much steeper dose-response relation between these two measures. CONCLUSIONS--The predictors of lead excretion after DMSA and EDTA are different and an earlier dose of EDTA may increase lead excretion after a subsequent dose of DMSA. The results suggest that two hour or four hour cumulative lead excretion after DMSA may provide an estimate of lead in storage sites that are most directly relevant to the health effects of lead.

Language of Publication

English

Unique Identifier

95211216

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MeSH Heading (Major)

Chelation Therapy|*; Edetic Acid|*TU; Lead|*; Occupational Exposure|*; Succimer|*TU

MeSH Heading

Adult; Comparative Study; Dose-Response Relationship, Drug; Environmental Monitoring; Human; Korea; Male; Middle Age; Time Factors

Publication Type

CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL

ISSN

1351-0711

Country of Publication

ENGLAND

Record 7 from database: MEDLINE
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Title

A ceramic glazer presenting with extremely high lead levels.

Author

Ooi DS; Perkins SL

Address

Division of Biochemistry, Ottawa Civic Hospital, Ontario, Canada.

Source

Hum Toxicol, 1988 Mar, 7:2, 171-4

Abstract

A case of lead poisoning in a ceramic glazer is reported. The patient had an extremely high level of blood lead at 29.5 mumol/l, and many of the laboratory features of lead toxicity: normocytic anaemia with marked basophilic stippling, abnormal blood and urinary porphyrins, and elevated liver enzymes. Surprisingly, the patient had no electromyographic evidence of neurologic involvement. The patient was treated with intravenous EDTA-calcium followed by oral penicillamine. Urinary porphyrin and porphyrin precursor excretion followed an interesting pattern, correlating with the chelator used. This patient illustrates that extremely high blood lead level can be achieved through the oral route in an adult.

Language of Publication

English

Unique Identifier

88243195

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MeSH Heading (Major)

Ceramics|*; Lead|*BL; Lead Poisoning|*BL/DI/DT; Occupational Diseases|*BL/DI/DT

MeSH Heading

Adult; Calcium|TU; Case Report; Coproporphyrins|AN; Edetic Acid|TU; Female; Human; Penicillamine|TU

Publication Type

JOURNAL ARTICLE

ISSN

0144-5952

Country of Publication

ENGLAND

CAS Registry/EC Number

0 (Ceramics); 0 (Coproporphyrins); 52-67-5 (Penicillamine); 60-00-4 (Edetic Acid); 7439-92-1 (Lead); 7440-70-2 (Calcium)

Record 8 from database: MEDLINE
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Title

Meso-2,3-dimercaptosuccinic acid in the diagnosis and treatment of lead poisoning.

Author

Bentur Y; Brook JG; Behar R; Taitelman U

Address

Source

J Toxicol Clin Toxicol, 1987, 25:1-2, 39-51

Abstract

Lead poisoning remains one of the hazards of industrialized civilization. CaNa2 EDTA and dimercaprol, the usual therapeutic measures, have many side effects and can be given by parenteral route alone. The authors present a case of chronic lead poisoning caused by ingestion of contaminated flour ground in a primitive flour mill. The diagnosis was confirmed by the CaNa2 EDTA provocative test. Dimercaptosuccinic acid (DMSA) was given orally as a further provocation and resulted in an 11-fold increase in urinary lead excretion. A 5-day course of treatment with DMSA was instituted, during which symptoms abated, urinary lead excretion increased and the blood lead level decreased. No side effects were noticed. There has been no relapse over several months of follow-up. The authors conclude that the oral use of DMSA is effective, safe and convenient both as a provocative test in establishing the diagnosis of lead poisoning and as a therapeutic tool.

Language of Publication

English

Unique Identifier

87226310

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MeSH Heading (Major)

Lead Poisoning|DI/*DT; Succimer|DU/*TU; Sulfhydryl Compounds|*TU

MeSH Heading

Adult; Bread; Case Report; Edetic Acid|DU; Food Contamination; Human; Lead|UR; Male

Publication Type

JOURNAL ARTICLE

ISSN

0731-3810

Country of Publication

UNITED STATES

CAS Registry/EC Number

0 (Sulfhydryl Compounds); 304-55-2 (Succimer); 60-00-4 (Edetic Acid); 7439-92-1 (Lead)

Record 9 from database: MEDLINE
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Title

Management of childhood lead poisoning: a survey [see comments]

Author

Glotzer DE; Bauchner H

Address

Department of Pediatrics, Boston City Hospital, MA 02118.

Source

Pediatrics, 1992 Apr, 89:4 Pt 1, 614-8

Abstract

Published recommendations (1985) for the management of childhood lead poisoning suggest the use of ethylenediaminetetraa cetic acid (EDTA) provocation testing and chelation as the mainstay of treatment for blood lead levels between 25 and 55 micrograms/dL. Since 1985 evidence has accumulated indicating that (1) levels of blood lead less than 25 micrograms/dL are detrimental to cognitive development, (2) EDTA provocation testing may result in potentially harmful shifts in the body lead burden, and (3) oral agents such as penicillamine and 2,3-dimercaptosuccinic acid are effective in reducing elevated lead levels. To determine how this evidence impacts on the management of childhood lead poisoning, the authors surveyed the lead poisoning clinics of pediatric departments in the cities estimated by the United States Public Health Service to have the largest number of children affected by lead poisoning. Thirty (70%) of 43 surveys were completed. Respondents indicated that the lowest blood lead level for which they would use a chelating agent to reduce the lead burden was as follows: 50 micrograms/dL (3%), 45 micrograms/dL (3%), 40 micrograms/dL (13%), 35 micrograms/dL (3%), 30 micrograms/dL (27%), 25 micrograms/dL (47%), and 20 micrograms/dL (3%). For all blood lead levels from 20 through 55 micrograms/dL, EDTA was the most frequently recommended chelating agent (chelation and provocation testing). Fifteen percent of responding lead clinics do not use the provocation test under any circumstances. For a child with a negative EDTA provocation test, the percentage of respondents recommending the use of any chelation therapy ranged from 16% for blood lead levels of 25 through 29 micrograms/dL to 66% for levels of 50 through 55 micrograms/dL.(ABSTRACT TRUNCATED AT 250 WORDS)

Language of Publication

English

Unique Identifier

92212631

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MeSH Heading (Major)

Chelating Agents|*TU; Lead Poisoning|BL/*DT

MeSH Heading

Child; Clinical Protocols; Drug Utilization; Edetic Acid|DU/TU; Human; Lead|BL; Penicillamine|TU; Succimer|TU; Support, U.S. Gov't, P.H.S.; United States

Publication Type

JOURNAL ARTICLE

ISSN

0031-4005

Country of Publication

UNITED STATES

CAS Registry/EC Number

0 (Chelating Agents); 304-55-2 (Succimer); 52-67-5 (Penicillamine); 60-00-4 (Edetic Acid); 7439-92-1 (Lead)

Record 10 from database: MEDLINE
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Title

Lead poisoning with pigmentation of the oral mucosa. Review of the literature and report of a case.

Author

ten Bruggenkate CM; Lopes Cardozo E; Maaskant P; van der Waal I

Address

Source

Oral Surg Oral Med Oral Pathol, 1975 May, 39:5, 747-53

Abstract

Some general aspects of the pathogenesis and the clinical and oral symptoms of chronic lead intoxication are presented. Treatment procedures are briefly discussed. The case of a patient suffering from plumbism is described. A typical Burtonian line was present in the mouth. By electron microprobe analysis, it was shown that this line was mainly the result of lead and, to a minor extent, the result of mercury-, copper-, and iron-bearing pigment in the subepithelial tissue.

Language of Publication

English

Unique Identifier

75195263

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MeSH Heading (Major)

Gingival Diseases|*CI; Lead Poisoning|*CO/DI/DT; Pigmentation Disorders|*CI

MeSH Heading

Adult; Biopsy; Calcium|AD/TU; Edetic Acid|AD/TU; Human; Injections, Intravenous; Male

Publication Type

JOURNAL ARTICLE

ISSN

0030-4220

Country of Publication

UNITED STATES

Record 11 from database: MEDLINE
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Title

Lead poisoning. A comprehensive review and report of a case.

Author

Gordon NC; Brown S; Khosla VM; Hansen LS

Address

Source

Oral Surg Oral Med Oral Pathol, 1979 Jun, 47:6, 500-12

Abstract

Lead, a ubiquitous heavy metal which has realized increased use, can cause poisoning by environmental contamination in either its organic or its inorganic form. Lead poisoning can be either acute or chronic, with the latter being the more common. The clinical signs and symptoms of lead poisoning are nonspecific, resulting in a difficult diagnostic problem, especially when it is not industrially related. On occasions, the dentist or oral surgeon may be the first to see an afflicted patient because of oral manifestations.

Language of Publication

English

Unique Identifier

79179332

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MeSH Heading (Major)

Lead Poisoning|*/BL/CO/DI/DT/ET/ME/UR

MeSH Heading

Adult; Anemia|ET; Case Report; Child; Diagnosis, Differential; Dimercaprol|TU; Edetic Acid|TU; Gingival Hyperplasia|ET; Hair|AN; Hematopoiesis|DE; Heme|BI; Hemolysis|DE; Human; Kidney|DE; Lead|AN/ME/PD; Male; Occupational Diseases|ET; Penicillamine|TU; Peripheral Nerves|DE

Publication Type

JOURNAL ARTICLE

ISSN

0030-4220

Country of Publication

UNITED STATES

Record 12 from database: MEDLINE
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Title

Lead, zinc, and erythrocyte delta-aminolevulinic acid dehydratase: relationships in lead toxicity.

Author

Thomasino JA; Zuroweste E; Brooks SM; Petering HG; Lerner SI; Finelli VN

Address

Source

Arch Environ Health, 1977 Nov, 32:6, 244-7

Abstract

A lead-intoxicated patient with extremely high blood lead levels and unexpectedly mild symptoms was studied prior to and following treatment with calcium disodium edetate (ethylenediaminetetraacetic acid) and then prior to and following oral administration of zinc sulfate. During chelation therapy, erythrocyte (delta)-aminolevulinic acid dehydratase (ALAD) activity decreased as blood lead levels fell. Urinary excretion of zinc increased and was more than 3.5 times greater than that of lead. The ratio of blood lead to serum zinc was greatest (1.47) when ALAD activity was lowest. Oral administration of zinc sulfate following chelation therapy resulted in a significant increase in mean ALAD activity. In vitro additions of zinc chloride to the patient's erythrocytes resulted in reactivation of ALAD activity. These studies suggest that zinc is an important element in the ALAD system in man. Zinc may play a protective role in lead toxicity, and zinc supplementation may be a useful adjunct to chelation therapy for lead toxicity.

Language of Publication

English

Unique Identifier

78059355

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MeSH Heading (Major)

Erythrocytes|*EN; Lead Poisoning|*BL/DT; Porphobilinogen Synthase|*BL; Zinc|*AD/BL/UR

MeSH Heading

Adult; Edetic Acid|TU; Human; Lead|BL/UR

Publication Type

JOURNAL ARTICLE

ISSN

0003-9896

Country of Publication

UNITED STATES

Record 13 from database: MEDLINE
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Title

Treatment of lead poisoning by 2,3-dimercaptosuccinic acid.

Author

Friedheim E; Graziano JH; Popovac D; Dragovic D; Kaul B

Address

Source

Lancet, 1978 Dec, 2:8102, 1234-6

Abstract

2,3-Dimercaptosuccinic acid (D.M.S.), a new orally effective agent for the treatment of heavy-metal intoxication, was administered to five lead-poisoned smelter workers for six days at dosages ranging from 8.4--12.7 mg/kg/day on the first day to 28.1--42.2 mg/kg/day on the last day. Mean blood-lead concentration decreased significantly from an initial value of 97 +/- 6 microgram/dl to 43 +/- 4 microgram/dl on the last day. Urinary lead excretion was significantly raised. D.M.S. was very well tolerated with no signs of toxicity and no effect on urinary zinc, calcium, magnesium, or iron excretion. Urinary copper excretion was significantly increased, but the magnitude of that effect was not clinically important. D.M.S. seems to be safe and effective for the treatment of lead poisoning.

Language of Publication

English

Unique Identifier

79071778

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MeSH Heading (Major)

Lead Poisoning|*DT; Succimer|*AD; Sulfhydryl Compounds|*AD

MeSH Heading

Administration, Oral; Adult; Chemistry; Comparative Study; Drug Administration Schedule; Drug Evaluation; Edetic Acid|AD; Human; Injections, Intravenous; Lead|ME; Metallurgy; Middle Age

Publication Type

JOURNAL ARTICLE

ISSN

0140-6736

Country of Publication

ENGLAND

Record 14 from database: MEDLINE
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Title

The effect of succimer therapy in lead intoxication using postural balance as a measure: a case study in a nine year old child.

Author

Bhattacharya A; Smelser DT; Berger O; Shukla R; Medvedovic M

Address

Biomechanics-Ergonomics Research Laboratory, University of Cincinnati Medical School, OH, USA.

Source

Neurotoxicology, 1998 Feb, 19:1, 57-64

Abstract

Postural balance testing was used as a measure of the effect of therapy on a 9 year old boy with high lead levels. Following therapy with CaEDTA and succimer, the patient's postural sway responses were comparable to a low-lead (< 10 micrograms/dL) comparison group for 3 out of 4 tests which rely relatively less on the higher centers for balance. This improvement in postural balance may be attributable to the combined influence of pharmacologic and age associated maturational effects. This case study provides suggestive evidence that while chelation therapy can reduce PbB levels quickly, it can also modify gross neuromotor function manifested by postural balance characteristics.

Language of Publication

English

Unique Identifier

98159656

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MeSH Heading (Major)

Equilibrium|*DE; Lead Poisoning|*DT/*PP; Succimer|*TU

MeSH Heading

Administration, Oral; Case Report; Child; Dimercaprol|TU; Drug Administration Schedule; Edetic Acid|TU; Human; Male; Patient Compliance; Support, U.S. Gov't, P.H.S.

Publication Type

JOURNAL ARTICLE

ISSN

0161-813X

Country of Publication

UNITED STATES

Record 15 from database: MEDLINE
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Title

The relationship between iron and lead absorption in humans.

Author

Flanagan PR; Chamberlain MJ; Valberg LS

Address

Source

Am J Clin Nutr, 1982 Nov, 36:5, 823-9

Abstract

Approximately 60% of an oral dose of 100 micrograms of 203Pb was retained in 85 fasting subjects with no difference noted between males and females. Body retention was proportional to dose up to 400 micrograms of lead. It was not related to the capacity to absorb iron or to the size of body iron stores, nor was it affected by the simultaneous ingestion of a 10-fold molar excess of iron. The effect of several dietary factors was also determined. Lead retention was lowered by eating food, slightly increased by ingestion of fat, but was unaffected by the administration of lactose or a 10-fold molar excess of zinc, cobalt, or calcium. One chelating agent, ascorbic acid, slightly lowered lead retention, whereas another agent ethylenediaminetetraacetic acid, produced a marked reduction. Several of these results suggest that human gastrointestinal lead absorption behaves differently to that of rodents. In particular, human lead retention was found to be unrelated to iron absorption or to body iron stores.

Language of Publication

English

Unique Identifier

83045487

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MeSH Heading (Major)

Ferritin|*BL; Iron|*ME; Lead|AD/*ME

MeSH Heading

Absorption; Adult; Diet; Dose-Response Relationship, Drug; Drug Interactions; Edetic Acid|PD; Female; Ferric Compounds|AD; Human; Lactose|PD; Male; Sex Factors; Support, Non-U.S. Gov't

Publication Type

JOURNAL ARTICLE

ISSN

0002-9165

Country of Publication

UNITED STATES

CAS Registry/EC Number

0 (Ferric Compounds); 301-04-2 (lead acetate); 60-00-4 (Edetic Acid); 63-42-3 (Lactose); 7439-89-6 (Iron); 7439-92-1 (Lead); 7705-08-0 (ferric chloride); 9007-73-2 (Ferritin)

Record 16 from database: MEDLINE
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Title

Adult lead poisoning.

Author

Zatlin GS; Senaldi EM; Bruckheim AH

Address

Source

Am Fam Physician, 1985 Oct, 32:4, 137-43

Abstract

Although the incidence of occupational and adult lead poisoning has declined, the problem still exists. It often goes unrecognized for long periods because of a low index of suspicion compounded by incomplete surveillance of risk populations. Abdominal pain, fatigue and arthralgia are the most frequent symptoms. Anemia, basophilic stippling of red blood cells and hyperuricemia are the most common clues. Diagnosis is based on blood lead levels. Chelation by calcium disodium edetate, followed by oral penicillamine, is the standard treatment.

Language of Publication

English

Unique Identifier

86022587

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MeSH Heading (Major)

Lead Poisoning|*BL/DT; Occupational Diseases|*BL/CI

MeSH Heading

Adult; Aged; Calcium|TU; Case Report; Edetic Acid|TU; Human; Lead|BL; Male; Middle Age; Protoporphyrins|BL

Publication Type

JOURNAL ARTICLE

ISSN

0002-838X

Country of Publication

UNITED STATES

CAS Registry/EC Number

0 (Protoporphyrins); 60-00-4 (Edetic Acid); 7439-92-1 (Lead); 7440-70-2 (Calcium)

Record 17 from database: MEDLINE
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Title

Brushing-induced effects with and without a non-fluoride abrasive dentifrice on remineralization of enamel surfaces etched with phosphoric acid.

Author

Kuroiwa M; Kodaka T; Kuroiwa M; Abe M

Address

Kuroiwa Dental Clinic, Kanagawa, Japan.

Source

Caries Res, 1994, 28:5, 309-14

Abstract

The remineralization of acid-etched enamel after brushing with and without a non-fluoride abrasive dentifrice was investigated using scanning electron microscopy after sodium hypochlorite (NaOCl) or ethylenediamine tetra-acetic acid treatment, of the specimens. Ground enamel pieces were etched with 30% phosphoric acid for 60 s and attached to resin plates. They were exposed to the oral environment of 4 subjects for 8 weeks and brushed for 1 min daily. Paste and brushing caused the acid-etched enamel to erode selectively, i.e., deep grooves were formed in the prism peripheral regions, while projections of the prism bodies showing a relatively low density of crystallites were retained. Brushing without dentifrice, on the other hand, caused about 0.5 micron thick pellicle with tag-like structures to cover the etched enamel. Fine mineral granules, presumably derived from saliva and minute fragments of etched crystallites, were precipitated on the enamel surface as a thin layer with the pellicle. These results indicate that daily brushing without dentifrice induces the remineralization of acid-etched enamel by depositing salivary components, while paste brushing will lead to abrasion of the weakened enamel.

Language of Publication

English

Unique Identifier

95094178

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MeSH Heading (Major)

Acid Etching, Dental|*; Dental Enamel|*DE/*PA; Dentifrices|AD/*TU; Phosphoric Acids|*PD; Tooth Abrasion|*PA; Tooth Remineralization|*; Toothbrushing|*

MeSH Heading

Adolescence; Adult; Calcium Phosphates|AD/TU; Child; Crystallography; Dental Deposits|PA; Edetic Acid|PD; Female; Human; Male; Microscopy, Electron, Scanning; Middle Age; Saliva|PH; Sodium Hypochlorite|PD; Tooth Erosion|PA

Publication Type

JOURNAL ARTICLE

ISSN

0008-6568

Country of Publication

SWITZERLAND

Record 18 from database: MEDLINE
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Title

Controlled study of meso-2,3-dimercaptosuccinic acid for the management of childhood lead intoxication.

Author

Graziano JH; Lolacono NJ; Moulton T; Mitchell ME; Slavkovich V; Zarate C

Address

Department of Pharmacology, Columbia University College of Physicians and Surgeons, New York, New York.

Source

J Pediatr, 1992 Jan, 120:1, 133-9

Abstract

We examined the efficacy and safety of meso-2,3-dimercaptosuccinic acid (DMSA) in children with markedly elevated blood lead (BPb) concentrations. Among 19 children with BPb concentrations of 50 to 69 micrograms/dl (2.41 to 3.33 mumol/L) who received a 5-day inpatient oral course of DMSA (1050 mg/m2 per day), the mean BPb concentration decreased by 61%; in four who received calcium disodium ethylenediaminetetraacetic acid (CaNa2EDTA) (1000 mg/m2 per day intravenously), it decreased by 45% (p less than 0.0007). Urinary lead excretion was comparable in both groups. Treatment with DMSA was more effective than treatment with CaNa2EDTA in restoring metabolic activity to the heme pathway and was well tolerated even among nine patients who received concomitant iron supplementation and two who had homozygous deficiency of glucose-6-phosphate dehydrogenase. On discharge, these 19 children received either no chelation therapy or DMSA, 350 or 700 mg/m2 per day for 14 days on an outpatient basis. After 14 days the mean BPb values for the no-chelation, low-DMSA, and high-DMSA groups were 73%, 66%, and 50% of the pretreatment values, respectively. We conclude that a 5-day oral course of DMSA is effective in the treatment of children with severe lead poisoning. In addition, on an outpatient basis the administration of DMSA, 700 mg/m2 per day, is capable of delaying the typical rebound in BPb values and should ultimately reduce the need for repeated hospitalizations.

Language of Publication

English

Unique Identifier

92113812

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MeSH Heading (Major)

Lead Poisoning|BL/*DT/UR; Succimer|AD/*TU

MeSH Heading

Administration, Oral; Ambulatory Care; Aminolevulinic Acid|UR; Aminolevulinic Acid Dehydratase|BL; Calcium|UR; Chelating Agents|AD/TU; Child; Child, Preschool; Dimercaprol|AD/TU; Edetic Acid|AD/TU; Erythrocytes|EN; Follow-Up Studies; Human; Infant; Injections, Intravenous; Lead|BL/UR; Safety; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.; Zinc|UR

Publication Type

CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; JOURNAL ARTICLE

ISSN

0022-3476

Country of Publication

UNITED STATES

CAS Registry/EC Number

EC 4.2.1.24 (Aminolevulinic Acid Dehydratase); 0 (Chelating Agents); 106-60-5 (Aminolevulinic Acid); 304-55-2 (Succimer); 59-52-9 (Dimercaprol); 60-00-4 (Edetic Acid); 7439-92-1 (Lead); 7440-66-6 (Zinc); 7440-70-2 (Calcium)

Record 19 from database: MEDLINE
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Title

Evaluation of the potential role of chelation therapy in treatment of low to moderate lead exposures.

Author

Chisolm JJ Jr

Address

Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD.

Source

Environ Health Perspect, 1990 Nov, 89:, 67-74

Abstract

In the overall long-term management of lead poisoning, chelation therapy can have short-term benefits; however, these benefits must be accompanied by drastic reduction in environmental exposure to lead if therapy is to have any long-term benefit. This discussion is limited to calcium disodium ethylenediaminetetraacetate (CaNa2EDTA), the chelating agent that has been the mainstay of treatment of lead poisoning for the past 38 years, and to meso-2,3-dimercaptosuccinic acid (DMSA), a new and promising oral chelating agent, which is an orphan drug and is currently classified as an investigational new drug by the U.S. Food and Drug Administration. With both drugs, multiple courses of treatment will be needed if any substantial reduction in body lead burden is to be achieved. A major limitation of CaNa2EDTA is the enormous diuresis of zinc that it produces. DMSA produces a comparable diuresis of lead, a greater decrease in blood lead, and has negligible influence on the urinary losses of zinc, copper, iron, and calcium. Limited experience to date in man has revealed no significant adverse side effects of DMSA. In animals, DMSA will promptly reduce the concentration of lead in brain and kidney, in particular. By contrast, similar 5-day courses of CaNa2EDTA do not produce any net reduction in brain lead. This is important, as the brain is the critical organ of the adverse effects of lead in children. If the efficacy of DMSA is to be comprehensively evaluated ethically in children, new and more sensitive neurochemical, electrophysiologic, or other markers must be developed.

Language of Publication

English

Unique Identifier

91209346

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MeSH Heading (Major)

Chelation Therapy|*; Lead Poisoning|BL/*DT

MeSH Heading

Animal; Chelating Agents|TU; Drug Evaluation; Edetic Acid|TU; Human; Lead|BL; Succimer|TU; Support, U.S. Gov't, Non-P.H.S.; Support, U.S. Gov't, P.H.S.

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0091-6765

Country of Publication

UNITED STATES

CAS Registry/EC Number

0 (Chelating Agents); 304-55-2 (Succimer); 60-00-4 (Edetic Acid); 7439-92-1 (Lead)

Record 20 from database: MEDLINE
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Title

Dose-response study of oral 2,3-dimercaptosuccinic acid in children with elevated blood lead concentrations.

Author

Graziano JH; Lolacono NJ; Meyer P

Address

Department of Pharmacology, Columbia University College of Physicians and Surgeons, New York, NY 10032.

Source

J Pediatr, 1988 Oct, 113:4, 751-7

Abstract

2,3-Dimercaptosuccinic acid (DMSA) is an orally effective orphan drug that is more specific and has a wider therapeutic index than other currently available drugs used for lead intoxication. Its investigational use in the United States has been limited to the treatment of men with occupational plumbism. Twenty-one children with blood lead concentrations of 31 to 49 micrograms/dl, who also had a positive calcium disodium edetate (CaNa2EDTA) mobilization test result, were hospitalized for 7 days. Fifteen children were randomly assigned to three groups that received either 350, 700, or 1050 mg/m2/day, respectively, of DMSA in three divided doses daily. A fourth group of six children received conventional treatment with 1000 mg/m2/day of intravenously administered CaNa2EDTA in two divided doses daily. The 1050 mg/m2/day dose of DMSA was significantly more effective than lower doses of DMSA or intravenously administered CaNa2EDTA in reducing blood lead levels and restoring erythrocyte delta-aminolevulinic acid dehydratase activity. Intravenously administered CaNa2EDTA significantly increased the urinary excretion of several essential minerals (zinc, copper, iron, and calcium), whereas DMSA did not. The DMSA was well tolerated and appears extremely promising as a drug that will simplify the management of childhood lead poisoning.

Language of Publication

English

Unique Identifier

89011219

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MeSH Heading (Major)

Lead Poisoning|*BL/UR; Succimer|*AD; Sulfhydryl Compounds|*AD

MeSH Heading

Administration, Oral; Child; Child, Preschool; Comparative Study; Drug Administration Schedule; Edetic Acid|AD; Human; Minerals|UR; Random Allocation; Sensitivity and Specificity; Support, U.S. Gov't, P.H.S.

Publication Type

CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL

ISSN

0022-3476

Country of Publication

UNITED STATES

CAS Registry/EC Number

0 (Minerals); 0 (Sulfhydryl Compounds); 304-55-2 (Succimer); 60-00-4 (Edetic Acid)

Record 21 from database: MEDLINE
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Title

Lead poisoning from contaminated flour in a family of 11 members.

Author

Koçak R; Anarat A; AltintaA G; Evliyaoglu N

Address

Department of Internal Medicine, Cukurova University Medical School, Adana, Turkey.

Source

Hum Toxicol, 1989 Sep, 8:5, 385-6

Abstract

Eleven members of a family living in southeastern Turkey are presented. They were diagnosed as suffering from 'lead poisoning' with typical clinical manifestations and high blood lead concentrations. Contaminated flour (665 micrograms Pb/g) was the cause of poisoning, by oral ingestion. The source of contamination was sought and it was found that the stone of the mill had been repaired with molten lead on the same day that the wheat of the family had been ground; while grinding the wheat some lead was mixed into the flour.

Language of Publication

English

Unique Identifier

90034908

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MeSH Heading (Major)

Flour|*AN; Food Contamination|*; Lead Poisoning|*/DT

MeSH Heading

Adolescence; Adult; Case Report; Child; Child, Preschool; Edetic Acid|TU; Female; Human; Male; Middle Age

Publication Type

JOURNAL ARTICLE

ISSN

0144-5952

Country of Publication

ENGLAND

CAS Registry/EC Number

60-00-4 (Edetic Acid)

Record 22 from database: MEDLINE
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Title

Succimer: the first approved oral lead chelator.

Author

Jorgensen FM

Address

Fairview General Hospital, Cleveland, Ohio.

Source

Am Fam Physician, 1993 Dec, 48:8, 1496-502

Abstract

The Centers for Disease Control and Prevention has redefined the threshold of concern for low-level lead toxicity, reducing it from a blood lead level of 25 micrograms per dL (1.21 mumol per L) to a blood lead level of 10 micrograms per dL (0.48 mumol per L), and has recommended universal screening of young children. Succimer (2,3-dimercaptosuccinic acid) is an effective oral lead chelating agent that has been approved for outpatient treatment of children with blood lead levels higher than 45 micrograms per dL (2.17 mumol per L). In the United States, clinical experience with succimer is limited; however, observed side effects, including gastrointestinal symptoms, rash and transient elevations of serum aminotransferase levels, are uncommon and mild. Isolated cases of neutropenia have been reported. Weekly monitoring of complete blood counts and serum aminotransferase levels is recommended during the 19-day treatment. Blood lead levels should be checked weekly to identify rebound from bone and soft tissue mobilization.

Language of Publication

English

Unique Identifier

94070584

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MeSH Heading (Major)

Lead Poisoning|BL/*DT/EP/PC/UR; Succimer|PD/*TU

MeSH Heading

Administration, Oral; Ambulatory Care; Aminotransferases|BL; Clinical Trials; Drug Costs; Drug Eruptions|ET; Drug Monitoring; Edetic Acid|TU; Female; Gastrointestinal Diseases|CI; Human; Mass Screening; Metabolic Clearance Rate; Neutropenia|CI; Pregnancy; United States; United States Food and Drug Administration

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0002-838X

Country of Publication

UNITED STATES

CAS Registry/EC Number

EC 2.6.1. (Aminotransferases); 304-55-2 (Succimer); 60-00-4 (Edetic Acid)

Record 23 from database: MEDLINE
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Title

An oral treatment for lead toxicity [see comments]

Author

Thomas PS; Ashton C

Address

Northwick Park Hospital, Harrow, Middlesex, UK.

Source

Postgrad Med J, 1991 Jan, 67:783, 63-5

Abstract

Chronic lead poisoning has traditionally been treated by parenteral agents. We present a case where a comparison of ethylene diaminetetra-acetic acid was made with 2,3-dimethyl succinic acid (DMSA) which has the advantage of oral administration associated with little toxicity and appeared to be at least as efficacious.

Language of Publication

English

Unique Identifier

91279604

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MeSH Heading (Major)

Antidotes|AD/*TU; Edetic Acid|AD/*TU; Lead Poisoning|CO/*DT; Succinates|*TU

MeSH Heading

Administration, Oral; Case Report; Chronic Disease; Comparative Study; Epilepsy, Tonic-Clonic|CI; Human; Male; Middle Age

Publication Type

JOURNAL ARTICLE

ISSN

0032-5473

Country of Publication

ENGLAND

CAS Registry/EC Number

0 (Antidotes); 0 (Succinates); 13545-04-5 (2,3-dimethylsuccinic acid); 60-00-4 (Edetic Acid)

Record 24 from database: MEDLINE
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Title

Tetracyclines inhibit human synovial collagenase in vivo and in vitro.

Author

Greenwald RA; Golub LM; Lavietes B; Ramamurthy NS; Gruber B; Laskin RS; McNamara TF

Address

Source

J Rheumatol, 1987 Feb, 14:1, 28-32

Abstract

To determine if tetracyclines can inhibit human synovial collagenase from rheumatoid tissue, paired synovial tissue (or synovial fluid) was collected from 7 patients before and after oral administration of minocycline (100 mg BID) for 10 days. With each patient serving as his own control, the postminocycline collagenase activities fell an average of 67% from pretreatment values. Qualitative SDS-PAGE revealed decreased loss of alpha collagen components and reduced formation of alpha A digestion fragments. Addition of minocycline or a chemically modified tetracycline to synovial culture media in vitro profoundly inhibited collagenase activity. Further study of this action of tetracyclines could serve as a probe of the role of collagenase in rheumatoid arthritis and lead to development of agents capable of modifying the tissue destructive actions of collagenase.

Language of Publication

English

Unique Identifier

87198535

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MeSH Heading (Major)

Microbial Collagenase|*AI/ME; Minocycline|*PD; Synovial Fluid|DE/*EN; Synovial Membrane|DE/*EN; Tetracyclines|*PD

MeSH Heading

Arthritis, Rheumatoid|EN; Edetic Acid|PD; Human; In Vitro; Support, U.S. Gov't, P.H.S.

Publication Type

JOURNAL ARTICLE

ISSN

0315-162X

Country of Publication

CANADA

CAS Registry/EC Number

EC 3.4.24.3 (Microbial Collagenase); 0 (Tetracyclines); 10118-90-8 (Minocycline); 60-00-4 (Edetic Acid)

Record 25 from database: MEDLINE
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Title

A study of the odontoblast process with transmission electron microscopy.

Author

White RK; Senia ES; Zislis T; Fox LT; Zeagler JW

Address

Source

Oral Surg Oral Med Oral Pathol, 1986 Nov, 62:5, 569-79

Abstract

Freshly extracted human third molars with completely formed roots were sectioned and placed in Karnovsky's fixative. The specimens were decalcified in ethylenediaminetetraacetic acid (EDTA) for 91 days, followed by digestion in collagenase. They were then fixed in a solution of buffered osmium tetroxide or ruthenium red and buffered osmium tetroxide, embedded in Spurr's plastic mixture, and sectioned for transmission electron microscopy. Each section was stained with uranyl acetate and lead citrate and viewed with a transmission electron microscope. No odontoblast processes could be identified at the cemental third of the dentin with the described technique.

Language of Publication

English

Unique Identifier

87066278

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MeSH Heading (Major)

Dentin|*UL; Odontoblasts|*UL

MeSH Heading

Adult; Dental Cementum|UL; Dental Pulp|UL; Female; Histological Techniques; Human; Microscopy, Electron; Ruthenium Red|DU; Staining

Publication Type

JOURNAL ARTICLE

ISSN

0030-4220

Country of Publication

UNITED STATES

CAS Registry/EC Number

11103-72-3 (Ruthenium Red)

Record 26 from database: MEDLINE
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Title

Cobalt in the environment and its toxicological implications.

Author

Domingo JL

Address

Source

Rev Environ Contam Toxicol, 1989, 108:, 105-32

Abstract

Cobalt is an essential trace element which is widely distributed in nature. Most of cobalt consumed is used in the manufacture of alloys, and although not released extensively in the environment, it may represent a hazard to human health. In addition, excess dietary cobalt produces toxic effects in animals. Polycythemia and hyperglycemia with transitory damage to pancreatic alpha-cells have been widely reported after cobalt administration. Cobalt salts induce respiratory deficiency in yeast. CoCl2 increased sister chromatid exchange (SCE) in P388D1 cells and in lymphocytes from two donors. So far it has not been possible to induce cancer in experimental animals using cobalt by any other route than by injection. Ingestion of cobalt may lead to reproductive changes in the male rat such as loss of testicular volume and darkening of testicle color. On the other hand, oral administration of cobalt did not produce teratogenicity or significant fetotoxicity in the rat at daily doses as high as 100 mg CoCl2/kg. However, cobalt affected the period of late gestation as well as the postnatal development of the pups. Occupational toxicology of cobalt, hygienic and epidemiologic aspects, and treatment of cobalt poisoning are also topics of special interest. Cobalt is a metal with marked allergenic potential. Asthma, interstitial lung disease and combined asthma and alveolitis have been described as occupational health hazards. EDTA, DTPA, and N-acetyl-L-cysteine have been suggested as possible antidotes in cobalt intoxication.

Language of Publication

English

Unique Identifier

89161229

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MeSH Heading (Major)

Cobalt|PD/PK/*TO

MeSH Heading

Air Pollutants, Occupational|TO; Animal; Carcinogens; Chelating Agents|TU; Diet; Human; Lethal Dose 50; Mutagens; Rats; Support, Non-U.S. Gov't

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0179-5953

Country of Publication

UNITED STATES

CAS Registry/EC Number

0 (Air Pollutants, Occupational); 0 (Carcinogens); 0 (Chelating Agents); 0 (Mutagens); 7440-48-4 (Cobalt)

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