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Vol. LXIV, No. 5
March 2, 2012
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Digest

High Levels of Cadmium, Lead in Blood Linked to Pregnancy Delay

Higher blood levels of cadmium in females, and higher blood levels of lead in males, delayed pregnancy in couples trying to become pregnant, according to a study by researchers at NIH and other academic research institutions.

Cigarette smoke is the most common source of exposure to cadmium, a toxic metal found in the Earth’s crust that is used in batteries, pigments, metal coatings and plastics. Smokers are estimated to have twice the levels of cadmium as do non-smokers. Exposure also occurs in workplaces where cadmium-containing products are made and from the air near industrial facilities that emit cadmium. Airborne cadmium particles can travel long distances before settling on the ground or water. Soil levels of cadmium vary with location. Fish, plants and animals absorb cadmium from the environment and all foods contain at least low levels of the metal.

Lead, a toxic metal also found in the Earth’s crust, is used in a variety of products such as ceramics, pipes and batteries. Common sources of lead exposure in the U.S. include lead-based paint in older homes, lead-glazed pottery, contaminated soil and contaminated drinking water.

Exposure to these metals is known to have a number of effects on human health, but the effects on human fertility have not been extensively studied, especially when studying both partners of a couple. The study was published online in Chemosphere. The study’s principal investigator was Dr. Germaine M. Buck Louis of NICHD.

“Our results indicate that men and women planning to have children should minimize their exposure to lead and cadmium,” Buck Louis said. “They can reduce cadmium exposure by avoiding cigarettes or by quitting if they are current smokers, especially if they intend to become pregnant in the future. Similarly, they can take steps to reduce their exposure to lead-based paints, which may occur in older housing, including during periods of home renovation.”

Autoinjectors Offer Way to Treat Prolonged Seizures

Drug delivery into muscle using an autoinjector is faster and may be a more effective way to stop a seizure lasting longer than 5 minutes, according to a study sponsored by NINDS and carried out by paramedics.
a device used to deliver anticonvulsant medicine (midazolam) is shown with the kit paramedics carry it in.
Drug delivery into muscle using an autoinjector is faster and may be a more effective way to stop a seizure lasting longer than 5 minutes, according to a study sponsored by NINDS and carried out by paramedics. Above, a device used to deliver anticonvulsant medicine (midazolam) is shown with the kit paramedics carry it in.

Drug delivery into muscle using an autoinjector, akin to the EpiPen used to treat serious allergic reactions, is faster and may be a more effective way to stop status epilepticus, a prolonged seizure lasting longer than 5 minutes, according to a study sponsored by NINDS. Status epilepticus is a potentially life-threatening emergency that causes 55,000 deaths each year. Anticonvulsant drugs are typically delivered intravenously (IV) as a first-line treatment.

Starting an IV in a patient experiencing seizures can pose a challenge for paramedics and waste precious time. Giving an intramuscular shot is easier, faster and more reliable, especially in patients having convulsions. The researchers sought to determine whether an intramuscular injection, which quickly delivers anticonvulsant medicine (midazolam) into a patient’s thigh muscle, is as safe and effective as giving medicine directly into a vein. The study, carried out by paramedics, compared how well delivery by each method stopped patients’ seizures by the time the ambulance arrived at the emergency department. The study appeared in the Feb. 16 issue of the New England Journal of Medicine.

“Patients with status epilepticus can suffer severe consequences if seizures are not stopped quickly,” said NINDS deputy director Dr. Walter Koroshetz. “This study establishes that rapid intramuscular injection of an anticonvulsant drug is safe and effective.”

Investigators said that while autoinjectors might someday be available for use by epilepsy patients and their family members, more research is required. Because of the strong sedative effect of midazolam, on-site medical supervision is now required for the safety of the patient.

Drug Halts Organ Damage in Inflammatory Genetic Disorder

A new study shows that Kineret (anakinra), a medication approved for the treatment of rheumatoid arthritis, is effective in stopping the progression of organ damage in people with neonatal-onset multisystem inflammatory disease (NOMID). This rare and debilitating genetic disorder causes persistent inflammation and ongoing tissue damage. The research, performed by scientists at NIAMS, was published online in Arthritis & Rheumatism.

NOMID affects numerous organs and body systems including the skin, joints, eyes and central nervous system. The first sign of the disease is often a rash that develops within the first weeks of life. Other problems, including fever, meningitis, joint damage, vision and hearing loss and mental retardation, can follow. Kineret, one of a relatively new class of drugs known as biologic response modifiers or biologics, blocks the activity of interleukin-1 (IL-1), a protein made by cells of the immune system. IL-1 is overproduced in NOMID and a number of other diseases, leading to damaging inflammation.—compiled by Carla Garnett


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