Estudio Realizado en el sudoeste de Francia en Dorgogne y Gironde en 3,777 personas iniciando en 1988 y 1989, con una duración en el seguimiento por 8 años. Se investigaron los efectos de la presencia de Aluminio en el Agua Potable y sus consecuencias : Se confirman las consecuencias de personas con Alzheimer entre mayor concentraciones de Aluminio. Se corroboran las hipótesis de varios estudios mas : Aluminio = Alzheimer http://www.ecodomestico.com
Mercury Contribution to Body Burden from Dental Amalgam v2zq
Mercury Contribution to Body Burden from Dental Amalgam - Resources for Healthy Children www.scribd.com/doc/254613619 - For more information, Please see Organic Edible Schoolyards & Gardening with Children www.scribd.com/doc/254613963 - Gardening with Volcanic Rock Dust www.scribd.com/doc/254613846 - Double Food Production from your School Garden with Organic Tech www.scribd.com/doc/254613765 - Free School Gardening Art Posters www.scribd.com/doc/254613694 - Increase Food Production with Companion Planting in your School Garden www.scribd.com/doc/254609890 - Healthy Foods Dramatically Improves Student Academic Success www.scribd.com/doc/254613619 - City Chickens for your Organic School Garden www.scribd.com/doc/254613553 - Huerto Ecológico, Tecnologías Sostenibles, Agricultura Organica www.scribd.com/doc/254613494 - Simple Square Foot Gardening for Schools - Teacher Guide www.scribd.com/doc/254613410 - Free Organic Gardening Publications www.scribd.com/doc/254609890 ~ amalgam-informationen.de
Statistical Analysis of Ground Water Quality in Rural Areas of Uttar Pradesh ...IJERA Editor
The importance of groundwater for the existence of human society cannot be exaggerated. Groundwater is the
major source of water in both rural and urban India.Duringlast decade, it was observed that ground water get
polluted drastically and hence, resulted into many water borne diseases which is a cause of many health hazards.
In this paper an attempt has been made to test groundwater quality of different villages of Uttar Pradesh, India
on the basis of thirteen parameters like pH, total dissolved solids, conductivity, total hardness, biological oxygen
demand etc. The results obtained were compared with the BIS (IS 10500:1991) Permissible Standards for
drinking water. Normal Distribution analysis was applied to describe various characteristics of the samples
collected and Correlation Analysiswas done on the samples which measured the strength of association between
twowaterparameters.On the basis of results obtained from analytical and statistical analysis, it was revealed that
all the water sources chosen for study are not suitable for the utilization of water.
Riesgos Graves del aluminio en la salud humana frricguer
En este estudio realizado en colaboración con la AFSSA (L'Agence française de sécurité sanitaire des aliments) se puede observar a partir de la página 41, los daños y la relación del consumo de este metal con la enfermedad del Alzheimer y numerosas enfermedades mas. El evitar consumirlo, significará reducir las probabilidades de llegar a padecer esta grave enfermedad. http://www.ecodomestico.com
Mercury Contribution to Body Burden from Dental Amalgam v2zq
Mercury Contribution to Body Burden from Dental Amalgam - Resources for Healthy Children www.scribd.com/doc/254613619 - For more information, Please see Organic Edible Schoolyards & Gardening with Children www.scribd.com/doc/254613963 - Gardening with Volcanic Rock Dust www.scribd.com/doc/254613846 - Double Food Production from your School Garden with Organic Tech www.scribd.com/doc/254613765 - Free School Gardening Art Posters www.scribd.com/doc/254613694 - Increase Food Production with Companion Planting in your School Garden www.scribd.com/doc/254609890 - Healthy Foods Dramatically Improves Student Academic Success www.scribd.com/doc/254613619 - City Chickens for your Organic School Garden www.scribd.com/doc/254613553 - Huerto Ecológico, Tecnologías Sostenibles, Agricultura Organica www.scribd.com/doc/254613494 - Simple Square Foot Gardening for Schools - Teacher Guide www.scribd.com/doc/254613410 - Free Organic Gardening Publications www.scribd.com/doc/254609890 ~ amalgam-informationen.de
Statistical Analysis of Ground Water Quality in Rural Areas of Uttar Pradesh ...IJERA Editor
The importance of groundwater for the existence of human society cannot be exaggerated. Groundwater is the
major source of water in both rural and urban India.Duringlast decade, it was observed that ground water get
polluted drastically and hence, resulted into many water borne diseases which is a cause of many health hazards.
In this paper an attempt has been made to test groundwater quality of different villages of Uttar Pradesh, India
on the basis of thirteen parameters like pH, total dissolved solids, conductivity, total hardness, biological oxygen
demand etc. The results obtained were compared with the BIS (IS 10500:1991) Permissible Standards for
drinking water. Normal Distribution analysis was applied to describe various characteristics of the samples
collected and Correlation Analysiswas done on the samples which measured the strength of association between
twowaterparameters.On the basis of results obtained from analytical and statistical analysis, it was revealed that
all the water sources chosen for study are not suitable for the utilization of water.
Riesgos Graves del aluminio en la salud humana frricguer
En este estudio realizado en colaboración con la AFSSA (L'Agence française de sécurité sanitaire des aliments) se puede observar a partir de la página 41, los daños y la relación del consumo de este metal con la enfermedad del Alzheimer y numerosas enfermedades mas. El evitar consumirlo, significará reducir las probabilidades de llegar a padecer esta grave enfermedad. http://www.ecodomestico.com
Risk factors in Multiple Sclerosis: Detection and Treatment in Daily Life
Caroline Pot and Patrice Lalive
Unit of Neuroimmunology and Multi Sclerosis Geneva University Hospital
Moderate alcohol consumption as risk factor for adverse brain outcomes and co...BARRY STANLEY 2 fasd
Recent longitudinal study. No mention of fasd or prenatal / pre conceptual alcohol consumption.
If the conclusions are correct how much more do they apply to the fetus, newborn and adolescent/
Es un articulo acerca de las lesiones que pueden producir el cigarrillo electrónico en cavidad oral, que consideraciones debemos tener en cuenta y como tratarlo
Smoking and alcoholism: Risk factors for papillitis?BIJCROO
Introduction: Papillitis is the inflammation of the optic nerve at the level of the optic papilla or optic disc. We did
not find enough published studies that corroborate smoking and alcoholism as absolute risk factors for papillitis;
however, it has been raised, so we were motivated to conduct this research, with the aim of identifying a statistically
significant causal association between these factors and papillitis in our hospital.
Methodology: An analytical study of cases and controls was carried out in patients with papillitis treated at the
Ophthalmology Centre of Santiago de Cuba (2017–2019). Group 1 (cases): 42 patients; group 2 (controls): 84
patients’ companions who attended in the same period and did not present ophthalmological entities.
Results: In the association of smoking with papillitis, we obtained an odds ratio (OR) = 1.60, with confidence
interval (CI): [0.74; 3.48], but p > 0.05. Alcoholism with papillitis resulted in an association with OR = 1.19, with CI:
[0.53; 2.68] and p > 0.05.
Conclusion: In this study, smoking and alcoholism had no statistically significant causal association with papillitis.
Risk Factors Early in the 2010 Cholera Epidemic, Haiti.docxhealdkathaleen
Risk Factors Early
in the 2010 Cholera
Epidemic, Haiti
Katherine A. O’Connor, Emily Cartwright,
Anagha Loharikar, Janell Routh, Joanna Gaines,
Marie-Délivrance Bernadette Fouché,
Reginald Jean-Louis, Tracy Ayers,
Dawn Johnson, Jordan W. Tappero,
Thierry H. Roels, W. Roodly Archer,
Georges A. Dahourou, Eric Mintz, Robert Quick,
and Barbara E. Mahon
During the early weeks of the cholera outbreak that
began in Haiti in October 2010, we conducted a case–
control study to identify risk factors. Drinking treated water
was strongly protective against illness. Our results highlight
the effectiveness of safe water in cholera control.
On October 19, 2010, the Haitian Ministry of Public Health and Population (MSPP) was notifi ed of
increased cases of acute watery diarrhea resulting in death
among adults in Artibonite Department. Within 2 days,
MSPP’s Laboratoire National de la Santé Publique had
identifi ed toxigenic Vibrio cholerae O1, serotype Ogawa,
biotype El Tor in stool specimens (1). The fi rst reports of
illness consistent with cholera occurred on October 16,
and, by November 19, cholera had reached all 10 Haitian
administrative departments (2).
Because the fi rst cases were in persons who worked
near the Artibonite River, contaminated river water was
suspected as the initial source. In a proactive effort to
protect the population, MSPP rapidly implemented a
cholera prevention campaign that began on October 22,
2010, to discourage the population from drinking river
water, distribute water treatment products, and promote
water treatment, handwashing, sanitation, and safe food
preparation. To inform further prevention activities, we
conducted a case–control study during the second and
third weeks of the outbreak to identify risk factors for
symptomatic cholera.
The Study
This study was conducted in Artibonite Department
close to where the fi rst cases were identifi ed. On the
basis of detailed hypothesis-generating interviews with
patients and known risk factors associated with cholera
in other investigations in the Americas, we created a
questionnaire to assess multiple exposures, including
river and other water-related exposures, sanitation and
hygiene practices, foods, and other factors. We enrolled
and interviewed participants from October 31 through
November 13, 2010, with a 4-day break during November
5–8 because of Hurricane Tomas. To rapidly generate
relevant information to guide outbreak response, we set
a goal of enrolling 50 case-patients and 100 controls, a
sample size that, although limited, was in line with that of
previous successful emergency investigations.
Eligible case-patients were persons >5 years of age
who were hospitalized between October 22 and November
9 for acute watery diarrhea at the Médecins Sans
Frontières cholera treatment unit in Petite Rivière, a town
in a densely populated rural region near the Artibonite
River. Only case-patients with the fi rst case of ...
Glycation plays a role as risk factor in Alzheimer’s Disease (AD) and D-ribose is one of the important contributors to protein glycation.
Here, we recruited 93 participants (49 AD patients, 44 cognitively normal participants) and measured their cognitive abilities with
Mini-Mental State Examination (MMSE), D-ribose and formaldehyde levels in the morning urine. Urine D-ribose levels of AD patients
(especially women) were signifi cantly higher than those of cognitively normal participants. Like formaldehyde, D-ribose levels were
negatively correlated with MMSE scores in all participants. Unlike formaldehyde, D-ribose levels still showed the negative correlation in
cognitively normal participants. These data may provide a novel clue to study AD.
REVIEW Open AccessWork-related leukemia a systematic revi.docxjoellemurphey
REVIEW Open Access
Work-related leukemia: a systematic review
Ioannis Polychronakis1*, George Dounias2, Vasilios Makropoulos2, Elena Riza1 and Athena Linos1
Abstract
Leukemia is a complex disease, which only became better understood during the last decades following the
development of new laboratory techniques and diagnostic methods. Despite our improved understanding of the
physiology of the disease, little is yet known about the causes of leukemia. A variety of potential risk factors have
been suggested so far, including personal habits and lifestyle, and a wide range of occupational or environmental
exposures. A causal association with leukemia has only been documented to date for ionizing radiation, benzene
and treatment with cytostatic drugs, but there is an ongoing scientific debate on the possible association of
leukemia with a number of other work-related hazards. In this article, we have reviewed scientific studies, published
over the past 5 years, which investigated potential associations between leukemia and exposure to occupational
risk factors. The systematic literature review took place via electronic databases, using specific search criteria, and
independent reviewers have further filtered the search results to identify the number of articles, presented in our
paper. A large number of studies included in the review referred to the effects of ionizing radiation, where new
data suggest that the effects of exposure to small doses of ionizing radiation should probably be reevaluated. Some
other works appear to substantiate a potential association of the disease with certain pesticides. Further research is
also suggested regarding the role of infectious agents or exposure to certain chemicals like formaldehyde or
butadiene in the pathogenesis of leukemia.
Keywords: Leukemia, Exposure, Occupation, Worker, Work-related, Hazard, Risk-factor
Review
Introduction
The term "leukemia" refers to a group of diseases with
different biological background, clinical presentation,
prognosis and response to treatment, characterized by a
malignant transformation of hematopoietic cells which
produce an abnormal leukemic population (clone) of cells
suppressing the production of normal blood cellular com-
ponents. The disease was first identified in the mid-19th
century when different researchers described a common
pathology caused by abnormalities of the white blood cells
[1], hence the term “Leukemia” which originates from the
Greek words “Leuko” (white) and “Haema” (blood). While
scientific research has advanced significantly since then as
regards to the underlying pathophysiology of the various
types of the disease, our knowledge on the causative
factors involved in the development of leukemia is
still limited.
Different researchers have proposed a number of po-
tential risk factors for leukemia, but to date exposure to
ionizing radiation, alkylating agents and benzene [2] re-
main the only hazards for which an association with
leukemia has b ...
Glisodin, a vegetal sod with gliadin, as preventative agent vs atherosclerosi...Esther K
SUMMARY: Prevention of cardiovascular disease should target high-risk subjects based on genetic/familial factors, blood chemistry, blood pressure, body mass index (BMI), and a history of/or current cigarette smoking. We selected active adults (n=76) aged 30-60 and investigated these risk factors, in order to recommend preventive measures.
Another interesting variable is the preclinical status or atheroma of the arterial (carotid) wall or lumen. We also investigated the presence of oxidative stress in, and the anti-oxidant status of these subjects.
We studied the anti-oxidative efficacy of superoxide dismutase (SOD) and variations of malondialdehyde (MDA).
Supplementation with GliSODin®, a vegetal SOD associated with gliadin, was effective in controlling the thickness of the carotid artery intima and media layers as measured by ultrasonography-B.
We could demonstrate the preventive efficacy of GliSODin at a preclinical stage in subjects with risk factors of cardiovascular disease.
Section 1 Definition of Epidemiology httpswww.cdc.govophs.docxbagotjesusa
Section 1: Definition of Epidemiology
https://www.cdc.gov/ophss/csels/dsepd/ss1978/lesson1/section1.html
Lesson 1: Introduction to Epidemiology
In fact, epidemiology is often described as the basic science of public health, and for good reason. First, epidemiology is a quantitative discipline that relies on a working knowledge of probability, statistics, and sound research methods. Second, epidemiology is a method of causal reasoning based on developing and testing hypotheses grounded in such scientific fields as biology, behavioral sciences, physics, and ergonomics to explain health-related behaviors, states, and events. However, epidemiology is not just a research activity but an integral component of public health, providing the foundation for directing practical and appropriate public health action based on this science and causal reasoning.(2)
A. Distribution
Epidemiology is concerned with the frequency and pattern of health events in a population:
a. Frequency refers not only to the number of health events such as the number of cases of meningitis or diabetes in a population, but also to the relationship of that number to the size of the population. The resulting rate allows epidemiologists to compare disease occurrence across different populations.
b. Pattern refers to the occurrence of health-related events by time, place, and person. Time patterns may be annual, seasonal, weekly, daily, hourly, weekday versus weekend, or any other breakdown of time that may influence disease or injury occurrence. Place patterns include geographic variation, urban/rural differences, and location of work sites or schools. Personal characteristics include demographic factors which may be related to risk of illness, injury, or disability such as age, sex, marital status, and socioeconomic status, as well as behaviors and environmental exposures.
Characterizing health events by time, place, and person are activities of descriptive epidemiology, discussed in more detail later in this lesson.
B. Determinants
Determinant: any factor, whether event, characteristic, or other definable entity, that brings about a change in a health condition or other defined characteristic.
Epidemiology is also used to search for determinants, which are the causes and other factors that influence the occurrence of disease and other health-related events. Epidemiologists assume that illness does not occur randomly in a population, but happens only when the right accumulation of risk factors or determinants exists in an individual. To search for these determinants, epidemiologists use analytic epidemiology or epidemiologic studies to provide the “Why” and “How” of such events. They assess whether groups with different rates of disease differ in their demographic characteristics, genetic or immunologic make-up, behaviors, environmental exposures, or other so-called potential risk factors. Ideally, the findings provide sufficient evidence to direct prompt and effective publ.
Role of serum trace elements magnesium, copper and zinc, level in Libyan pati...iosrjce
IOSR Journal of Biotechnology and Biochemistry (IOSR-JBB) covers studies of the chemical processes in living organisms, structure and function of cellular components such as proteins, carbohydrates, lipids, nucleic acids and other biomolecules, chemical properties of important biological molecules, like proteins, in particular the chemistry of enzyme-catalyzed reactions, genetic code (DNA, RNA), protein synthesis, cell membrane transport, and signal transduction. IOSR-JBB is privileged to focus on a wide range of biotechnology as well as high quality articles on genetic engineering, cell and tissue culture technologies, genetics, microbiology, molecular biology, biochemistry, embryology, cell biology, chemical engineering, bioprocess engineering, information technology, biorobotics.
Respuesta a Solicitud de Estudios de Calidad de Agua, Municipio San Luis Poto...ricguer
Cuando existe "Transparencia de la Información", se puede acceder por cuaquier medio. Sin embargo, el Municipio de San Luis Potosi, obliga a que si alguien quiere conocer la información pública, se presente, con identificación y en los horarios que ellos imponen para que hagan el favor de enseñar la información pública. Esta es una aberración de la "Transparencia".
Estudios de Calidad de Agua, Municipio de Monterrey, Nuevo León 2014 Estudios...ricguer
PRIMER ATLAS DE CALIDAD DE AGUA POR COLONIA DE MEXICO : http://www.ecodomestico.com
Calidad de Agua del Municipio de Monterrey, Estado de Nuevo León, México. En este estudio se muestran exclusivamente los Análisis Fisico-químicos. No se entrega la Información por Colonia y en su lugar se entregan los Estudios por POZOS, TANQUES Y RED que existe en diversos puntos del Municipio de Monterrey. Cabe destacar, que de los 46 parámetros que indica la norma, se entregan 42 parámetros, faltando únicamente 4 parámetros, totalmente contrario a lo que entregó, por ejemplo el municipio de Toluca, en el Estado de México. Los niveles de Dureza son elevados en general. Es necesario monitorear los niveles de Cianuro, Fluoruros, Arsénico, Aluminio, Sulfatos y Sodio, ya que podrían variar y sobrepasar la norma establecida fácilmente y ser altamente peligrosos para la Salud.
More Related Content
Similar to Relación entre concentraciones de aluminio en el agua potable y el alzheimer estudio de 8 años
Risk factors in Multiple Sclerosis: Detection and Treatment in Daily Life
Caroline Pot and Patrice Lalive
Unit of Neuroimmunology and Multi Sclerosis Geneva University Hospital
Moderate alcohol consumption as risk factor for adverse brain outcomes and co...BARRY STANLEY 2 fasd
Recent longitudinal study. No mention of fasd or prenatal / pre conceptual alcohol consumption.
If the conclusions are correct how much more do they apply to the fetus, newborn and adolescent/
Es un articulo acerca de las lesiones que pueden producir el cigarrillo electrónico en cavidad oral, que consideraciones debemos tener en cuenta y como tratarlo
Smoking and alcoholism: Risk factors for papillitis?BIJCROO
Introduction: Papillitis is the inflammation of the optic nerve at the level of the optic papilla or optic disc. We did
not find enough published studies that corroborate smoking and alcoholism as absolute risk factors for papillitis;
however, it has been raised, so we were motivated to conduct this research, with the aim of identifying a statistically
significant causal association between these factors and papillitis in our hospital.
Methodology: An analytical study of cases and controls was carried out in patients with papillitis treated at the
Ophthalmology Centre of Santiago de Cuba (2017–2019). Group 1 (cases): 42 patients; group 2 (controls): 84
patients’ companions who attended in the same period and did not present ophthalmological entities.
Results: In the association of smoking with papillitis, we obtained an odds ratio (OR) = 1.60, with confidence
interval (CI): [0.74; 3.48], but p > 0.05. Alcoholism with papillitis resulted in an association with OR = 1.19, with CI:
[0.53; 2.68] and p > 0.05.
Conclusion: In this study, smoking and alcoholism had no statistically significant causal association with papillitis.
Risk Factors Early in the 2010 Cholera Epidemic, Haiti.docxhealdkathaleen
Risk Factors Early
in the 2010 Cholera
Epidemic, Haiti
Katherine A. O’Connor, Emily Cartwright,
Anagha Loharikar, Janell Routh, Joanna Gaines,
Marie-Délivrance Bernadette Fouché,
Reginald Jean-Louis, Tracy Ayers,
Dawn Johnson, Jordan W. Tappero,
Thierry H. Roels, W. Roodly Archer,
Georges A. Dahourou, Eric Mintz, Robert Quick,
and Barbara E. Mahon
During the early weeks of the cholera outbreak that
began in Haiti in October 2010, we conducted a case–
control study to identify risk factors. Drinking treated water
was strongly protective against illness. Our results highlight
the effectiveness of safe water in cholera control.
On October 19, 2010, the Haitian Ministry of Public Health and Population (MSPP) was notifi ed of
increased cases of acute watery diarrhea resulting in death
among adults in Artibonite Department. Within 2 days,
MSPP’s Laboratoire National de la Santé Publique had
identifi ed toxigenic Vibrio cholerae O1, serotype Ogawa,
biotype El Tor in stool specimens (1). The fi rst reports of
illness consistent with cholera occurred on October 16,
and, by November 19, cholera had reached all 10 Haitian
administrative departments (2).
Because the fi rst cases were in persons who worked
near the Artibonite River, contaminated river water was
suspected as the initial source. In a proactive effort to
protect the population, MSPP rapidly implemented a
cholera prevention campaign that began on October 22,
2010, to discourage the population from drinking river
water, distribute water treatment products, and promote
water treatment, handwashing, sanitation, and safe food
preparation. To inform further prevention activities, we
conducted a case–control study during the second and
third weeks of the outbreak to identify risk factors for
symptomatic cholera.
The Study
This study was conducted in Artibonite Department
close to where the fi rst cases were identifi ed. On the
basis of detailed hypothesis-generating interviews with
patients and known risk factors associated with cholera
in other investigations in the Americas, we created a
questionnaire to assess multiple exposures, including
river and other water-related exposures, sanitation and
hygiene practices, foods, and other factors. We enrolled
and interviewed participants from October 31 through
November 13, 2010, with a 4-day break during November
5–8 because of Hurricane Tomas. To rapidly generate
relevant information to guide outbreak response, we set
a goal of enrolling 50 case-patients and 100 controls, a
sample size that, although limited, was in line with that of
previous successful emergency investigations.
Eligible case-patients were persons >5 years of age
who were hospitalized between October 22 and November
9 for acute watery diarrhea at the Médecins Sans
Frontières cholera treatment unit in Petite Rivière, a town
in a densely populated rural region near the Artibonite
River. Only case-patients with the fi rst case of ...
Glycation plays a role as risk factor in Alzheimer’s Disease (AD) and D-ribose is one of the important contributors to protein glycation.
Here, we recruited 93 participants (49 AD patients, 44 cognitively normal participants) and measured their cognitive abilities with
Mini-Mental State Examination (MMSE), D-ribose and formaldehyde levels in the morning urine. Urine D-ribose levels of AD patients
(especially women) were signifi cantly higher than those of cognitively normal participants. Like formaldehyde, D-ribose levels were
negatively correlated with MMSE scores in all participants. Unlike formaldehyde, D-ribose levels still showed the negative correlation in
cognitively normal participants. These data may provide a novel clue to study AD.
REVIEW Open AccessWork-related leukemia a systematic revi.docxjoellemurphey
REVIEW Open Access
Work-related leukemia: a systematic review
Ioannis Polychronakis1*, George Dounias2, Vasilios Makropoulos2, Elena Riza1 and Athena Linos1
Abstract
Leukemia is a complex disease, which only became better understood during the last decades following the
development of new laboratory techniques and diagnostic methods. Despite our improved understanding of the
physiology of the disease, little is yet known about the causes of leukemia. A variety of potential risk factors have
been suggested so far, including personal habits and lifestyle, and a wide range of occupational or environmental
exposures. A causal association with leukemia has only been documented to date for ionizing radiation, benzene
and treatment with cytostatic drugs, but there is an ongoing scientific debate on the possible association of
leukemia with a number of other work-related hazards. In this article, we have reviewed scientific studies, published
over the past 5 years, which investigated potential associations between leukemia and exposure to occupational
risk factors. The systematic literature review took place via electronic databases, using specific search criteria, and
independent reviewers have further filtered the search results to identify the number of articles, presented in our
paper. A large number of studies included in the review referred to the effects of ionizing radiation, where new
data suggest that the effects of exposure to small doses of ionizing radiation should probably be reevaluated. Some
other works appear to substantiate a potential association of the disease with certain pesticides. Further research is
also suggested regarding the role of infectious agents or exposure to certain chemicals like formaldehyde or
butadiene in the pathogenesis of leukemia.
Keywords: Leukemia, Exposure, Occupation, Worker, Work-related, Hazard, Risk-factor
Review
Introduction
The term "leukemia" refers to a group of diseases with
different biological background, clinical presentation,
prognosis and response to treatment, characterized by a
malignant transformation of hematopoietic cells which
produce an abnormal leukemic population (clone) of cells
suppressing the production of normal blood cellular com-
ponents. The disease was first identified in the mid-19th
century when different researchers described a common
pathology caused by abnormalities of the white blood cells
[1], hence the term “Leukemia” which originates from the
Greek words “Leuko” (white) and “Haema” (blood). While
scientific research has advanced significantly since then as
regards to the underlying pathophysiology of the various
types of the disease, our knowledge on the causative
factors involved in the development of leukemia is
still limited.
Different researchers have proposed a number of po-
tential risk factors for leukemia, but to date exposure to
ionizing radiation, alkylating agents and benzene [2] re-
main the only hazards for which an association with
leukemia has b ...
Glisodin, a vegetal sod with gliadin, as preventative agent vs atherosclerosi...Esther K
SUMMARY: Prevention of cardiovascular disease should target high-risk subjects based on genetic/familial factors, blood chemistry, blood pressure, body mass index (BMI), and a history of/or current cigarette smoking. We selected active adults (n=76) aged 30-60 and investigated these risk factors, in order to recommend preventive measures.
Another interesting variable is the preclinical status or atheroma of the arterial (carotid) wall or lumen. We also investigated the presence of oxidative stress in, and the anti-oxidant status of these subjects.
We studied the anti-oxidative efficacy of superoxide dismutase (SOD) and variations of malondialdehyde (MDA).
Supplementation with GliSODin®, a vegetal SOD associated with gliadin, was effective in controlling the thickness of the carotid artery intima and media layers as measured by ultrasonography-B.
We could demonstrate the preventive efficacy of GliSODin at a preclinical stage in subjects with risk factors of cardiovascular disease.
Section 1 Definition of Epidemiology httpswww.cdc.govophs.docxbagotjesusa
Section 1: Definition of Epidemiology
https://www.cdc.gov/ophss/csels/dsepd/ss1978/lesson1/section1.html
Lesson 1: Introduction to Epidemiology
In fact, epidemiology is often described as the basic science of public health, and for good reason. First, epidemiology is a quantitative discipline that relies on a working knowledge of probability, statistics, and sound research methods. Second, epidemiology is a method of causal reasoning based on developing and testing hypotheses grounded in such scientific fields as biology, behavioral sciences, physics, and ergonomics to explain health-related behaviors, states, and events. However, epidemiology is not just a research activity but an integral component of public health, providing the foundation for directing practical and appropriate public health action based on this science and causal reasoning.(2)
A. Distribution
Epidemiology is concerned with the frequency and pattern of health events in a population:
a. Frequency refers not only to the number of health events such as the number of cases of meningitis or diabetes in a population, but also to the relationship of that number to the size of the population. The resulting rate allows epidemiologists to compare disease occurrence across different populations.
b. Pattern refers to the occurrence of health-related events by time, place, and person. Time patterns may be annual, seasonal, weekly, daily, hourly, weekday versus weekend, or any other breakdown of time that may influence disease or injury occurrence. Place patterns include geographic variation, urban/rural differences, and location of work sites or schools. Personal characteristics include demographic factors which may be related to risk of illness, injury, or disability such as age, sex, marital status, and socioeconomic status, as well as behaviors and environmental exposures.
Characterizing health events by time, place, and person are activities of descriptive epidemiology, discussed in more detail later in this lesson.
B. Determinants
Determinant: any factor, whether event, characteristic, or other definable entity, that brings about a change in a health condition or other defined characteristic.
Epidemiology is also used to search for determinants, which are the causes and other factors that influence the occurrence of disease and other health-related events. Epidemiologists assume that illness does not occur randomly in a population, but happens only when the right accumulation of risk factors or determinants exists in an individual. To search for these determinants, epidemiologists use analytic epidemiology or epidemiologic studies to provide the “Why” and “How” of such events. They assess whether groups with different rates of disease differ in their demographic characteristics, genetic or immunologic make-up, behaviors, environmental exposures, or other so-called potential risk factors. Ideally, the findings provide sufficient evidence to direct prompt and effective publ.
Role of serum trace elements magnesium, copper and zinc, level in Libyan pati...iosrjce
IOSR Journal of Biotechnology and Biochemistry (IOSR-JBB) covers studies of the chemical processes in living organisms, structure and function of cellular components such as proteins, carbohydrates, lipids, nucleic acids and other biomolecules, chemical properties of important biological molecules, like proteins, in particular the chemistry of enzyme-catalyzed reactions, genetic code (DNA, RNA), protein synthesis, cell membrane transport, and signal transduction. IOSR-JBB is privileged to focus on a wide range of biotechnology as well as high quality articles on genetic engineering, cell and tissue culture technologies, genetics, microbiology, molecular biology, biochemistry, embryology, cell biology, chemical engineering, bioprocess engineering, information technology, biorobotics.
Similar to Relación entre concentraciones de aluminio en el agua potable y el alzheimer estudio de 8 años (20)
Respuesta a Solicitud de Estudios de Calidad de Agua, Municipio San Luis Poto...ricguer
Cuando existe "Transparencia de la Información", se puede acceder por cuaquier medio. Sin embargo, el Municipio de San Luis Potosi, obliga a que si alguien quiere conocer la información pública, se presente, con identificación y en los horarios que ellos imponen para que hagan el favor de enseñar la información pública. Esta es una aberración de la "Transparencia".
Estudios de Calidad de Agua, Municipio de Monterrey, Nuevo León 2014 Estudios...ricguer
PRIMER ATLAS DE CALIDAD DE AGUA POR COLONIA DE MEXICO : http://www.ecodomestico.com
Calidad de Agua del Municipio de Monterrey, Estado de Nuevo León, México. En este estudio se muestran exclusivamente los Análisis Fisico-químicos. No se entrega la Información por Colonia y en su lugar se entregan los Estudios por POZOS, TANQUES Y RED que existe en diversos puntos del Municipio de Monterrey. Cabe destacar, que de los 46 parámetros que indica la norma, se entregan 42 parámetros, faltando únicamente 4 parámetros, totalmente contrario a lo que entregó, por ejemplo el municipio de Toluca, en el Estado de México. Los niveles de Dureza son elevados en general. Es necesario monitorear los niveles de Cianuro, Fluoruros, Arsénico, Aluminio, Sulfatos y Sodio, ya que podrían variar y sobrepasar la norma establecida fácilmente y ser altamente peligrosos para la Salud.
Estudios de Calidad de Agua, Municipio de Monterrey, Nuevo León 2014 Cloro Re...ricguer
PRIMER ATLAS DE CALIDAD DE AGUA POR COLONIA DE MEXICO : http://www.ecodomestico.com
Calidad de Agua del Municipio de Monterrey, Estado de Nuevo León, México. En este estudio se muestran exclusivamente los Análisis de Cloro Residual. No se entrega la Información por Colonia y en su lugar se entregan los Estudios de Cloro Residual que existe en diversos puntos del Municipio de Monterrey.
Calidad de Agua del Municipio de Aguascalientes, Aguascalientes Mexico junio ...ricguer
Se solicita la Calidad de Agua del Municipio de Aguascalientes, Estado de Aguascalientes, México. NO NOS ENTREGAN LOS ESTUDIOS, pero la respuesta es que : SE CLASIFICA COMO INFORMACION RESERVADA, porque ".. su divulgamiento pondría en peligro la estabilidad Financiera del municipio...".
Según el titular, porque estan en proceso un análisis de inversión para equipamiento de los pozos.
Sin embargo, no exsite relación alguna para impedir a los ciudadanos el conocer la Calidad de Agua que distribuyen. Este "Clasificación de Información Reservada" es un claro signo que puede indicar Alertas de Corrupción en este ayuntamiento o de ocultamiento de la Información, a fin de que la población no tenga ni la mas mínima idea del probable veneno que distribuyen a los ciudadanos. En todo caso, es un raro, pero típico caso de Ocultamiento de la Información en detrimento de la población a la que dicen servir y de la cual se sirven con un inmerecido salario.
Calidad de Agua de Cancún, Municipio Benito Juárez, Quintana Roo. Mayo 2014 ...ricguer
PRIMER ATLAS DE CALIDAD DE AGUA POR COLONIA DE MEXICO : http://www.ecodomestico.com
Calidad de Agua de Cancún, dentro del Municipio de Benito Juárez, en el estado de Quintana Roo, México. Faltan 37 parámetros de medición establecidos por la Norma Oficial Mexicana de los 46 establecidos. 3 de estos solo aparecen ls encabezados. Con los Datos Proporcionados, este municipio cuenta con una de las peores Calidades de Agua de Todo el País, administrada por una compañia privada llamada AGUAKAN.
Los niveles de Nitratos se encuentran muy por encima de los niveles máximos de la norma. Los elevados niveles de Cloruros y de Solidos Disueltos Totales -SDT- (sales y residuos orgánicos) hacen que el agua sea prácticamente imbebible.En Estados Unidos, el límite máximo de SDT es de 500, mientras que en México se permiten 1000 ppm.
El nivel de Dureza (calcio y magnesio) es generalmente muy alto en la casi totalidad de las fuentes que suministran agua. La elevada dureza del agua puede generar hipercalcemia, insuficiencia renal, hipertiroidismo o cáncer de pulmón, además que las tuberías se tapan por la acumulación de calcio.
La empresa AGUAKAN presume en su página de internet el contar con el Premio Nacional de Cloración, olvidando los 45 parámetros restantes y obligatorios para proporcionar Agua Potable. En este caso NO EXISTE DIFERENCIA entre una empresa privada y una pública para entregar una Calidad de agua que sea aceptable y POTABLE.
Calidad de Agua Municipio de tepic, estado de Nayarit, Julio 2013 INFOPLACITUMricguer
PRIMER ATLAS DE CALIDAD DE AGUA DE MEXICO : http://www.ecodomestico.com
Estudios Calidad de Agua de Tepic Nayarit. No entregan análisis de 2013 porque estos no los han realizado (ya que consideran que no es importante) o porque simplemente no desean que se sepa la calidad que proveen a los ciudadanos.
38 experts on bpa panel consensus statement. effects in animals and potential...ricguer
Un conjunto de 38 prestigiados científicos de todo el mundo alertan sobre el potencial nocivo y los impactos de exposición al Bisphenol A para la salud humana.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
2. 60 Rondeau et al.
Prevalent and incident cases of dementia were detected by a
two-step procedure. First, after the psychometric evaluation,
the psychologist systematically completed a standardized
questionnaire designed to obtain the A (memory impairment),
B (impairment of at least one other cognitive function), and C
(interference with social and professional life) criteria for
dementia according to the DSM-III-R (22). Second, subjects
who were positive for these criteria were examined by a
senior neurologist, who confirmed the diagnosis and applied
the NINCDS-ADRDA (23) criteria for Alzheimer’s disease
and the Hachinski score for vascular dementia (24) to document the diagnosis of dementia and its etiology: probable or
possible Alzheimer’s disease or other type of dementia.
Follow up
Measure of exposure
A specific study (Aluminum Maladie d’Alzheimer
(ALMA)) was started in 1991 to examine the relation between
aluminum in drinking water and Alzheimer’s disease for the
Paquid subjects. After investigation of the water distribution
network, the sample was divided into 77 drinking water areas
(with the largest parish of the study, Bordeaux, divided into
three areas). Two surveys were carried out in 1991 to measure
pH and concentrations of aluminum, calcium, and fluorine in
each water supply and to study the variability of the measurements. These data were described in detail by Jacqmin-Gadda
et al. (18). Then all the results of the chemical analyses of
drinking water (including silica) carried out by the sanitary
administration between 1991 and 1994 were collected. To
evaluate the past exposure of the subjects, we retraced the history of the water distribution network over the previous 10
years (1981–1991). During this period, any parish for which
there was not full information for sources constituting at least
20 percent of the water supply was excluded from the study.
Therefore, for each drinking water area, we computed a
weighted mean of all the measures of each drinking water
component. The weighting took into account the length of the
period of use of each water supply over the previous 10 years
(1981–1991) and the relative contribution of each water supply. Our study is based on 70 areas for which measurements
were available.
Statistical analysis
A Cox proportional hazard model with delayed entry (25)
was performed to estimate relative risks and adjust for
Am J Epidemiol
Vol. 152, No. 1, 2000
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Subjects were then reevaluated with the same procedure as
for the baseline screening 1, 3, 5, and 8 years after the initial
visit in Gironde and 3, 5, and 8 years after the initial visit in
Dordogne to diagnose incident cases of dementia. To improve
the sensitivity of the detection of incident cases, another criterion was added for the selection of subjects for the second
stage (neurologic examination): Subjects were selected for
this stage if they met the criteria for DSM-III-R dementia or
if they had experienced a cognitive decline of more than two
points at the Mini-Mental State Examination (MMSE) score.
covariates. Age was chosen as the basic time scale in the
analysis, so the risk of dementia or Alzheimer’s disease
were adjusted nonparametrically for age. This has two
implications: first, it enables inferences on the effects of risk
factors to be made without making parametric assumptions
about the effect of age, and second, the hazard functions are
the age-specific incidence of the disease (25, 26). For the
analyses, we excluded the subjects with prevalent dementia
at baseline. A subject was considered at risk from his age at
entry into the cohort to his age of censorship or age of outcome. Subjects still unaffected at the last visit were rightcensored at that time. Deceased subjects who were unaffected at the last visit were right-censored at that date, i.e.,
the last time their disease status was assessed. For a
demented subject, we considered half of the time between
the last visit at which the subject was seen nondemented and
the first visit at which he was diagnosed as demented. This
midpoint imputation is a reasonable procedure to estimate
relative risks when interval widths are not too large (26).
In a previous analysis (26), we observed that the proportional hazards assumption was violated for gender, so we
chose to perform a stratified analysis for gender (27). We
tried three different ways of coding aluminum: as a quantitative variable, as a binary variable with the threshold of 0.1
mg/liter already used in previous studies (7, 9), and in four
classes according to the three tertiles (on parishes) under 0.1
and the category above 0.1 mg/liter; silica was coded as a
binary variable with 11.25 mg/liter (the median in our sample) as the cutoff. We adjusted for potential confounders:
educational level with five classes coded by four binary
variables (no education, did not graduate from primary
school, graduated from primary school, high school level,
and university level (28)); wine consumption (nondrinkers
or mild drinkers vs. moderate or heavy drinkers) (29), and
place of residence (rural vs. urban). Adjustment for baseline
cognitive status measured by the MMSE (30) scores was
performed in a complementary analysis (MMSE was available for 2,658 subjects).
We then examined separately the effect of bottled mineral
water consumption (daily consumption of mineral water vs.
no or occasional consumption). This information was collected only at the 3-year follow-up visit. Thereafter, we
examined the subsample of nondemented subjects who were
visited at that follow-up and used incident cases of dementia between the 3- and 8-year follow-up visits.
We performed a sensitivity analysis to assess how the
subjects who had no follow-up because they refused (n.f.
refusals) and those who had no follow-up because they died
before any follow-up visit (n.f. deaths) may have affected
our estimates. Four extreme possibilities were considered.
The first assumed that none of the n.f. refusals had developed dementia. The second assumed that all of those subjects had developed dementia. The third supposed that none
of the n.f. deaths had developed dementia. The last extreme
possibility assumed that all n.f. deaths had developed
dementia. New ages of outcome or censorship were attributed to these subjects (refusals or deaths). For demented
subjects, the age of dementia was evaluated by the age at
entry in the cohort plus the mean duration until dementia in
3. Aluminum in Drinking Water and Alzheimer’s Disease 61
the study (3.6 years). For nondemented subjects, the age of
censoring was evaluated by the age at entry into the cohort
plus the mean follow-up evaluation (5.9 years).
The main analyses were performed with EGRET software (EGRET Statistics and Epidemiology Research
Corporation, Seattle, Washington).
RESULTS
TABLE 1. Numbers and percentages of subjects followed in
the cohort and subjects who had no follow-up because they
died (n.f. deaths) or refused (n.f. refusals) for 3,401 subjects
eligible at baseline, Paquid study, France, 1988–1989
n.f deaths
n.f. refusals
Total
Aluminum
(mg/liter)
Followed
at least
once (%)
≥0.1
<0.1
63 (73.3)
2,635 (79.5)
12 13.9
371 11.2
11 12.8
309 9.3
86 100
3,315 100
Total
2,698 (79.3)
383 11.3
320
3,401
No.
%
No.
%
9.4
No.
%
TABLE 2. Follow-up of the cohort with numbers and percentages of surviving subjects who completed
the follow-up evaluation 1, 3, 5, and 8 years after the initial visit, according to aluminum exposure in the
3,401 subjects eligible at baseline, Paquid study, France, 1988–1989
No. of subjects (%)*
Aluminum
exposure
(mg/liter)
1 year†
3 years
5 years
8 years
Eligible at
baseline
≥0.1
<0.1
0 (0)
1,693 (68.8)
57 (77.0)
2,046 (69.6)
53 (75.7)
1,867 (71.2)
46 (73.0)
1,403 (62.4)
86
3,315
Total
1,693 (68.3)
2,103 (69.8)
1,920 (71.3)
1,449 (62.5)
3,401
* Percentages were calculated on the number of surviving subjects at follow-up times.
† Only subjects living in one of the parishes of the administrative area of Gironde were seen.
Am J Epidemiol Vol. 152, No. 1, 2000
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Among the 3,777 subjects who initially agreed to participate, 102 with prevalent dementia were excluded and 3,675
were nondemented at the first visit. Measurements of water
and adjustment covariates were available for 3,401 subjects
unaffected at the initial visit. Among the 3,401 subjects, 703
(20.6 percent) did not participate in the follow-up because
they had died before any dementia evaluation (n ϭ 383, 11.3
percent) or had refused the follow-up procedure (n ϭ 320,
9.4 percent); the percentages were not significantly different
between those exposed and nonexposed to aluminum
(deaths, p ϭ 0.42; refusals, p ϭ 0.27) (table 1). At least one
complete follow-up evaluation was performed on 2,698 subjects (79.3 percent). During the 8-year follow-up of these
subjects, 253 subjects were diagnosed with dementia; among
these, 17 had been exposed to high levels of aluminum (≥0.1
mg/liter). There were 182 (72.0 percent) who were classified
as having Alzheimer’s disease (probable or possible); among
these, 13 had been exposed to high levels of aluminum. The
incidence rates for all causes of dementia and for
Alzheimer’s disease were estimated as 1.69 per 100 personyears and 1.22 per 100 person-years, respectively.
The mean follow-up duration was 5.9 years. Table 2
shows the follow-up of the cohort, with the number and percentages of surviving subjects who were followed at 1, 3, 5,
and 8 years.
Aluminum levels in water supplies ranged from 0.001 to
0.459 mg/liter, with a median value of 0.009 mg/liter.
Among subjects followed up at least once, 63 living in four
parishes were exposed to more than 0.1 mg/liter of aluminum. Silica levels in water ranged from 4.2 to 22.4
mg/liter and were inversely related to aluminum concentrations, but this negative correlation was weak in our study
(Spearman rank correlation coefficient ϭ –0.18, p ϭ 0.13).
At baseline, 91 percent of the individuals had lived more
than 10 years in the same parish, and the mean length of residence in the same parish was 41 years. Baseline characteristics of the cohort at risk, according to level of aluminum,
are shown in table 3.
The results of the analyses (table 4) suggest that the risk
of dementia was higher for subjects living in parishes where
the mean aluminum concentrations exceeded 0.1 mg/liter
than for those living in areas where concentrations were less
than 0.1 mg/liter (relative risk (RR) nonparametrically
adjusted for age and gender ϭ 2.33, p < 0.001, model 1).
Conversely, higher silica concentrations (≥11.25 mg/liter)
were associated with a reduced risk of dementia (RR nonparametrically adjusted for age and gender ϭ 0.71, p ϭ
0.007, model 3). After additional adjustment for educational
level, wine consumption, and place of residence, aluminum
and silica concentrations remained associated with dementia
(RR for aluminum ϭ 1.99, p ϭ 0.007; RR for silica ϭ 0.74,
p ϭ 0.021, model 5). We also performed a model equivalent
to model 5, in which we added the principal lifetime occupation with an eight-class variable, coded by seven binary
variables: The RR for aluminum and silica (not shown in the
tables) were unchanged, and occupation was not significant
(likelihood ratio test ϭ 10.6, 7 df, p ϭ 0.16). It did not seem
necessary to adjust for occupation after having adjusted for
education level. When aluminum concentrations were separated into four classes, no tendency for a dose-response
effect for aluminum was apparent (table 4, model 4, likelihood ratio statistic ϭ 6.12, 3 df, p ϭ 0.11), even though a
significant linear relation between aluminum and dementia
was obtained in model 6 (adjusted RR for aluminum ϭ 1.25
for an increase of 0.1 mg/liter, p ϭ 0.015). However, the
model with aluminum in two classes was slightly better than
4. 62 Rondeau et al.
TABLE 3. Distribution of potential confounding variables across levels of aluminum exposure
concentrations, Paquid study, France, 1988–1997
Aluminum ≥0.1 mg/liter
(n = 63)
Aluminum <0.1 mg/liter
(n = 2,635)
Total (n = 2,698)
No.
%
No.
%
No.
%
16
47
25.4
74.6
1,613
1,022
61.2
38.8
1,629
1,069
60.4
39.6
21
33.3
816
31.0
837
31.0
31
9
2
0
49.2
14.3
3.2
0.0
1,194
322
156
147
45.3
12.2
5.9
5.6
1,225
331
158
147
45.4
12.3
5.9
5.4
Place of residence
Rural
Urban
16
47
25.4
74.6
817
1,818
31.0
69.0
833
1,865
30.9
69.1
Wine consumption
Nondrinkers or light drinkers
Moderate or heavy drinkers
54
9
85.7
14.3
2,208
427
83.8
16.2
2,262
436
83.8
16.2
Silica (mg/liter)
≥11.25
<11.25
Education
No education
Did not graduate from elementary
school
Graduated from elementary school
High school level
University level
consumption. There was no evidence of a significant interaction between aluminum and mineral water consumption.
In this subanalysis, after adjustment for educational level,
wine consumption, place of residence, and aluminum, the
relative risk for silica was estimated to be 0.61 (95 percent
CI: 0.41, 0.91, p ϭ 0.016). The effect of silica was not
changed after adjustment for mineral water consumption
(RR ϭ 0.61, 95 percent CI: 0.41, 0.91, p ϭ 0.016). In the
analyses, we considered as exposed all the subjects living in
parishes with high levels of aluminum. An alternative was to
consider subjects who drank daily mineral water as nonexposed; in this case, the effect of aluminum still remained
unchanged and was still significantly associated with
dementia.
The results of the sensitivity analyses on the 320 n.f.
refusals and the 383 n.f. deaths are presented in tables 7 and
8, respectively. The sensitivity analyses on n.f. refusals and
n.f. deaths showed a decrease in the effect of aluminum on
dementia compared with results in the study, but the effect
of aluminum on the risk of dementia remained significant.
The effect of silica was also changed slightly in these sensitivity analyses, and it was no longer significant in the fourth
assumption, i.e., that all n.f. deaths had developed dementia.
DISCUSSION
In this study, high aluminum levels in drinking water
(≥0.1 mg/liter) were associated with an elevated risk of
dementia and Alzheimer’s disease. This result is highly significant despite the small number of subjects exposed to
such levels. No dose-response relation was apparent in the
analyses. Although this weakens the plausibility that aluminum has a causal effect on Alzheimer’s disease, the interpretation may also be that there is a threshold effect around
0.1 mg/liter. Inversely, high silica levels (≥11.25 mg/liter)
Am J Epidemiol
Vol. 152, No. 1, 2000
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that in which aluminum was a continuous variable (Akaike
criterion: 2,722.0 vs. 2,723.1) (table 4, models 5 and 6).
There was no significant interaction between aluminum and
silica concentrations (likelihood ratio test ϭ 0.72, p ϭ 0.48).
The results of model 5 were not significantly changed after
adjustment for baseline MMSE (RR for aluminum ϭ 2.08,
p ϭ 0.005; RR for silica ϭ 0.74, p ϭ 0.017). The pH level
was not associated with dementia, and the interaction
between aluminum and pH was not significant.
Analyses restricted to cases classified as Alzheimer’s disease (182 cases) also suggested a deleterious effect of high
aluminum concentrations and a protective effect of high silica concentrations on the risk of Alzheimer’s disease (table
5). These effects were not significant for other types of
dementia (71 cases), although the relative risks were of the
same order. This may be explained by a lack of power in the
latter analysis.
The observations are summarized in table 6. Among the
exposed subjects, the expected number of demented cases,
using the Cox model adjusted for covariates (27), was computed to be 8.71 while 17 cases were observed, and the
expected number of Alzheimer’s cases was computed to be
5.65 while 13 cases were observed.
Information about mineral water consumption was collected for 1,638 nondemented subjects seen at the 3-year
follow-up for whom covariates were available; 105 subjects
developed dementia (including 88 Alzheimer’s disease
cases) between the 3- and the 8-year follow-up. In this subsample, 48 percent of the subjects were classified as daily
drinkers of mineral water. The analysis of this subsample,
adjusted for age, gender, educational level, wine consumption, place of residence, and silica yielded a relative risk of
2.89 (95 percent CI: 1.51, 5.52, p < 0.001) for aluminum
≥0.1 mg/liter. This relative risk reached 3.36 (95 percent CI:
1.74, 6.49, p < 0.001) after adjustment for mineral water
5. Aluminum in Drinking Water and Alzheimer’s Disease 63
TABLE 4. Relative risks and 95% confidence intervals for
253 cases of dementia according to aluminum and silica
concentrations in the water, Paquid study*, France, 1988–1997
Variable
RR†
95% CI†
p
value
TABLE 5. Relative risks and 95% confidence intervals for
182 cases of Alzheimer’s disease according to aluminum and
silica concentrations in the water, Paquid study*, France,
1988–1997
Variable
RR†
95% CI†
p
value
2.33
1.42, 3.82
<0.001
Model 1‡
Aluminum ≥0.1 vs. <0.1
mg/liter
2.20
1.24, 3.84
0.007
Model 2‡
Aluminum (continuous)§
1.36
1.15, 1.61
<0.001
Model 2‡
Aluminum (continuous)§
1.46
1.23, 1.74
<0.001
0.007
Model 3‡
Silica ≥11.25 vs. <11.25
mg/liter
0.69
0.52, 0.94
0.016
Model 4¶
Aluminum concentration
(mg/liter)
<0.0038
≥0.0038–<0.0110
≥0.0110–<0.1000
≥0.1000
Silica ≥11.25 vs. <11.25
mg/liter
1
1.16
0.97
2.27
0.78, 1.72
0.63, 1.49
1.19, 4.34
0.460
0.880
0.013
0.74
0.54, 1.00
0.052
2.14
1.21, 3.80
0.007
0.73
0.55, 0.99
0.040
1.35
1.11, 1.62
0.003
0.77
0.57, 1.04
0.087
Model 3‡
Silica ≥11.25 vs. <11.25
mg/liter
Model 4¶
Aluminum concentration
(mg/liter)
<0.0038
≥0.0038–<0.0110
≥0.0110–<0.1000
≥0.1000
Silica ≥11.25 vs. <11.25
mg/liter
Model 5¶
Aluminum ≥0.1 vs. <0.1
mg/liter
Silica ≥11.25 vs. <11.25
mg/liter
Model 6¶
Aluminum (continuous)§
Silica ≥11.25 vs. <11.25
mg/liter
0.71
0.56, 0.91
1
1.03
0.98
2.00
0.74, 1.43
0.69, 1.40
1.15, 3.50
0.850
0.920
0.015
0.74
0.58, 0.96
0.026
1.99
1.20, 3.28
0.007
0.74
0.58, 0.96
0.021
1.25
1.05, 1.50
0.015
0.76
0.59, 0.98
0.037
* Analyses performed on the sample of 2,698 nondemented
subjects at baseline for whom components of drinking water and
covariates were available.
† RR, relative risk; CI, confidence interval.
‡ Nonparametrically adjusted for age and gender.
§ Concentrations of aluminum (RR given for an increase of 0.1
mg/liter).
¶ Nonparametrically adjusted for age and gender and parametrically adjusted for educational level, wine consumption, and place
of residence.
were associated with a lower risk of dementia and
Alzheimer’s disease.
Subjects who refused to participate in the follow-up (31)
or who died are probably more likely to be demented. If the
participation of these subjects were different in the exposed
and the nonexposed groups, this could produce an “attrition”
bias. In our study, the percentages of deaths before any
follow-up visit and refusals before any follow-up visit were
slightly higher for subjects exposed to aluminum, but this
difference was not significant, which makes such a bias
unlikely. The effect of aluminum estimated in the sensitivity
analyses appeared to be somewhat lower than that calculated from the study (table 4, model 5). Nonetheless, all
these sensitivity analyses suggest that the main result is
robust.
Am J Epidemiol Vol. 152, No. 1, 2000
Model 5¶
Aluminum ≥0.1 vs. <0.1
mg/liter
Silica ≥11.25 vs. <11.25
mg/liter
Model 6¶
Aluminum (continuous)§
Silica ≥11.25 vs. <11.25
mg/liter
* Analyses performed on the sample of 2,698 nondemented
subjects at baseline, for whom components of drinking water and
covariates were available.
† RR, relative risk; CI, confidence interval.
‡ Nonparametrically adjusted for age and gender.
§ Concentrations of aluminum (RR given for an increase of 0.1
mg/liter).
¶ Nonparametrically adjusted for age and gender and parametrically adjusted for educational level, wine consumption, and place
of residence.
Since the number of demented subjects exposed to high
levels of aluminum was low, our results could be sensitive to
a misdiagnosis of demented subjects. Therefore, in an additional analysis, we chose to define as demented the subjects
who screened positive in the first stage of the diagnostic procedure. The prevalent who “screened positive” were removed,
so we analyzed 2,670 subjects. Among these, 359 (of whom
21 exposed to aluminum) were considered as demented by the
new definition. The results remained unchanged; high levels
of aluminum were still significantly associated with an elevated risk of dementia (adjusted RR ϭ 1.95, p ϭ 0.004).
Therefore, it is unlikely that the apparent effect of aluminum
comes from a misclassification of the subjects.
In our analyses, Alzheimer’s subjects were classified as
those with probable or possible Alzheimer’s disease. To
Downloaded from aje.oxfordjournals.org by guest on July 24, 2011
Model 1‡
Aluminum ≥0.1 vs. <0.1
mg/liter
6. 64 Rondeau et al.
TABLE 6. Expected and observed numbers of cases of
dementia or Alzheimer’s disease according to aluminum
exposure after an 8-year follow-up of 2,698 subjects, Paquid
study*, France, 1988–1997
Aluminum
<0.1 mg/liter
(n = 2,635)
Dementia subjects
Observed no.
Expected no.
17
8.71
169
176.35
13
5.65
* Expected number calculated with Martingale residuals, nonparametrically adjusted for age and gender and parametrically
adjusted for educational level, wine consumption, and place of residence.
TABLE 7. Results of the sensitivity analyses on dementia for
subjects who refused to participate in the follow-up
procedure comparing two extreme possibilities, Paquid
study*, France, 1988–1997
All‡
95% CI
RR
95% CI
1.90
1.15, 3.14
1.53
1.04, 2.26
0.76
0.59, 0.97
0.85
0.72, 1.00
* Analyses performed on 3,018 subjects: 2,698 were followed
effectively at least once, and 320 subjects refused the follow-up procedure.
† Relative risk (RR) and 95% confidence interval (CI) under the
assumption that none of the subjects who refused the follow-up procedure had developed dementia.
‡ RR and 95% CI under the assumption that all of the subjects
who refused the follow-up procedure had developed dementia.
§ Nonparametrically adjusted for age and gender and parametrically adjusted for educational level, wine consumption, and place
of residence.
increase the specificity of the analyses, another analysis was
performed that considered only the 89 probable Alzheimer’s
disease cases, including six exposed subjects. A higher risk
of Alzheimer’s disease was still associated with a higher
concentration of aluminum (adjusted RR ϭ 1.77), although
the association was not significant (p ϭ 0.19), probably due
to a lack of power of the analysis.
Of course, when studying the effects of risk factors in
an old population, it must be remembered that the subjects
are highly selected because they are still alive and have
not developed the disease. Selection in a heterogeneous
population may produce apparent effects that are different
from true effects, as shown by Aalen (32). One way of
partially coping with this problem is to adjust on explanatory variables that may explain part of the heterogeneity.
This is why, in an additional analysis, we adjusted for
baseline cognitive status, which is a good predictor of
dementia and Alzheimer’s disease. Controlling this base-
All‡
RR
Aluminum ≥0.1 vs.
<0.1 mg/liter§
Silica ≥11.25 vs.
<11.25 mg/liter§
95% CI
RR
95% CI
1.98
1.20, 3.27
1.52
1.04, 2.22
0.69
0.54, 0.89
1.06
0.89, 1.24
* Analyses performed on 3,081 subjects: 2,698 were followed
effectively at least once and 383 subjects died before any follow-up
evaluation.
† Relative risk (RR) and 95% confidence interval (CI) under the
assumption that none of the subjects died before any follow-up evaluation.
‡ RR and 95% CI under the assumption that all of the subjects
died before any follow-up evaluation had developed dementia.
§ Nonparametrically adjusted for age and gender and parametrically adjusted for educational level, wine consumption, and place
of residence.
line heterogeneity did not modify the relative risks for
aluminum and silica.
The Paquid survey design incorporates a grouping of the
participants into parishes, and this may induce a correlation
of the observations. It is thus not to be excluded that some
unmeasured environmental factor shared by the members
of the same parish could play a confounding role. Analysis
of dependent survival data by the classical Cox proportional hazard model using conventional partial likelihood
methods may underestimate the variance of regression
coefficients specific to each group, leading to incorrect
inferences. We thus considered a “frailty model” (27) to
take into account the grouping of the subjects in the different parishes. In the frailty model, the hazard function
depends partly on an unobservable random variable (a random effect) thought to act multiplicatively on the hazard. A
large value of the variance of the random effects means
closer positive relation between the subjects of the same
parish and a greater heterogeneity between the groups. The
Statistical Analysis System (version 6.12) was used for
these analyses (SAS Institute, Inc., Cary, North Carolina).
An SAS macro (World Wide Web site: http://biostat.
mcw.edu/Software.html) was used to implement the
frailty model. The macro did not allow left truncated data,
so we analyzed the delay between the time of entry into
the cohort and the time of censorship or the time of outcome and then adjusted for age at entry. The estimated
variance of the frailty parameter was not significantly different from zero (p ϭ 0.21). This means we may admit
that there is no intragroup correlation in our sample or that
such a correlation is weak. The relative risks for aluminum and silica were unchanged, but the standard errors
of these regression coefficients were slightly increased.
However, aluminum and silica concentrations were still
significantly associated with dementia (p ϭ 0.004 and
0.042, respectively).
Am J Epidemiol
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None†
RR
Aluminum ≥0.1 vs.
<0.1 mg/liter§
Silica ≥11.25 vs.
<11.25 mg/liter§
None†
Aluminum
≥0.1 mg/liter
(n = 63)
236
244.29
Alzheimer’s disease subjects
Observed no.
Expected no.
TABLE 8. Results of the sensitivity analyses on dementia for
subjects who died before any follow-up evaluation
comparing two extreme possibilities, Paquid study*,
France, 1988–1997
7. Aluminum in Drinking Water and Alzheimer’s Disease 65
Am J Epidemiol Vol. 152, No. 1, 2000
ACKNOWLEDGMENTS
Supported by Agence de Bassin Seine-Normandie,
Aluminum Péchiney, ARMA (Institut du Cerveau),
Association Recherche et Partage, AXA-AGIPI, Groupe
Danone, Caisse Nationale d’Assurance Maladie des
Travailleurs Salariés, Caisse Primaire d’Assurance Maladie
de la Dordogne, CAPIMMEC, Conseil Général de la
Dordogne, Conseil Général de la Gironde, Conseil Régional
d’Aquitaine, Caisse de Retraite Interentreprises, Direction
Régionale des Affaires Sanitaires et Sociales d’Aquitaine,
2010 Média, Fondation de France, INSERM, M.G.E.N.,
Ministère de la Recherche et de la Technologie, Ministère de
l’Aménagement du Territoire et de l’Environnement,
M.S.A. de la Dordogne, M.S.A. de la Gironde, Novartis
Pharma.
The authors thank Luc Letenneur and the Paquid staff for
their collaboration in the study and the DDASS Dordogne
and DDASS Gironde who took part in the study by supplying data on drinking water components.
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Several investigators have described how the pH of
drinking water may affect the solubility of aluminum components (33). It is plausible that the biological availability
of aluminum is higher for low pH than for high pH, which
would lead to an interaction between pH and aluminum.
These results were not confirmed in our study; nevertheless, 98.7 percent of the pH values were higher than 7
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the exact risk attributable to aluminum is probably underestimated in our study, which does not consider total daily aluminum intake (which is difficult to measure). However, many
authors have postulated that aluminum in drinking water may
be more bioavailable than aluminum from other sources.
In conclusion, our study suggests that a concentration of
aluminum in drinking water above 0.1 mg/liter may be a
risk factor of dementia and, especially, Alzheimer’s disease. This result needs to be confirmed using a higher
number of exposed subjects.
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