Search

Sewage from clinical chemical laboratories is despite of its low chemical load one of the main critical effluents from hospitals, particularly with regard to their ecotoxicity and mutagenic effects. Only little data is available with respect to their environmental impact. Therefore, an inventory was carried out in clinical laboratories and the biological degradation and mutagenicity of liquid reaction residues from analysers used in clinical chemical routine laboratory diagnostics were investigated. The reaction mixtures were only partly biodegradable. Thereby the possibility of transfer into water bodies and for accumulation in the food-chain absolutely consists for a part of it. Moreover, the highly with test reagents and patient material contaminated liquid reaction residues from analysers show strong mutagenic effects which were only partial eliminated microbially. For a final environmental risk assessment of the strong contaminated reaction mixtures from clinical chemical analysers further investigations into persistence, biological accumulation and degradation should be carried out. Sewage from clinical chemical laboratories is despite of its low chemical load one of the main critical effluents from hospitals, particularly with regard to their ecotoxicity and mutagenic effects. Only little data is available with respect to their environmental impact. Therefore, an inventory was carried out in clinical laboratories and the biological degradation and mutagenicity of liquid reaction residues from analysers used in clinical chemical routine laboratory diagnostics were investigated. The reaction mixtures were only partly biodegradable. Thereby the possibility of transfer into water bodies and for accumulation in the food-chain absolutely consists for a part of it. Moreover, the highly with test reagents and patient material contaminated liquid reaction residues from analysers show strong mutagenic effects which were only partial eliminated microbially. For a final environmental risk assessment of the strong contaminated reaction mixtures from clinical chemical analysers further investigations into persistence, biological accumulation and degradation should be carried out.

Objectives.We sought to determine whether 12,500 IU of unfractionated heparin given subcutaneously twice daily for 4 months after percutaneous transluminal coronary angioplasty beneficially influences the subsequent rate of angiographic restenosis and the incidence of clinical events.Background.Heparin has been shown to exhibit powerful antiproliferative effects against smooth muscle cells in several animal models.Methods.A randomized trial with blinded data analysis was undertaken to assess the effect of unfractionated subcutaneous heparin on angiographic restenosis after coronary angioplasty. After successful angioplasty, patients were randomized to receive no heparin or 12,500 IU of heparin given subcutaneously twice daily for 4 months. Quantitative coronary angiography was performed before angioplasty, immediately after angioplasty and at follow-up (“early” [before 4 months] or electively [at 4 months]).Results.The study group comprised 339 patients, 167 randomly assigned to receive heparin, 172 to receive no heparin. Repeat cardiac catheterization was performed in 90% of randomized patients. At early and elective restudy (mean 4.2 months), the mean ± SD difference in minimal lumen diameter between the postangioplasty and follow-up measurement was −0.55 ± 0.58 mm for the no heparin group and −0.43 ± 0.59 mm for the heparin group (p = NS). Clinical events during the follow-up period did not differ significantly between groups: fatal myocardial infarction (1 patient in each group), coronary bypass grafting (5 patients in each group), repeat angioplasty (12 in the no heparin, 6 in the heparin group), angina at 4-month assessment (33% in the no heparin, 32% in the heparin group).Conclusions.Long-term treatment with high dose subcutaneous heparin (12,500 IU twice daily) for 4 months did not favorably influence angiographic or clinical outcome after coronary angioplasty.