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Sample records for acute organophosphate poisoning

  1. Neurology of acute organophosphate poisoning

    Singh Gagandeep

    2009-01-01

    Full Text Available Acute organophosphate (OP poisoning is one of the most common poisonings in emergency medicine and toxicological practice in some of the less-developed nations in South Asia. Traditionally, OP poisoning comes under the domain of emergency physicians, internists, intensivists, and toxicologists. However, some of the complications following OP poisoning are neurological and involve neurologists. The pathophysiological basis for the clinical manifestations of OP poisoning is inactivation of the enzyme, acetylcholinesterase at the peripheral nicotinic and muscarinic and central nervous system (CNS nerve terminals and junctions. Nicotinic manifestations occur in severe cases and late in the course; these comprise of fasciculations and neuromuscular paralysis. There is a good correlation between the electrophysiological abnormalities and the severity of the clinical manifestations. Neurophysiological abnormalities characteristic of nicotinic junctions (mainly neuromuscular junction dysfunction include: (1 single, supramaximal electrical-stimulus-induced repetitive response/s, (2 decrement-increment response to high frequency (30 Hz repetitive nerve stimulation (RNS, and (3 decremental response to high frequency (30 Hz RNS. Atropine ameliorates muscarinic manifestations. Therapeutic agents that can ameliorate nicotinic manifestations, mainly neuromuscular, are oximes. However, the evidence for this effect is inconclusive. This may be due to the fact that there are several factors that determine the therapeutic effect of oximes. These factors include: The OP compound responsible for poisoning, duration of poisoning, severity of poisoning, and route of exposure. There is also a need to study the effect of oximes on the neurophysiological abnormalities.

  2. Cardiovascular Effects of Acute Organophosphate Poisoning

    Shankar Laudari

    2014-06-01

    Conclusion:Cardiac effects of OP poisoning can be life-threatening. Prompt diagnosis, early supportive and definitive therapies with atropine and oximes along with vigilant monitoring of the patients for prominent cardiac effects such as QT prolongation, VT or VF during hospital stay can definitely save lives of the victims.

  3. To identify morbidity and mortality predictors in acute organophosphate poisoning

    Arti Muley

    2014-01-01

    Full Text Available Background: Organophosphorus poisoning remains an important cause of morbidity and mortality, but no definite parameters have been identified as predictors of outcome. Prediction of morbidity at presentation might help in decision making in places of limited resources like rural settings in developing countries. Materials and Methods: A total of 76 cases were included in this retrospective cohort study. Logged relative risk of requirement of mechanical ventilation and hospital stay >7 days was measured in patients with serum acetylcholinesterase (s. acetylcholinesterase 1000, presenting in 12 and in patients with SpO 2 7 days. Conclusion: S. acetylcholinesterase, SpO 2 at room air, GCS, and duration of exposure at presentation can be used to identify the requirement of special care in acute organophosphorus poisoning. This can aid in decision making regarding admission to intensive care unit and referral in the places with limited resources.

  4. Electrophysiological correlates of respiratory failure in acute organophosphate poisoning: Evidence for differential roles of muscarinic and nicotinic stimulation

    Jayawardane, Pradeepa; Senanayake, Nimal; Buckley, Nick A.; Dawson, Andrew H

    2012-01-01

    Background. Respiratory failure in acute organophosphate (OP) poisoning can occur early and also relatively late in the clinical course, and the pathophysiology of respiratory failure at these different phases may have important clinical implications. Objective. To compare the electrophysiological findings in patients with early and late respiratory failure following acute OP poisoning. Methods. A prospective observational case series of consenting symptomatic patients with acute OP poisoning...

  5. Brain injury due to acute organophosphate poisoning Magnetic resonance imaging manifestation and pathological characteristics

    2007-01-01

    BACKGROUND: Acute organophosphate poisoning can cause injuries of multiple visceras; especially,central nervous system injury can increase risk factors of patients with severe acute organophosphate poisoning. An application of modem image may increase diagnostic rate of brain injury in an earlier period and provide evidences for clinical treatment.OBJECTIVE: To reveal imaging manifestations, pathological characteristics and multi-ways injured mechanism of brain injury due to acute organophosphate poisoning.DESIGN: Contrast observational study.SETTING: Department of Medical Image, the Second Hospital of Hebei Medical University.MATERIALS: The experiment was carried out in the Department of Nerve Molecule Imaging Medicine and Laboratory of Neurology, the Second Hospital of Hebei Medical University from August 2003 to February 2004. A total of 30 healthy cats weighing 2.8 - 3.5 g and of both genders were selected from Animal Experimental Center of Hebei Medical University.METHODS: Thirty healthy cats were randomly divided into control group (n =5) and intoxication group (n=25). Cats in the control group were subcutaneously injected with 0.3 mL/kg saline at four points; while, cats in the intoxication group were subcutaneously injected with 400 g/L 0.3 mL/kg O,O-dimethyl-S-(methoxycarbonylmethyl) thiophosphate at four points. Two minutes after intoxication, cats received muscular injection with 0.5 mg/kg atropine sulfate, and then, brain tissues were collected from parietal lobe, basal ganglia, hippocampus, cerebellum and brain stem were observed at 3, 6, 24 hours, 3 and 7 days after intoxication respectively under optic microscope and electron microscope and expressions of acetylcholinesterase (AChE), choline acetyltransferase (ChAT), glial fibrillary acidic protein (GFAP),glutamic acid (Glu) and γ-amino butyric acid after immunohistochemical staining.MAIN OUTCOME MEASURES: Results of MRI examinations; histological changes under optic microscope and electron

  6. The spectrum of intermediate syndrome following acute organophosphate poisoning: a prospective cohort study from Sri Lanka.

    Pradeepa Jayawardane

    2008-07-01

    Full Text Available BACKGROUND: Intermediate syndrome (IMS is a major cause of death from respiratory failure following acute organophosphate poisoning. The objective of this study was to determine repetitive nerve stimulation (RNS predictors of IMS that would assist in patient management and clinical research. METHODS AND FINDINGS: Seventy-eight consenting symptomatic patients with organophosphate poisoning were assessed prospectively with daily physical examination and RNS. RNS was done on the right and left median and ulnar nerves at 1, 3, 10, 15, 20, and 30 Hz. The study was conducted as a prospective observational cohort study in the Central Province, Sri Lanka. IMS was diagnosed in ten out of 78 patients using a priori clinical diagnostic criteria, and five of them developed respiratory failure. All ten patients showed progressive RNS changes correlating with the severity of IMS. A decrement-increment was observed at intermediate and high frequencies preceding the onset of clinical signs of IMS. As the patient developed clinical signs of IMS, decrement-increment was progressively noted at low and intermediate frequencies and a combination of decrement-increment and repetitive fade or severe decrement was noted at high frequencies. Severe decrement preceded respiratory failure in four patients. Thirty patients developed forme fruste IMS with less severe weakness not progressing to respiratory failure whose RNS was characterized by decrement-increment or a combination of decrement-increment and repetitive fade but never severe decrements. CONCLUSIONS: Characteristic changes in RNS, preceding the development of IMS, help to identify a subgroup of patients at high risk of developing respiratory failure. The forme fruste IMS with the characteristic early changes on RNS indicates that IMS is a spectrum disorder. RNS changes are objective and precede the diagnosis and complications of IMS. Thus they may be useful in clinical management and research.

  7. Alcohol Withdrawal Mimicking Organophosphate Poisoning

    Nezihat Rana Disel

    2014-02-01

    Full Text Available Organophosphates, which can cause occupational poisoning due to inappropriate personal protective measures, are widely used insecticides in agricultural regions of southern Turkey. Therefore, the classical clinical findings of this cholinergic poisoning are myosis, excessive secretions, bradicardia and fasciculations are easy to be recognized by local medical stuff. Diseases and conditions related to alcoholism such as mental and social impairments, coma, toxicity, withdrawal, and delirium are frequent causes of emergency visits of chronic alcoholic patients. Here we present a case diagnosed and treated as organophosphate poisoning although it was an alcohol withdrawal in the beginning and became delirium tremens, due to similar symptoms.

  8. Effects of acute organophosphate poisoning on pituitary target gland hormones at admission, discharge and three months after poisoning: A hospital based pilot study

    Pinaki Dutta

    2015-01-01

    Full Text Available Background: Organophosphate compound (OPC poisoning is common in the developing countries such as India. The acute and later effects of OPC poisoning on pituitary and target gland hormones is largely unknown. Materials and Methods: This prospective study was conducted at Postgraduate Institute of Medical Education and Research between January 2012 and March 2013. Fourteen patients (8 males, age 18-50 years with acute OPC poisoning were included in the study based on the history and clinical features, documented decreased in plasma cholinesterase activity or presence of the OPC in gastric lavage/blood samples. The hormonal parameters were done at baseline, at the time of discharge and at three months of follow-up. Results: A total of 14 patients out of 46 with the mean age of 30.1 ± 10.3 years were finally eligible for the study. Hormonal alterations at admission were similar to sick euhormonal syndrome. Overall 7 of them had nine hormonal deficits at three months of follow up, 4 having sub normal basal cortisol level and two each had low testosterone and growth hormone and only one had thyroxine deficiency. Conclusion: Acute organophosphate poisoning results in endocrine dysfunction akin to sick euhormonal syndrome. However, in a small subset of patients, varying level of hormonal insufficiency may occur either at admission or later. These observations need re-validation in a larger group of patients with specific OPC.

  9. EFFECTS OF ORGANOPHOSPHATES ON ACUTE POISONING AND ACETYL CHOLINESTERASE INHIBITION IN ZEBRA FISH

    TH Sukirtha* MV Usharani

    2013-03-01

    Full Text Available Organophosphates (Ops. are the most widely used insecticides available today. These are a group of insecticides used in chemical sprays to kill bugs, and insects in orchards, vineyards, vegetables and cereal crops. The present study examined effects of the pesticide Methyl parathion, Dichlorvos and Chlorpyrifos on adult zebra fish were exposed to various concentrations (5, 10 & 25mg/L for 24 and 48hrs acute toxic study. Chlorpyrifos showed mortality in all concentrations and Methyl parathion and Dichlorvos showed the same in 25 mg/L. LC 50 value for Methyl parathion and Dichlorvos was 5 & 10 mg/L respectively. The total protein, LPO content was increased except SOD, Catalase in the brain tissue of the treated fishes.  There was no significant decrease in the GPX activity at 5ppm test groups. The GPX activity decreased significantly in test group treated with 10ppm and a significant difference was found between 5ppm and 10ppm test groups. The histopathological studies of brain tissue showed that neuronal degeneration and tissue damages in the brain of treated fishes when compared with the control. Ops. produce toxicity by inhibiting the cholinesterase enzymes in the nervous system. Monitoring of acetyl cholinesterase (AChE inhibition has been widely used in terrestrial and freshwater aquatic systems as an indicator of OP exposure and effects.

  10. Unexpected Diagnosis in the Metropolis: Organophosphate Poisoning

    Işıl Bavunoğlu; Musa Balta; Eda Tanrıkulu; Zeynep Türkmen; İbrahim İkizceli

    2012-01-01

    We aimed to point out that organophosphate poisoning is rarely seen in the metropolis and therefore diagnosis and treatment of these poisonings can be delayed. A 62 year old woman with a history of diabetes type II and ischemic cerebrovascular disease was admitted to the Emergency Department of Cerrahpaşa Faculty of Medicine with diarrhea. During a 24-h follow-up, dysphagia, bronchorrhea and myosis were established. The patient was investigated for cholinergic symptoms due to intoxication. To...

  11. Unexpected Diagnosis in the Metropolis: Organophosphate Poisoning

    Işıl Bavunoğlu

    2012-02-01

    Full Text Available We aimed to point out that organophosphate poisoning is rarely seen in the metropolis and therefore diagnosis and treatment of these poisonings can be delayed. A 62 year old woman with a history of diabetes type II and ischemic cerebrovascular disease was admitted to the Emergency Department of Cerrahpaşa Faculty of Medicine with diarrhea. During a 24-h follow-up, dysphagia, bronchorrhea and myosis were established. The patient was investigated for cholinergic symptoms due to intoxication. Toxicologic analysis was made and atropine treatment begun in the emergency room, and the patient was followed up for 10 days at the intensive care unit (ICU without intubation. After the muscarinic symptoms improved, atropine treatment was terminated. The patient was discharged from the ICU and followed up in the service because of continual hypoxia. At the service follow-up, intermediated syndrome manifested as paralysis and respiratory distress. Hence the patient was intubated and mechanical ventilation was begun at the ICU. After the treatment, she was discharged without any sequel. In unintentional organophosphate poisoning cases, diagnosis and the treatment can be delayed because it is rare in large cities, so that the patient and their relatives are not aware of the poisoning.

  12. [Acute poisoning by pesticides in children].

    Leveau, P

    2016-07-01

    Acute pesticide poisoning in children is rare but potentially serious. Some clinical patterns (toxidromes) are suggestive of the drug class: cholinergic crisis for organophosphate or carbamate insecticides; neurological syndrome for rodenticides; digestive and respiratory syndrome for herbicides. Treatment is symptomatic and only a few patients are treated with an antidote: atropine and pralidoxime for organophosphate insecticides, vitamin K for anticoagulant rodenticides. PMID:27266642

  13. Temperature changes among organophosphate poisoned patients, Tehran- Iran

    Talaie Haleh

    2012-10-01

    Full Text Available Abstract Background Acute poisoning with organophosphorus compounds (OPs is a major global clinical problem in the developing countries. There have been many animal studies and few human surveys on the effects of organophosphorus pesticide (OP poisoning on thermoregulation. The aim of this prospective study was to document the pattern of tympanic temperature changes among OP poisoned patients throughout the length of their hospital stay. Methods 60 patients with diagnose of organophosphate poisoning were included in this study. Questioner was filled out by trained nurses including demographic, clinical and paraclinical data. Tympanic temperature and Pulse rate data of the cases were collected on five- occasions after admission. Results There were 41 (68.3% male and 19 (31.7% female, with a mean age of 34.4 ±19.4 years (range 13–89 years. Forty five patients had intentional poisoning for suicidal attempt. At the time of entry, the mean tympanic temperature, pulse rate, respiratory rate and blood pressure (systolic and diastolic of the OP poisoned patients were respectively 37.1+/−0.6°C (36.0- 39.5, 91+/−18 (55–145, 18+/−5.6 (8–44, 116+/−20 mm Hg (70–170 and 75+/−11.6 mm Hg (40–110. 41.7% of the cases had serum butyryl cholinesterase activities (BChE ≥ 50% normal (≥1600 mU/ml. Our patients had normal temperature at the time entry (mean = 37.1. Tympanic temperature decreasing below 36°C was not detected among the patients during the study period. A rise in mean tympanic temperature was found after atropine administration. Conclusion Our study showed hypothermia was not considerable factor among organophosphate poisoned patients, although more studies with similar situations in tropical countries are needed.

  14. Comparison of two pre-exposure treatment regimens in acute organophosphate (paraoxon) poisoning in rats: Tiapride vs. pyridostigmine

    Recently, the FDA approved the medical use of oral pyridostigmine as prophylactic treatment of possible nerve agent exposure: the concept is to block the cholinesterase transitorily using the carbamate (pyridostigmine) in order to deny access to the active site of the enzyme to the irreversible inhibitor (nerve agent) on subsequent exposure. We have shown previously that tiapride is in vitro a weak inhibitor of acetylcholinesterase and that in rats administration of tiapride before the organophosphate paraoxon significantly decreases mortality. The purpose of the present study was to compare tiapride- and pyridostigmine-based pretreatment strategies, either alone or in combination with pralidoxime reactivation, by using a prospective, non-blinded study in a rat model of acute high-dose paraoxon exposure. Groups 1-6 received 1 μMol paraoxon (∼ LD75) groups 2-6 received in addition: G2 50 μMol tiapride 30 min before paraoxon; G3 50 μMol tiapride 30 min before paraoxon and 50 μMol pralidoxime 1 min after paraoxon; G4 1 μMol pyridostigmine 30 min before paraoxon; G5 1 μMol pyridostigmine 30 min before paraoxon and 50 μMol pralidoxime 1 min after paraoxon; G6 50 μMol pralidoxime 1 min after paraoxon; Mortality data were compared using Kaplan-Meier plots and logrank tests. Mortality is statistically significantly influenced by all treatment strategies. Tiapride pretreatment followed by pralidoxime treatment (G3) is aux par with pyridostigmine pretreatment followed by pralidoxime treatment (G5). Tiapride pretreatment only (G2) is inferior to pyridostigmine pretreatment only (G4). The best results are achieved with pyridostigmine pretreatment only or pralidoxime treatment only (G4 and G6)

  15. Organophosphate poisoning: Diagnosis of intermediate syndrome

    Poojara L

    2003-01-01

    Full Text Available Organophosphate compound (OPC poisoning with suicidal intent is common in Indian ICUs. The effect of OPCs is to produce a persistent depolarization of the neuromuscular junction leading to muscle weakness. After initial recovery from cholinergic crisis, some patients have resurgence of respiratory muscle paralysis requiring continued ventilatory support. This is termed intermediate syndrome (IMS. This could be due to a change in the type of neuromuscular block to a non depolarisation block characterized by a fade on tetanic stimulation. However peripheral nerve stimulation using train-of-four ratio (TOF and/tetanus have failed to consistently show such a change. We elected to study whether electro physiological monitoring using repetitive nerve stimulation might show a decremental response during IMS. Material & Methods: This was a prospective blinded study done from April 2002 to March 2003 in our ICU. 45 consecutive patients of OPC poisoning admitted during this period were included in this study. Repetitive nerve stimulation (RNS using a train of ten at 3Hz 10Hz and 30Hz (slow , intermediate and fast speeds respectively at the median nerve was done on all patients on day 1, 4, 7 and every 4th day thereafter until discharge. Patients were ventilated until ready to wean as per our usual protocol. The results of the RNS study were not revealed to the intensivist. Results: 9 out of 45 patients required ventilation for more than 6 days and showed overt signs of intermediate syndrome - proximal muscle weakness, twitching and respiratory weakness. Only 2 patients out of the 9 had a decremental response on RNS at 3Hz indicating a post-junctional dysfunction at the motor end-plate, Both patients had consumed a very large quantity of OPC and were deeply comatose for >4 days and required ventilation for >12 days. All other patients with IMS showed no changes on RNS. The exact type of poison consumed varied with each individual patient. Conclusion: RNS

  16. Organophosphorus poisoning (acute)

    Blain, Peter G

    2011-01-01

    Acetylcholinesterase inhibition by organophosphorus pesticides or organophosphate nerve agents can cause acute parasympathetic system dysfunction, muscle weakness, seizures, coma, and respiratory failure. Prognosis depends on the dose and relative toxicity of the specific compound, as well as pharmacokinetic factors.

  17. Organophosphate acetylcholine esterase inhibitor poisoning from a home-made shampoo

    Sadaka, Yair; Broides, Arnon; Tzion, Raffi Lev; Lifshitz, Matitiahu

    2011-01-01

    Organophosphate acetylcholine esterase inhibitor poisoning is a major health problem in children. We report an unusual cause of organophosphate acetylcholine esterase inhibitor poisoning. Two children were admitted to the pediatric intensive care unit due to organophosphate acetylcholine esterase inhibitor poisoning after exposure from a home-made shampoo that was used for the treatment of head lice. Owing to no obvious source of poisoning, the diagnosis of organophosphate acetylcholine ester...

  18. 21例急性有机磷农药中毒患者皮肤灼伤处理%21 cases of acute organophosphate pesticide poisoning patients with skin burns

    丁娴; 张文军; 周彬

    2011-01-01

    目的探讨急性有机磷农药中毒患者皮肤灼伤处理.方法回顾性分析我院的21例急性有机磷农药中毒患者皮肤灼伤的临床资料.结果创面浅Ⅱ度6-10天治愈,创面深Ⅱ度10-18天治愈.讨论反复进行灼伤创面清洗以及保持灼伤创面的干燥及涂抹典类制剂是灼伤创面扩大和后期感粢的重要措施.%objective to explore the acute organophosphate pesticide poisoning patients with skin burns. Methods retrospective analysis of 21 cases of acute organophosphate pesticide poisoning were burned skin clinical data. Results the wound H degrees 6-shallow 10 days. II deep wounds heal degrees 10-18 days cured. Discuss the repeated bum wounds and keep the wound clean burns dry and daub Canon agents is wound infection and later expanded burns the important measures.

  19. Massive acute arsenic poisonings.

    Lech, Teresa; Trela, Franciszek

    2005-07-16

    Arsenic poisonings are still important in the field of toxicology, though they are not as frequent as about 20-30 years ago. In this paper, the arsenic concentrations in ante- and post-mortem materials, and also forensic and anatomo-pathological aspects in three cases of massive acute poisoning with arsenic(III) oxide (two of them with unexplained criminalistic background, in which arsenic was taken for amphetamine and one suicide), are presented. Ante-mortem blood and urine arsenic concentrations ranged from 2.3 to 6.7 microg/ml, respectively. Post-mortem tissue total arsenic concentrations were also detected in large concentrations. In case 3, the contents of the duodenum contained as much as 30.1% arsenic(III) oxide. The high concentrations of arsenic detected in blood and tissues in all presented cases are particularly noteworthy in that they are very rarely detected at these concentrations in fatal arsenic poisonings. PMID:15939162

  20. Pipazethate--acute childhood poisoning.

    da Silva, O A; Lopez, M

    1977-01-01

    A previously healthy child who who had accidentally ingested an unknown quantity of 20-mg tablets of pipazethate developed severe acute poisoning with neurologic, metabolic, and cardiovascular disturbances. She recovered with symptomatic and supportive therapy. PMID:589958

  1. Carbon monoxide poisoning (acute)

    Olson, Kent; Smollin, Craig

    2010-01-01

    The main symptoms of carbon monoxide poisoning are non-specific in nature and relate to effects on the brain and heart. The symptoms correlate poorly with serum carboxyhaemoglobin levels. People with comorbidity, elderly or very young people, and pregnant women are most susceptible.Carbon monoxide is produced by the incomplete combustion of carbon fuels, including inadequately ventilated heaters and car exhausts, or from chemicals such as methylene chloride paint stripper.Poisoning is cons...

  2. Pattern of acute food, drug, and chemical poisoning in Sari City, Northern Iran.

    Ahmadi, Amirhossein; Pakravan, Nasrin; Ghazizadeh, Zeynab

    2010-09-01

    This descriptive and retrospective study was conducted at the poisoning ward of Imam teaching hospital, Sari, Iran, with the aim of evaluating the pattern of poisoning. Hence, the medical profiles of 2057 patients, who were admitted, were carefully reviewed during the period from April 2006 to March 2008 for 2 years. During this period, 2057 cases, 53.9% female and 46.1% male, were admitted with the indication of acute poisoning. The greatest proportion of poisoning occurred between the ages of 18 and 29 years, with suicidal intentions. Most cases of poisoning were intentional (85%). The most common agents involved in acute poisoning were drugs (77.7%), especially sedatives/hypnotics such as benzodiazepines, followed by opioid analgesics. Organophosphate and carbamate insecticides were the third major agent that induced poisoning. Twenty-seven patients (1.3%) who were mostly females and young adults died. Death mostly occurred due to organophosphate and carbamate insecticides (19 cases) poisoning, followed by sedatives/hypnotics like benzodiazepines (3 cases). High prevalence of intentional overdose and mortality among young adults requires considerable attention and further studies to find out the underlying causes. In addition, strict rules must be followed regarding the sale of central nervous system drugs and pesticides, particularly organophosphate and carbamate insecticides. Establishing poison information centers in different parts of the country, preparing national treatment guidelines, training healthcare providers, and ensuring easy availability of the antidotes are also recommended. PMID:20144960

  3. A comprehensive review on experimental and clinical findings in intermediate syndrome caused by organophosphate poisoning

    Acute organophosphate (OP) intoxication is important because of its high morbidity and mortality and occurrence of muscular paralysis associated by inhibition of acetylcholinesterase (AChE) activity at the neuromuscular junction. Cholinergic crisis, intermediate syndrome (IMS), and OP-induced delayed neuropathy (OPIDN) are the evidences that can be observed in OP intoxication. The main cause of morbidity due to OP poisoning is IMS that occurs 24–96 h after poisoning. Mechanisms underlying the IMS are not fully known. Although the electrophysiological aspects of delayed neuropathy are best characterized, the IMS remain very little studied. The aim of this study was to revisit current knowledge related to OP and the IMS. For this purpose, a systematic review without date limitation was performed. A total of 599 relevant articles were found and reviewed. Data were categorized according to experimental and clinical studies. Occurrences of persistent AChE inhibition, electromyography changes, muscle cell injury, and oxidative stress are the most important pieces of evidence for involvement of IMS in OP toxicity. Delayed AChE inhibition, muscle necrosis, down regulation or desensitization of postsynaptic ACh receptors, failure of postsynaptic ACh release, and oxidative stress-related myopathy are involved in IMS. Toxicokinetic factors, such as a high lipid-solubility, duration of AChE inhibition and metabolite excretion, evolution of alterations on repetitive nerve stimulation (RNS), type and frequency of muscle lesions can estimate the probability of the IMS. Plasma AChE of less than 200 units is a predictor and the 30 Hz RNS decremental response could be a useful marker for the IMS.

  4. NMDA antagonists exert distinct effects in experimental organophosphate or carbamate poisoning in mice

    Organophosphate (OP) and carbamate acetylcholinesterase (AChE) inhibitors produce seizures and lethality in mammals. Anticonvulsant and neuroprotective properties of N-methyl-D-aspartate (NMDA) antagonists encourage the investigation of their effects in AChE inhibitor-induced poisonings. In the present study, the effects of dizocilpine (MK-801, 1 mg/kg) or 3-((RS)-2-carboxypiperazin-4-yl)-propyl-1-phosphonic acid (CPP, 10 mg/kg), alone or combined with muscarinic antagonist atropine (1.8 mg/kg), on convulsant and lethal properties of an OP pesticide dichlorvos or a carbamate drug physostigmine, were studied in mice. Both dichlorvos and physostigmine induced dose-dependent seizure activity and lethality. Atropine did not prevent the occurrence of convulsions but decreased the lethal effects of both dichlorvos and physostigmine. MK-801 or CPP blocked or attenuated, respectively, dichlorvos-induced convulsions. Contrariwise, NMDA antagonists had no effect in physostigmine-induced seizures or lethality produced by dichlorvos or physostigmine. Concurrent pretreatment with atropine and either MK-801 or CPP blocked or alleviated seizures produced by dichlorvos, but not by physostigmine. Both MK-801 and CPP co-administered with atropine enhanced its antilethal effects in both dichlorvos and physostigmine poisoning. In both saline- and AChE inhibitor-treated mice, no interaction of the investigated antidotes with brain cholinesterase was found. The data indicate that both muscarinic ACh and NMDA receptor-mediated mechanisms contribute to the acute toxicity of AChE inhibitors, and NMDA receptors seem critical to OP-induced seizures

  5. A comprehensive review on experimental and clinical findings in intermediate syndrome caused by organophosphate poisoning

    Abdollahi, Mohammad, E-mail: mohammad.abdollahi@utoronto.ca; Karami-Mohajeri, Somayyeh

    2012-02-01

    Acute organophosphate (OP) intoxication is important because of its high morbidity and mortality and occurrence of muscular paralysis associated by inhibition of acetylcholinesterase (AChE) activity at the neuromuscular junction. Cholinergic crisis, intermediate syndrome (IMS), and OP-induced delayed neuropathy (OPIDN) are the evidences that can be observed in OP intoxication. The main cause of morbidity due to OP poisoning is IMS that occurs 24–96 h after poisoning. Mechanisms underlying the IMS are not fully known. Although the electrophysiological aspects of delayed neuropathy are best characterized, the IMS remain very little studied. The aim of this study was to revisit current knowledge related to OP and the IMS. For this purpose, a systematic review without date limitation was performed. A total of 599 relevant articles were found and reviewed. Data were categorized according to experimental and clinical studies. Occurrences of persistent AChE inhibition, electromyography changes, muscle cell injury, and oxidative stress are the most important pieces of evidence for involvement of IMS in OP toxicity. Delayed AChE inhibition, muscle necrosis, down regulation or desensitization of postsynaptic ACh receptors, failure of postsynaptic ACh release, and oxidative stress-related myopathy are involved in IMS. Toxicokinetic factors, such as a high lipid-solubility, duration of AChE inhibition and metabolite excretion, evolution of alterations on repetitive nerve stimulation (RNS), type and frequency of muscle lesions can estimate the probability of the IMS. Plasma AChE of less than 200 units is a predictor and the 30 Hz RNS decremental response could be a useful marker for the IMS.

  6. Spectrum of Acute Pharmaceutical and Chemical Poisoning in Northern Bangladesh

    Devendranath Sarkar

    2013-03-01

    Full Text Available Background: Acute poisoning is a major public health problem in Bangladesh. It is a common method for suicide. A clear picture regarding clinical presentation, most commonly used toxic agents, background factors and outcome of poisoned patients is necessary in every region. The aim of this study was to investigate frequency and outcome of acute pharmaceutical and chemical poisoning cases in Northern Bangladesh. Methods: This was a retrospective descriptive study on poisoned patients with 18 years of age and above who were admitted to Rangpur Medical College Hospital during 1st December 2011 to 30th November 2012. Results: During the study period, a total of 956 patients were investigated. Males slightly outnumbered females (51.6%. The majority of patients (92% were in the 18-40 year age-group. Regarding occupation, housewives were the most frequent (33.6% followed by farmers (31.7% and students (20.9%. Organophosphate compounds (OPC were the most commonly used toxic agents (73.5%. Most of poisoning cases occurred following suicidal attempts (88%. Familial disharmony was the main cause of suicidal attempts (92.3%. Univariate Analysis showed that age less than 40 years, being married, living in rural areas and educational attainment below secondary level were significantly associated with an increased risk of poisoning (P

  7. Organophosphate Poisoning-Induced Intermediate Syndrome: Can Electrophysiological Changes Help Predict Outcome?

    Jayawardane, Pradeepa; Dawson, Andrew H; Weerasinghe, Vajira; Karalliedde, Lakshman; Buckley, Nicholas A.; Senanayake, Nimal

    2008-01-01

    Editors' Summary Background. Each year, many thousands of deaths around the world are caused by pesticide poisoning. Often, the pesticide involved is an organophosphate. These highly toxic compounds, which are widely used in agriculture, particularly in developing countries, disrupt the transmission of messages from the brain to the body in insect pests and in people. The brain controls body movements by sending electrical impulses along nerve cells (neurons). At the end of the neurons, these...

  8. Pulmonary edema in acute carbon monoxide poisoning

    Acute carbon monoxide poisoning has frequently occurred in Korean, because of the coal briquette being widely used as fuel in Korean residences. Carbon monoxide poisoning has been extensively studied, but it has been sparsely reported that pulmonary edema may develop in acute CO poisoning. We have noticed nine cases of pulmonary edema in acute CO poisoning last year. Other possible causes of pulmonary edema could be exclude in all cases but one. The purpose of this paper is to describe nine cases of pulmonary edema complicated in acute CO poisoning and discuss the pathogenesis and the prognosis

  9. Organophosphorus poisoning (acute)

    Eddleston, Michael; Singh, Surjit; Buckley, Nick

    2007-01-01

    Acetylcholinesterase inhibition by organophosphorus pesticides or nerve gases can cause acute parasympathetic system dysfunction, muscle weakness, seizures, coma, and respiratory failure. Prognosis depends on the dose and relative toxicity of the specific compound, as well as pharmacokinetic factors.

  10. Presentation and management of organophosphate poisoning in an intensive care unit

    To determine the various demographic factors, clinical features, management and outcome of organophosphate poisoning in an intensive care unit (ICU) setting. Study Design: Descriptive quantitative study. Place and Duration of study: ICU of PNS Shifa hospital, Karachi. From February 2008-February 2010. Patients and Methods: Total of 40 patients were admitted in the ICU of PNS Shifa hospital, Karachi from Feb 2008- Feb 2010 with the history of organophosphate (OP) ingestion. A complete history was taken from the patients and relatives. Baseline laboratory investigations were done. All the data was tabulated on a structured performed after tasking consent from the relatives. Variables of the study were demographic factors as gender, age, cause and mode of poisoning, clinical course, ICU management and its outcome. Results: Out of 40 patients 32 (80%) were females and 8 (20%) were males. The age varied from 12-56 years. Twenty eight (70%) were in the 14-28 years age group. Twenty nine (72%) had poison for suicidal purpose and rest had the insecticide accidently. Twenty six (62%) of them were unmarried. In 38 (95%) patients the clinical features of parasympathetic overactivity was observed. All these patients were given atropine and pralidoxime. Fifteen (37%) patients required mechanical ventilation. Five (12%) out of these patients developed ventilator associated pneumonia. The time duration of mechanical ventilation was 1-3 weeks. All the patients were successfully recovered. Total duration of hospital stay on our patients was 2-4 weeks. Conclusion: Early and aggressive management of organophosphate poisoning in an ICU setting reduces not only the mortality but also decreases the duration of hospital stay. (author)

  11. Posterior reversible encephalopathy syndrome in a patient of organophosphate poisoning

    Rajesh Phatake

    2014-01-01

    Full Text Available A 32-year-old male presented with a history of consuming some organophosphorous compound with suicidal intention.He was treated with atropine, pralidoxime, ventilator support. During stay patient had persistent irritability, tachycardiaand hypertension despite sedation and labetalol infusion. He developed headache, visual blurring hemiparesis and focal seizures. Magnetic resonance imaging of the brain revealed multifocal hyperintensities mainly in subcortical areas of parietal and occipital regions in T2-weighted images, with increased values of Apparent Diffusion Coefficient, suggesting posterior reversible encephalopathy syndrome (PRES. The possibilities of PRES caused by organophosphorous poisoning either due to hypertension caused by autonomic deregulation or direct neurological toxicity has been discussed.

  12. Organophosphorus pesticide poisoning : cases and developments

    Aardema, H.; Ligtenberg, J. J. M.; Peters-Polman, O. M.; Tulleken, J. E.; Zijlstra, J. G.; Meertens, John H. J. M.

    2008-01-01

    Self-poisoning with organophosphate pesticides is a major health problem world-wide. Through the inhibition of acetylcholinesterase, organophosphorus poisoning is characterised by the clinical picture of acute cholinergic crisis. Other manifestations are the intermediate neurotoxic syndrome and dela

  13. Profile of acute mixed organophosphorus poisoning.

    Thunga, Girish; Sam, Kishore Gnana; Khera, Kanav; Xavier, Vidya; Verma, Murlidhar

    2009-06-01

    Organophosphorus (OP) pesticide self-poisoning is a major clinical and public health problem across much of rural Asia and responsible for two thirds of suicidal deaths. However, clinical reports or evidence for the management of mixed poisoning are lacking. Patients are often treated based on the type of symptoms they exhibit, and there are no specific guidelines available to treat mixed poisoning. In this case series, we report 3 acute OP poisoning cases with mixed poisons such as organochlorine, fungicide, copper sulfate, and kerosene. All 3 patients were treated successfully, with a greater focus on OP poisoning with pralidoxime and atropine infusion along with standard decontamination procedures. Because patients developed complications due to the concomitant poisons ingested, they were later treated symptomatically, and in one case, D-penicillamine was administered as antidote for copper poisoning. Mixed poisoning especially with OP compounds makes the diagnosis difficult because the clinical symptoms of OP predominate, whereas damage produced by other pesticides is late to develop and often neglected. Common treatment procedures are focused mainly on the OP poisoning ignoring the complications of other concomitant pesticides ingested. Treating physicians should be prepared and consider the possibility of mixed poisoning prevalent in that region before initiating therapy. PMID:19497478

  14. Delayed encephalopathy after acute carbon monoxide poisoning

    Mehmet İbrahim Turan

    2014-03-01

    Full Text Available Carbon monoxide poisoning is a major cause of death following attempted suicide and accidental exposures. Although clinical presentation depends on the duration and the intensity of exposure, the assessment of the severity of intoxication is difficult. A small percentage of patients who show complete initial recovery may develop delayed neurological deficits. Delayed encephalopathy after acute carbon monoxide poisoning is a rare and poor prognosis neurologic disorders and there is no specific treatment. We present a case with early onset of delayed encephalopathy after acute carbon monoxide poisoning with typical cranial imaging findings in a child with atypical history and clinical presentation.

  15. Severe chorea after acute carbon monoxide poisoning.

    Davous, P; Rondot, P; Marion, M H; Gueguen, B

    1986-01-01

    Ten days after an acute exposure to carbon monoxide, a 33-year-old woman exhibited severe chorea. CT scan revealed bilateral lucencies of the pallidum and anterior arm of the internal capsule. Chorea was successfully treated by chlorpromazine and did not relapse after treatment withdrawal. The mechanism of chorea in acute carbon monoxide poisoning is discussed.

  16. Delayed encephalopathy after acute carbon monoxide poisoning

    Mehmet İbrahim Turan; Atilla Çayır; Haşim Olgun

    2014-01-01

    Carbon monoxide poisoning is a major cause of death following attempted suicide and accidental exposures. Although clinical presentation depends on the duration and the intensity of exposure, the assessment of the severity of intoxication is difficult. A small percentage of patients who show complete initial recovery may develop delayed neurological deficits. Delayed encephalopathy after acute carbon monoxide poisoning is a rare and poor prognosis neurologic disorders and there is no specific...

  17. Acute Poisoning in Children in Bahia, Brazil

    Rodrigues Mendonça, Dilton; Menezes, Marta Silva; Matos, Marcos Antônio Almeida; Rebouças, Daniel Santos; Filho, Jucelino Nery da Conceição; de Assis, Reginara Souza; Carneiro, Leila

    2016-01-01

    Acute poisoning is a frequent accident in childhood, particularly in children under 4 years of age. This was a descriptive study with data collected from standardized forms of the Poison Control Center and patient record charts. All the cases of acute poisoning in children aged 0 to 14 years during the period 2008 to 2012 were selected. The variables studied comprised characteristics of the events and toxic agents, clinical development, and outcome. A total of 657 cases of acute poisoning, with higher frequency in the age-group from 1 to 4 years (48.7%) and male sex (53.4%), were recorded. The occurrences were accidental in 92% of the cases, and 5.8% were due to suicide attempts. Among the toxic agents, medications (28.5%), venomous animals (19.3%), nonvenomous animals (10%), household cleaning products (9.0%), and raticide agents (8.7%) predominated. The majority of cases were characterized as light (73.5%) and around 18% required hospitalization, and there was low lethality (0.5%). PMID:27335994

  18. Acute Poisoning in Children in Bahia, Brazil.

    Rodrigues Mendonça, Dilton; Menezes, Marta Silva; Matos, Marcos Antônio Almeida; Rebouças, Daniel Santos; Filho, Jucelino Nery da Conceição; de Assis, Reginara Souza; Carneiro, Leila

    2016-01-01

    Acute poisoning is a frequent accident in childhood, particularly in children under 4 years of age. This was a descriptive study with data collected from standardized forms of the Poison Control Center and patient record charts. All the cases of acute poisoning in children aged 0 to 14 years during the period 2008 to 2012 were selected. The variables studied comprised characteristics of the events and toxic agents, clinical development, and outcome. A total of 657 cases of acute poisoning, with higher frequency in the age-group from 1 to 4 years (48.7%) and male sex (53.4%), were recorded. The occurrences were accidental in 92% of the cases, and 5.8% were due to suicide attempts. Among the toxic agents, medications (28.5%), venomous animals (19.3%), nonvenomous animals (10%), household cleaning products (9.0%), and raticide agents (8.7%) predominated. The majority of cases were characterized as light (73.5%) and around 18% required hospitalization, and there was low lethality (0.5%). PMID:27335994

  19. ONE CASE REPORT OF ACUTE POISONING BY BARIUM CARBONATE

    GE Qin-min; BIAN Fan; WANG Shu-yun; SHEN Sheng-hui

    2009-01-01

    @@ Most barium poisoning cases were caused by oral intake by mistake. Recent years, barium carbonate poisoning has been rare to be reported. Here we reported a case of acute barium carbonate toxication taken orally on purpose.

  20. The Profile of Acute Poisonings in South East of Turkey

    Davut Akın; Yekta Tüzün; Timuçin Çil

    2007-01-01

    The aim of this prospective study was to analyze the rate characteristics of acute poisonning adults admitted to Departments emergency and hospitalized in Department of internal medicineAll cases of acute poisoning admitted to Dicle University Hospital, between, 2005 and 2006, were included in study. Clinical, laboratory, and demographic characteristics, type of poison and patient’s outcomes were recorded.Eighty poisoning cases included in the study. The mean age was 23±8 years and the majori...

  1. Acute organophosphorus poisoning complicated by acute coronary syndrome.

    Pankaj, Madhu; Krishna, Kavita

    2014-07-01

    We report a case of 30 year old alcoholic male admitted with vomiting, drowsiness, limb weakness and fasciculations after alleged history of consumption of 30 ml of chlorpyriphos insecticide. He had low serum cholinesterase levels. With standard treatment for organophosphorus poisoning (OPP), he improved gradually until day 5, when he developed neck and limb weakness and respiratory distress. This intermediate syndrome was treated with oximes, atropine and artificial ventilation. During treatment, his ECG showed fresh changes of ST elevation. High CPK & CPK-MB levels, septal hypokinesia on 2D echo suggested acute coronary syndrome. Coronary angiography was postponed due to his bedridden and obtunded status. The patient finally recovered fully by day 15 and was discharged. Acute coronary syndrome is a rare occurrence in OP poisoning. The present case thus emphasises the need for careful electrocardiographic and enzymatic monitoring of all patients of organophosphorus poisoning to prevent potential cardiac complication which can prove fatal. PMID:25672037

  2. Gastric lavage in patients with acute poisoning

    Montserrat Amigó Tadín

    2012-05-01

    Full Text Available Acute poisonings are a frequent complaint in emergency departments and therapy which prevents the absorption of toxic products taken orally is often indicated: one such option is gastric lavage. Gastric lavage is a digestive decontamination technique whose goal is to remove the maximum amount of poison from the stomach and prevent its absorption. The procedure involves inserting a gastric tube into the stomach through the mouth or nose; firstly to aspirate all the stomach contents and then to perform gastric washing manoeuvres. The effectiveness of gastric lavage is limited and involves a risk of iatrogenesis, and therefore the indications and contraindications should be carefully considered and the technique carried out meticulously to increase its effectiveness and reduce complications, primarily bronchoaspiration. Gastric lavage may be used in conjunction with other digestive decontamination techniques such as administration of activated charcoal. This gastric lavage protocol is based on a review of the literature on this procedure and is supported by the expertise of our research group in gastrointestinal decontamination techniques in patients with acute poisoning.

  3. Acute arsenic poisoning in two siblings.

    Lai, Melisa W; Boyer, Edward W; Kleinman, Monica E; Rodig, Nancy M; Ewald, Michele Burns

    2005-07-01

    We report a case series of acute arsenic poisoning of 2 siblings, a 4-month-old male infant and his 2-year-old sister. Each child ingested solubilized inorganic arsenic from an outdated pesticide that was misidentified as spring water. The 4-month-old child ingested a dose of arsenic that was lethal despite extraordinary attempts at arsenic removal, including chelation therapy, extracorporeal membrane oxygenation, exchange transfusion, and hemodialysis. The 2-year-old fared well with conventional therapy. PMID:15995066

  4. Cortical blindness in acute carbon monoxide poisoning.

    Katafuchi, Y; Nishimi, T; Yamaguchi, Y; Matsuishi, T; Kimura, Y; Otaki, E; Yamashita, Y

    1985-01-01

    A 3-year-old boy had persistent cortical blindness following acute carbon monoxide poisoning. He was believed to have suffered anoxic brain damage due to incomplete combustion of the briquette-type solid fuel. Computed tomographic (CT) scan of the brain and visual evoked potentials (VEP) in the early stage were normal. However, on the 20th hospital day CT scan showed leukomalacia and VEP showed an absence of N1-, and P1-waves which was well correlated with the clinical feature at that time. PMID:4083389

  5. Acute Anterolateral Myocardial Infarction Due to Aluminum Phosphide Poisoning

    Bita Dadpour; Zohre Oghabian

    2013-01-01

    Aluminum phosphide (AlP) is a highly effective rodenticide which is used as a suicide poison. Herein, a 24 year-old man who’d intentionally ingested about 1liter of alcohol and one tablet of AlP is reported. Acute myocardial infarction due to AlP poisoning has been occurred secondary to AIP poisoning. Cardiovascular complications are poor prognostic factors in AlP poisoning

  6. Acute Anterolateral Myocardial Infarction Due to Aluminum Phosphide Poisoning

    Bita Dadpour

    2013-08-01

    Full Text Available Aluminum phosphide (AlP is a highly effective rodenticide which is used as a suicide poison. Herein, a 24 year-old man who’d intentionally ingested about 1liter of alcohol and one tablet of AlP is reported. Acute myocardial infarction due to AlP poisoning has been occurred secondary to AIP poisoning. Cardiovascular complications are poor prognostic factors in AlP poisoning

  7. Comparative Study of Continuous Pralidoxime Infusion versus Intermittent Dosing: Application of High-Performance Liquid Chromatography Method on Serum of Organophosphate Poisoned Patients

    Girish Thunga

    2013-09-01

    How to cite this article: Thunga G, Pandey S, Nair S, Mylapuri R, Vidyasagar S, Kunhikatta V, et al. Comparative Study of Continuous Pralidoxime Infusion versus Intermittent Dosing: Application of High-Performance Liquid Chromatography Method on Serum of Organophosphate Poisoned Patients. Asia Pac J Med Toxicol 2013;2:105-10.

  8. Pesticide use and self-reported symptoms of acute pesticide poisoning among aquatic farmers in Phnom Penh, Cambodia

    Jensen, Hanne Klith; Konradsen, Flemming; Jørs, Erik;

    2011-01-01

    associated with the number of hours spent spraying with OPs/CMs (OR = 1.14, CI 95%: 1.02-1.28). The higher educated farmers reduced their risk of poisoning by 55% for each extra personal protective measure they adapted (OR = 0.45, CI 95%: 0.22-0.91). These findings suggest that improving safe pesticide......Organophosphates and carbamates (OPs/CMs) are known for their acetylcholinesterase inhibiting character. A cross-sectional study of pesticide handling practices and self-perceived symptoms of acute pesticide poisoning was conducted using questionnaire-based interviews with 89 pesticide sprayers in...... Boeung Cheung Ek (BCE) Lake, Phnom Penh, Cambodia. The study showed that 50% of the pesticides used belonged to WHO class I + II and personal protection among the farmers were inadequate. A majority of the farmers (88%) had experienced symptoms of acute pesticide poisoning, and this was significantly...

  9. Acute Pancreatitis Caused By Mushroom Poisoning

    Karahan, Samet; Erden, Abdulsamet; Cetinkaya, Ali; Avci, Deniz; Ortakoyluoglu, Adile Irfan; Karagoz, Hatice; Bulut, Kadir; Basak, Mustafa

    2016-01-01

    Of the more than 5000 species of mushrooms known, 100 types are toxic and approximately 10% of these toxic types can cause fatal toxicity. A type of mushroom called Amanita phalloides is responsible for 95% of toxic mushroom poisonings. In this article, we report 2 cases of mushroom poisonings caused by Lactarius volemus, known as Tirmit by the local people. The patient and his wife were admitted to the emergency room with abdominal pain, nausea, and vomiting 20 hours after consuming Lactarius volemus, an edible type of mushroom. The patients reported that they had been collecting this mushroom from the mountains and eating them for several years but had never developed any clinicopathology to date. Further examination of the patients revealed a very rare case of acute pancreatitis due to mushroom intoxication. The male patient was admitted to the intensive care unit while his wife was followed in the internal medicine service, because of her relative mild clinical symptoms. Both patients recovered without sequelae and were discharged. In this article, we aimed to emphasize that gastrointestinal symptoms are often observed in mushroom intoxications and can be confused with acute pancreatitis, thus leading to misdiagnosis of patients. Early diagnosis and appropriate treatment can improve patients’ prognosis and prevent the development of complications. PMID:26835473

  10. Acetylcholinesterase inhibition as an indicator of organophosphate and carbamate poisoning in Kenyan agricultural workers.

    Ohayo-Mitoko, G.J.A.; Heederik, D.; Kromhout, H.; Omondi, B.E.O.; Boleij, J.S.M.

    1997-01-01

    Acetylcholinesterase inhibition was determined for 666 Kenyan agricultural workers; 390 (58.6%) mainly pesticide applicators exposed to organophosphate and carbamate pesticides and 276 (41.4%) unexposed controls from four rural agricultural areas during 1993 and 1994. Baseline levels were depressed

  11. Pre-hospital treatment of acute poisonings in Oslo

    Nore Anne K; Bjornaas Mari A; Hovda Knut E; Heyerdahl Fridtjof; Figueiredo Jose CP; Ekeberg Oivind; Jacobsen Dag

    2008-01-01

    Background Poisoned patients are often treated in and discharged from pre-hospital health care settings. Studies of poisonings should therefore not only include hospitalized patients. Aims: To describe the acutely poisoned patients treated by ambulance personnel and in an outpatient clinic; compare patients transferred to a higher treatment level with those discharged without transfer; and study the one-week mortality after pre-hospital discharge. ...

  12. The Profile of Acute Poisonings in South East of Turkey

    Davut Akın

    2007-01-01

    Full Text Available The aim of this prospective study was to analyze the rate characteristics of acute poisonning adults admitted to Departments emergency and hospitalized in Department of internal medicineAll cases of acute poisoning admitted to Dicle University Hospital, between, 2005 and 2006, were included in study. Clinical, laboratory, and demographic characteristics, type of poison and patient’s outcomes were recorded.Eighty poisoning cases included in the study. The mean age was 23±8 years and the majority of the patients (75% were in 15-25 years of ages. 85% of acute poisonings were self-inflicted. Medical drugs overdose were the major cause (62.5% of intoxication followed by agricultural chemicals (35%. The most frequently involved medicinal drugs were psychiatric drugs (20% and paracetamol (17.5%. There was a high rate of suicides attemp in groups of young singles, females, crowded families, patients with low education status, and patient living in cities.

  13. Reversal of Cardiovascular Toxicity in Severe Organophosphate Poisoning with 20% Intralipid Emulsion Therapy: Case Report and Review of Literature

    Shafat Ahmad Mir

    2014-12-01

    Full Text Available Background: Cardiac toxicity is one of the life-threatening effects of severe organophosphate (OP poisoning. We presented a patient with severe OP poisoning, in cardiovascular shock poorly responsive to conventional treatments, who could be resuscitated successfully with intravenous lipid emulsion (ILE therapy. Case report: A 26-year-old female was admitted to our emergency department who had ingested unquantifiable amount of parathion. On admission, she was tachycardic, tachypneic and hypotensive with pin-point pupils. Neurological examination revealed Glasgow coma scale (GCS of 6. Immediately, she was admitted to intensive care unit, and was intubated and put under mechanical ventilation. Standard treatments including atropine and pralidoxime (according to WHO protocol were given to the patient. However, the patient did not show favorable response to antidotes and supportive treatments and her condition continued to deteriorate. Because of bradycardia and hypotension, she was given noradrenaline vasopressor support. Due to failure of treatments in improvement of the patient's condition, a single 100 mL bolus (1.5 mL/kg of 20% intralipid was administered intravenously and the same dose repeated 2 minutes later. Over 15 minutes, cardiovascular condition of the patient noticeably improved. ILE was continued up to a total dose of 300 mL when extrasystoles disappeared. The patient could be extubated from ventilator with GCS score of 15 on the 5th day of admission. Discussion: OPs are lipid soluble and ILE can move these kinds of compounds away from the site of toxicity and dissolve them in the plasma which will alleviate their toxic effects. Conclusion: This is the first human case report of OP poisoning which showed efficacy of intralipids as antidotal therapy outside the accepted setting of local anesthetic toxicity.

  14. Acute carbon monoxide poisoning alters hemorheological parameters in human.

    Ozturk, Baris; Arihan, Okan; Coskun, Figen; Dikmenoglu-Falkmarken, Neslihan H

    2016-01-01

    Acute carbon monoxide (CO) poisoning seriously hinders oxygen delivery to tissues. This harmful effect of CO may be aggravated by accompanying changes in the viscosity of blood. We had previously reported increased plasma viscosity in people chronically exposed to CO. This study was planned to test our hypothesis that acute CO poisoning increases blood viscosity. For this purpose four main parameters contributing to blood viscosity - hematocrit, erythrocyte deformability, erythrocyte aggregation and plasma viscosity - were determined in patients with acute CO poisoning and compared with healthy controls. Plasma viscosity and erythrocyte aggregation tendency were lower in the CO group (p <  0.05). Erythrocyte deformability was also lower in CO group (p <  0.05). Our results indicate that acute CO poisoning has diverse effects on hemorheological parameters such as attenuating hematocrit value, plasma viscosity, erythrocyte aggregation tendency and erythrocyte deformability. PMID:25536918

  15. Antidotal effects of varthemia persica DC extract in organophosphate poisoning or warfare agents by measuring whole blood acetylcholinesterase

    The organophosphates (ORPs) or war fare agents toxicity results from inhibition of acetylcholinesterase (AchE). phosphylation of the active serin of AchE leads to accumulation of acetylcholine in synaptic clefts leading to generalized cholinergic over-stimulation. Standard treatment of ORP poisoning includes a muscarinic antagonist such as Atropine, and acetylcholinesterase reactivator (oxime). Presently, oximes like abidoxime and pralidoxime are approved as antidotes against ORP poisoning but are considered to be rather ineffective against certain ORP. Like Soman. In this study, the protective effect of Varthemia persica DC extract on acetylcholinesterase was examined in rats. Animals in weight range of 200-225 g were divided in 8 groups. The negative control group received only 0.4 ml normal saline, reference group, received ethylparaoxone in dose of 50 percent of LD50, positive control group, received ethylparaoxone (50% LD50) and one minute later 50 mol of pralidoxime. Test group 1: received ethylparaoxone and one minute later single dose of methanolic extract of Varthemia persica (250 mg/kg), Test Group 2: daily received methanolic extract of V.persica (250 mg/kg) in six days and one minute after last dose of extract, ethylparaoxone (50% LD50) were injected, Test Group 3: received ethylparaoxone (50% LD50) and then six doses of methanolic extract of V.persica (250 mg/kg) in six continuous days. Test Group 4: received ethylparaoxone and then single dose of dichloromethane extract of V.persica (250 mg/kg). Test Group 5: received ethylparaoxone and one minute later single high dose of methanolic extract of V.persica (1000 mg/kg). Then blood withdrawn and acetylcholinesterase activity was measured according to modified Ellman's method. Only in groups which received extract of V. persica before and after injection of ethylparaoxone, the mean of acetylcholinesterase activity was significantly different with reference group (p 0.05) but no significant difference with

  16. Emergency care outcomes of acute chemical poisoning cases in Rawalpindi

    Ibrar Rafique; Umbreen Akhtar; Umar Farooq; Mussadiq Khan; Junaid Ahmad Bhatti

    2016-01-01

    Objective: To assess the emergency care outcomes of acute chemical poisoning cases in tertiary care settings in Rawalpindi, Pakistan. Methods: The data were extracted from an injury surveillance study conducted in the emergency departments (ED) of three tertiary care hospitals of Rawalpindi city from July 2007 to June 2008. The World Health Organization standard reporting questionnaire (one page) was used for recording information. Associations of patients' characteristics with ED care outcomes, i.e., admitted vs. discharged were assessed using logistic regression models. Results: Of 62 530 injury cases reported, chemical poisoning was identified in 434 (0.7%) cases. The most frequent patient characteristics were poisoning at home (61.9%), male gender (58.6%), involving self-harm (46.0%), and youth aged 20–29 years (43.3%). Over two-thirds of acute poisoning cases (69.0%) were admitted. Acute poisoning cases were more likely to be admitted if they were youth aged 10–19 years [odds ratio (OR)=4.41], when the poisoning occurred at home (OR=21.84), and was related to self-harm (OR=18.73) or assault (OR=7.56). Conclusions: Findings suggest that controlling access of poisonous substances in youth and at homes might reduce related ED care burden. Safety promotion agencies and emergency physicians can use these findings to develop safety messages.

  17. Pesticide Use and Self-Reported Symptoms of Acute Pesticide Poisoning among Aquatic Farmers in Phnom Penh, Cambodia

    Hanne Klith Jensen

    2011-01-01

    Full Text Available Organophosphates and carbamates (OPs/CMs are known for their acetylcholinesterase inhibiting character. A cross-sectional study of pesticide handling practices and self-perceived symptoms of acute pesticide poisoning was conducted using questionnaire-based interviews with 89 pesticide sprayers in Boeung Cheung Ek (BCE Lake, Phnom Penh, Cambodia. The study showed that 50% of the pesticides used belonged to WHO class I + II and personal protection among the farmers were inadequate. A majority of the farmers (88% had experienced symptoms of acute pesticide poisoning, and this was significantly associated with the number of hours spent spraying with OPs/CMs (OR = 1.14, CI 95%: 1.02–1.28. The higher educated farmers reduced their risk of poisoning by 55% for each extra personal protective measure they adapted (OR = 0.45, CI 95%: 0.22–0.91. These findings suggest that improving safe pesticide management practices among the farmers and enforcing the effective banning of the most toxic pesticides will considerably reduce the number of acute pesticide poisoning episodes.

  18. Respiratory Failure in Acute Organophosphorus Pesticide Self-Poisoning

    Eddleston, Michael; Mohamed, Fahim; Davies, James OJ; Eyer, Peter; Worek, Franz; Sheriff, Mh Rezvi; Buckley, Nick A.

    2006-01-01

    Background: Acute organophosphorus (OP) pesticide poisoning is a major clinical problem in the developing world. Textbooks ascribe most deaths to respiratory failure occurring in one of two distinct clinical syndromes - acute cholinergic respiratory failure or the intermediate syndrome. The delayed failure appears to be due to respiratory muscle weakness, but its pathophysiology is not yet clear.

  19. Acute Pancreatitis Caused By Mushroom Poisoning

    Karahan, Samet; Erden, Abdulsamet; Cetinkaya, Ali; Avci, Deniz; Ortakoyluoglu, Adile Irfan; Karagoz, Hatice; BULUT, Kadir; Basak, Mustafa

    2016-01-01

    Of the more than 5000 species of mushrooms known, 100 types are toxic and approximately 10% of these toxic types can cause fatal toxicity. A type of mushroom called Amanita phalloides is responsible for 95% of toxic mushroom poisonings. In this article, we report 2 cases of mushroom poisonings caused by Lactarius volemus, known as Tirmit by the local people. The patient and his wife were admitted to the emergency room with abdominal pain, nausea, and vomiting 20 hours after consuming Lactariu...

  20. A CLINICAL PROFILE OF ACUTE POISONING

    Vaddadi

    2015-04-01

    Full Text Available 100 patients were studied to know the common poisons, age, sex, clinical manifestations, response to treatment, motive behind the consumption and prognostic factors. Out of 100 cases, most of them committed this with suicidal intention, 21 - 30 age group, males, insecticide poison consumed were affected. 70% of them had domestic problems as the main reason to commit this extreme step. Those who reached early to the hospital had recovered well with a mortality rate of 7%.

  1. CLINICAL STUDY OF ACUTE POISONING: A RETROSPECTIVE STUDY

    Praveen

    2014-11-01

    Full Text Available : OBJECTIVES: To determine the common agents, clinical features and outcomes of acute poisoning. MATERIALS AND METHODS: A retrospective study of patients of acute poisoning of more than 14 years age admitted through emergency with a history of intentional, self-inflicted and suicidal poisoning in SRMS-IMS from Jan 2010 to Dec 2012. RESULTS: A total of 58 cases were included with a common age of affection 16 to 25 years and male to female ratio 1.63: 1. Poisoning cases occur throughout the year with maximum prevalence in May and minimum in June. Organophosphorus was the most common poison followed by aluminium phosphide. Vomiting was the most common symptoms followed by altered sensorium. 70.68% patients were discharged, 20.68% expired and 8.62% left against medical advice. Aluminium phosphide was the most common toxin consumed by dead patients. CONCLUSION: Acute poisoning is commonly affecting young population and is caused by variety of toxin. High mortality is associated with aluminum phosphide.

  2. Therapy against organophosphate poisoning: The importance of anticholinergic drugs with antiglutamatergic properties

    Potent cholinesterase inhibitors (e.g., soman, sarin), induce a wide range of deleterious effects including convulsions, behavioral impairments and ultimately, death. Due to the likelihood of various scenarios of military or terrorist attacks by these and other chemical weapons, research has to be aimed at finding optimal therapies. Early accumulation of acetylcholine in synaptic clefts was suggested to trigger an array of toxic events including an excessive release of glutamate, culminating in the activation of its receptors. Stimulation of the N-Methyl-D-Aspartate (NMDA) subtype of these receptors was associated with the neuronal injury that initiates organophosphate-induced brain damage. The notion of a stepwise mechanism yielded treatments based on a combination of an immediate administration of enzyme reactivators and anticholinergic drugs. This strategy dramatically increased survival rates but did not abolish convulsions and failed to prevent the ensuing cognitive dysfunction. Efforts to improve this paradigm by adding anticonvulsants or antiglutamatergic drugs with anti-epileptic characteristics produced dubious results. Under these conditions, benactyzine and caramiphen, agents with anticholinergic and antiglutamatergic properties, provided improved protection when introduced as adjunct agents to oximes, reversible cholinesterase inhibitors and/or specific antimuscarinic drugs such as atropine. In contrast, the specific antimuscarinic drug scopolamine failed to block soman-induced changes in glutamatergic and behavioral parameters even when given prophylactically. These findings along with a large number of additional reports led towards the conclusion that the therapeutic advantage of drugs such as benactyzine and caramiphen could derive from their ability to modulate central cholinergic and glutamate neurotransmission

  3. Acute Pancreatitis in the Course of Meprobamate Poisoning

    Neila Fathallah

    2011-07-01

    Full Text Available Context We report a case of massive poisoning with meprobamate leading to acute pancreatitis. Case report A 43-year-old patient with a history of schizophrenia and multiple suicide attempts was admitted to the intensive care unit for severe poisoning with meprobamate (voluntary ingestion of 60 g. On admission, the patient was deeply comatose with low blood pressure and hypothermia. Laboratory analysis revealed leukocytosis and high lipase and amylase serum levels. There was no eosinophilia. Abdominal computed tomography showed pancreatitis grade A. The patient was intubated and ventilated, and intravenous dopamine was infused. The patient regained consciousness and was extubated five days later. Improvement in pancreatic tests was noted several days later. The outcome was favorable. Discussion According to the Naranjo probability scale, meprobamate-induced acute pancreatitis was probable. Acute pancreatitis in meprobamate poisoning is exceptional. The pathogenesis of pancreatitis-induced meprobamate poisoning may be explained by two mechanisms: stimulation of pancreatic secretion secondary to cholinergic activation and pancreatic ductal hypertension. Conclusions The signs of severe meprobamate toxicity are numerous including cardiovascular and central nervous symptoms. Acute pancreatitis should also be added as a possible manifestation of meprobamate poisoning.

  4. Pre-hospital treatment of acute poisonings in Oslo

    Nore Anne K

    2008-11-01

    Full Text Available Abstract Background Poisoned patients are often treated in and discharged from pre-hospital health care settings. Studies of poisonings should therefore not only include hospitalized patients. Aims: To describe the acutely poisoned patients treated by ambulance personnel and in an outpatient clinic; compare patients transferred to a higher treatment level with those discharged without transfer; and study the one-week mortality after pre-hospital discharge. Methods A one-year multi-centre study with prospective inclusion of all acutely poisoned patients ≥ 16 years of age treated in ambulances, an outpatient clinic, and hospitals in Oslo. Results A total of 3757 health service contacts from 2997 poisoning episodes were recorded: 1860 were treated in ambulances, of which 15 died and 750 (40% were discharged without transfer; 956 were treated in outpatient clinic, of which 801 (84% were discharged without transfer; and 941 episodes were treated in hospitals. Patients discharged alive after ambulance treatment were mainly poisoned by opiates (70%, were frequently comatose (35%, had respiratory depression (37%, and many received naloxone (49%. The majority of the patients discharged from the outpatient clinic were poisoned by ethanol (55%, fewer were comatose (10%, and they rarely had respiratory depression (4%. Among the hospitalized, pharmaceutical poisonings were most common (58%, 23% were comatose, and 7% had respiratory depression. Male patients comprised 69% of the pre-hospital discharges, but only 46% of the hospitalized patients. Except for one patient, who died of a new heroin overdose two days following discharge from an ambulance, there were no deaths during the first week after the poisonings in the 90% of the pre-hospital discharged patients with known identity. Conclusion More than half of the poisoned patients treated in pre-hospital treatment settings were discharged without transfer to higher levels. These poisonings were more often

  5. Profile of acute poisoning in three health districts of Botswana

    Mary Kasule

    2009-04-01

    Full Text Available Background: This study sought to characterise acute poisoning cases seen in three health districts of Botswana.Method: A retrospective review of patients’ records was conducted and included patients treated from January 2004 to December 2005. Data on the demographic status of the patients, information about the poisonous agent(s involved, and the circumstances and outcomes of the poisoning incidents were recorded on a pre-tested data collection form.Results: A total of 590 cases of acute poisoning were included in the analysis. The most affected age category was that of children aged less than six years, who constituted 33.4% of the cases. Most incidents were recorded in the urban district of Gaborone. Seventy-eight percent (78% of the incidents were accidental, with the remainder being intentional. The poisonous agents involved were pharmaceuticals (26.6%, natural toxins (25.6%, household products (14.6%, foods (14.4%, alcohol (6.9%, traditional medicines (4.7%, unspecified agents (3.2%, and agrochemicals (2.7%. The most common route of poison exposure was by oral (82.2%, followed by dermal contact (16.5%, while the inhalation of gases occurred in 1.2% of cases. An incidence rate of 4.7/1000, a case fatality rate of 3.8/100, and 1.5% of deaths were recorded over the two-year period.Conclusion: In conclusion, it can be stated that acute poisoning involved mainly young children and resulted in an incidence rate of 4.7/1000, a case fatality rate of 3.8/100, and 1.5% of deaths over the two-year period. There were differences based on age category, gender and residence of the victims, the types of toxic agents involved, as well as the circumstances and the outcomes of the poisoning incidents. Given the fact that pharmaceuticals, natural toxins, household products and foods were the agents most commonly involved, targeted interventions should take these differences into account in addressing the problem of acute poisoning.

  6. Assessing the connection between organophosphate pesticide poisoning and mental health: A comparison of neuropsychological symptoms from clinical observations, animal models and epidemiological studies.

    Stallones, Lorann; Beseler, Cheryl L

    2016-01-01

    Psychiatry and psychology are beginning to recognize the importance of lead, mercury and heavy metals as causal partners in the development of mental disorders. Further, mental health researchers and clinicians are embracing the idea that the combined effects of genetics and environmental exposures can result in perturbations in brain neurochemistry leading to psychiatric disorders. The purpose of this review is to examine the biological foundations for the epidemiological observations previously identified by reviewing the toxicology literature and relating it to epidemiological studies addressing the role of poisoning with organophosphate pesticides (OPs) in neurobehavioral and neuropsychological disorders. The goal of this review is to raise awareness in the mental health community about the possibility that affective disorders might be the result of contributions from environmental and occupational pesticide poisoning. PMID:26654853

  7. Acute myocardial infarction: Can it be a complication of acute organophosphorus compound poisoning?

    Joshi, P.; P Manoria; Joseph, D., T.; Z Gandhi

    2013-01-01

    Organophosphorus compounds are used as pesticides and represent a common cause of poisoning in developing countries including India due to their widespread availability and use. Toxicity due to these agents can affect many organs including heart. Here, we report a case of acute organophosphorus poisoning (parathion), followed by acute myocardial infarction; documented by clinical features, electrocardiographic changes, and elevated cardiac enzymes. Myocardial infarction has been rarely report...

  8. Acute aluminium phosphide poisoning, what is new?

    Yatendra Singh

    2014-01-01

    Full Text Available Aluminium phosphide (AlP is a cheap solid fumigant and a highly toxic pesticide that is commonly used for grain preservation. AlP has currently generated interest with increasing number of cases in the past four decades because of its increased use for agricultural and nonagricultural purposes, and also its easy availability in the markets has led to its increased misuse to commit suicide. Ingestion is usually suicidal in intent, uncommonly accidental and rarely homicidal. The poison affects all systems, shock, cardiac arrhythmias with varied ECG changes and gastrointestinal features being the most prominent. Diagnosis is made on the basis of clinical suspicion, a positive silver nitrate paper test to phosphine, and gastric aspirate and viscera biochemistry. Treatment includes early gastric lavage with potassium permanganate or a combination of coconut oil and sodium bicarbonate, administration of charcoal and palliative care. Specific therapy includes intravenous magnesium sulphate and oral coconut oil. Unfortunately, the lack of a specific antidote Results in very high mortality and the key to treatment lies in rapid decontamination and institution of resuscitative measures. This article aims to identify the salient features and mechanism of AlP poisoning along with its management strategies and prognostic variables.

  9. Acute mercury poisoning: a case report

    Aktas Can

    2010-03-01

    Full Text Available Abstract Background Mercury poisoning can occur as a result of occupational hazard or suicide attempt. This article presents a 36-year-old case admitted to emergency department (ED due to exposure to metallic mercury. Case Presentatıon A 36-year-old woman presented to the ED with a three-day history of abdominal pain, diarrhea and fever. One week ago her daughter had brought mercury in the liquid form from the school. She had put it on the heating stove. One day later, her 14-month old sister baby got fever and died before admission to the hospital. Her blood pressure was 134/87 mmHg; temperature, 40.2°C; heart rate 105 bpm and regular; respiration, 18 bpm; O2 saturation, 96%. Nothing was remarkable on examination and routine laboratory tests. As serine or urinary mercury levels could not be tested in the city, symptomatic chelation treatment with N-acetyl cysteine (NAC was instituted with regard to presumptive diagnosis and history. At the 7th day of admission she was discharged without any sequelae or complaint. At the discharge day blood was drawn and sent for mercury levels which turned out to be 30 μg/dL (normal range: 0 - 10 μg/dL. Conclusion Public education on poisoning and the potential hazards of mercury are of vital importance for community health.

  10. An Unusual Cause of Supraventricular Tachycardia: Acute Carbon Monoxide Poisoning

    Suat Zengin

    2014-03-01

    Full Text Available      Carbon monoxide (CO is a toxic gas produced by the incomplete combustion of carbon-containing compounds. Exposure to high concentrations of CO can be letha and is the most common cause of death from poisoning worldwide. Cardiac manifestations after exposure to CO, including myocardial ischemia, heart failure, and arrhythmias, have been reported. A 28-year-old a patient was admitted to our emergency department with altered consciousness as a consequence of acute domestic exposure to CO from a stove. His carboxyhemoglobin level was 39%. The oxygen treatment was started promptly, and therapeutic red cell exchange was performed. An electrocardiogram revealed supraventricular tachycardia (SVT, and an echocardiographic examination demonstrated normal cardiac functions. To the best of our knowledge, this study is the second to report a case of SVT attack due to acute CO intoxication. This paper discusses the management of this complication in patients poisoned with CO.

  11. Respiratory Complications from Acute Corrosive Poisonings in Adults

    Chibishev, Andon; Simonovska, Natasa; Bozinovska, Cvetanka; Pereska, Zanina; Smokovski, Ivica; Glasnovic, Marija

    2014-01-01

    Introduction: Acute corrosive poisonings are caused by ingestion of corrosive chemicals which are most commonly used as household agents. Intoxications with these kind of agents produce numerous and severe post-corrosive complications of the upper gastrointestinal tract. On the other hand, our experience showed that corrosive agents may also cause injuries of the respiratory system, which makes the treatment very hard and additionally complicates the severe clinical condition of the patient. ...

  12. Prognostic Significance of Various Biochemical Parameters in Acute Organophosphorus Poisoning

    Sumathi, M. E.; Kumar, S. Harish; Shashidhar, K N; Takkalaki, Nandini

    2014-01-01

    Background: Organophosphorus (OP) compounds are a heterogeneous group of insecticides widely used in agricultural industry. These OP compounds are likely to have more adverse effects in developing countries like India due to its easy availability and less awareness which results in high morbidity and mortality. Aims and objectives: 1. To estimate plasma cholinesterase, amylase, lipase and, creatine phosphokinase (CPK) in acute OP poisoning. 2. To correlate these biochemical parameters with pl...

  13. Cases of Acute Poisoning in Southeast Anatolia of Turkey

    Cahfer Güloğlu

    2004-01-01

    Full Text Available This study was conducted to determine the biological effects of acute poisoning, nature ofagents involved and pattern of poisoning during 2000 in Diyarbakır City in Southeast AnatolianRegion of Turkey.Data from hospital records of all admissions to Emergency Department (ED of Dicle UniversityHospital following acute poisoning collected retrospectively were analysed for the period January toDecember in 2000. Present study included 44 (25.9% male (M and 126 (74.1% female (F, a total170 consecutive patients. A M/F ratio was found as 1.0/3.5 in the study.Mean age of cases was 23.3±6.3 years old; 63 (37.1% of them were under age of 20 years oldand 147 (86.5% of them were under age of 30 years old. Cases of intoxication have admitted insummer season (93 of 170 patients, especially in April, May and July (24, 26 and 30 patients,respectively. Sixty-two (36.5% cases due to accidental, 108 (63.5% cases due to suicidal goal. Thecases of suicidal purposeful intoxications were mostly determined in females (77 cases, 71.3%,p<0.05, and singles (74 cases, 68.5%, p<0.05. There were only two deaths (1.2% among the 170admissions of acute poisonings during hospitaliztion. One of the deaths was due to pesticides; otherone was due to abuse of medical drug. According to physical examination, tachycardia (59, 34.7%,vomit history (55, 32.4%, and unconsciousness (42, 24.7% were frequently observed; however,hypersecretion (15, 8.8%, bradycardia (5, 2.9%, convulsion (8, 4.7%, and hipertension (2, 1.2%,were seen rarely. Cases who poisoned with pesticide compared other cases have had significantlyhigher rate of convulsion (6, 10.2%, miosis (6, 10.2%, and hypersecretion (12, 20.3% (p=0.018,p<0.0001 and p<0.0001, respectively.In our region, pesticides intoxication especially affected to young unmarried females, and mostof them resulted from suicidal purpose. The annual rate of poisoning-related ED visits and mortalitywere within the reported ranges, psychoactive agents being

  14. Assessing biomarkers and neuropsychological outcomes in rural populations exposed to organophosphate pesticides in Chile – study design and protocol

    Ramirez-Santana, M.; Zuniga, L.; S Corral; R. Sandoval; Scheepers, P.T.J.; Velden, K. van der; Roeleveld, N.; Pancetti, F.

    2015-01-01

    BACKGROUND: Health effects of pesticides are easily diagnosed when acute poisonings occurs, nevertheless, consequences from chronic exposure can only be observed when neuropsychiatric, neurodegenerative or oncologic pathologies appear. Therefore, early monitoring of this type of exposure is especially relevant to avoid the consequences of pathologies previously described; especially concerning workers exposed to pesticides on the job. For acute organophosphate pesticides (OPP) exposure, two b...

  15. Acute pesticide poisoning--a global public health problem

    Konradsen, Flemming

    2007-01-01

    Acute pesticide poisoning has become a major public health problem worldwide, following the intensification of agriculture and the promotion of agro-chemicals in low and middle income countries, with more than 300,000 deaths each year. The easy availability of highly toxic pesticides in the homes...... of farming communities has made pesticides the preferred means of suicide with an extremely high case fatality. Similarly, the extensive use of pesticides exposes the community to both long-term and acute occupational health problems. A concerted effort is urgently needed to address the situation....

  16. Bioconcentration and Acute Intoxication of Brazilian Freshwater Fishes by the Methyl Parathion Organophosphate Pesticide.

    de Salles, João Bosco; Lopes, Renato Matos; de Salles, Cristiane M C; Cassano, Vicente P F; de Oliveira, Manildo Marcião; Bastos, Vera L F Cunha; Bastos, Jayme Cunha

    2015-01-01

    Three species of freshwater Brazilian fishes (pacu, Piaractus mesopotamicus; piavussu, Leporinus macrocephalus, and curimbatá, Prochilodus lineatus) were exposed to an acute dose of 5 ppm methyl parathion organophosphate pesticide. Three to five individuals per species were exposed, one at a time, to 40 liters tap water spiked with Folidol 600. Pesticide concentrations and cholinesterase (ChE) activities were evaluated in serum, liver, brain, heart, and muscle. The bioconcentration of methyl parathion was similar for all studied fishes. Brain tissue showed the highest pesticide concentration, reaching 80 ppm after exposure for 30 min to methyl parathion. Three to 5 hours of 5 ppm methyl parathion exposure provoked the death of all P. lineatus at 92% brain AChE inhibition, whereas fish from the other two species survived for up to 78 hours with less than 80% brain AChE inhibition. Our results indicate that acute toxic effects of methyl parathion to fish are correlated with brain AChE sensitivity to methyl paraoxon. PMID:26339593

  17. Correlation between Cholinesterase and Paraoxonase 1 Activities: Case Series of Pesticide Poisoning Subjects

    S Austin Richard

    2013-08-01

    Full Text Available Introduction: Acute exposure to pesticide due to suicidal poisoning is the most extensive cause of pesticide exposure, compared with all other causes including agricultural or industrial exposure. Organophosphate (OP and carbamate group of pesticides can inhibit acetylcholinesterase; on the other hand, paraoxonase1 can detoxify organophosphate poisoning by hydrolyzing organophosphate metabolites. Methods: We have compared the serum paraoxonase1 status and cholinesterase activity of subjects who attempted to commit suicide by consuming OP pesticide. Cholinesterase and paraoxonase1 activity were measured spectrophotometrically using butyrylthiocholine and phenyl acetate as substrates, respectively. Results: A positive correlation was found between serum paraoxonase1 activity and cholinesterase activity among pesticide consumed subjects. Conclusion: Our results suggest that subjects with higher paraoxonase1 activity may have a better chance of detoxifying the lethal effect of acute organophosphate poisoning.

  18. Pralidoxime in Acute Organophosphorus Insecticide Poisoning-A Randomised Controlled Trial

    Eddleston, M; Eyer, P; Worek, F.; Juszczak, E; Alder, N; F. Mohamed; Senarathna, L.; Hittarage, A; Azher, S; Jeganathan, K; Jayamanne, S; Von Meyer, L.; Dawson, AH; Sheriff, MH; Buckley, NA

    2009-01-01

    Editors' Summary Background Each year, about 200,000 people worldwide die from poisoning with organophosphorous insecticides, toxic chemicals that are widely used in agriculture, particularly in developing countries. Organophosphates disrupt communication between the brain and the body in both insects and people. The brain controls the body by sending electrical impulses along nerve cells (neurons) to the body's muscle cells. At the end of the neurons, these impulses are converted into chemic...

  19. Analysis of chest image performance in patients with acute chlorine poisoning

    Objective: To explore chest image features of patients with acute chlorine poisoning and their clinical values. Methods: A retrospective analysis was performed by chest image features of 117 patients with acute chlorine poisoning. All the patients were classified according to Chinese management of occupational acute chlorine poisoning diagnosis standard. Results: Sixty-five patients presented with stimulus response, and normal or both lungs had a little more white on their chest images. Thirty-one cases presented with minor poisoning, and without or the texture of both lungs was increased, and grew hazy and coarse.seventeen cases were moderate, and small sample vague shadows or single or multiple limitations lamellar shadow. Four cases were serious,and two lungs had extensive and density homogeneous consolidation shadow. Conclusions: It would make the diagnosis and assessment of chlorine poisoning more easier based on the combination of chest image features, the clear history of acute chlorine poisoning and relevant clinical performance. (authors)

  20. Pattern of acute poisoning at two urban referral hospitals in Lusaka, Zambia

    Z’gambo, Jessy; Siulapwa, Yorum; Michelo, Charles

    2016-01-01

    Background Poisoning remains an important public health problem contributing significantly to the global burden of disease. Evidence on the exact burden and pattern of acute poisoning in Zambia is limited. We aimed to characterise acute poisoning with regard to demographic and epidemiologic factors of cases reported at the University Teaching Hospital and Levy Mwanawasa General Hospital; two large referral hospitals in Lusaka, Zambia. Methods This was a cross-sectional study involving retrosp...

  1. Severe but reversible acute kidney injury resulting from Amanita punctata poisoning

    Kang, Eunjung; Cheong, Ka-Young; Lee, Min-Jeong; Kim, Seirhan; Shin, Gyu-Tae; Kim, Heungsoo; Park, In-Whee

    2015-01-01

    Mushroom-related poisoning can cause acute kidney injury. Here we report a case of acute kidney injury after ingestion of Amanita punctata, which is considered an edible mushroom. Gastrointestinal symptoms occurred within 24 hours from the mushroom intake and were followed by an asymptomatic period, acute kidney injury, and elevation of liver and pancreatic enzymes. Kidney function recovered with supportive care. Nephrotoxic mushroom poisoning should be considered as a cause of acute kidney i...

  2. CT of the brain in acute carbon monoxide poisoning

    Cerebral computed tomographic (CT) findings of acute carbon monoxide (Co) poisoning were analized in thirty-six cases treated with hyperbraric oxygen therapy and their relationship with prognosis was evaluated. The cases were classified into there groups, early stage, interval form, and non-interval form groups. In all groups, the initial abnormality was low density areas presumably due to edema, demyelination and/or softening. It was seen in the globus pallidus and/or white matter. Following these initial changes, cerebral hemorrhage, ventricular dilatation, and cerebral atrophy developed in a few cases. The frequency of abnormal CT findings was higher in the interval form group (85 %) or non-interval group (83 %) than the early stage group (41 %). The prognosis was good in most cases with normal CT findings. The possibility of recovery diminished in the patients with abnormal CT findings. The prognosis was particularly poor in cases showing abnormality both in globus pallidus and white matter. We conclude that CT is useful not only for detecting the pathologic change but also for predicting the prognosis of the patient with acute Co poisoning. (author)

  3. A simplified acute physiology score in the prediction of acute aluminum phosphide poisoning outcome

    Shahin Shadnia

    2010-01-01

    Full Text Available Background : Aluminum phosphide (AlP is used as a fumigant. It produces phosphine gas, which is a mitochondrial poison. Unfortunately, there is no known antidote for AlP intoxication, and also, there are few data about its prognostic factors. AIMS: The aim of this study was to determine the impact of the Simplified Acute Physiology Score II (SAPS II in the prediction of outcome in patients with acute AlP poisoning requiring admission to the Intensive Care Unit (ICU. Materials and Methods : This was a prospective study in patients with acute AlP poisoning, admitted to the ICU over a period of 12 months. The demographic data were collected and SAPSII was recorded. The patients were divided into survival and non-survival groups due to outcome. Statistical Analysis : The data were expressed as mean ± SD for continuous or discrete variables and as frequency and percentage for categorical variables. The results were compared between the two groups using SPSS software. Results : During the study period, 39 subjects were admitted to the ICU with acute AlP poisoning. All 39 patients required endotracheal intubation and mechanical ventilation in addition to gastric decontamination with sodium bicarbonate, permanganate potassium, and activated charcoal, therapy with MgSO 4 and calcium gluconate and adequate hydration. Among these patients, 26 (66.7% died. SAPSII was significantly higher in the non-survival group than in the survival group (11.88 ± 4.22 vs. 4.31 ± 2.06, respectively (P < 0.001. Conclusion : SAPSII calculated within the first 24 hours was recognized as a good prognostic indicator among patients with acute AlP poisoning requiring ICU admission.

  4. Electrocardiographic findings and cardiac manifestations in acute aluminum phosphide poisoning.

    Soltaninejad, Kambiz; Beyranvand, Mohammad-Reza; Momenzadeh, Seyed-Akbar; Shadnia, Shahin

    2012-07-01

    Aluminium phosphide (AlP) poisoning has a high mortality due to cardiovascular involvement. In this study, we evaluated the frequency of cardiac manifestations and electrocardiographic (ECG) findings in 20 patients with acute AlP poisoning, who were admitted to the intensive care unit (ICU) in Tehran, Iran, over a period of 6 months (between October 2008 and April 2009). The sex, age, cause and manner of ingestion, number of ingested AlP tablets, cardiac and ECG manifestations, creatine phosphokinase (CPK), CPK-myocardial band (CPK-mb) and troponin-T (TnT) were extracted from the patients' files. All data were analysed with Statistical Package for the Social Sciences (SPSS) software. The majority (60%) of patients were male. The mean age was 27 ± 8.7 years. The mortality rate was 40%. In all of the patients, the cause of poisoning was intentional suicide and ingestion was the route of exposure. The mean number of ingested AlP tablets per patient was 2.2 ± 1.1. The average time interval between admission and cardiovascular manifestations or ECG findings was 168.8 ± 116.2 min. The range of systolic (SBP) and diastolic blood pressure was 60-130 mmHg and 40-70 mmHg, respectively. Dysrhythmia was observed in nine (45%) cases. Elevation of the ST segment was seen in nine cases (45%). Seven patients (35%) had prolonged QTc intervals. Bundle branch block (BBB) was observed in four (20%) patients. In nine (45%) patients, the serum cardiac TnT qualitative assay was positive. There were no significant differences between normal and abnormal ECG groups according to sex, age, number and manner of ingested AlP tablets and SBP. There was a significant correlation between cardiac manifestations and ECG findings and TnT-positive results with mortality in acute AlP poisoning. PMID:22687771

  5. Severe acute caffeine poisoning due to intradermal injections: Mesotherapy hazard

    Perković-Vukčević Nataša

    2012-01-01

    Full Text Available Introduction. Caffeine is indicated in the treatment of migraine headaches, as well as neonatal apnea and bradycardia syndrome. In mild poisoning, the most prevalent symptoms are nausea, vomiting, diarrhea, tremor, anxiety and headache. In more severe cases, symptoms consist of heart rythym abnormalities, myocardial infarction and seizures. Due to its common lipolytic effect, caffeine is used in mesotherapy, usually in combination with drugs of similar effect. We presented a patient with acute iatrogenic caffeine poisoning. Case report. A 51-year-old woman, with preexisting hypertension and hypertensive cardiomyopathy was subjected to cosmetic treatment in order to remove fat by intradermal caffeine injections. During the treatment the patient felt sickness, an urge to vomit, and a pronounced deterioration of general condition. Upon examination, the patient exhibited somnolence, hypotension and nonsustained ventricular tachycardia, which was sufficient enough evidence for further hospitalization. On admission to the intensive care unit the patient was anxious with increased heart rate, normotensive, with cold, damp skin, and visible traces of injection sites with surrounding hematomas on the anterior abdominal wall. Paroxysmal supraventricular tachycardia (PSVT on electrocardiographic monitoring was found. The laboratory analysis determined a lowered potassium level of 2.1 mmol/L (normal range 3,5 - 5.2 mmol/L, and a toxicological analysis (liquid chromatography with ultraviolet detection proved a toxic concentration of caffeine in plasma - 85.03 mg/L (toxic concentration over 25 mg/L. On application of intensive therapy, antiarrhythmics, and substitution of potassium, as well as both symptomatic and supportive therapy, there was a significant recovery. The patient was discharged without any sequele within four days. Conclusion. A presented rare iatrogenic acute caffeine poisoning occured due to massive absorption of caffeine from the

  6. Acute poisoning in children; changes over the years, data of pediatric clinic department of toxicology

    Alije Keka

    2014-01-01

    Conclusion: In our study drugs and house cleaning products are the most frequent agents causing accidental poisoning in children less than 5 years-old, this age of children is the most susceptible in terms of morbidity. Compared with the previous studies in Pediatric Clinic of Pristina, drugs are still the most frequent cause of acute poisoning in children; the number of poisoning with pesticides has fallen but has increased the number of poisoning with cleaning products. All preventive measures against poisoning should be taken including preventive strategies of education at national level especially in drug and household product storage.

  7. Poisoning

    ... talking with the Poison Control Center. GETTING HELP Call the Poison Control Center emergency number at 1-800-222-1222. DO NOT wait until the person has symptoms before you call. Try to have the following information ready: The ...

  8. Brain CT scan in acute carbon monoxide poisoning

    The brain CT findings in 19 patients with acute carbon monoxide poisoning was analysed and the emphasis was placed on the relationship between CT findings and prognosis. Five had a normal manifestation in CT ; eight had the findings of ovoid or patchy low density area in globus pallidus, bilateral or unlateral, during the second day to fifth week after poisoning, and the low density areas were decreasing and blurring in edge in follow up and at last disappeared during 3 - 14 weeks in three cases of them ; nine showed the appearance of diffuse low density of white matter and of globus pallidus in some of them ; two had an appearance of brain atrophy. The pathology of CT findings mentioned above may be brain edema, necrosis, malacia and degeneration in gray matter and globus pallidus. The result suggested the cases with normal CT manifestation, cerebral edema and decreasing and disappearing low density area had a good prognosis, in contrary, the cases with persistant low density in globus pallidus had a poorer prognosis. (author)

  9. Delayed onset neuropathy along with recurrent laryngeal nerve palsy due to organophosphate poisoning and the role of physiotherapy rehabilitation

    Jaimala Vijay Shetye; Surkar, Swati M.; Niteen D Karnik; Amita A Mehta

    2014-01-01

    Organophosphorus poisoning is a major global cause of health problems and the leading cause of mortality and morbidity in the developing countries. In this, the inhibition of acetyl-choline esterase and neurotoxic esterase along with nicotinic receptor involvement produces three well-identified and documented clinical phases: The initial cholinergic phase, which is a medical emergency often requiring management in an intensive care unit; the intermediate syndrome, during which prolonged venti...

  10. Analysis of Nine Cases of Acute Thallium Poisoning

    WANG Qiwei; HUANG Xiaojiang; LIU Liang

    2007-01-01

    In this study nine cases of thallium poisoning in a series of homicidal poisoning were analyzed in order to provide more information concerning thallium poisoning. It was found that the most common clinical feature of thallium poisoning was peripheral neuropathy and paraesthesia was more common than amyasthenia. Understanding of these clinical characteristics of thallium poisoning was helpful to early identification and differential diagnosis. Since the early administration of Prussian Blue, as a specific antidote for thallium poisoning, can substantially improve the prognosis, it is of great importance to establish a correct and early diagnosis.

  11. [Acute coronary syndrome with impaired left ventricular function in a carbon monoxide poisoning].

    Capilla, E; Pons, F; Poyet, R; Kerebel, S; Jego, C; Louge, P; Cellarier, G-R

    2016-02-01

    Carbon monoxide poisoning is the leading cause of death by poisoning in France. Neuropsychological symptoms are most common. We report on a patient with acute coronary syndrome and transient left ventricular dysfunction in carbon monoxide poisoning. Patient improved under hyperbaric oxygen therapy. Coronary angiography shows no significant lesion leading to myocardial stunning diagnose. Patients exposed to carbon monoxide must have systematic cardiac evaluation with electrocardiogram and dosage of biomarkers. PMID:25261170

  12. Acute poisoning in northern Vietnam: epidemiologic, diagnostic and therapeutic aspects

    Ha, Tran Hung

    2010-01-01

    Poisoning is a major health problem in northern Vietnam. The aims of these studies were to improve prevention, differential diagnosis and treatment of this threat to the public. A hospital-based retrospective study of poisoning emergencies admitted to the first Poison Control Center (PCC) in Vietnam during the years 1999 and 2003 (Paper I) revealed that a vast majority of the poisoning emergencies occurred at home. Pesticides, hypnotic pharmaceuticals and heroin were among t...

  13. Acute poisoning with clenbuterol--a case report.

    Chodorowski, Z; Sein Anand, J

    1997-01-01

    In the paper we have described a case of acute, unintentional intoxication with clenbuterol, a selective beta 2-agonist. A 21-year-old bodybuilder to improve his physical fitness and to increase his muscle bulk was using clenbuterol in a dose of two tablets (20 mg) daily for a week before poisoning. On a day of acute intoxication he drank orange juice containing 48 tablets (4.8 g) of clenbuterol, which had been placed there by his friends. The patient was admitted to our clinic with tachycardia at rate 160 bpm, headache, dizziness, tremor, sweats, muscle weakness, agitation. Serum potassium concentration was 2.6 mmol/L, blood glucose level 18.7 mmol/L. All the symptoms and biochemical abnormalities disappeared after intravenous treatment with propranolol (1.0 mg) and potassium chloride (60 mmol) within five hour period. This case indicates that more attention should be paid to clenbuterol widely used as a stimulant by athletes, especially by bodybuilders. PMID:9478104

  14. Causes of Acute Poisoning Hospital admission in Shahid Beheshti Hospital of Yasuj, 2008

    S Mohammad Hosseini

    2012-08-01

    Full Text Available Background & aim: About 7% of patient referred to hospital are various forms of poisoning. This study was performed to determine the major causes of acute poisoning leading to Hospitalization at Shahid Beheshti Hospital of Yasuj, Iran. Methods: This descriptive study was performed from August 2007 to July 2008 on 470 cases of poisonings referred to Shahid Beheshti hospital of Yasuj. Demographic characteristics, time of poisoning, poisoning factor, history of previous poisoning, history of psychiatric disease, medication and other therapeutic intervention based on questionnaires and interviews with patients or companions of patients were recorded. Data were analyzed by Chi-Square Test. Results: Majority of poisoned patients were single females, in the age range of 21-30 years, unemployed, lived in urban areas, and had at least a diploma. The majority of cases were intentional poisoning with a history of depression, previous poisoning and attempted suicide. Significant relationship were seen between poisoning, age, sex, and job, (p0.05. Conclusion: With respect to the results of this study, the majority of these poisonings occurred among young, single and unemployed females due to suicide and drug intoxication. Necessary actions should be done in drug usage and maintenance, taking action against non-prescription drugs and giving proper public education to families.

  15. Diagnostic value of low-field MRI for acute poisoning brain injury

    Objective: To investigate the value of low-field MIR in diagnosis of acute CO poisoning brain injury. Methods: The brain MIR and clinical data of 110 patients with acute CO poisoning brain injury confirmed by clinical examination were retrospectively analyzed. Results: Long T1 and T2 signal intensity was showed on MRI in cerebral hemispheres and globus pallidus symmetrically. There were three basic types of MIR manifestations, white matter of brain type, globus pallidus type and brain mixed type. Conclusions: MRI could be used for confirming the degree and range of acute CO poisoning brain injury. It has important clinical value in the diagnosis, staging and prognosis of patients with acute CO poisoning brain injury. (authors)

  16. Structural Findings in the Brain MRI of Patients with Acute Carbon Monoxide Poisoning

    Yasmin Davoudi

    2014-09-01

    Conclusion: The white matter and globus pallidus were the most common affected regions in brain following acute CO poisoning. Signal abnormalities and restricted diffusion in MRI were correlated with duration of exposure to CO but not with the carboxyhemoglobin levels.

  17. Neurological Effects of Acute Carbon Monoxide Poisoning in Children

    Coskun YARAR

    2009-11-01

    Full Text Available Carbon monoxide poisoning (COP is one of the most common causes of mortality and morbidity due to poisoning in all over the world. Although the incidence of COP has not been known exactly in the childhood, almost one-third of CO exposures occurred in children. The data regarding COP in children are inconclusive. Children may be more vulnerable to CO exposure than adults as a result of their high respiration and metabolic rates, high oxygen metabolism, and immature central nervous system. Recent researches proposed new theories about neurological effects of CO toxicity. The clinical presentations associated acute COP may be various and nonspecific. Unrecognized CO exposure may lead to significant morbidity and mortality. CO exposed children often become symptomatic earlier, and recover more rapidly, than similarly CO exposed adults. Mild clinical signs and symptoms associated with COP are headache, dizziness, weakness, lethargy, and myalgia; however, severe signs and symptoms such as blurred vision, syncope, convulsion, coma, cardiopulmonary arrest and death can also accompany with COP. Neurologic manifestations can include altered mental status at different degrees, neck stiffness, tremor, ataxia, and positive Babinski's sign. Delayed neurologic sequels (DNS of COP might be seen in children like adults. DNS symptoms and signs in children include memory problems, mental retardation, mutism, fecal and urinary incontinence, motor deficits, facial palsy, psychosis, chronic headache, seizures, and epilepsy. After CO exposure children must be cared to detect and treat DNS. Although hyperbaric oxygen therapy (HBOT is reported to prevent development of DNS, its indications, application duration and procedures are controversial in both of the children and adults. Although their predictive values are limited, exposing to CO more than eight hours and suffering from CO-induced coma, cardiac arrest, lactic acidosis, high COHb levels, and pathologic findings

  18. Characteristics of Children with Acute Carbon Monoxide Poisoning in Ankara: A Single Centre Experience.

    Unsal Sac, Rukiye; Taşar, Medine Ayşin; Bostancı, İlknur; Şimşek, Yurda; Bilge Dallar, Yıldız

    2015-12-01

    The purpose of the study was to define characteristics of children with acute carbon monoxide poisoning. Eighty children hospitalized with acute carbon monoxide poisoning were recruited prospectively over a period of 12 months. Sociodemographic features, complaints and laboratory data were recorded. When the patient was discharged, necessary preventive measures to be taken were explained to parents. One month later, the parents were questioned during a control examination regarding the precautions that they took. The ages of the cases were between one month and 16 yr. Education levels were low in 86.2% of mothers and 52.6% of fathers. All families had low income and 48.8% did not have formal housing. The source of the acute carbon monoxide poisoning was stoves in 71.2% of cases and hot-water heaters in 28.8% of cases. Three or more people were poisoned at home in 85.1% of the cases. The most frequent symptoms of poisoning were headache and vertigo (58.8%). Median carboxyhemoglobin levels at admission to the hospital and discharge were measured as 19.5% and 1.1% (P carbon monoxide poisoning are usually from families with low socioeconomic and education levels. Education about prevention should be provided to all people who are at risk of carbon monoxide poisoning before a poisoning incident occurs. PMID:26713060

  19. Delayed onset neuropathy along with recurrent laryngeal nerve palsy due to organophosphate poisoning and the role of physiotherapy rehabilitation

    Jaimala Vijay Shetye

    2014-01-01

    Full Text Available Organophosphorus poisoning is a major global cause of health problems and the leading cause of mortality and morbidity in the developing countries. In this, the inhibition of acetyl-choline esterase and neurotoxic esterase along with nicotinic receptor involvement produces three well-identified and documented clinical phases: The initial cholinergic phase, which is a medical emergency often requiring management in an intensive care unit; the intermediate syndrome, during which prolonged ventilator care is necessary; and finally delayed neurotoxicity. Vocal cord paralysis is rare and leads to aphonia. Role of physiotherapy rehabilitation is substantial in all three stages and aims at early weaning off from mechanical ventilator until the functional independence and community integration of the patient.

  20. Hospital Performance Indicators and Their Associated Factors in Acute Child Poisoning at a Single Poison Center, Central Saudi Arabia.

    Alanazi, Menyfah Q; Al-Jeriasy, Majed I; Al-Assiri, Mohammed H; Afesh, Lara Y; Alhammad, Fahad; Salam, Mahmoud

    2015-12-01

    Admission rate and length of stay (LOS) are two hospital performance indicators that affect the quality of care, patients' satisfaction, bed turnover, and health cost expenditures. The aim of the study was to identify factors associated with higher admission rates and extended average LOS among acutely poisoned children at a single poison center, central Saudi Arabia.This is a cross-sectional, poison and medical chart review between 2009 and 2011. Exposures were child characteristics, that is, gender, age, body mass index (BMI), health history, and Canadian 5-level triage scale. Poison incident characteristics were, that is, type, exposure route, amount, form, home remedy, and arrival time to center. Admission status and LOS were obtained from records. Chronic poisoning, plant allergies, and venomous bites were excluded. Bivariate and regression analyses were applied. Significance at P 1 h. Triage levels: non-urgent cases (58%), less urgent (11%), urgent (18%), emergency (12%), resuscitative (1%). Admission rate was (20.6%) whereas av. LOS was 13 ± 22 h. After adjusting and controlling for confounders, older children (adj.OR = 1.19) and more critical triage levels (adj.OR = 1.35) were significantly associated with higher admission rates compared to younger children and less critical triage levels (adj.P = 0.006) and (adj.P = 0.042) respectively. Home remedy prior arrival was significantly associated with higher av. LOS (Beta = 9.48, t = 2.99), compared to those who directly visited the center, adj.P = 0.003.Hospital administrators are cautioned that acutely poisoned children who received home remedies prior arrival are more likely to endure an extended LOS. This non-conventional practice is not recommended. PMID:26717371

  1. Edaravone attenuates brain damage in rats after acute CO poisoning through inhibiting apoptosis and oxidative stress.

    Li, Qin; Bi, Ming Jun; Bi, Wei Kang; Kang, Hai; Yan, Le Jing; Guo, Yun-Liang

    2016-03-01

    Acute carbon monoxide (CO) poisoning is the most common cause of death from poisoning all over the world and may result in neuropathologic and neurophysiologic changes. Acute brain damage and delayed encephalopathy are the most serious complication, yet their pathogenesis is poorly understood. The present study aimed to evaluate the neuroprotective effects of Edaravone against apoptosis and oxidative stress after acute CO poisoning. The rat model of CO poisoning was established in a hyperbaric oxygen chamber by exposed to CO. Ultrastructure changes were observed by transmission electron microscopy (TEM). TUNEL stain was used to assess apoptosis. Immunohistochemistry and immunofluorescence double stain were used to evaluate the expression levels of heme oxygenase-1 (HO-1) and nuclear factor erythroid 2-related factor 2 (Nrf-2) protein and their relationship. By dynamically monitored the carboxyhemoglobin (HbCO) level in blood, we successfully established rat model of severe CO poisoning. Ultrastructure changes, including chromatin condensation, cytoplasm dissolution, vacuoles formation, nucleus membrane and cell organelles decomposition, could be observed after CO poisoning. Edaravone could improve the ultrastructure damage. CO poisoning could induce apoptosis. Apoptotic cells were widely distributed in cortex, striatum and hippocampus. Edaravone treatment attenuated neuronal apoptosis as compared with the poisoning group (P < 0.01). Basal expressions of HO-1 and Nrf-2 proteins were found in normal brain tissue. CO poisoning could activate HO-1/Nrf-2 pathway, start oxidative stress response. After the administration of Edaravone, the expression of HO-1 and Nrf-2 significantly increased (P < 0.01). These findings suggest that Edaravone may inhibit apoptosis, activate the Keapl-Nrf/ARE pathway, and thus improve the ultrastructure damage and neurophysiologic changes following acute CO poisoning. © 2014 Wiley Periodicals, Inc. Environ Toxicol 31: 372-379, 2016

  2. Successful Treatment of Acute Lethal Dose of Acrylamide Poisoning

    Ali Banagozar Mohammadi

    2015-03-01

    Full Text Available Background: Acrylamide (C3H5NO is a vinyl monomer. This water-soluble crystalline solid is a colorless, odorless agent which is used in scientific laboratories and some industries. Acrylamide has cellular oxidative effects. Acute or chronic poisoning with this agent happens as a result of skin, respiratory, or oral contacts. Clinical manifestations depend on the dose, duration, and frequency of contact. Management of these patients consists of conservative and palliative therapies to reduce the oxidative effects. Case: The case was a 29-year-old girl with a Master of Sciences degree in genetics who worked in a university research center with previous history of depression. She had ingested 100cc of 30% Acrylamide solution for intentional suicide attempt. The patient was successfully managed using N-acetyl cysteine, vitamin C, and melatonin. Conclusion: Early diagnosis and appropriate treatment with recommended agents together with supportive therapies can save the life of patients exposed to potentially lethal doses of acrylamide, although intentional or accidental.

  3. Poisoning

    ... that could poison you include the following: Cleaning products Household products, such as nail polish remover and other personal ... Get rid of old or expired medicines and household products. Keep medicines and chemicals in their original containers. ...

  4. Salvianolic Acids Attenuate Rat Hippocampal Injury after Acute CO Poisoning by Improving Blood Flow Properties

    Li Guan

    2015-01-01

    Full Text Available Carbon monoxide (CO poisoning causes the major injury and death due to poisoning worldwide. The most severe damage via CO poisoning is brain injury and mortality. Delayed encephalopathy after acute CO poisoning (DEACMP occurs in forty percent of the survivors of acute CO exposure. But the pathological cause for DEACMP is not well understood. And the corresponding therapy is not well developed. In order to investigate the effects of salvianolic acid (SA on brain injury caused by CO exposure from the view point of hemorheology, we employed a rat model and studied the dynamic of blood changes in the hemorheological and coagulative properties over acute CO exposure. Compared with the groups of CO and 20% mannitol + CO treatments, the severe hippocampal injury caused by acute CO exposure was prevented by SA treatment. These protective effects were associated with the retaining level of hematocrit (Hct, plasma viscosity, fibrinogen, whole blood viscosities and malondialdehyde (MDA levels in red blood cells (RBCs. These results indicated that SA treatment could significantly improve the deformation of erythrocytes and prevent the damage caused by CO poisoning. Meanwhile, hemorheological indexes are good indicators for monitoring the pathological dynamic after acute CO poisoning.

  5. Risk factors for acute pesticide poisoning in Sri Lanka

    van der Hoek, Wim; Konradsen, Flemming

    2005-01-01

    pesticide poisoning and having ended an emotional relationship in the past year was clearly associated with intentional self-poisoning. The presence of mental disorders could only be assessed for a subsample of the cases and controls and this showed that alcohol dependence was a risk factor. This study...

  6. Neuropsychological and psychiatric functioning in sheep farmers exposed to low levels of organophosphate pesticides

    Mackenzie Ross, Sarah Jane; Brewin, Chris Ray; Curran, Helen Valerie; Furlong, Clement Eugene; Abraham-Smith, Kelly Michelle; Harrison, Virginia

    2010-01-01

    The study aim was to determine whether low level exposure to organophosphate pesticides (OPs) causes neuropsychological or psychiatric impairment. Methodological weaknesses of earlier studies were addressed by: recruiting participants who had retired on ill health grounds; excluding participants with a history of acute poisoning, medical or psychiatric conditions that might account for ill health; and exploring factors which may render some individuals more vulnerable to the effects of OPs th...

  7. Pharmacotherapy to protect the neuromuscular junction after acute organophosphorus pesticide poisoning.

    Bird, Steven B; Krajacic, Predrag; Sawamoto, Keigo; Bunya, Naofumi; Loro, Emanuele; Khurana, Tejvir S

    2016-06-01

    Organophosphorus (OP) pesticide poisoning is a leading cause of morbidity and mortality in the developing world, affecting an estimated three million people annually. Much of the morbidity is directly related to muscle weakness, which develops 1-4 days after poisoning. This muscle weakness, termed the intermediate syndrome (IMS), leads to respiratory, bulbar, and proximal limb weakness and frequently necessitates the use of mechanical ventilation. While not entirely understood, the IMS is most likely due to persistently elevated acetylcholine (ACh), which activates nicotinic ACh receptors at the neuromuscular junction (NMJ). Thus, the NMJ is potentially a target-rich area for the development of new therapies for acute OP poisoning. In this manuscript, we discuss what is known about the IMS and studies investigating the use of nicotinic ACh receptor antagonists to prevent or mitigate NMJ dysfunction after acute OP poisoning. PMID:27258847

  8. Organophosphate Induced Neuropathy - An Epidemic Case Report at Civil Hospital, Ahmedabad.

    M.M. Prabhakar

    2015-12-01

    Full Text Available Introduction: Organophosphates are the important biochemical substance, generally used as insecticides, nematocides, fungicides, solvents, plasticizers, drugs, herbicides and chemical warfare nerve agents. The most common route of entry of OPs in to body, is through insecticides, whether suicidal or accidental. Acute poisoning of OP is frequently observed in developing countries. Organophosphates cause inhibition of acetylcholinesterase enzyme in the body which leads to accumulation of acetylcholine. Acetylcholine is very important for nerve function. The Prevalence of OP poisoning is around 1 million per year. Aim: Aim of this study was to do an epidemic case study the effect of Organophosphet on peripheral nerves. Material and method: 17 (9 male and 8 female Patients with organophosphate consumptions were clinically assessed and were tested by NCV study at Physiotherapy Department of Civil Hospital, Ahmedabad. Results and Conclusions: The Study of 17 organophosphate poison consumption revealed that there was Electrophysiological evidence of demyelinating and axonal type of pure motor polyneuropathy affecting LL >Ul with normal sensory nerve conduction.

  9. Noninvasive Biomonitoring Approaches to Determine Dosimetry and Risk Following Acute Chemical Exposure: Analysis of Lead or Organophosphate Insecticide in Saliva

    There is a need to develop approaches for assessing risk associated with acute exposures to a broad-range of chemical agents and to rapidly determine the potential implications to human health. Non-invasive biomonitoring approaches are being developed using reliable portable analytical systems to quantitate dosimetry utilizing readily obtainable body fluids, such as saliva. Saliva has been used to evaluate a broad range of biomarkers, drugs, and environmental contaminants including heavy metals and pesticides. To advance the application of non-invasive biomonitoring a microfluidic/ electrochemical device has also been developed for the analysis of lead (Pb), using square wave anodic stripping voltammetry. The system demonstrates a linear response over a broad concentration range (1 2000 ppb) and is capable of quantitating saliva Pb in rats orally administered acute doses of Pb-acetate. Appropriate pharmacokinetic analyses have been used to quantitate systemic dosimetry based on determination of saliva Pb concentrations. In addition, saliva has recently been used to quantitate dosimetry following exposure to the organophosphate insecticide chlorpyrifos in a rodent model system by measuring the major metabolite, trichloropyridinol, and saliva cholinesterase inhibition following acute exposures. These results suggest that technology developed for non-invasive biomonitoring can provide a sensitive, and portable analytical tool capable of assessing exposure and risk in real-time. By coupling these non-invasive technologies with pharmacokinetic modeling it is feasible to rapidly quantitate acute exposure to a broad range of chemical agents. In summary, it is envisioned that once fully developed, these monitoring and modeling approaches will be useful for accessing acute exposure and health risk

  10. Acute kidney injury and disseminated intravascular coagulation due to mercuric chloride poisoning

    Dhanapriya, J.; Gopalakrishnan, N; Arun, V.; Dineshkumar, T.; Sakthirajan, R.; Balasubramaniyan, T.; Haris, M

    2016-01-01

    Mercury is a toxic heavy metal and occurs in organic and inorganic forms. Inorganic mercury includes elemental mercury and mercury salts. Mercury salts are usually white powder or crystals, and widely used in indigenous medicines and folk remedies in Asia. Inorganic mercury poisoning causes acute kidney injury (AKI) and gastrointestinal manifestations and can be life-threatening. We describe a case with unknown substance poisoning who developed AKI and disseminated intravascular coagulation (...

  11. Acute methanol poisonings: Folates administration and visual sequelae

    Zakharov, S.; Nurieva, O.; Navrátil, Tomáš; Diblik, P.; Kuthan, P.; Pelclová, D.

    2014-01-01

    Roč. 12, č. 4 (2014), s. 309-316. ISSN 1214-021X Institutional support: RVO:61388955 Keywords : Methanol poisoning * Treatment outcome * Folinic acid Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 1.302, year: 2014

  12. An interesting cause of pulmonary emboli: Acute carbon monoxide poisoning

    Sevinc, A.; Savli, H.; Atmaca, H. [Gaziantep University, Gaziantep (Turkey). School of Medicine

    2005-07-01

    Carbon monoxide poisoning, a public health problem of considerable significance, is a relatively frequent event today, resulting in thousands of hospitalizations annually. A 70-year-old lady was seen in the emergency department with a provisional diagnosis of carbon monoxide poisoning. The previous night, she slept in a tightly closed room heated with coal ember. She was found unconscious in the morning with poor ventilation. She had a rare presentation of popliteal vein thrombosis, pulmonary emboli, and possible tissue necrosis with carbon monoxide poisoning. Oxygen treatment with low-molecular-weight heparin (nadroparine) and warfarin therapy resulted in an improvement in both popliteal and pulmonary circulations. In conclusion, the presence of pulmonary emboli should be sought in patients with carbon monoxide poisoning.

  13. Acute carbon monoxide poisoning: Emergency management and hyperbaric oxygen therapy

    Severance, H.W.; Kolb, J.C.; Carlton, F.B.; Jorden, R.C.

    1989-10-01

    An ice storm in February 1989 resulted in numerous incidences of carbon monoxide poisoning in central Mississippi secondary to exposure to open fires in unventilated living spaces. Sixteen cases were treated during this period at the University of Mississippi Medical Center and 6 received Hyperbaric Oxygen therapy. These 6 cases and the mechanisms of CO poisoning are discussed and recommendations for emergency management are reviewed.10 references.

  14. Profile of acute carbon monoxide poisoning in the west province of Iran

    Objective: To document the epidemiology and risk factors of acute carbon monoxide (CO) poisoning in the west of Iran and specify potentially presentable characteristics. Study Design: Observational study. Place and Duration of Study: Imam Khomeini Hospital of Kermanshah, Iran, from July 2006 to March 2008. Methodology: This study was conducted using the records of 143 cases of CO poisoning referred to the only centre for the reference of poisoning cases. Intent, age groups, source of poisoning and clinical presentation were noted and described as frequency. Results: One-hundred forty two cases (99.3%), were accidental and only one case (0.7%) was suicidal. Mortality was (21.7%, n=31). The highest mortality was found in the age groups of 20-30 years and below 10 years. The greatest frequency happened in autumn and winter. The clinical symptoms and manifestations of CO poisoning included headache (35.3%), nausea (25.4%), vomiting (21%), dyspnea (10.3%), and decrease in level of consciousness (8%). Gas water heaters (35%), room heaters (32%), stoves (24%) and other items (9%) were the principal sources of the individuals' exposure to CO. Conclusion: CO poisoning is a serious public health problem in west of Iran (Kermanshah). The number of CO poisoning cases was highest in the colder seasons of the year, whereas the majority of the poisoning cases could be prevented. (author)

  15. Pattern of acute poisonings in childhood in Ankara: what has changed in twenty years?

    Andiran, Nesibe; Sarikayalar, Fikriye

    2004-01-01

    Poisoning represents one of the most common medical emergencies in childhood, and epidemiological properties differ from country to country. Thus, special epidemiological surveillance for each country is necessary to determine the problem according to which preventive measures can be taken. The purpose of this study was to clarify the characteristics of acute poisoning cases admitted to a pediatric referral hospital. All poisoned patients under 17 years of age, except for cases food poisoning, presenting to the Emergency Department (ED) from January 1995 to December 2000 were determined. The information about each case was recorded on standardized forms and a retrospective chart review survey was done. Complete epidemiological and clinical data were obtained for 489 patients. The mean age of all poisoned patients (mean +/- standard deviation) was 5.96 +/- 4.87 years, and the age range was 0.01 to 17 years. Three hundred and thirty-one children, forming 63.6% of all patients, were under five years of age. Slightly more boys (52.3%) than girls were intoxicated at ages less than 10 years, after which more girls (79%) than boys were involved. The majority of all cases were due to accidental poisoning (78.1% of all poisonings) which occurred mostly in children under five years of age (73.3%). While accidental poisonings (97.1%) were the most common mode of poisoning between 1-5 years, self-poisonings (67.3%) had the highest ratio in cases over 10 years of age. In patients younger than one year of age, 74.2% of all poisonings were due to therapeutical error. Drugs were the most frequent offending agent (57.7%), followed by ingestion of a caustic/corrosive substance (16.8%) and carbon monoxide (CO) intoxication (9.4%). Analgesics were the most common agents, forming 23.7% of all poisonings due to drugs, followed by ingestion of multiple drugs and tricyclic antidepressants at ratios of 21.6% and 9.6%, respectively. The most common route of poisoning was ingestion of the

  16. Acute poisoning in children; changes over the years, data of pediatric clinic department of toxicology

    Keka Alije; Ramosaj A; Toro H; Azemi M; Baloku A; Sylaj B; Lenjani B; Kyseni K

    2014-01-01

    Objective:To present the frequency, etiology, changes over the years of acute poisoning in children admitted toPediatricClinic ofPristina and to determine the extent and characteristics of the problem, according to which related preventive measures can be taken.Methods:Retrospectively we have analyzed the epidemiology of accidental and suicidal poisonings in children hospitalization inPediatricClinicDepartment ofToxicology during the year2012. Our data we compared with data from previous studies on acute poisoning in children in the PediatricClinic conducted during the years1976-1985 and2001.Results:During the year2012, inPediatricClinic ofPristina5723 children were hospitalized,136 of them or2.3% were treated due to acute poisoning inDepartment ofToxicology,82 of them was boys and54 was girls, rate boys girls was1.5:1.The majority of cases101 or74.2% were under five years with peak age three and35% or25.7% were over five years.The most of the cases was accidentally97% and only 2.9% was suicidal and all of them were over the age of ten.Drugs were the most common agent causing the poisoning71(52.2%) followed by house cleaning products38(27.9%), food10(5.8%), pesticides7(5.14%), rare agent that caused poisoning were: narcotic substances, plant, heavy metals, alcohol, carbon monoxide, carburant.Poisoning occurred mostly in spring and the peak was observed inMay,(1.17% of all patients).January was the month of lowest rate of poisoning. During the years1976-1985, inPediatricClinic ofPristina900 children were hospitalized due to acute poisoning,44.11% were from drugs,15.88% from pesticides,65(7.2%), while during2001 in the unit care intensive were hospitalized66 children due to acute poisoning, among them51.5% were poisoning from drugs,30.03 from pesticides,12.2% from cleaning products.Conclusion:In our study drugs and house cleaning products are the most frequent agents causing accidental poisoning in children less than5 years-old, this age of children is the most

  17. Effect of acute paraquat poisoning on CYP450 isoforms activity in rats by cocktail method.

    Wang, Shuanghu; Wang, Zhiyi; Chen, Dongxin; Chen, Mengchun; Lin, Yingying; Liu, Zezheng; Zhang, Lijing; Wen, Congcong; Wang, Xianqin; Ma, Jianshe

    2015-01-01

    Paraquat is a highly effective contact herbicide that is marketed worldwide as a fantastical, non-selective compound for broadleaf weed control. As compared to most pesticides, paraquat is extremely toxic to humans and the lack of strategies to manage paraquat poisoning has resulted in high fatality rates. The rats were randomly divided into acute paraquat poisoning group and control group. The paraquat group rats were given 36 mg/kg paraquat by intragastric administration. The influence of acute paraquat poisoning on the activities of CYP450 isoforms CYP2B6, CYP1A2, CYP2C9, CYP2D6, CYP3A4 and CYP2C19 were evaluated by cocktail method, they were responded by the changes of pharmacokinetic parameters of bupropion, phenacetin, tolbutamide, metoprolol, midazolam and omeprazole. The six probe drugs were given to rats through intragastric administration, and the plasma concentrations were determined by UPLC-MS/MS. In the results of paraquat group compared to control group, there was statistical pharmacokinetic difference for bupropion, tolbutamide, metoprolol, midazolam and omeprazole. Acute paraquat poisoning may induce the activities of CYP2C19, and inhibit of CYP2B6, CYP2C9, CYP2D6 and CYP3A4 in rats. This may give advising for reasonable drug use after acute paraquat poisoning. PMID:26770539

  18. Minoxidil poisoning presenting as acute coronary syndrome: a rare case scenario

    Shrikant Kalyanrao Panchal

    2014-04-01

    Full Text Available We present a case of severe minoxidil poisoning (3000 mg with resultant severe hypotension, tachycardia and subendocardial ischemia initially treated crystalloid, dopamine, aspirin, clopidogrel on the lines of acute coronary syndrome with partial haemodynamic improvement. After getting the history of minoxidil poisoning, the patient was treated with bolus doses of norepinephrine, and norepinephrine infusion, resulting in resolution of hypertension, tachycardia and reversal of ischemia. Topical minoxidil is commonly used agent for male pattern baldness. It also has got antihypertensive action when ingested, acute coronary syndrome and compensatory tachycardia with successful management with norepinephrine bolus and infusion. [Int J Res Med Sci 2014; 2(2.000: 784-785

  19. Acute Poisoning in Children: A Hospital-Based Study in Arak, Iran (2008-2012

    Ali Arjmand Shabestari

    2014-09-01

    Full Text Available Background: Poisoning is one of the important reasons for children’s admission to hospital. Knowledge of epidemiology of poisoning in each region plays an important role in planning prevention, care, and treatment of patients. This study was conducted to determine the characteristics of acute poisoning epidemiology in children attending pediatric wards of Amirkabir Hospital in Arak in a five-year period (March 2008 to March 2012. Methods: This descriptive cross-sectional study was conducted on 224 children admitted for poisoning. Data were retrospectively collected from patients’ files and analyzed using SPSS 16 software. Results: Of the total population, 54.9% were boys and the rest were girls. Mean age of children was 3.54±2.99 years, and the most common age range was 1-3 years (50.9%. The highest rate of children’s admission due to poisoning was in the winter (30.8%. The most common causes of poisoning included drugs (65.2%, kerosene (7.1%, and food poisoning (5.4%. The most common poisoning drugs, included benzodiazepines (21.9%, gastrointestinal drugs (19.9%, opioid analgesics (15.1%. The most prevalent drugs were methadone, metoclopramide, and clonazepam. At admission, the most common presenting symptoms were neurological (51.3%, and gastrointestinal symptoms (38.4%. Conclusion: High prevalence of poisoning with groups of drugs mentioned could indicate community-wide excessive use of these drugs, as well as negligence of families in keeping them out of children’s reach. Therefore, raising knowledge and awareness about variety of poisoning and how to prevent them, through holding workshops, national media, schools, and health centers can be a valuable step toward upkeep of children’s health.

  20. ACUTE ACCIDENTAL POISONING IN CHILDREN: A HOSPITAL-BASED RETROSPECTIVE STUDY

    Kameshore

    2014-10-01

    Full Text Available INTRODUCTION: Acute accidental poisoning in children is a big problem anywhere in the world. Studies done elsewhere in India showed a wide range of incidence of the problem. Hence, it was felt important to study its magnitude and associated characteristics as of now. OBJECTIVE: The current study was taken up to know the magnitude among children admitted in JNIMS, Imphal which is a newly established medical institute and also to study the characteristics like age, gender, type of poison, duration of hospital-stay and outcome of the cases. MATERIALS & METHODS: Retrospective data of all acute accidental poisoning cases among children admitted in the Pediatrics Ward, JNIMS, Imphal during the period July 2008 - December 2013 were analyzed by using descriptive statistics. RESULT: Of all the 13,663 children admitted, 148 cases were because of acute accidental poisoning giving an incidence rate of 1.08%. The male is to female ratio was 1.31:1. The last three years of the study period showed a slightly increasing trend in the incidence. Children aged 1-4 years were the most commonly affected (65.54%. Kerosene oil was by far the commonest (42% of all the poisonous substances consumed. Food poisoning, poisoning with organic compounds, poisoning with medicinal drugs and poisoning with corrosives comprised 21%, 12%, 9% and 8% respectively of all the cases. There was no mortality. DISCUSSION: The incidence rate of 1.08% as found out from the current study was on the lower side as compared to reports of previous studies done in other parts of the country. Yet, it was two-fold of the incidence reported from RIMS which is situated in the same State. Parental negligence in storing poisonous substances in the household was implicated. They need to be made aware for keeping harmful poisonous substances in safe places out of the reach of children. CONCLUSION: Community-based studies are recommended for estimating more accurately the magnitude of the problem in the

  1. A Case of Mushroom Poisoning with Russula subnigricans: Development of Rhabdomyolysis, Acute Kidney Injury, Cardiogenic Shock, and Death.

    Cho, Jong Tae; Han, Jin Hyung

    2016-07-01

    Mushroom exposures are increasing worldwide. The incidence and fatality of mushroom poisoning are reported to be increasing. Several new syndromes in mushroom poisoning have been described. Rhabdomyolytic mushroom poisoning is one of new syndromes. Russula subnigricans mushroom can cause delayed-onset rhabdomyolysis with acute kidney injury in the severely poisoned patient. There are few reports on the toxicity of R. subnigricans. This report represents the first record of R. subnigricans poisoning with rhabdomyolysis in Korea, describing a 51-year-old man who suffered from rhabdomyolysis, acute kidney injury, severe hypocalcemia, respiratory failure, ventricular tachycardia, cardiogenic shock, and death. Mushroom poisoning should be considered in the evaluation of rhabdomyolysis of unknown cause. Furthermore, R. subnigricans should be considered in the mushroom poisoning with rhabdomyolysis. PMID:27366018

  2. Should hyperbaric oxygen be used to treat the pregnant patient for acute carbon monoxide poisoning

    Van Hoesen, K.B.; Camporesi, E.M.; Moon, R.E.; Hage, M.L.; Piantadosi, C.A. (Duke Univ. Medical Center, Durham, NC (USA))

    1989-02-17

    Carbon monoxide (CO) is the leading cause of death due to poisoning. Although uncommon, CO poisoning does occur during pregnancy and can result in fetal mortality and neurological malformations in fetuses who survive to term. Uncertainty arises regarding the use of hyperbaric oxygen (HBO) as a treatment for the pregnant patient because of possible adverse effects on the fetus that could be induced by oxygen at high partial pressures. While the dangers of hyperoxia to the fetus have been demonstrated in animal models, careful review of animal studies and human clinical experience indicates that the short duration of hyperoxic exposure attained during HBO therapy for CO poisoning can be tolerated by the fetus in all stages of pregnancy and reduces the risk of death or deformity to the mother and fetus. A case is presented of acute CO poisoning during pregnancy that was successfully treated with HBO. Recommendations are suggested for the use of HBO during pregnancy.

  3. The Effects of Acute Hydrogen Sulfide Poisoning on Cytochrome P450 Isoforms Activity in Rats

    Xianqin Wang

    2014-01-01

    Full Text Available Hydrogen sulfide (H2S is the second leading cause of toxin related death (after carbon monoxide in the workplace. H2S is absorbed by the upper respiratory tract mucosa, and it causes histotoxic hypoxemia and respiratory depression. Cocktail method was used to evaluate the influences of acute H2S poisoning on the activities of cytochrome P450 isoforms CYP2B6, CYP2D6, CYP3A4, CYP1A2, CYP2C19, and CYP2C9, which were reflected by the changes of pharmacokinetic parameters of six specific probe drugs, bupropion, metoprolol, midazolam, phenacetin, omeprazole, and tolbutamide, respectively. The experimental rats were randomly divided into two groups, control group and acute H2S poisoning group (inhaling 300 ppm for 2 h. The mixture of six probes was given to rats by oral administration and the blood samples were obtained at a series of time points through the caudal vein. The concentrations of probe drugs in rat plasma were measured by LC-MS. The results for acute H2S poisoning and control groups were as follows: there was a statistically significant difference in the AUC and Cmax for bupropion, metoprolol, phenacetin, and tolbutamide, while there was no statistical pharmacokinetic difference for midazolam and omeprazole. Acute H2S poisoning could inhibit the activity of CYP2B6, CYP2D6, CYP1A2, and CYP2C9 in rats.

  4. Oral administration of lactulose: a novel therapy for acute carbon monoxide poisoning via increasing intestinal hydrogen production.

    Fan, Dan-Feng; Hu, Hui-Jun; Sun, Xue-Jun; Meng, Xiang-En; Zhang, Yu; Pan, Shu-Yi

    2016-01-01

    It has been known that the pathophysiology of carbon monoxide (CO) poisoning is related to hypoxia, the increased production of reactive oxygen species (ROS) and oxidative stress. Studies have shown that the novel, safe and effective free radical scavenger, hydrogen, has neuroprotective effects in both acute CO poisoning and delayed neuropsychological sequelae in CO poisoning. Orally administered lactulose, which may be used by some intestinal bacteria as a food source to produce endogenous hydrogen, can ameliorate oxidative stress. Based on the available findings, we hypothesize that oral administration of lactulose may be a novel therapy for acute CO poisoning via increasing intestinal hydrogen production. PMID:27000012

  5. Severe acute caffeine poisoning due to intradermal injections: Mesotherapy hazard

    Perković-Vukčević Nataša; Babić Gordana; Šegrt Zoran; Vuković-Ercegović Gordana; Janković Snežana; Aćimović Ljubomir

    2012-01-01

    Introduction. Caffeine is indicated in the treatment of migraine headaches, as well as neonatal apnea and bradycardia syndrome. In mild poisoning, the most prevalent symptoms are nausea, vomiting, diarrhea, tremor, anxiety and headache. In more severe cases, symptoms consist of heart rythym abnormalities, myocardial infarction and seizures. Due to its common lipolytic effect, caffeine is used in mesotherapy, usually in combination with drugs of similar effect. We presented a patient wit...

  6. N-acetylcysteine in Acute Organophosphorus Pesticide Poisoning: A Randomized, Clinical Trial.

    El-Ebiary, Ahmad A; Elsharkawy, Rasha E; Soliman, Nema A; Soliman, Mohammed A; Hashem, Ahmed A

    2016-08-01

    Organophosphorus poisoning is a major global health problem with hundreds of thousands of deaths each year. Research interest in N-acetylcysteine has grown among increasing evidence of the role of oxidative stress in organophosphorus poisoning. We aimed to assess the safety and efficacy of N-acetylcysteine as an adjuvant treatment in patients with acute organophosphorus poisoning. This was a randomized, controlled, parallel-group trial on 30 patients suffering from acute organophosphorus poisoning, who were admitted to the Poison Control Center of Tanta University Emergency Hospital, Tanta, Egypt, between April and September 2014. Interventions included oral N-acetylcysteine (600 mg three times daily for 3 days) as an added treatment to the conventional measures versus only the conventional treatment. Outcome measures included mortality, total dose of atropine administered, duration of hospitalization and the need for ICU admission and/or mechanical ventilation. A total of 46 patients were screened and 30 were randomized. No significant difference was found between both groups regarding demographic characteristics and the nature or severity of baseline clinical manifestations. No major adverse effects to N-acetylcysteine therapy were reported. Malondialdehyde significantly decreased and reduced glutathione significantly increased only in the NAC-treated patients. The patients on NAC therapy required less atropine doses than those who received only the conventional treatment; however, the length of hospital stay showed no significant difference between both groups. The study concluded that the use of N-acetylcysteine as an added treatment was apparently safe, and it reduced atropine requirements in patients with acute organophosphorus pesticide poisoning. PMID:26786042

  7. Poisoning by organophosphorus insecticides and sensory neuropathy

    Moretto, A; M. Lotti

    1998-01-01

    OBJECTIVES—Poisoning by organophosphate insecticides causes cholinergic toxicity. Organophosphate induced delayed polyneuropathy (OPIDP) is a sensory-motor distal axonopathy which usually occurs after ingestion of large doses of certain organophosphate insecticides and has so far only been reported in patients with preceding cholinergic toxicity. Surprisingly, it was recently reported by other authors that an exclusively sensory neuropathy developed in eight patients afte...

  8. Magnetic resonance (MR) imaging in delayed encephalopathy of acute carbon monoxide poisoning - comparison with CT -

    Eleven magnetic resonance (MR) and computed tomographic (CT) imaging were performed in nine patients with mild to moderate degree of delayed neuropsychiatric symptoms following acute carbon monoxide (CO) poisoning, to evaluate the capability of MR in demonstrating any additional finding to CT. The MR images were obtained using 0.15 Tesla resistive system with various combination of three pulse sequences, including partial saturation recovery, T2-weighted spin echo and inversion recovery. Bilateral white matter abnormalities suggesting demyelination were demonstrated in 4 patients with MR and in only 2 patients with CT. The contrast discrimination between normal and abnormal white matter proved to be better with T2-weighted spin echo and inversion recovery than with partial saturation recovery and CT. But necrosis of the globus pallidus (1 patient) and diffuse atrophy (3 patients) were equally demonstrated on both MR and CT. It is suggested that MR be used as a initial imaging method in the evaluation of the delayed encephalopathy following acute CO poisoning, especially for the detection of the possible white matter lesions. Acute carbon monoxide (CO) poisoning produces hypoxia by displacing oxygen from hemoglobin and preventing its release from hemoglobin in tissues, often resulting in fetal event. Victims who survive acute CO poisoning may have various delayed symptoms and signs. Occasionally, an apparent recovery is followed within two days to three weeks by a sudden neurological deterioration. The degree of neuropsychiatric symptoms depends upon the extent and severity of the pathologic changes in the brain. The pathologic effects of CO poisoning are present in almost all organs of patients. However, the most important changes occur in the brain, which consist of necrosis of the globus pallidus and reticular zone of the substantia nigra, and the degeneration of the cerebral white matter. The diagnostic superiority of magnetic resonance (MR) over CT has already

  9. Effects of acute organophosphate ingestion on cognitive function, assessed with the mini mental state examination

    S S Jayasinghe

    2012-01-01

    Full Text Available Background : Chronic damage to the central nervous system resulting in cognitive impairment has been shown with repeated, low doses of organophosphorus (OP exposure over month or years. Aim: The study aimed to find out whether there is any cognitive impairment following acute OP exposure that could be detected by a simple screening instrument, the Mini Mental State Examination (MMSE, in clinical settings. Settings and Design: A cohort study. Materials and Methods: The study was conducted with matched controls. Consecutive patients admitted to the hospital with acute ingestion of OP were recruited. Cognitive function was assessed with the MMSE, digit span test, test of long-term memory function and concentration. Patients were assessed twice: at 1 and 6 weeks of exposure. Statistical Analysis: Continuous variables were analyzed with the paired and unpaired T-tests. Non-normally distributed data were analyzed with the Mann-Whitney U test and Wilcoxon Signed Rank test. Discrete variables were analyzed with the Chi-square test. Results: There were 60 patients and 61 controls. The mean age (SD of the patients and controls was 31.5 (11.6 and 31.3 (11.8 years, respectively. Forty-two patients turned up for the second assessment. Significant impairment of cognitive function was seen in the total score of MMSE (95% CI -2.5 to -0.3, orientation (95% CI -1 to -0.2 and language (95% CI -0.9 to -0.1 domains of MMSE, digit span test (95% CI 0.1-1.7 and test of long-term memory function (95% CI 0.3-2.3 in the first assessment compared with the controls. When the results of the second assessment were compared with the controls, no significant differences were seen. Conclusion: Although there was a slight transient cognitive impairment detected with the screening tests following acute OP ingestion, no long-term cognitive defects was detected.

  10. Ulinastatin suppresses endoplasmic reticulum stress and apoptosis in the hippocampus of rats with acute paraquat poisoning

    Hai-feng Li

    2015-01-01

    Full Text Available Lung injury is the main manifestation of paraquat poisoning. Few studies have addressed brain damage after paraquat poisoning. Ulinastatin is a protease inhibitor that can effectively stabilize lysosomal membranes, prevent cell damage, and reduce the production of free radicals. This study assumed that ulinastatin would exert these effects on brain tissues that had been poisoned with paraquat. Rat models of paraquat poisoning were intraperitoneally injected with ulinastatin. Simultaneously, rats in the control group were administered normal saline. Hematoxylin-eosin staining showed that most hippocampal cells were contracted and nucleoli had disappeared in the paraquat group. Fewer cells in the hippocampus were concentrated and nucleoli had disappeared in the ulinastatin group. Western blot assay showed that expressions of GRP78 and cleaved-caspase-3 were significantly lower in the ulinastatin group than in the paraquat group. Immunohistochemical findings showed that CHOP immunoreactivity was significantly lower in the ulinastatin group than in the paraquat group. Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling staining showed that the number of apoptotic cells was reduced in the paraquat and ulinastatin groups. These data confirmed that endoplasmic reticular stress can be induced by acute paraquat poisoning. Ulinastatin can effectively inhibit this stress as well as cell apoptosis, thereby exerting a neuroprotective effect.

  11. Using bosentan to treat paraquat poisoning-induced acute lung injury in rats.

    Zhongchen Zhang

    Full Text Available BACKGROUND: Paraquat poisoning is well known for causing multiple organ function failure (MODS and high mortality. Acute lung injury and advanced pulmonary fibrosis are the most serious complications. Bosentan is a dual endothelin receptor antagonist. It plays an important role in treating PF. There is no related literature on the use of bosentan therapy for paraquat poisoning. OBJECTIVE: To study the use of bosentan to treat acute lung injury and pulmonary fibrosis as induced by paraquat. METHOD: A total of 120 adult Wister male rats were randomly assigned to three groups: the paraquat poisoning group (rats were intragastrically administered with paraquat at 50 mg/kg body weight once at the beginning; the bosentan therapy group (rats were administered bosentan at 100 mg/kg body weight by intragastric administration half an hour after paraquat was administered, then the same dose was administered once a day; and a control group (rats were administered intragastric physiological saline. On the 3rd, 7th, 14th, and 21st days following paraquat exposure, rats were sacrificed, and samples of lung tissue and venous blood were collected. The levels of transforming growth factor-β1 (TGF-β1, endothelin-1 (ET-1, and hydroxyproline (HYP in the plasma and lung homogenate were determined. Optical and electronic microscopes were used to examine pathological changes. RESULT: The TGF-β1, ET-1, and HYP of the paraquat poisoning group were significantly higher than in the control group, and they were significantly lower in the 21st day therapy group than in the paraquat poisoning group on the same day. Under the optical and electronic microscopes, lung tissue damage was observed to be more severe but was then reduced after bosentan was administered. CONCLUSION: Bosentan can reduce inflammation factor release. It has a therapeutic effect on acute lung injury as induced by paraquat.

  12. “有机磷酸酯类中毒及解救”实验方法的改进%Improving Experimental Method of “Organophosphate Poisoning and Rescue”

    杨东旭; 胡小敏; 马思明; 陈怡; 郝刚

    2015-01-01

    通过“有机磷酸酯类中毒与解救”实验,使学生掌握相关的“中毒及解救”知识,这有助于医学生将来的临床实践。传统实验采用家兔,因采血方式等问题而影响了实验的成功率。用小鼠取代家兔进行实验,方法简便易行,结果可靠。同时符合动物福利,节约实验成本。%Students can acquire the knowledge of “poisoning and rescue” by “organophosphate poisoning and rescue” experiment. It is helpful for the medical students in clinical practice in the future. In the past, the animals are rabbits used in this experiment. The method of blood collection and other issues affect the success rate of traditional experiment. The experiment using mice instead of rabbits is simple and viable, and showed reliable results. At the same time the new method meet the animal welfare and save the cost of experiments.

  13. Acute Lantana camara poisoning in a Boer goat kid : case report

    A. Ide

    1998-07-01

    Full Text Available Acute Lantana camara poisoning in a Boer goat kid is described. The animal was part of a flock of boer goats that was introduced from the Kalahari thornveld, where the plant does not occur, to an area where the plant grew abundantly. At necropsy, the animal was severely icteric, dehydrated and constipated, with hepatosis, distention of the gall-bladder and nephrosis, but no skin lesions. Histopathological findings of the liver confirmed moderate hepatosis with single-cell necrosis and bile stasis. The pathology is consistent with that described in acute Lantana poisoning in cattle, sheep and goats. The absence of photosensitisation may be attributed to relatively mild liver damage, or the rapid course of this toxicosis.

  14. Research progress in immunological mechanism of delayed encephalopathy after acute carbon monoxide poisoning

    Kai FENG

    2014-10-01

    Full Text Available Delayed encephalopathy after acute carbon monoxide poisoning (DEACMP is a syndrome constituted by acute dementia, psychiatric symptoms, pyramidal and extrapyramidal symptoms, which can be developed after the original clinical symptoms of carbon monoxide poisoning recovered. Lots of studies have been done to explain the mechanisms of DEACMP, and more and more researches have demonstrated that the immunological mechanism may be involved in or play an important role on the pathogenesis of the process. This article will review the researches of immunological mechanism of DEACMP in recent years and give some prompts to clinical study in the future. doi: 10.3969/j.issn.1672-6731.2014.10.006

  15. Analysis of characteristics of acute poisoning caused by various poisons in Guangxi, China%广西各类毒物致急性中毒分析

    胡德宏; 张振明; 刘清华; 蒋东方

    2013-01-01

    Objective To investigate the characteristics of acute poisonings caused by various poisons in Guangxi,China.Methods A retrospective investigation was performed in 5859 cases of acute poisonings who were admitted to 63 hospitals in 11 cities,as well as 531 types of poisons involved.The poisons were categorized into 6 groups; each group of cases was stratified by the rural or urban settings,frequency of poisoning,and cause of poisoning to analyze the numbers of cases and constituent ratios.Results Most types of poisons (68.74%) belonged to drugs (217 types) and pesticides (148 types).Most cases of poisonings (61.63%) were caused by pesticides (n=2547) and chemicals (n=1064).Pesticides,poisons of plant origins,and poisons of animal origins were responsible for most of the cases in rural settings; 88.46%,79.10%,and 66.74% of the cases of these poison categories happened in rural settings.Chemicals,drugs,and other poisons were responsible for most of the cases in urban settings; 70.20%,61.74%,and 63.73% of the cases of these poison categories happened in urban settings.The numbers of cases in 5-year-poisoning groups were the highest in all categories of poisons,accounting for 85.24%,88.57%,55.16%,70.79%,68.36%,and 66.44% of cases of respective categories.Most cases of poisonings by chemicals,poisons of animal origin,and other poisons were accident-related (86.24%,72.66%,and 46.71% of the poison categories).Most cases of poisonings by pesticides and drugs were suiciderelated (59.39% and 33.52% of the poison categories).Most cases by poisons of plant origin were caused by accidental ingestion (70.36% of the poison category).Conclusion Most of the acute poisonings in Guangxi area are caused by pesticides and chemicals; the most common causes of poisoning are accidents,accidental ingestion,and suicide.There are significant differences in the causes of acute poisonings between the urban and rural settings.%目的 探讨广西各类毒

  16. Acute Lantana camara poisoning in a Boer goat kid : case report

    Ide, A.; C.L.C. Tutt

    1998-01-01

    Acute Lantana camara poisoning in a Boer goat kid is described. The animal was part of a flock of boer goats that was introduced from the Kalahari thornveld, where the plant does not occur, to an area where the plant grew abundantly. At necropsy, the animal was severely icteric, dehydrated and constipated, with hepatosis, distention of the gall-bladder and nephrosis, but no skin lesions. Histopathological findings of the liver confirmed moderate hepatosis with single-cell necrosis and bile st...

  17. Combined administration of hyperbaric oxygen and hydroxocobalamin improves cerebral metabolism after acute cyanide poisoning in rats

    Hansen, M B; Olsen, Niels Vidiendal; Hyldegaard, O

    2013-01-01

    -to-pyruvate ratio in rat brain by means of microdialysis during acute CN poisoning. Anesthetized rats were allocated to three groups: 1) vehicle (1.2 ml isotonic NaCl intra-arterially); 2) potassium CN (5.4 mg/kg intra-arterially); 3) potassium CN, OHCob (100 mg/kg intra-arterially) and subsequent HBOT (284 kPa in...

  18. ACUTE ACCIDENTAL POISONING IN CHILDREN: A HOSPITAL-BASED RETROSPECTIVE STUDY

    Kameshore; Singh; Jibo; Minita

    2014-01-01

    INTRODUCTION: Acute accidental poisoning in children is a big problem anywhere in the world. Studies done elsewhere in India showed a wide range of incidence of the problem. Hence, it was felt important to study its magnitude and associated characteristics as of now. OBJECTIVE: The current study was taken up to know the magnitude among children admitted in JNIMS, Imphal which is a newly established medical institute and also to study the characteristics like age, gender, type ...

  19. Sequential CT change of the globus pallidus in acute carbon monoxide poisoning

    We presented CT findings in the globus pallidus of three cases of acute CO poisoning. The initial low density lesions in the bilateral globus pallidus became isodense two to three weeks after the onset, and later appeared again as low density spots. These changes on CT were similar to the so-called ''fogging effect'' that is often found in cases of cerebral infarcts. (author)

  20. Abnormal pancreatic enzymes and their prognostic role after acute paraquat poisoning

    Yi Li; Meng Wang; Yanxia Gao; Wen Yang; Qun Xu; Michael Eddleston; Li Li; Xuezhong Yu

    2015-01-01

    Ingestion of paraquat causes multi-organ failure. Prognosis is best estimated through measurement of blood paraquat concentrations but this facility is not available in most hospitals. We studied the prognostic significance of abnormal pancreatic enzymes for survival. Patients with acute paraquat poisoning were recruited. An extensive series of blood tests including serum amylase were serially checked. Patients were sorted according to their serum amylase activity (normal [660 U/L]), and surv...

  1. The Effect of Acute Fluoride Poisoning on Nitric Oxide and Methemoglobin Formation in the Guinea pig

    ŞİRELİ, Meltem

    2004-01-01

    To study the effect of acute fluoride poisoning on nitric oxide and methemoglobin formation, 250 mg/kg bw sodium fluoride was applied alone and verapamil was applied together with fluoride. Blood nitric oxide (Griess reaction) and calcium levels; hemoglobin, methemoglobin and hematocrit values; and erythrocyte counts were determined and compared with those of the controls. After the fluoride application it was found that there was a relative relationship between the increase in nitric oxide a...

  2. Effect of hemoperfusion on internal environment of patients with acute poisoning

    Hua Li; Wen-Qiang Li

    2016-01-01

    Objective:To explore the effect of hemoperfusion on the internal environment of patients with acute poisoning.Methods: A total of 36 patients with the acute poisoning who received the hemoperfusion treatment in Department of Emergency Medicine of this hospital were selected as the research subjects and a retrospective study was performed on them. At the beginning, 30 min and 120 min of hemoperfusion treatment, the blood was taken from the blood-collecting point of artery with cardiopulmonary bypass to detect the blood pH, partial pressure of CO2, partial pressure of oxygen, blood lactic acid, potassium, sodium, free calcium, bicarbonate ion and blood glucose level. The above indicators at the different time point were compared. Results:At the beginning, 30 min and 120 min of hemoperfusion, there was no significant difference in the partial pressure of CO2, pH, blood potassium, blood sodium, bicarbonate ion and free calcium between groups. But at the beginning, 30 min and 120 min of hemoperfusion, there was the significant difference in the partial pressure of oxygen, lactic acid and blood glucose between groups.Conclusion:There is no significant effect on the internal environment of patients with acute poisoning who receive the hemoperfusion treatment.

  3. Acute Copper Sulfate Poisoning: Case Report and Review of Literature

    Mahesh Chand Meena

    2014-09-01

    Full Text Available Background: Copper sulfate ingestion is a relatively popular method for committing suicide in Indian subcontinent. It causes a high mortality rate, and so a growing concern has been raised to identify the severe alarming signs suggestive of poor prognosis and to improve treatment approaches. Case report: A 22-year-old unmarried man working as a painter was found unconscious at his friend residence. The patient developed hypotension, hemorrhagic gastroenteritis with hematemesis and melena, renal and hepatic failure, severe metabolic acidosis and intravascular hemolysis during admission at hospital. His signs were refractory to treatment with fluid replacement therapy, vasoactive drugs, antiemetic drugs, ranitidine, furosemide, methylene blue and 2,3 dimercaptopropane-1-sulphonate. He died six hours post-admission. In post-mortem examinations, there were multiple sub-pleural and sub-epicardial hemorrhages and the gastrointestinal mucosa was congested, hemorrhagic, and greenish blue in color. The liver, on histological examination, showed sub-massive hepatic necrosis. On toxicological analyses, copper sulfate was detected in preserved viscera and results for other heavy metals were negative. Conclusion: Hypotension, cyanosis, uremia and jaundice can be considered as signs of poor prognosis in copper sulfate poisoning. Copper sulfate ingestion is life-threatening due to its deleterious effects on the upper GI, kidneys, liver and blood. Having no time to waste, aggressive treatments should be immediately instituted and signs of poor prognosis should be kept in mind.

  4. Acute human self-poisoning with imidacloprid compound: a neonicotinoid insecticide.

    Fahim Mohamed

    Full Text Available BACKGROUND: Deliberate self-poisoning with older pesticides such as organophosphorus compounds are commonly fatal and a serious public health problem in the developing world. The clinical consequences of self-poisoning with newer pesticides are not well described. Such information may help to improve clinical management and inform pesticide regulators of their relative toxicity. This study reports the clinical outcomes and toxicokinetics of the neonicotinoid insecticide imidacloprid following acute self-poisoning in humans. METHODOLOGY/PRINCIPAL FINDINGS: Demographic and clinical data were prospectively recorded in patients with imidacloprid exposure in three hospitals in Sri Lanka. Blood samples were collected when possible for quantification of imidacloprid concentration. There were 68 patients (61 self-ingestions and 7 dermal exposures with exposure to imidacloprid. Of the self-poisoning patients, the median time to presentation was 4 hours (IQR 2.3-6.0 and median amount ingested was 15 mL (IQR 10-50 mL. Most patients only developed mild symptoms such as nausea, vomiting, headache and diarrhoea. One patient developed respiratory failure needing mechanical ventilation while another was admitted to intensive care due to prolonged sedation. There were no deaths. Median admission imidacloprid concentration was 10.58 ng/L; IQR: 3.84-15.58 ng/L, Range: 0.02-51.25 ng/L. Changes in the concentration of imidacloprid in serial blood samples were consistent with prolonged absorption and/or saturable elimination. CONCLUSIONS: Imidacloprid generally demonstrates low human lethality even in large ingestions. Respiratory failure and reduced level of consciousness were the most serious complications, but these were uncommon. Substitution of imidacloprid for organophosphorus compounds in areas where the incidence of self-poisoning is high may help reduce deaths from self-poisoning.

  5. The pathology of acute Nolletia gariepina poisoning of cattle

    E. C. Du Plessis

    2011-04-01

    Full Text Available Toxicity in cattle by the shrub Nolletia gariepina was induced experimentally by intraruminal administration of 3 g/kg dried, milled plant material as a single dose. The animals had to be starved for 24 hours before dosing, as dosing on a full rumen did not induce any signs of toxicity during 5 days of observation and clinical pathology monitoring. Clinical signs were not specific and varied according to the duration (acute versus subacute of the toxicological process. Clinical pathological parameters indicated renal and to a lesser extent hepatic damage, with raised serum concentrations of urea, creatinine, aspartate aminotransferase (AST and gamma glutamyl transferase (GGT. Increased urinary sodium and potassium concentration and GGT activity, as well as proteinuria, were evident. Histological and electron microscopic examinations revealed acute renal tubular epithelial cell degeneration and necrosis, especially of the proximal convoluted tubules. Mild hepatocellular degeneration was also noticeable.

  6. Acute methoxetamine and amphetamine poisoning with fatal outcome: A case report

    Marek Wiergowski

    2014-08-01

    Full Text Available Methoxetamine (MXE is a psychoactive substance distributed mostly via the Internet and is not liable to legal regulation in Poland. MXE has a toxicity profile similar to that of ketamine but longer-lasting effects. The paper describes a case of acute poisoning that resulted from recreational use of MXE and amphetamine and ended in death. In mid-July 2012, a 31-year old man was admitted to the clinical toxicology unit in Gdańsk because of poisoning with an unknown psychoactive substance. The patient was transported to the emergency department (ED at 5:15 a.m. in a very poor general condition, in a deep coma, with acute respiratory failure, hyperthermia (> 39°C and generalized seizures. Laboratory tests showed marked leukocytosis, signs of massive rhabdomyolysis, hepatic failure and beginning of acute renal failure. Despite intensive therapy, the patient died 4 weeks after the poisoning in the course of multi-organ dysfunction syndrome. Chemical and toxicological studies of serum and urine samples collected on the poisoning day at 1:40 p.m. confirmed that amphetamine and MXE had been taken earlier that day. Concentration of amphetamine in the serum (0.06 μg/ml was within the non-toxic range, while MXE (0.32 μg/ml was within the toxic range of concentrations. Amphetamine was also detected in the patient's hair, which suggested a possibility of its use within the last dozen weeks or so. The serious clinical course of intoxication and co-existence of amphetamine and MXE in the patient's blood and urine suggest the possibility of adverse interactions between them.

  7. Toxicokinetics of paraquat in Korean patients with acute poisoning

    Kim, Hak-Jae; Kim, Hyung-Ki; Lee, HwaYoung; Bae, Jun-Seok; Kown, Jun-Tack; Gil, Hyo-Wook; Hong, Sae-Yong

    2015-01-01

    To conduct a kinetic study of paraquat (PQ), we investigated 9 patients with acute PQ intoxication. All of them ingested more than 20 ml of undiluted PQ herbicide to commit suicide and arrived at our hospital early, not later than 7 h after PQ ingestion. The urine dithionite test for PQ in all of the nine patients was strongly positive at emergency room. Blood samples were obtained every 30 min for the first 2~3 h and then every 1 or 2 h, as long as the clinical progression was stable among t...

  8. Duration of an induced resistance of sheep to acute poisoning by Crotalaria retusa seeds

    Lisanka Angelo Maia

    2014-06-01

    Full Text Available The aim of this study was to determine the duration of the resistance after the end of the ingestion of non-toxic doses of Crotalaria retusa seeds. Ten sheep were divided into 3 groups of 3 animals each and a control group with 1 sheep. To induce resistance, sheep in groups 1, 2 and 3 received 20 daily doses of 2g kg-1 of C. retusa seeds, followed by 7 daily doses of 4g kg-1. To determine the duration of resistance the sheep in groups 1, 2 and 3 were challenged orally, 3, 7 and 15 days, respectively, after receiving the last dose of 4g kg-1, with a single dose of 5g kg-1. Sheep of groups 1 and 2 did not develop overt signs of poisoning. Two sheep of group 3, challenged 15 days after the end of the resistance induction period, showed signs of acute poisoning and died. These results suggest that the induced resistance of sheep to acute poisoning by C. retusa seeds is of short duration, from 7 to 15 days.

  9. [Acute drug poisonings in children in a general pediatric service (epidemiologic profile)].

    Aïlal, F; Dehbi, F; Slaoui, B

    1998-06-01

    Acute drug poisonings of the child is a major problem for health authorities all over the world, and are responsible for serious morbidity with mortality risks. The present retrospective study has involved 150 cases of drug poisoning observed in the Casablanca children's hospital over a period of 7 years. Most intoxication cases are accidental (84%), (mostly in children of 1 to 5 years old 74.6%), willful (11.3%), or iatrogenic (4.7%). Happening most often at home (95%) with a high frequency between 5 and 6 p.m. (24%) and 11 a 12 p.m. (13.3%), time of strong hunger. The large majority of drugs wer psychotropic agents (56%), principally diazepins (39%). Followed by oral contraceptive (8%), antihistaminics (8%), analgesics (7%), antibiotics (4%) and others (11%). Prevention is of high importance, and must be made effective on the wildest scale. PMID:9689865

  10. [Clinical symptoms and circumastances of acute poisonings with fly agaric (Amanita muscaria) and panther cap (Amanita pantherina)].

    Łukasik-Głebocka, Magdalena; Druzdz, Artur; Naskret, Maciej

    2011-01-01

    Mushroom poisonings in Poland are quite common, especially in summer and autumn, but fly agaric (Amanita muscaria) and panther cap (Amanita pantherina) are rather rare cause of these intoxications. Fly agaric is a cause of deliberate poisoning, whereas panther cap poisoning also happens accidentally. The main toxins of these two mushrooms are ibotenic acid (pantherine, agarine), muscimol, muscazone and muscaridine. The other bioactive substances are stizolobic and stizolobinic acids and aminodicarboxyethylthiopropanoic acids. All these compounds are responsible for diverse picture of intoxication. An analysis of patients with Amanita muscaria and Amanita pantherina poisoning hospitalized in the Poznan Departament of Toxicology revealed that symptoms occurred after 30 minutes to 2 hours with vomiting, hallucinations, restlessness, increased psychomotor drive and central nervous system depression. Other antycholinergic symptoms like tachycardia and increased blood pressure, mydriasis, dry and red skin were seen only in a few cases. Acute respiratory failure was the most dangerous symptom observed in the course of poisoning. PMID:22010435

  11. Toxicokinetics of paraquat in Korean patients with acute poisoning.

    Kim, Hak-Jae; Kim, Hyung-Ki; Lee, Hwayoung; Bae, Jun-Seok; Kown, Jun-Tack; Gil, Hyo-Wook; Hong, Sae-Yong

    2016-01-01

    To conduct a kinetic study of paraquat (PQ), we investigated 9 patients with acute PQ intoxication. All of them ingested more than 20 ml of undiluted PQ herbicide to commit suicide and arrived at our hospital early, not later than 7 h after PQ ingestion. The urine dithionite test for PQ in all of the nine patients was strongly positive at emergency room. Blood samples were obtained every 30 min for the first 2~3 h and then every 1 or 2 h, as long as the clinical progression was stable among the patients for 30 h after PQ ingestion. The area under the plasma concentration-time curve (AUCinf), which was extrapolated to infinity, was calculated using the trapezoidal rule. Toxicokinetic parameters, such as the terminal elimination half-life, apparent oral clearance, and apparent volume of distribution (Vd/F) were calculated. The maximum PQ concentration (Cmax) and the time to reach maximum PQ concentration (Tmax) were also obtained. Plasma PQ concentrations in nine patients were well described by a bi-exponential curve with a mean terminal elimination half-life of 13.1±6.8 h. Cmax and AUCinf were 20.8±25.7 mg/l and 172.5±160.3 h·mg/l, respectively. Apparent volume of distribution and apparent oral clearance were 50.9±61.3 l/kg and 173.4±111.2 l/h, respectively. There were a significant correlation (r =0.84; p<0.05) between the PQ amount ingested and Cmax. AUCinf also showed a significant correlation (r =0.83; p<0.05) with the PQ amount ingested. These correlations provide evidence that PQ has dose-linear toxicokinetic characteristics. PMID:26807021

  12. Ultrastructural effects of acute tetraethyllead poisoning on nerve cells of the rabbit brain

    Niklowitz, W.J.

    1974-08-01

    A study of the ultrastructural alterations of nerve cell components in specific areas of the brain of the rabbit after acute poisoning with tetraethyllead (TEL). A single dose of 100 mg/kg of TEL caused neurological disorders such as convulsions after a latency of 12 to 18 h. An electron microscopic study revealed that the nerve cells of the areas investigated contained different stages of degenerative changes not demonstrated by light microscopy. These appear to be dependent on location and antedate the neurological disorders. The cytopathogenesis is discussed in the light of these findings and available biochemical data. (CIS Abstract Vol. 2)

  13. Glasgow coma scale in acute poisonings before and after use of antidote in patients with history of use of psychotropic agents

    Poplas-Sušić Tonka; Klemenc-Ketis Zalika; Komericki-Grzinić Marija; Kersnik Janko

    2010-01-01

    Introduction. Data on emergency interventions in poisonings are scarce. Objective. To determine the effectiveness of antidote therapy in acute poisoning-related emergency medical services (EMS) interventions. Methods. A prospective observational study included all poisoning-related intervention cases over 3 years (1999-2001) in the Celje region, Slovenia, covering 125,000 inhabitants. Data were recorded on an EMS form. Results. Psychoactive agents were present in 56.5% out of 244 poisoning-re...

  14. Brain temperature measured by {sup 1}H-magnetic resonance spectroscopy in acute and subacute carbon monoxide poisoning

    Fujiwara, Shunrou; Nishimoto, Hideaki; Murakami, Toshiyuki; Ogawa, Akira; Ogasawara, Kuniaki [Iwate Medical University, Department of Neurosurgery, Morioka, Iwate (Japan); Yoshioka, Yoshichika [Osaka University, Laboratory of Biofunctional Imaging, WPI Immunology Frontier Research Center, Osaka (Japan); Matsuda, Tsuyoshi [MR Applications and Workflow Asia Pacific, GE Healthcare Japan, Tokyo (Japan); Beppu, Takaaki [Iwate Medical University, Department of Neurosurgery, Morioka, Iwate (Japan); Iwate Medical University, Department of Hyperbaric Medicine, Iwate (Japan)

    2016-01-15

    Brain temperature (BT) is associated with the balance between cerebral blood flow and metabolism according to the ''heat-removal'' theory. The present study investigated whether BT is abnormally altered in acute and subacute CO-poisoned patients by using {sup 1}H-magnetic resonance spectroscopy (MRS). Eight adult CO-poisoned patients underwent 3-T magnetic resonance imaging in the acute and subacute phases after CO exposure. MRS was performed on deep cerebral white matter in the centrum semiovale, and MRS-based BT was estimated by the chemical shift difference between water and the N-acetyl aspartate signal. We defined the mean BT + 1.96 standard deviations of the BT in 15 healthy controls as the cutoff value for abnormal BT increases (p < 0.05) in CO-poisoned patients. BT of CO-poisoned patients in both the acute and subacute phases was significantly higher than that of the healthy control group. However, BT in the subacute phase was significantly lower than in the acute phase. On the other hand, no significant difference in body temperature was observed between acute and subacute CO-poisoned patients. BT weakly correlated with body temperature, but this correlation was not statistically significant (rho = 0.304, p = 0.2909). The present results suggest that BT in CO-poisoned patients is abnormally high in the acute phase and remains abnormal in the subacute phase. BT alteration in these patients may be associated with brain perfusion and metabolism rather than other factors such as systemic inflammation and body temperature. (orig.)

  15. Brain temperature measured by 1H-magnetic resonance spectroscopy in acute and subacute carbon monoxide poisoning

    Brain temperature (BT) is associated with the balance between cerebral blood flow and metabolism according to the ''heat-removal'' theory. The present study investigated whether BT is abnormally altered in acute and subacute CO-poisoned patients by using 1H-magnetic resonance spectroscopy (MRS). Eight adult CO-poisoned patients underwent 3-T magnetic resonance imaging in the acute and subacute phases after CO exposure. MRS was performed on deep cerebral white matter in the centrum semiovale, and MRS-based BT was estimated by the chemical shift difference between water and the N-acetyl aspartate signal. We defined the mean BT + 1.96 standard deviations of the BT in 15 healthy controls as the cutoff value for abnormal BT increases (p < 0.05) in CO-poisoned patients. BT of CO-poisoned patients in both the acute and subacute phases was significantly higher than that of the healthy control group. However, BT in the subacute phase was significantly lower than in the acute phase. On the other hand, no significant difference in body temperature was observed between acute and subacute CO-poisoned patients. BT weakly correlated with body temperature, but this correlation was not statistically significant (rho = 0.304, p = 0.2909). The present results suggest that BT in CO-poisoned patients is abnormally high in the acute phase and remains abnormal in the subacute phase. BT alteration in these patients may be associated with brain perfusion and metabolism rather than other factors such as systemic inflammation and body temperature. (orig.)

  16. Acute Renal Failure due to Copper Sulfate Poisoning; a Case Report

    Fakhrossadat Mortazavi

    2009-03-01

    Full Text Available Background:Copper sulfate is a blue and odorless salt with various industrial, chemical, agricultural and medicinal applications. Copper sulfate poisoning is rare in children. Case Presentation:A 23-month old boy accidentally ingested a solution of copper sulfate, used as a disinfectant agent in animal husbandry. He was referred to Children's Hospital of Tabriz because of frequent vomiting and lethargy. The major systemic complications were intravascular hemolysis, anemia and acute renal failure. The patient was successfully treated with multiple packed cell transfusions, dimercaprol, penicillamine and peritoneal dialysis. Plasma copper level 15 days after ingestion was 216 ?g/dl.Conclusion:Copper sulfate is a highly toxic agent that, when ingested, can cause local and systemic damage including coma, shock, severe intravascular hemolysis, hepatotoxicity and acute renal failure with high mortality.

  17. Neurotoxicity and reactive astrogliosis in the anterior cingulate cortex in acute ciguatera poisoning.

    Zhang, Xu; Cao, Bing; Wang, Jun; Liu, Jin; Tung, Vivian Oi Vian; Lam, Paul Kwan Sing; Chan, Leo Lai; Li, Ying

    2013-06-01

    Ciguatoxins (CTXs) cause long-term disturbance of cerebral functions. The primary mechanism of neurotoxicity is related to their interaction with voltage-gated sodium channels. However, until now, the neurological targets for CTXs in the brain of intact animals have not been described. In our study, 1 day following oral exposure to 0.26 ng/g of Pacific ciguatoxin 1 (P-CTX-1), we performed in vivo electrophysiological recordings in the rat anterior cingulate cortex (ACC) and identified the increase in spontaneous firings and enhanced responses to visceral noxious stimulation. Local field recordings characterized the P-CTX-1-induced synaptic potentiation and blockage of the induction of electrical stimulation-induced long-term potentiation in the medial thalamus (MT)-ACC pathway. Furthermore, intracerebroventricular administration of P-CTX-1 at doses of 1.0, 5.0, and 10 nM produced a dose-dependent increase in ACC neuronal firings and MT-ACC synaptic transmission. Further studies showed upregulated Na(+) channel expression in astrocytes under pathological conditions. We hypothesized that the astrocytes might have been activated in the ciguatera poisoning in vivo. Increases in glial fibrillary acid protein expression were detected in reactive astrocytes in the rat ACC. The activation of astroglia was further indicated by activation of the gap junction protein connexin 43 and upregulation of excitatory amino acid transporter 2 expression suggesting that glutamate was normally rapidly cleared from the synaptic cleft during acute ciguatera poisoning. However, neurotoxicity and reactive astrogliosis were not detected in the ACC after 7 days of P-CTX-1 exposure. The present results are the first characterization of P-CTX-1-invoked brain cortex neuronal excitotoxicity in vivo and supported the theme that neuron and astroglia signals might play roles in acute ciguatera poisoning. PMID:23494292

  18. Acute Pancreatitis Caused By Mushroom Poisoning: A Report of Two Cases.

    Karahan, Samet; Erden, Abdulsamet; Cetinkaya, Ali; Avci, Deniz; Ortakoyluoglu, Adile Irfan; Karagoz, Hatice; Bulut, Kadir; Basak, Mustafa

    2016-01-01

    Of the more than 5000 species of mushrooms known, 100 types are toxic and approximately 10% of these toxic types can cause fatal toxicity. A type of mushroom called Amanita phalloides is responsible for 95% of toxic mushroom poisonings. In this article, we report 2 cases of mushroom poisonings caused by Lactarius volemus, known as Tirmit by the local people. The patient and his wife were admitted to the emergency room with abdominal pain, nausea, and vomiting 20 hours after consuming Lactarius volemus, an edible type of mushroom. The patients reported that they had been collecting this mushroom from the mountains and eating them for several years but had never developed any clinicopathology to date. Further examination of the patients revealed a very rare case of acute pancreatitis due to mushroom intoxication. The male patient was admitted to the intensive care unit while his wife was followed in the internal medicine service, because of her relative mild clinical symptoms. Both patients recovered without sequelae and were discharged. In this article, we aimed to emphasize that gastrointestinal symptoms are often observed in mushroom intoxications and can be confused with acute pancreatitis, thus leading to misdiagnosis of patients. Early diagnosis and appropriate treatment can improve patients' prognosis and prevent the development of complications. PMID:26835473

  19. Utility of the Measurement of Carboxyhemoglobin Level at the Site of Acute Carbon Monoxide Poisoning in Rural Areas.

    Onodera, Makoto; Fujino, Yasuhisa; Kikuchi, Satoshi; Sato, Masayuki; Mori, Kiyofumi; Beppu, Takaaki; Inoue, Yoshihiro

    2016-01-01

    Objective. This study examined the hypothesis that correlations exist between the carbon monoxide exposure time and the carboxyhemoglobin concentration at the site of carbon monoxide poisoning, using a pulse carbon monoxide oximeter in rural areas or the carboxyhemoglobin concentration measured at a given medical institution. Background. In previous studies, no definitive relationships between the arterial blood carboxyhemoglobin level and the severity of carbon monoxide poisoning have been observed. Method. The subjects included patients treated for acute carbon monoxide poisoning in whom a medical emergency team was able to measure the carboxyhemoglobin level at the site of poisoning. We examined the relationship between the carboxyhemoglobin level at the site of poisoning and carbon monoxide exposure time and the relationships between the arterial blood carboxyhemoglobin level and carbon monoxide exposure time. Results. A total of 10 patients met the above criteria. The carboxyhemoglobin levels at the site of poisoning were significantly and positively correlated with the exposure time (rs = 0.710, p = 0.021), but the arterial blood carboxyhemoglobin levels were not correlated with the exposure time. Conclusion. In rural areas, the carboxyhemoglobin level measured at the site of carbon monoxide poisoning correlated with the exposure time. PMID:27239377

  20. Determinants of lethality from suicidal pesticide poisoning in metropolitan HsinChu.

    Sheu, J J; Wang, J D; Wu, Y K

    1998-12-01

    Acute pesticide poisoning is a global health problem, especially in developing countries. Although Taiwan has quickly industrialized during the last several decades, pesticide use is still prevalent in the agricultural sector. We reviewed 187 consecutive hospitalized cases of the Provincial HsinChu Hospital from January 1989 through December 1995 to explore the determinants of acute pesticide poisoning in Metropolitan HsinChu. The annual incidence rate of acute pesticide poisoning was 3.2/100,000 with an overall fatality rate of 23% which was more severe than the rates found in developed countries. The major agents involved were organophosphates, and the major cause of poisoning was suicide. Alcohol abuse, history of major medical illnesses, and history of suicide were significantly associated with suicidal poisoning; quarrel was the immediate risk factor. Causes of poisoning (suicide vs non-suicide) and selection of the pesticides were major determinants of lethality. More stringent legislation and enforcement regarding the sale and distribution of extremely toxic pesticides are needed to reduce fatalities due to acute pesticide poisoning. PMID:9830692

  1. Evaluation of respiratory dysfunction in a pig model of severe acute dichlorvos poisoning

    HE Xin-hua; WU Jun-yuan; LI Chun-sheng; SU Zhi-yu; JI Xian-fei; HAN Yi; WANG Sheng-qi; ZHANG Jian

    2012-01-01

    Background Respiratory failure is the main cause of death in acute organophosphorus pesticide poisoning.In this study,a pulse-induced contour cardiac output monitor was used to evaluate the respiratory status in a pig model of acute dichlorvos poisoning.Methods Twenty female pigs were randomly allocated to dichlorvos (n=7),atropine (n=7),and control (n=6) groups.In the dichlorvos group,pigs were administered 80% emulsifiable dichlorvos (100 mg/kg) via a gastric tube.In the atropine group,pigs were similarly administered dichlorvos,and 0.5 hours later,atropine was injected to attain and maintain atropinization.The control group was administered saline solution.Arterial blood gas was measured at 0,0.5,1,2,4,and 6 hours post-injection.The extravascular lung water index and pulmonary vascular permeability index were recorded by the pulse-induced contour cardiac output monitor.At termination of the study,the animals were euthanized,the lung wet-to-dry weight ratio was determined,and histopathology was observed.Results In the dichlorvos group,the extravascular lung water index and pulmonary vascular permeability index were substantially increased from 0.5 hours and were particularly high within 1 hour.In the atropine group,these indices increased initially,but decreased from the 1-hour mark.The control group exhibited no obvious changes.In both the dichlorvos and atropine groups,the extravascular lung water index was negatively correlated with partial pressure of oxygen/fraction of inspiration oxygen (PO2/FiO2) and positively correlated with the pulmonary vascular permeability index.Compared with the control group,the lung wet-to-dry weight ratio markedly increased and the histopathological findings obviously changed in the dichlorvos group,but only mildly increased and changed,respectively,in the atropine group.Conclusion The extravascular lung water index is an appropriate and valuable parameter for assessment of respiratory function in acute dichlorvos poisoning.

  2. Comparative assessment of blood and urine analyses in patients with acute poisonings by medical, narcotic substances and alcohol in clinical toxicology.

    Ostapenko, Yury Nikolaevich; Lisovik, Zhanna Andreevna; Belova, Maria Vladimirovna; Luzhnikov, Evgeny Alekseevich; Livanov, Alexandr Sergeevich

    2005-01-01

    Acute poisonings by medical, narcotic substances and alcohol are actual in Russia in the recent years. Comparison of analytic facilities of modern analytical techniques: chromatographic (HPLC, GC, GC-MS) and immuno-chemical (FPIA) in clinical toxicology for urgent diagnostics, assessment of the severity of acute poisoning and the efficacy of the treatment in patients with acute poisonings by psychotropic drugs, narcotics and alcohol have been done. The object of the study were serum, blood, urine of 611 patients with acute poisonings by amitriptyline, clozapine, carbamazepine, opiates and also alcohol. Threshold concentrations (threshold, critical and lethal) of the toxicants and their active metabolites which corresponded to different degrees of poisoning severity have been determined. The most comfortable and informative screening method for express diagnostics and assessment of severity of acute poisonings by psychotropic drugs and narcotics showed the HPLC with using automatic analyzers. FPIA using the automatic analyzer could be applied for screening studies, if group identification is enough. GC-FID method is advisable in case of poisoning by medical substances and narcotics in view of repeated investigation for assessment of the efficacy of the therapy. GC-MS could be advisable for confirming the results of other methods. GC-TCD possess high sensitivity and specificity and is optimal for express differential diagnostics and quantitative assessment of acute poisoning by ethanol and other alcohols. PMID:16225131

  3. Hydrogen peroxide potentiates organophosphate toxicosis in chicks

    Banan K. Al-Baggou

    2011-11-01

    Full Text Available Objective: The purpose of the present study was to examine the effect of hydrogen peroxide(H2O2 on the acute toxicity of organophosphate insecticides dichlorvos and diazinon and their inhibitoryactions on plasma, brain and liver cholinesterase activities. Material and Methods: H2O2 was given indrinking water (0.5% v/v for 2 weeks in unsexed day old chicks, a regimen known to induce oxidativestress in this species. A control group received drinking tap water. All experiments were conducted onthe chicks at the age of 15 days after exposure to H2O2. The acute (24 h oral LD50 values of dichlorvosand diazinon in the insecticidal preparations as determined by the up-and-down method in the controlchicks were 9.4 and 15.6 mg/kg, respectively. Results: The poisoned chicks manifested signs ofcholinergic toxicosis within one hour after the dosing including salivation, lacrimation, gasping, frequentdefecation, drooping of wings, tremors, convulsions and recumbency. The acute (24 h oral LD50 valuesof dichlorvos and diazinon in chicks provided with H2O2 were reduced to 3.5 and 6.5 mg/kg, by 63 and58%, respectively when compared to respective control LD50 values. The intoxicated chicks also showedcholinergic signs of toxicosis as described above. Plasma, brain and liver cholinesterase activities of thechicks exposed to H2O2 were significantly lower than their respective control (H2O values by 25, 28 and27%, respectively. Oral dosing of chicks with dichlorvos at 3 mg/kg significantly inhibited cholinesteraseactivities in the plasma, brain and liver of both control (42-67% and H2O2-treated (15-59% chicks.Diazinon at 5 mg/kg, orally also inhibited cholinesterase activities in the plasma, brain and liver of bothcontrol (36-66% and H2O2-treated (15-30% chicks. In the H2O2 groups, dichlorvos inhibition of livercholinesterase activity and diazinon inhibition of liver and brain cholinesterase activities weresignificantly lesser than those of the respective values of

  4. Detoxification of organophosphate nerve agents by bacterial phosphotriesterase

    Organophosphates have been widely used as insecticides and chemical warfare agents. The health risks associated with these agents have necessitated the need for better detoxification and bioremediation tools. Bacterial enzymes capable of hydrolyzing the lethal organophosphate nerve agents are of special interest. Phosphotriesterase (PTE) isolated from the soil bacteria Pseudomonas diminuta displays a significant rate enhancement and substrate promiscuity for the hydrolysis of organophosphate triesters. Directed evolution and rational redesign of the active site of PTE have led to the identification of new variants with enhanced catalytic efficiency and stereoselectivity toward the hydrolysis of organophosphate neurotoxins. PTE has been utilized to protect against organophosphate poisoning in vivo. Biotechnological applications of PTE for detection and decontamination of insecticides and chemical warfare agents are developing into useful tools. In this review, the catalytic properties and potential applications of this remarkable enzyme are discussed

  5. Study on decorporating and detoxicating acute depleted uranium poison with some flavonoids

    In order to investigate decorporating and detoxicating acute depleted uranium poison of flavonoids, the decorporation effect of flavonoids with catechol group, chelating agent of catechols amino carboxylic acid type (8102) and dimethyl sulfoxide (DMSO) were studied under DU exposure and Wistar rats as animal model. In 3d later after injecting DU with dose of 20 mg/kg and then injecting flavonoids with dose of 10 mg/kg in abdomen, the mortality, uranium contents, kidney function and pathological observation of kidney were investigated. It has been found that nearly 20% mortality occurs both in the T2 and in T1 groups meanwhile 30% mortality occurs in the control group. But death has not been observed in 8102 group. The concentration of excreted urine uranium increases and the level of serum uranium decreases when T2 used. The retention of uranium in kidney with T2 group also increases. Large reducing of urea nitrogen and creatinine in serum has been observed in 8102 and F1 groups, and reducing of creatinine has also been observed in F2, T1 and T2 groups. The serious injury of kidney has not been observed in T2 group. The protection efficiency can be listed as T2> 8102>T1>F1>QU. It has been revealed that flavonoid T2 is the most effective protector from the damage and poison of DU. (authors)

  6. Paraquat poisoning: an experimental model of dose-dependent acute lung injury due to surfactant dysfunction

    M.F.R. Silva

    1998-03-01

    Full Text Available Since the most characteristic feature of paraquat poisoning is lung damage, a prospective controlled study was performed on excised rat lungs in order to estimate the intensity of lesion after different doses. Twenty-five male, 2-3-month-old non-SPF Wistar rats, divided into 5 groups, received paraquat dichloride in a single intraperitoneal injection (0, 1, 5, 25, or 50 mg/kg body weight 24 h before the experiment. Static pressure-volume (PV curves were performed in air- and saline-filled lungs; an estimator of surface tension and tissue works was computed by integrating the area of both curves and reported as work/ml of volume displacement. Paraquat induced a dose-dependent increase of inspiratory surface tension work that reached a significant two-fold order of magnitude for 25 and 50 mg/kg body weight (P<0.05, ANOVA, sparing lung tissue. This kind of lesion was probably due to functional abnormalities of the surfactant system, as was shown by the increase in the hysteresis of the paraquat groups at the highest doses. Hence, paraquat poisoning provides a suitable model of acute lung injury with alveolar instability that can be easily used in experimental protocols of mechanical ventilation

  7. Computed tomography of delayed encephalopathy of acute carbon monoxide poisoning - correlation with clinical findings -

    Cerebral computed tomography (CT) findings were described in twenty-six cases with the late sequelae of acute carbon monoxide poisoning and were computed with the neurological symptoms and signs. The CT findings include symmetrical periventricular white matter low density in five cases, globes pallidus low density in six cases, ventricular dilatation in seven cases, ventricular dilatation and sulci widening in three cases, and normal findings in ten cases. Only one case showed low densities in both periventricular white matter and globes pallidus. Late sequelae of the interval from of carbon monoxide poisoning were clinically categorized as cortical dysfunction, parkinsonian feature, and cerebella dysfunction. The severity of the clinical symptoms and signs of neurological sequelae is generally correlated with presence and multiplicity of abnormal brain CT findings. But of fourteen cases showing the parkinsonian feature, only five cases had low density of globes pallidus in brain CT. Another case showing small unilateral low density of globes pallidus had no parkinsonian feature but showed mild cortical dysfunction.

  8. Intoxicación aguda por plaguicidas Acute poisoning from pesticides

    Jaime Jesús Durán-Nah

    2000-02-01

    Full Text Available OBJETIVO: Describir la epidemiología de la intoxicación aguda por plaguicidas (IAP en el Hospital General O'Horán de Mérida, Yucatán, México. MATERIAL Y MÉTODOS: Se revisaron los expedientes de 33 pacientes ³ 13 años, tratados en una unidad de cuidados intensivos (UCI, entre 1994 y 1998. Se recopilaron variables demográficas y clínicas relevantes, y se aplicó estadística descriptiva. RESULTADOS: En la población estudiada predominó el sexo masculino (82% del medio rural (70%, y la edad media fue de 34 ± 15.8 años. El intento de suicidio fue causa frecuente de IAP (79%, y en 33% de los casos la intoxicación se produjo por la utilización de organofosforados. La mortalidad fue de 12%. CONCLUSIONES: La IAP fue baja entre los sujetos del medio rural, por lo que los resultados de este estudio parecen no reflejar la realidad del problema. Es importante añadir que los plaguicidas son utilizados con relativa frecuencia para el intento de suicidio.OBJECTIVE: To describe the epidemiologic pattern of acute pesticide poisoning (APP in a general hospital in Merida, Yucatan, Mexico. MATERIAL AND METHODS: From 1994 to 1998, 33 patients 13 years of age or older with diagnosis of APP were studied. Descriptive statistics were used to analyze information. RESULTS: Males were frequently affected (82%, specially those coming from rural areas (60%. The mean age of the group was 34 ± 15.8 years. In 79% of the cases, pesticides were used to commit suicide and 33% of poisoning cases were due to organophospate pesticides. The mortality rate was 12%. CONCLUSIONS: In this small sample, acute poisoning from pesticides in the agricultural setting may be underestimated, since it was less frequent than in the general population. APP was more commonly used by indigent people to commit suicide.

  9. Does Early-Life Exposure to Organophosphate Insecticides Lead to Prediabetes and Obesity?

    Slotkin, Theodore A.

    2010-01-01

    Human exposures to organophosphate insecticides are ubiquitous. Although regarded as neurotoxicants, increasing evidence points toward lasting metabolic disruption from early-life organophosphate exposures. We gave neonatal rats chlorpyrifos, diazinon or parathion in doses devoid of any acute signs of toxicity, straddling the threshold for barely-detectable cholinesterase inhibition. Organophosphate exposure during a critical developmental window altered the trajectory of hepatic adenylyl cyc...

  10. Management of exogenous intoxication by carbamates and organophosphates at an emergency unit

    Sydney Correia Leão

    2015-10-01

    Full Text Available Summary Objectives: to evaluate and indicate the procedure to be followed in the health unit, both for diagnosis and the treatment of acute exogenous intoxications by carbamates or organophosphates. Methods: a descriptive study based on retrospective analysis of the clinical history of patients diagnosed with intoxication by carbamates or organophosphates admitted at the emergency unit of the Hospital de Urgências de Sergipe Governador João Alves (HUSE between January and December of 2012. Some criteria were evaluated, such as: intoxicating agent; patient's age and gender; place of event, cause, circumstances and severity of the intoxication; as well as signs and symptoms of the muscarinic, nicotinic and neurological effects. Results: seventy patients (average age: 25±19.97 formed the study's population. It was observed that 77.14% of them suffered carbamate intoxication. However, organophosphate intoxications were more severe, with 68.75% of patients presenting moderate to severe forms. Suicide attempt was the leading cause of poisoning, with 62 cases (88.57% of total. Atropine administration was an effective therapeutic approach for treating signs and symptoms, which included sialorrhea (p=0.0006, nausea (p=0. 0029 and emesis (p lt0.0001. The use of activated charcoal was shown effective, both in combating the signs and symptoms presented by both patient groups (p <0.0001. Conclusion: it is concluded that the use of atropine and activated charcoal is highly effective to treat the signs and symptoms developed by patients presenting acute exogenous intoxication by carbamates or organophosphates.

  11. The clinical and imaging characteristics of delayed encephalopathy after acute carbon monoxide poisoning

    Objective: To discuss the clinical and imaging characteristics of delayed encephalopathy after acute carbon monoxide poisoning (DEACMP). Methods: The clinical data of 14 patients with DEACMP were respectively analyzed. Results: Initial symptom included mentally falling (MMSE rate < 20 points) in 14 patients (100%), incontinence of urine in 11 patients (78%). Relatively significant increase of hematoma (HCT) (average level 0.503±0.027) was found in 6 patients. Three kinds of brain magnetic resonance imaging (MRI) appearance including diffuse white matter lesion, cortical lesion and basal nuclei lesion often existed in association. Therapy for improving circulation was given in 14 patients, and therapy with hormone was given in 9 patients; with 85% improvement rate. 5 patients without hormone therapy but with improving circulation therapy also received improvement. Conclusion: High level of HCT might be one of the causes of DECACMP due to acute disturbance of brain micro-circulation.. Close monitoring the change of HCT levels should be adopted for at least 3-6 months during therapy. Therapy for improving circulation and for anti-agglutination of platelets should be performed besides the routine high-tension oxygen therapy. Low FA value on DTI indicates the occurrence of a demyelization change in the brain long tract fibers, which indicated therapeutic effect of hormone treatment. And, therefore it would be better to perform DTI scan before therapy for individualized therapy. (authors)

  12. THE SPECTRUM OF INTERMEDIATE SYNDROME FOLLOWING ACUTE ORGANOPHOSPHORUS POISONING: A RETROSPECTIVE COHORT STUDY FROM A TEACHING HOSPITAL OF CHHATTISGARH

    Murthy

    2014-05-01

    Full Text Available Intermediate syndrome is a common complication found in patients with organo-phosphorus poisoning. The aim of this study was to find its incidence in this tribal dominated area of Chhattisgarh state. This is a retrospective study carried out at the ICU of a teaching Medical College hospital. In a period of one year, 720 cases of acute poisoning were admitted in the medical ICU ward, out of which, 682 cases (94.7% were of organo-phosphorus poisoning. 64 cases (9.3% had signs & symptoms of intermediate syndrome, which included inability to flex the neck, respiratory difficulty, convulsions and other features. All the 64 cases of intermediate syndrome required ventilatory support. Male: female ratio was 8:10. The commonest compound implicated in poisoning was Fenthion. Mortality was 18%. Patients with respiratory muscle weakness & proximal muscle paresis were the definitive predictors for the development of intermediate syndrome. Early recognition & prompt treatment has often proved successful, but, in mixed poisoning, recovery is variable and unpredictable.

  13. A retrospective study of paradigm and outcome of acute poisoning cases in a tertiary care teaching hospital in Southern India

    Arulmurugan C.

    2015-10-01

    Results: Incidence was high among males (60.36% compared to females (39.64%. Most of the cases of acute poisoning were in the age group 10 to 30 years (60.95% followed by 30 to 50 years age group (30.77%. A majority of poisoning cases (27.2% were due to organophosphorus (OPC insecticide. Total mortality was found to be 5.32%. Mortality rate due to Paraquat, Abrus Pretorius seeds was significantly high compared with OPC because there is no specific antidote. Time lapse had a very significant role in the mortality in cases of poisoning. Conclusions: Poisoning is common with young males. The mortality is high, in cases of self-poisoning with parquet and abrus seeds. Despite the highest consumption rate, no mortality was observed with organophosphorus because of early medical intervention and specific antidote. Early medical care in a tertiary care hospital will help to reduce significant mortality in India. [Int J Res Med Sci 2015; 3(10.000: 2654-2657

  14. Speciation analysis of arsenic compounds in the serum and urine of a patient with acute arsine poisoning

    Yamanaka K.; Yamano Y.; Yoshimura Y.; Shimoda Y.; Endo Y; Endo G.

    2013-01-01

    Arsine is one of the most potent hemolytic agents. It is important to clarify arsine metabolism as well as its chemical interactions with biological components. The aim of the present study was to clarify arsine metabolism by arsenic speciation analysis in serum and urine from an acute poisoning patient with hematuria, anemia, and renal and liver dysfunction. Speciation analysis of arsenics in serum and urine was performed using HPLC-ICP-MS. The total arsenic (T-As) concentration in serum was...

  15. Gastric Lavage in Acute Organophosphorus Pesticide poisoning (GLAOP – a randomised controlled trial of multiple vs. single gastric lavage in unselected acute organophosphorus pesticide poisoning

    Cao YuPing

    2006-10-01

    Full Text Available Abstract Background Organophosphorus (OP pesticide poisoning is the most common form of pesticide poisoning in many Asian countries. Guidelines in western countries for management of poisoning indicate that gastric lavage should be performed only if two criteria are met: within one hour of poison ingestion and substantial ingested amount. But the evidence on which these guidelines are based is from medicine overdoses in developed countries and may be irrelevant to OP poisoning in Asia. Chinese clinical experience suggests that OP remains in the stomach for several hours or even days after ingestion. Thus, there may be reasons for doing single or multiple gastric lavages for OP poisoning. There have been no randomised controlled trials (RCTs to assess this practice of multiple lavages. Since it is currently standard therapy in China, we cannot perform a RCT of no lavage vs. a single lavage vs. multiple lavages. We will compare a single gastric lavage with three gastric lavages as the first stage to assess the role of gastric lavage in OP poisoning. Methods/Design We have designed an RCT assessing the effectiveness of multiple gastric lavages in adult OP self-poisoning patients admitted to three Chinese hospitals within 12 hrs of ingestion. Patients will be randomised to standard treatment plus either a single gastric lavage on admission or three gastric lavages at four hour intervals. The primary outcome is in-hospital mortality. Analysis will be on an intention-to-treat basis. On the basis of the historical incidence of OP at the study sites, we expect to enroll 908 patients over three years. This projected sample size provides sufficient power to evaluate the death rate; and a variety of other exposure and outcome variables, including particular OPs and ingestion time. Changes of OP level will be analyzed in order to provide some toxic kinetic data. Discussion the GLAOP study is a novel, prospective cohort study that will explore to the toxic

  16. Determination of as by instrumental neutron activation analysis in sectional hair samples for forensic purposes. Chronic or acute poisoning?

    Complete text of publication follows. Autopsy of 29-year old woman suspicious of having committed suicide by ingestion of As2O3 yielded contradictory findings. All pathological findings as well as clinical symptoms suggested acute poisoning, while a highly elevated. As level of 26.4 μg g-1 in her hair collected at the autopsy (measured with ICP-MS) indicated chronic poisoning. To elucidate this discrepancy, INAA with proven accuracy of sectional hair samples obtained from a hair-brush from the left estate of the deceased person was performed. Levels of As found in this work in the range of 0.06-0.26 μg g-1 excluded chronic poisoning, because the person died after approximately 14 hours after the As2O3 ingestion. Two reasons for the discordant As results are considered: (1) accidental, non-removed contamination of hair on the As2O3 ingestion; (2) erroneous performance of ICP-MS. A brief review is also presented of As determination in hair for forensic purposes, including supposed, and until now frequently discussed, poisoning of Napoleon Bonaparte.

  17. A one-year observational study of all hospitalized acute poisonings in Oslo: complications, treatment and sequelae

    Lund Cathrine

    2012-07-01

    Full Text Available Abstract Objectives Changes in poisoning trends may affect both complications and outcomes in patients with acute poisoning. This study reports the treatments given and the frequency of complications, also related to treatment, mortality and sequelae related to various toxic agents. Methods All acute poisonings in adults (≥16 years admitted to the five hospitals in Oslo were included consecutively during one year (2008 to 2009 in an observational cross-sectional multicenter study. A standardized form was completed by the treating physician, which covered the study aims. Results There were 1065 admissions in 912 patients. The median length of hospital stay was one day, and 49% were observed in an intensive care unit (ICU. Active treatment was given to 83%, and consisted of supportive therapy (70%, antidote(s (38%, activated charcoal (16% and gastric lavage (9%. The most commonly used antidotes were flumazenil (19%, naloxone (17% and N-acetylcysteine (11%. The rate of treatment-related complications was 2.4% (21/884. Neither flumazenil, naloxone, nor the combination, was associated with convulsions or other complications. Among those receiving N-acetylcysteine, 5% (6/120 developed allergic reactions, one of which mandated discontinuation of treatment. Nineteen percent presented in a coma. Complications developed in 30%, compared with 18% in a 2003 study, mainly respiratory depression (12%, prolonged QTc interval (6% and hypotension (5%. Eight patients died (0.8% and five (0.5% survived with permanent sequelae, mainly anoxic brain damage. Discussion Few patients stayed more than two days. The use of the ICU was liberal, considering that only one out of five presented in a coma. Antidotes were frequently given diagnostically. Although N-acetylcysteine induced allergic reactions, most were mild and treatment discontinuation was only necessary once. The frequency of complications had almost doubled in five years, although the poisoning pattern was

  18. PREDICTING OUTCOME AND SEVERITY IN ACUTE ORGANOPHOSPHOROUS POISONING WITH CLINICAL SCORING AND SERUM CHOLINESTERASE LEVELS

    Basavaraj R

    2014-11-01

    Full Text Available BACKGROUND AND OBJECTIVES: Organophosphorus compound poisoning is the most common medico toxic emergency in India the increase in pesticide use in agriculture has paralleled the increase in the use of these products for deliberate self-warm. Respiratory failure is the most common complication of OP poisoning leading to death. Early recognition and prompt ventilator support may improve survival. Owing to limited availability of resources, all OP poisoning patients are not managed in ICUs in Indian setup. It is therefore important that clinical features and criteria to predict the need for ventilator support be identified at initial examination. Hence this study was undertaken to assess the severity of organophosphorus compound poisoning both clinically by using Peradeniya scoring and by estimating serum choline esterase levels. METHODS: Cross sectional study was done at basaveswar teaching and general hospital attached to MR Medical College. Cases with history of exposure to organophosphorus compound within previous 24 hours were chosen after applying inclusion and exclusion criteria. Patients were evaluated for Peradeniya OP poisoning scale and serum cholinesterase levels for assessment of severity of poisoning. Serum cholinesterase levels and Peradeniya OP poisoning scale were studied to predict the need for ventilator support. The results were analyzed using Chi-square test. STATISTICAL ANALYSIS: It was done using pearson’s chi square test. RESULTS: In this study requirement of ventilator support was seen in 36% of patients. Mortality in our study was 18%. Only 15.6% of patients with mild grade of poisoning according to Peradeniya OP poisoning scale required ventilator support, whereas 84.4% did not require ventilator support. Most of patients with moderate (70.6% and severe poisoning (100% according to Peradeniya OP poisoning scale required ventilator support. 93.7% of patients with serum cholinesterase levels more than 50% did not require

  19. Acute Human Self-Poisoning with Imidacloprid Compound: A Neonicotinoid Insecticide

    Fahim Mohamed; Indika Gawarammana; Robertson, Thomas A.; Roberts, Michael S; Chathura Palangasinghe; Shukry Zawahir; Shaluka Jayamanne; Jaganathan Kandasamy; Michael Eddleston; Buckley, Nick A.; Dawson, Andrew H.; Roberts, Darren M.

    2009-01-01

    BACKGROUND: Deliberate self-poisoning with older pesticides such as organophosphorus compounds are commonly fatal and a serious public health problem in the developing world. The clinical consequences of self-poisoning with newer pesticides are not well described. Such information may help to improve clinical management and inform pesticide regulators of their relative toxicity. This study reports the clinical outcomes and toxicokinetics of the neonicotinoid insecticide imidacloprid following...

  20. Acute disturbance of calcium homeostasis in PC12 cells as a novel mechanism of action for (sub)micromolar concentrations of organophosphate insecticides

    Meijer, Marieke; Hamers, Timo; Westerink, Remco H S

    2014-01-01

    Organophosphates (OPs) and carbamates are widely used insecticides that exert their neurotoxicity via inhibition of acetylcholine esterase (AChE) and subsequent overexcitation. OPs can induce additional neurotoxic effects at concentrations below those for inhibition of AChE, indicating other mechani

  1. Determination of As by instrumental neutron activation analysis in sectioned hair samples for forensic purposes: chronic or acute poisoning?

    Autopsy of 29-year old woman suspicious of committing suicide by the ingestion of As2O3 yielded contradictory findings. All pathological findings as well as clinical symptoms suggested acute poisoning, while a highly elevated As level of 26.4 μg g-1 in her hair collected at the autopsy, which was determined with inductively coupled plasma mass spectrometry indicated chronic poisoning. To elucidate this discrepancy, instrumental neutron activation analysis (INAA) with proven accuracy was performed of another set of sectioned hair samples. Levels of As found by INAA in the range of 0.16-0.26 μg g-1 excluded chronic poisoning, because the person died after approximately 14 h after the As2O3 ingestion. Two reasons for the discordant As results obtained by ICP-MS and INAA are considered: (1) accidental, non-removed contamination of hair on the As2O3 ingestion; (2) erroneous performance of ICP-MS. (author)

  2. The Antidotal Effects of High-dosage γ-Aminobutyric Acid on Acute Tetramine Poisoning as Compared with Sodium Dimercaptopropane Sulfonate

    SUN Peng; HAN Jiyuan; WENG Yuying

    2007-01-01

    To investigate the therapeutic effect of high-dosage γ-aminobutyric acid (GABA) on acute tetramine (TET) poisoning, 50 Kunming mice were divided into 5 groups at random and the antidotal effects of GABA or sodium dimercaptopropane sulfonate (Na-DMPS) on poisoned mice in different groups were observed in order to compare the therapeutic effects of high-dosage GABA with those of Na-DMPS. Slices of brain tissue of the poisoned mice were made to examine pathological changes of cells. The survival analysis was employed. Our results showed that both high-dosage GABA and Na-DMPS could obviously prolong the survival time, delay onset of convulsion and muscular twitch, and ameliorate the symptoms after acute tetramine poisoning in the mice.Better effects could be achieved with earlier use of high dosage GABA or Na-DMPS. There was no significant difference in prolonging the survival time between high-dose GABA and Na-DMPS used immediately after poisioning. It is concluded that high-dosage GABA can effectively antagonize acute toxicity of teramine in mice. And it is suggested that high-dosage GABA may be used as an excellent antidote for acute TET poisoning in clinical practice. The indications and correct dosage for clinical use awaits to be further studied.

  3. Relationship between Acute Organophosphorus Pesticide Poisoning and Damages Induced by Free Radicals

    2002-01-01

    Objective To study the relationship between abnormal reactions of free radicals in bodies of patients with acute organophosphorus pesticide poisoning (AOPP) and damages induced by free radicals. Methods 58 AOPP patients and 58 healthy adult volunteers (HAV) were enrolled in an independent samples control design, in which spectrophotometric methods were used to determine the concentrations of nitric oxide (NO) and lipoperoxides (LPO) in plasma, and LPO in erythrocytes, vitamin C (VC), vitamin E (VE) and b-carotene (b-CAR) in plasma as well as activities of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px) and acetylcholinesterase (AChE) in erythrocytes. Results Compared with the average values of every biochemical parameter in the HAV group, the average values of LPO in plasma and in erythrocytes, and NO in plasma in the AOPP group were significantly increased (P=0.000001), while the average values of VC, VE, a-CAR in plasma as well as SOD, CAT, GSH-Px and AChE in erythrocytes in the AOPP group were significantly decreased (P=0.000001). The findings of Pearson product-moment correlation analysis between the value of AChE in erythrocytes and the values of above biochemical parameters for 58 AOPP patients showed that there was a significant linear negative correlation between AChE in erythrocytes and LPO, NO in plasma, and LPO in erythrocytes (P=0.000001~0.001319), while there was a significant linear positive correlation between AChE in erythrocytes and VC, VE, a-CAR in plasma as well as SOD, CAT, GSH-Px in erythrocytes (P=0.000013~0.000824). The results of discriminant analysis of above chemical parameters for 58 AOPP patients and 58 HAV suggested that the correct rates of discriminant analysis were increased to 100 % when the values of AChE and LPO in plasma and in erythrocytes, or AChE and others, were jointly used for the discriminant analysis. Conclusion The findings of the present study suggest that a series of free radical

  4. Liver histopathology of the fish brachydanio rerio hamilton-buchman after acute exposure to sublethal levels of the organophosphate dimethoate 500

    Edson de Lara Rodrigues; Edith Fanta

    1998-01-01

    Among the new substances that were synthesised by the chemical industiy during the last decades, with the aim to improve human prosperity, some cause negative effects on non target organisms like fish. Among the pesticides, the organophosphates (OP) are widely used in cattle management, agriculture and aquaculture activities. Brachydanio rerio Hamilton-Buchman, 1822 is used world-wide in fish-tests for the establishment of the lethal levels of pesticides. Nevertheless, these fish show morphol...

  5. Is prevention of acute pesticide poisoning effective and efficient, with Locally Adapted Personal Protective Equipment?

    Varma, Anshu; Neupane, Dinesh; Ellekilde Bonde, Jens Peter;

    2016-01-01

    BACKGROUND: Farmers' risk of pesticide poisoning can be reduced with personal protective equipment but in low-income countries farmers' use of such equipment is limited. OBJECTIVE: To examine the effectiveness and efficiency of Locally Adapted Personal Protective Equipment to reduce organophospha...

  6. Four-Year Study on Acute Poisoning Cases Admitted to a Tertiary Hospital in Bangladesh: Emerging Trend of Poisoning in Commuters

    Mohammad Shafiqul Bari

    2014-12-01

    Conclusion:Commuter or travel-related poisoning is an emerging public health threat in this part of Bangladesh. Public awareness should be raised and school-based educational programs should be emphasized regarding the commuter poisoning and the consequence of accepting and eating food from strangers.

  7. Analysis on structural characteristics of poison system in acute poisoning of Guangxi%广西急性中毒毒物体系构成特点分析

    蒋东方; 张振明; 刘清华

    2013-01-01

    A total of 6004 cases of acute poisoning with 532 kinds of related poisons from 63hospitals were analyzed.According to the classification of pharmaceutical,pesticide,chemical,animal,plant and other poisons,the numbers of poison categories were 217,148,61,34,36 and 36 kinds accounting for 40.8%,27.8%,11.5%,6.4%,6.8%,6.7% of total number of poisons respectively.According to the case count,they were divided into three groups of low,medium and high morbidity and their poison numbers were 462,59 and 11 kinds accounting for 86.8%,11.1%,2.1% of total number of poisons respectively.According to the types of poisons,they were divided into five groups of poisoning 1,2,3,4,5 years and their poison numbers were 320,91,34,33 and 54 kinds accounting for 60.2%,17.1%,6.4%,6.2%,10.1% of total number of poisons respectively.According to the time of poisoning,they were divided into three groups of 1-year,discontinuous and perennial poisoning and their poison numbers were 320,158 and 54 kinds accounting for 60.2%,29.7%,10.1% of total number of poisons respectively.%分析63家医院收治的6004例急性中毒病例的相关毒物,共有532种,按医药、农药、化学、动物、植物、其他分为6类,各类毒物数为217、148、61、34、36、36种,分别占总毒物数的40.8%、27.8%、11.5%、6.4%、6.8%、6.7%.将各类毒物按中毒病例数分为低、中、高发病3组,各组毒物数分别为462(86.8%)、59(11.1%)、11(2.1%)种.各类毒物按中毒发生年数分为5个组,各类毒物合计数分别为320(60.2%)、91(17.1%)、34(6.4%)、33(6.2%)、54(10.1%)种.各类毒物按发生中毒的时间分为1年、间断、常年中毒3个组,各类毒物合计数分别为320(60.2%)、158 (29.7%)、54(10.1%)种.

  8. Pralidoxime in acute organophosphorus insecticide poisoning--a randomised controlled trial.

    Michael Eddleston

    2009-06-01

    Full Text Available BACKGROUND: Poisoning with organophosphorus (OP insecticides is a major global public health problem, causing an estimated 200,000 deaths each year. Although the World Health Organization recommends use of pralidoxime, this antidote's effectiveness remains unclear. We aimed to determine whether the addition of pralidoxime chloride to atropine and supportive care offers benefit. METHODS AND FINDINGS: We performed a double-blind randomised placebo-controlled trial of pralidoxime chloride (2 g loading dose over 20 min, followed by a constant infusion of 0.5 g/h for up to 7 d versus saline in patients with organophosphorus insecticide self-poisoning. Mortality was the primary outcome; secondary outcomes included intubation, duration of intubation, and time to death. We measured baseline markers of exposure and pharmacodynamic markers of response to aid interpretation of clinical outcomes. Two hundred thirty-five patients were randomised to receive pralidoxime (121 or saline placebo (114. Pralidoxime produced substantial and moderate red cell acetylcholinesterase reactivation in patients poisoned by diethyl and dimethyl compounds, respectively. Mortality was nonsignificantly higher in patients receiving pralidoxime: 30/121 (24.8% receiving pralidoxime died, compared with 18/114 (15.8% receiving placebo (adjusted hazard ratio [HR] 1.69, 95% confidence interval [CI] 0.88-3.26, p = 0.12. Incorporating the baseline amount of acetylcholinesterase already aged and plasma OP concentration into the analysis increased the HR for patients receiving pralidoxime compared to placebo, further decreasing the likelihood that pralidoxime is beneficial. The need for intubation was similar in both groups (pralidoxime 26/121 [21.5%], placebo 24/114 [21.1%], adjusted HR 1.27 [95% CI 0.71-2.29]. To reduce confounding due to ingestion of different insecticides, we further analysed patients with confirmed chlorpyrifos or dimethoate poisoning alone, finding no evidence of

  9. Analysis of serum anion gap and osmolal gap in diagnosis and prognosis of acute methanol poisoning: clinical study in 86 patients

    Zakharov, S.; Navrátil, Tomáš; Pelclová, D.

    2015-01-01

    Roč. 146, č. 5 (2015), s. 787-794. ISSN 0026-9247 R&D Projects: GA ČR(CZ) GAP208/12/1645 Institutional support: RVO:61388955 Keywords : serum anion gap * osmolal gap * acute methanol poisoning Subject RIV: CG - Electrochemistry Impact factor: 1.222, year: 2014

  10. Correlations among copeptin, ischemia-modified albumin, and the extent of myocardial injury in patients with acute carbon monoxide poisoning.

    Li, J; Wang, J S; Xie, Z X; Wang, W Z; Wang, L; Ma, G Y; Li, Y Q; Wang, P

    2015-01-01

    This study evaluated the relationships among copeptin, ischemia-modified albumin (IMA), and extent of myocardial injury in patients with acute carbon monoxide poisoning (ACOP). A total of 110 patients with different degrees of ACOP were selected as the poisoning group, and 30 healthy individuals as the control group. The levels of troponin I (cTnI), IMA, and copeptin were detected. Based on the presence of complications, the patients were assigned to the complication (26 patients) or non-complication (84 patients) group. Levels of cTnI, IMA, and copeptin were compared among the control, complication, and non-complication groups. Compared with the control group, in the 2 h after admission, the IMA levels decreased and copeptin levels increased in the poisoning group; these changes were more significant in patients with severe ACOP than in those with mild ACOP, and the difference was statistically significant (P < 0.05). There were no differences in the IMA and copeptin levels between the groups 7 days after admission; the cTnI levels increased more significantly in patients with severe ACOP than in patients with mild and moderate ACOP, and the differences were statistically significant (P < 0.05). In the complication group, at 7 days after admission, the IMA levels decreased whereas the copeptin and cTnI levels were significantly higher than in the non-complication group, with a statistically significant difference (P < 0.05). IMA was negatively correlated with copeptin. IMA and copeptin detection is clinically useful in the early diagnosis and prognosis of ACOP-related myocardial injury and in guiding early clinical drug application. PMID:26345979

  11. Notes from the Field: Acute Sulfuryl Fluoride Poisoning in a Family - Florida, August 2015.

    Mulay, Prakash R; Clark, Grethel; Jackson, William L; Calvert, Geoffrey M

    2016-01-01

    On August 19, 2015, the Florida Department of Health (FDOH) was notified by the Florida Poison Information Center Network and a local hospital of possible sulfuryl fluoride poisonings affecting a family in Martin County, in southeastern Florida. Sulfuryl fluoride is a highly toxic (toxicity category I) gas fumigant used for termite control of homes and buildings.* FDOH personnel in Martin County commenced an investigation and identified a family of five (a grandmother, mother, father, son, and daughter) exposed to sulfuryl fluoride after their house was fumigated. The Florida Department of Agriculture and Consumer Services (FDACS), and the U.S. Environmental Protection Agency (EPA) Criminal Investigation Division also conducted an investigation after being notified by FDOH. Medical records were reviewed, and the father was interviewed by FDOH. PMID:27414166

  12. Acute glyphosate-surfactant poisoning with neurological sequels and fatal outcome

    Potrebić Olivera; Jović-Stošić Jasmina; Vučinić Slavica; Tadić Jelena; Radulac Mišel

    2009-01-01

    Introduction. Clinical picture of severe glyphosatesurfactant poisoning is manifested by gastroenteritis, respiratory disturbances, altered mental status, hypotension refractory to the treatment, renal failure, shock. Single case report indicated possible neurotoxic sequels of glyphosatesurfactant exposure with white matter lesions and development of Parkinsonism. We described a patient with massive white matter damage which led to vigil coma and lethal outcome. Case report. A 56-year old wom...

  13. Phosphorus poisoning in waterfowl

    Coburn, D.R.; DeWitt, J.B.; Derby, J.V., Jr.; Ediger, E.

    1950-01-01

    Black ducks and mallards were found to be highly susceptible to phosphorus poisoning. 3 mg. of white phosphorus per kg. of body weight given in a single dose resulted in death of a black duck in 6 hours. Pathologic changes in both acute and chronic poisoning were studied. Data are presented showing that diagnosis can be made accurately by chemical analysis of stored tissues in cases of phosphorus poisoning.

  14. Effect of a brief outreach educational intervention on the translation of acute poisoning treatment guidelines to practice in rural Sri Lankan hospitals: a cluster randomized controlled trial.

    Lalith Senarathna

    Full Text Available BACKGROUND: In developing countries, including Sri Lanka, a high proportion of acute poisoning and other medical emergencies are initially treated in rural peripheral hospitals. Patients are then usually transferred to referral hospitals for further treatment. Guidelines are often used to promote better patient care in these emergencies. We conducted a cluster randomized controlled trial (ISRCTN73983810 which aimed to assess the effect of a brief educational outreach ('academic detailing' intervention to promote the utilization of treatment guidelines for acute poisoning. METHODS AND FINDINGS: This cluster RCT was conducted in the North Central Province of Sri Lanka. All peripheral hospitals in the province were randomized to either intervention or control. All hospitals received a copy of the guidelines. The intervention hospitals received a brief out-reach academic detailing workshop which explained poisoning treatment guidelines and guideline promotional items designed to be used in daily care. Data were collected on all patients admitted due to poisoning for 12 months post-intervention in all study hospitals. Information collected included type of poison exposure, initial investigations, treatments and hospital outcome. Patients transferred from peripheral hospitals to referral hospitals had their clinical outcomes recorded. There were 23 intervention and 23 control hospitals. There were no significant differences in the patient characteristics, such as age, gender and the poisons ingested. The intervention hospitals showed a significant improvement in administration of activated charcoal [OR 2.95 (95% CI 1.28-6.80]. There was no difference between hospitals in use of other decontamination methods. CONCLUSION: This study shows that an educational intervention consisting of brief out-reach academic detailing was effective in changing treatment behavior in rural Sri Lankan hospitals. The intervention was only effective for treatments with

  15. A study of neurologic symptoms on exposure to organophosphate pesticides in the children of agricultural workers

    Rastogi S

    2010-01-01

    Full Text Available Pesticides are used extensively throughout the world in agriculture and in pest control as well as for community health purposes. Organophosphate (OP pesticide self-poisoning is an important clinical problem in rural regions of the developing world that kills an estimated 200,000 people every year. Unintentional poisoning kills far fewer people but is an apparent problem in places where highly toxic OP pesticides are available. Neurologic dysfunction is the best documented health effect of pesticide exposure. High-level exposure has both acute and long-term neurologic signs and symptoms, and adverse effects have been reported in most type of pesticides, including organophosphate (OP, carbamate, organochlorine, and pyrethroid insecticides, herbicides, fungicides, and fumigants. Acute OP pesticide exposure can involve in wide range of both central and peripheral neurologic symptoms. Increased neurologic symptom prevalence may provide early evidence of neurologic dysfunctions, before clinically measurable signs are evident. In this study, we analyzed the cross-sectional data on neurologic signs and symptoms from 225 rural children, both males (n = 132 and females (n = 93 who were occupationally and paraoccupationally exposed to methyl OPs (dichlorvos, fenthion, malathion, methyl parathion and ethyl OPs (chlorpyrifos, diazinon, ethyl parathion as they belonged to agricultural families handling, mixing, and spraying the OP pesticides. The children completed a specially designed questionnaire (Q16 on neurologic symptoms associated with pesticide exposure with their parental help. A suitable reference group consisting of rural children (n = 50 never involved in pesticide handling (neither outdoor nor indoor belonging to similar socioeconomic strata included in the study to compare the prevalence of various neurologic symptoms between the two groups. Among all the neurologic self-reported symptoms, headache, watering in eyes, and burning sensation in

  16. One case of acute Alocasia macrorrhiza poisoning and management%急性海芋中毒救治1例

    谢立璟; 王英伟; 龙鑫; 孙承业

    2011-01-01

    A 44-year-old man took the tuber of Alocasia macronhiza by mistake. Several minutes after ingestion of the tuber, he presented with numbness of lip, sore throat, nausea, vomiting, salivation, dyspnea, and dysphonia. Twenty minutes after poisoning, he was hospitalized and diagnosed as having acute laryngeal edema. He received diphenhydramine 20 mg and dexamethasone 5 mg via IV push, followed by an IV infusion of dexaroethasone 10 mg. Meanwhile oxygen inhalation, liver protective treatment, and other symptomatic treatment were given. Five hours after poisoning, his symptoms gradually resolved and, 50 days later, he recovered. Alocasia macronhiza is a poisonous plant of Alocasia Sckott in the family Araceae, and it contains sapotoxin and calcium oxalate which can induce neurological and gastrointestinal disorder after ingestion of the plant. The latent period from exposure to onset of symptoms is 10 to 30 minutes and death might occur in patients with severe poisoning. Skin contact or eye contact with Alocasia macronhiza juice can cause pruritus, conjunctivitis, and even blindness. Inhalation of Alocasia macronhiza powder can lead to severe mucosal irritation in the eye, nasal cavity, and throat. Poisoning could be diagnosed by the history of contact with the plant and clinical manifestations. There is no specific antidote for Alocasia macronhiza poisoning and main management is symptomatic treatment.%1例44岁男性误食海芋块根,数分钟后出现口唇麻木、咽喉疼痛、恶心、呕吐、流涎、呼吸困难、发音困难等症状,中毒后20 min入院,诊断为急性喉头水肿.给予静脉推注苯海拉明20 mg、地塞米松5mg和静脉滴注地塞米松10 ng等处理,并行吸氧、保肝等对症治疗.中毒5h后症状逐渐好转,50 d后痊愈.海芋是天南星科海芋属有毒植物,含有皂素毒苷及草酸钙等.口服后可致神经和胃肠系统症状,潜伏期一般为10~30 min,严重者可致死亡;皮肤或者眼接触海芋汁

  17. Lead poisoning

    ... help if this information is not immediately available. Poison Control If someone has severe symptoms from possible ... be caused by lead poisoning, call your local poison control center. Your local poison center can be ...

  18. Food Poisoning

    ... Got Homework? Here's Help White House Lunch Recipes Food Poisoning KidsHealth > For Kids > Food Poisoning Print A ... find out how to avoid it. What Is Food Poisoning? Food poisoning comes from eating foods that ...

  19. An in vivo zebrafish screen identifies organophosphate antidotes with diverse mechanisms of action.

    Jin, Shan; Sarkar, Kumar S; Jin, Youngnam N; Liu, Yan; Kokel, David; Van Ham, Tjakko J; Roberts, Lee D; Gerszten, Robert E; Macrae, Calum A; Peterson, Randall T

    2013-01-01

    Organophosphates are a class of highly toxic chemicals that includes many pesticides and chemical weapons. Exposure to organophosphates, either through accidents or acts of terrorism, poses a significant risk to human health and safety. Existing antidotes, in use for over 50 years, have modest efficacy and undesirable toxicities. Therefore, discovering new organophosphate antidotes is a high priority. Early life stage zebrafish exposed to organophosphates exhibit several phenotypes that parallel the human response to organophosphates, including behavioral deficits, paralysis, and eventual death. Here, we have developed a high-throughput zebrafish screen in a 96-well plate format to find new antidotes that counteract organophosphate-induced lethality. In a pilot screen of 1200 known drugs, we identified 16 compounds that suppress organophosphate toxicity in zebrafish. Several in vitro assays coupled with liquid chromatography/tandem mass spectrometry-based metabolite profiling enabled determination of mechanisms of action for several of the antidotes, including reversible acetylcholinesterase inhibition, cholinergic receptor antagonism, and inhibition of bioactivation. Therefore, the in vivo screen is capable of discovering organophosphate antidotes that intervene in distinct pathways. These findings suggest that zebrafish screens might be a broadly applicable approach for discovering compounds that counteract the toxic effects of accidental or malicious poisonous exposures. PMID:22960781

  20. Paraquat poisoning: an experimental model of dose-dependent acute lung injury due to surfactant dysfunction

    M.F.R. Silva; P.H.N. Saldiva

    1998-01-01

    Since the most characteristic feature of paraquat poisoning is lung damage, a prospective controlled study was performed on excised rat lungs in order to estimate the intensity of lesion after different doses. Twenty-five male, 2-3-month-old non-SPF Wistar rats, divided into 5 groups, received paraquat dichloride in a single intraperitoneal injection (0, 1, 5, 25, or 50 mg/kg body weight) 24 h before the experiment. Static pressure-volume (PV) curves were performed in air- and saline-filled l...

  1. Intoxicaciones medicamentosas (I: Psicofármacos y antiarrítmicos Acute pharmacologic poisoning (I: Psychotropic and antiarrhythmic drugs

    I. Osés

    2003-01-01

    Full Text Available En la valoración de la Intoxicación Medicamentosa Aguda (IMA en pacientes graves con dosis potencialmente no tóxicas del teórico fármaco responsable es importante insistir en la anamnesis en la coingesta de otros fármacos o tóxicos. Inicialmente se prestará atención a las medidas de soporte vital, oxigenando, protegiendo la vía aérea y expandiendo la volemia. El ECG es una herramienta diagnóstica de primer orden en las IMA, sobre todo por antidepresivos tricíclicos (ADT y medicación cardiovascular. Su monitorización continua durante las primeras 12-24 horas suele ser necesaria en la mayoría de los casos. Las benzodiacepinas no suelen producir intoxicaciones graves. El uso del flumazenilo se reservará a los casos de depresión respiratoria, coma profundo o de causa no filiada. Pueden dar lugar a convulsiones, sobre todo en caso de intoxicación mixta con antidepresivos, y síndrome de abstinencia. Los ADT poseen una potencial gravedad enorme, pudiendo originar arritmias mortales. El rango terapéutico del litio es muy estrecho, pudiendo producirse signos de toxicidad fundamentalmente digestiva y neurológica. En caso de intoxicación por digoxina, se considerará el uso de anticuerpos antidigital en caso de bradiarritmias graves, bloqueos AV o PCR. El glucagón es el antídoto para la intoxicación grave por ß-bloqueantes y para la hipotensión refractaria en caso de calcioantagonistas.In the evaluation of Acute Drug Poisoning (ADP in patients seriously ill with a potentially non-toxic dose of the drug that is theoretically responsible, it is important to insist on anamnesis in the coingestion of other drugs or toxics. Initially attention is given to life support measures, oxygenation, protection of the airway and expanding the volemia. The ECG is a diagnostic tool of the first order in ADPs, above all for tricyclic antidepressants (TAD and cardio-vascular drugs. In the majority of cases continuous monitoring is usually

  2. Miotoxicidade por organofosforados Organophosphate myotoxicity

    Maria J. Cavaliere

    1996-06-01

    Full Text Available Os organofosforados são um grupo de compostos químicos amplamente utilizados em agropecuária como inseticidas, ocasionando intoxicações acidentais em animais e humanos, e mesmo sendo utilizados em tentativas de suicídio. A toxicidade desses produtos decorre sobretudo de insuficiência cárdio-respiratória por compromentimento do sistema nervoso autônomo. Sabe-se que alguns destes compostos induzem em animais de experimentação e em humanos, uma miopatia caracterizada por degeneração de células musculares, comprometendo sobretudo a musculatura respiratória. Baseado no fato de que este comprometimento contribui para a piora da função respiratória, propõe-se um protocolo de avaliação rotineira de miotoxicidade por compostos organofosforados, através de uma bateria mínima e suficiente de colorações e reações histoquímicas para quantificação da necrose muscular. Utilizaram-se como modelo experimental, grupos de ratos albinos (Wistar intoxicados com o organofosforado paraoxon, com e sem antídotos (atropina ou pralidoxima. Verificou-se nos grupos tratados com paraoxon e paraoxon mais atropina, necrose de fibras musculares no diafragma, que atingia em determinadas áreas até 15% das fibras. No grupo tratado com paraoxon mais pralidoxima, a necrose foi mínima, evidenciando o papel mioprotetor deste último antídoto.Organophosphates comprise a group of chemical compounds extensively used in farming as insecticides, which cause accidental poisoning in animals and men and are also used in suicide attempts. The toxicity of these compounds is due especially to the cardiac and respiratory impairment in consequence of autonomic nervous system disorders. However, it is known that some of these products induce a myopathy in experimental animals and humans. This myopathy is characterized by muscle cell degeneration, involving above all the respiratory muscles. Based on the fact that this involvement certainly enhances the

  3. A Randomized Controlled Trial of Puncturing and Bloodletting at Twelve Hand Jing Points to Treat Acute Carbon Monoxide Poisoning as Adjunct to First Aid Treatment: A Study Protocol

    Yue, Ying; Pan, Xingfang; Zhang, Sai; Jin, Jun; Wang, Wei; Wang, Dongqiang; Han, Dexin; Wang, Guirong; Hu, Qunliang; Kang, Jingqing; Ding, Shasha; Yang, Yi; Bu, Huaien; Guo, Yi

    2015-01-01

    Background. Acute carbon monoxide poisoning (ACOP) is a significant cause of morbidity and mortality in many countries. Twelve Hand Jing Points (THJP) have been believed to be effective to treat all kinds of emergency calls in traditional Chinese medicine (TCM) for more than 3000 years. This randomized controlled trial (RCT) is designed to evaluate the effectiveness of THJP in curing acute carbon monoxide poisoning in first aid treatment. This paper reports the protocol of the trial. Methods/Design. This RCT is a multicenter, randomized, controlled study undergoing in China. The compliant patients are divided into the bloodletting group and standard of care group. With first aid treatments given to both of the groups, the bloodletting group is bleeding at THJP upon being hospitalized. Primary outcomes and secondary outcomes will be measured and compared between these two groups. Before treatment, immediately after treatment, and 30 minutes, 1 hour, and 4 hours after treatment, patients' basic vital signs and state of consciousness were observed. Before treatment and 1 and 4 hours after treatment, carboxyhemoglobin concentration in venous blood samples was detected. Discussion. The objective of this study is to provide convincing evidence to clarify the efficacy and safety of THJP for early treatment of acute carbon monoxide poisoning. PMID:26339271

  4. A Randomized Controlled Trial of Puncturing and Bloodletting at Twelve Hand Jing Points to Treat Acute Carbon Monoxide Poisoning as Adjunct to First Aid Treatment: A Study Protocol

    Ying Yue

    2015-01-01

    Full Text Available Background. Acute carbon monoxide poisoning (ACOP is a significant cause of morbidity and mortality in many countries. Twelve Hand Jing Points (THJP have been believed to be effective to treat all kinds of emergency calls in traditional Chinese medicine (TCM for more than 3000 years. This randomized controlled trial (RCT is designed to evaluate the effectiveness of THJP in curing acute carbon monoxide poisoning in first aid treatment. This paper reports the protocol of the trial. Methods/Design. This RCT is a multicenter, randomized, controlled study undergoing in China. The compliant patients are divided into the bloodletting group and standard of care group. With first aid treatments given to both of the groups, the bloodletting group is bleeding at THJP upon being hospitalized. Primary outcomes and secondary outcomes will be measured and compared between these two groups. Before treatment, immediately after treatment, and 30 minutes, 1 hour, and 4 hours after treatment, patients’ basic vital signs and state of consciousness were observed. Before treatment and 1 and 4 hours after treatment, carboxyhemoglobin concentration in venous blood samples was detected. Discussion. The objective of this study is to provide convincing evidence to clarify the efficacy and safety of THJP for early treatment of acute carbon monoxide poisoning.

  5. Confirmation of acute nitrate poisoning differentiating from anthrax in three Indian indigenous cattle

    Kumaresan Nagarajan

    2015-03-01

    Full Text Available This article reports cases of nitrate poisoning in Indian indigenous cattle breeds comprising two Gir cows aging 4 years each, and one Barugur cow at 1.5 years of age. The cattle with case history of sudden death and oozing of partially clotted blood from the anal opening were brought to the Central University Laboratory (CUL, Center for Animal Health Studies (CAHS, Tamil Nadu Veterinary and Animal Sciences University (TANUVAS for diagnostic investigation with a suspicion of anthrax. According to anamnesis, all the animals were clinically normal and did not reveal any abnormality on the previous day. The animals were fed with recently harvested sorghum leaves and stalks. Smears examined for anthrax were found negative. Biological test (mice inoculation for anthrax was also negative. Gross lesions on necropsy examination of the carcases were suggestive of nitrate intoxication. Finally, nitrate intoxication of these cattle was confirmed by chemical and toxicological analysis of fodder, rumen content, aqueous humor, liver, kidney and urine.

  6. Ischemic colitis associated with acute carbon monoxide poisoning--a case report.

    Weaver, Lindell K; Deru, Kayla

    2016-01-01

    Carbon monoxide (CO) poisoning is common, but it has rarely been reported to cause ischemic colitis. In this case, a 34-year-old female with depression presented to an emergency department after a period of unconsciousness, with urinary and bowel incontinence, following exposure to car exhaust. Her carboxyhemoglobin level was 23%. She had metabolic acidosis. She was transferred to our facility for hyperbaric oxygen treatment, where she had intractable nausea/vomiting with abdominal pain and bright-red bleeding per rectum. She exhibited lower abdominal tenderness and hypoactive bowel sounds. Vital signs were: temperature 36.8 degrees C; blood pressure 137/ 86 mmHg; heart rate 114 beats/minute; respiratory rate 28 breaths/minute. The patient's electrocardiogram showed sinus tachycardia with T-wave inversions in leads I, aVL and V3-V6. The troponin I level peaked at 3.7 ng/ml. Echocardiogram showed a reduced ejection fraction of 30%-35%, with akinesis in the posterior lateral and distal anterior distributions. Computed tomography of the abdomen revealed diffuse colonic mural thickening, supporting mesenteric ischemia. Sigmoidoscopy showed edematous friable pale mucosa from rectum to distal sigmoid colon. Hyperbaric oxygen was deferred based on the patient's status. Over three days, the initial hematochezia progressed to melena and then resolved. Adenosine cardiac stress MRI was normal. She was transferred to the psychiatry service and discharged four days later. Four years later, she has no gastrointestinal, cardiac or cognitive problems. PMID:27265995

  7. Glasgow coma scale in acute poisonings before and after use of antidote in patients with history of use of psychotropic agents

    Poplas-Sušić Tonka

    2010-01-01

    Full Text Available Introduction. Data on emergency interventions in poisonings are scarce. Objective. To determine the effectiveness of antidote therapy in acute poisoning-related emergency medical services (EMS interventions. Methods. A prospective observational study included all poisoning-related intervention cases over 3 years (1999-2001 in the Celje region, Slovenia, covering 125,000 inhabitants. Data were recorded on an EMS form. Results. Psychoactive agents were present in 56.5% out of 244 poisoning-related EMS interventions. Prescription drugs were a cause of intoxication in 93 (39.2% cases alone or in combination with alcohol or illegal drugs. More than one fifth of poisonings were due to the use of illegal drugs in 52 (21.9% cases, 43 (18.1% out of them heroin related. At the time of EMS arrival, more patients who ingested illegal drugs were in coma or comatose than the rest. 24 (45.3% vs. 32 (17.3% of poisoned patients were in coma (p<0.001. Glasgow Coma Scale (GCS at the first contact was lower in patients who ingested illegal drugs than in the remaining patients (9.0 vs. 11.6, p=0.001. In 23.2% of the cases, an antidote was administered. In 29 (12.2% naloxone and in 16 (6.7% flumazenil was administered. Mean GCS after intervention was higher in all cases but significantly higher in illegal drug cases, 13.4 vs. 12.2 (p=0.001, with a mean positive change in GCS of 4.5 vs. 0.6 (p<0.001. In illegal drug users, mean change after antidote administration was 8.2 vs. 0.5 without antidote administration (p<0.001. Conclusion. High rate of successful antidote use during the intervention indicated the importance of good EMS protocols and the presence of a skilled doctor in the EMS team.

  8. Acute thiopurine overdose: analysis of reports to a national poison centre 1995-2013

    Gregoriano, Claudia; Ceschi, Alessandro; Rauber-Lüthy, Christine; Kupferschmidt, Hugo; Banner, Nicholas R.; Krähenbühl, Stephan; Taegtmeyer, Anne B

    2014-01-01

    Literature regarding acute human toxicity of thiopurines is limited to a handful of case reports. Our objectives were to describe all cases of overdose with thiopurines reported to the Swiss Toxicological Information Centre between 1995-2013. A retrospective analysis was performed to determine circumstances, magnitude, management and outcome of overdose with these substances. A total of 40 cases (14 paediatric) were reported (azathioprine, n = 35; 6-mercaptopurine, n = 5). Of these, 25 were w...

  9. Mushroom Poisoning

    ... poisoning, call your doctor or the Poison Control Center. Call 911 immediately if the person is unconscious, not breathing or convulsing. The phone number for the Poison Control Center is 1-800-222-1222. This number is ...

  10. Oleander poisoning

    ... if known Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  11. Detergent poisoning

    ... if known) Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  12. Philodendron poisoning

    ... if known Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  13. Ammonia poisoning

    ... if known) Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  14. Foxglove poisoning

    ... if known Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  15. Yew poisoning

    ... if known Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  16. Kerosene poisoning

    ... if known) Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  17. Zinc poisoning

    ... help if this information is not immediately available. Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  18. Mistletoe poisoning

    ... if known Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  19. Poison Ivy

    ... Health Gynecology Medical Conditions Nutrition & Fitness Emotional Health Poison Ivy Posted under Health Guides . Updated 2 June ... everyone is sensitive to these plants. What is poison ivy? Poison ivy is a plant that can ...

  20. Diazinon poisoning

    ... if known) Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  1. Iodine poisoning

    ... help if this information is not immediately available. Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  2. Jimsonweed poisoning

    ... if known Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  3. Deodorant poisoning

    ... if known) Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  4. Hydroxyethyl Starch Could Save a Patient With Acute Aluminum Phosphide Poisoning.

    Marashi, Sayed Mahdi; Nasri Nasrabadi, Zeynab; Jafarzadeh, Mostafa; Mohammadi, Sogand

    2016-07-01

    A 40-year-old male patient with suicidal ingestion of one tablet of aluminium phosphide was referred to the department of toxicology emergency of Baharloo Hospital, Tehran, Iran. The garlic odor was smelled from the patient and abdominal pain and continuous vomiting as well as agitation and heartburn were the first signs and symptoms. Systolic and diastolic blood pressures at the arrival time were 95 and 67 mmHg, respectively. Gastric lavage with potassium permanganate (1:10,000), and 2 vials of sodium bicarbonate through a nasogastric tube was started for the patient and the management was continued with free intravenous infusion of 1 liter of NaCl 0.9% serum plus NaHCO3, hydrocortisone acetate (200 mg), calcium gluconate (1 g) and magnesium sulfate (1 g). Regarding the large intravenous fluid therapy and vasoconstrictor administering (norepinephrine started by 5 µg/min and continued till 15 µg/min), there were no signs of response and the systolic blood pressure was 49 mmHg. At this time, hydroxyethyl starch (HES) (6% hetastarch 600/0.75 in 0.9% sodium chloride) with a dose of 600 cc in 6 hours was started for the patient. At the end of therapy with HES, the patient was stable with systolic and diastolic blood pressure of 110 and 77 mmHg, respectively. He was discharged on the 6th day after the psychological consultation, with normal clinical and paraclinical examinations. This is the first report of using HES in the management of AlP poisoning and its benefit to survive the patient. PMID:27424021

  5. DNA pooling base genome-wide association study identifies variants at NRXN3 associated with delayed encephalopathy after acute carbon monoxide poisoning.

    Wenqiang Li

    Full Text Available Delayed encephalopathy after acute carbon monoxide poisoning (DEACMP is more characteristic of anoxic encephalopathy than of other types of anoxia. Those who have the same poisoning degree and are of similar age and gender have a greater risk of getting DEACMP. This has made it clear that there are obvious personal differences. Genetic factors may play a very important role. The authors performed a genome-wide association study involving pooling of DNA obtained from 175 patients and 244 matched acute carbon monoxide poisoning without delayed encephalopathy controls. The Illumina HumanHap 660 Chip array was used for DNA pools. Allele frequencies of all SNPs were compared between delayed encephalopathy after acute carbon monoxide poisoning and control groups and ranked. A total of 123 SNPs gave an OR >1.4. Of these, 46 mapped in or close to known genes. Forty-eight SNPs located in 19 genes were associated with DEACMP after correction for 5% FDR in the genome-wide association of pooled DNA. Two SNPs (rs11845632 and rs2196447 locate in the Neurexin 3 gene were selected for individual genotyping in all samples and another cohort consisted of 234 and 271 controls. There were significant differences in the genotype and allele frequencies of rs11845632 and rs2196447 between the DEACMP group and controls group (all P-values <0.05. This study describes a positive association between Neurexin 3 and controls in the Han Chinese population, and provides genetic evidence to support the susceptibility of DEACMP, which may be the resulting interaction of environmental and genetic factors.

  6. THE ROLE OF EARLY HAEMOPERFUSION/HAEMODIALYSIS WITH STEROIDS, CYCLOPHOSPHAMIDE, N ACETYL CYSTEINE AND EVEROLIMUS IN ACUTE PARAQUAT POISONING: IS THERE STILL HOPE?

    Rajesh

    2016-01-01

    Full Text Available BACKGROUND Acute Paraquat poisoning is associated with very high mortality rate. There are no standardized treatment protocols and no effective antidote. AIMS In the absence of an effective antidote, early removal of paraquat by haemoperfusion/haemodialysis and addition of immunosuppressive agents, anti-oxidants and anti-fibrotic agents to counter the effect of paraquat may be beneficial. We present our experience of using Haemoperfusion/Haemodialysis in combination with pulse steroids, intravenous cyclophosphamide N Acetylcysteine infusion and Everolimus in such patients. MAIN METHODS AND RESULTS This study is conducted in two phases, during the first phase, the patients with paraquat poisoning are treated by the physicians as done in usual practice. In the second phase, standardized protocols were followed and patients received either early Haemoperfusion or Haemodialysis along with steroids, cyclophosphamide, N acetyl cysteine and Everolimus. We noted that with the use of standardized treatment protocol, the survival rate of severe paraquat poisoning has increased from 8% to 45.8%. CONCLUSION Early Haemoperfusion/haemodialysis when used in combination with steroids, Cyclophosphamide, N acetyl infusion and Everolimus may be an effective treatment strategy in patients with severe paraquat poisoning.

  7. [Acute accidental poisoning in children at the pediatrics service of the Gabriel Touré hospital].

    Sylla, M; Coulibaly, Y; Dicko, F T; Kourouma, N; Togo, B; Keita, M M

    2006-01-01

    The accidental intoxications constitute more and more a serious problem among young children in the developing countries because of their frequency and difficulties for taking care of those victims. The objective of our work was to study acute intoxications among children in order to determine the frequency, to identify the products in question and to determine the impact of those accidents in the future life of the victims. The study was carried out in the Paediatric Service of the CHU Gabriel Touré from January 2001 to June 2002. We enrolled 89 children from 0 to 15 years of age. Information on our patients was recorded on investigational questionnaire and completed with data from their entry and hospitalization records. Among 8237 children hospitalized during the study period, 89 of them had acute intoxication i.e. 1.08%. Children less than five years of age were more frequent with 85.4% with a male prevalence of 61.8%. Antimalarial drugs and petroleum were the most accused products. Administration of milk and provoked vomiting were the attitudes and practices of the entourage of the victims when intoxication occurs. The evolution was favourable in 67.2% of the cases with a hospital lethality of 13.7%. PMID:19617084

  8. Acute thiopurine overdose: analysis of reports to a National Poison Centre 1995-2013.

    Claudia Gregoriano

    Full Text Available Literature regarding acute human toxicity of thiopurines is limited to a handful of case reports. Our objectives were to describe all cases of overdose with thiopurines reported to the Swiss Toxicological Information Centre between 1995-2013. A retrospective analysis was performed to determine circumstances, magnitude, management and outcome of overdose with these substances. A total of 40 cases (14 paediatric were reported (azathioprine, n = 35; 6-mercaptopurine, n = 5. Of these, 25 were with suicidal intent, 12 were accidental and 3 were iatrogenic errors. The magnitude of overdose ranged from 1.5 to 43 (median 8 times the usual dose in adults. Twelve cases (30% had attributable symptoms. The majority of these were minor and included gastrointestinal complaints and liver function test and blood count abnormalities. Symptoms were experienced by patients who took at least 1.5-times their usual daily thiopurine dose. Overdoses over two or more consecutive days, even if of modest size, were less well tolerated. One case of azathioprine and allopurinol co-ingestion over consecutive days led to agranulocytosis. Decontamination measures were undertaken in 11 cases (10 activated charcoal, 1 gastric lavage and these developed fewer symptoms than untreated patients. This study shows that acute overdoses with thiopurines have a favourable outcome in the majority of cases and provides preliminary evidence that gastrointestinal decontamination with activated charcoal may reduce symptom development after overdose of these substances if patients present to medical services soon after ingestion.

  9. Acute thiopurine overdose: analysis of reports to a National Poison Centre 1995-2013.

    Gregoriano, Claudia; Ceschi, Alessandro; Rauber-Lüthy, Christine; Kupferschmidt, Hugo; Banner, Nicholas R; Krähenbühl, Stephan; Taegtmeyer, Anne B

    2014-01-01

    Literature regarding acute human toxicity of thiopurines is limited to a handful of case reports. Our objectives were to describe all cases of overdose with thiopurines reported to the Swiss Toxicological Information Centre between 1995-2013. A retrospective analysis was performed to determine circumstances, magnitude, management and outcome of overdose with these substances. A total of 40 cases (14 paediatric) were reported (azathioprine, n = 35; 6-mercaptopurine, n = 5). Of these, 25 were with suicidal intent, 12 were accidental and 3 were iatrogenic errors. The magnitude of overdose ranged from 1.5 to 43 (median 8) times the usual dose in adults. Twelve cases (30%) had attributable symptoms. The majority of these were minor and included gastrointestinal complaints and liver function test and blood count abnormalities. Symptoms were experienced by patients who took at least 1.5-times their usual daily thiopurine dose. Overdoses over two or more consecutive days, even if of modest size, were less well tolerated. One case of azathioprine and allopurinol co-ingestion over consecutive days led to agranulocytosis. Decontamination measures were undertaken in 11 cases (10 activated charcoal, 1 gastric lavage) and these developed fewer symptoms than untreated patients. This study shows that acute overdoses with thiopurines have a favourable outcome in the majority of cases and provides preliminary evidence that gastrointestinal decontamination with activated charcoal may reduce symptom development after overdose of these substances if patients present to medical services soon after ingestion. PMID:24489721

  10. Hemlock (Conium Maculatum) Poisoning In A Child

    Çapan Konca; Zelal Kahramaner; Mehmet Boşnak; Halil Kocamaz

    2014-01-01

    Poison hemlock (Conium maculatum) is a poisonous plant for humans and animals. Accidental ingestion of the plant may result in central nervous system depression, respiratory failure, acute rhabdomyolysis, acute renal failure and even death. The main treatment of its poisoning is supportive care. A 6-year-old girl who admitted to the emergency department with complaints of burning sensation in mouth, hypersalivation, tremor in hands and ataxia after ingestion of poison hemlock was presented wi...

  11. 急性有机磷农药中毒患者的急救护理%Emergency nursing care of patients with acute organophosphorus pesticide poisoning

    马鑫

    2014-01-01

    目的:探讨急性有机磷农药中毒患者的急救和护理措施。方法:我院收治35例有机磷农药中毒患者,采取急救措施和护理措施,实施治疗。结果:35例患者在经过精心的救护后,治愈34例,死亡1例。结论:对急性有机磷农药中毒患者,采取一定的急救措施,并给予相应的护理干预,具有较好治疗效果,值得推广。%Objective:To investigate the first aid and nursing measuresof acute organophosphorus pesticide poisoning patients. Methods Patients in our hospital 35 cases of organophosphorus pesticide poisoning, take emergency measures and nursing measures, the implementation of treatment. Results:35 patients after carefultreatment, 34 cases were cured, 1 cases died. Conclusion:Patients with acute organophosphorus pesticide poisoning, take someemergency measures, and give the corresponding nursing intervention, has better curative effect, is worth promoting.

  12. Carbon monoxide poisoning

    Dolan, Michael C.

    1985-01-01

    Carbon monoxide poisoning is a significant cause of illness and death. Its protean symptoms probably lead to a gross underestimation of its true incidence. Low levels of carbon monoxide aggravate chronic cardiopulmonary problems, and high levels are associated with cardiac arrhythmias and cerebral edema. Patients who survive acute poisoning are at risk of delayed neurologic sequelae. The measurement of carboxyhemoglobin levels does not reveal the tissue levels of carbon monoxide but is useful...

  13. Pesticides poisoning in San Miguel de Tucumán during 2001-2002

    Marta Peñaloza de Terán

    2005-10-01

    Full Text Available Pesticides are a frequent worldwide poisoning cause due to their wide spreading and use. The aim of this paper was to describe and analyzed data from 184 patients seen for acute pesticide poisoning at the Toxicology Department of the Municipal Health Bureau of the city of S. M. de Tucumán during 2001-2002. The poisonings were diagnosed by anamnesis and clinic exploration and lab-confirmed using thin-layer chromatography and enzymatic methods. Poisoning motivation (occupational, environmental, food and suicide attempts, age, sex, pesticide type and incidence area were analyzed.Motivations were: occupational (OP (39%, suicide attempts (SA (25%, food (FP (18% and environmental (EP (18%. 94% of OP were males and 82% of SA, females. 94% of EP affected people under 20 years of age. In 58% of the cases organophosphate pesticides were involved. Results show the importance of making workers and population in general aware of the pesticides use and of limiting and strictly controlling the trade of such products.

  14. Speciation analysis of arsenic compounds in the serum and urine of a patient with acute arsine poisoning

    Yamanaka K.

    2013-04-01

    Full Text Available Arsine is one of the most potent hemolytic agents. It is important to clarify arsine metabolism as well as its chemical interactions with biological components. The aim of the present study was to clarify arsine metabolism by arsenic speciation analysis in serum and urine from an acute poisoning patient with hematuria, anemia, and renal and liver dysfunction. Speciation analysis of arsenics in serum and urine was performed using HPLC-ICP-MS. The total arsenic (T-As concentration in serum was 244.8 μg/l at admission and 97.1 μg/l at discharge. In the speciation analysis, four kinds of As compounds derived from arsine metabolism were detected in serum and urine. The concentration of arsenite (AsIII, arsenate (AsV, monomethylarsonic acid (MMA, and dimethylarsinic acid (DMA in serum at admission were 45.8, 5.2, 17.9 and 9.3 μg/l, respectively. The concentrations of AsIII, AsV, and MMA decreased with biological half time (BHT of 30.1, 43.0, and 96.3 h, respectively. Only DMA was increased at discharge. The urinary AsIII, AsV, MMA and DMA concentrations were 223.0, 12.1, 317.5 and 1053.5 μg/l at discharge, and decreased with BHT of 15.1, 20.8, 14.7, and 16.0 d, respectively. The results indicate that arsine was quickly metabolized to AsIII and subsequently up to DMA, with the result that the toxic effects of inorganic arsenic were added to those of arsine toxicity.

  15. Fomepizole in the treatment of acute methanol poisonings: experience from the Czech mass methanol outbreak 2012-2013

    Zakharov, S.; Navrátil, Tomáš; Pelclová, D.

    2014-01-01

    Roč. 158, č. 4 (2014), s. 641-649. ISSN 1213-8118 Institutional support: RVO:61388955 Keywords : methanol poisoning * fomepizole * treatment outcome Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 1.200, year: 2014

  16. Fluctuations in serum ethanol concentration in the treatment of acute methanol poisoning: a prospective study of 21 patients

    Zakharov, S.; Navrátil, Tomáš; Salek, T.; Kurcová, I.; Pelclová, D.

    2015-01-01

    Roč. 159, č. 4 (2015), s. 666-676. ISSN 1213-8118 Institutional support: RVO:61388955 Keywords : methanol poisoning * ethanol * antidote Subject RIV: CG - Electrochemistry Impact factor: 1.200, year: 2014

  17. Detection of neutrophil-lymphocyte ratio as a serum marker associated with inlfammations by acute carbon monoxide poisoning

    Mustafa Karabacak; Kenan Ahmet Turkdogan; Abuzer Coskun; Orhan Akpinar; Ali Duman; Mcahit Kapci; Sevki Hakan Eren; Pnar Karabacak

    2015-01-01

    Objective: To investigate neutrophil–lymphocyte ratio (NLR), which is an indicator of systemic inflammation, in patients with carbon monoxide (CO) poisoning. Methods: We included 528 patients (275 women) who presented with a diagnosis of CO poisoning between June 2009 and March 2014. Control group was composed of 54 patients (24 women). Platelet count and mean platelet volume level were significantly higher in the CO poisoning group. Results: White blood cell level (9.8 ± 3.3vs 8.6 ± 2.9× 103/mL, respectively;P= 0.01), neutrophil count (6.00 ± 2.29vs 4.43 ± 2.04×103/mL, respectively;P Conclusions: The increase ofNLR may indicate the progression of fatal complications due to CO poisoning.

  18. STUDY ON 52 PATIENTS WITH ACUTE SEVERE ORGANOPHOSPHORUS PESTICIDE POISONING%急性重度有机磷中毒52例临床研究

    孟瑞; 卢敏

    2011-01-01

    Objective To evaluate the clinical application of hemoperfusion combined with hemodialysis and continuous micropump infusion of atropine in the treatment of acute severe organophosphorus pesticide poisoning( ASOPP ). Methods A total of 104 patients with ASOPP were retrospectively analysed, all patients were treated with gastric lavage and so on, the treated group adopted hemoperfusion combined with hemodialysis and continuous micropump infusion of atropine in addition to basic therapy. The clinical data was compared. Results The treated group was superior to the control group in time from coma to consciousness, total amount of atropine and recovery time of cholinesterase etc. The recovery rate was 84.6%. Conclusion It is effective to apply hemoperfusion combined with hemodialysis and continuous micropump iffusion of atropine in rescuing the acute severe organophosphorus pesticide poisoning.%目的 评价血液灌流联合血液透析、阿托品微量泵持续泵入治疗急性重度有机磷中毒(acute severe organophosphorus pesticide poisoning,ASOPP)的临床应用价值.方法 对104例ASOPP患者进行回顾性分析,所有患者均给予洗胃等治疗,治疗组在对照组基础上加用血液灌流联合血液透析、阿托品微量泵治疗,比较2组各项临床资料.结果 治疗组昏迷至清醒时间、阿托品总量、胆碱酯酶恢复时间等明显优于对照组,治愈率为84.6%.结论 应用血液灌流联合血液透析、阿托品微量泵治疗ASOPP效果较好.

  19. Utility of the Measurement of Carboxyhemoglobin Level at the Site of Acute Carbon Monoxide Poisoning in Rural Areas

    Onodera, Makoto; Fujino, Yasuhisa; Kikuchi, Satoshi; Sato, Masayuki; Mori, Kiyofumi; Beppu, Takaaki; Inoue, Yoshihiro

    2016-01-01

    Objective. This study examined the hypothesis that correlations exist between the carbon monoxide exposure time and the carboxyhemoglobin concentration at the site of carbon monoxide poisoning, using a pulse carbon monoxide oximeter in rural areas or the carboxyhemoglobin concentration measured at a given medical institution. Background. In previous studies, no definitive relationships between the arterial blood carboxyhemoglobin level and the severity of carbon monoxide poisoning have been o...

  20. Distribution and Economic Loss Analysis for 38 Hospitalized Children with Acute Poisoning%38例急性中毒住院儿童病例分布及经济损失分析

    宋瑞娟; 宋瑞华; 牛彦青; 王莉

    2014-01-01

    Objective:To understand the distribution features and economic losses of the hospitalized children with acute poisoning, scientific basis was provided to prevent and control the acute poisoning in children.Methods:A retrospective analysis of 38 cases of acute poisoning in children admitted to the pediatric in Heji Hospital affiliated to Changzhi Medical College from 2007 to 2012.Results:In the children with poisoning,25 cases were male,while 13 caseswere female.Children were divided into four groups according to the age:<1,1~4,5~9,and 10~14,whose distribution were respectively 6 cases,20 cases,4 cases,8 cases.Rural and urban poisoning proportion was 1.38:1.The peak was in September and the indoor poisoning accounted for 86.84%.34.21% poisoning was caused by the drug in acute poisoning,while the same with the chemical poisoning.The economic losses of acute poisoning caused by pesticide was(5 171.03 ±4 843.46)RMB on average,which was the highest.The economic losses caused by plant was (2 062.63±715.78)RMB on average, which was the second highest.Conclusion:The number of male children with acute poisoning in the hospital were larger than the female, and mainly concentrated in 1~4 years old,who lived in rural rather than the city.In addition,drug poisoning was the main type of acute poisoning.Pesticide poisoning made the largest economic loss.Measures should be taken to prevent and control the acute poisoning according to its epidemiological characteristics.%目的:了解急性中毒住院患儿的分布特征和经济损失,为儿童急性中毒的预防、控制提供科学依据。方法:回顾性分析38例儿童急性中毒病例。结果:38例中毒患儿中,男25例,女13例;<1岁、1~4岁、5~9岁、10~14岁年龄组分别为6、20、4、8例;农村、城市中毒比例1.38∶1;9月份为发病高峰期;发生在户内占86.84%。急性中毒中药物中毒和化学性中毒各占34.21%。急性中毒的经济损失

  1. The diagnostic value of apparent diffusion coefficient value on the delayed encephalopathy after acute carbon monoxide poisoning

    Objective: To investigate the diagnostic value of ADC on delayed encephalopathy after acute carbon monoxide poisoning (DEACMP). Methods: Forty healthy subjects with normal head MRI appearance and 32 cases with DEACMP were recruited and scanned using MRI. ADC values in bilateral globus pallidus, cerebral white matter (peri-ventricle, centrum semioval) and cortex were measured respectively. According to conventional MRI, 32 DEACMP patients were divided into abnormal and normal signal intensity groups, and followed up more than one year. Thirteen cases without evident symptoms and 3 cases with little headache and dizziness were good prognosis group. Fifteen cases with disturbance of intelligence and mental anomaly and one case with manifested unresponsive, inability in life self-care, urinary and fecal incontinence were poor prognosis group. Independent samples t-test was used to compared all parts of brain ADC values between DEACMP group and normal control, abnormal and normal signal intensity groups, normal signal intensity group and normal control, good and poor prognosis groups. Results: According to MRI findings, DEACMP were classified into three types: type 1: showing white matter involvement; type 2: showing neural nuclei involvement and type 3: showing brain cortex involvement. The ADC values [peri-ventricle white matter (0.62±0.06) x 10-3 mm2/s, the globus pallidus (0.67± 0.05) x 10-3 mm2/s, centrum semioval(0.57±0.07) x 10-3 mm2/s] in DEACMP group were statistically different with those [(0.74±0.03) x 10-3, (0.74±0.04) x 10-3, (0.73±0.05) x 10-3 mm2/s] in normal people (t=2.82,2.89,2.98, P-3 mm2/s, centrum semioval(0.52±0.09) x 10-3 mm2/s] in 20 cases with abnormal signal on routine MRI were statistically different with the ADC values [(0.66±0.05) x 10-3, (0.62±0.06) x 10-3 mm2/s] in 12 cases without abnormal signal (t=4.45,3.98, P-3 mm2/s, centrum semioval (0.58±0.05) x 10-3 mm2/s] in good prognosis group, the ADC value of 16 cases [(0.56±0.02) x

  2. Poison control services in China

    The following aspects are discussed: the public health problems of acute poisoning in China in recent years; the characteristics of acute poisoning; the negative effects of poison cases on the society and economy. The four stages of development of a poison control system in China are: (1) clinical hospital as the only facility used for detoxification; (2) institutes and hospitals of occupational medicine got involved in the program; (3) the traditional model of poison control changed to the modern National Poison Control Center (NPCC), and its network got established and it began to play a key role; (4) establishment of a multi-disciplinary network for dealing with emergencies in which chemical poison control is an important component. Introduction of the operations of the NPCC: the functions of the center are a 24 h hotline service, clinical consultants service, poison identification and diagnosis, laboratory analysis, education for public, training for physicians, coordination of anti-dotes, and the development of a network of poison control centers for dealing with chemical emergencies. The work practice and achievement of NPCC and its network in the field of poison control during the last 3 years is discussed. Lessons from SARS infection: to extend the network, to strengthen multi-disciplinary cooperation, enhance communication between centers, to pay attention to capacity building, to improve reporting systems, and to share resources

  3. Non-accidental chlorpyrifos poisoning-an unusual cause of profound unconsciousness.

    Lee, Jiun-Chang; Lin, Kuang-Lin; Lin, Jainn-Jim; Hsia, Shao-Hsuan; Wu, Chang-Teng

    2010-04-01

    Chlorpyrifos is an organophosphorus anticholinesterase insecticide, and organophosphate intoxication can induce symptoms such as miosis, urination, diarrhea, diaphoresis, lacrimation, excitation of central nervous system, salivation, and consciousness disturbance (MUDDLES). Although accidental poisoning of children with drugs and chemicals is a common cause for consciousness disturbance in children, the possibility of deliberate poisoning is rarely considered. We report on a healthy 5-year 6-month-old boy with recurrent organophosphate intoxication. Reports of chlorpyrifos intoxication in children are quite rare. This case report demonstrates decision-making process and how to disclose deliberate chlorpyrifos poisoning of the toddler by the stepmother, another example of Munchausen syndrome by proxy. PMID:19763618

  4. Compartment Syndrome Resulting from Carbon Monoxide Poisoning.

    Serbest, Sancar; Belhan, Oktay; Gürger, Murat; Tosun, Haci Bayram

    2015-12-01

    Every year, especially in the cooler Fall and Winter months, hundreds of people die because of carbon monoxide poisoning. This occurs usually as an accident. It is a significant cause of poisoning worldwide. We present a case of compartment syndrome in both lower extremities with accompanying acute renal failure and systemic capillary leakage syndrome because of carbon monoxide poisoning. PMID:26588033

  5. Poison Ivy

    ... leaves of the plants. Look Out for Poison Plants These plants can be anywhere — from the woods ... pill or liquid form. Preventing Rashes From Poison Plants The best approach is to avoid getting the ...

  6. Ethanol poisoning

    ... this page: //medlineplus.gov/ency/article/002644.htm Ethanol poisoning To use the sharing features on this page, please enable JavaScript. Ethanol poisoning is caused by drinking too much alcohol. ...

  7. Starch poisoning

    Cooking starch poisoning; Laundry starch poisoning ... Cooking and laundry starch are both made from vegetable products, most commonly: Corn Potatoes Rice Wheat Both are usually considered nonpoisonous (nontoxic), but ...

  8. Insecticide poisoning

    ... Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 76. Borron SW. Pyrethins, repellants, ... Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 77. Cannon RD, Ruha A- ...

  9. Cologne poisoning

    ... Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 100. Jacobsen D, Hovda KE. ... Poisoning and Drug Overdose. 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 32. Mycyk MB. Toxic alcohols. ...

  10. Copper poisoning

    ... Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 75. Holland MG. Pulmonary toxicology. ... Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 9. Jones AL, Dargan PI. ...