Electrocardiographic Evaluation in Patients with Endemic Fluorosis without Clinically Evident Heart Disease
Öz
Klinik olarak belirgin kalp hastalığı olmayan endemik florozisli hastaların elektrokardiyografik bulguları
Amaç: Bu çalışma endemik florozisli hastaların elektrokardiyografik (EKG) bulgularının incelenmesi açısından yapıldı. Ellialtı endemik florozis hastası ve yaş, cinsiyet ve vücut kütle indeksi eşitlenmiş 44 sağlıklı bireyin standart 12 derivasyon EKG si, idrar flor düzeyi ve serum sodium, potasyum, kalsiyum ve fosfor analizi yapıldı. Temel EKG ölçümleri ve EKG değişkliklerinin frekansı değerlendirildi. Bulgular: İdrar flor düzeyleri floroz hastalarında kontrol grubuna göre anlamlı derecede yüksekti (1.9 ± 0.2 mg/l vs. 0.4 ± 0.1 mg/l sırasıyla; P<0.001). Yaş, cinsiyet, vücut kütle indeksi ve serum sodium, potasyum, kalsiyum ve fosfor düzeyleri açısından kontrol grubu ve florozis hastaları arasında istatistiksel açıdan fark yoktu. Kalp hızı, temel EKG ölçümleri ve EKG değişiklikleri açısından kontrol grubu ve florozis hastaları arasında istatistiksel olarak anlamlı fark yoktu. Sonuç: Endemik florozun EKG üzerine etksi olmadığı sonucuna vardık.
Objective: This study was carried out to analyse the electrocardiogram (ECG) in patients with endemic fluorosis. Methods: Fifty six patients with endemic fluorosis and 44 age, sex and body mass index (BMI) matched healthy controls with normal fluoride intake underwent standart 12-lead ECG, urine fluoride level and serum sodium, potassium, calcium and phosphorus determination. Basic ECG measurements and frequency of ECG abnormalities were evaluated. Results: The urine fluoride levels of fluorosis patients were significantly higher than control subjects as expected (1.9 ± 0.2 mg/l vs. 0.4 ± 0.1 mg/l respectively; P<0.001). There were no statistically significant differences between the two groups with respect to age, gender, BMI and serum levels of sodium, potassium, calcium and phosphorus. There were no statistically significant differences between controls and fluorosis patients with respect to heart rate, basic ECG measurements and ECG abnormalities. Results: We concluded that endemic fluorosis has no effect on ECG
Anahtar Kelimeler
Kaynakça
- Oruc N. Occurrence and problems of high fluoride waters in Turkey: an overview. Environ Geochem Health 2008;30(4):315-23.
- Teotia M, Teotia SP, Singh KP. Endemic chronic fluoride toxicity and dietary calcium deficiency interaction syndromes of metabolic bone disease and deformities in India: year 2000. Indian J Pediatr 1998;65(3):371381.
- Wang LF, Huang JZ. Outline of control practice of endemic fluorosis in China. Soc Sci Med 1995;41(8):1191 1195.
- Brouwer ID, Dirks OB, De Bruin A, Hautvast JG. Unsuitability of World Health Organisation guidelines for fluoride concentrations in drinking water in Senegal. Lancet 1998;1(8579):223225.
- Bilgin, A, Koseoglu, M Ozkan, G. Minerology, Petrography and Geochemistry of rocks of Isparta- Golcuk Area. Doga TR.T. of Engineering and Environmental Sciences 1990;14:342361.
- Okushi I. Experimental studies on the effects of sodium fluoride upon the heart muscle of rabbits. Shikoku Acta Med 1954;5:238-45.
- Shashi A, Thapar SP. Histopathology of myocardial damage in experimental fluorosis in rabbits. Fluoride 2001;34(1):43-50.
- Cicek E, Aydin G, Akdogan M, Okutan H. Effects of chronic ingestion of sodium fluoride on myocardium in a second generation of rats. Hum Exp Toxicol 2005;24(2):79-87.
- Donmez N and Cinar A. Effects of chronic fluorosis on electrocardiogram in sheep. Biol Trace Elem Res 2003;92:115-22.
- Kilicalp D, Cinar A, Belge F. Effects of chronic fluorosis on electrocardiogram in dogs. Fluoride 2004;37(2): 96-101.
- Takamori T, Miyanaga S, Kawahara H, Okushi D, Hirao M, Wakatsuki H. Electrocardiographic studies of the inhabitants in high fluoride districts. Tokushima J Experimental Medicine 1956;3:50-53.
- Zhou QH, Zhang DC. Electrocardiogram analysis of 271 dental fluorosis cases. Chinese Journal of Endemiology 1988;5(4):296-297.
- Xu RY, Xu RQ. Electrocardiogram analysis of patients with skeletal fluorosis. Fluoride 1997;30(1):16-8.
- Wu ZJ, Ding JY, Qi DS, Yu YH. Biochemical indexes of buffalo with fluorosis and their significance for diagnosis. Journal of Huazhong Agricultural University 1995;14:369373.
- Wang Y, Yin Y, Gilula LA, Wilson AJ. Endemic fluorosis of the skeleton: radiographic features in 127 patients. AJR Am J Roentgenol 1994;162:93-98.
- Savas S, Cetin M, Akdogan M, Heybeli N. Endemic fluorosis in Turkish patients: relationship with knee osteoarthritis. Rheumatology International 2001;21(1):30-35.
- Bazett HC. An analysis of the time-relations of elec- trocardiograms. Heart 1920;7:353370.
- Bildik A, Camas H. Research on some specific liver enzyme activities and PBI values in the blood serum of sheep with fluorosis. Kafkas Univ J Sciences 1996;1:16-23.
- Guan ZZ, Zhuang ZJ, Yang PS, Pan S. Synergistic action of iodine deficiency and fluorine intoxication on rat thyroid. Chin Med J 1988;101(9):679-84.
- Gaugl JF, Wooldridge B. Cardiopulmonary response to sodium fluoride infusion in the dog. J Toxicol Environ Health 1983;11(4-6):765-82.
- Olgar S, Kuybulu AE, Karademir S, Sipahi T, Ormeci AR, Kosker M. Effects of chronic fluorosis on cardiovascular system in children. 5th World Congress of Pediatric Cardiology and Cardiac Surgery, Cairns Convention Center, Cairns, Australia, 2009;21-26 June.
- McIvor ME, Cummings CE, Mower MM, Wenk RE, Lustgarten JA, Baltazar RF, et al. Sudden cardiac death from acute fluoride intoxication: the role of potassium. Ann Emerg Med 1987;16(7):777-81.
- Cummings CC, McIvor ME. Fluoride-induced hyperkalemia: the role of Ca2+-dependent K+ channels. Am J Emerg Med 1988;6(1):1-3.
- McIvor ME. Delayed fatal hyperkalemia in a patient with acute fluoride intoxication. Ann Emerg Med 1987;16(10):1165-7.
- Baltazar RF, Mower MM, Reider R, Funk M, Salomon J. Acute fluoride poisoning leading to fatal hyperkalemia. Chest 1980;78(4):660-3.
- Kant V, Srivastava AK, Verma PK, Raina R, Pankaj NK. Alterations in Electrocardiographic Parameters after Subacute Exposure of Fluoride and Ameliorative Action of Aluminium Sulphate in Goats. Biol Trace Elem Res 2009;Aug 4. (Epub ahead of print)
- Kant V, Srivastava AK, Verma PK, Raina R. Alterations in biochemical parameters during subacute toxicity of fluoride alone and in conjunction with aluminum sulfate in goats. Biol Trace Elem Res 2009;130(1):20-30.
- Das TK, Susheela AK. Effect of long-term administration of sodium fluoride on plasma calcium level in relation to intestinal absorption and urinary excretion in rabbits. Environ Res 1993;62(1):14-8.
- Shivashankara AR, Shankara YMS, Rao SH, Bhat GP. A clinical and biochemical study of chronic fluoride toxicity in children of Kheru Thanda of Gulbarga District, Karnataka, India. Fluoride 2000;33(2):66-73.
- Barot VV. Occurrence of endemic fluorosis in human population of North Gujarat, India: human health risk. Bull Environ Contam Toxicol 1998;61(3):303-10.
- Sharifian A, Momeni VR, Shahriaran S, Aminiana O. Serum calcium and parathyroid hormone levels in alumium potroom workers exposed to fluoride e m i s s i o n s F l u o r i d e 2 0 0 8 ; 4 1 ( 4 ) 3 1 4 3 1 6 .
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Aralık 2010 |
| Gönderilme Tarihi | 12 Mayıs 2010 |
| Yayımlandığı Sayı | Yıl 2010 Cilt: 17 Sayı: 4 |
Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi/Medical Journal of Süleyman Demirel University is licensed under Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International.